Medicine- Conference papers

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Browsing Medicine- Conference papers by Author "Adigun, A"

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    Open Access
    Clinical audit of the process of diabetes mellitus foot syndrome prevention in Lagos, Nigeria
    (Endocrine and Metabolism Society of Nigeria, 2010-09) Adigun, A; Okunromade, L; Ohwovoriole, A; Fasanmade, O; Onung, S
    BACKGROUND: Diabetes mellitus foot syndrome (DMFS), places a great burden on the patient. If the right preventive measures are put in place, this burden can be reduced to the barest minimum. It is in line with this goal that this clinical audit was conducted with emphasis on process of preventing DMFS in LUTH Nigeria. OBJECTIVE: To determine if the process of preventing DMFS in LUTH is adequate. SUBJECTS, MATERIALS AND METHODS This is a clinical audit involving patients living with diabetes mellitus who are attending the diabetic clinic of LUTH Nigeria. Subjects were selected from consecutive weekly diabetic clinics and interviewed using a questionnaire prepared by the investigator. Data collected was analyzed using Epi-info version 3.5.1. A total of thirty-seven (37) patients have so far been recruited in this pilot study. RESULTS: 88.9% of the patients were found to have had formal education on diabetes mellitus and its complications. In the past one year 33.3% of the patients have had their feet examined by a doctor while 94.4% have never had a Doppler done in the past. 88% of the patients have never had a monofilament test done on them and 97.2% have never been examined for vibration sense CONCLUSION: There is need for more efforts to be channeled towards the clinical examination of our diabetic patients with the sole aim of reducing the burden of diabetes mellitus foot syndrome in Lagos. Efforts directed at diabetic education appear adequate.
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    Open Access
    Outcome of Diabetes mellitus Admissions in Elderly Nigerians- A chart Review from January, 2009 through December, 2009.
    (2010-09) Ogedengbe, O.S; Adigun, A; Fasanmade, O; Ohwovoriole, A
    Background: Aging is associated with important metabolic changes, making the elderly a special group of people requiring a special care for their medical conditions. Aim: To determine the reasons for admission and outcome of such admissions in elderly persons with diabetes mellitus. Method: The records of the medical wards of the LUTH were obtained for the period of January, 2009 to December, 2009 and analyzed with outcome being mortality and number of discharges made. Analysis was done with excel. Results: Of 1200 admissions for the review period, 9.3% (112) were diabetes related admissions. Elderly persons with diabetes (aged ≥ 60 years) made 59.8% (67) of diabetes related admissions [mean age of 69.2 ± 7.1 years. The male to female ratio was 1.7:1. Diabetes related mortality in the elderly was 16.4% TABLE 1: Reasons for Admission and Outcome of Admissions in Elderly Persons living with Diabetes REASONS FOR ADMISSION FREQUENCY OUT COME DISCHAGED MORTALITY HYPERGLYCAEMIC EMERGENCIES 21 (31.3%) 15 4 HYPOGLYCAEMIA 5 (7.5%) 3 2 DIABETIC RELATED FOOT PROBLEMS 11 (16.4%) 9 2 SEPSIS 3 (4.5%) 2 1 DIABETIC NEPHROPATHY 4 (6.0%) 4 0 DIARRHOEA 1 (1.5%) 1 0 POOR GLYCAEMIC CONTROL 16 (23.8%) 16 0 PULMONARY TUBERCULOSIS 3 (4.5%) 3 0 STROKE 3 (4.5%) 1 2 A third of those that presented in sepsis and two third of those who had a stroke died while 40% of those who presented in hypoglycaemia died. Over a quarter of those who presented with a hyperglycaemic emergency died while 22% of those who presented with a foot related problem died. Conclusions: Sepsis, metabolic emergencies and foot related problems require aggressive management in the elderly.
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    Open Access
    Reliability of signs and symptoms in the diagnosis of thyrotoxicosis in Nigeria.
    (2010-09) Ogedengbe, O.S; Onung, S; Orolu, F; Adigun, A; Oyekan, A.K; Fasanmade, O
    Background: Thyroid dysfunction is an important endocrine problem in Nigeria of which some of its features are not specific to thyroid disease alone. A laboratory work-up is therefore necessary in confirming the diagnosis. Previous attempts in using the Wayne’s index in making a diagnosis was cumbersome and time consuming. Aim: To determine the reliability of signs and symptoms in diagnosing thyrotoxicosis. Method: Forty patients were recruited for this study of which 36 where biochemically confirmed to have thyrotoxicosis (low thyroid stimulating hormone and elevated thyroxine) while 4 were normal. The top four signs and symptoms were identified in the toxic patients and a combination of any two symptoms and one sign from the identified top signs and symptoms was used as a screening test to identify patients with thyrotoxicosis. The sensitivity, specificity, positive and negative predictive values were calculated. Results: Top four symptoms were: 1. Excessive sweating 2. Heat intolerance 3. Palpitation and 4. Weight loss. The top four signs were: 1. Tachycardia 2. Exophthalmos 3. Moist palms and 4. Fine tremors of the hands. BIOCHEMICAL DIAGNOSIS TOTAL YES NO 2 symptoms plus one sign YES 17 2 19 NO 19 2 21 36 4 40 Sensitivity =47.2%, Specificity =50.0%, Positive predictive value=89.5%, Negative predictive value =9.5%. Conclusions: The biochemical diagnosis is an important tool in the confirmation and monitoring of thyrotoxicosis. A combination of the above signs and symptoms can be used as an initial screening test in identifying persons likely to have thyrotoxicosis because of its high positive predictive value. This approach is shorter and simpler than the Wayne’s index and can be used even at the primary and secondary health care levels.