Annals of Clinical Sciences

DISSATISFACTION AND UNDEREMPLOYMENT: PRE-EMPTIVE PERCEPTIONS IN NIGERIAN YOUNG HEALTH PROFESSIONALS – A CRISIS OF THE EMERGING WORKFORCE?

THERESA JOHN — 2025-07-30

Background: Within the Nigerian Health Sector, underemployment and dissatisfaction are recognised push factors of brain drain amongst health workers. These factors have not been adequately considered in the emerging workforce that continues to be lost to migration even before work experience in Nigeria. We wanted to know if graduating young health professionals (YHPs) harbour perspectives of underemployment and dissatisfaction.
Methodology: Graduating YHPs: doctors—181 students, dentists—16 students, nurses—60 students, physiologists—58 students, and pharmacologists—53 students; a total of 368 students of Lagos State University College of Medicine (LASUCOM) were survey respondents in this descriptive survey using a five-point structured Likert scale questionnaire in two successive academic sessions, 2021/2022 and 2022/2023. Statistics of coded data were done with Microsoft Office 2013 Excel® spreadsheet and Statistical Product and Service Solution package (IBM SPSS Statistics 27®) to obtain descriptive statistics, correlation, and graphs.
Results: The majority of students (>60%) were educated in entrepreneurship through the curricular ENT
202 and ENT 302 courses, and 25.5% indicated interest in studying business later. The emerging workforce
from LASUCOM has preemptive perceptions of both dissatisfaction and underemployment, with the most
frequent responses to indicators of either variable being agree (coded 4). The YHPs’ strongest dissatisfaction
is that many financially endowed patients prefer to go abroad for treatment, with a skewness of -0.863 ±
0.131 towards agree—strongly agree. The YHPs’ highest leaning towards agree-strongly agree amongst
underemployment indicators is for “I do not know excellent places wherein I would like to work in Lagos
State,” with a skewness of .240±.131. The highest sum of coded responses for underemployment, 1111, is
for “I do not know famous health professions specialists working in Lagos State that inspire me.”
Conclusion: The YHPs investigated in this study, an emerging workforce, have not yet been exposed to proper employment nor acquired work experience within Nigeria as professionals but harbour preemptive perspectives of underemployment and dissatisfaction.

ALBUMINURIA AND REDUCED RENAL FUNCTION IN HYPERTENSIVE PATIENTS IN SOUTHERN PART OF NIGERIA

Augustine Onovuakpo Eguvbe — 2025-07-30

Background: Hypertension is the most important risk factor of cardiovascular disease. Other known risk factors of cardiovascular disease such as microalbuminuria and low estimated glomerular filtration rate (eGFR) are prevalent in hypertension. Reduced kidney function and microalbuminuria have been independently associated with a higher cardiovascular mortality risk.

Methods: This was a cross-sectional hospital-based study carried out among three hundred individuals made up of two hundred hypertensives and one hundred normotensive controls between October 2022 and January 2024 at the Delta State Central Hospital, Warri.

Results: The mean age and standard deviation of both groups were 58.23 ± 13.07 years and 43.78 ± 10.68 years respectively. The hypertensives were significantly older than the controls (p < 0.001). The hypertensives included 147 (73.5%) females and 53 (26.5%) males while the controls included 47 (47.0%) females and 53 (53.0%) males. The difference in sex distribution was statistically significant (p = 0.007). The mean urine albumin-to-creatinine ratio (UACR) was significantly higher in the hypertensives than in the controls (1.02 ± 1.42 vs. 0.28 ± 0.16 mg/mmol respectively, p < 0.001). Thirty (15.0%) of the hypertensives compared to 0 (0.0%) of the controls had microalbuminuria. There was a statistically significant difference between the two groups (p = 0.046). One hundred and forty-seven (73.5%) of hypertensives had normal renal status, while 53 (26.5%) had impaired renal function (eGFR< 60mls/m²/min). In contrast, 92 (92.0%) of controls had normal results, while 8 (8.0%) had impaired renal function. The difference in the two groups was statistically significant (P= 0.004). In the hypertensive group, UACR and eGFR were negatively correlated (r = -0.141). This correlation was statistically significant (p = 0.046).

Conclusion: Albuminuria and impaired renal function were significantly higher in the hypertensives than in the controls. Albuminuria was negatively correlated with kidney function in the hypertensive group.

PERCEPTION, ACCEPTANCE, OWNERSHIP AND USE OF INSECTICIDE TREATED NETS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINICS IN PRIVATE HOSPITALS IN IFAKO-IJAIYE LOCAL GOVERNMENT AREA OF LAGOS STATE, NIGERIA

Modupe Akinyinka — 2025-07-30

Background: The use of insecticide-treated mosquito nets is a practical and valid tool for the prevention of malaria globally and is a key intervention among pregnant women in Nigeria. There is a lack of data about ownership and use of these nets in women receiving antenatal care at private clinics. This study was conducted to assess the perception, acceptance, ownership and use of insecticide treated nets (nets) among pregnant women attending antenatal clinics in private hospitals in Ifako-Ijaiye local Government Area of Lagos State.

Methodology: The study was descriptive and cross-sectional in design. Based on the calculated sample size, 420 pregnant women aged 18-49 years were selected via multi-stage sampling from 15 private hospitals in Ifako-Ijaiye local government area in 2022. Data was collected using a self- administered questionnaire. Univariate and bivariate analysis were conducted and chi-square test was used to test for association between categorical variables.

Results: Over half of the respondents (53.8%), had a positive perception of net usage. However, a large proportion of the respondents (78%) were willing to accept the nets if given for free. A third of respondents (33%), owned a net and 68.6% of these used the nets. The most common reason for not using a net even when in the possession of respondents was that the net was worn out (63.6%). Respondents’ level of education (p= 0.039) and occupation (p= 0.000) were significantly associated with the utilization of nets.

Conclusion: Insecticide treated net ownership and utilization is still low in Lagos, frequent and free distribution of nets with education and empowerment of women are recommended to improve the situation.

A COMPARATIVE, RANDOMIZED AND CONTROLLED TRIAL OF THE EFFECTIVENESS OF ORAL KETAMINE AND ORAL MIDAZOLAM IN PAEDIATRIC DENTAL SEDATION

Oluwaseun Oladokun — 2025-07-30

Background: Dental anxiety among children can lead to uncooperative behaviours which can compromise treatments. Employing sedation for anxiolysis can reduce uncooperative behaviours, facilitate provision of prompt and adequate care to children. This study was designed to compare the effectiveness of oral ketamine and oral midazolam as sedatives among children undergoing elective dental treatments.

Methodology: A total of one hundred and four (104), ASA I and II patients between the ages of 3 – 9 years, were randomized into two groups of 52 patients each. Group A patients received ketamine 7.5 mg.kg-1 orally, while group B patients received midazolam 0.75 mg.kg-1. The intravenous forms of both drugs were formulated in apple juice and administered par oris. After achieving Ramsay sedation score (RSS) 3, all the patients receive IV paracetamol 15 mg.kg-1 through a previously identified vein to which EMLA cream was applied. Pain score during cannulation was assessed using the FLACC scoring system.

Results: The time to achieve a Ramsay sedation score (RSS) 3 was faster among the patients in the ketamine group versus midazolam group (24.25 ± 5.55 min versus 28.79 ± 5.75 min, respectively) p<0.001. Behaviour of the patients was better in the midazolam group (p=0.026). Time to respond to stimulus in the recovery room was similar between the two groups (p=0.867). While the mean discharge time was shorter in the midazolam group than the ketamine group (62.81 ± 13.64 and 78.46 ±14.48 min respectively); p<0.001. Midazolam had fewer side effects than ketamine; vomiting (0% vs 15%), hypersecretion (0% vs 17.3%), Nystagmus (0% vs 26.9%), somnolence (5.8% vs 28.8%) and crying (5.8% vs 9.6%).

Conclusion: Both agents were effective in providing favourable conditions for dental treatments. However, midazolam demonstrated superior behavioural outcomes, shorter discharge times and better side effect profile, thereby favouring its choice in outpatient paediatric dentistry.

TIME OF HOSPITAL PRESENTATION OF ADULT PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES AND IMPACT ON CLINICAL OUTCOME – A SINGLE CENTRE STUDY

Ishau Muhammad Dirisu — 2025-07-30

Background: Haematological malignancies cause significant morbidity and mortality and are not uncommon in resource-limited-low-income countries. However, the types, pattern of presentation and treatment outcomes vary across regions. We assessed the time of hospital presentation with the haematologist and its impact on survival over a period of three years.

Methodology: This longitudinal study evaluated patients who presented with haematological malignancies between 2021–2024 at the Delta state University Teaching Hospital (DELSUTH), Oghara. Haematological malignancies were categorized as either early or late presentation based on available staging systems.

Results: One hundred and thirty-two patients were evaluated. Males were affected more and patients aged 55-64 years were mainly affected. 43.9% of the patients presented late with advanced stage of disease. Of all the cancers, chronic lymphocytic leukaemia was the most prevalent (20.4%). 70.7% of patients who presented late died during the period of the study and the commonest cause of death was chronic lymphocytic leukaemia (24.6%). There was significant association between time of presentation and mortality (p<0.001).

Conclusion: We found an association between time and stage of presentation and survival. Patients who presented late had a worse stage of the disease and the outcome was poor.

EVALUATION OF DRY EYES IN USERS OF DIGITAL ELECTRONIC GADGETS

Modupe Medina Balogun — 2025-07-30

Background: To investigate the association between the use of digital electronic gadgets and dry eye disease, and to provide recommendations for preventing dryness while using these devices.

Methodology: A hospital-based cross-sectional study was conducted at the Lagos State University Teaching Hospital (LASUTH) among 295 participants aged 7-69 years. Participants were administered the Ocular Surface Disease Index (OSDI) questionnaire and were examined for dry eyes using the Schirmer’s test, Tear Break-Up Time (TBUT) and corneal fluorescein staining. Data analysis was done using SPSS version 27, with multivariate regression to correlate the type and duration of digital electronic device usage with dry eye disease.

Results: A total of 295 respondents participated in the study, with 62.4% being female. The mean age of participants was 30-39 years. Smartphones were the most commonly used digital device (98.6%), and more than half of participants (55.9%) spent 10 hours or more daily on screens. A significant association was found between prolonged screen time and abnormal Schirmer’s tests (38%), reduced TBUT (42%), and increased corneal fluorescein staining (47.5%). Females had more dry eye disease symptoms than males. The OSDI score showed that more than half of the participants (65.4%) experienced varying severity of dry eye symptoms, and prolonged screen time (10 hours or more) increased the severity.

Conclusion: Prolonged use of digital devices correlates significantly with the presence of dry eye symptoms, particularly amongst females and prolonged users. Advocacy and preventive strategies such as following the 20-20-20 rule, using screen filters, and adjusting brightness, are recommended ways to reduce the ocularsurface effects of digital screen use.

HEPATOPROTECTIVE ACTIVITY OF HYDROETHANOL EXTRACT OF CURCUMA LONGA LINN. ON PARACETAMOL AND CARBON TETRACHLORIDE-INDUCED HEPATOTOXICITY IN RATS

Omoniyi Kayode Yemitan — 2025-07-31

Background: Curcuma longa Linn. is extensively used for its culinary and ethnomedicinal properties, which include claims of prevention and treatment of hepatic diseases. However, there are limited studies on the effectiveness of C. longa on drug and chemically-induced hepatotoxicity; thus, we evaluated the anti-hepatotoxic effects of doses of the hydroethanol extract of C. longa L. (HECL) using Paracetamol (PCM) and Carbon tetrachloride (CCl₄) models.

Methodology: This study was conducted on forty rats randomly divided into PCM and CCl₄ models of four study groups each (n=5). For the PCM model, Group I: Normal saline (NS, 10 ml/kg, p.o. ); Group II: PCM (600 mg/kg, p.o.) & 3 ml/kg NS; Group III & IV: PCM & HECL (200 & 400 mg/kg, respectively, p.o.); while the CCl₄ model, Group V: Olive oil (10 ml/kg, i.p.); Group VI: CCl₄ (15 ml/kg. of 20% v/v, i.p.) & olive oil; Group VII & VIII: CCl₄ & HECL (100 & 300 mg/kg, respectively, p.o.). HECL was administered at 2, 6, and 10 h post-induction. Following euthanizing, blood samples were collected for liver function tests: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and uric acid levels were measured, while liver was excised for histopathology was assessed via hematoxylin and eosin staining.
Results: In the PCM model, HECL (200 and 400 mg/kg) significantly reduced ALT and uric acid (p<0.05), with 400 mg/kg showing superior efficacy. AST reductions were non-significant. In the CCl₄ model, CCl₄ significantly increased ALT, AST, and uric acid (p<0.05). HECL (100 and 300 mg/kg) significantly lowered these biomarkers (p<0.05), with 300 mg/kg more effective.
Conclusions: HECL elicited remarkable hepatoprotective effects, likely due to apoptotic restoration and cytosolic restoration, thereby supporting its use in ethnomedicine for prevention and treatment of liver diseases.

BACTERIOLOGY PROFILE OF DIABETIC FOOT ULCERS IN A TERTIARY HEALTHFACILITY IN NORTH CENTRAL NIGERIA

JONES UWAKWE — 2025-07-31

Introduction: Diabetes mellitus is a chronic metabolic disorder that is characterized by hyperglycemia as well as the potential of developing chronic complications such as retinopathy, nephropathy and neuropathy. One of such chronic complications is the diabetic foot ulcer, which is an important cause of morbidity and mortality. The presence of infection contributes to the chronicity of such diabetic foot ulcers. Therefore, an understanding of the kinds of organisms that may be encountered in such ulcers as well as the appropriate antimicrobial treatment approach is essential in the management of foot ulcers in diabetes mellitus.

Methodology: This was a retrospective cross-sectional study that reviewed the medical records of patients admitted with diabetic foot ulcers into the Dalhatu Araf specialist hospital, Lafia, Nasarawa State, Nigeria between 2017 and 2022. Data such as age, sex, species of bacteria cultured from foot ulcer and their antibiotic sensitivity patterns were extracted and entered into pre designed proforma. Statistical analysis was done

using the SSPS statistics software version 23.0.

Results: The prevalence of diabetic foot ulcer was determined to be 19.5%. Bacteria were isolated via culture from only 34.9% of foot ulcers, and Escherichia coli was the predominant bacteria isolated (54.5%). It showed high level of sensitivity to ciprofloxacin and chloramphenicol.

Conclusion: The findings of this study didn't exactly mirror the findings in similar studies done within Nigeria and in other parts of the world. This reflects the fact that the predominant bacteria cultured from diabetic foot ulcers may vary from location to location, depending on factors such as variations in the type and regimens of antibiotic therapy in persons living with diabetes mellitus.