ANNALS OF MEDICAL AND SURGICAL PRACTICE <p>The Annals of Medical and Surgical Practice is a peer-reviewed journal published on behalf of<br />the Nigerian Medical Association, Edo State Branch. This journal publishes original<br />communications in the form of original research, high-quality case report, short communications,<br />letter to the editor and systematic reviews on clinical medicine (surgery, surgical specialties,<br />paediatrics, internal medicine, public health, obstetrics and gynaecology etc), laboratory<br />medicine, and other specialties in the basic medical science, the allied health science and<br />health related social science. The journal is published twice yearly, in the months of June<br />and December. </p> en-US (Prof Afekhide E. Omoti) (soundgodword Tech) Wed, 22 Jul 2020 22:30:09 +0000 OJS 60 THE CORONA VIRUS OUTBREAK (COVID 19): A PANDEMIC LIKE NO OTHER <p><strong>Aim:</strong> To attempt to show the profound effect of the corona virus outbreak in every sphere of our lives.<br><strong>Method:</strong> Information was obtained from the social media, discussions, news outlets, scientific journals and releases from the World Health Organisation and Centres for Disease Control.<br><strong>Results:</strong> The corona virus outbreak has really affected every sphere of human existence including but not limited to the physical, social, economic, educational, political, recreational and spiritual spheres. Apart from being a pandemic, it has caused major behavioural changes which may persist far into the post covid era and possibly forever. The profound effects on the economy has resulted in collapse of businesses and job losses as well as economic recession.<br><strong>Conclusion:</strong> The covid-19 pandemic may have come to stay and will continue to cause profound changes in our lives. The disease is becoming more of a political than a pathological disorder. Management of the post covid era will be a major challenge for most countries.</p> A E Omoti, C E Omoti Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 COVID-19 PANDEMIC: SAVE HUMANITY THROUGH GOOD LEADERSHIP AND SOLIDARITY TO DEFEAT THE CORONAVIRUS <p><strong>Aim:</strong> To assess the Public health crisis and Potential social and economic crises caused by the Coronavirus disease (COVID-19) in Nigeria. <strong>Methods:</strong> The information used in this article were retrieved from online publications, newspapers and personal field experience as a member of Edo State case management pillar and infections, prevention and control pillar COVID-19. Also, as the director of infections, prevention and control, co-coordinator of preparedness and prompt response to COVID-19, Igbinedion University Teaching Hospital (IUTH), Okada, and a member of guideline monitoring of COVID-19, Igbinedion University Okada, (IUO), Edo State.</p> <p><strong>Result:</strong> Nigeria was found to be the third-highest Covid-19 cases in Africa, trailing South Africa and Egypt with over fourteen thousand people who have been infected by the novel coronavirus. Despite all these figures, many Nigerians appear not to believe that Covid-19 is real, while others gloat that Covid-19 is mainly targeting the country's elite, particularly politicians. But with borders closed and each country haunted by its own Covid-19 nightmare, Nigeria's big men and women were forced to use their country's hospitals, prompting a stream of taunts and jokes. The infections and deaths by COVID-19 in Nigeria and elsewhere in Africa generally indicate a low level contrary to the WHO projection. The fatality rate in Nigeria is between 2.9% to 3.6% after three months of the pandemic. After 100 days of the index case of Covid-19, the virus has spread to 35 states and the Federal Capital Territory (FCT). The caseload however keeps increasing, especially in Lagos, Abuja, Kano, Ogun and Edo State. Seventy nine thousand nine hundred forty eight people has been tested, and four thousand two hundred and six people had been successfully treated and discharged as at 9th June, 2020. The cases with travel history went from 100% to a current 2%. Twenty three percent of cases were contacts of confirmed cases while source of infection of 75% was a reflection of ongoing community transmission in Nigeria. A small proportion of the population attests to have received any support from the government. However, some private sectors, religious leaders, churches, mosques and non-governmental organisations provided a lot of support to communities across the country. <strong>Conclusion:</strong> Timely and evidence-based information is the best vaccine against rumors and misinformation. Information, communication and education are the most important resource to enable a population to make informed decisions on how to take care of their health, and to prevent rumors and misinformation. The Nigerian government must aim to protect its citizens and provide them with the necessary commodities or funds to help mitigate the consequences of this pandemic.<br><br></p> BS. Ehis, A E Omoti Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 UPDATE ON LABORATORY DIAGNOSIS OF SARS-COV-2 (COVID-19) <p><strong>Aim:</strong> To show the currently available methods of laboratory diagnosis of the novel corona virus. <strong>Methods:</strong> Information was obtained from the WHO/CDC guidelines, internet search, journal articles, Entrez PubMed.</p> <p><strong>Results:</strong> Origin of SARS-CoV-2 was from Wuhan, China. It is a positive single stranded RNA virus belonging to the betacoronavirus. Mode of transmission after review was through droplet, airborne aerosol, direct and indirect contact through fomites. Affected patients may be asymptomatic and symptomatic ones present with fever, cough and shortness of breath. This results from the spike glycoprotein of the virus entering the body through ACE2 receptors to cause a cytokine storm. Challenges of setting up a laboratory testing was divided into preanalytical, analytical and post analytical including using the laboratory assessment tools (LAT); taking note of the risk assessment tools and laboratory bio security risks involved. Type of specimens collected include nasopharngeal/ oropharngeal swabs, blood etc. Nucleic acid base testing for the genome of SARS-CoV-2 was recommended.</p> <p><strong>Conclusion:</strong> Covid 19 is caused by SARS-CoV-2 which is transmitted by droplets, aerosols and by contact. Main diagnostic test is by molecular Nucleic acid base from nasopharngeal swabs. Infection prevention and control measures are key to containing the virus. No vaccine has been produced so far</p> C E Omoti, AAB Ahmed Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 LEVEL OF AWARENESS AND KNOWLEDGE OF CATARACT AMONGST STAFF OF IRRUA SPECIALIST TEACHING HOSPITAL, IRRUA, EDO, STATE, NIGERIA <p><strong>Aim:</strong> To assess the level of awareness and knowledge of cataract among workers at the Irrua<br>Specialist Teaching Hospital, Irrua, Edo State, Nigeria.<br><strong>Methods:</strong> Enrolled into the study were five hundred (500) participants, however only 370 consented. Data on demographics, awareness and knowledge of cataract was gathered through structured researcher-administered questionnaires using a systematic random sampling technique to participants, which included Accounts, Personnel, Laundry, Security, Pharmacy, Radiology, and Laboratory services. Staffs from the department of Ophthalmology were excluded from the study as a way of eliminating bias. Statistical Package for Social Sciences 21 (SPSS Inc. 2007. SPSS for Windows, Version 21.0. Chicago) Software was used to analyze data. Yates-corrected Chi-square test (χ2)/Chi-square (χ2) with trend or Fisher Exact Test as appropriate were used to determine association between discrete variables. Regression analysis to identify significant factors (e.g. demographics) affecting awareness and knowledge among the participants was also done. The level of knowledge among the staff categories was also compared using the Chi-square test. Statistical significance was taken as P&lt; 0.05.<br><strong>Results:</strong> A total of 500 participants from various departments were recruited for the study but only 370 consented and took part in the study, giving a 74% response rate. This represented 18.4% of the total population. There were 149 males and 221 females that participated in the study, with a male to female ratio of 1:1.5. The mean age of the participants was 39.9 (±7.9) years. All participants had some formal education with a little over two-third of the participants 282(76.2%) having tertiary level of education. A total of 327(88.4%) of the participants were aware of cataract. Awareness of cataract was higher among the paramedical staff and among the respondents with higher education. Lectures during training (24.4%) and hospital seminars (23.5%) were the most common source of information among participants who had heard about cataract. Other sources of information were mass media, relatives with cataract and during an eye clinic visit.<br>Out of 327 participants who were aware of cataract, 61(18.7%) had good knowledge of cataract, 100 (30.6%) participants had fair knowledge and a little over half (50.8%) had poor knowledge.<br>The significant predictors found for knowledge of cataract was occupation, which was independently associated with the participants’ knowledge of cataract after adjustment. The results showed that a medical staff is more likely to have better knowledge of cataract than a domestic/security staff (p = 0.005), &lt;0.05.<br><strong>Conclusion:</strong> Awareness of cataract was higher among the paramedical staff and among the respondents with higher education. The significant predictors found for knowledge of cataract was occupation, which was independently associated with the participants’ knowledge of cataract after adjustment.</p> IE Eguaoje, UC Fuh, ME Enock Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 SINGLE VISIT ROOT CANAL TREATMENT: OPINIONS OF A POPULATION OF YOUNG NIGERIAN DENTISTS <p><strong>AIM:</strong> To evaluate the opinions and practices of fresh graduate dentists in Nigeria with regards to single-visit root canal treatment.<br><strong>METHODS:</strong> A questionnaire-based cross-sectional study of House Officers, information on the frequency of undertaking root canal treatment in the course of the posting, the average number of appointments needed to complete single-rooted teeth with single canals, teeth with two canals and teeth with three or more canals, their performance of single-visit root canal treatment in the course of their postings, and the factors influencing undertaking single-visit root canals was sought.<br><strong>RESULTS:</strong> A total of 60 house officers agreed to participate in this study. For single-rooted teeth and teeth with two root canals, 48.3% and 55.0% of the respondents respectively stated that 3 visits were required while for teeth with three or more root canals, 43.3% of the respondents specified that 3 or more visits were required to complete the root canal treatment. Less than half (43.3%) of the respondents reported that they performed single-visit root canal treatment. The most commonly reported factor influencing the choice of performing single visit root canal treatment was the vitality of the tooth (34.6%), followed by the electiveness of the root canal treatment (30.8%) and the tooth with a single canal (23.1%) while the least reported factor was the cost of treatment (7.7%).<br><strong>CONCLUSION:</strong> Single visit root canal treatment, though an acceptable alternative treatment procedure for endodontic problems, tends to be dependent on the pre-operative condition of a tooth. Fresh graduates who are conversant with this concept as part of their undergraduate curriculum are disposed to undertaking single visit root canal treatment in well-selected cases.</p> LO Ibhawoh, JE Enabulele Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 COMPLIANCE WITH MEDICAL THERAPY IN GLAUCOMA PATIENTS IN THE NATIONAL HOSPITAL, ABUJA. <p><strong>Aim:</strong> To determine the adherence to drug therapy of glaucoma patients at the National hospital, Abuja and factors affecting compliance with medical therapy.<br><strong>Methods:</strong> This was a prospective study which was carried out among patients with Primary open angle glaucoma at the Eye clinic of the National Hospital Abuja. All glaucoma patients presenting for the first time in the hospital eye clinic over a one year period with a diagnosis of primary open angle glaucoma were enrolled in the study. Data was obtained using interviewer administered questionnaires. The patients were followed up for a minimum period of 3 months to determine the level of compliance and reasons for default. Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 15.<br><strong>Results:</strong> Only 110 patients (72.3%) of the 152 glaucoma patients met the inclusion criteria of a minimum follow up of 3 months. The frequency of instillation showed that 63 patients (57.3%) used drops once daily, 46 (41.8%) used drops twice daily and 1 patient (0.9%) used drops thrice daily. Compliance rate in this study was 71.8%. The majority of patients (56.4%) were in compliance grade II. The main reason for missing doses was forgetfulness (64.5%) and the majority of them were in group II. The time of day patients were most likely miss their drugs was at night followed by the morning dose. Patients with mild to moderate visual field defects were more likely to be compliant than those with severe visual field defect (p&lt;0.05). Educational status and occupation were significantly associated with compliance (p&lt;0.01). Those with tertiary level of education were most likely to comply with medical therapy when compared with those with lower levels of education. Those in higher occupational classes were also more likely to comply with medical treatment when compared with those in the lower levels. Patients with higher monthly incomes complied better than patients with lower monthly incomes (p&lt;0.01). Good knowledge was significantly associated with good compliance.<br><strong>Conclusion:</strong> Glaucoma patients attending the Eye Clinic of the National Hospital, Abuja complied better with medical therapy compared with what was reported in previous studies from other parts of Nigeria. Patients who had good knowledge of the disease, glaucoma, complied better than those who had poor knowledge. Furthermore, knowing the name of the disease was significantly associated with good compliance</p> PO Musa, AE Omoti Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 OCULAR FINDINGS IN PATIENTS WITH LASSA FEVER IN IRRUA SPECIALIST TEACHING HOSPITAL, IRRUA, EDO STATE, NIGERIA. <p><strong>Aim:</strong> To determine the ocular findings in Lassa fever patients as well as their usefulness in making diagnosis and predicting mortality in Lassa fever patients.<br><strong>Methods:</strong> A study of patients who presented in the accident and emergency unit, the children emergency room, male and female medical wards, pediatrics and Lassa Fever wards of the Irrua Specialist Teaching Hospital over a six-month period. Consecutive Lassa RT-PCR positive cases and febrile Lassa RT-PCR negative controls were recruited. A structured questionnaire was filled by the survey team for each patient. General and ocular examinations were carried out by the researcher after donning level-4 safety gear, using Snellen’s chart, pen-torch, non-contact Keeler Pulsair tonometer, portable hand held slit lamp bio-microscope, fluorescein strips where indicated, indirect ophthalmoscopy with fully dilated pupils and fundus photography with the Volk Pictor fundus camera.<br><strong>Results:</strong> A total of 29 patients comprising of 19 males (65.5%) and 10 females (34.5%) who tested positive for Lassa RT-PCR were seen over the period. The study showed that more than 80% of the patients had normal presenting visual acuity for distance (6/6 – 6/12). Nearly a quarter (24.1%) had significant adnexal abnormalities such as eye discharge, ptosis, lid oedema and tearing. More than 50% of the cases had diffuse conjunctival injection. Sub conjunctival haemorrhage (3.4%) and circumcorneal injection (3.4%) were also seen. Keratic precipitates were seen on the cornea of 2 cases (6.9%) and bilateral dendritic corneal ulcers in one case (3.4%). Significant retinal findings included flame shaped haemorrhages and retinal oedema. More than 65% of the cases had flame shaped haemorrhages at the macula. One case (3.4%) had a punched out chorio-retinal scar with hyperpigmented borders, pale center and satellite lesions presumed to be an old toxoplasmosis scar. The intra-ocular pressures were less than 10mmHg in 15 patients (79.0%).<br><strong>Conclusion:</strong> Significant ocular findings in Lassa fever patients were IOP less than 10mmHg, discharge, ptosis, tearing, lid oedema, dendritic corneal ulcer, keratic precipitates, retinal haemorrhages, retinal oedema, orange vessels, silver wiring of vessels and flame shaped haemorrhages at the macula. Intra ocular pressure less than 10mmHg, retinal haemorrhages, macular haemorrhages, keratic precipitates were specific in predicting Lassa fever in the study. None of the ocular findings was statistically significant in predicting mortality.</p> AA Alikah, ME Enoch, AE Omoti, CE Omoti, UC Fuh, CO Obasuyi, OO Bamidele, OA Adediran, PO Okokhere Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000 VITAL REGISTRATION PRACTICE OF HOUSEHOLD HEADS IN AN URBAN AND RURAL COMMUMITY IN EDO STATE, SOUTHERN, NIGERIA <p><strong>Aim:</strong> To determine vital registration practice of household heads in an urban and rural community in Edo State, Nigeria.<br><strong>Methods:</strong> A descriptive cross-sectional study was carried out on 1,121 households, comprising 526 households urban (Oluku) and 595 in rural (Awoyemi) communities in Edo State. The respondents were selected by cluster sampling method. Structured, pre-tested, interviewer-administered questionnaire was the tool used for data collection. Data was analyzed using SPSS version 20.0.<br><strong>Result:</strong> Majority of the respondents in the urban and rural communities were between ages 15-64 with mean ages 23.0 (SD = 0.4) and 24.0 (SD = 0.5) years respectively. The proportions of males to females were almost equal 49.6% and 50.4% while married 42.4% and widowed 2.3% were more in rural households. The nuclear family type was more prevalent in urban 427 (86.8%) than in rural with 461 (83.1%). Male household heads were prevalent in both communities. There were more polygamous marriages in the rural, 122 (21.7%) than in urban, 72 (13.2%). Most of the households sizes were between 1–5 members in both communities with mean household size of 2.8 (SD = 0.5) and 4.6 (SD = 0.5) for urban and rural respectively. Vital registrations were generally poor in both communities but better in urban than rural.<br><strong>Conclusion:</strong> Registration of vital events was poor in both communities. There is need to improve on these deficiencies through health education to provide health planners necessary information to improve health care services.</p> BS Ehis, V Wagatsoma Copyright (c) 2020 Wed, 22 Jul 2020 00:00:00 +0000