Background: Malnutrition is a global problem affecting all, irrespective of age and race. However, countries in Africa are disproportionately affected due to endemic poverty and war. The problem of malnutrition is worsened by the high burden of the human immunodeficiency virus in the region, which also significantly alters the body image of people affected. Objectives: This study aimed to assess the nutritional status and body image perception among people living with human immunodeficiency virus in a tertiary center in Southwest Nigeria. Materials and Methods: A total of 258 participants were recruited for this descriptive cross-sectional study conducted between March and July 2022 using a simple random sampling technique. Data were collected using an interviewer-administered questionnaire and analyzed using IBM® SPSS version 23. Chi-square test was used to assess for associations between sociodemographic characteristics and the outcome variables, while kappa statistic was used to measure agreement between participants’ actual and perceived nutritional status. Results: The mean age of respondents was 44.6 ± 11 years. A Close to half (48.1%) of the respondents had normal body mass index, while 17.1% and 6.6% were obese and underweight, respectively. Most respondents (72.9%) perceived their body image as “just right,” with another 14.3% perceiving theirs as “too thin.” Of most respondents, 78.3% were satisfied with their perceived body image. Conclusion: Most of the respondents in this study had positive body image perception; however, a sizable proportion suffers from overweight and obesity, which may increase their risk of cardiovascular events. Consequently, clinic managers should encourage routine nutritional assessment and education for early detection and prevention of overnutrition in all antiretroviral therapy clinics.
{"title":"Assessment of nutritional status and body image perception among people living with human immunodeficiency virus in a tertiary center, Southwest Nigeria","authors":"Ayotunde Azees, AbdulMuminK Ahmed, M. Fasiku, MakindeA Adeniyi, Abiola Temitayo-Oboh, Abdullahi Ahmed, Olumide Isarinde","doi":"10.4103/ijmh.IJMH_16_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_16_23","url":null,"abstract":"Background: Malnutrition is a global problem affecting all, irrespective of age and race. However, countries in Africa are disproportionately affected due to endemic poverty and war. The problem of malnutrition is worsened by the high burden of the human immunodeficiency virus in the region, which also significantly alters the body image of people affected. Objectives: This study aimed to assess the nutritional status and body image perception among people living with human immunodeficiency virus in a tertiary center in Southwest Nigeria. Materials and Methods: A total of 258 participants were recruited for this descriptive cross-sectional study conducted between March and July 2022 using a simple random sampling technique. Data were collected using an interviewer-administered questionnaire and analyzed using IBM® SPSS version 23. Chi-square test was used to assess for associations between sociodemographic characteristics and the outcome variables, while kappa statistic was used to measure agreement between participants’ actual and perceived nutritional status. Results: The mean age of respondents was 44.6 ± 11 years. A Close to half (48.1%) of the respondents had normal body mass index, while 17.1% and 6.6% were obese and underweight, respectively. Most respondents (72.9%) perceived their body image as “just right,” with another 14.3% perceiving theirs as “too thin.” Of most respondents, 78.3% were satisfied with their perceived body image. Conclusion: Most of the respondents in this study had positive body image perception; however, a sizable proportion suffers from overweight and obesity, which may increase their risk of cardiovascular events. Consequently, clinic managers should encourage routine nutritional assessment and education for early detection and prevention of overnutrition in all antiretroviral therapy clinics.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139328121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Nnagbo, C. Dim, M. Eze, Emmanuel Ugwu, Ifeanyi Nwagha
{"title":"Unmet need for assisted reproductive technology in Nigerian Tertiary Hospitals: An unspoken menace","authors":"J. Nnagbo, C. Dim, M. Eze, Emmanuel Ugwu, Ifeanyi Nwagha","doi":"10.4103/ijmh.IJMH_40_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_40_23","url":null,"abstract":"","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139326562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abubakar Y’au, C. Batta, O. Osi-ogbu, Amina Ahmed, Onyedika Okoye
{"title":"Diagnostic dilemma: A case of pre-ileal appendicitis presenting with chronic diarrhea at National Hospital Abuja, Nigeria","authors":"Abubakar Y’au, C. Batta, O. Osi-ogbu, Amina Ahmed, Onyedika Okoye","doi":"10.4103/ijmh.IJMH_8_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_8_23","url":null,"abstract":"","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139327488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: With the advent of family planning policies and evolving societal norms, there has been a noticeable shift from large families to single-child families. For a single child, the presence of parents takes on a profound significance while they navigate the world. Conversely, children from larger families often find encouragement from their siblings, thereby fostering independent engagement in the world. Objective: This study investigated the psychosomatic and psychosocial problems of single children in families and compared them with those of children with siblings. Materials and Methods: A cross-sectional study was conducted among students in Jaipur, Rajasthan, India. A total of 120 single children were randomly selected and used for the study. The control group consisted of a similar number of students who had siblings. Relevant data were obtained using pretested interviewer-administered questionnaires. Results: Out of the 240 students studied, 47 had psychosocial problems which correspond to a prevalence rate of 19.6%. The prevalence of psychological problems was significantly higher in single children than in children with siblings (38/120% vs. 9/120%; odds ratio [OR]: 5.72; 95% confidence interval [CI]: 2.6–12.5; P < 0.001). On the other hand, 89 students had psychosomatic problems which correspond to a prevalence rate of 37.1%. The prevalence of psychosomatic problems was significantly higher in single children than in children with siblings (54/120% vs. 35/120%; OR: 1.99; 95% CI: 1.2–3.4; P = 0.01). Conclusion: Both psychosocial and psychosomatic problems are more prevalent in single children than in children with siblings. These findings suggest that having no sibling(s) has a negative impact on a child’s mental health.
{"title":"A Study on comparison of psychosocial and psychosomatic problems of a single-child versus a child with sibling(s)","authors":"Sujan Singh, Ashish Jain, Alpana Choudhary, Anjali Jain","doi":"10.4103/ijmh.IJMH_23_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_23_23","url":null,"abstract":"Background: With the advent of family planning policies and evolving societal norms, there has been a noticeable shift from large families to single-child families. For a single child, the presence of parents takes on a profound significance while they navigate the world. Conversely, children from larger families often find encouragement from their siblings, thereby fostering independent engagement in the world. Objective: This study investigated the psychosomatic and psychosocial problems of single children in families and compared them with those of children with siblings. Materials and Methods: A cross-sectional study was conducted among students in Jaipur, Rajasthan, India. A total of 120 single children were randomly selected and used for the study. The control group consisted of a similar number of students who had siblings. Relevant data were obtained using pretested interviewer-administered questionnaires. Results: Out of the 240 students studied, 47 had psychosocial problems which correspond to a prevalence rate of 19.6%. The prevalence of psychological problems was significantly higher in single children than in children with siblings (38/120% vs. 9/120%; odds ratio [OR]: 5.72; 95% confidence interval [CI]: 2.6–12.5; P < 0.001). On the other hand, 89 students had psychosomatic problems which correspond to a prevalence rate of 37.1%. The prevalence of psychosomatic problems was significantly higher in single children than in children with siblings (54/120% vs. 35/120%; OR: 1.99; 95% CI: 1.2–3.4; P = 0.01). Conclusion: Both psychosocial and psychosomatic problems are more prevalent in single children than in children with siblings. These findings suggest that having no sibling(s) has a negative impact on a child’s mental health.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139328589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arnav Tongaonkar, Kavita Joshi, Alhad Mulkalwar, Setu Dagli
Background: Polypharmacy or the use of multiple medications is one of the most common and significant causes of adverse drug reactions (ADRs). While there are potential risks associated with polypharmacy, there are numerous benefits when drugs are combined to cure and alleviate symptoms, or prevent complications. Balancing the risks and benefits is becoming increasingly difficult, especially with the advent of over-the-counter drugs and alternative medicine. Objectives: To determine the incidence and impact of polypharmacy on ADRs in an inpatient medicine ward of a tertiary care hospital in India. Materials and Methods: This was a hospital-based, prospective, observational, study. The Patients’ data was recorded using a structured ADR reporting form. The baseline parameters, medical history, clinical data, characteristics of ADRs, and details of the medication responsible for ADRs and those used to treat ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences version 26.0 software. Results: A total of 164 patients fulfilling the inclusion criteria were admitted during the study period. Of this number with ADR, 95 (57.9%) had polypharmacy while 69 (42.1%) did not have polypharmacy. The observed difference was statistically significant (OR: 1.90; 95% CI: 1.2-2.9; P = 0.004). Conclusion: Polypharmacy is a significant contributor to ADR-related admissions and inpatient ADRs in India. Therefore, there should be careful and adequate consideration before initiating multiple drugs as well as regular follow-up to identify and treat any case of ADR.
{"title":"Analysis of the incidence of polypharmacy in cases of adverse drug reactions at a Tertiary Care Centre in India","authors":"Arnav Tongaonkar, Kavita Joshi, Alhad Mulkalwar, Setu Dagli","doi":"10.4103/ijmh.IJMH_77_22","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_77_22","url":null,"abstract":"Background: Polypharmacy or the use of multiple medications is one of the most common and significant causes of adverse drug reactions (ADRs). While there are potential risks associated with polypharmacy, there are numerous benefits when drugs are combined to cure and alleviate symptoms, or prevent complications. Balancing the risks and benefits is becoming increasingly difficult, especially with the advent of over-the-counter drugs and alternative medicine. Objectives: To determine the incidence and impact of polypharmacy on ADRs in an inpatient medicine ward of a tertiary care hospital in India. Materials and Methods: This was a hospital-based, prospective, observational, study. The Patients’ data was recorded using a structured ADR reporting form. The baseline parameters, medical history, clinical data, characteristics of ADRs, and details of the medication responsible for ADRs and those used to treat ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences version 26.0 software. Results: A total of 164 patients fulfilling the inclusion criteria were admitted during the study period. Of this number with ADR, 95 (57.9%) had polypharmacy while 69 (42.1%) did not have polypharmacy. The observed difference was statistically significant (OR: 1.90; 95% CI: 1.2-2.9; P = 0.004). Conclusion: Polypharmacy is a significant contributor to ADR-related admissions and inpatient ADRs in India. Therefore, there should be careful and adequate consideration before initiating multiple drugs as well as regular follow-up to identify and treat any case of ADR.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139325040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Opakunle, O. Aloba, C. Nwozo, David-Daniel Adesanya, O. A. Adebimpe
Background: A key step in the detection of suicide risk in a primarily nonpsychiatric population will be the use of a simple brief self-reported psychometrically valid and reliable instrument that does not require prior training to administer. Objective: This study aimed to explore the possibility of adapting the 14‑item hospital anxiety and depression scale (HADS) as a self-rated suicide risk screening tool in a sample of Nigerian surgical patients. Materials and Methods: This is a cross-sectional study involving 462 Nigerian patients attending a surgical outpatient clinic. They completed the Sociodemographic questionnaire, the 14-item HADS, the suicidality module of the Mini‑International Neuropsychiatric Interview, and the brief version of the World Health Organization Quality of Life Questionnaire. The reliabilities of the HADS-anxiety and depression subscales were evaluated by calculating the omega (ω) coefficients. Receiver operating characteristics curve analysis was performed to determine the suicide risk screening characteristics of the HADS-anxiety and depression subscales. Results: The omega (ω) reliability coefficients of the HADS subscales were satisfactory. At a cutoff score of 10 HADS-anxiety subscale exhibited satisfactory sensitivity (0.750) and specificity (0.938) while the HADS-Depression subscale at a cutoff score of 7 had the best combination of sensitivity (0.750) and specificity (0.905). The prevalence rate of lifetime suicide attempts in our sample was 1.5%, whereas 1.8% of our respondents had high suicide risk. Conclusion: The 14-item HADS has shown to be a suitable self-rated suicide risk assessment tool among Nigerian surgical patients.
{"title":"Psychometric adaptation of the hospital anxiety and depression scale as a self-rated suicide risk assessment instrument among Nigerian surgical patients","authors":"T. Opakunle, O. Aloba, C. Nwozo, David-Daniel Adesanya, O. A. Adebimpe","doi":"10.4103/ijmh.IJMH_34_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_34_23","url":null,"abstract":"Background: A key step in the detection of suicide risk in a primarily nonpsychiatric population will be the use of a simple brief self-reported psychometrically valid and reliable instrument that does not require prior training to administer. Objective: This study aimed to explore the possibility of adapting the 14‑item hospital anxiety and depression scale (HADS) as a self-rated suicide risk screening tool in a sample of Nigerian surgical patients. Materials and Methods: This is a cross-sectional study involving 462 Nigerian patients attending a surgical outpatient clinic. They completed the Sociodemographic questionnaire, the 14-item HADS, the suicidality module of the Mini‑International Neuropsychiatric Interview, and the brief version of the World Health Organization Quality of Life Questionnaire. The reliabilities of the HADS-anxiety and depression subscales were evaluated by calculating the omega (ω) coefficients. Receiver operating characteristics curve analysis was performed to determine the suicide risk screening characteristics of the HADS-anxiety and depression subscales. Results: The omega (ω) reliability coefficients of the HADS subscales were satisfactory. At a cutoff score of 10 HADS-anxiety subscale exhibited satisfactory sensitivity (0.750) and specificity (0.938) while the HADS-Depression subscale at a cutoff score of 7 had the best combination of sensitivity (0.750) and specificity (0.905). The prevalence rate of lifetime suicide attempts in our sample was 1.5%, whereas 1.8% of our respondents had high suicide risk. Conclusion: The 14-item HADS has shown to be a suitable self-rated suicide risk assessment tool among Nigerian surgical patients.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139328802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Solomon Ariyibi, Ayodele Ojuawo, R. Ibraheem, F. Afolayan, Roseline Ariyibi, Peace Akanbi
Background: In spite of the enormous benefits of immunization, uptake of the expanded programme on immunization vaccines has remained low, especially in Northern Nigeria. Pentavalent-3 uptake in Nigeria was 33% in 2017, and up to 40% of children 12 months old were not vaccinated. Objectives: This study aimed at determining the factors influencing routine vaccination uptake and completion among children 12–23 months in North-central Nigeria. Materials and Methods: This was a cross-sectional survey conducted in Ilorin between December 2019 and January 2020 among 456 mothers/caregivers-children pairs. Participants were recruited using multistage cluster sampling technique. Results: Eighty percent (80%) of the children studied were fully vaccinated, with a vaccine uptake of 100% for Bacille Calmette-Guerin, OPV0, HBV0, OPV1, and Penta1; 83.8% for measles; and 83.1% for yellow fever. Significant factors associated with complete vaccination are: mothers/caregivers having formal education, P = 0.001; antenatal care (ANC) attendance, P = 0.001; being employed, P = 0.007, delivery in hospital, P = 0.001 and low birth order, P = 0.003. Predictors of complete vaccination are mothers with tertiary education (odd ratio [OR]: 11.51, confidence interval [CI]: 2.43–54.64, P = 0.002), ANC attendance (OR: 7.76, CI: 2.58–23.33, P < 0.001), and hospital delivery (OR: 2.86, CI: 1.6–5.0, P < 0.001). Psychosocial factors such as religious belief, cultural acceptance, and husbands’ support are also associated with vaccination uptake and completion among the children. Conclusion: Vaccination uptake for the various antigens and full vaccination status are generally high in this study, but still below the global target. Access to ANC services, hospital delivery, and female empowerment will enhance and improve vaccine uptake and completion.
{"title":"Factors influencing routine vaccination uptake and completion among children aged 12–23 months in Ilorin, North-Central Nigeria: A cross-sectional survey","authors":"Solomon Ariyibi, Ayodele Ojuawo, R. Ibraheem, F. Afolayan, Roseline Ariyibi, Peace Akanbi","doi":"10.4103/ijmh.IJMH_20_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_20_23","url":null,"abstract":"Background: In spite of the enormous benefits of immunization, uptake of the expanded programme on immunization vaccines has remained low, especially in Northern Nigeria. Pentavalent-3 uptake in Nigeria was 33% in 2017, and up to 40% of children 12 months old were not vaccinated. Objectives: This study aimed at determining the factors influencing routine vaccination uptake and completion among children 12–23 months in North-central Nigeria. Materials and Methods: This was a cross-sectional survey conducted in Ilorin between December 2019 and January 2020 among 456 mothers/caregivers-children pairs. Participants were recruited using multistage cluster sampling technique. Results: Eighty percent (80%) of the children studied were fully vaccinated, with a vaccine uptake of 100% for Bacille Calmette-Guerin, OPV0, HBV0, OPV1, and Penta1; 83.8% for measles; and 83.1% for yellow fever. Significant factors associated with complete vaccination are: mothers/caregivers having formal education, P = 0.001; antenatal care (ANC) attendance, P = 0.001; being employed, P = 0.007, delivery in hospital, P = 0.001 and low birth order, P = 0.003. Predictors of complete vaccination are mothers with tertiary education (odd ratio [OR]: 11.51, confidence interval [CI]: 2.43–54.64, P = 0.002), ANC attendance (OR: 7.76, CI: 2.58–23.33, P < 0.001), and hospital delivery (OR: 2.86, CI: 1.6–5.0, P < 0.001). Psychosocial factors such as religious belief, cultural acceptance, and husbands’ support are also associated with vaccination uptake and completion among the children. Conclusion: Vaccination uptake for the various antigens and full vaccination status are generally high in this study, but still below the global target. Access to ANC services, hospital delivery, and female empowerment will enhance and improve vaccine uptake and completion.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139327246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Nnakenyi, A. Madu, I. Ajuba, Sunday Ocheni, Gladys Ilechukwu, Nnenna Ogbodo, O. Nnachi
Background: Abnormal plasma cells in multiple myeloma produce excessive amounts of immunoglobulins and free light chains, of which certain patterns predict patient survival. Objective: To determine the pattern of elevated and suppressed serum immunoglobulins and free light chain levels among patients diagnosed with multiple myeloma in southeast Nigeria. Materials and Methods: This was a 5-year retrospective study of laboratory results of newly diagnosed symptomatic multiple myeloma patients at three tertiary hospitals in southeast Nigeria. Serum immunoglobulin gamma (IgG), immunoglobulin alpha (IgA), and immunoglobulin mu (IgM) results that were obtained at the time of diagnosis of multiple myeloma were included. Medical records obtained were as follows: age, sex, serum protein, and free light chain concentrations. Data analysis was performed with IBM SPSS 20.0, and P value < 0.05 was considered to be statistically significant. Results: Serum immunoglobulin results of 147 patients comprising 79 (54%) males and 68 (46%) females were included, with mean ± standard deviation age of 60 ± 11.1 years. The most frequently elevated immunoglobulin was IgG (114 [77.6%]) followed by IgA (17 [12%]), then IgM (13 [9%]). Serum IgA was the most frequently suppressed immunoglobulin (71 [48.3%]). Suppression of uninvolved immunoglobulins was commonest with IgG myeloma as 72 (49%) patients had either suppressed IgA < 70 mg/dL, IgM < 40 mg/dL, or both. With values more than 100 mg/L, kappa was the more frequently involved light chain. Conclusion: Elevated IgG was the commonest immunoglobulin, with kappa being the commonly involved free light chain, whereas IgA was the most suppressed immunoglobulin. It is important to determine the patterns of monoclonal proteins in patients with multiple myeloma to predict treatment response and patient survival.
背景：多发性骨髓瘤中的异常浆细胞会产生过量的免疫球蛋白和游离轻链，其中某些模式可预测患者的存活率。研究目的确定尼日利亚东南部确诊的多发性骨髓瘤患者血清免疫球蛋白和游离轻链水平升高和抑制的模式。材料与方法：这是一项为期 5 年的回顾性研究，研究对象是尼日利亚东南部三家三级医院新确诊的无症状多发性骨髓瘤患者的化验结果。研究纳入了多发性骨髓瘤诊断时获得的血清免疫球蛋白γ（IgG）、免疫球蛋白α（IgA）和免疫球蛋白μ（IgM）结果。获得的医疗记录包括：年龄、性别、血清蛋白和游离轻链浓度。数据分析采用 IBM SPSS 20.0，P 值小于 0.05 为具有统计学意义。结果147名患者的血清免疫球蛋白结果，其中男性79人（54%），女性68人（46%），平均年龄（±标准差）为（60±11.1）岁。最常升高的免疫球蛋白是 IgG（114 [77.6%]），其次是 IgA（17 [12%]），然后是 IgM（13 [9%]）。血清 IgA 是最常被抑制的免疫球蛋白（71 [48.3%]）。在 IgG 骨髓瘤中，未受影响的免疫球蛋白受抑制的情况最为常见，有 72 例（49%）患者的 IgA 受抑制值小于 70 毫克/分升，IgM 受抑制值小于 40 毫克/分升，或两者均受抑制。当数值超过 100 毫克/分升时，kappa 是最常涉及的轻链。结论IgG 升高是最常见的免疫球蛋白，kappa 是最常涉及的游离轻链，而 IgA 是最常被抑制的免疫球蛋白。确定多发性骨髓瘤患者的单克隆蛋白模式对预测治疗反应和患者存活率非常重要。
{"title":"Pattern of serum immunoglobulins and free light chain levels among patients diagnosed with multiple myeloma in Southeast Nigeria","authors":"I. Nnakenyi, A. Madu, I. Ajuba, Sunday Ocheni, Gladys Ilechukwu, Nnenna Ogbodo, O. Nnachi","doi":"10.4103/ijmh.IJMH_22_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_22_23","url":null,"abstract":"Background: Abnormal plasma cells in multiple myeloma produce excessive amounts of immunoglobulins and free light chains, of which certain patterns predict patient survival. Objective: To determine the pattern of elevated and suppressed serum immunoglobulins and free light chain levels among patients diagnosed with multiple myeloma in southeast Nigeria. Materials and Methods: This was a 5-year retrospective study of laboratory results of newly diagnosed symptomatic multiple myeloma patients at three tertiary hospitals in southeast Nigeria. Serum immunoglobulin gamma (IgG), immunoglobulin alpha (IgA), and immunoglobulin mu (IgM) results that were obtained at the time of diagnosis of multiple myeloma were included. Medical records obtained were as follows: age, sex, serum protein, and free light chain concentrations. Data analysis was performed with IBM SPSS 20.0, and P value < 0.05 was considered to be statistically significant. Results: Serum immunoglobulin results of 147 patients comprising 79 (54%) males and 68 (46%) females were included, with mean ± standard deviation age of 60 ± 11.1 years. The most frequently elevated immunoglobulin was IgG (114 [77.6%]) followed by IgA (17 [12%]), then IgM (13 [9%]). Serum IgA was the most frequently suppressed immunoglobulin (71 [48.3%]). Suppression of uninvolved immunoglobulins was commonest with IgG myeloma as 72 (49%) patients had either suppressed IgA < 70 mg/dL, IgM < 40 mg/dL, or both. With values more than 100 mg/L, kappa was the more frequently involved light chain. Conclusion: Elevated IgG was the commonest immunoglobulin, with kappa being the commonly involved free light chain, whereas IgA was the most suppressed immunoglobulin. It is important to determine the patterns of monoclonal proteins in patients with multiple myeloma to predict treatment response and patient survival.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139327643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Multiple endocrine neoplasia (MEN) occurs throughout the body with an array of symptoms. Its management is challenging. Diet-mediated immune dysfunction may provoke their pathogenesis and clinical symptoms. Hence, diet-mediated immune optimization strategies may be useful for their management and prevention. Objective: The objective of this study was to discuss our putative diet-mediated immune dysfunction model of cancers using MEN as a classic disease paradigm. Materials and Methods: Online searches on databases such as Google Scholar, PubMed, Biomed Central, Directorate of Open Access Journal (DOAJ), and SciELO were carried out. An attempt was made to review articles with keywords such as cancer, tumor immunology, MEN, diet and immune system, T lymphocyte activation/dysfunction, and cytokines in cancers. Results: Putative diet-mediated immune dysfunction mechanisms in MEN and diet-mediated immune optimization strategies were found to be useful in preventing MEN, and as effective therapeutic adjuncts for management of MEN. Conclusion: Diet-mediated immune optimization could serve as a preventive and therapeutic adjunct for the management of MEN and other cancers.
背景：多发性内分泌肿瘤（MEN多发性内分泌肿瘤（MEN）遍布全身，症状多种多样。其治疗具有挑战性。饮食介导的免疫功能障碍可能会引发其发病机制和临床症状。因此，饮食介导的免疫优化策略可能有助于多发性内分泌肿瘤的治疗和预防。研究目的本研究旨在以 MEN 为典型疾病范例，讨论我们推测的饮食介导的癌症免疫功能障碍模型。材料与方法：对谷歌学术、PubMed、Biomed Central、Directorate of Open Access Journal (DOAJ) 和 SciELO 等数据库进行了在线搜索。尝试以癌症、肿瘤免疫学、MEN、饮食与免疫系统、T 淋巴细胞活化/功能障碍和癌症中的细胞因子等关键词对文章进行综述。结果：研究发现，MEN 中假定的饮食介导的免疫功能失调机制和饮食介导的免疫优化策略有助于预防 MEN，并可作为治疗 MEN 的有效辅助手段。结论：饮食介导的免疫优化可作为治疗 MEN 和其他癌症的预防和治疗辅助手段。
{"title":"Diet-mediated immune optimization as a preventive and therapeutic adjunct for management of multiple endocrine neoplasia","authors":"Michael Okafor, Uzoamaka A Okoli, Adaugo Okafor","doi":"10.4103/ijmh.IJMH_14_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_14_23","url":null,"abstract":"Background: Multiple endocrine neoplasia (MEN) occurs throughout the body with an array of symptoms. Its management is challenging. Diet-mediated immune dysfunction may provoke their pathogenesis and clinical symptoms. Hence, diet-mediated immune optimization strategies may be useful for their management and prevention. Objective: The objective of this study was to discuss our putative diet-mediated immune dysfunction model of cancers using MEN as a classic disease paradigm. Materials and Methods: Online searches on databases such as Google Scholar, PubMed, Biomed Central, Directorate of Open Access Journal (DOAJ), and SciELO were carried out. An attempt was made to review articles with keywords such as cancer, tumor immunology, MEN, diet and immune system, T lymphocyte activation/dysfunction, and cytokines in cancers. Results: Putative diet-mediated immune dysfunction mechanisms in MEN and diet-mediated immune optimization strategies were found to be useful in preventing MEN, and as effective therapeutic adjuncts for management of MEN. Conclusion: Diet-mediated immune optimization could serve as a preventive and therapeutic adjunct for the management of MEN and other cancers.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139325981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Sarate, Shivshankar Hodgir, Diksha Bedre, Alhad Mulkalwar
Background: Ubiquitously spread hepatitis B virus (HBV) is one of the leading causes of end-stage liver disease. Chronic HBV infection presents with different outcomes including cure, chronic carriers, and death. Objectives: To assess the clinical profile and outcomes of hepatitis B patients admitted in a tertiary care teaching hospital in Mumbai, India. Materials and Methods: This was a single-center, observational, prospective study conducted over a period of 18 months at the medical and gastroenterology wards of King Edward Memorial Hospital, Mumbai, India. All the newly diagnosed patients of hepatitis B infection aged more than 12 years, admitted during the study duration in the medical and gastroenterology wards were included in the study. Results: A total of 77 patients were studied. The clinical presentations of the patients were: abdominal distension (28.6%), jaundice (24.7%), loss of appetite (24%), pallor (18.2%), leg swelling (16%), gastrointestinal bleeding (11%), fever (11%), altered sensorium (10.4%) malena (9%), hepatic failure (7.8%), hematemesis (7.7), abdominal pain (5%), and oliguria (1%). The associated co-morbidities included: diabetes mellitus (15%), chronic kidney disease (18%), hypertension (19.5%), pulmonary tuberculosis (6.4%), and anemia of chronic disease (5%). Following investigations and treatments, 9.09% achieved cure, 79.22% progressed to chronicity, and 11.09% died. Conclusion: The clinical profile of patients with hepatitis B infection in India is varied and associated with some co-morbidities. Less than one tenth of the patients achieve complete cure while majority progress to chronicity. There is need for improvement in public health enlightenment campaign and quality of care for hepatitis B infection in view of the poor outcomes observed in this study.
{"title":"Study of clinical profile and outcomes of patients with hepatitis B infection in India","authors":"N. Sarate, Shivshankar Hodgir, Diksha Bedre, Alhad Mulkalwar","doi":"10.4103/ijmh.IJMH_27_23","DOIUrl":"https://doi.org/10.4103/ijmh.IJMH_27_23","url":null,"abstract":"Background: Ubiquitously spread hepatitis B virus (HBV) is one of the leading causes of end-stage liver disease. Chronic HBV infection presents with different outcomes including cure, chronic carriers, and death. Objectives: To assess the clinical profile and outcomes of hepatitis B patients admitted in a tertiary care teaching hospital in Mumbai, India. Materials and Methods: This was a single-center, observational, prospective study conducted over a period of 18 months at the medical and gastroenterology wards of King Edward Memorial Hospital, Mumbai, India. All the newly diagnosed patients of hepatitis B infection aged more than 12 years, admitted during the study duration in the medical and gastroenterology wards were included in the study. Results: A total of 77 patients were studied. The clinical presentations of the patients were: abdominal distension (28.6%), jaundice (24.7%), loss of appetite (24%), pallor (18.2%), leg swelling (16%), gastrointestinal bleeding (11%), fever (11%), altered sensorium (10.4%) malena (9%), hepatic failure (7.8%), hematemesis (7.7), abdominal pain (5%), and oliguria (1%). The associated co-morbidities included: diabetes mellitus (15%), chronic kidney disease (18%), hypertension (19.5%), pulmonary tuberculosis (6.4%), and anemia of chronic disease (5%). Following investigations and treatments, 9.09% achieved cure, 79.22% progressed to chronicity, and 11.09% died. Conclusion: The clinical profile of patients with hepatitis B infection in India is varied and associated with some co-morbidities. Less than one tenth of the patients achieve complete cure while majority progress to chronicity. There is need for improvement in public health enlightenment campaign and quality of care for hepatitis B infection in view of the poor outcomes observed in this study.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139329907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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