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Quality of Health Care in Resource Limited Settings-Patients’ Satisfaction Survey at a Mission Hospital in South East, Nigeria

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Open Journal of Internal Medicine 2021年第4期11卷 201-209页

作者： Olaronke Fayosi afolabi Collins Nwachi Ugwu Chukwuemeka Okorie Eze Djobissie Fankou Serges-Anthanase Chiemela Okezie Onwuchekwa Moses Agha Ude Department of Internal Medicine Alex-Ekweueme Federal University Teaching Hospital Abakaliki Nigeria African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki Nigeria Mater Misericordiae Hospital Afikpo Nigeria

Introduction: Quality healthcare is a major contributor to health disparities and inequalities in resource limited settings. Patient satisfaction remains an important and valuable method of assessing the quality of care. Aim: This study assessed patients’ satisfaction with quality of inpatient clinical care in a mission hospital in a semi urban setting. Methods: The study was a cross-sectional study carried out on 140 inpatients at a mission hospital in Afikpo, South East Nigeria. Data was collected using pretested structured questionnaires designed on a five-point likert scale with 1 indicating the lowest and 5 indicating the highest scale. Knowledge of factors contributing to quality of care and satisfaction in the following domains: patient-staff relationship, patient-staff (doctors/nurses) communication, facility convenience, technical aspect of care (availability of equipment, drugs and adequacy of staff) and overall general satisfaction were measured. Operationally, patients who rated 3 points and above were considered satisfied while ratings less than 3 points were considered dissatisfied. Results: Knowledge of factors contributing to quality of care was 4.65 ± 0.48. General satisfaction rated 4.22 ± 0.52. Specifically, the different domains had the following scores: inter personal relationship 4.28 ± 0.81, technical aspect of care (availability of drugs, equipment and medical personnel) 4.29 ± 0.57 and facility convenience 4.21 ± 0.51. Conclusions: Knowledge of factors contributing to quality of care and overall patients’ satisfaction with inpatient care were good and comparable with patients’ satisfaction with tertiary health institutions in Nigeria. Mission hospitals may serve as excellent alternatives to government hospitals in resource limited settings to promote health equity across populations.

关键词： Inpatients Satisfaction Mission Hospital Nigeria

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Prevalence of Carotid Atheromatous Plaques in Pre-Dialysis Chronic Kidney Disease Patients in South East, Nigeria

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World Journal of Cardiovascular Diseases 2020年第9期10卷 639-647页

作者： Olaronke F. afolabi C. Uche Ibewuike Chukwuemeka O. Eze Monday U. Nwobodo Ifeoma I. Ulasi Department of Internal Medicine Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria Department of Radiation Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Internal Medicine University of Nigeria Teaching Hospital Enugu Nigeria

Background: Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events;hence, this study evaluated the prevalence of carotid atherosclerotic plaques in pre-dialysis CKD patients at a tertiary institution in south-east, Nigeria. Materials and Method: 107 pre-dialysis CKD patients were consecutively recruited for the study. 81 subjects who were screened and had no kidney disease served as control. The control group was sex and age matched with the CKD patients. A pre-tested questionnaire was administered to all participants and physical examination was done. Presence of atheromatous plaques was assessed using doppler ultrasound at 3 sites—distal common carotid artery (CCA), the internal carotid artery (ICA) and the carotid bulb by a single skilled radiologist specialized in doppler ultrasound. Results: Atheromatous plaques were significantly increased in CKD patients. 14.2% of CKD patients had atheromatous plaques versus 2.5% in the control group (p value Conclusions: Atheromatous plaques are prevalent in CKD patients. It is recommended that carotid doppler ultrasound should be done in CKD patients

关键词： Carotid Plaques CKD Predialysis Nigeria

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Analysis of the Load Flow Problem in Power System Planning Studies

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Energy and Power Engineering 2015年第10期7卷 509-523页

作者： Olukayode A. afolabi Warsame H. Ali Penrose Cofie John Fuller Pamela Obiomon Emmanuel S. Kolawole Department of Electrical and Computer Engineering Prairie View A&M University Prairie View USA

Load flow is an important tool used by power engineers for planning, to determine the best operation for a power system and exchange of power between utility companies. In order to have an efficient operating power system, it is necessary to determine which method is suitable and efficient for the system’s load flow analysis. A power flow analysis method may take a long time and therefore prevent achieving an accurate result to a power flow solution because of continuous changes in power demand and generations. This paper presents analysis of the load flow problem in power system planning studies. The numerical methods: Gauss-Seidel, Newton-Raphson and Fast Decoupled methods were compared for a power flow analysis solution. Simulation is carried out using Matlab for test cases of IEEE 9-Bus, IEEE 30-Bus and IEEE 57-Bus system. The simulation results were compared for number of iteration, computational time, tolerance value and convergence. The compared results show that Newton-Raphson is the most reliable method because it has the least number of iteration and converges faster.

关键词： Load Flow Bus Gauss-Seidel Newton-Raphson Fast Decoupled Voltage Magnitude Voltage Angle Active Power Reactive Power Iteration Convergence

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Impact of COVID-19 Pandemic on Haemodialysis Care at a Tertiary Centre in South East Nigeria

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Open Journal of Nephrology 2020年第4期10卷 383-387页

作者： Olaronke F. afolabi Monday U. Nwobodo Chukwuemeka O. Eze Ugochukwu U. Nnadozie Department of Internal Medicine Alex-Ekweueme Federal University Teaching Hospital Abakaliki Nigeria African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki Nigeria Division of Plastic Surgery Department of Surgery Alex-Ekweueme Federal University Teaching Hospital Abakaliki Nigeria

COVID-19 pandemic has had a significant impact on health services for patients suffering from chronic diseases. Patients suffering from kidney failure require heamodialysis and this modality of treatment is mostly offered in the hospital. Impacts of COVID-19 pandemic on haemodialysis care at a tertiary institution in South East, Nigeria include a reduction in the number of haemodialysis cases during the period of lockdown, an increase in the cost of heamodialysis, scarcity of materials used for the procedure and minor disruption of haemodialylsis care. An improvement in infection control practice at the dialysis unit is observed as a positive effect. It is advocated that the government should assist patients with kidney disease and make the procedure free to ameliorate the health and socio-economic hardships faced by the patients during the pandemic.

关键词： COVID-19 Heamodialysis Care Nigeria

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Men without Sperms

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Open Journal of Urology 2018年第1期8卷 25-42页

作者： Abayomi B. Ajayi Bamgboye M. afolabi Victor D. Ajayi Ifeoluwa Oyetunji Oluwafunmilola Biobaku Adedamilola Atiba Nordica Fertility Centre Lagos Nigeria Health Environment and Development Foundation Lagos Nigeria

Introduction: Men without sperm (azoospermic) make up about 15% of all infertile men in reproductive age of fatherhood. Male infertility is a health and social problem in many communities. Subjects and Methods: This retrospective study was carried from 2010 to 2015. Initially, 907 men were included in the study among whom 109 (12.02%), 346 (38.15%) and 452 (49.83%) were azoospermic, oligospermic and normospermic, respectively. This study only investigated the association between age, BMI, semen volume, liquefaction time and pus cells among normospermic and azoospermic men. Standard semen analysis was performed and subjects were categorized by age into Results: The 562 subjects of the study had means (±sd) age of 42.6 (±7.10) years and BMI of 27.0 (4.1) kg/m2 respectively. In all, 109 (19.4%) were azoospermic. Overweight and obese men were, respectively, more than 1? and about 2? times more likely to be azoospermic compared to normal weight men. Azoospermic men were significantly heavier than men with normal sperm count (t = -0.34;P-value = 0.003). Among those with normal weight, liquefaction time was significantly shorter (t = 5.49, P-value = 0.000001) in azoospermic (28.70 min.) than in men with normal sperm count (31.82 min.). Obese azoospermic men were about 4 times as likely to have high pus cells in semen than normal weight azoospermic men (OR = 3.82;95% CI: 0.39, 37.01). Multivariate regression analysis shows a strong but negative coefficient correlation between sperm concentration and BMI (coef. = -0.48, Std Err. = 0.25, P-value = 0.05, 95% CI: -0.96, 0.10). Conclusion: Our findings suggest that high BMI is associated with azoospermia. Azoospermia also did not seem to negatively impact liquefaction time.

关键词： Azoospermia Normal Sperm Concentration Age Body Mass Index Male Infertility Sub-Sahara Africa

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Characterization of Phosphide Platelets in Eutectic Sand Cast Cu-Sn-P Alloy

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International Journal of Nonferrous Metallurgy 2015年第3期4卷 28-35页

作者： L. O. Mudashiru T. M. Azeez S. O. afolabi I. A. Babatunde Department of Mechanical Engineering Ladoke Akintola University of Technology Ogbomosho Nigeria Department of Mechanical and Mechatronics Engineering Afe Babalola University Ado Ekiti Nigeria

A procedure for evaluating the degree of spheroidization of phosphide platelets in cast Cu-4%Sn- 5%P alloys using fractal analysis was investigated. The specimens were obtained by melting copper and tin in an improvised clay mould raised to a temperature of 1850°C ± 20°C, holding for a period of 10 minutes to 1 hour to modify the aspect ratio of the phosphide platelets. It was found that these platelets have the tendency to change their shape from being spherical to more Euclidian shapes as time elapses. It was found that the inter-platelets distances are approximately equal with time. This effect was more pronounced in samples with high holding time.

关键词： Spheroidization Clay Mould Platelets Euclidian Shapes

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中国物流和西非物流之间差异现状与发展研究

中国物流和西非物流之间差异现状与发展研究

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作者：安一凡（ADESINA IFEOLUWA afolabi）兰州交通大学

学位级别：硕士

近年来,随着市场经济的快速增长,中国和西非加快了物流结构的调整步伐,虽然物流市场加快发展以适应经济和社会发展的形势已大大改善,但仍然落后于市场的需求。因此,物流的结构性问题和社会经济发展的协调,仍然是人们需要研究的重要课题... 详细信息

近年来,随着市场经济的快速增长,中国和西非加快了物流结构的调整步伐,虽然物流市场加快发展以适应经济和社会发展的形势已大大改善,但仍然落后于市场的需求。因此,物流的结构性问题和社会经济发展的协调,仍然是人们需要研究的重要课题。本研究以系统理论为指导,综合运用了经济学、管理学、数学的相应基础理论和方法来进行分析和研究中国和西非物流发展中的相关问题。首先论述了国内外对物流概念的认识及物流经营运作方式方法的基本演变历程;对于物流的基本属性以及其所造成的重大影响进行了阐述;另外,站在物流交通基本设施建立,基本基地建立以及发展等不同的角度全面的研究了中国和西非物流的差异;随后,应用SWOT分析法,分别对中国和西非物流业发展现状进行了优劣势对比,分析中国物流和西非物流发展存在的机遇与挑战;最后,在系统地分析、总结中国和西非物流业发展现状及存在问题的基础上,解析中国和西非物流业发展潜力,提出两个国家物流业发展的应对措施和未来物流应朝系统集成化、管理网络化、标准统一化、园区便利化、配送精细化、运输现代化方向发展。

关键词：中国西非物流 SWOT分析法差异

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Clinically Diagnosed Guillain-Barre Syndrome in Pregnancy: Case Report and Review of Literature

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Case Reports in Clinical Medicine 2014年第8期3卷 487-490页

作者： afolabi Korede Koledade Adekunle O. Oguntayo Sani A. Abubakar Godfrey K. Katung Sunday Oladapo Shittu Neurology Unit Internal Medicine Department Ahmadu Bello University Teaching Hospital Zaria Nigeria Obstetrics and Gynaecology Department Ahmadu Bello University Teaching Hospital Zaria Nigeria

Background: Guillain-Barre syndrome (GBS) is an autoimmune disorder characterized by a heterogeneous group of pathological and clinical entities. It is associated with ascending areflexic paralysis, some autonomic dysfunction and respiratory failure in severe cases and ultimately death if not promptly diagnosed and treated. It may be preceded by an antecedent event in about two-third of cases. This could be an upper respiratory tract infection, viral illness, recent history of vaccination, pregnancy, cancer or even trauma. The condition is exceedingly rare in pregnancy and only few cases have been reported in literature. Case Report: This is a case of a 28-year-old Gravida 3, Para 1+1 and Estimated Gestational Age of 30 weeks and 4 days. There was a history of upper respiratory tract infection eight weeks prior to presentation which spontaneously resolved. On examination, she was a young woman, anxious, weak, afebrile, not pale, the neck could not hold the head upright and there was bilateral non tender pitting pedal oedema extending to her mid-shin. There were no cranial nerve deficits and no sign of meningeal irritation. There were normal muscle bulk with global hypotonia and flaccid quadriparesis, Power was 3/5. The proximal groups of muscles were more affected than the distal parts. Reflexes were diminished globally with plantar flexor response. She had immunoglobulin as treatment. Conclusion: In a low resource setting like ours it is important to have a high index of suspicion of GBS when an apparently healthy gravid woman presents with progressive weakness of the limbs.

关键词： Guillain-Barre Syndrome Pregnancy Immunoglobulin Plasmapheresis

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Open Prostatectomy in the Management of Benign Prostate Hyperplasia in a Developing Economy

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Open Journal of Urology 2016年第12期6卷 179-189页

作者： Abdulkadir A. Salako Tajudeen A. Badmus afolabi M. Owojuyigbe Rotimi A. David Chinedu U. Ndegbu Chigozie I. Onyeze Department of Surgery Faculty of Clinical Sciences Obafemi Awolowo University Ile-Ife Nigeria Urology Unit Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria Department of Anaesthesia and Intensive Care Faculty of Clinical Sciences Obafemi Awolowo University Ile-Ife Nigeria

Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the indications and outcomes of OP in a typical developing economy. Method: The records of patients with benign prostate hyperplasia (BPH) who had OP in our university teaching hospital between July 2004 and June 2014 were retrospectively reviewed. Some analyzed parameters include the demographic characteristics, indications, pre-operative work-up, anaesthetic techniques, OP type, complications, histopathology results and follow-up duration. Results: A total of 247 cases were studied. Mean age was 67 years while the commonest surgery indication was recurrent acute urinary retention. Average prostate specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common comorbidity (44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic prostatectomy was the commonest OP type done (58.7%). The enucleated specimen weighed above 60 g in 91.9% of cases. All our patients were able to micturate spontaneously with urine stream above 20 mls/second on follow-up one week after discharge. Mean duration of hospital admission and follow-up were 7 days and 9 months respectively. Complications occurred in 90 patients (36.4%), of which surgical site infections were the commonest (9.8%). There was 0.4% mortality. Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma (2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains an important therapeutic option for management of BPH in developing countries partly due to relatively large prostate size and presence of BPH complications from late presentationin many patients. The surgery is efficient and has relatively low morbidity and minimal mortality.

关键词： Open Prostatectomy Benign Prostate Hyperplasia Developing Economy Nigeria

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Billateral Femoral Osteomyelitis Following Venous Cutdown

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Open Journal of Orthopedics 2013年第7期3卷 306-310页

作者： Gbenga Muyiwa Akinsorotan Samuel Uwale Eyesan Dike Chijoke Obalum Joseph Chinedum Itie Chukwudi Benjamin Aroh afolabi Benjamin Abiodun Bowen University Teaching Hospital Ogbomoso Nigeria Bowen University Teaching Hospital Ogbomoso Nigeria Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital Ogbomoso Nigeria. State House Clinic Abuja Nigeria

Obtaining rapid access in emergency situations for infusion of IV fluids, blood and blood products or medications is vital in using various methods. These include venopuncture, intraosseous infusion, percutanous central venous access and peripheral venous cut-down. We report a case of a 30-year-old woman who developed severe obstetric hemorrhage and had peripheral venous cut-down that was complicated by bilateral femoral osteomyelitis. This is a rare occurrence and this case report shows the need for strict adherence to safety precautions to prevent complications such as that from the procedure.

关键词： Bilateral Femoral Osteomyelitis Venous Cut-Down

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