RESPONSE TO THE COVID-19 OUTBREAK: LESSONS FROM A TERTIARY HEALTHCARE FACILITY IN SOUTHWEST NIGERIA

Background

Mitigating the risk of nosocomial infection is one of the core functions of healthcare managers in hospital environments. This study aimed to describe the COVID-19 outbreak response in a tertiary healthcare facility in Nigeria.

Methods

A qualitative cross-sectional study was conducted among representatives of Heads of Infection Control Committees and units, the Accident and Emergency unit, Family Medicine unit, and Private Suites on the COVID-19 outbreak response at the University College Hospital, Ibadan, Nigeria. Data were analyzed using Colaizzi's phenomenological method.

Results

Overall, seven (six physicians and one nurse) HCWs were interviewed; six (71.4%) males and two (28.6%) females. The average age of the key informants was 45 ± 4.73 years. Four themes were identified. Theme one "Essentials of screening protocol and screening area" described the development of screening protocol, and dedication of a triage area. Theme two "Infection prevention and control within consultation premises" detailed adequate spacing; hand hygiene, use of personal protective equipment; environmental sanitation; and waste management. Theme three "Mounting up surveillance in the response activity" specified communication with the Disease Surveillance Unit; and surveillance activities. Theme four "Training and psychosocial support for staff " described staff training, and provision of psychosocial care to infected staff.

Conclusion

The COVID-19 outbreak measures implemented by the management of the University College Hospital, Ibadan were aimed at ensuring that the hospital does not get overwhelmed by the surge in COVID-19 cases. In order to improve outbreak response in hospital settings, it is important to undertake training, modify hospital practices, and evaluate implemented measures.

The impact of non-closure of the platysma muscle layer on the cosmesis of thyroidectomy scar – a randomised double-blind controlled trial

BACKGROUND: The relevance of closing the platysma muscle layer after open thyroidectomy has received little interest in terms of research. The objective was to determine whether non-closure of the platysma muscle layer after open thyroidectomy impacts significantly on the cosmetic outcome of the resulting collar scar. METHODS: In this prospective randomised controlled clinical trial, patients were assigned randomly to have the platysma muscle layer closed or not closed. The primary endpoint was the cosmesis of the collar scar six weeks after surgery assessed using the patient and observer scar assessment scale (POSAS). Additional endpoints included operation time and early postoperative wound complications. RESULTS: Ninety-two patients were recruited, with 46 randomised to each group. The patient scar assessment subscale (PSAS) of the POSAS showed no significant difference in the scar cosmesis between the two groups six weeks after surgery (median PSAS: 16.5 vs 17.5; p = 0.514). The observer scar assessment subscale (OSAS) showed that the platysma muscle layer closure group had marginally better scars (median OSAS: 15 vs 17; p = 0.045). The size of the goitre did not make any significant difference in the scar cosmesis. There was no significant difference in the incidence of early postoperative wound complications as well as the median operation time. CONCLUSION: Not closing the platysma muscle layer had no significant impact on the scar cosmesis six weeks after open thyroidectomy, with no significant difference in the incidence of early postoperative wound complications and the operation time.

Comparison of percutaneous minimally invasive versus open posterior spine surgery for fixation of thoracolumbar fractures: A retrospective matched cohort analysis

Introduction

Percutaneous minimally invasive spine surgery (MISS) is a treatment option for thoracolumbar fractures and we aim to evaluate its outcomes.

Methods

A retrospective matched cohort study of all patients with thoracolumbar fractures treated with MISS or open posterior approach.

Results

We included 100 MISS and 155 open patients. After controlling for patient characteristics, our results statistically favor MISS in mean operative time, mean intraoperative blood loss, and number of patients requiring postoperative blood transfusions within 48 h.

Conclusions

Advantages of using MISS for treatment of thoracolumbar fractures are decreased operative time, decreased blood loss, and fewer patients requiring transfusions.

Item analysis of university-wide multiple choice objective examinations: the experience of a Nigerian private university

Teachers and Students worldwide often dance to the tune of tests and examinations. Assessments are powerful tools for catalyzing the achievement of educational goals, especially if done rightly. One of the tools for ‘doing it rightly’ is item analysis. The core objectives for this study, therefore, were: ascertaining the item difficulty and distractive indices of the university wide courses. A range of 112–1956 undergraduate students participated in this study. With the use of secondary data, the ex-post facto design was adopted for this project. In virtually all cases, majority of the items (ranging between 65% and 97% of the 70 items fielded in each course) did not meet psychometric standard in terms of difficulty and distractive indices and consequently needed to be moderated or deleted. Considering the importance of these courses, the need to apply item analyses when developing these tests was emphasized.

Magnesium sulphate for treatment of eclampsia: the Nigerian experience

The preliminary result of an ongoing study in 4 major hospitals across Nigeria on the use of magnesium sulphate (MgSO4) as an anticonvulsant in the management of eclampsia is presented. All the 21 obstetric patients with eclampsia (recruited so far) were treated with MgSO4 as the only anticonvulsant. All the patients responded well to the treatment regime in terms of control of fit, and remained conscious thereafter. There was no incidence of severe adverse reactions to the drug. The mean number of convulsions in the patients treated was 4. The observed side effects were nausea, vomiting and dizziness in 3 patients and there were 3 perinatal deaths. The findings so far on maternal and fetal outcomes support the routine administration of MgSO4 as the drug of choice for the control of convulsion in women with eclampsia.