This study presents a comprehensive review of digital tools used in clinical learning at a time when clinical learning is moving from its core traditional format to digitalised tools. This transition has been hastened and made more imperative by the coronavirus disease 2019 pandemic. The review highlights the main digital tools used for clinical learning, the challenges, benefits and prospects of digital tools in clinical learning. These digital tools have made some gains and in this rapidly expanding digital age, and the onus rests on students, medical educators and training bodies to keep abreast with its scope and possibilities, as well as its challenges and limitations, for the best outcomes in the application of digital tools to clinical education.

BACKGROUND: Laparoscopic myomectomy for removal of uterine fibroid in resource-limited settings is cost prohibitive. Open abdominal myomectomy is unarguably more affordable, despite the drawbacks. OBJECTIVE: The study aimed to determine fertility and obstetric outcomes after an open abdominal myomectomy. MATERIALS AND METHODS: A retrospective descriptive study that involved the retrieval of medical records, and analysis of the data of women who had open abdominal myomectomy due to uterine fibroid and unexplained infertility, in a private health facility in Abraka, Delta State, Nigeria, from 1 February 2014 to 31 January 2021. The age, duration of infertility, location of fibroid masses within the uterus, history of previous pregnancy, pregnancy after myomectomy, pregnancy outcome and amongst other variables were captured and analysed using IBM SPSS version 23. RESULTS: The data for 69 (88.5%) out of the 78 patients who had myomectomy was available for analysis. The mean age of patients was 33.3 ± 4.7 years; about 2/3 (65.5%) of the patients were ≤30 years. The pregnancy rate after myomectomy was 55.1% (38/69), most (44.9%) of the pregnancies occurred in the 1^st year after myomectomy and about half (46.4%) of the patients were delivered by caesarean section. Patient's age, shorter duration of infertility and fewer fibroid masses were significantly associated with favourable fertility outcomes (P < 0.001, P < 0.001 and P < 0.05, respectively). Age ≤30 years was most predictive of pregnancy after myomectomy, P < 0.017. CONCLUSION: The study showed that women with uterine fibroid and unexplained causes of infertility at age ≤30 years have good fertility and obstetric outcome after open abdominal myomectomy.

BACKGROUND: Sickle cell anaemia (SCA) is a chronic multi-systemic condition characterized by haemoglobin polymerization leading to erythrocytes rigidity, frequent haemolysis and vaso- occlusion. It is an autosomal recessive disorder associated with high morbidity and mortality. The prevalence of the disease varied from one location to the other. AIM AND OBJECTIVES: This study determined the prevalence in Nasarawa state, the commonest crisis and the risk factors / complications of the disease. MATERIALS AND METHODS: A hospital-based study of sickle cell anaemic patients seen between January 1st of 2013 to the December 31st of 2018. Hospital records, emergency units register and patients' folders served as the source of the secondary data. Analysis was done using SPSS version 23. Data was presented in tables, with categorical variables in frequencies and percentages while the continuous variables were presented as mean and stand deviation. RESULTS: There are slightly more males than females with a ratio of 1.2:0.8. The mean age of diagnosing SCA was 9.7±6.6 years, with 55.7% of cases aged between 5 – 15 years. The prevalence of SCA in Nasarawa state was 0.02%. Two third of reasons for hospital presentation by sickle cell anaemic patients are due to vaso-occlusive crisis. About one in every five presents with deepening jaundice suggestive of hyperhemolytic crisis. Cellulitis and malaria were the commonest triggers leading to hospital admission in this study. Vaso-occlusive crisis warranting admission, while about a third had received blood transfusion at least once. CONCLUSIONS: The burden of sickle cell anaemia is low in Nasarawa State. Vaso-occlusive crisis is the commonest acute manifestation at admission. Cellulitis and malaria are the leading triggers of such cases warranting hospital admission. Keywords:

BACKGROUND: The Southern part of Nigeria, where Delta State's Central Senatorial District lies, has continued to record low levels of family planning (FP) service uptake despite their high level of awareness. This situation has led to poor health outcomes amongst women, children and the general population. Thus, poor progress towards achieving Sustainable Development Goal 3 which aims to ensure healthy lives and promotes well-being for all at all ages, with specific targets related to promoting family planning services. AIM: This study aims to assess the level of awareness of FP uptake, the socioeconomic and sociocultural predictors of FP uptake and the major barriers influencing the uptake of FP services in the Central Senatorial District of Delta State. METHODS: The study employed a cross-sectional descriptive design. Multistage sampling method was used to obtain a sample of 407 respondents drawn from females of reproductive age in suburban and rural communities. Data were collected through a researcher-administered questionnaire and analysed using SPSS version 26. Chi-square test was used to determine significant associations, and logistic regression analysis was used to determine the predictors. RESULTS: Findings from this study revealed that awareness about FP amongst females was high (69.3%), but only two-fifths (42.3%) were using FP. The socioeconomic predictors of FP uptake were marital status (P = 0.004) and the type of community lived in (P = 0.010). The sociocultural predictors of FP uptake were spousal approval (P = 0.02), social groups' approval (P = 0.053), belief in the effect of curses (P = 0.001), prayers (P = 0.016) and traditional practises (P = 0.000). CONCLUSION: This study revealed high awareness about FP but low uptake amongst females of reproductive age due to identified socioeconomic and sociocultural factors. Therefore, the local and state governments should increase health education and promotion in rural areas to improve health knowledge. Furthermore, non-governmental organisations associated with reproductive health should extend their programmes into rural areas and promote the creation of more FP advocacy social groups, to channel FP messages to the communities.

BACKGROUND: The adopted health facility pilot demonstration programme was targeted to achieve sustainable development goals 3 and 5. Nigeria is one of the countries with poor maternal, newborn/child health outcomes – over 800 maternal deaths per 100,000; under-5 mortality 113–200/1000 live births; NMR of 36/1000 live births. Improving health indices through clinical monitoring, reducing neonatal tetanus (NT) risk factors and health systems strengthening can improve MNCH indicators. These factors were considered in the program and indicators were related to Medical Women's Association of Nigeria's themes/subthemes. METHODS: Interested states were given a letter of introduction to their selected health facility, a plaque to mount in the facility and a template for data submission. Data were sent from facility focal persons through the State Presidents to the National Coordinator, collated and analysed from January 2020 to December 2021. Data were used to track MNCH indicators and intervene. Interventions implemented included training on Strengthening Health Systems, supportive supervision, provision of commodities, for example, chlorhexidine gel, flier distribution and airing jingles. Monthly Monitoring/Evaluation Sessions started from January 2021 for dissemination to stakeholders and receiving feedback. A major intervention was sensitisation on family planning (FP), maternal/NT elimination, female genital mutilation, HIV/AIDS during 2021 World Population Day commemoration. RESULTS: The project involved 16 health facilities in 14 states. The results of 12 health facilities from 10 States are being presented in this article. There was a marked reduction of NT cases from 16 in 2020 to 3 in 2021. After WPD activities, 10 states had increased contraceptive utilisation. Lack of FP commodities, insecurity and COVID-19 negatively affected FP uptake in four facilities. Facilities increased food demonstrations after supportive supervision. CONCLUSION: This project demonstrates that instituting an efficient all-embracing monitoring/evaluation system in the health sector using objectively verifiable indicators, can contribute to improving health indices of African nations such as Nigeria.

We report the cases of three patients who presented to our retinal outpatient clinic over a 3-year period with sudden visual loss and features suggestive of subhyaloid or sub-internal limiting membrane haemorrhage characteristic of Valsalva (VS) retinopathy. The first patient was a 14-year-old male student with sudden visual loss in the left eye of 2 days with a history of cough. His best-corrected visual acuity (BCVA) was 6/5 and counting fingers, respectively, in the right and left eyes. Our second patient was a 21-year-old primigravida at the gestational age of 32 weeks who presented with sudden visual loss in the right eye of 9-day duration associated with a history of vomiting and BCVA of counting fingers and 6/6 right and left eyes, respectively, whereas the third case was a 30-year-old P2⁺⁰ (2 alive) female with poor vision in the right eye post-delivery of a live neonate through vaginal delivery with BCVA of counting fingers and 6/6, respectively, in the right and left eyes at presentation. The patients' demographics, presentation and risk factors for VS retinopathy are discussed. All patients in this series were managed conservatively.