Abstrak
The last issue of Volume 49 of our journal contains 6 articles that deal with auditing for better utilization of resources and for better health of patients. Audit is essential for progress by identifying areas of strength that need consolidation, and on the contrary, obviating weaknesses by identifying areas of need. There are various types of audit – clinical, financial, quality control and investigative. In this issue of the journal, Fasola and colleagues reported on their audit of blood utilization for elective general surgery at the University College Hospital, Ibadan. They noted that only 8% of the blood demanded and cross-matched was eventually utilized. The practice of minimal-blood-loss surgery is praiseworthy because blood transfusion is not without its risk.
Everybody appreciates the importance of transfusing blood to save lives when there is massive blood loss as could occur with surgical operations but a utilization rate of 8% implies that some guidelines should be put in place for blood demand. The authors advocated the operation of a Maximum Surgical Blood Ordering Schedule (MSBOS) for efficient blood utilization. It would therefore be most appropriate if an algorithm can be developed to guide blood utilization for surgical operations in our hospitals which can be adopted for use
nation-wide.
The other audit-related papers that our readers will find interesting include i) negligence of caregivers resulting in poor compliance with vaccination appointments of infants with forgetfulness blamed; ii) preference of older dental surgeons for multiple patient visits for endodontics care to allow for effective medications; iii) 80% success rate of apicectomy at 12- month follow notably in female patients, those less than 30 years of age and those with radicular cysts; iv) low frequency of self-breast examination for cancer screening especially women who had no obvious breast problems and those who felt well, which could be deceptive; and v) that knowledge was a key determinant for submission to have cervical cancer screening, and therefore, non-doctors and middle/lower cadre health workers should be targeted during cancer screening awareness campaigns.
There are interesting papers on work-place health issues, association of depression and hypertension among the elderly from the Ibadan Study of Ageing data, the pattern of bone metastasis in breast cancer patients, presbyopia as a common eye problem in individuals aged over 30 years, and increased incidence of dental caries among pre-teenage children associated with snacking. Idowu and colleagues’ paper on multi-drug resistant Klebsiella species should interest readers, and lastly there is a preliminary report on the potential benefit of NImreh B for managing hepatitis B infection. Three case reports complete the selection of papers for this issue of the journal.
The Editorial Committee will like to thank all our authors for their immense contributions and for ensuring that we keep pace with global developments in medicine. It is through the auditing of our clinical and educational activities that we can bring about desired changes for better health despite the pervasive lack of resources and other social challenges.