Background: Emergency preparedness programs enable organizations and communities to deal with emergencies effectively and appropriately. Integrated Disease Surveillance and Response (IDSR) contributes to epidemic preparedness by providing skills and information for early detection of outbreaks, leading to enhanced preparedness for emergency situations. Methods: This cross sectional descriptive study was carried out to assess the knowledge, attitude and implementation of IDSR among doctors and nurses at the Lagos State University Teaching Hospital, Ikeja. Stratified sampling technique was used to collect information from 246 respondents using self administered structured questionnaires. Data obtained was analyzed using Epi Info 2002 version 3.5.1. Results: This study revealed that only 24.4% (60) of the doctors and nurses were aware of IDSR, among this group, two third had good knowledge of IDSR and almost all had good attitude towards IDSR. Less than 50.0% of the doctors and nurses who knew about IDSR had been involved in disease notification campaign, 36.7% in preventive care campaign, 16.7% in investigation and confirmation of outbreaks, 5.0% in data collection while 18.3% had been trained. None of the nurses had been trained on IDSR, while being a doctor was a predictor for participating in preventive campaign and investigation of suspected outbreak. Conclusion: Implementation of IDSR was poor in this tertiary health facility. There is need for a functioning committee and training of health care workers to improve knowledge and practice.

Objective: Normal gestation is associated with an increased plasma volume (PV) and vasodilation which plasma prostacyclin (PGI2) may account for. This study measured PGI2 levels in pregnant haemoglobin (Hb) SS patients as they have been reported to lack PV expansion. Methods: Urinary prostacyclin (UP) concentration and full blood count parameters were determined in pregnant Hb AA and Hb SS women, with non-pregnant controls. Results: Thirty-three Hb AA (19 non-pregnant and 14 pregnant) and 25 Hb SS (18 non-pregnant and 7 pregnant) were studied. UP did not rise in pregnant Hb SS women compared to non-pregnant (Geometric mean (GM) 614 ± 2.4 vs 248 ± 3.8, p=0.063), despite a very significant rise in Hb AA pregnancy (GM 1406 ± 2.1 vs 260 ± 2.9 pg/ml, p<0.0001). Conclusion: There is a lack of significant rise in plasma prostacyclin levels during pregnancy in Hb SS women, which could account for their reported lack of plasma volume expansion.

Background: Undergraduate medical education is only an initial step in training the highly differentiated doctor. The medical specialties chosen by doctors for their career play an important part in workforce planning of healthcare services and as a predictive index in the composition of medical graduates and potential physicians. However, there is little theoretical understanding of how different medical specialties are perceived or how choices are made. Objective: The aim of this study is to shed more light on how medical students view specialisation as well as to discover the factors that strongly influence their choice of medical specialty. Methodology: This study was a descriptive cross-sectional study carried out using anonymous self-administered questionnaire. Simple random sampling technique was used. Data management and analysis was done using SPSS software version 15.0. Results: The response rate was 93.7%. The respondents had a good overall knowledge about specialisation in Medicine as 175 (98.3%) of the respondents knew about specialisation in Medicine as well as the different specialties in Medicine. Majority 126 (70.8%) of the respondents would want to specialise and about two-thirds, 112 (62.9%) indicated preferred specialties as Obstetrics & Gynecology 31 (17.5%), Pediatrics 30 (16.7%), Surgery 25 (14.3%), Internal medicine 17 (9.5%) and Public Health 14 (7.9%). Conclusion: The study revealed the patterns of preference of medical students to medical specialty and factors that strongly influence their choice during clinical postings.

Background: Technological advances and computing have expanded both the scope and capacity of diagnostic medical imaging (the radiography profession). This has created many diverse imaging modalities which in turn, have culminated in different sub-specialties in the profession. Objective: The aims of the study were to determine the level of awareness of imaging sub-specialties, preferred sub specialties and reasons for preferences of sub-specialties in senior level radiography students of the University of Lagos. Methods: The study was a prospective cross-sectional survey. Consents were obtained before the students were recruited for the study. Data Collection and Analysis: A questionnaire semi-structured in line with objectives of the study was used in data collection. A computer software Epi Info version 3.3 was used to analyze data while results were expressed as percentages of responses and were presented in tables and pie charts. Results : Greater than 90% showed awareness of sub-specialties in the radiography profession whereas 35% preferred ultrasonography to other sub-specialties. The least preferred sub-specialty was conventional radiography (4.3%). Remuneration (73.3%) and less physical exertion (73.3%) were major attractors to preferred sub-specialties whereas concerns over radiation hazard were major detractors (58.3%). Conclusion : Awareness of sub-specialties in the radiography profession was high amongst students studied. Furthermore, ultrasonography was the most preferred sub-specialty among the respondents. Remuneration was the main attractor to sub-specialties whereas fears over effects of ionizing radiation were the major detractors to some sub-specialties.

Background: Acute medical deaths are usually consequences of acute critical diseases, or acute exacerbations of chronic diseases. Thus, autopsy - confirmed characteristics would provide support for future management strategies. Objectives: To examine clinical and autopsy parameters including causes of death (COD) and mechanisms of death (MOD) among acute medical deaths. Methods: A 5-year (2005-2009) retrospective analysis was undertaken of Emergency Department (ED) related medical deaths occurring <24 hours after presentation. Case-notes provided clinical details while autopsy records supplied the COD and MOD respectively. Results: Decedents were 250 males (58.5%) and 177 females (41.5%), (male: female ratio=1.4: 1), predominantly (78%) young; with mean age of 43.7±16.6 years. In 22.8%, symptom duration was <1 day but >4 days in 42.8%. Coma -36%, and dyspnoea -10% prompted early presentation; but late presentation (>4days) characterised cough (4%), fever (10%), and body swelling (19%). Of the total, 23% presented after 10 pm, 16% were "dead on arrival" (DOA), and 40% died within six hours of arrival. Three commonest CODs were circulatory-cardiovascular disease [CVD](36%), infections/septicaemia (18%), and malignancies (8.4%). CVD subset was older (52 years), with significant male preponderance (62.5% vs 37.5%; p<0.05); but comparable mean age in both sexes. Common MODs were cerebral dysfunction (29%) - including sub-types of intra-cerebral haemorrhage (51.8%) and tonsillar herniation (33.3%), heart failure (19%), and septicaemia (15%). Conclusion: The highlights were late presentation, early demise from communicable and noncommunicable diseases; and common "exit" mechanisms of septicaemia, heart failure and cerebral dysfunction. These data will guide management and preventive strategies.