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Background: The prevalence of acute coronary syndrome (ACS) in Nigeria is on the rise with dire morbidity and mortality risks. Cardiac biomarkers are rapid and sensitive tools used as adjunct in the diagnosis of ACS. The clinical utility of cardiac biomarkers is yet to be well explored in Nigerian setting. Objectives: To determine the indications and clinical utility of cardiac biomarkers as well as their electrocardiographic (ECG) changes. Methods: This study is a retrospective review of all patients who had point-of-care serum Troponin-I, Creatine kinase MB isoenzyme and myoglobin done at the medical emergency department of LASUTH over a three year period (January 2017 to December 2019). Their records were retrieved; demographics, indications for testing and ECG findings were recorded. Data was analyzed using SPSS version 20.0 software. Results: 593 tests were done in the 3 years period of study. Only 397 patients had complete records. 48.6% were male. The mean age of the study population was 55.02 + 16.64 years (range 13-94 years). Chest pain was the commonest indication for test (91%). Other indications are loss of consciousness, palpitations, seizures and unexplained dyspnea. Mean duration of chest pain prior to presentation was 9 days. 16.1% (64 patients) of patients tested had elevated cardiac biomarkers and 87.5% of those with elevated cardiac biomarkers had abnormal ECG suggestive of ACS. Conclusion: This study showed that cardiac biomarker is an important point-of-care test in the evaluation of chest pain. Cardiac biomarkers should therefore be a routine test in the emergency room.

Objectives: The understanding of antimicrobial utilization patterns is pertinent to successful implementation of the National Action Plans on Antimicrobial Resistance (AMR). There is, however, limited information on antibiotics utilization in Nigeria. This study was undertaken to build on existing information and provide direction for appropriate interventions including Antibiotics Stewardship Programs (ASP). Method: A Point Prevalence Study (PPS) was conducted in two public urban health facilities in Lagos, Nigeria using a design adapted from the European Center for Disease Prevention and Control (ECDC) and Global-PPS surveys. Results: The prevalence of antibiotics use was 80.6% administered mostly parenterally (83.1% of total prescriptions) with concerns with extended surgical antibiotics prophylaxis. The mostly used antibiotics in the secondary hospital were parenteral metronidazole (32.4%), ceftriaxone (27.5%), and amoxicillin + clavulanate (8.2%) while the mostly used in the tertiary hospital were ceftriaxone (25.3%), parenteral metronidazole (19.1%), and amoxicillin + clavulanate (9.3%). There was an appreciable lack of specific functional capacities, policies, and processes to promote appropriate antimicrobial use in both hospitals. Conclusions: There is high rate of antibiotics utilization in these facilities with lack of institutional frameworks and processes for ensuring appropriate antibiotic use. The study provides the information needed to improve future antimicrobial use in hospitals and reduce AMR.

Background: The prevalence of diabetes is on the increase worldwide. Type 2 diabetes is the most common form of diabetes and is characterized by disorders of insulin action and insulin secretion; any of these two abnormalities may be the predominant feature of the disease. The aim of the study was to review the drug treatment of patients with type 2 diabetes attending a follow-up clinic. Materials and Methods: The study took place at the outpatient clinic of a tertiary health center among patients attending a follow-up clinic. The study design was a descriptive cross-sectional review of the use of antidiabetic medications among adult males and females with type 2 diabetes. Results: A total of 235 participants took part in this study. 64.3% were females; the average age of the participants was 60.7 years with an age range of 20–88 years. This study showed metformin as the most commonly prescribed medication among the participants. Almost two-thirds of the participants were diagnosed with diabetes after they had developed symptoms or complications of diabetes. The proportion of participants with fasting blood sugar at the target level was 54.5%. Conclusion: In conclusion, this study revealed that metformin is the most commonly prescribed antidiabetic medication among the participants; almost two-thirds of the participants were detected to be diabetic after they have either developed symptoms or complications of the disease. Fasting blood sugar was at target levels in more than half of the participants.

Context: Hypertension is a disease of global public health importance affecting an estimated 1 billion people worldwide. Hypertension accounts for about 10.4 million deaths in 2017. Many guidelines are available for the management of hypertension, but despite this, there are wide variations in physicians' choice of antihypertensive medications for blood pressure (BP) control. Aims: We reviewed the prescription pattern of antihypertensive medication and the level of BP control in patients with hypertension. Settings and Design: This is a cross-sectional study among hypertensive patients attending follow-up clinics of a tertiary hospital. Methodology: Structured questionnaires were used to collect information on the antihypertensive medications and clinical profiles of the study participants. Questionnaires were administered to participants during the attendance of the follow-up clinic to capture information relevant to the study. Information retrieved from patients includes details about their baseline demographic characteristics, clinical history, antihypertensive drug history and blood BP recordings. The study protocol was reviewed and approved by the institutional ethics committee. Statistical Analysis: Data were analysed using Microsoft Excel 2003 and the Statistical Package for the Social Sciences version 22.0 software. Results: A total of 489 hypertensive patients took part in the study. The study found that the rate of BP control was 44.6% among the participants. Calcium channel blockers (CCBs) are the most common antihypertensive medication prescribed in our clinics. There was no significant relationship between how long a patient had been attending the follow-up clinic and the level of BP control in patients who have attended the clinic for a minimum period of 3 months. Conclusion: BP control was less than optimal in more than half of the participants, and the most commonly prescribed antihypertensive medication were CCBs.

Purpose: Dietary modification in association with life style changes is important in the management of the diabetes. Cereals account for as much as 77% of total caloric consumption in most African diets. Corn which is the largest cultivated cereal crop in Nigeria is prepared as a meal in many forms. The objective of this study was to assess the glycaemic responses to different preparations of corn meals. Material and Method: The design was a quasi-experimental with a total of 32 participants, 16 subjects with type diabetes and 16 age-and sex-matched non-diabetic control subjects. After an overnight fast, the participants were given corn meals to eat and had their blood sample collected every 30 minutes for over a 2 hour period for the assessment of blood sugar level and estimation of glycaemic responses. This was repeated weekly till the glycaemic index (GI) and plasma sugar level response to the different test corn meal preparation, such as boiled corn, roasted corn, pap and cornflakes had been assessed. Results: All the different corn meal preparations had high GI, with corn flakes having the highest GI and pap the lowest. The GI for the corn meals in the non-diabetic were; pap 71.7±14.4%, roasted corn 76.5±14.9%, boiled corn 82.2±14.9% and cornflakes 88.1±14.4%. Discussion: Methods of preparing a meal from corn affect glycaemic response. Turk Jem 2015; 19: 79-82

Antimicrobial agents are reported to be the commonest prescribed medication among physicians. Studies have shown that up to 50% of antimicrobial agents prescriptions are inappropriate. The study was a retrospective cross-sectional design. Records of all patients admitted to both the medical and paediatrics wards during the period of audit were reviewed after discharge from the hospital. The appropriateness of the prescribed antimicrobial agents given to them was determined by a microbiologist who was independent of the team that managed the patients. More than 50% of antimicrobial agents prescribed for our inpatients were inappropriate. The most common test done to investigate infections in these patients was complete blood count and the most common class of antimicrobial agents prescribed was cephalosporin. Based on the outcomes of this study we recommend constituting a drug and therapeutics committee to develop an antimicrobial stewardship policy and the guideline for implementing the policy for a more rational use of these agents. Key words: Antimicrobial agents, physicians, prescriptions.

Background Research on human subjects is a public trust; therefore, there is a need to ensure that research coming out of Africa is conducted to the highest ethical standards. Ethics codes ensure that participants in research projects are treated with dignity and respect while they contribute to the social good. History of past abuse of human participants in research and the need for a body to be responsible for ensuring adherence to the principles of ethics in clinical research has necessitated the formation of ethics committees. This study assessed the knowledge of resident doctors, who are medical specialists in training, on their understanding of ethical issues involved in clinical research and their perception of the working and operations of ethics committees.

BACKGROUND Medication errors are preventable causes of patient harm with significant contributions to adverse drug events but they remain understudied in Nigeria. OBJECTIVES To estimate the prevalence of self-reported medication errors among health professionals and examine their knowledge of medication errors with the hope of identifying appropriate measures to promote medication safety. METHODS A cross sectional survey among doctors, pharmacists and nurses in 10 tertiary hospitals. Information was obtained using a self-administered structured questionnaire. Correct responses evaluating the knowledge of prescription, dispensing and administration errors were scored one mark each and the composite scores computed. Appropriate statistics were applied to summarize and establish the relationship between variables at 5% level of significance using SPSS 17.0. RESULTS A total of 2,386 professionals participated in the study (46.3% nurses, 44.9% doctors, 8.8% pharmacists).The prevalence of self-reported medication errors was 47%.The professional groups differ in their knowledge of all the aspects of medication errors with professional cadres influencing knowledge.Overwork was the most reason for being error prone (59.2%) and only 35.5% had ever reported medication error. 33.4% did not think reporting was necessary. CONCLUSIONS The prevalence of medication errors is high among health care professionals in Nigeria. Knowledge gaps and practice deficiencies were identified requiring interventions.

Background: Prostate cancer is the most common cancer among Nigerian men and the second most common cause of death from cancer in men worldwide. The aim of this study was to assess the level of awareness of prostate cancer among men attending the various outpatients’ clinics of the Lagos State University Teaching Hospital, Ikeja. Materials and Methods: This study is a descriptive cross‑sectional study. Self‑administered structured questionnaires were used to collect information from consecutives patients attending the various outpatient clinics of the hospital. Results: One hundred and forty‑six respondents with an age range of 40–80 years participated in this study. Sixty‑nine (47.3%) respondents were aware of prostate cancer while 77 (52.7%) have never heard of the disease. Twenty (13.7%) participants were aware of the availability of a screening test for the disease and only 12 (8.2%) have had any form of screening for prostate cancer. Conclusion: There is a low level of awareness of prostate cancer among patients seen at our center and also level of voluntary screening for the disease is low.Keywords: Awareness, Lagos, Nigeria, prostate cancer

Epilepsy is a common neurological disease affecting almost 50 million people worldwide, about 40 million of those affected live in developing countries.A cross-sectional descriptive study of 120 subjects, a structured questionnaire was administered on adults 18 years and above. Information was obtained about patients' baseline characteristics, estimated monthly income and determinants of adherence. Adherence to the AEDs was categorised as good, moderate or poor. Good adherence was recorded in 70% of participants, 26.7% had moderate adherence in 26.7% and poor in remaining 3.3%. Education was statistically significantly associated with adherence (ᵡ213.092, p=0.01). Adherence rate among patients in this study was high despite poor control of seizure.

We studied the practice of malaria prevention and treatment in pregnancy of 394 private medical practitioners in Lagos State, Nigeria using a self-administered pre-tested structured questionnaire. Only 39 (9.9%) respondents had correct knowledge of the World Health Organization (WHO) strategies. Malaria prophylaxis in pregnancy was offered by 336 (85.3%), but only 98 (24.9%) had correct knowledge of recommended chemoprophylaxis. Of these, 68 (17.3%) had correct knowledge of first trimester treatment, while only 41 (10.4%) had knowledge of second and third trimester treatment. Only 64 (16.2%) of respondents routinely recommended use of insecticide-treated bed nets. The most common anti-malarial drug prescribed for chemoprophylaxis was pyrimethamine (43.7%); chloroquine was the most common anti-malarial prescribed for both first trimester treatment (81.5%) and second and third trimester treatment (55.3%). The study showed that private medical practitioners have poor knowledge of malaria prophylaxis and treatment in pregnancy, and the practice of most do not conform to recommended guidelines.