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In Nigeria, the medical education system faces challenges ranging from inadequate infrastructure to a lack of qualified personnel. These challenges not only affect the competency of graduating medical students but also lead to disruptions in academic calendars. The role of the Medical and Dental Consultants' Association of Nigeria (MDCAN) in addressing these issues is crucial. This review examines the impact of MDCAN in enhancing the competency of graduating medical students and preventing disruptions in academic calendars in Nigeria. It discusses the importance of maintaining academic continuity and explores the reasons why disruptions in academic calendars are not viable options for pressuring the government to improve doctors' and lecturers' welfare packages. Through an analysis of relevant literature, this review underscores the significance of collaboration between stakeholders to ensure the quality of medical education and the smooth functioning of academic institutions in Nigeria. Ultimately, this paper proffers some solutions to mitigate the negative effects of strikes and improve the quality of undergraduate medical education.
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Healthcare started as a one-man business where only the doctor received, reviewed, diagnosed, prescribed, dispensed the treatment, and nursed the patient. There was no regulation, and hence society relied solely on the doctor's morals for appropriate treatment, professional handling of patients, and confidentiality. The doctor was highly regarded in society and was close to royalty. The perceived benefits and lack of external regulation bred charlatans and eroded society's confidence stimulating the development of the Hippocratic Oath. The Hippocratic Oath has progressively evolved in tandem with developments in society to what it is today. From the Hippocratic Oath, medical ethics sprung and evolved. We review several oaths that abound in medical practice and their evolution over the years to what we have today as the Physician's Pledge. We reviewed several articles published in English within ten years based on specified search terms for conformity. The selected articles were screened for relevance to the research topic, and necessary data were extracted. The Oath, though controversial in origin, evolved from a one-liner "primus non nocere" to what it is today, having started as a document heavily influenced by religion to become completely secular. It also transitioned from relying on the physician's morality for compliance to becoming externally enforceable. The transformations of the Oath and Ethics, which could be seen as the compartmentalization of the Oath based on this study, resulted from landmark events in society and changes in religious ideologies and societal morals. The existence of many forms of the Oath was also established. Some of the Oaths were also adapted to suit the morals and beliefs of the areas used. In conclusion, concluded that the "One Oath for All" era is over. We propose an Oath or Pledge that will suit our society to avoid going counter to our laws.
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Introduction: The prevalence of obesity is increasing in sub-Saharan Africa which reflects the current global trend. Epidemiological data have consistently shown a strong relationship between obesity and hypertension in Africans, and this association is stronger for central obesity. The aim of this study was to describe the pattern of overweight/obesity among patients living with hypertension in a tertiary hospital in Enugu, Southeast Nigeria. Methods: This was a cross-sectional study conducted in the Medical Out-Patient Clinic of the Enugu State University Teaching Hospital in Enugu, Enugu State, Southeast Nigeria. Data were analyzed using the SPSS version 22. Results: Data were collected from a total of 450 consenting patients, most of whom 64% (288) were females. The mean body mass index (BMI) was 28.9 ± 6.1 kg/m2 higher in females than males (29.8 ± 6.5 kg/m2 vs. 26.7 ± 5.2 kg/m2, P < 0.001). The gender distribution of classes of obesity showed female preponderance. A little more than one-third of the patients were overweight, whereas about four out of every ten patients were obese. While overweight did not differ significantly across gendeWr (P = 0.67), more feWmales than males were significantly obese (P < 0.001). The age distribution of BMI showed increasing rates of underweight and decreasing rate of morbid obesity with age. About 86.8% of the females had substantially increased waist circumference compared to 26.5% of the males. Overall, 53% of the males and 97.6% of the females have abnormal waist circumferences. Waist-hip ratio was equally abnormal in 89.3% of the study population even though no statistically significant difference was observed across gender. Conclusion: Overweight and obesity are common among patients with hypertension as demonstrated in this study. There is need to set up an aspect of health education which specifically sensitizes the public against the untoward consequences of overweight and obesity.
RésuméIntroduction: La prévalence de l'obésité augmente en Afrique subsaharienne (ASS), ce qui reflète la tendance mondiale actuelle. Les données épidémiologiques ont constamment montré une forte relation entre l'obésité et l'hypertension chez les Africains et cette association est plus forte pour l'obésité centrale. Le but de cette étude était de décrire le schéma de surpoids / obésité chez les patients souffrant d'hypertension dans un hôpital tertiaire à Enugu, dans le sud-est du Nigeria. Méthodes: Il s'agit d'une étude transversale menée dans la clinique de consultations externes de l'hôpital universitaire d'Enugu State University à Enugu, dans l'État d'Enugu, dans le sud-est du Nigéria. Les données ont été analysées à l'aide de la version 22 de SPSS. Résultats: Les données ont été recueillies auprès d'un total de 450 patients consentants, dont 64% (288) étaient des femmes. L'IMC moyen était de 28,9 ± 6,1) kg / m2 plus élevé chez les femmes que chez les hommes 29,8 ± 6,5) kg / m2 contre 26,7 ± 5,2 kg / m2, p <0,001). La répartition par sexe des classes d'obésité a montré une prépondérance féminine. Un peu plus d'un tiers des patients étaient en surpoids, tandis qu'environ quatre patients sur dix étaient obèses. Bien que le surpoids ne diffère pas significativement selon le sexe (p = 0,67), plus de femmes que d'hommes étaient significativement obèses. (P <0,001). La répartition par âge de l'IMC a montré une augmentation du taux d'insuffisance pondérale et une diminution du taux d'obésité morbide avec l'âge. Environ 86,8% des femmes avaient considérablement augmenté le tour de taille, contre 26,5% des hommes. Dans l'ensemble, 53% des hommes et 97,6% des femmes ont des circonférences de taille anormales. Le rapport taille / hanche était également anormal et anormal dans 89,3% de la population étudiée, même si aucune différence statistiquement significative n'a été observée entre les sexes. Conclusion: Le surpoids et l'obésité sont courants chez les patients souffrant d'hypertension, comme démontré dans cette étude. Il est nécessaire de mettre en place un aspect de l'éducation sanitaire qui sensibilise spécifiquement le public aux conséquences fâcheuses du surpoids et de l'obésité.
Asunto(s)
Hipertensión/epidemiología , Obesidad/epidemiología , Adulto , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , PrevalenciaRESUMEN
Background: Topical corticosteroids have had an immense impact in the treatment of skin diseases since their advent and are important in the management of corticosteroid-responsive dermatoses. Triple action creams (TAC) on the other hand are a combination of antibiotics, antifungals and corticosteroids in one cream, in an unspecific bid to target infected dermatoses. The use of TAC has constituted a source of corticosteroid misuse and abuse. This study aims to determine the knowledge, attitude, and prescription practices of TACs among doctors in South-Eastern Nigeria. Methodology: A section of doctors in the five South Eastern states of Nigeria participated in this study. Data was collected using printed or e-copies of pre-tested questionnaires. Information about sociodemographic, steroid classification, the role of TAC, steroid side effects, duration of prescription of TAC, were sought. Statistical analysis was carried out using the statistical package for social sciences version 20. Good knowledge of TAC was set at >65% and poor knowledge <65%. Results: Two hundred and six doctors participated, 59.2% (122) males and 40.8% (84) females. Respondents were distributed as follows: Enugu 28.2% (58), Abia 25.2% (52) Imo 18.4 % (38), Ebonyi 17.5% (36), and Anambra 10.7 % (22). One hundred and seventy-eight (86.4%) work in a tertiary facility while 13.6 % (28) work in primary/secondary facilities. About forty-eight per cent (99) had good knowledge while 51.9 % (107) had poor knowledge. Twenty-five per cent (52) knew that TAC is not useful in managing skin disorders while 66% (136) prescribed TAC as first-line therapy. Conclusion: This study has helped uncover the magnitude of poor knowledge and prescription practice of TAC amongst doctors. To curb topical steroid misuse in a given population, doctors should be re-trained.
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BACKGROUND: Autonomic dysfunction (AD) has been recognized as an important contributor to the poor outcome in chronic kidney disease (CKD) patients. Several studies have reported abnormalities in heart rate variability (HRV) among these patients. OBJECTIVES: To determine the prevalence of Autonomic Dysfunction (AD) in pre-dialysis Chronic Kidney Disease (CKD) patients in a tertiary hospital in South East Nigeria. METHODS: A cross sectional study of eighty chronic kidney disease patients attending the renal unit out-patient in the University of Nigeria Teaching Hospital (UNTH) Enugu was carried out. Forty subjects, drawn randomly, who had no kidney disease served as control. Autonomic function was assessed with non - invasive cardiovascular tests including, measurement of resting tachycardia, orthostatic hypotension, heart rate response (HRR) to standing test, heart rate response to Vasalva manoeuvre and heart rate response to respiration. RESULTS: With the battery of 5 tests used to assess AD, the frequency of autonomic dysfunction in pre-dialysis chronic kidney disease patients was 51.3% compared to 7.5% in the control group. Heart rate response to standing was the most sensitive test to detect AD in this group of subjects. CONCLUSION: AD is a common problem among pre-dialysis CKD patients in Nigeria.