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Background: Monitoring of patients' experiences and satisfaction provide the health institution one of several parameters to measure quality of services and determine areas where improvement and or additional services are needed. Aim: To determine patients' satisfaction regarding the services in the ophthalmic out-patient clinic in University of Calabar Teaching Hospital. Materials and methods: A descriptive cross sectional study was conducted among patients attending the eye clinic of the department of ophthalmology, University of Calabar Teaching hospital, Calabar from 1st October to 31st December 2016. All consecutive registered adult patients who gave consent, along with consenting guardians of patients who were younger than 18 years were included in the study and interviewed. An Interviewer-administered pretested and validated questionnaire was used for data collection. Data obtained were analyzed using SPSS (Statistical Package for Social Sciences version 20 software). Frequencies and percentages were used. Parametric analyses included bivariate analysis and multiple logistic regressions and Pearson coefficient of correlation with p 0·05 being considered statistically significant. Results: The level of satisfaction with accessibility to the hospital and medical care in the eye clinic was very high 95.4%. On time spent in clinic, majority of respondents (50.8%) felt that the waiting time for emergency treatment was good. However, only 39.9% of the respondents felt that the waiting time to be attended to by a doctor in the routine clinic was short. Waiting time for performing an investigation and subsequently getting the result was reported as poor by 62.5% and very poor by 69% respectively. Conclusion: This study demonstrated that only 35.2% of respondents were satisfied with the overall quality of the medical care service received from the eye clinic of the UCTH, Calabar. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a leading cause of morbidity and mortality globally. Over a quarter of patients with hypertension have uncontrolled hypertension. Lifestyle modification has been shown to improve blood pressure control, thus measures that would help patients with hypertension achieve positive lifestyle modification would improve BP control. The study aims to determine the effect of motivational interviews on lifestyle modification and blood pressure control among patients with hypertension attending the Family Medicine Clinics of Irrua Specialist Teaching Hospital (ISTH), Irrua, Nigeria., Methods: The proposed study will be a randomised control trial (PACTR202301917477205). About 212 adults between 18 and 65 years with hypertension presenting to the Family Medicine Clinics of ISTH will be randomised into intervention and control groups. The intervention group will be given a motivational interview (MI) on lifestyle modification at the start of the study and monthly for 6 months in addition to standard care for the management of hypertension. The control group will be given standard care for the management of hypertension only without MI and seen monthly for 6 months. Both groups will be assessed at baseline and 6 months. At baseline, a qualitative technique will be used to determine the reason for not adopting lifestyle modification., Study Outcome: The primary outcome shall be lifestyle modification at 6 months while the secondary outcome shall be blood pressure control at 6 months., Conclusion: Findings from the study will provide cost-effective ways of blood pressure control and reduction in the disease burden of hypertension in Nigeria., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2024 by West African Journal of Medicine.)

Tissue factor (TF)-bound factor (F)VIIa plays a critical role in activating FX, an event that rapidly results in blood coagulation. Despite recent advances in the structural information about soluble TF (sTF)-bound VIIa and Xa individually, the atomic details of the ternary complex are not known. As part of our long-term goal to provide a structural understanding of the extrinsic blood coagulation pathway, we built an all atom solution-equilibrated model of the human sTF-VIIa-Xa ternary complex using protein-protein docking and molecular dynamics (MD) simulations. The starting structural coordinates of sTF-VIIa and Xa were derived from dynamically equilibrated solution structures. Due to the flexible nature of the light-chain of the Xa molecule, a three-stage docking approach was employed in which SP (Arg195-Lys448)/EGF2 (Arg86-Arg139), EGF1 (Asp46-Thr85) and GLA (Ala1-Lys45) domains were docked in a sequential manner. The rigid-body docking approach of the FTDOCK method in conjunction with filtering based on biochemical knowledge from experimental site-specific mutagenesis studies provided the strategy. The best complex obtained from the docking experiments was further refined using MD simulations for 3 ns in explicit water. In addition to explaining most of the known experimental site-specific mutagenesis data pertaining to sTF-VIIa, our model also characterizes likely enzyme-binding exosites on FVIIa and Xa that may be involved in the ternary complex formation. According to the equilibrated model, the 140s loop of VIIa serves as the key recognition motif for complex formation. Stable interactions occur between the FVIIa 140s loop and the FXa -strand B2 region near the sodium-binding domain, the 160 s loop and the N-terminal activation loop regions. The helical-hydrophobic stack region that connects the GLA and EGF1 domains of VIIa and Xa appears to play a potential role in the membrane binding region of the ternary complex. The proposed model may serve as a reasonable structural basis for understanding the exosite-mediated substrate recognition of sTF-VIIa and to advance understanding of the TFPI-mediated regulatory pathway of the extrinsic blood coagulation cascade.