Nigerian Journal of Clinical Medicine

Association between social support and glycaemic control among older Type 2 diabetes patients attending the family medicine clinic, Lagos State University Teaching Hospital

E.O. Oluwatuyi — 2024-07-29

Background: Poor glycemic control is a major health problem that greatly contributes to the development of diabetes-related complications. especially in older adults. Social support among older diabetics has been linked with many health outcomes including glycemic control.

Aim: This study aims to determine the association between social support and glycemic control among older T2DM patients with a view to improve clinical outcomes of older T2DM patients.

Method: This was a descriptive cross-sectional hospital-based study involving 384 consenting older type 2 diabetes patients recruited using the systematic random sampling method. The Multidimensional Scale of Perceived Social Support (MSPSS) and The Morisky Medication Adherence Scale (MMAS-8) were used to obtain information on social support and medication adherence. Glycosylated Hemoglobin (HbA1c) was used to assess glycemic control. Data were analyzed using SPSS 27.

Results: Forty nine point seven percent (49.7% ) of the respondents had high overall perceived social support. About 50% percent of respondents had poor glycaemic control. Overall, 60.6% of those with moderate/low support had poor glycemic control (OR 2.253, p- < 0.001), other identiied predictors of poor glycaemic control were; duration of diabetes less than 5 years (OR 2.386 p- 0.002), low medication adherence (OR-1.746, p-0.031), and treatment with oral medication and insulin (OR- 2.734, p-0.001).

Conclusion: Close attention should be paid to older diabetics with low and moderate perceived social support. In addition, those with the duration of diabetes < 5 years who have poor medication adherence and are treated with oral medication and insulin, as they are more likely to have poor glycaemic control.

Serologic screening for Herpes Simplex Virus infection among undergraduates in a university in southwestern, Nigeria

C.J. Elikwu — 2024-07-29

Background: Sexually transmitted infections (STIs) are a public health challenge with Herpes simplex virus (HSV) being one of the most prevalent STIs. Adolescents and young adults are at a greater risk of acquiring and transmitting the infection. Adequate and accurate knowledge is crucial in developing effective sexual and reproductive health education programmes. The study aimed to assess the knowledge and prevalence of HSV-1 and -2 among undergraduate students in a University in Southwestern Nigeria.

Methods: A cross-sectional study was conducted from October 2018 to January 2019. Questionnaires were administered to participants to assess their knowledge of HSV infection. Sera obtained were screened for the presence of HSV-1 and -2 immunoglobulin M (IgM) and immunoglobulin G (IgG) using enzyme-linked immunosorbent assay (ELISA).

Results: Correct responses to the knowledge of HSV were obtained from 16.1% to 71.4% and 25.5% to 83.3% had incorrect responses. Self-reported prevalence of cold sores was 4.2%. IgM and IgG antibodies to HSV-1 and -2 were detected in 1.1% and 96.8% of the participants respectively.

Conclusion: A low knowledge and high seroprevalence of HSV infection was recorded. Thereby, emphasising the need for proper education to limit the prevalence and spread of HSV.

Impact of antimicrobial stewardship program in the paediatric department of a tertiary health facility in Nigeria

T.O. Oluwole — 2024-07-29

Background: Antimicrobial resistance is a major issue limiting the successful treatment of infectious diseases. Development of antimicrobial resistance can be curbed by the adoption of antimicrobial stewardship programs which aims to optimize the use of antimicrobial agents and combat antimicrobial resistance. The study aimed to evaluate the impact of antimicrobial stewardship program implemented in the paediatric department of a tertiary healthcare facility.

Methods: This was a retrospective, cross-sectional study before and after the introduction of an antimicrobial stewardship program. A Global-point prevalence survey was conducted in 2017 to determine the baseline prescription practices. Based on the results, an antimicrobial stewardship program was developed. A second Global-point prevalence survey was conducted in 2018. The impact of the antimicrobial stewardship interventions was evaluated.

Results: An 8.1% reduction in antimicrobials prescribed, an 18% increase in targeted therapy and increased use of biomarkers in the institution of therapy were observed. There was an 8.2% reduction in parenteral therapy. Compliance with the antibiotic guideline was 67.8%. Utilization of the medical microbiology laboratory increased. An increase in the detection of multidrugresistant organisms was observed. The majority of the antimicrobials prescribed were in the Access group of the AWaRe classiication of antibiotics by WHO.

Conclusion: This study demonstrated an improvement in antimicrobial prescribing practices due to the implementation of an antimicrobial stewardship program. This study contributes to the growing body of evidence supporting the effectiveness of antimicrobial stewardship programs. Sustained practice of antimicrobial stewardship will improve antimicrobial prescription patterns thus controlling the development of antimicrobial resistance in healthcare facilities.

Body Mass Index and blood pressure control among hypertensive patients attending The Family Medicine Clinic of Lagos State University Teaching Hospital (LASUTH)

R.N. Odiana — 2024-07-29

Background: Hypertension is one of the most common chronic diseases in the world, contributing to cardiovascular disease and early death worldwide. The reduction of complications from hypertension lies in achieving blood pressure control. Body mass index is a predictor of both hypertension and blood pressure control.

Aim: This study aimed to determine the relationship between body mass index and blood pressure control among hypertensive patients attending the Family Medicine clinic, LASUTH to address issues of uncontrolled blood pressure.

Methodology: This was a descriptive cross-sectional study involving 384 consenting hypertensive adults who were selected using systematic random sampling method. An interviewer-administered semi-structured questionnaire was used to obtain relevant data. Data was analyzed using SPSS 27.

Results: The age range of the participants was 28-87 years, 59.6% of the participants had good blood pressure control. 67.2% of the participants had abnormal BMI: 49.2% overweight, 16.4% obese, and 1.6% underweight. Underweight and obesity were associated with Uncontrolled BP (p-<0.001).

Conclusion: This study showed that underweight and obesity components of the BMI are associated with uncontrolled BP, hence plans for achieving normal weight should be incorporated early in the management of hypertensive individuals.

Health care utilization and its determinants among sickle cell disease patients attending outpatient clinic at Usmanu Danfodiyo University Teaching Hospital Sokoto

Anas Ibrahim Yakubu — 2024-07-29

Background: Sickle Cell Disease (SCD) is associated with high utilization of healthcare services owing to the multitude of medical and surgical complications as well as comorbidities linked to the condition, which place a signiicant inancial burden on healthcare resources, particularly due to recurrent episodes of vaso-occlusive crisis.

Aim:To determine the health care utilization and its determinants among sickle cell disease patients attending outpatient clinic at Usmanu Danfodiyo University Teaching Hospital Sokoto. (UDUTH)

Materials and Methods: The study was conducted at UDUTH in Sokoto and involved the use of sociodemographic, clinical, and healthcare utilization (HCU) questionnaires.

Results: The rate of hospitalization was 1.51 standard deviations (SD) ± 2.31 days, while the number of days hospitalized was 10.89 SD ± 23.96 days per year. Emergency care visits transpired at a rate of 1.39 SD ± 2.83 days per year., while Day Care Visits averaged 4.82 SD ± 7.98 days per year. Marital status (p=0.009) and level of education (p=0.036) were signiicantly associated with high HCU. Level of education was a statistically signiicant predictor (p=0.019).

Conclusion: The indings indicated high healthcare utilization among the SCD patients. Furthermore, the researchers identiied low level of education as a signiicant determinant of high healthcare utilization within this patient cohort.

The involvement, barriers, and constraints of resident doctors in research: a web-based cross-sectional study

Adeola O. Ajibare — 2024-07-29

Background: Evidence-based medicine is highly dependent on research with the primary objective of improvement in health outcomes. Results obtained from quality research form the basis of sound healthcare policies and good clinical practice. Resident doctors are budding highly skilled medical professionals who are future researchers and trainers of undergraduates and postgraduate medical practitioners. Therefore, they need a good research background, sound understanding of research principles, and mentors who can guide them through the basics of research and publications.

Methodology: The study was a web-based descriptive cross-sectional study conducted between April and June 2024 among 146 resident doctors who had spent at least one year in postgraduate training. Data was collected via a self-administered equestionnaire and data analysis was done using SPSS version 27 statistical package. The statistical signiicance level was set at p=0.05.

Results: Respondents' attitude to research was generally good with the majority of them stating that research was vital to their discipline (100%) as well as a critical tool in medical research (97.3%) however, most of them (89%) ind research very challenging. About two-thirds (64.4%) have been involved in research during residency training while only 35.6% of respondents have a research mentor. Inadequate research funding and lack of research mentorship were the commonest barriers. There was no signiicant gender difference in the involvement and constraints in research.

Conclusion: Research-related practices are still poor among resident doctors and we recommend improved research training and funding, grantsmanship training, and proper mentorship for resident Doctors.