Annals of Clinical and Biomedical Research最新文献

{"title":"Aetiological factors, outcomes and mortality risk of acute kidney injury in hospitalized patients in a tertiary health centre in Nigeria: An eleven year review","authors":"Manmak Mamven, S. Ajayi, U. Galadima, E. Nwankwo","doi":"10.4081/acbr.2022.230","DOIUrl":"https://doi.org/10.4081/acbr.2022.230","url":null,"abstract":"Acute kidney injury is a major public health issue in Nigeria, and it is associated with an increase in mortality. The study’s goal was to look at the most common precipitating factors, outcomes, and risk factors associated with mortality in our patients. This study examined the medical records of 11 years, of of hospitalized adult patients with confirmed Acute Kidney Injury (AKI). The patient record was searched for relevant information. The Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria were used to define AKI. The logistic regression analysis was used to determine the risk factors associated with mortality. A total of 399 patients were analysed. The overall mean age was 45.0 ± 17.3. The older age group (≥ 60years) compared to the younger group (<60 years) developed hospital acquired AKI (10% vs 5%). Pre-existing diseases like, hypertension (p<0.001), diabetes mellitus (p<0.001), anemia (p<0.001), stroke (p<0.001) and malignancy (p<0.001) were significantly higher in the older group. More of the older age group had more than 1 comorbidity (66 vs. 48%), were on diuretic and ACEI. The commonest causes/precipitants of AKI were septicaemia and other infections (62%) and hypovolaemia/hypoperfusion (45%). Overall mortality was 34%. The median length of stay was 11 (7.20) days, 25% had hemodialysis and 16% were admitted in the ICU. The risk factors for mortality identified were, hospital acquired AKI (OR: 6.59, 95% CI: 1.320-32.889, p=0.021), ICU admission (OR: 5.66, 95% CI: 2.061–15.512, p=0.001) and HIV infection (OR: 2.61, 95% CI: 1.063-6.424, p=0.036). The Commonest causes of AKI still remain infections and hypovolaemia and mortality from it was high in our patient population. Early identification of AKI and those at high risk of mortality and provision of adequate treatment are critical to improving outcomes in AKI patients.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"24 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120841807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artemisinin-based combination therapy amongst medical students in the University of Benin, South-South Nigeria: A cross-sectional study","authors":"S. Ayinbuomwan, A. Opadeyi, A. Isah","doi":"10.4081/acbr.2022.209","DOIUrl":"https://doi.org/10.4081/acbr.2022.209","url":null,"abstract":"Since 2005, the recommended first-line therapy for uncomplicated malaria in Nigeria has been Artemisinin-based Combination Therapy (ACT). Previous research indicates that these therapies are widely accepted by health care providers and other end users. Nonetheless, few studies have examined the preferences of clinical students who will be future prescribers of these medications. This was a descriptive cross-sectional survey of medical students undergoing clinical placements at the University of Benin Teaching Hospital in Benin City, Edo State, South-South Nigeria, to assess ACT preferences, tolerability, and cost considerations. Consenting clinical medical students who were recruited sequentially were given a semi-structured questionnaire. The questionnaire collected information about the students’ demographics, previous episodes of malaria symptoms, diagnosis, and treatment. Their preferred antimalarial, tolerability to ACTs, and ACT cost. The information was presented descriptively. There were 475 registered clinical students, but only 416 agreed to participate in the survey, yielding an 87.6% response rate. The students’ mean (standard deviation) age was 24.3 (3.8) years, with a male preponderance of 250 (60.1%). The majority, 154 (37.0%), were in the 600 level, while the 500 and 400 levels were 130 (31.3%) and 132 (31.7%), respectively. The majority of students, 272 (65.5%), treated malaria presumptively, and the majority of students, 344 (82.7%), had treated one to five episodes of malaria in the previous 12 months. The ACTs were known to nearly all of the final year clinical students (97.4%). The majority, 289 (69.5%), had no adverse drug reactions with the ACTs. Among those who experienced adverse drug reactions, 23 (39.7%) discontinued their medication, while 2 (3.4%) required hospitalization. The mean cost of the ACT was ₦1263.4 (SD ± 529.6) (₦=Naira) (3.0 USD), with a range of ₦ 300- ₦3000 (0.72- 7.2 USD). This study demonstrates a high level of acceptance for ACTs, particularly artemether-lumefantrine. However, the adverse effects of ACTs, particularly other recommended ACTs, must be evaluated on a regular basis because they may have an impact on their continued use.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124321685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, pattern and determinants of self-medication for fevers in children: A survey of caregivers in an emergency unit in Benin City, Nigeria","authors":"M. Abiodun, Stephen Airmuanwosa Ayinboumwan","doi":"10.4081/acbr.2022.215","DOIUrl":"https://doi.org/10.4081/acbr.2022.215","url":null,"abstract":"Self-medication is common in medically underserved areas, with disastrous consequences. It is necessary to determine the frequency and risk factors in our area. The purpose of this study was to find out the frequency, pattern, and risk factors for self-medication for febrile childhood illnesses among caregivers seen in the emergency paediatric unit. A descriptive, cross-sectional design was used for this study. Participants included caregivers for children seen in the unit. A semi-structured questionnaire was used to collect data, which included sections on demography, determinants, pattern, and reasons for self-medication, as well as actual reports of self-medication in the previous three weeks. In order to identify risk factors for self-medication, inferential analyses were performed. P-values less than 0.05 were considered significant. The study included 153 caregivers, with an average (SD) age of 45.6 (13.8) years. Self-medication for fevers in children was 25.5%, with 20 (51.3%) of the children treated being under the age of five. Antipyretics (20.3%) and antimalarials (13.7%), particularly artemisinin-based combination therapy (ACT), were the most commonly used drugs. Place of residence (p= 0.011), living arrangement (p= 0.030), and awareness of an adverse drug event (p= 0.045) are factors that influence self-medication in the previous three weeks. Having health insurance, NHIS (OR = 2.734, 95% CI: 1.120-6.678; p=0.027), and using an insecticide-treated net (OR = 0.272, 95% CI: 0.117-0.634; p=0.003) are also independent predictors of self-medication. With multifactorial determinants in the setting, self-medication is common. There is a need for increased access to subsidized healthcare for children, as well as caregiver education on the potential harms of self-medication.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131517139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diarrhoea prevalence, characteristics and outcome among children admitted into the emergency ward of a tertiary hospital in Southern Nigeria","authors":"A. O. Atimati, Fidelis E. Eki-Udoko","doi":"10.4081/acbr.2022.218","DOIUrl":"https://doi.org/10.4081/acbr.2022.218","url":null,"abstract":"Diarrhoea is a leading cause of morbidity and mortality in children, particularly in developing nations. The majority of cases can be successfully managed at home, but a few cases may necessitate admission to the emergency ward. The purpose of this research is to determine the prevalence, characteristics, outcome, and associated factors among those admitted. After obtaining consent, all children who presented with diarrhoea within a year were recruited for the study. A semi-structured interviewer-administered questionnaire was used to collect biodata, diarrhoea treatment, and outcome information from caregivers. The Statistical Package for Social Sciences (SPSS) version 21 was used to analyze the data. A total of 164 of the 5,087 children seen were admitted for diarrhoea, resulting in a 3.2% prevalence. A higher proportion of the participants were males, aged 0-24 months, and were not exclusively breastfed. A third of the participants had diarrhoea in the previous year, with a higher proportion having 1-2 episodes. The case fatality rate was 2.4%. The prevalence of diarrhoeal admissions is low, as is the case fatality rate. Stool frequency, hydration status, and socioeconomic class were all significant predictors of fatal diarrhoea outcomes. Recurrent episodes of diarrhoea were significantly associated with maternal education and attendance at day care centers.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133041053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of childhood illnesses seen before and during COVID-19 pandemic at children out-patient clinic of a tertiary health facility in Enugu, South-East Nigeria: An observational study","authors":"U. Ekwochi, F. N. Ogbuka, S. Mba","doi":"10.4081/acbr.2022.195","DOIUrl":"https://doi.org/10.4081/acbr.2022.195","url":null,"abstract":"The COVID-19 pandemic is a worldwide threat. Currently, all attention is focused on defining the disease, its presentation, treatment, and prevention, with little thought given to the impact of this disease on the prevalence and pattern of other diseases that pose health challenges. This study was a retrospective and observational study of the pattern of cases presenting at the Children Out-Patient (CHOP) Clinics of Enugu State University Teaching Hospital Parklane (ESUTHP) from five months before COVID detection to five months after COVID detection (COVID era). Clinical data from the clinic register, including age, gender, and diagnosis, was retrieved and recorded in an excel sheet before being transferred to SPSS version 20 for analysis. A total of 9377 children attended CHOP Clinics (6094 in the pre-COVID-19 era and 3283 in the COVID-19 era), representing a significant decrease in total clinic attendance in the COVID-19 era. During the study period, there was a 50% reduction in the number of cases (diseases and followups) documented from children attending clinics (pre-COVID-19 era, 4596 and COVID-19 era, 2367), indicating a significant reduction in the prevalence of these cases during the COVID-19 period. The prevalence of cases seen during the COVID-19 era was significantly lower than in the pre-COVID-19 era. This observed reduction could be attributed to COVID-19 control measures implemented in the hospital during the COVID-19 era. As a result, it is recommended that these measures be maintained in order to further reduce the prevalence of these cases even after COVID-19.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128318779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental finding of a rare anomaly: Bilateral maternal pelvic kidneys","authors":"A. Nnamani, S. Ezeofor, N. Iloanusi, P. Okere","doi":"10.4081/acbr.2022.221","DOIUrl":"https://doi.org/10.4081/acbr.2022.221","url":null,"abstract":"Pelvic kidney occurs when kidney fails to migrate above the pelvic brim during embryologic development. Bilateral pelvic kidneys are rare. We present a 31-year-old multigravida [G4 P3+0] female, who presented for routine early obstetric scan which revealed non-fused kidneys located posterio-lateral to the fundus of the gravid uterus and anterior to the sacrum. Pelvic kidneys are largely asymptomatic; and this was the case in our patient who had three previous uneventful pregnancies and vaginal deliveries without diagnosis of bilateral pelvic kidneys.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127725661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and clinical findings in late presenting posterior urethral valves in a resource-constrained economy","authors":"E. Nwankwo","doi":"10.4081/acbr.2022.219","DOIUrl":"https://doi.org/10.4081/acbr.2022.219","url":null,"abstract":"Posterior Urethral Valve (PUV) is the commonest cause of lower urinary tract obstruction in male children. Late presentation with delayed diagnosis is common in our setting. This study aims to review the clinical, biochemical, imaging findings and parental factors in late-presenting posterior urethral valves. A retrospective analysis of patients with PUVs seen at UNTH from 2011-2019 was done. Patients who presented at or later than six months of age were considered late presenters and were studied. Patients’ sociodemographic characteristics, antenatal diagnosis, clinical features, and imaging findings at presentation were retrieved. Data analysis was done using SPSS version 22. Statistical significance was set at a p-value<0.05. Twenty-four cases of PUV with complete clinical data were studied. Mean age 3.3 (SD±2.1) years had a positive association with maternal educational level (p≤0.001). Nineteen (72.9%) had antenatal care, 4 (16.7%) had prenatal Ultrasonography (USS), and were part of those who had antenatal care. None had a prenatal diagnosis. Prenatal USS was associated with higher paternal education (p=0.03). The most common clinical symptom and finding respectively were straining to pass urine 23 (95.8%) and palpable bladder 23 (95.8%). The common electrolyte derangements included hyperkalemia (50%), raised serum urea (70.8%) while postnatal hydronephrosis 23 (95.8%) was the main ultrasound and MCUG findings. Late presentation is common with urinary dysfunction and azotemia. Improved antenatal care including late trimester ultrasound and parental health education will enhance prenatal diagnosis and early presentation.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126238550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine adhesions, peritubal adhesions and tubal occlusion on hysterosalpingography","authors":"A. Onuh, S. Udobi, M. Aronu","doi":"10.4081/acbr.2022.200","DOIUrl":"https://doi.org/10.4081/acbr.2022.200","url":null,"abstract":"Pelvic Inflammatory Disease (PID), Dilatation and Curettage (D&C) and other abdominopelvic surgeries are often presumed to cause female infertility. This can occur through adhesions formation that can result in Intrauterine Adhesions (IUA), Peritubal Adhesions (PTA) and Tubal Occlusion (TO). Hysterosalpingography (HSG) can be used to diagnose IUA, PTA, and TO; and the correlations of these findings with the histories of PID, D&C and other abdominopelvic surgeries statistically tested. The available literature shows very few of such correlation tests. The objective of this study was to document HSG diagnosis of IUA, PTA and TO, and test their correlation with histories of previous PID, D&C and abdominopelvic surgeries among women with secondary infertility. This is a prospective descriptive study of 158 subjects, analyzed with SPSS version 21. For correlation test, p≤0.05 is considered significant. There was history of previous PID in 53 subjects (33.5%), D&C in 114 (72.2%), and abdominopelvic surgery in 80 (50.6%). The important findings included: IUA in 20 subjects (12.7%), TO in 53 (33.5%) and PTA in 30 (19.0%). Significant correlation was found between D&C and PTA, but not between PID and IUA, PID and TO, PID and PTA, D&C and IUA, D&C and TO, abdominopelvic surgery and IUA, abdominopelvic surgery and TO, or abdominopelvic surgery and PTA. Tubal occlusion, followed by PTA and by IUA were detected in that order as the possible causes of infertility in our subjects; and these did not correlate well with the history of PID, D&C and other abdominopelvic surgeries.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131469362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and driving: Assessing knowledge of patient safety recommendations among medical doctors in Nigeria","authors":"M. Olamoyegun, O. Akinlade, G. Ajani","doi":"10.4081/acbr.2022.196","DOIUrl":"https://doi.org/10.4081/acbr.2022.196","url":null,"abstract":"Many complications of diabetes and its treatment modalities may reduce driving safety and contribute to increase in the number of accidents. Hence, we assessed doctors’ knowledge on safety and driving with diabetes especially those on insulin. A total of 102 doctors of different cadres participated in the study conducted by an online survey in Nigeria over a 4 weeks period in April 2021. Of the 102 respondents, 97 (95.1%), 93 (92.2%), 69 (67.6%) knew that hypoglycaemia, retinopathy and neuropathy respectively predisposed to road traffic accidents. Only a third had ever discussed the possible risk of road traffic crashes with insulin-treated patients. While 32.6% participants knew glucose level be checked not later than 30 minutes before driving, 53.7% respondents knew the need to wait at least 30-45 minutes after treatment of mild to moderate hypoglycaemia before driving. Only 37.9% knows the acceptable blood glucose level considered safe to drive and 12.6% knew the recommended frequency and time to recheck glucose levels during a long trip. Results shows poor knowledge of doctors on several aspects of fitness to drive, hence, it is necessary for all doctors to have basic knowledge on requirements to drive among diabetics for appropriate advice.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133549870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of methanolic leaf extracts of Jatropha curcas, Alchonnea cordifolia, Secamone afzelii in Doxorubicin-induced hypertensive nephropathy in pregnant Wistar rats","authors":"K. Atoe, H. O. Egbo, B. Ikhajiagbe, M. Idu","doi":"10.4081/acbr.2022.189","DOIUrl":"https://doi.org/10.4081/acbr.2022.189","url":null,"abstract":"This study assessed the Effects of methanolic leaf extracts of Jatropha curcas, Alchonnea cordifolia, Secamone afzelii in Doxorubicin-induced hypertensive nephropathy in pregnant Wistar rats. Plant samples (leaves) were washed severally with distilled water, air-dried, and crushed to powder and were filtered, then soaked in 200mL of methanol for 12 hours. The LD50 was determined to ascertain the safety of the plant extracts for use. Female Wistar rats, aged 3 days apart, used in the study, were acclimatized for one week. Doxorubicin nephropathy was induced with 3.5mg dose intravenously through the caudal vein. Urea levels were found to have increased significantly in the third trimester (9.3 mmol/L) in the hypertensive nephropathic group. Hypertensive nephropathy also caused an increase in plasma Creatinine levels (333.64 μmol/L) and (172.73 μmol/L) in the third trimester and postpartum, respectively. The administration of plant extracts resulted in a significant decrease in urine creatinine (845.45–481.82 μmol/L) and a significant increase in Protein- Creatinine Ratio (PCR, 3.0–7.3 mg/dL) in the nephropathic group, but a contrary report in the post-partum group, with significant increases in micro-protein (17.1–21.9 mg/dL). Plasma urea and plasma creatinine had a significant relationship in the third trimester (r=0.853 and 0.810, p=0.01). Plasma urea, on the other hand, had no significant association with plasma creatinine throughout the postpartum period. This study’s findings suggested that Jatropha curcas, Alchonnea cordifolia, and Secamone afzelii extracts could be useful in the treatment of chronic renal disease.","PeriodicalId":251105,"journal":{"name":"Annals of Clinical and Biomedical Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131676998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}