Nigerian Hospital Practice

Factors affecting the choice of urology subspecialty among surgical residents in Nigeria

2024-06-26T08:13:20+00:00

The career choice of the surgical trainee has generated a lot of interest all over the world. This is especially true in Nigeria where there is shortage of specialist in the different surgical subspecialties. The issues of gender composition, influencing and motivating factors and declining enrolment are areas of concern. There is little data on the factors that influence the final choice of urology as a subspecialty in Nigeria, after enrolment into surgical residency This study aimed to determine the reasons for the choice of urology sub-specialty amongst urology residents in Nigeria and to sample the experiences of the urology trainees that affect the quality of the training. This was a nationwide cross-sectional study amongst Urology residents and specialist urologists less than 5 years post qualification via an online Google form survey for 8 weeks (1^st August to 30^th September 2022) There were a total of 43 respondents, 42 males and one female. The age range was between 34-47yrs with a mean age of 39.5yrs. Twenty-three (53.5%) were residents while 19(44.2%) were consultants less than 5 years of post qualification. Majority of trainees had role models/mentors as urologists 33(76.7%). Thirty-five (81.4%) of respondents had attended courses or training in urology. Personal interest (62.8%), work/life balance (53.5%), and advances in technology (37.2%) were the common reasons for choosing urology as a sub-specialty. The top-ranked factors that influenced respondent training quality were having good collaboration with colleagues (100%), having enthusiastic Consultants/Seniors (93%); having the appropriate level of responsibility at the training post (93%) as well as clinical teachers who are accessible. The least influencing factor is the non-availability of good counseling opportunities towards training satisfactorily (44.2%). The results of this study have given insight into ways to improve the training of Urologists thereby encouraging more surgical residents to choose this sub specialty in Nigeria. There should be established urology orientation programs and the use of clinical protocols should be established. Urology trainers need to be more effective in motivating young surgical residents to choose urology subspecialty.

Pattern and correlates of Methylene tetrahydofolate reductase enzyme level in Nigerian women with pre-eclampsia

2024-06-26T08:27:59+00:00

The role of folate enzyme defects as possible modulators of plasma homocysteine level in pre-eclampsia is still a subject of study. This study, therefore, aim to describe a base line reference value for Methylene tetrahydrofolate reductase enzyme (MTHFR) levels in normotensive women and evaluate variations in the MTHFR activities in women diagnosed with pre-eclampsia (PE) in Lagos Nigeria. The study also determined some demographic and biochemical correlates of diminished MTHFR enzyme level in this category of women. The study included 200 pregnant women with clinical and laboratory evidence of PE (study group) and 200 apparently healthy pregnant women (control group). A pre-tested, interviewer-administered questionnaire and patient hospital records were used to obtain demographic data. The MTHFR enzyme level was determined using commercial ELISA kits by MyBiosource, Inc., San Diego, (USA). Serum homocysteine levels were determined by the Enzyme Immunoassay assay method (ELISA) using Axis® Homocysteine EIA kit by Shield Diagnostics Ltd., Scotland, United Kingdom. Full blood count was done using the automated hematology analyzers Sysmex XN-20 by Sysmex Corporation (Kobe, Japan). DNA extraction, PCR amplification and restriction digestion were done to obtain genomic MTHFR for restriction fragment length polymorphism of MTHFR C677T SNP and for methylation specific Polymorphism (MSP) analysis. Statistical analyses were performed using SPSS 25.0 software (Armonk, NY: IBM Corp., USA). Significant associations (p<0.05) were established between low MTHFR enzyme levels and some haematological variables (WBC, RDW, and MCV). Low MTHFR enzyme levels were also associated with folate, MTHFR 677TT, MTHFR gene methylation status, and serum homocysteine levels (p<0.05 respectively). MTHFR enzyme defect is a significant risk factor in preeclampsia among Nigerian women in Lagos.

Vagina lesions seen at a tertiary hospital in Nigeria

2024-06-26T08:31:27+00:00

Due to the relative rarity of data on vaginal lesions in Nigeria, it is important that we study these lesions and report the data for comparison with other regions of the world and for use in future studies. Our study's objective is to provide baseline data for upcoming research by describing the vaginal lesions seen in biopsies received in our department over five years. We carried out a retrospective study on all vagina specimens received by the department of Morbid Anatomy and Forensic medicine at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria, between January 1, 2018, and December 31, 2022. During the study period, 22 vaginal samples were received, from patients with age ranging from 26 to 84 years. This accounts for 0.16% of all biopsies received at the centre. The most common malignant tumour was squamous cell carcinoma, which accounted for four cases. One of the squamous cell carcinomas was well differentiated (keratinized); the other three were moderately differentiated (non-keratinized). One case of adenosquamous carcinoma and one case of metastatic choriocarcinoma were seen. Two cases of adenocarcinoma were seen. Vaginal lesions are seldom seen at our facility. Squamous cell carcinoma is the most common malignancy of the vaginal epithelium seen in our centre. Choriocarcinoma can be found in the wall of the vagina. The lack of preinvasive lesions in our analysis might be the result of gynaecologists' unwillingness to obtain biopsies of non-tumoral vaginal lesions or of patients coming to clinics later than expected.

Attitude of 500-level medical students towards radiology

2024-06-26T08:35:33+00:00

To ascertain the receptiveness and attitude of 5th-year medical students towards radiology and determine if they would choose radiology as a postgraduate speciality in a tertiary institution. This study is an observational prospective study. It was carried out at a Medical College of a Tertiary Health Care Centre in Lagos State, Nigeria amongst its 5th-year students, comprising of 500-level medical Students doing coursework in radiology for the partial fulfilment of their degree. This study took place during an academic year at the onset and end of their posting in the Department of Radiology. The study showed a significant increase in knowledge and interest in radiology among medical students. Exposure to radiology courses increased from 12.9% to 64.3%. The pre-test showed that 8.6% found radiology a worthless discipline, but no respondent felt this way in the post-test. The impact of radiology on patient care and other areas of medicine also increased significantly. The intention to do an elective in radiology increased from 8.6% to 60.0%. The pre-test showed that 28.6% had heard of radiology, 55.7% had some idea, 14.3% were familiar with it as with other specialities and only 1.4% knew much about radiology. Radiology education changes can improve medical students' views. Regularly updating curricula is essential to keep up with medical advancements. Collaboration among educators, healthcare professionals, and physicians is crucial to promote a positive outlook on radiology.