Background Healthcare workers are a burnout-prone occupational group and the prevalence is particularly high among physicians. With the prevailing low physician-patient ratio in Nigeria which has worsened with the recent wave of physician emigration, among other socio-economic constraints; a setting for high physician burnout may have been nurtured. Our survey set out to determine the prevalence of burnout among physicians practicing in Nigeria, ascertain the factors that were associated with the development of burnout and evaluate the respondents’ perceived impact of physician burnout on patient safety. Methods We used the Oldenburg burnout inventory as the measurement tool for burnout in the cross-sectional study conducted between November and December, 2019 among physicians in five tertiary health institutions in Nigeria. A 5- point Likert-type scale was used to evaluate the participants rating of their perceived impact of physician burnout on patient safety. Data entry and analysis were done using IBM Statistical package for social sciences software version 25 and the level of statistical significance was determined by a p value < 0.05. Results The response rate was 61% (535/871), and burnout prevalence was 75.5% (404/535). Majority of the physicians (74.6%) perceive that physician burnout could impact patient safety. Physicians’ professional grade, age and years in practice, but not specialty, gender or marital status were associated with the exhaustion domain, whereas only the physicians’ age was associated with the disengagement domain of burnout. No socio-demographic or work-related characteristics determined overall burnout in our respondents. Conclusion Physician burnout in Nigeria is high and pervasive, and this should alert physicians to be wary of their general and mental health status. Public health policy should address this development which has implications for patient safety, physician safety and healthcare system performance.

<p class="abstract"><strong>Background:</strong> The femoral neck-shaft angle (FNSA) has been implicated in the aetiology of hip fractures. The longer moment arm of a higher FNSA has been theorized to impart a greater deforming force to the greater trochanter, which may cause a hip fracture.</p><p class="abstract"><strong>Methods:</strong> A prospective study that involves adults with hip fractures and a control group matched for age and sex. The FNSA of both groups were measured on an anteroposterior X-ray of the pelvis. The mean FNSA were compared with a paired samples t-test, and a binary logistic regression analysis was run with the FNSA as a predictor variable and the presence of hip fracture as an outcome variable.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 150 patients were recruited for the study, 75 per group. The mean age of patients with hip fractures was 71.30 years (S.D.=14.34), and that of the control group was 73.94 years (S.D.=12.55), p=0.264. The mean FNSA of the study group was 133.96^o (S.D.=3.77) while that of the control group was 131.05^o (S.D.=3.86), p&lt;0.001. Increasing FNSA imparts a higher risk of having a hip fracture, O.R.=1.24 (95% C.I, 1.12-1.37).</p><p><strong>Conclusions:</strong> Individuals with higher FNSA demonstrated a significantly increased risk of developing hip fractures. However, the exact cut-off point of the FNSA, which predisposes to the risk of these fractures, remains to be elucidated. </p>

Aim of the study This was to compare the early outcome of closed femoral shaft fractures treated with locked intramedullary nailing and plating at the National Orthopaedic Hospital Enugu. Methods The study was a prospective study over 12-month period at the National Orthopaedic Hospital Enugu. Ethical clearance was obtained from the hospital ethical committee. Written informed consent was obtained from all prospectively recruited participants. Patients who met the inclusion criteria were randomly selected by simple balloting into either intramedullary nailing group or plating group. The patients were evaluated at presentation and postoperatively within 48 hours, then at two weeks, six weeks, 12 weeks and 18 weeks, respectively. Participants were evaluated using Thoresen criteria. Results A total of 52 femoral shaft fractures in 50 patients were included and analysed using SPSS version 20.0. Bone union was obtained in all the patients in the intramedullary nailing group at 12 weeks and in 84.6% patients in the plating group between 12 and 18 weeks. The overall wound infection rate was 11.5% in the locked intramedullary group and 7.7% in the plating group. Similarly, the overall limb length discrepancy was 11.5% in the locked intramedullary nailing group and 19.2% in the plating group. Based on the Thoresen criteria, good to excellent outcome was achieved in 65.4% of patients in the locked intramedullary nailing group. Discussion The patients in both groups were evaluated clinically, radiologically and functionally based on the Thoresen criteria and significantly higher number of patients in the intramedullary nailing group (17; 65.4%) than the plating group had good to excellent outcome (x 2 = 9.734; p = 0.020). Conclusion The early outcome of treatment of closed femoral shaft fractures in adults is significantly better following locked intramedullary nailing than plating.