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IJMBS Table of Content: May 2015 3(3)

Research Articles

 

Emmanuel Olushola Shobowale, Ibrahim Oreagba, Sunday Olayemi, Edamisan Temiye.  pp. 22 - 30

THERAPEUTIC EFFECTS OF VITAMIN A ON UNCOMPLICATED CHILDHOOD MALARIA

 

           

Malaria is one of the leading causes of mortality in children worldwide. It is estimated that up to 40% of the world’s population is at risk of contracting malaria. This study on therapeutic effects of malaria on uncomplicated childhood malaria was conducted at The Lagos University Teaching Hospital were to determine the incidence of malaria, assess the relationship between Vitamin A administration and malaria and identify factors that affect patient outcome. The study design was a prospective randomized cross sectional controlled clinical trial, employing the use of questionnaires to obtain relevant data. Data entry and analysis were done using EPI-INFO 2002 and data were presented in frequency distribution tables and graphs. The association between Vitamin A administration and malaria was assessed using length of stay in the hospital. More than 50% of the patients were between 1 to 3 years of age reflecting the age range that is most vulnerable to malaria. Males represented 57.5% of respondents while 42.5% were female. 15.1% of patients received malaria prophylaxis while 84.9% did not. A total of 12.3% of children had malaria positive smears by Giemsa while 87.7% did not. Vitamin A was administered to 6 patients while 7 received placebo. The study show that if vitamin A is administered on a large scale it will reduces the signs and symptoms of malaria in children in our environment especially if combined with sleeping in insecticide treated nets and selective anti-malarial prophylaxis are instituted. It is recommended that Vitamin A supplementation be strengthened and advocated in childhood malaria so as to reduce morbidity and hasten recovery of patients..

Keywords: Malaria, Mortality, Childhood, Vitamin A.


Ademoyo E.A; BabaTunde Ayoola; Musharat B.S; Ituebor R.D.  pp. 31 - 37

PREOPERATIVE MEDICAL TESTING IN PATIENTS UNDERGOING CATARACT SURGERY

 

           

Routine preoperative testing is not recommended for patients undergoing cataract surgery, because testing neither decreases adverse events nor improves outcomes. We sought to assess adherence to this guideline, estimate expenditures from potentially unnecessary testing, and identify patient and health care system characteristics associated with potentially unnecessary testing. Using an observational cohort of Medicare beneficiaries undergoing cataract surgery in 2013, we determined the prevalence and cost of preoperative testing in the month before surgery. We compared the prevalence of preoperative testing and office visits with the mean percentage of beneficiaries who underwent tests and had office visits during the preceding 14 months. Using multivariate hierarchical analyses, we examined the relationship between preoperative testing and characteristics of patients, health system characteristics, surgical setting, care team, and occurrence of a preoperative office visit. Of 440,857 patients, 53% had at least one preoperative test in the month before surgery. Expenditures on testing during that month were $4.8 million higher and expenditures on office visits $12.4 million higher (42% and 78% higher, respectively) than the mean monthly expenditures during the preceding 14 months. Testing varied widely among ophthalmologists; 36% of ophthalmologists ordered preoperative tests for more than 75% of their patients. A patient’s probability of undergoing testing was associated mainly with the ophthalmologist who managed the preoperative evaluation. Preoperative testing before cataract surgery occurred frequently and was more strongly associated with provider practice patterns than with patient characteristics.

Keywords: Cataract, Surgery, Preoperative Testing, ophthalmologists.