FACULTY OF CLINICAL SCIENCES
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Item Determinants of Outcome of Neonates Admitted in the University College Hospital (UCH) Ibadan, Oyo State, Nigeria(West African College of Nursing, 2018) Ike, E. U.; Ndikom, C. M.Neonatal period is a crucial period compared to any other time during infancy as they are at high risk of dying during this period. The Neonatal Intensive Care Unit (NICU) of UCH is a highly technical specialized unit in the hospital that provides medical/nursing care to sick and/or high-risk premature infants. Yet some babies admitted to this unit fail to survive. The aim of this study is to determine characteristics of neonates admitted at NICU and factors influencing outcome of care. A retrospective descriptive survey based on case record of babies admitted for a five year period between January 2007 and December 2011. Check list was used for data collection of the 1020 neonates admitted during the period. Analysis was done using statistical package for social sciences (SPSS) version 17 software. Out of the 1020 neonates, male babies were more 549(53.8%) than their female counterparts 468 (45.9%). Most 992(97.3%) of their mothers were not booked or registered for antenatal care and were not referred early to UCH causing the babies to be in fetal distress before arrival to the hospital. Mortality was less (16.6%) among the in-born than out-born babies (35.8%). It was observed that male neonates, preterm/low birth weight and their time of admission were associated with poor outcome. There is a significant association between mothers' occupation, pregnancy complication, place of birth, mode of delivery and neonates care outcomes (p<0.05). Binary logistic regression analysis shows that mothers who had up to tertiary (university) level of education are three times more likely to have babies who survived and discharged home alive compared to those who had no formal education. There is need for nurses to educate women on the importance of early antenatal booking and delivery in a well-equipped facility. Prompt screening, identification and referral of women at risk and prompt resuscitation of new-born with asphyxia should be ensured.Item Staging of schizophrenia with the use of PANSS: an international multi-center study(Oxford University Press, 2021) Fountoulakis, K.N.; Dragioti, E.; Theofilidis, A.T.; Wikilund, T.; Atmatzidis, X.; Nimatudis, I; Thys, E.; Wampers, M.; Hranov, L.; Hristova, T.; Aptalidis, D.; Milev, R.; Iftene, F.; Esan, O.B.; Oladele, O.B.; Osunbote, C.Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. Methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. Results: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. Discussion: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.Item The self-perceived health-care needs of patients with bipolar disorder in Nigeria.(Springer Nature, 2018) Esan, O.B.; Medubi, A.Few studies have examined the health care needs of patients with bipolar disorder. The aim of this study was to comprehensively assess the clinical and social needs of patients with bipolar disorder in Nigeria and to study the demographic and clinical correlates of such needs. This was a cross-sectional study. Consecutive and consenting out patients with bipolar disorder (n = 100), were assessed with the Camberwell Assessment of Needs Short Appraisal Schedule, the Interpersonal Support Evaluation List-Shortened Version (ISEL-12), the World Health Organization Quality of life-BREF and the Young Mania Rating Scale (YMRS). The most frequently rated areas of total needs as well as unmet needs were in the domain of sexual expression, intimate relationships and the need for company. The mean number of total needs per participant was 10.70 while the median number of unmet needs was 1.50. The total number of unmet needs was significantly higher for unremitted participants compared to remit ted participants. The total number of unmet needs was positively correlated with the severity of manic symptoms (YMRS score) and negatively correlated with the level of social relationships (social domain of WHOQOL), functioning (Global Assessment of Functioning (GAF) score) and social support (Tangible Support subscale of the ISEL). The GAF score and YMRS score significantly predicted unmet needs. The study underscores the importance of assessing the needs of patients with bipolar disorder in Nigeria.Item Childhood acute glomerulonephritis in Ibadan Nigeria(Paediatric Association of Nigeria, 2020) Asinobi, A. O.; Ademola, A. D.; Nwankwo, A. F.Item Partograph utilization and clinical decision making: A veritable tool in reducing maternal mortality in the 21st century.(2023) Famutimi, E. O.; Oluwasola, T. A. O.; Oni, O. O.; Olagunju, A. S.; Okanlawon, F. A.Introduction and Objective: Poor obstetric outcomes in Nigeria with its attendant implications for measuring health indices have remained a significant health concern. The occurrence of adverse events due to unsafe care is a major contributor to the causes of maternal morbidity and mortality globally. The main objective of this study was to assess the pattern of admission as well as the outcome of Obstetrics practices in Oluyoro Catholic Hospital (OCH) Ibadan. Methodology: This was a retrospective, cross-sectional descriptive analysis of medical records of 194 cases managed between Janu-ary and December 2018. Using a proforma, data was obtained on obstetric characteristics of patients, indications for admission, outcome of pregnancy and the interventions received during patient's admission into the maternity ward. The socio-demographic characteristics were described sequentially with frequency tables and percentages. Chi-square statistics was used to determine the association between categorical variables at 5% level of statistical significance. Results: The mean age of the participants was 30.45 + 4.83 years and the majority, 183 (94.3%), of them were booked. Common indications for admission were onset of labour pains 74 (38.1%), and elective induction of labour 38 (19.6%). Two-fifths, 79 (40.7%) of the respondents had intrapartum augmentation of labour with oxytocin. The prevalence of episiotomy in this study was 22.2% while 5.2% had laceration. Majority, 182 (93.8%) had live babies out of which 8.2% required admission into the neonatal intensive care unit. Conclusion: Overall findings showed that the obstetric practices in the study setting were within the margin of acceptable standard and efforts to sustain the obstetric skills and practices of healthcare providers should be maintained.Item Pattern of infertility at LAUTECH teaching hospital, Ogbomoso, Nigeria.(2019) Suleiman, B. K.; Bello, O. O.; Tijani, A. M.; Oluwasola, T. A. O.Background and Objectiver Infertility is a socially destabilising health problem, which remains a cause of stigma and threat to couples desirous of conception in Nigeria. This sludy aimed to ecxamine the pattern of presentation and management outcome of infertility at LAUTECH Teaching Hospital (LTH), Ogbomoso. Methods A descriptive retrospective study of infertile couples attending the gynaecological clinicovera 3-yearpe-riod was conducted. Intonation on sociodemographic and gynaccological characteristics, medical history and management outcome was obtained from the medical reconls of the patients using a stctured proforma Data was analysed using SPSS version 20.0. Results The incidence of infertility was 34.30ol The mean age of the infertile women was 6.44 4.7 ycars. Secondary infertility/ accounted for the majority of the cases (73.0") with the_ mean duration of infertility being3,92 1 years. Male factor was identified in 10.4 of cases while female factor wasscen in 4L6"ot cases Both partners contributed to infertility in 34% while there was no identifiable cause in 14%. The commonest causes of infertility in the women were inadequate coital exposure, previous abnormal vaginal discharge and previous induced abortion representing 39.5%, 37.1%, and 33.7% respectively. Pregnancy was achieved in 3.0% of the women following treatment Conclusion The institutional incidence of infertility was high with a preponderance of secondary infertility. Pregnancy rate following conventional treatment was poorItem Outcome of trabeculectomy with 5-fluorouracil using releasable suture technique in a Nigerian tertiary hospital(West African College of Physicians (WACP) and the West African College of Surgeons (WACS), 2011-06) Komolafe, O. O.; Ashaye, A. O.; Bekibele, C. O.; Baiyeroju, A. M.; Olawoye, O. O.BACKGROUND: Trabeculectomy has undergone a series of modifications in recent times most of which are aimed at improving the efficacy of the procedure while reducing complications. The use of releasable sutures is one of such modifications. OBJECTIVE: To assess the efficacy and complications associated with the use of releasable sutures and 5- Fluorouracil(5-FU) in trabeculectomy among indigenous African patients with primary open angle glaucoma. METHODS: This was a chart review of 22 eyes of 17 patients diagnosed with primary open angle glaucoma. All the eyes included in the review had trabeculectomy with 5-Fluorouracil using releasable suture technique with postoperative clinic follow- up visit for a minimum period of 72 weeks. Information sought included patient’s demographics, preoperative antiglaucoma medications, pre- and post- operative intraocular pressure, and associated complications. RESULTS: There were 17(13 M, 4 F) patients with 22 eye surgeries. Their mean age was 49.8 ± 9.3 years. The mean preoperative intraocular pressure was 27.7 ± 5.9 mmHg. The intraocular pressure on the first post-operative day was 10.6 ± 11.1 mmHg. The mean pressure before the removal of the releasable suture was 14.1 ± 10.8 mmHg and after removal was 6.0 ± 7.2 mmHg, (p < 0.0001). The mean intraocular pressure at 72 weeks of follow up was 16.9 ± 5.6 mmHg. A qualified success rate of 81.8% was achieved in terms of intraocular pressure control. There were two eyes complicated by blebitis and an eye complicated by malignant glaucoma. CONCLUSION: The use of releasable suture in trabeculectomy helped in maintaining the intraocular pressure at a lower level in the early postoperative period and in reducing postoperative shallowing of the anterior chamber. The procedure appears to be associated with some sight- threatening complications such as endophthalmitis.