Nigerian Journal of Clinical Medicine

Length of stay on admission and clinical outcomes among patients with mental disorders at A Tertiary Hospital, in northwest Nigeria: An eight-year retrospective study

2025-01-08T06:35:56+00:00

Background: There is limited information available about the Length of Stay (LOS) on admissions among persons with mental disorders and the associated factors in our environment. Understanding these patterns could provide valuable insights into the efficiency and quality of inpatient care.

Aim: To the determine the length of Stay (LOS) and clinical outcomes among inpatients with mental disorders at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Materials and Methods: An eight-year retrospective study analyzed data from 434 patients admitted to the psychiatry ward of Usmanu Danfodiyo University Teaching Hospital, using SPSS software version 25 to analyze sociodemographic and clinical information, with statistical significance determined by Chi-squared and Fisher's exact tests at a 5% level of significance.

Results: The mean length of stay was 15.8 days (SD ± 12.2). Approximately 52.6% of patients were hospitalized for less than two weeks. Notably, 85.8% of patients remained until discharge, and 31.1% of admissions were diagnosed with affective disorders. There was a statistically significant association between the length of stay (LOS) and the outcome among in patients admitted (P= 0.029).

Conclusion: Our study found an association between length of stay (LOS) and patient outcomes, emphasizing the importance of early psychiatric assessments for inpatients to reduce mortality and prolonged care. It also highlights the need to inform caregivers about expected admission durations.

The relationship between refractive error and central corneal thickness in patients seen at Federal Teaching Hospital, Owerri, Imo State

2025-01-08T06:49:30+00:00

Background: Refractive error and central corneal thickness are factors that can affect vision relatedly. Refractive errors, including myopia, hyperopia and astigmatism are common visual anomalies that affect millions worldwide. Central corneal thickness influences the eye's biomechanical stability and susceptibility to various ocular conditions.

Objective: To determine the relationship between refractive error and central corneal thickness (CCT) in participants seen at Federal Teaching Hospital, Owerri.

Methods: This is an analytical, cross-sectional study of 175 non-glaucomatous patients. A purposive sampling method was used to recruit participants. Data was analyzed using SPSS version 19.0 Statistical software

Results: The highest proportion of participants were in the 41-50 years (20.6%)age group. The females were (66.9%) and males (33.1%). (M: F= 1.0:2.02). The mean refractive error for the right and left eyes were -0.24DS and -0.19 DS respectively while the mean CCT for the right and left eyes were 534.30µm and 528.71µm respectively. There was no significant difference in the refractive error between the two eyes of the participants (p=0.443), but a significant difference in the central corneal thickness (p=0.001). There was a significant relationship between refractive errors and central corneal thickness (p=0.008). For every unit rise in refractive error in the positive direction, the central corneal thickness increased by 4.073µm, while controlling age meaning that the central corneal thickness is thicker in hyperopes than in myopes.

Conclusion and Recommendation: Myopes had thin central corneal thickness while Hyperopes had thicker central cornea. Myopes should have pachymetric evaluation considering that their thin cornea may result in underestimation of the intraocular pressure

Ocular firework injury: A case for advocacy

2025-01-08T07:03:27+00:00

Background: Ocular trauma is a common finding in eye care practices. These injuries can be mild with no visual or ocular consequence, and it can be devastating with loss of vision in one or both eyes or significant deformity. Fireworks of various types are commonly used during festivals and occasions. This article reports cases of ocular firework injury seen at the Lagos State University Teaching Hospital (LASUTH).

Method: This was a retrospective hospital study. Case notes of patients with ocular firework injury between January 2022 and December 2023 (2 years) at the Eye Institute of LASUTH were retrieved. Data on demographic, mechanism of injury, intervention and eventual ocular status was collected and analyzed using descriptive statistics.

Results: 5 cases of ocular firework injury was seen during the period. There were 4 males and 1 female. Age range was between 5 - 51 years. The 4 males were primary victims and they were irreversibly blind in the affected eye at presentation and all 4 had surgical intervention. There was only one secondary victim.

Conclusion: Fireworks injuries at the Eye institute of LASUTH were found to have severe visual consequence with all primary victims losing vision in the affected eye. Advocacy and Government policies can see to a massive reduction in these fatal complications of fireworks.

Unique metastatic patterns of uterine carcinosarcoma: A rare autopsy case report

2025-01-08T07:19:14+00:00

Introduction: Uterine carcinosarcoma also called Malignant mixed Mullerian tumor (MMMT) is an extremely rare endometrial malignant tumor of biphasic character consisting of epithelial and mesenchymal components.
Case Description: This paper is a case of a 69-year-old obese woman been clinically evaluated for metastatic lung disease ?primary site for about a year. There was no history of postmenopausal bleeding per vagina, no offensive vaginal discharge and no family history of malignancy. She eventually died of metastatic disease and her body brought for postmortem examination.
Findings: Autopsy reported findings of uterine carcinosarcoma (Figure 1) with rare metastases to previously reported sites such as the cervix, lungs, bladder, stomach and the chest. Also metastasis to atypical more rare sites such as the thyroid, pancreas, adrenals and the kidneys were found. Histology revealed a biphasic tumor with both epithelial and mesenchymal components (Figure 2). Immunohistochemistry showed positivity to pancytokeratin and desmin (Figure 3&4).
Conclusions: This is potentially the first documented case of uterine carcinosarcoma metastasizing to the thyroid gland, pancreas and kidneys. This is to raise the awareness of typical and atypical metastatic sites of endometrial carcinosarcoma, facilitating early diagnosis and treatment, and thus provides a learning point for clinicians.

Propofol induced perioperative anaphylaxis: A case report

2025-01-08T07:37:39+00:00

Background: Although propofol is one of the most commonly used drugs for induction of anaesthesia, it is not devoid of anaphylactic potential. Early detection of any suspected anaphylactic reaction during anaesthesia, identification of the offending agent, prompt management and prevention of exposure to the offending agent in the future is the responsibility of the anaesthesiologist. This is a case report of anaphylaxis to propofol at induction of anaesthesia in a previously nonallergic 9year old boy who had right herniotomy done and responded to epinephrine injection.

Case Report: A9yr old male child who had right herniotomy on account of right communicating hydrocele. Preoperative history was not remarkable. Intraoperative period was complicated by an anaphylactic reaction following administration of propofol at induction and was subsequently managed by securing the airway and adrenaline administration. Postoperatively he had bronchospasm/laryngospasm which was also managed successfully. He was transferred to PACU and monitored closely for several hours before he was discharged to the ward.

Conclusion: Early recognition and administration of adequate adrenaline is the mainstay of anaphylaxis management. Anaphylaxis is a clinical diagnosis, and tests such as total plasma tryptase are only supportive of the diagnosis. The anaesthesiologist plays a key role in coordinating care for the patient during and after a perioperative anaphylaxis event.