A 5-year retrospective analysis of the pattern of adult femoral fracture in central hospital warri delta state

Abstract

Background

 The femur is the strongest and largest bone in the human body. It therefore requires high-energy trauma for it to fracture unless there is an ongoing pathology that weakens the bone. Femoral fractures are thus associated with significant pain, deformities, bleeding and varying degrees of injuries. The aim of this study is to determine the pattern of femoral fractures and the associated injuries in our region while recommending possible means of averting these injuries.

Materials and Methods:

 A 5-year retrospective study was done in National Orthopedic Hospital Warri from January-December 2020. The demographic data, etiology, the part of femur affected and associated injuries were collated from the hospital records/folders. The analysis was performed using descriptive statistics in Microsoft Excel 2007.

Results

A total of 562 cases were reviewed, 63.7% of all the patients were males and the most common etiological factor was road traffic accidents. The site of fracture varied with age and etiology with 26.5% occurring at the mid-shaft with an average age of 27.2 years and 16% occurring at the neck of femur, more in the elderly, with 55.6% following minor falls and trips. The most common associated injury was soft tissue injuries requiring secondary wound closure.

Conclusion

Femoral fractures are common and the pattern varies with age and the mechanism of injury. They are associated with other injuries that may be life-threatening.

References

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Accessing the relationship between lifestyle and health problems suffered by the people

CHAPTER ONE INTRODUCTION

Background to the Study

An individual‟s health depends alot on their lifestyle. Maintaining physical and mental health is crucial to an individual‟s longevity. The more time spent on hygiene, physical fitness, and diet regulation, the healthier lifestyle they have. Those who choose to participate in any kind of physical activity on weekly basis are generally healthier than those who don‟t. Mental illness may occur through various ways for example, depression may promote mental illness through stress and anxiety, poor habit eating not promoting good physical health. Poor habits may eventually lead to a poor or even dangerous life style. More interestingly, a healthy or unhealthy lifestyle will most likely be transmitted across generations.

United States (Administration on aging and retirement, 2005), changes in body composition, reduction in physical activity, and physiological factors affect the dietary requirements of retired Bozetti (2003). As people age, body fat increase and lean body mass decreases, which reduces protein reserves in the body. The predisposition of older individuals to

chronic pain or unless also may limit physical activity reduced physical activity and decrease in lean body, mass lower energy needs older adult. Consume fever calorie than young adults to obtain adequate protein and micro nutrients reduced energy needs, Bozettic (2003) retired especially those in low income groups, are at a high risk for nutritional deficiencies due to poor diet and low nutrients intake.

• Statement of the Problem

The problem of the retired civil servants in the society is supposed to be a tropical issue, especially in Katsina state, Nigeria. This is so because in the problems of poverty, illiteracy, ignorance and corruption, afflicts almost all segments of the society, but most biting to the retired population (Kasim, 2007).

In any given society the retirees is referred to, or perceived as „senior citizen‟ previewed experience in life on which the younger population are supposed to draw for aspiration, motivation and orientation. Yet this is very important segment of the population could be said to be among the weak and vulnerable population in our society almost in the same category with children, orphans and the disabled. This is because of the various problems that the retirees face and in the society particularly with regards to lifestyle.

Socioeconomic status affects overall human functioning, including their physical and mental health e.g. when retired. Income and access to resources mitigate a social problem that ultimately affects retirees, retired people in Nigeria this category remain among te most economically vulnerable groups, the majority of retired do not work or have fewer options for continued income in Katsina state. They are at risk for rising costs of living, which may place them at an economic disadvantage (social security administration, 2006).

Recent studies indicated that the quality of care afforded to retired adults with medicate condition is substandard in Katsina state (Adamu, 2004). Furthermore, older people who work are less likely to maintain employment as their health declines.

Psychological health and wellbeing of the retired in Katsina state, the researcher observed that poverty is the risk factor for declines in mental health among the retirees. Those at

 

the lower levels of socioeconomic status are often most afflicted with psychological disorder.

Poverty affects the health of the retired in significant ways. Some of the retired in Katsina were simply unable to afford. The basics of minimal health care and prescription drugs

e.g. the urban retirees. It is not unusual to find this group skipping on their prescriptions, skipping days or cutting the dosage. They may even share prescription drugs with others or take medication that is out of date and therefore ineffective or potentially dangerous. All this amount to drug abuse which is dangerous to their failing health.

Social activities of the retirees are somehow affected when they are unable to afford simple care, e.g. eyeglasses or hearing aids. They are unable to afford simple care, e.g. eyeglasses or hearing aids. They begin to isolate themselves and feel cutoff from the life around them. Many cannot afford simple nutritious food/ three square meal in aday. They prepare to buy the cheapest. Many retirees died of heat exhaustion had no access to air conditioning and were too afraid to open their windows fearing intruders. They died in their sealed apartments; they heat their rooms often using dangerous methods such as firewood and charcoal.

Some retired in Katsina cannot afford even the simple pleasures of social interaction or entertainment. Combine this with physical limitation, health problems like hypertension, diabetes, body pains, arthritis etc. and unsafe community or neighborhoods.

Kamala (2007) indicates that the retired people in the society suffered from ill health and are not properly taking care of by their children or the society. Also within Katsina state the retired are mostly seen by the researcher begging for assistance on the streets, places where they

 

work before. This prompted the researcher to look into the type of care and welfare given to the retired in Katsina state.

Thus majority of the retiree‟s population do not get their benefits on time. Most of them rely on the active members of the family for support, particularly their children if they have any. Where income earning children of this group could not meet their demands they depend on good will of relatives and good samaritans in the community/society. This is why a lot of them are compelled to live a life of begging in one form or the other. In this situation the mode of their life style changes and involves them in socially disapproved behaviours. Similarly, retired health status can also be determined by the lifestyle where there is change in health status there is possibility of being unhealthy, disability due to disease like hypertension and depression. Most  of the retired were facing problem with their general health due to lack of good nutritional food intake, especially those who reside in rural areas. The retired people experience financial hardships following retirement, therefore finding it difficult to care for themselves, eat good food and healthy life, from there the situation worsened (Salim, 2002). It is as a result of the above disturbing issues that the researcher was worried to investigate the relationship between life style and health status of retired civil servants in Katsina State, Nigeria

•       Objectives of the Study

 

The major objective of the study is to examine the relationship between lifestyle and health status of retired civil servants in Katsina State.

The Specific Objectives of the Study are to;

 

• determine the relationship between the health status and food consumption patterns of retired civil servants in Katsina
• determine the relationship between the lifestyle and income of retired civil servants in Katsina
• identify the social network that exists for enhancing lifestyle and health status of the retired civil servant in Katsina
• determine the care given by the relations of the retired civil servants and his/her lifestyle in Katsina

Research Questions

 

• What is the relationship between health status and food consumption patterns of retired civil servants in Katsina State?
• What is the relationship between lifestyle and income of retired civil servants in Katsina State?
• What is the relationship between social network that exists for enhancing lifestyle and health status of the retired civil servant in Katsina

1. What is the relationship between the care given by the relations of the retired civil servants and his/her lifestyle in Katsina State?

•   Hypotheses

 

• There is no significant relationship between the health status and food consumption patterns of retired civil servants in Katsina
• There is no significant relationship between lifestyle and income of retired civil servants in Katsina
• There is no significant relationship between social network that exists for enhancing lifestyle and health status of the retired civil servant in Katsina
• There is no significant relationship between the care given by the relations of the retired civil servants and his/her lifestyle in Katsina

• 1.3 Significance of the study

 

This study is going to be of benefit to policy makers, civil society, general public, scholar, academicians and Home economist.

The study will enlighten policy makers, based on facts and what need to be done with regards to retired civil servants lifestyle and health status in Katsina State and this could be achieved publications and seminars. For civil society the study will help and provide information on how to save judiciously and prepare for their retirement and this could be achieved through awareness campaign during and after their services.

To the general public, the study would provide general information on how retired civil servants strive to make ends meet and such information that would facilitate information sharing and discharge, and the general public would have access to this findings through radio and other media publicities. For Scholars, academicians and Home economist, this study would serve as an avenue or source of information which would aid further studies and it would be available for the academicians and scholars in school libraries.

• Basic Assumption

 

There are several assumptions underlying this study, it was assumed that unobservable concepts such as individual expectations of lifestyle, and health status of retired civil servants would be qualified and measured by the instrument. It is assumed that the retired civil servants have expectations for good lifestyle and good health status. The researcher assumed that the individual retired civil servants would provide truthful and accurate answer to the questions measuring the concepts of interest in this study.

• Delimitation

 

The research work was delimited to lifestyle (nutrition) and health status (depression, diabetes, hypertension and cancer) of the retired civil servants population in Katsina State. The study was also delimited to food consumption patterns of retirees in Katsina state. The study was also delimited to the three senatorial zones of Katsina States. The study was be delimited to both male and female retired civil servants.

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EXAMINATION OF EFFICIENCY OF HOSPITAL FACILITIES IN THE NIGERIAN HEALTH SYSTEM

 

CHAPTER ONE

INTRODUCTION

1.1     Background   of the Study

Health is one of the most important services provided by the government in  every country of the world. In both the developed and developing nations, a significant proportion of the nation’s wealth is devoted to health. For example, the World Health Reports (2006) gave Nigerian government’s expenditure on health as a percentage of the nation’s Gross Domestic Product (GDP) for year 2001, 2002, and 2003 as 5.3 percent, 5 percent, and 4.7 percent respectively. This is to show the fact that Nigerian government health care expenditures are not only significant in absolute terms but also relative to the Gross Domestic Product.

 

Developing nations’ expenditure on health, however, ought to be more substantial than that of the developed nations. This is because in developing countries like Nigeria, with relatively low level of mechanization and automation, health assumes additional dimension of importance in terms of implications for economic activities. The Federal Ministry of Health in Nigeria (1998) noted that the health of the people not only contributes to better quality of life, it was also essential for sustained economic and social development of the country as a whole. Hence, health is regarded as a critical resource in the process of economic development.

 

Consequently, spending on health is not only consumption expenditure, but a productive investment both at individual and national levels. On the enterprise scale, for example, a healthy workforce reduce the cost of building slacks into the production schedules; enhance investment in staff training and exploitation of the benefits of specialization (Nwaobi, undated). At the national level, a healthy population is potentially a more productive population. This reasoning   justifies national resource deployment to health and the increased campaign to use organized healthcare. It is assumed that increased access and use of health services will improve the health status of the population.

 

It is the quest for increased access to health care so as to ensure that Nigerians attain a level of health that would make it possible for the people to lead socially and economically productive life that informed the health sector reform. The reform made primary healthcare the cornerstone of the nation’s health system with responsibilities for health shared among the three tiers of government. Thus, the Nigerian health system based on the national administrative structure is vertically divided into three tiers of primary, secondary and tertiary levels each being the responsibility of Local, State and the Federal Government respectively.

 

In terms of institution, the primary health care level is made up of public health care centres and clinics, dispensaries, private clinics and maternity centres. The secondary care level consists of general, cottage and mission hospitals, while teaching and specialist hospitals exist at the tertiary level. These tiers, by design, are closely related to one another with the higher tier designed to assist the lower care levels by handling referral cases from the lower facilities. Responsibilities for health at the primary level reside with the local government while the Federal government has responsibility for policy formulation, monitoring and evaluation of the nation’s health system. The states manage secondary facilities and provide logistic support for the local government in form of personnel training, financial assistance, planning and operations (Federal Ministry of Health, 2000).

 

However, this segregation of responsibilities for health has inherent problems of coordination. In effect, the organizational structure of the Nigerian health system has significantly affected managerial decisions, financing and incentive structure. This has altered the operation of healthcare facilities, hospitals and health centres in terms of medical inputs and service provisions. Chang (1998) and Rosko (1999) indicated that changes in financial mechanism of public hospitals can increase financial pressures and point to the need for performance improvement.

 

This highlights the need for prudential principles of healthcare management in the Nigerian health system especially in the nation’s hospitals and health centres. This is because hospitals are the prime resource consuming units in any national health care system and it is the dominant sector of the health care system (Rosko, Chiligerian, Zin and Aaronson, 1995; Mckee and Healy, 2002). Though direct evidence is difficult, it is however reasonable to assume that hospitals can contribute to overall populations care health status by providing care to the people. In addition, hospital services can reduce poverty levels and promote economic developments through minimizing mortality in the population (Mackee and Henley, 2000). Besides, hospitals as a dominant sector and prime resource consuming agent in the health system, their performances and resource utilization are a key determinant of the overall performance of the health care system. It is intuitively compelling to reason that health centres and hospital functions can improve population well being and meet social needs.

 

The performance of these critical institutions in the health care sector must be assessed if health and development goals are to be met. According to Sowlati (2001), there has been an increasing emphasis on measuring and comparing efficiency of organizational units such as banks and healthcare facilities where there are relatively similar sets of unit. In the light of apparent resource constraints in the Nigerian health care sector, social pressures that demand greater accountability from public organizations and research evidences indicating that private and public sector organizations do not always use resource efficiently (Yaisawarng and Puthucheary, 1997) interest in performance evaluation of public organization has increased. These and the increased demand to provide justification for resource allocation seem to have increased motivations for performance measurement efforts.

 

Furthermore, performance metric for public sector assumes important dimensions in terms of its implication for service expansion and justification of public expenditures. Dash, Vaishnari, Muraleedharan and Acharya (2007) observed that performance measurement constitutes a rational framework for the distribution of human and other resources between and within health care facilities. And, efficiency measurement by monitoring performance of individual hospital and comparing them with one another is a useful tool for improving management, rationalizing resource allocation, and mobilizing additional inputs (Afzali, 2007).

 

Higher efficiency can allow greater production and better quality of services often without consuming additional financial and real resources. Therefore, a key question to ask is; are Nigerian health care facilities efficient? If there is need for improvement, by how much can they be improved? A deliberate focus on how well the production process transforms resources into output should prove useful for addressing such questions for public allocation decisions.

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