CAREER ASPIRATIONS OF MEDICAL STUDENTS AND MEDICAL INTERNS IN GHANA. IS THERE A DIFFERENCE?

  
Yifieyeh AC, Duduyemi BM, Kumahor E, Kotoku E, Moses MO, Fefemwole P, Akwetey FM
Background: Understanding the reasons for the selection of medical specialties by medical graduates is necessary for policy formulation and targeted mentoring to prevent a skewing of the lean resources and maximize the improving doctor to patient ratio in Ghana. This is particularly so due to an increase in the desire for specialization among medical graduates since the establishment of the Ghana College of Physicians and Surgeons.
Methodology: A cross-sectional study was designed. To consenting first and final year clinical students of the School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana and first and second year medical interns at Komfo Anokye Teaching Hospital and Sunyani Regional Hospital respectively were administered semi – structured questionnaires. Data were analysed with SPSS version 24 and result put in tables and graphs
Result: Three hundred and forty and 100 questionnaires were administered to students and interns with 92% and 75% responders’ rate respectively. The M: F ratio for students and interns were 1.23:1 and 1.34:1 respectively. Postgraduate specialization and additional qualification were desired by all categories irrespective of sex, financial or family consideration. Surgery (43.9% students; 33.3% interns) and Internal Medicine (23.8% students; 24% interns) were the 2 most popular choices.
Conclusion: While Surgery and Internal Medicine appeared to be the favoured choices by our students and interns, deliberate effort through mentoring is required to avert lop-sidedness in workforce in our hospitals.

[FULL ARTICLE (PDF)]

 

REMOVAL OF DISTALLY MIGRATED CANNULATED INTERLOCKING TIBIAL NAIL USING SCHANZ SCREW; A CASE REPORT

  
Mamuda AA, Bello, B.

SUMMARY
Background: Distal migration of nails is one of the reasons for nails removal, though they are hardly reported in relation to cannulated interlocking nails.
Objectives: To present a rare case of distally migrated cannulated interlocking nail of the tibia and a proposed technique for the removal of the nail using Schanz screw.
Case: A 55year old woman had cannulated interlocking nailing for diaphyseal left tibial fracture 5 years prior to presentation. She later had septic loosening of the distal locking screw with subsequent symptomatic distal migration of the nail despite united osteosynthesis. Attempt at free hand removal using conventional instruments failed due to increased distance of the nail from the entry point, malrotation and lack of visibility of the nail following obliteration by fibrous and granulation tissues within the nail cavity. Thus, an improvisation with Schanz screw, due to its threading surface was used to capture and remove the nail successfully without any cortical damage of the bone.
Conclusion: The use of Schanz screw is a safe, cheap and effective means of free hand removal of distally migrated cannulated interlocking nails.

[FULL ARTICLE (PDF)]

 

SONOGRAPHIC EVALUATION OF CAROTID ARTERY LUMINAL DIAMETER AND DEGREE OF STENOSIS IN ADULT DIABETIC PATIENTS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, NORTH EASTERN NIGERIA

  
Ahmadu MS, Mubi BM, Adeyomoye AAO, Ahidjo A, Adeyinka AO, Tahir AA
Background: Carotid artery luminal diameter measurements have been used as clinico-radiological index of carotid artery atherosclerosis in patients with diabetes mellitus. Luminal diameter values have also been used in epidemiological and interventional studies as surrogate index of carotid atherosclerosis. However, values for luminal diameter measurements in diabetic patients are scarce in our environment.
Objectives: This study evaluates the carotid artery luminal diameter dimensions and degree of stenosis among adult diabetic patients using carotid duplex ultrasonography (CDUS).
Methods: This was a cross-sectional study carried out at the University of Maiduguri Teaching Hospital, Nigeria. One hundred and twenty adult diabetic patients aged 20 - 78 years had CDUS for measurements of carotid artery luminal diameter and degree of stenosis. Measurements were taken at 1cm below and 1cm above the carotid bulb for the common carotid (CCA) and internal carotid arteries (ICA). Pearson’s correlation and Student t-test were used to compare the means between the variables.
Results: There were 72 males and 48 female diabetic patients aged 20 to 78 years (mean = 50.03±11.4 years). The mean luminal diameter, in millimeters (mm), for normal (non-stenotic) carotid arteries on the right and left were (CCA=6.58±0.52 and 6.51±0.50; ICA=4.80±0.29 and 4.79±0.31); and abnormal (stenotic) were (CCA=6.41±0.62 and 6.35±0.62; ICA=3.44±0.44 and 3.11±0.29) respectively. A total of 75 patients (62.5% of study population) had no carotid artery stenosis; 38 patients (31.7%) had <50% carotid stenosis; 6 patients (5.0%) had 50-69% carotid stenosis; and 1 patient (0.8%) had 72% carotid stenosis. The prevalence of carotid stenosis in diabetic patients was 37.5% in this study. Negative and significant correlation was noted between percentage degree of stenosis and luminal diameter (r=≥ - 0.5; p=<0.05).
Conclusion: The findings of this study have indicated the presence of atherosclerotic changes in the carotid arteries of adult diabetic patients in our environment who are at risk of developing stroke from carotid stenosis. CDUS has proved to be a valuable diagnostic and screening tool in the evaluation of these patients because of its safety, low cost, wide availability, and accuracy in detecting carotid artery disease.

[FULL ARTICLE (PDF)]

 

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Written by Administrator On Sunday, 24 March 2013 17:23
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