Nigerian medical journal : journal of the Nigeria Medical Association最新文献

{"title":"Perception of Enrollee Health Insurance Fraud among Healthcare Workers at a Tertiary Hospital in Kaduna State, North-western Nigeria.","authors":"Hajara Adamu Kasim, Auwal Garba Suleiman, Fahad Abubakar Saulawa, Suleiman Usman, Muhammad Aliyu, Nazifi Sani Aminu","doi":"10.71480/nmj.v66i1.700","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.700","url":null,"abstract":"<p><strong>Background: </strong>Fraud in healthcare is an immense challenge that poses a direct threat to sustainable healthcare financing across low and high-income countries. Enrollee health insurance fraud is a relatively understudied form of fraud that thrives in settings characterized by weak and fragmented healthcare systems. This study examined the knowledge and perception of enrollee health insurance fraud among healthcare workers at a tertiary hospital in Kaduna State, North-western Nigeria.</p><p><strong>Methodology: </strong>Using a stratified sampling technique, 232 healthcare workers were interviewed using a structured, self-administered questionnaire that was developed for the study. Data on knowledge and perception of enrollee fraud was obtained and analysed using IBM SPSS Statistics. The data was presented using frequency distribution tables, while figures were drawn using Microsoft Excel.</p><p><strong>Results: </strong>The majority of the respondents were clinical staff, including medical doctors (29.7%), nurses (31.5%) and health assistants (14.2%). A total of170 (73.3%) respondents were aware of enrollee fraud and up to 113 (66.5%) encountered at least one case of enrollee fraud. The most common types of enrollee fraud identified by the respondents were impersonation (67.7%) and faking symptoms (57.1%). Respondents recognised adverse consequences of enrollee fraud, including depletion of resources (74.1%), blocking eligible patients from accessing care (73.6%), and exhaustion of healthcare workers (61.8%). A total of 111 (65.3%) agreed that enrollee fraud is common in the hospital and despite a high level of awareness, only 72 (42.3%) agreed that they are adequately informed about enrollee fraud.</p><p><strong>Conclusion: </strong>There was a high level of awareness of enrollee fraud among the respondents with a good perception of its manifestations and implications on healthcare delivery. It is recommended that immediate steps be taken to educate healthcare workers and enhance their capacity to detect and deter enrollee fraud while investing in longterm strategic measures and technology-based solutions.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"256-265"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of Uptake of Routine Immunization amongst Under-Five Children: Comparison of Nomadic and Non-nomadic Fulani in Yobe State, Nigeria.","authors":"Dauda Abdulhamid, Usman Muhammad Ibrahim, Boateng Kofi, Sunday Audu, Mahdi Musa Wade, Abba Ahmed Danzomo, Nuruddeen Muhammad, Abdullahi Namadi Faruk, Salihu Abdullahi Ahmed, Jamilu Aliyu Bawa, Abdullahi Sadiq Uba, Tukur Ismail, Awwal Umar Gajida, Abubakar Mohammed Jibo","doi":"10.71480/nmj.v66i1.542","DOIUrl":"10.71480/nmj.v66i1.542","url":null,"abstract":"<p><strong>Background: </strong>Immunization is an important public health intervention that reduces morbidity and mortality associated with vaccine-preventable diseases (VPDs). This study aimed to determine and compare the correlates of routine immunization uptake among under-five children of nomadic and non-nomadic Fulani in Yobe State, Nigeria.</p><p><strong>Methodology: </strong>A multistage sampling technique was used to study the eligible caregivers and under-five children in the selected households using an interviewer-administered questionnaire, observation for the child immunization card, or a recall of immunization history. Data were analysed using IBM SPSS version 22.0 with a statistical significance set at p≤5%.</p><p><strong>Results: </strong>The response rate among nomadic and non-nomadic Fulani was (348/348, 100% vs. 345/348, 99%).The Penta 1 uptake based on routine immunization cards among nomadic and non-nomadic under-five children was (23.6% vs.76.4% P<0.001).Availability of the vaccine (adjusted odds ratio = 22, 95% confidence interval = 13.7-35.5), the purpose of vaccination (adjusted odds ratio = 1.9, 95% confidence interval = 1.1-3.4), vaccines safety (adjusted odds ratio = 17.3, 95% confidence interval = 10.0-29.8), and friendly healthcare workers (adjusted odds ratio = 18.8, 95% confidence interval = 11.3-31.3) were found to be independent predictors facilitating uptake of routine immunization among nomadic and non-nomadic under-five children, while long distance to the health facility (adjusted odds ratio = 9.6, 95% confidence interval = 6.6-14.0), lack of knowledge on immunization (adjusted odds ratio = 2.1, 95% confidence interval = 1.4-2.9), fear of side effect (adjusted odds ratio = 1.6, 95% confidence interval = 1.1-2.5), were independent barriers to uptake of routine immunization among nomad and non-nomadic under-five children.</p><p><strong>Conclusion: </strong>Vaccine uptake is still a problem among nomads and non-nomadic under-five children. The government and relevant stakeholders should ensure a strategy for improved outreach services to all the nomads and hard-to-reach settlements.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"44-59"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verification of the HbA1c method on the STANDARD F2400^® analyzer in a Nigerian Laboratory.","authors":"Modupe Akinrele Kuti, Jokotade Oluremilekun Adeleye","doi":"10.71480/nmj.v66i1.698","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.698","url":null,"abstract":"<p><strong>Background: </strong>For methods that report quantitatively, an assessment of their imprecision and bias should be assessed in the laboratory before their deployment into routine service. This study assessed these parameters of the HbA1C method on the STANDARD F2400® point of care analyzer. These parameters were further combined to generate sigma metrics for the method.</p><p><strong>Methodology: </strong>An external quality assurance (EQA) material from the Randox International Quality Assessment Scheme (RIQAS) was analysed according to the EP15 protocol of the Clinical Laboratory Standards Institute in SYNLAB Nigeria Laboratory Quality Assurance Department. Estimates of precision and an assessment of bias were determined from the data which consisted of 5 replicates per day for 5 consecutive days. Precision estimates were compared with manufacturer-provided information and estimates of bias were compared with the verification interval for the target value provided by RIQAS. Sigma metrics were determined for total allowable error (TAE) of 8% and 10%.</p><p><strong>Results: </strong>The grand mean (standard deviation) for the study was 4.95 (0.15) %. The Within-run CV and within laboratory CV were 1.28% and 1.86%, respectively. These were within the manufacturer claims of 1.70% and 1.90%, also respectively. The target value by RIQAS was 5.04(0.24) % with a calculated verification interval of 4.95 - 5.13%. The sigma metrics for the method at TAE of 8% and 10% were 4.8/3.3 and 6.3/4.3 within the run/within laboratory estimates respectively.</p><p><strong>Conclusion: </strong>The HbA1C method on the STANDARD F2400® Analyzer displayed performance characteristics that are consistent with manufacturer specifications and are above industry standard quality for a point-of-care device for HbA1C. These suggest that may be used to support routine monitoring of persons with diabetes mellitus in Nigeria.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"246-255"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Optic Atrophy and Epiretinal Membranes: An Atypical Presentation of Ocular Tuberculosis.","authors":"Yewande Olubunmi Babalola","doi":"10.71480/nmj.v66i1.711","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.711","url":null,"abstract":"<p><p>A 15-year-old boy presented himself to the retina clinic with a six-year history of poor vision in both eyes. Ocular symptoms started with deterioration in the vision of both eyes associated with ocular pain. There was no history of antecedent trauma, headaches, seizures, or loss of consciousness. The general and systemic examinations were normal. On ocular examination, the corrected visual acuity was 6/24 and 6/6 in the right and left eyes, respectively. The anterior segment examination was normal except for a relative afferent pupillary defect in the right eye. Examination of the posterior segment revealed bilateral optic atrophy worse in the right eye and cup disc ratios of 0.3 bilaterally. The vessels were within normal limits with epiretinal membranes in both eyes. Yellowish chorioretinal lesions were present temporal to the disc in both eyes. There was a positive history of tuberculosis in the father and brother. A diagnosis of bilateral optic atrophy and epiretinal membranes secondary to presumed ocular tuberculosis was made.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"389-393"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, acceptance and willingness to pay for malaria vaccine among residents of a semi-urban community in Kaduna State, North-western Nigeria.","authors":"Hanan Faridah Yusuf, Auwal Garba Suleiman, Shefaatu Shehu, Umar Yahaya, Suleiman Usman, Usman Hamisu Indabo","doi":"10.71480/nmj.v66i1.701","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.701","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a life-threatening parasitic infection associated with high morbidity and mortality in endemic regions. The World Health Organization (WHO) has approved two malaria vaccines for use in children and as countries begin the phased rollout of these vaccines, uncertainties around community awareness, attitudes, and willingness to accept the vaccines remain.</p><p><strong>Methodology: </strong>This study used a multistage sampling to select 200 mostly female caregivers of children under the age of five years in Samaru, a semi-urban community in Kaduna State, North-western Nigeria. Data on knowledge, attitude, and willingness to accept the malaria vaccine was obtained using a structured questionnaire and analysed using IBM SPSS Statistics. Knowledge and attitude were scored and graded into good and poor categories. The data was presented using frequency tables and a chi-square test was used to check for associations between willingness to accept malaria vaccine and relevant variables. A <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The majority of the respondents were females (65.5%) and married (93.0%), with a mean age of 33.1 (±9.3) years. Fifty-seven (28.5%) caregivers heard of the malaria vaccine mostly through healthcare workers and traditional media, while 39 (19.5%) showed good knowledge of the vaccine. A total of 194 (97.0%) had a good attitude towards the vaccine, 188 (94.0%) were willing to accept the vaccine, and 176 (88.0%) said they were willing to pay for it. Factors associated with vaccine acceptance included the caregiver being vaccinated as a child, having at least one child who is vaccinated, and having a good attitude toward the vaccine.</p><p><strong>Conclusion: </strong>Despite low awareness, willingness to accept the malaria vaccine was high in the community. It is recommended that immediate steps be taken by relevant stakeholders to educate the public and begin the rollout of the vaccine to avoid the spread of rumours and misconceptions.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"266-278"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroxyurea therapy in sickle cell disease: knowledge and prescription patterns among care providers in a low-and middle-income setting.","authors":"Akinyemi O D Ofakunrin, Edache Sylvanus Okpe, Rasaq Olaosebikan, Onyeka Mary Ukpoju-Ebonyi, Tolulope Olumide Afolaranmi, Dangkat Bitrus Kilson, Stephen Oguche","doi":"10.71480/nmj.v66i1.675","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.675","url":null,"abstract":"<p><strong>Background: </strong>Hydroxyurea is a safe, effective, and well-tolerated disease-modifying therapy for patients with sickle cell disease (SCD), leading to reduced morbidity, mortality, and an improved quality of life. However, its underutilization, driven by inadequate knowledge and variability in use among SCD care providers, may limit its benefits. This study assessed the knowledge and prescription patterns of hydroxyurea among SCD care providers in Jos, Nigeria.</p><p><strong>Methodology: </strong>A cross-sectional survey of 132 physicians managing SCD was conducted to collect data on socio-demographics, hydroxyurea knowledge, and prescription patterns using a proforma. Knowledge was assessed using 17 questions (maximum score: 17). Scores above 12 (50th percentile) were classified as \"good,\" while scores of 12 or below were categorized as \"poor.\" Prescription patterns were evaluated against the National Institutes of Health (2014) and British Society for Haematology (2018) guidelines. Data were analyzed using descriptive and inferential statistics.</p><p><strong>Results: </strong>Sixty-seven (50.8%) of the 132 physicians had inadequate knowledge of hydroxyurea's clinical benefits and safety. Only 35 (26.5%) were aware of available treatment guidelines, and 32 (24.2%) had ever prescribed hydroxyurea. Among prescribers, nine (28.1%) used inappropriate criteria to initiate treatment and six (18.8%) prescribed below recommended doses. The median maximum daily prescribed dose was 750mg, whereas five (15.6%) physicians did not exceed 200mg, irrespective of patient weight. Treatment guidelines were not followed by 25 (78.1%) of prescribers.</p><p><strong>Conclusion: </strong>This study revealed a high prevalence of inadequate knowledge and inconsistent hydroxyurea prescription practices among SCD care providers. Targeted training is essential to enhance hydroxyurea utilization and ensure adherence to standardized treatment guidelines, ultimately improving patient outcomes.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"198-209"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there Co-infection of Influenza and Covid-19 in Jos, North Central Nigeria?","authors":"Nathan Yakubu Shehu, Mark Ojogba Okolo, Emmanuel Ameh Ameh, Daniel Geofrey Thankgod, Oluwatoyin Ruth Morenikeji, Ferdinand Ibu Ogbaji, Dung Davou Pam, Filibus Danjuma Dami, Pam Dachung Luka","doi":"10.71480/nmj.v66i1.342","DOIUrl":"10.71480/nmj.v66i1.342","url":null,"abstract":"<p><strong>Background: </strong>Influenza virus and severe acute respiratory syndrome virus-2 (SARS CoV-2) are known to cause respiratory disease in humans that may be fatal. They have caused epidemics and constitute significant public health challenges because of their ability to spread and cause severe disease. Co-infection with both viruses has been shown to increase the odds of fatality among affected patients. Our study aimed to investigate co-infection with influenza among patients with coronavirus disease-2019 (COVID-19) in Jos, Plateau State.</p><p><strong>Methodology: </strong>We carried out a cross-sectional study using stored nasopharyngeal and oropharyngeal samples of patients diagnosed with COVID-19 using GeneXpert. The samples were collected at our institution and stored at -80 °C. The samples were analysed for influenza co-infection using real-time reverse transcriptase polymerase chain reaction.</p><p><strong>Results: </strong>Two-hundred-and-forty-one (241) stored samples of patients diagnosed with COVID-19 were analysed. None of the samples tested positive for the influenza virus.</p><p><strong>Conclusion: </strong>We found no case of influenza and SARS-CoV-2 co-infection among the patients studied. This suggests that the prevalence of influenza virus infection may be low in our setting and partly explains the relatively benign outcome of SARS-CoV-2 infections in our region.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"357-363"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Easing the Pain: Lignocaine Spray in Mid-Trimester Amniocentesis - A Randomized Double-Blind, Placebo-Controlled Trial.","authors":"Tanya Sharma, Meenakshi Gothwal, Charu Sharma, Pratibha Singh, Garima Yadav, Manoj Kumar Gupta, Manisha Jhirwal, Priyanka Kathuria","doi":"10.71480/nmj.v66i1.737","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.737","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effect of lignocaine spray on maternal pain perception during mid-trimester amniocentesis compared to placebo.</p><p><strong>Methodology: </strong>This was a double-blinded, prospective, randomized controlled trial conducted at a tertiary teaching hospital in Western Rajasthan. Singleton pregnancies between 15- and 24-weeks' gestation undergoing amniocentesis were included. Participants were randomly assigned to receive either lignocaine spray or placebo (normal saline). Pain was assessed using the Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Numerical Rating Scale (NRS). A total of 138 women were enrolled, with 69 receiving lignocaine spray and 69 receiving placebos.</p><p><strong>Results: </strong>Pain perception measured by VAS showed no significant difference between the lignocaine and placebo groups (p = 0.412). VRS and VAS demonstrated a positive correlation (r = 0.692, p < 0.001). Median VAS scores at 30 minutes post-procedure were significantly lower in the lignocaine group (p = 0.008). The Kappa agreement between VAS and VRS was found to be 59.20%. No significant difference in procedure-related complications was observed between groups.</p><p><strong>Conclusion: </strong>The study demonstrates no significant difference in VAS scores or secondary outcomes between the lignocaine and placebo groups, suggesting that lignocaine spray may not provide additional benefit for pain relief in amniocentesis.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"327-336"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of serum laminin and hyaluronic acid as markers of hepatic fibrosis in patients with chronic Hepatitis B.","authors":"Sogo Jide Busuyi, Abiodun Olabamiji Ajose, Olusegun Sylvester Ojo, Olusegun Adekanle, Olufemi Samuel Smith, Adetokunbo Oluwafunso Ajala, Omolade Adefolabi Betiku","doi":"10.71480/nmj.v66i1.653","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.653","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) is a major cause of chronic liver disease worldwide. Fibrosis of hepatic parenchyma has been reported as a common pathway to complications of chronic liver disease. There is a need to monitor fibrosis in these patients to abort or delay disease progression following treatment. Liver biopsy is recognized as the gold standard for disease monitoring; however, the procedure is invasive and bedeviled with potential complications. For these reasons, non-invasive biomarkers of fibrosis are now being evaluated as alternatives to liver biopsy. The study aimed to assess the characteristics of laminin, and hyaluronic acid as markers of hepatic fibrosis in patients with chronic hepatitis B.</p><p><strong>Methodology: </strong>One hundred participants with HBV-induced chronic liver disease (CLD) were recruited for the study. A liver biopsy was conducted, and the degree of hepatic fibrosis was scored using the Metavir scoring system. Serum levels of the biomarkers were determined using enzyme-linked immunosorbent assay (ELISA) technique. Medians and interquartile ranges were compared using the Mann-Whitney U test. The degree of correlation between continuous variables was determined using Spearman's correlation analysis. Statistical significance was set at p ≤ 0.05.</p><p><strong>Results: </strong>Serum laminin was significantly higher in participants with hepatic fibrosis: 39.09 (27.6-89.4) ng/ml [median (interquartile range)], vs 24.3 (21.5-31.9) ng/ml, p = 0.001, Hyaluronic acid was significantly higher in participants with hepatic fibrosis: 45.1 (26.9-94.4) ng/ml vs 23.1 (12.7-35.7) ng/ml, p < 0.001. There was a strong significant positive correlation of both serum laminin and hyaluronic acid with Metavir score in the study participants (r=0.766, p<0.001; r=0.708, p<0.001 respectively). At a serum laminin concentration of 44.6 ng/ml, sensitivity and specificity for detecting moderate to severe hepatic fibrosis were 86.8% and 88.7% respectively, with an area under the curve (AUC) of 0.943 on the Receiver Operator Characteristic (ROC) curve. The sensitivity and specificity of hyaluronic acid for detecting moderate to severe hepatic fibrosis were 81.6% and 85.5% at a serum concentration of 53.5 ng/ml. AUC was 0.930 on the ROC curve.</p><p><strong>Conclusion: </strong>This study underscores the evidence that laminin and hyaluronic acid may be helpful clinically in identifying patients with moderate to severe hepatic fibrosis. Serum laminin had a slightly better diagnostic ability than hyaluronic acid in the study participants. Further studies are needed to elucidate our findings.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"156-164"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pattern of Medical Admissions at the Intensive Care Unit of the University of Port Harcourt Teaching Hospital, Nigeria.","authors":"Otokwala Job Gogo, Akpa Maclean Romokere, Stanley Rosemary Oluchi","doi":"10.71480/nmj.v66i1.742","DOIUrl":"https://doi.org/10.71480/nmj.v66i1.742","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units offer specialized care to critically ill patients and are an integral part of modern health care. In low-income countries, with limited resources, the demand to optimize patient care and improve outcomes depends on a better understanding of the pattern of medical referrals to the ICU for varying reasons of resource allocation, staffing, and quality improvement initiatives. This study aims to describe and provide valuable insights into the patterns of medical admissions to the intensive care unit (ICU), including case mixes, intensive care interventions, duration of stay, and outcomes to highlight the need for proper resource allocation.</p><p><strong>Methodology: </strong>A retrospective descriptive study was conducted at the University of Port Harcourt Teaching Hospital ICU between January 2022 and December 2024. We reviewed all patients from the Department of Internal Medicine referred to the ICU with a purely medical diagnosis. Data were retrieved from the ICU admissions register and patients' medical records following ethical exemption approval.</p><p><strong>Results: </strong>A total of 377 patients with medical referrals were reviewed, accounting for approximately 56.9% of all ICU admissions. More males were admitted, and the mean age of patients was 48.6 ± 15.3 years. The emergency unit was the commonest source of referral and offered a significant source of in hospital delays prior to transfer to the ICU. The most common indication for ICU admission was stroke, with hemorrhagic stroke, sepsis, and cardiogenic shock associated with the worst outcomes.</p><p><strong>Conclusion: </strong>Stroke predominated medical referrals and provided the worst outcome. The in-hospital delays at the emergency unit which became the largest source of referral contributed to the high mortality. This study highlights the need to strengthen stroke care at the tertiary level of care as well as other medical referrals to improve care.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"66 1","pages":"337-346"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}