Journal of Medical and Basic Scientific Research

The Role of Intravesical 1% Povidone-iodine in Reducing Open Prostatectomy Surgical Site Infection

2023-08-10T17:32:12-05:00

Background: Surgical Site Infections following open prostatectomy are common and can account for as much as 12 - 36% of post-prostatectomy complications. This study aimed to determine the role of preoperative bladder irrigation with 1% povidone-iodine in reducing surgical site infection following open transvesical prostatectomy. Methods: A prospective randomized study over a period of eighteen months. Sixty patients who met the inclusion criteria were recruited into two groups using a computer-generated random sequence. Study group, A had bladder irrigation with 150mls of 1% povidone-iodine for 10 minutes before surgery, and Control group B had bladder irrigation for 10mins with 150mls normal saline before surgery. The patients were followed up for 30 days for signs of SSI. Results: The incidence of surgical site infections in group A was 6.7% compared to 23.3% in the control group B. There was no statistically significant difference in the surgical site infection rate between the study and control groups. (p =0.145). The overall incidence of surgical site infection was 15.0%. Escherichia coli was the most common organism isolated from the culture of infected wounds (34.0%). Surgical site infection was statistically associated with age (p=0.044); higher estimated blood loss (p=0.032) and duration of hospital stay (p < 0.001). Conclusion: There was less incidence of surgical site infection in the patients who had pre-operative 1% povidone-iodine bladder irrigation compared to controls, though the magnitude was not statistically significant. The use of 1% Povidone- iodine for pre-operative bladder irrigation in patients undergoing open transvesical prostatectomy may reduce the incidence of postoperative surgical site infection. A larger study is required to confirm the validity.

An Audit of Patients' Perception of Urology Outpatient Services in a Nigerian University Teaching Hospital

2023-08-10T08:59:52-05:00

Background: There is increasing recognition that patients' perceptions and experience of healthcare service delivery by medical personnel are important indicators of satisfaction from the care received, subsequent attendance at follow-up visits, and referrals of friends and family. The goals of this study were to determine the reasons for patients' attendance at our outpatient urology clinic, and satisfaction level to ultimately help develop measures to improve the service. Methodology: This study was done in the outpatient urology clinic of a teaching hospital. A cross-sectional descriptive study involving all patients attending the urology outpatient clinic. The patients completed pre-tested questionnaires following consultation with a urology consultant or senior registrar. The data obtained was analysed using the international business machines, statistical package for social sciences (IBM-SPSS) version 25. Results: There were 142 patients who completed the questionnaires; of which 45.2% were follow-up visits, 25.2% for change of catheter, 14.3% for first clinic appointments, 4.8% for hormonal injections for cancer, 4.8% for wound dressing, and 2.4% for other unspecified reasons. The clinic schedule was convenient for 90.9%. There was a perception of a long delay before seeing the doctor by 61.8%. However, 97% felt the reception team was friendly. All the patients (100%) reported that the consultation process with the doctors and nurses met their expectations. About 94.1% were likely to return for follow-up visits while 93.9% were likely to refer a friend or family member to the clinic. Conclusion: The patients attended the urology clinic for a variety of reasons, the commonest being for a change of catheter. All the patients reported a satisfactory level of experience, though a significant majority reported delays. However, only a few were unlikely to attend follow-up visits or not refer a friend or family member.

Quality of Life as a Predictor of Childhood Cancer Treatment Abandonment

2023-06-26T10:14:47-05:00

Background: Childhood cancer comes with a huge burden of medical and economic consequences on the child and family. The toxicities associated with treatment cause increased morbidity, and impact on their quality of life. This study set out to compare the quality of life of children adhering to cancer treatment versus children who abandon treatment using the Lansky Play Performance Scale score indices. Methodology: The study was a prospective, hospital-based survey in two tertiary paediatric oncology centres in north-western Nigeria conducted between February–August 2022. Consecutive patients registered for cancer treatment were enrolled, and data depicting demography, pathologic diagnosis and treatment outcome was collated. Cases without a confirmed histologic/cytologic diagnosis of cancer were excluded. The Lansky Play Performance Scale (LPPS) was used to assess the quality of life, and categorized as fully active, normal (score 100, Group I); mild restriction (score 70-90, Group II); moderate restriction (score 50-60, Group III); severe restriction (20-40, Group IV) and disabled (score 0-10, Group V). Results: There were 51 patients in the study, aged 1-16 years (mean 7.2+3.8), male: female ratio 1.4:1. There were 12(23.5%) leukaemia, 11(21.6%) retinoblastoma, 10(19.6%) lymphoma, 9(17.6%) rhabdomyosarcoma, 6(11.8%) nephroblastoma, 2(3.9%) neuroblastoma and 1(2.0%) carcinoma cases. Treatment-related adverse events occurred in 20(39.2%) patients. The LPPS scores were: Group I - 15(29.4%), Group II - 18(35.3%), Group III - 4(7.8%), Group IV - 13(25.5%), Group V - 1(2.0%). There were 33(64.7%) patients on follow-up, 10(19.6%) mortalities and 8(15.7%) cases of abandonment. In the abandonment category, 4(50%) were LPPS Group I, 3(37.5%) Group II and 1(12.5%) Group III. In addition, 6(75%) had no change in LPPS, while 1(12.5%) each had a positive change and negative change respectively. The risk of abandonment was not statistically significant based on LPPS.Conclusion: The study found that treatment abandonment was commoner among patients with normal or mild impairment of play activity.

Osteoid Osteoma of the Oral and Maxillofacial Region: Report of Two Cases

2023-07-24T02:22:57-05:00

Background: Osteoid osteoma frequently affect long bones such as femur and tibia but seldomly affect jaw bones. It is neither locally aggressive nor does it have the potential for malignant transformation. Reports suggest that it occurs in young adults below 30 years of age. Case presentations: We document and discuss 2 cases of osteoid osteoma, one, a 22-year-old with a giant lesion on the right maxillary region, partially occluding the vision. The patient complained of associated pain. The second patient, a 25-year-old female presented with a mandibular swelling of about 1 cm which was also associated with pain. These two patients had temporary relief of their pain by ingestion of analgesic. They both had uneventful surgeries. Conclusion: We documented and discussed 2 cases of Osteoid osteoma on the maxillofacial region in young patients with both of the cases almost occluding the patient's vision

Comparison of Artesunate and Ivermectin on the Treatment of Mild COVID -19 Infection in Kaduna State, Nigeria

2023-03-13T16:10:40-05:00

Background: At the outbreak, there was no specific therapeutic agent for the management of the novel Corona Virus Disease 2019 (COVID-19). Several agents have been tried in different countries with varying outcomes. Ivermectin an anti-parasitic agent was found to be effective in the management of mild COVID-19 infections. Artesunate, being a semisynthetic derivative of artemisinin, an antimalarial drug is suggested to be effective in the treatment of COVID-19. The study was carried out to compare the effect of Artesunate and Ivermectin in the treatment of mild COVID-19 cases in Kaduna state. Methodology: It was a comparative cross-sectional study conducted among 40 mild COVID-19 cases enrolled for the study in the 3 isolation centers between 15/09/2020 to 14/12/2020. The outcome variables viral clearance and resolution of symptoms from the onset at the commencement of the treatment regimens. Data were collected from patients' folders using a questionnaire and were analyzed using SPSS 26 and level of significance at P < 0.05. Results: A total of 40 patients were enrolled in this study. 16 patients managed on Artesunate with a mean age of 40.37±3.79 (95%CI= 32.79-47.95) while 24 on Ivermectin 33.58±2.39 (95%CI= 28.8-38.36. There were 7 males (43.8) and 9 females (56.2) on Artesunate. There were statistically significant differences between respondents' ethnicity, religion and occupation and the type of regimen. Fifteen (93.8%) on Artesunate have symptoms comparable to twenty-two (91.7%) on Ivermectin and there was no significant statistical difference. Symptoms ranged from fever, anosmia, and cough. At Day 7 of the commencement of therapy, 14 (87.5%) patients on Artesunate tested negative to COVID-19 PCR compared to 20 (83.3%) of the Ivermectin group. Bivariate analysis revealed no significant difference in symptom resolution and viral clearance between the two groups. However, patients on Artesunate reported side effects on the first and second day of treatment, ranging from dizziness and nausea while none among the Ivermectin group. Conclusion: Artesunate plus standard care in the management of COVID-19 was not found to have any difference from the use of Ivermectin plus standard care. It was however noticed to present more side effects.