Background: Due to the perennial shortage of diabetes specialists, primary care physicians (PCPs) constitute the largest diabetes care manpower in Nigeria. However, the competence of the PCPs to undertake this task is not known. This study was aimed at evaluating diabetes care knowledge and practice among PCPs in Southeastern part of Nigeria. Methods: This was a cross-sectional study among PCPs in Southeastern Nigeria. Diabetes care knowledge and practices were evaluated using a structured self administered questionnaire. Results: A total of 64 PCPs with mean duration of practice of 17.3 ± 11.6 years completed the study. 65.6% were in private practice and 50% attended to between 11 and 20 persons living with diabetes (PLWD) weekly. Majority (78.1%) had not participated in any diabetes training since graduation from medical school and 79.9% were not aware of any diabetes clinical practice guideline. The PCPs had adequate knowledge of classical symptoms of diabetes. However, they had very poor knowledge of glycemic thresholds for diagnosis of diabetes which was 26.6, 45.3 and 10.9% for fasting blood glucose (FBG), random blood glucose (RBG) and glycated hemoglobin (A1c) respectively. We observed serious gaps in diabetes care practice such that only 18.8% of the respondents performed foot examination on newly diagnosed PLWD while 28.1 and 39.1% provided counseling on foot care and hypoglycemia respectively. Annual comprehensive foot examination was conducted by only 12.5%, none of the physicians ever screened for microalbuminuria and only 21.9% conducted annual dilated eye examination. Majority (57.8%) rated their confidence in prescribing insulin as "low" and only 23.4% had ever prescribed outpatient insulin for type 2 diabetes in their practice. Glycemic monitoring was largely limited to FBG and only 17.2% monitored A1c. Duration of practice more than 10 years (OR 10.1; P 0.034) and non participation in diabetes training (OR 6.5; P 0.027) were significant predictors of poor diabetes care knowledge. Conclusion: Diabetes care knowledge and practice were poor among PCPs in Southeast Nigeria. There is an urgent need to improve their capacity to provide diabetes care through periodic training.

Background and Objective: Cardiovascular diseases (CVDs) are leading causes of non-communicable diseases and are increasingly becoming the major causes of morbidity and mortality in Nigeria. Published literature on the changing patterns and outcome of CVD admissions in the southeast region of Nigeria is scanty. This study, therefore, set out to bridge this gap in knowledge. Subjects and Methods: This was a 10-year retrospective descriptive study in which data about patients admitted on account of the CVDs to the medical wards of Abia State University Teaching Hospital (ABSUTH), Aba from May 1, 2007 to April 30, 2017 were extracted from the Admission/Discharge registers in the medical wards. Relevant data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 23.0 software. Results: A total of 2044 patients were admitted because of CVDs, made up of 927 (45.4%) males and 1117 (54.6%) females. Cerebrovascular disease (stroke), heart failure (HF) and uncontrolled systemic hypertension (SHTN) were the major cardiovascular indications for hospitalization at 44.08%, 38.85% and 15.31% respectively. With an overall CVD mortality of 24.9% of the medical admissions, the commonest cause of CVD deaths was stroke. Majority of the CVD deaths (70.9%) occurred within the first 7 days of hospitalization Conclusion: Contribution of cardiovascular diseases to medical admissions is considerable in Aba, Southeast Nigeria. In-patient mortality of the CVDs is high especially from stroke. It is recommended that every effort should be made to control the modifiable risk factors of CVDs while early detection and treatment of CVDs be effected. Keywords: Aba, cardiovascular diseases, medical wards, non-communicable diseases, Southeast, Nigeria

Medical conditions present at the Accident and Emergency (A&E) or Emergency Department (ED) very often. Outcome of medical emergencies depends, among other factors, on the age of patients, gender, socioeconomic factors, medical conditions, their severity, time of patients' presentations, quality of care/treatment given and the available resources (manpower and facilities) in the A&E. There is a paucity of published literature on medical emergencies outcome in Aba, Southeast Nigeria. This study, therefore, set out to bridge this gap in knowledge. This was a 1-year observational study in which patients presenting to the A&E/ED of ABSUTH, Aba for treatment of a medical condition were consecutively recruited and followed up until discharged home, admitted to the medical wards or died in A&E. This study lasted from January 1, 2018 to December 31, 2018. Relevant data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0 software. A total of 589 patients presented at A&E because of medical conditions/emergencies, made up of 269 (45.7%) males and 320 (54.3%) females. The commonest medical emergencies were DM related complications, acute malaria, HIV/AIDS, heart failure and stroke. Study subjects discharged home were 17.5%, 71.1% were admitted into the medical wards and 11.4% died. Medical emergencies, caused predominantly by non-communicable diseases (NCDs), contributed significantly to the A&E cases in the city of Aba, Nigeria and are associated with considerable mortality. It is recommended that efforts should be made to control the modifiable risk factors of NCDs while early detection and treatment of communicable and NCDs should be affected.

Diabetes mellitus (DM) is characterized by chronic hyperglycaemia; the latter predisposes persons living with diabetes to certain diseases of the eyes such as diabetic retinopathy, diabetic macular oedema, cataract, glaucoma etc, each of which may progress to visual loss and blindness. The burden and pattern of diabetic eye diseases among persons living with diabetes in the commercial city of Aba, Nigeria is not known. This study, therefore, set out to determine this. This was a 6-year retrospective study in which all diabetic patients referred to or presenting at the Ophthalmology clinic of Abia State University Teaching Hospital (ABSUTH) Aba, Nigeria between January 2013 and December 2018 were included. The patients were examined by ophthalmologists and optometrists. Visual acuity, refraction, tonometry, slit-lamp examination of the anterior segment and fundus examination were carried out on each patient. Data was analyzed using SPSS version 20.0 and p<0.05 was considered statistically significant. Participants in the study were 56 (44.4%) males and 70 (55.6%) females. Diabetic ocular complications occurred in 2.4% of the total Ophthalmology clinic visits in ABSUTH, Aba. The commonest diabetic eye disease was cataract which was present in 50% of the participants, No diabetic patient presented with blindness and the commonest co morbid disease in the participants was systemic hypertension. Ocular complications of DM constitute a significant burden to the Ophthalmology clinic visits in the commercial city of Aba and the commonest of these complications is cataract.

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