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Search Results: 1 - 10 of 23959 matches for " JO Fadare "
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Some ethical issues in teh prenatal diagnosis of sickle cell anaemia
JO Fadare
Annals of Ibadan Postgraduate Medicine , 2009,
Abstract: Sickle cell anaemia (SCA) is the most common form of haemoglobinopathy in Nigeria affecting 1-3% of the population and it is associated with physical, psychosocial and emotional suffering. Prenatal diagnosis (PND) and genetic counseling are ways of preventing the spread of the disease; however these means of prevention are associated with many ethical dilemmas. Ethical issues discussed in this paper include the safety of the procedures used in obtaining tissue sample for prenatal diagnosis, abortion of affected fetuses and the question of genetic selection. Finally, the ethical implications of genetic counseling and issues relating to the principle of justice in healthcare are highlighted.
The pattern of medical mortalities in a specialist hospital in north-central Nigeria.
JO Fadare, AO Afolabi
Annals of Ibadan Postgraduate Medicine , 2010,
Abstract: Background: Review of causes of morbidity and mortality in health care facilities is an important exercise which gives a picture of the prevailing disease pattern in the particular community and at the same time looks out for any change in the disease pattern over time. This exercise is a necessary component for planning of the health care needs of the community. Objective: To determine the mortality pattern on the medical wards of the Kogi State Specialist Hospital, a tertiary center located in Lokoja, North-Central Nigeria. Methods: A retrospective review of medical records of all patients admitted to the medical wards of the hospital over a period of 18 months (December 2008 – May 2010) was carried out. The information recorded from these sources included the age and gender, diagnosis/cause of death and the duration of admission. Results: A total of six hundred and eighty-four patients were admitted during the period being studied with a predominance of female patients (Female: Male Ratio = 1.07). There were seventy-six deaths (11.1%) during the period in question with HIV and related >complications accounting for most recorded mortality (32.9%) closely followed by non-communicable cardiovascular conditions (hypertension, heart failure and CVD) – 28.9%. Conclusion: This study clearly shows that HIV infection and its complications remains the leading cause of death despite the advent of HAART. Clearly there is a need to revisit the strategies of HIV prevention and control. Also there is an urgent need to focus on the prevention and treatment of non-communicable diseases like hypertension and diabetes.
Drug Prescription Pattern in a Nigerian Tertiary Hospital
I Tamuno, JO Fadare
Tropical Journal of Pharmaceutical Research , 2012,
Abstract: Purpose: To evaluate the prescribing pattern of clinicians in the general outpatient unit of the Aminu Kano Teaching Hospital, Kano (AKTH),. Methods: This was a descriptive retrospective study conducted using 500 prescriptions made at the general outpatient unit of AKTH between April and July 2009. Results: A total of 497 prescriptions were successfully analyzed. The average number of drugs per encounter in the facility was 3.04. Generic prescribing was low at 42.7 % while antibiotic prescription was high at 34.4 %. Injections were prescribed in 4 % of encounters while 36.2, 19.1, 25.8 and 1 % of encounters had analgesics, antimalarials, antihypertensives and anxiolytics prescribed, respectively. Vitamins were prescribed in 9.7 % of encounters. Conclusion: Polypharmacy, low rate of generic prescriptions and overuse of antibiotics still remain a problem in health care facilities in Nigeria.. This calls for sustained interventional strategies and periodic audit at all levels of health care to avoid the negative consequences of inappropriate prescriptions.
Discharge against medical advice: Ethico-legal implications from an African perspective
JO Fadare, AC Jemilohun
South African Journal of Bioethics and Law , 2012,
Abstract: Background. Discharge against medical advice (DAMA) is a problematic issue for physicians worldwide, which can disrupt the physicianpatient relationship, have adverse medical outcomes and increase healthcare costs. This review aims to highlight the ethical and legal aspects of the issue from the perspective of developing countries in Africa, and make suggestions for resolving them. Methods. A comprehensive literature review of articles relating to DAMA was performed using databases such as PubMed, Medline and Google Scholar. The search criteria used were ‘discharge against medical advice AND ethics*’, ‘discharge against medical advice AND Africa’, ‘leaving against medical advice’, ‘discharge against medical advice AND legal issues’ and ‘self-discharge’. Relevant articles published from 1980 till 31 December 2011 were included. Results. The conflict between the professional values (beneficence) of the physician and the autonomy (self-determination) of the patient is the most prominent ethical dilemma in cases of DAMA. The issue of DAMA is more complicated in developing countries, especially because of communal models of decision making. One important ethical dilemma is the rationing of hospital admissions, especially for chronic conditions with poor prognosis. We have suggested a communal model for dealing with the issues. The main legal issue found in this review is the possibility of medical doctors being sued for medical malpractice. Conclusion. DAMA is associated with numerous ethical and legal issues of which physicians need to take cognizance.
Audit of Completion of Radiology Request Form in a Nigerian Specialist Hospital
OA Afolabi, JO Fadare, EM Essien
Annals of Ibadan Postgraduate Medicine , 2012,
Abstract: Background: Clinical audit is one approach to improve the quality of patient care, completion of request form inclusive. Radiology request forms are essential communication tools between the clinician and the radiologist. The aim of this study is to audit the adequacy of completion of X-ray request forms. Methodology: A review of all consecutive request form received at the X-ray unit of the over a period of six weeks to assess the completeness of filling of the forms, details of biodata/clinical information, previous exposure and information about the requesting officer. The data was entered into a SPSS statistical software and analysed descriptively and results presented in tables/figures. Result: Two hundred and two request forms were analysed. All the request had names on it however 89.1% had complete and adequate information while 10.9% have incomplete and inadequate information on names, one hundred and ninety-six (97%) had dates while, 6(3%) did not have information regarding date of request, space for the addresses were filled in 80 (39.6%) out of which only 24 (11.9%) had adequate and complete information. Clinical information were adequate and complete in 34.4%, only 6(8.3%) of those with previous x-rays submitted their previous film with the new request. Conclusion: We concluded that radiological investigation forms are still incompletely and inadequately filled. This will have effect on the quality and the overall service provided by both the radiographer and the radiologist and may have effect sometimes on the clinical decision and outcome.
Prescription pattern and prevalence of potentially inappropriate medications among elderly patients in a Nigerian rural tertiary hospital
Fadare JO, Agboola SM, Opeke OA, Alabi RA
Therapeutics and Clinical Risk Management , 2013, DOI: http://dx.doi.org/10.2147/TCRM.S40120
Abstract: escription pattern and prevalence of potentially inappropriate medications among elderly patients in a Nigerian rural tertiary hospital Original Research (213) Total Article Views Authors: Fadare JO, Agboola SM, Opeke OA, Alabi RA Published Date March 2013 Volume 2013:9 Pages 115 - 120 DOI: http://dx.doi.org/10.2147/TCRM.S40120 Received: 09 November 2012 Accepted: 04 January 2013 Published: 13 March 2013 Joseph O Fadare,1 Segun Matthew Agboola,2 Olumide Augustine Opeke,3 Rachel A Alabi4 1Department of Medical Pharmacology and Therapeutics, Obafemi Awolowo University, Ile-Ife, Nigeria; 2Department of Family Medicine, 3Department of Internal Medicine, 4Pharmacy Department, Federal Medical Centre, Ido-Ekiti, Nigeria Introduction: Polypharmacy and inappropriate prescriptions are prominent prescribing issues with elderly patients. Beers criteria and other guidelines have been developed to assist in the reduction of potentially inappropriate medications prescribed to elderly patients. The objectives of this study were to assess the prescribing pattern for elderly Nigerian outpatients and estimate the prevalence of potentially inappropriate medications among them using the Beers criteria. Methodology: This was a prospective cross-sectional study of elderly patients (65 years and above) who were attending the general outpatients clinic of a rural Nigerian hospital. For the drug utilization aspect of the study, drug-use indicators were assessed using established World Health Organization guidelines, while the Beers criteria was used to screen for potentially inappropriate medications. Result: The medical records of 220 patients aged 65 years and above were utilized for the study. A total of 837 drugs were prescribed for the patients, giving an average of 3.8 ± 1.3 drugs per person. Antihypertensive drugs accounted for 30.6% of the prescriptions, followed by multivitamins/food supplements (11.5%) and analgesics (10.8%). A review of the prescribed medications using the 2012 Updated Beers Criteria by the American Geriatric Society identified 56 patients with at least one potentially inappropriate medication prescribed giving a rate of 25.5%. The drug groups identified were nonsteroidal anti-inflammatory drugs, antihistamines, and amitriptyline. Conclusion: Polypharmacy and prescription of potentially inappropriate medications are major therapeutic issues in Nigeria. There is a need for prescriber training and retraining with emphasis on the geriatric population.
Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting among Healthcare Workers in a Tertiary Centre in Northern Nigeria
JO Fadare, OO Enwere, AO Afolabi, BAZ Chedi, A Musa
Tropical Journal of Pharmaceutical Research , 2011,
Abstract: Purpose: To determine the knowledge, attitude and practice of ADR monitoring and reporting among healthcare workers in a teaching hospital in Kano, Nigeria Methods: The study was cross-sectional and questionnaire-based involving mainly medical doctors, nurses and pharmacists working in different departments of the Aminu Kano Teaching Hospital hospital. A total of 110 questionnaires were distributed to the respondents (60 doctors, 40 nurses, 10 pharmacists). The completion of the questionnaire by respondents was taken as their consent to participate in the study. Results: Only 65 respondents filled and returned the questionnaire within the stipulated time frame giving a response rate of about 59.1 %. The standard yellow reporting form for adverse drug reactions was only known to 35.9 % of the participating health care workers. Only 42.7 % of the respondents had ever reported an adverse drug reaction and the report was verbal in over 75 % of cases. Ignorance of the rules and procedures of reporting, lack of knowledge of the forms for reporting and which ADRs to report were some of the factors responsible for non-reporting of adverse drug reactions among respondents in the study Conclusion: Adverse drug reaction reporting using the yellow card reporting scheme is low among health care workers (doctors, nurses and pharmacists) in Kano, Nigeria. There is a need for regular training and re-enforcement of guidelines for ADR reporting among health care personnel. The inclusion of nurses in pharmacovigilance will go a long way in improving reporting of ADRs.
Prescription pattern and prevalence of potentially inappropriate medications among elderly patients in a Nigerian rural tertiary hospital
Fadare JO,Agboola SM,Opeke OA,Alabi RA
Therapeutics and Clinical Risk Management , 2013,
Abstract: Joseph O Fadare,1 Segun Matthew Agboola,2 Olumide Augustine Opeke,3 Rachel A Alabi41Department of Medical Pharmacology and Therapeutics, Obafemi Awolowo University, Ile-Ife, Nigeria; 2Department of Family Medicine, 3Department of Internal Medicine, 4Pharmacy Department, Federal Medical Centre, Ido-Ekiti, NigeriaIntroduction: Polypharmacy and inappropriate prescriptions are prominent prescribing issues with elderly patients. Beers criteria and other guidelines have been developed to assist in the reduction of potentially inappropriate medications prescribed to elderly patients. The objectives of this study were to assess the prescribing pattern for elderly Nigerian outpatients and estimate the prevalence of potentially inappropriate medications among them using the Beers criteria.Methodology: This was a prospective cross-sectional study of elderly patients (65 years and above) who were attending the general outpatients clinic of a rural Nigerian hospital. For the drug utilization aspect of the study, drug-use indicators were assessed using established World Health Organization guidelines, while the Beers criteria was used to screen for potentially inappropriate medications.Result: The medical records of 220 patients aged 65 years and above were utilized for the study. A total of 837 drugs were prescribed for the patients, giving an average of 3.8 ± 1.3 drugs per person. Antihypertensive drugs accounted for 30.6% of the prescriptions, followed by multivitamins/food supplements (11.5%) and analgesics (10.8%). A review of the prescribed medications using the 2012 Updated Beers Criteria by the American Geriatric Society identified 56 patients with at least one potentially inappropriate medication prescribed giving a rate of 25.5%. The drug groups identified were nonsteroidal anti-inflammatory drugs, antihistamines, and amitriptyline.Conclusion: Polypharmacy and prescription of potentially inappropriate medications are major therapeutic issues in Nigeria. There is a need for prescriber training and retraining with emphasis on the geriatric population.Keywords: drug utilization pattern, elderly patients, rational use of medicines, adverse drug reactions, Beers criteria
Dysplastic Ichthyosis Uteri-like changes of the entire endometrium associated with a squamous cell carcinoma of the uterine cervix
Oluwole Fadare
Diagnostic Pathology , 2006, DOI: 10.1186/1746-1596-1-8
Abstract: A 38-year-old nulligravid female presented with complaints of a vague pelvic heaviness and a vaginal discharge. Her past medical history is significant for acquired immune deficiency syndrome (diagnosed 9 months previously) and Hepatitis A, B and C infections. Physical examination revealed a massively enlarged, barrel-shaped cervix with areas of ulceration on the ectocervix and a fungating mass protruding from the endocervical region. Following a biopsy, the patient underwent a type III radical hysterectomy, bilateral salpingo-oophorectomy and pelvic/paraaortic lymph node sampling. The procedure was well-tolerated and without any complications. She has had no evidence of tumor recurrence at last follow-up, 9 months after her surgery.Upon external inspection of the uterus, both the cervix and the inferior portion of the lower uterine segment were significantly enlarged. Sectioning revealed a 7 cm × 4 cm exophytic, friable, tan to tan-brown mass obliterating the endocervix and extending into the lower uterine segment (Figure 1). Sectioning revealed stromal invasion of the tumor to almost 100% of the cervical wall thickness. In the portions of the endometrium immediately proximal to the main mass, small soft satellite tumor nodules were present. The rest of the endometrium was tan-pink, flat and glistening but was otherwise unremarkable.The tumor was a moderately differentiated, large cell, keratinizing squamous cell carcinoma as previously described [1]. Notably, the epithelium retained prominent koilocytic changes throughout the tumor. The tumor was deeply invasive, extending to almost 100% of the cervical wall thickness. Perineural invasion was present. There was no evidence of extrauterine disease and the patient was assigned an International Federation of Gynecology and Obstetrics stage of 1B2. The endometrium was of the proliferative-type and there was no evidence of acute or chronic endometritis. Overlying the endometrium, however, was flat layer of mature, kera
Uncommon sarcomas of the uterine cervix: a review of selected entities
Oluwole Fadare
Diagnostic Pathology , 2006, DOI: 10.1186/1746-1596-1-30
Abstract: In 2004, an estimated 10,520 new malignancies of the uterine cervix were diagnosed in the United States [1]. There are no current, systematically collected data on the precise percentage of these cases that were pure sarcomas. However, during a 5-year period in the United States (1973–1977), sarcomas constituted only 0.55% of all malignancies that were reported in the cervix [2]. Based on current data from individual institutions, and in the author's own experience, this proportion has remained largely unchanged. Wright et al [3] identified only 3 pure sarcomas out of 1583 cervical malignancies treated between 1986 and 2003 at a large tertiary center in the United States. [3]. The ratio of benign to malignant mesenchymal tumors at this anatomic location is approximately 1.9:1 [4]. Of the sarcomas, rhabdomyosarcomas, most commonly of the embryonal subtype, are the most frequently reported, with over 150 cases in the literature [4]. The proportional distribution of all previously reported cases of cervical sarcoma are summarized in figure 1. In this report, a select group of the more uncommon sarcomas of the uterine cervix are briefly reviewed, including all previously reported examples of leiomyosarcoma, liposarcoma, alveolar soft part sarcoma, Ewing sarcoma, undifferentiated endocervical sarcoma, and malignant peripheral nerve sheath tumor (MPNST). Since the basic pathologic features of most of these entities have been outlined in detail elsewhere in the soft tissue context [5], the emphasis is placed herein on any distinctive clinicopathologic features relating to the uterine cervix.Since cervical involvement by uterine corpus leiomyosarcomas are not uncommon, the diagnosis of a primary cervical leiomyosarcoma requires, at minimum, an attempt to exclude the possibility that the putative cervical tumor arose from the corporal isthmus (lower uterine segment). In the author's opinion, deference should be given to a corpus location in cases that are truly equivocal. Ho
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