The Nigerian postgraduate medical journal
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Niger Postgrad Med J · Mar 2013
Routine reporting of estimated glomerular filtration rate (eGFR) in African laboratories and the need for its increased utilisation in clinical practice.
Chronic Kidney Disease (CKD) is defined as the presence of markers of kidney damage or of estimated glomerular filtration rate (eGFR)<60 mL.min(-1).(1.73 m2) [<1 mL(-1) (1.73 m2)1 for three months or more. CKD is associated with poor outcomes and high cost, disproportionately affecting the elderly, the Black race and the middle aged in Nigeria. Thus, new public health campaigns focus on early detection of CKD. ⋯ The high cost of treating CKD patients in advanced stages and the low per capital income status of the populace in Sub-Saharan Africa.6. Poor health infrastructure to manage advanced CKD patients in the continent.7. Several studies, now show lack of awareness of CKD among non-nephrologists that is related, at least in part, to difficulty in interpreting serum creatinine concentrations (the reciprocal, non-linear relationship between GFR and serum creatinine).8 Mathematical estimates of GFR [ as in eGFR] that incorporate creatinine concentration, as well as factors affecting creatinine production rates, such as size, gender, age and ethnic background, are more sensitive to changes in renal function than serum creatinine value alone.9 Recent guidelines define "action plans" for CKD according to the GFR, including referral to nephrologists at GFRs<30 mL.min(-1).(1.73 m2).
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Niger Postgrad Med J · Mar 2013
Knowledge of Glasgow coma scale by physicians in a tertiary health institution in Nigeria.
The Glasgow coma scale (GCS) form the basis for important management decisions by the attending physicians or other health personnel in the care of comatose patients. Inaccurate reporting may result in unnecessary treatment and diagnostic tests. The purpose of this study is to assess the knowledge of GCS among physicians in different specialties of training in a tertiary centre in Nigeria. ⋯ Improved training with retention strategies in the use of the GCS and retraining of all physicians involved in the management of the comatose patients should be the focus of future strategic plans.
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Niger Postgrad Med J · Sep 2012
ReviewA review of obesity and orthopaedic surgery: the critical issues.
Obesity is a growing concern in the health community because of the morbidities associated with it. There is a higher occurrence of many orthopaedic conditions among obese individuals than their non-obese counter parts. Obesity also worsens the progression of many of these orthopaedic conditions. ⋯ These contribute to preponderance of musculoskeletal co-morbidities among obese patients. Critical peri-operative issues which include increased cardiopulmonary risks, issues of special equipment, instrumentation, surgical approach, patients' positioning and adjustments in medication should be acknowledged and meticulously addressed in operative management of orthopaedic conditions in obese patients. Surgeries in obese patients are fraught with operative challenges and post-operative complications than in the non-obese and a good knowledge of the critical issues in surgical management of obese patients is necessary to facilitate decision making as well as rendering of effective and efficient orthopaedic care.
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Niger Postgrad Med J · Jun 2012
Gastric precancerous lesions among Nigerians with chronic gastritis.
To investigate the frequency of precancerous lesions in H. pylori gastritis in Nigerians ⋯ Frequency of precancerous lesions is low among Nigerians with H.pylori gastritis. Intestinal metaplasia was the commonest lesion and was mostly type I with relatively low risk for gastric cancer development. The relatively high prevalence H.pylori infection among these cases could have resulted from repeated infection and most were localised to the corpus relative to the antral region where the precancerous lesions were seen.