Pub Date : 2018-01-01Epub Date: 2018-05-29DOI: 10.4103/jomt.jomt_8_18
Ochaka J Egesie, Patricia A Agaba, Olugbenga A Silas, Chad Achenbach, Ayuba Zoakah, Oche O Agbaji, Jeremiah A Madaki, Edith N Okeke, Lifang Hou, Atiene S Sagay, Robert Murphy
Background: Haematologic malignancies cause significant morbidity and mortality and are not uncommon in resource-limited-low income countries. However, the types, pattern of presentation and treatment outcomes vary across regions. We assessed the presentation and overall survival over an 11-year period in adult patients presenting with haematologic cancers in Jos, North Central Nigeria.
Materials and methods: This retrospective outcome study evaluated patients who presented with haematologic malignancies between 2005-2015 at the Jos University Teaching Hospital (JUTH), Jos. Variables of interest were abstracted through chart reviews. Descriptive statistics were used to evaluate baseline and follow-up parameters. Overall survival (OS) was assessed using Kaplan-Meier method.
Results: Sixty patients, contributing 25,994 person-days of follow-up were evaluated. The mean age was 43+17 years and 61.7% were males. Thirty-one patients (51.7%) presented with leukemia, 45.0% with lymphoma, and 3.3% with multiple myeloma. Forty-two (70.0%) presented with advanced disease, 5 (5.2%) were HIV positive and 4 (6.7%) had died at the end of follow-up. OS was 84.3% (95% CI: 58.1-94.7). Survival differed by disease group (p=0.01) and having fever at presentation (p=0.02).
Conclusion: We found long-term OS to be impacted by disease type and status of fever at presentation. Disease-specific Strategies to improve early diagnosis and therapies are needed to ensure optimal outcomes in Nigerian patients.
{"title":"Presentation and survival in patients with hematologic malignancies in Jos, Nigeria: A retrospective cohort analysis.","authors":"Ochaka J Egesie, Patricia A Agaba, Olugbenga A Silas, Chad Achenbach, Ayuba Zoakah, Oche O Agbaji, Jeremiah A Madaki, Edith N Okeke, Lifang Hou, Atiene S Sagay, Robert Murphy","doi":"10.4103/jomt.jomt_8_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_8_18","url":null,"abstract":"<p><strong>Background: </strong>Haematologic malignancies cause significant morbidity and mortality and are not uncommon in resource-limited-low income countries. However, the types, pattern of presentation and treatment outcomes vary across regions. We assessed the presentation and overall survival over an 11-year period in adult patients presenting with haematologic cancers in Jos, North Central Nigeria.</p><p><strong>Materials and methods: </strong>This retrospective outcome study evaluated patients who presented with haematologic malignancies between 2005-2015 at the Jos University Teaching Hospital (JUTH), Jos. Variables of interest were abstracted through chart reviews. Descriptive statistics were used to evaluate baseline and follow-up parameters. Overall survival (OS) was assessed using Kaplan-Meier method.</p><p><strong>Results: </strong>Sixty patients, contributing 25,994 person-days of follow-up were evaluated. The mean age was 43+17 years and 61.7% were males. Thirty-one patients (51.7%) presented with leukemia, 45.0% with lymphoma, and 3.3% with multiple myeloma. Forty-two (70.0%) presented with advanced disease, 5 (5.2%) were HIV positive and 4 (6.7%) had died at the end of follow-up. OS was 84.3% (95% CI: 58.1-94.7). Survival differed by disease group (p=0.01) and having fever at presentation (p=0.02).</p><p><strong>Conclusion: </strong>We found long-term OS to be impacted by disease type and status of fever at presentation. Disease-specific Strategies to improve early diagnosis and therapies are needed to ensure optimal outcomes in Nigerian patients.</p>","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"20 1","pages":"49-56"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024253/pdf/nihms974957.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36276410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Chronic kidney disease (CKD) affects the hypothalamus–pituitary–thyroid axis and peripheral metabolism of thyroid hormones, which affects the concentration and activity of the hormones. Subclinical hypothyroidism (SCH) is the most common thyroid abnormality reported among patients with CKD and it has been associated with increased cardiovascular risk. The objective of this study was to determine thyroid hormone levels and thyroid disorders among Nigerian nondialysis-dependent patients with CKD. Materials and Methods: A cross-sectional, observational study was conducted in a tertiary hospital in southern Nigeria. Nondialysis-dependent patients with CKD attending the renal outpatient clinic of the hospital were recruited over a period of 3 months. Control participants were recruited from healthy consenting hospital staff. Patients with known thyroid disease were excluded. Serum thyroxine (T4), triiodothyronine (T3), and thyroid stimulating hormone (TSH) levels were assayed using the enzyme-linked immunosorbent assay method. Results: Forty patients with CKD (26 men and 14 women) and 20 healthy adults (10 men and 10 women) were studied. The mean age of patients and controls were 54.9 ± 13 years and 44.7 ± 7.3 years, respectively. The mean T4 levels for patients and controls were 4.98 ± 1.23 μg/ml and 5.49 ± 1.06 μg/ml, respectively. The median (interquartile range) values of T3 and TSH for patients were 0.8 (0.7) ηg/ml and 2.6 (3.1) μIU/ml, while that of the controls were 1.85 (2.1) ηg/ml and 1.4 (3.1) μIU/ml. Overt biochemical hypothyroidism was seen in 22% of patients while 10% of patients had SCH. Conclusion: Overt biochemical hypothyroidism was more prevalent among nondialysis-dependent patients with CKD compared to SCH in this study. A larger population study should be performed to confirm this finding among Nigerian patients with CKD.
{"title":"Thyroid profile in nondialysis-dependent patients with chronic kidney disease in a tertiary hospital in southern Nigeria","authors":"E. Okaka, E. Ayinbuomwan","doi":"10.4103/JOMT.JOMT_12_18","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_12_18","url":null,"abstract":"Background: Chronic kidney disease (CKD) affects the hypothalamus–pituitary–thyroid axis and peripheral metabolism of thyroid hormones, which affects the concentration and activity of the hormones. Subclinical hypothyroidism (SCH) is the most common thyroid abnormality reported among patients with CKD and it has been associated with increased cardiovascular risk. The objective of this study was to determine thyroid hormone levels and thyroid disorders among Nigerian nondialysis-dependent patients with CKD. Materials and Methods: A cross-sectional, observational study was conducted in a tertiary hospital in southern Nigeria. Nondialysis-dependent patients with CKD attending the renal outpatient clinic of the hospital were recruited over a period of 3 months. Control participants were recruited from healthy consenting hospital staff. Patients with known thyroid disease were excluded. Serum thyroxine (T4), triiodothyronine (T3), and thyroid stimulating hormone (TSH) levels were assayed using the enzyme-linked immunosorbent assay method. Results: Forty patients with CKD (26 men and 14 women) and 20 healthy adults (10 men and 10 women) were studied. The mean age of patients and controls were 54.9 ± 13 years and 44.7 ± 7.3 years, respectively. The mean T4 levels for patients and controls were 4.98 ± 1.23 μg/ml and 5.49 ± 1.06 μg/ml, respectively. The median (interquartile range) values of T3 and TSH for patients were 0.8 (0.7) ηg/ml and 2.6 (3.1) μIU/ml, while that of the controls were 1.85 (2.1) ηg/ml and 1.4 (3.1) μIU/ml. Overt biochemical hypothyroidism was seen in 22% of patients while 10% of patients had SCH. Conclusion: Overt biochemical hypothyroidism was more prevalent among nondialysis-dependent patients with CKD compared to SCH in this study. A larger population study should be performed to confirm this finding among Nigerian patients with CKD.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"34 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90942810","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}
B. Toma, D. Shilong, D. Shwe, G. Bot, U. Diala, Akinyemi Ofakunrin, Anyebe Prince, Peter O. Binitie
Background: Congenital anomalies are an important cause of neonatal deaths, chronic illness, and disability and are most common in low- and middle-income countries. Central nervous system (CNS) congenital anomalies are one of the most common abnormalities. Information on the burden and types of CNS anomalies will facilitate health system planning and an efficient allocation of scarce resources. We determined the prevalence and pattern of CNS congenital anomalies in a neonatal unit in Jos, north-central Nigeria. Materials and Methods: A retrospective descriptive study of all neonates admitted with CNS congenital anomalies into the neonatal unit of Jos University Teaching Hospital (JUTH) from October 2013 to September 2016 was conducted. Results: One hundred and fifty-five (14.8%) of the 1046 babies admitted during the period had congenital anomalies. Twenty-seven babies (14 males and 13 females) had CNS anomalies giving a prevalence rate of 2.6%. CNS anomalies constituted 17.4% of the 155 babies admitted with congenital anomalies. All 27 (100%) of the babies were born outside the teaching hospital, with 13 (48.2%) of them delivered at home. Neural tube defects (NTDs) were the most common CNS malformations (26; 96.3% of the CNS anomalies). Talipes equinovarus was the most common associated anomaly (6; 22.2% of the babies). Conclusion: The prevalence of CNS anomalies among admitted neonates in the JUTH is high. NTDs were the most common CNS anomalies, with myelomeningocele being the single most common disorder.
{"title":"The prevalence and pattern of central nervous system anomalies in a neonatal unit in a tertiary hospital in Jos, north-central Nigeria","authors":"B. Toma, D. Shilong, D. Shwe, G. Bot, U. Diala, Akinyemi Ofakunrin, Anyebe Prince, Peter O. Binitie","doi":"10.4103/JOMT.JOMT_10_18","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_10_18","url":null,"abstract":"Background: Congenital anomalies are an important cause of neonatal deaths, chronic illness, and disability and are most common in low- and middle-income countries. Central nervous system (CNS) congenital anomalies are one of the most common abnormalities. Information on the burden and types of CNS anomalies will facilitate health system planning and an efficient allocation of scarce resources. We determined the prevalence and pattern of CNS congenital anomalies in a neonatal unit in Jos, north-central Nigeria. Materials and Methods: A retrospective descriptive study of all neonates admitted with CNS congenital anomalies into the neonatal unit of Jos University Teaching Hospital (JUTH) from October 2013 to September 2016 was conducted. Results: One hundred and fifty-five (14.8%) of the 1046 babies admitted during the period had congenital anomalies. Twenty-seven babies (14 males and 13 females) had CNS anomalies giving a prevalence rate of 2.6%. CNS anomalies constituted 17.4% of the 155 babies admitted with congenital anomalies. All 27 (100%) of the babies were born outside the teaching hospital, with 13 (48.2%) of them delivered at home. Neural tube defects (NTDs) were the most common CNS malformations (26; 96.3% of the CNS anomalies). Talipes equinovarus was the most common associated anomaly (6; 22.2% of the babies). Conclusion: The prevalence of CNS anomalies among admitted neonates in the JUTH is high. NTDs were the most common CNS anomalies, with myelomeningocele being the single most common disorder.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"74 1","pages":"63 - 67"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76081616","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}
A. Adeniran, Moji Mobolaji-Ojibara, K. Adesina, A. Aboyeji, M. Ijaiya, O. Balogun
Background: The use of intermittent preventive treatment in pregnancy with sulfadoxine/pyrimethamine (IPTp-SP) for malaria remains an important tool for improving pregnancy outcome in malaria endemic areas. Objective: To assess the knowledge, attitude, and factors associated with the use of IPTp-SP among antenatal clinic attendees in Ilorin. Materials and Methods: A prospective, multicentre, cross-sectional study among consenting parturients receiving antenatal care at three public health facilities in Ilorin, Nigeria. Statistical analysis was conducted with the Statistical Package for the Social Sciences version 20.0 software (SPSS Inc., Chicago, IL, United States) with the calculation of percentages, chi square, odds ratios (ORs), and confidence intervals (CIs); P < 0.05 was considered significant. Results: There were 422 participants with mean age of 28.8 ± 4.7 years and 368 (87.2%) were aware of the use of IPTp-SP for malaria prevention, while 388 (91.9%) were willing to use IPTp-SP. Only 154 (36.5%) had prescription for IPTp-SP among whom 139 (90.3%) were compliant; IPTp-SP uptake in preceding pregnancy was 148 (59.7%). The most common reason for the nonuse of IPTp-SP prescribed was the fear of harm to the fetus (53.3%). Significant determinants of willingness to use IPTp-SP were maternal age (P = 0.007) and monthly income (P = 0.013), IPTp-SP use in preceding pregnancy (P = 0.001), and the treatment for malaria in index pregnancy (P = 0.014). On logistic regression, maternal age <20 years (OR = 36.457, 95% CI = 2.260–588.011; P = 0.011) and the use of IPTp-SP in preceding pregnancy (OR = 0.051, 95% CI = 0.010–0.252; P = 0.001) were significant predictors of willingness to use IPTp-SP. Conclusion: Parturients desire IPTp-SP, but the prescription rate by healthcare providers was low. Healthcare providers should increase the prescription and address the concerns about its teratogenicity. Governments and other agencies should prioritize free provision and the availability of SP at health facilities.
背景:在疟疾流行地区,在妊娠期间使用磺胺多辛/乙胺嘧啶(IPTp-SP)间歇性预防治疗疟疾仍然是改善妊娠结局的重要工具。目的:了解伊洛林市产前门诊就诊人员对IPTp-SP使用的相关知识、态度及其影响因素。材料和方法:一项前瞻性、多中心、横断面研究,在尼日利亚伊洛林三家公共卫生机构同意接受产前护理的产妇中进行。采用Statistical Package for the Social Sciences version 20.0软件(SPSS Inc., Chicago, IL, United States)进行统计分析,计算百分比、卡方、比值比(ORs)和置信区间(ci);P < 0.05为差异有统计学意义。结果:422名参与者平均年龄28.8±4.7岁,其中368名(87.2%)知晓使用IPTp-SP预防疟疾,388名(91.9%)表示愿意使用IPTp-SP。仅154例(36.5%)有IPTp-SP处方,其中139例(90.3%)遵医嘱;妊娠前期IPTp-SP摄取148例(59.7%)。不使用IPTp-SP处方的最常见原因是害怕对胎儿造成伤害(53.3%)。产妇年龄(P = 0.007)、月收入(P = 0.013)、孕前是否使用IPTp-SP (P = 0.001)、指数妊娠是否接受疟疾治疗(P = 0.014)是影响IPTp-SP使用意愿的重要因素。logistic回归分析:产妇年龄<20岁(OR = 36.457, 95% CI = 2.260 ~ 588.011;P = 0.011)和妊娠前使用IPTp-SP (OR = 0.051, 95% CI = 0.010-0.252;P = 0.001)是使用IPTp-SP意愿的显著预测因子。结论:产妇希望使用IPTp-SP,但医护人员处方率较低。医疗保健提供者应增加处方,并解决其致畸性的担忧。各国政府和其他机构应优先考虑在卫生设施免费提供和提供SP。
{"title":"Intermittent preventive therapy in pregnancy with sulfadoxine/pyrimethamine for malaria prophylaxis among parturients in Ilorin, Nigeria","authors":"A. Adeniran, Moji Mobolaji-Ojibara, K. Adesina, A. Aboyeji, M. Ijaiya, O. Balogun","doi":"10.4103/JOMT.JOMT_32_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_32_17","url":null,"abstract":"Background: The use of intermittent preventive treatment in pregnancy with sulfadoxine/pyrimethamine (IPTp-SP) for malaria remains an important tool for improving pregnancy outcome in malaria endemic areas. Objective: To assess the knowledge, attitude, and factors associated with the use of IPTp-SP among antenatal clinic attendees in Ilorin. Materials and Methods: A prospective, multicentre, cross-sectional study among consenting parturients receiving antenatal care at three public health facilities in Ilorin, Nigeria. Statistical analysis was conducted with the Statistical Package for the Social Sciences version 20.0 software (SPSS Inc., Chicago, IL, United States) with the calculation of percentages, chi square, odds ratios (ORs), and confidence intervals (CIs); P < 0.05 was considered significant. Results: There were 422 participants with mean age of 28.8 ± 4.7 years and 368 (87.2%) were aware of the use of IPTp-SP for malaria prevention, while 388 (91.9%) were willing to use IPTp-SP. Only 154 (36.5%) had prescription for IPTp-SP among whom 139 (90.3%) were compliant; IPTp-SP uptake in preceding pregnancy was 148 (59.7%). The most common reason for the nonuse of IPTp-SP prescribed was the fear of harm to the fetus (53.3%). Significant determinants of willingness to use IPTp-SP were maternal age (P = 0.007) and monthly income (P = 0.013), IPTp-SP use in preceding pregnancy (P = 0.001), and the treatment for malaria in index pregnancy (P = 0.014). On logistic regression, maternal age <20 years (OR = 36.457, 95% CI = 2.260–588.011; P = 0.011) and the use of IPTp-SP in preceding pregnancy (OR = 0.051, 95% CI = 0.010–0.252; P = 0.001) were significant predictors of willingness to use IPTp-SP. Conclusion: Parturients desire IPTp-SP, but the prescription rate by healthcare providers was low. Healthcare providers should increase the prescription and address the concerns about its teratogenicity. Governments and other agencies should prioritize free provision and the availability of SP at health facilities.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"56 1","pages":"30 - 35"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80214382","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}
P. Agrawal, S. Chandra, A. Jaiswal, A. Gautam, P. K. Maheshwari
Context: Type 2 diabetes mellitus (type 2 DM) is a heterogeneous and complex combination of metabolic condition caused by high levels of blood glucose and insulin resistance or insulin deficiency. Some studies suggest the increased levels of gastrin following the administration of proton pump inhibitors (PPIs), which seek to improve glycemic status and increased pancreatic insulin content. Aim: We determined the effect of pantoprazole on glycemic control in patients with type 2 DM. Material and Methods: Two groups, each with 30 patients of type 2 DM under treatment with oral hypoglycemic agent, were considered for this study. Patients were treated for 24 weeks with placebo or 40 mg pantoprazole tablets twice daily. Fasting blood glucose (FBG), postprandial blood glucose (PP blood glucose), as well as glycated hemoglobin (HbA1C) before and after treatment were measured. Study: Duration 1 year. Statistical Analysis: A hospital-based, randomized, double-blind, placebo-controlled study was used. Data were expressed as mean with standard deviation, numbers, and percentage. Baseline parameters and laboratory safety parameters were compared using appropriate parametric and nonparametric tests. A P value <0.05 was considered as significant. Results: The mean FBG readings at baseline in the intervention and control groups were 170.47 ± 16.65 and 163.39 ± 14.95 mg/dL, respectively, and those at the end of intervention were 157.95 ± 14.37 and 165.32 ± 12.40 mg/dL. The within-group changes in the intervention group were statistically significant (P = 0.003). The statistical analysis between groups after intervention showed a significant differences (P = 0.03). HbA1C changes in the intervention and control groups in the study were 0.53 ± 0.03% and 0.20 ± 0.08%, respectively, but a decrease in the intervention group was statistically significant (P = 0.005). In the end, the change between the two groups was also statistically significant (P = 0.005). Conclusions: There is a significant reduction in FBG, PP blood glucose, and HbA1C after 24 weeks of pantoprazole (40 mg BID) administration, which improved glycemic control in type 2 DM patients. PPI such as pantoprazole may be a new therapeutic approach in type 2 DM in future.
{"title":"Study of the effect of pantoprazole on glycemic control of type-2 diabetes mellitus in tertiary care center and hospital in North India","authors":"P. Agrawal, S. Chandra, A. Jaiswal, A. Gautam, P. K. Maheshwari","doi":"10.4103/JOMT.JOMT_2_18","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_2_18","url":null,"abstract":"Context: Type 2 diabetes mellitus (type 2 DM) is a heterogeneous and complex combination of metabolic condition caused by high levels of blood glucose and insulin resistance or insulin deficiency. Some studies suggest the increased levels of gastrin following the administration of proton pump inhibitors (PPIs), which seek to improve glycemic status and increased pancreatic insulin content. Aim: We determined the effect of pantoprazole on glycemic control in patients with type 2 DM. Material and Methods: Two groups, each with 30 patients of type 2 DM under treatment with oral hypoglycemic agent, were considered for this study. Patients were treated for 24 weeks with placebo or 40 mg pantoprazole tablets twice daily. Fasting blood glucose (FBG), postprandial blood glucose (PP blood glucose), as well as glycated hemoglobin (HbA1C) before and after treatment were measured. Study: Duration 1 year. Statistical Analysis: A hospital-based, randomized, double-blind, placebo-controlled study was used. Data were expressed as mean with standard deviation, numbers, and percentage. Baseline parameters and laboratory safety parameters were compared using appropriate parametric and nonparametric tests. A P value <0.05 was considered as significant. Results: The mean FBG readings at baseline in the intervention and control groups were 170.47 ± 16.65 and 163.39 ± 14.95 mg/dL, respectively, and those at the end of intervention were 157.95 ± 14.37 and 165.32 ± 12.40 mg/dL. The within-group changes in the intervention group were statistically significant (P = 0.003). The statistical analysis between groups after intervention showed a significant differences (P = 0.03). HbA1C changes in the intervention and control groups in the study were 0.53 ± 0.03% and 0.20 ± 0.08%, respectively, but a decrease in the intervention group was statistically significant (P = 0.005). In the end, the change between the two groups was also statistically significant (P = 0.005). Conclusions: There is a significant reduction in FBG, PP blood glucose, and HbA1C after 24 weeks of pantoprazole (40 mg BID) administration, which improved glycemic control in type 2 DM patients. PPI such as pantoprazole may be a new therapeutic approach in type 2 DM in future.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"1 1","pages":"1 - 5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78224286","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}
B. Augustine, F. Abdulrahman, G. Yahaya, A. Adebayo, R. Obiako, H. Muktar
Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common occurrence among patients who have received neurotoxic chemotherapy for hematological and other malignancies. Case Presentation We report a case of a 28-year-old man with Hodgkin lymphoma, who received cumulative doses of vinblastine and vincristine among his combination regimen and subsequently developed severe neurotoxicity, which led to withholding of cytotoxic chemotherapy, and the patient eventually succumbed to the disease. Discussion The incidence of CIPN varies considerably for each chemotherapeutic agent when administered alone or in combination, but often ranges from 30% to 40% of patients. Sensory complaints are often the first symptoms and are far more common than motor or autonomic symptoms, and may interfere with treatment, by limiting therapeutic options, doses, or warrant the early cessation of chemotherapy, thereby potentially impacting negatively on patient survival. Conclusion Our case report therefore emphasizes the need for clinicians and hemato-oncologist to be more alert to CIPN, which is a debilitating adverse effect of these commonly used, first-line agents.
{"title":"Vinca alkaloid-induced peripheral neuropathy in Zaria, North Western Nigeria: A case report","authors":"B. Augustine, F. Abdulrahman, G. Yahaya, A. Adebayo, R. Obiako, H. Muktar","doi":"10.4103/jomt.jomt_16_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_16_18","url":null,"abstract":"Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common occurrence among patients who have received neurotoxic chemotherapy for hematological and other malignancies. Case Presentation We report a case of a 28-year-old man with Hodgkin lymphoma, who received cumulative doses of vinblastine and vincristine among his combination regimen and subsequently developed severe neurotoxicity, which led to withholding of cytotoxic chemotherapy, and the patient eventually succumbed to the disease. Discussion The incidence of CIPN varies considerably for each chemotherapeutic agent when administered alone or in combination, but often ranges from 30% to 40% of patients. Sensory complaints are often the first symptoms and are far more common than motor or autonomic symptoms, and may interfere with treatment, by limiting therapeutic options, doses, or warrant the early cessation of chemotherapy, thereby potentially impacting negatively on patient survival. Conclusion Our case report therefore emphasizes the need for clinicians and hemato-oncologist to be more alert to CIPN, which is a debilitating adverse effect of these commonly used, first-line agents.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"123 1","pages":"135 - 139"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77098489","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}
M. Gyang, M. Dankyau, S. Gidado, B. Gyang, A. Madaki
Background: Job satisfaction has been identified as a key factor determining patient satisfaction in health care organizations. This study was undertaken to assess the job satisfaction index among staff in the facility, and to identify factors influencing job satisfaction as a means of improving services in the hospital. Methodology: This was a cross-sectional survey of health care workers conducted using the Linda Powells (Mountains State Group Inc) self-administered questionnaire. This is a 50-item questionnaire assessing eight thematic areas; 1. Overall satisfaction, 2. Planning, 3. General Attitudes, 4. Performance issues, 5. Management issues, 6. Supervisory issues, 7. Training and salary issues, 8. Benefits. Results: Overall, 64.8% of respondents were satisfied with their jobs. The thematic area that had the highest job satisfaction score was general attitudes; while the lowest was benefits 37.7%. Conclusion: The overall job satisfaction was found to be 64.8%. The thematic area that scored highest for level of satisfaction was general attitudes followed by performance issues, supervisory issues and planning. Staff were not satisfied with management issues, training and salary issues and benefits.
背景:工作满意度被认为是决定医疗机构患者满意度的关键因素。进行这项研究是为了评估该设施工作人员的工作满意度指数,并确定影响工作满意度的因素,作为改善医院服务的一种手段。方法:这是一项对卫生保健工作者进行的横断面调查,使用Linda powell (mountain State Group Inc)自我管理问卷。这是一份50项调查问卷,评估8个主题领域;1. 总体满意度,2分。规划、3。4.一般态度;5.性能问题。6.管理问题;7.监管问题。8.培训和薪资问题;的好处。结果:总体而言,64.8%的受访者对自己的工作感到满意。工作满意度得分最高的主题领域是一般态度;最低的是福利(37.7%)。结论:总体工作满意度为64.8%。满意度最高的主题领域是一般态度,其次是绩效问题、监管问题和规划。员工对管理问题、培训问题、工资问题和福利不满意。
{"title":"Job satisfaction among healthcare workers at a district hospital in Plateau State, Nigeria","authors":"M. Gyang, M. Dankyau, S. Gidado, B. Gyang, A. Madaki","doi":"10.4103/jomt.jomt_11_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_11_18","url":null,"abstract":"Background: Job satisfaction has been identified as a key factor determining patient satisfaction in health care organizations. This study was undertaken to assess the job satisfaction index among staff in the facility, and to identify factors influencing job satisfaction as a means of improving services in the hospital. Methodology: This was a cross-sectional survey of health care workers conducted using the Linda Powells (Mountains State Group Inc) self-administered questionnaire. This is a 50-item questionnaire assessing eight thematic areas; 1. Overall satisfaction, 2. Planning, 3. General Attitudes, 4. Performance issues, 5. Management issues, 6. Supervisory issues, 7. Training and salary issues, 8. Benefits. Results: Overall, 64.8% of respondents were satisfied with their jobs. The thematic area that had the highest job satisfaction score was general attitudes; while the lowest was benefits 37.7%. Conclusion: The overall job satisfaction was found to be 64.8%. The thematic area that scored highest for level of satisfaction was general attitudes followed by performance issues, supervisory issues and planning. Staff were not satisfied with management issues, training and salary issues and benefits.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"62 1","pages":"111 - 116"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77271342","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}
Introduction: Head injury (HI) is defined as physical damage to the brain or skull caused by external forces. The aim of this study was to examine the epidemiology of HI-related emergency department visits in our institution. Materials and Methods: This was a retrospective study of all patients with HI presenting at the accident and emergency department (AED) of the University of Port Harcourt Teaching Hospital from January 2013 to December 2014. The variables extracted for the study included patients’ age, gender, etiology, the severity of injury, the period of presentation, and the outcome of the management of HI by the AED. Results: HI occurred in 415 (30.9%) of the patients with trauma (1344) and 3.6% of all AED admissions (11,393). Of the patients with HI, 319 (76.9%) were males, and 96 (23.1%) were females. The male/female ratio was 3.3:1. The median age was 27 years (range − 1 month to 100 years). The highest frequency of 133 (32.0%) was in the age range of 21–30 years followed by 98 (23.6%) in the age range of 31–40 years. The most common etiologic factor was road traffic accident (RTA) [260 (62.6%)]. Most of the HIs were mild [162 (39.0%)]. More patients presented at night [161 (38.8%)]. There were 94 deaths, giving a case fatality rate of 22.6%. Conclusion: The 21–40 years age bracket was more affected by HI. RTA was the major cause of HI in our environment. The evening and night periods recorded the highest HI visits to the AED.
{"title":"An epidemiologic study of traumatic head injuries in the emergency department of a tertiary health institution","authors":"R. Onwuchekwa, R. Echem","doi":"10.4103/JOMT.JOMT_28_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_28_17","url":null,"abstract":"Introduction: Head injury (HI) is defined as physical damage to the brain or skull caused by external forces. The aim of this study was to examine the epidemiology of HI-related emergency department visits in our institution. Materials and Methods: This was a retrospective study of all patients with HI presenting at the accident and emergency department (AED) of the University of Port Harcourt Teaching Hospital from January 2013 to December 2014. The variables extracted for the study included patients’ age, gender, etiology, the severity of injury, the period of presentation, and the outcome of the management of HI by the AED. Results: HI occurred in 415 (30.9%) of the patients with trauma (1344) and 3.6% of all AED admissions (11,393). Of the patients with HI, 319 (76.9%) were males, and 96 (23.1%) were females. The male/female ratio was 3.3:1. The median age was 27 years (range − 1 month to 100 years). The highest frequency of 133 (32.0%) was in the age range of 21–30 years followed by 98 (23.6%) in the age range of 31–40 years. The most common etiologic factor was road traffic accident (RTA) [260 (62.6%)]. Most of the HIs were mild [162 (39.0%)]. More patients presented at night [161 (38.8%)]. There were 94 deaths, giving a case fatality rate of 22.6%. Conclusion: The 21–40 years age bracket was more affected by HI. RTA was the major cause of HI in our environment. The evening and night periods recorded the highest HI visits to the AED.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"43 1","pages":"24 - 29"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83487536","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}
Introduction: The tropical sunshine is deleterious to the albino skin predisposing their melanin deficient skin to lentigenes, dermatoheliosis, actinic keratosis, and skin cancers. Many of them die in the early adulthood or middle age from cutaneous malignancy. We determined the prevalence and types of photodermatoses and their relationship with sun protective methods in people living with albinism in Benin City, Nigeria. Materials and Methods: This was a descriptive cross-sectional study that involved 73 albinos and 73 age and sex-matched controls. Data were collected using an interviewer-administered questionnaire and relevant information on sociodemographics, history of dermatological problems, and use of sun protection methods were obtained. Diagnosis of photodermatoses was made on clinical grounds, and dermatoscopic evaluation and skin biopsy punches were utilized where applicable to boost diagnostic accuracy. Results: The mean ages for the albino population and their controls were 24 ± 11 years and 24 ± 11 years, respectively (P = 0.994). The male:female ratio of both groups was 1:1.3 The prevalence of photodermatoses in the albino population vs. control was 57 (78.1%) vs. 7 (9.6%) (P≥0.001). The observed photodermatoses in albino population were solar lentigenes 46 (63.0%), photoaging 33 (45.2%), actinic keratosis 22 (28.6%), sun burn 12 (16.3%), and skin cancers 9 (12.3%). Photodermatoses in the albinos, occurred more frequently in those who did not use sun screens and this finding was statistically significant for solar lentigenes (P = 0.038). The spectrum of photodermatoses seen in the controls included exogenous ochronosis 6 (8.2%) and polymorphic light eruptions 1 (1.4%). Conclusion: Photodermatoses are highly prevalent in albinos. The common types were solar lentigenes, photoaging, and actinic keratosis. Photodermatoses are more common in albinos, who do not use sun protection.
{"title":"Photodermatoses in the Nigerian albino: A study in an urban hospital in southern Nigeria","authors":"M. Roli, O. Abel","doi":"10.4103/JOMT.JOMT_30_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_30_17","url":null,"abstract":"Introduction: The tropical sunshine is deleterious to the albino skin predisposing their melanin deficient skin to lentigenes, dermatoheliosis, actinic keratosis, and skin cancers. Many of them die in the early adulthood or middle age from cutaneous malignancy. We determined the prevalence and types of photodermatoses and their relationship with sun protective methods in people living with albinism in Benin City, Nigeria. Materials and Methods: This was a descriptive cross-sectional study that involved 73 albinos and 73 age and sex-matched controls. Data were collected using an interviewer-administered questionnaire and relevant information on sociodemographics, history of dermatological problems, and use of sun protection methods were obtained. Diagnosis of photodermatoses was made on clinical grounds, and dermatoscopic evaluation and skin biopsy punches were utilized where applicable to boost diagnostic accuracy. Results: The mean ages for the albino population and their controls were 24 ± 11 years and 24 ± 11 years, respectively (P = 0.994). The male:female ratio of both groups was 1:1.3 The prevalence of photodermatoses in the albino population vs. control was 57 (78.1%) vs. 7 (9.6%) (P≥0.001). The observed photodermatoses in albino population were solar lentigenes 46 (63.0%), photoaging 33 (45.2%), actinic keratosis 22 (28.6%), sun burn 12 (16.3%), and skin cancers 9 (12.3%). Photodermatoses in the albinos, occurred more frequently in those who did not use sun screens and this finding was statistically significant for solar lentigenes (P = 0.038). The spectrum of photodermatoses seen in the controls included exogenous ochronosis 6 (8.2%) and polymorphic light eruptions 1 (1.4%). Conclusion: Photodermatoses are highly prevalent in albinos. The common types were solar lentigenes, photoaging, and actinic keratosis. Photodermatoses are more common in albinos, who do not use sun protection.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"15 1","pages":"68 - 73"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74905389","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}
M. Isah, M. Makusidi, A. Sabir, J. Okpapi, C. Njoku, A. Abba
Background: Ventilatory function indices [forced vital capacity (FVC), expiratory volume in 1 (FEV1), and FEV1/FVC] are a function of the basic anthropometric parameters (weight and height). Cigarette smoking is an important confounder in the relationship between ventilatory function indices and basic anthropometric parameters. Aim: To determine the relationship between anthropometric parameters and ventilatory function among male adult cigarette smokers. Materials and Methods: This is a community-based cross-sectional study incorporating 200 male participants (150 cigarette smokers and 50 non-smokers) who met inclusion criteria using stratified random sampling technique. Participants were drawn from local governments that constituted Sokoto metropolis. Subsequently, participants had a questionnaire adapted from European Community Respiratory Health Survey administered to collect demographic, clinical and cigarette smoking data. Ventilatory function test was performed using Clement Clarke One Flow Spirometer, version 1.3 Revision 0 (Clement Clarke International, Edinburgh, UK). The highest value of each ventilatory function indices (FEV1, FVC, FEV1/FVC) was chosen for analysis. Data were summarized, and statistical tests were applied using the software Statistical Package for Social Sciences, version 19 (IBM SPSS Inc., Chicago, IL, USA). Result: The majority of study participants among cigarette smokers and control were young, single and had a form of formal education. There was no significant difference in the mean of anthropometric indices [weight, height, body mass index (BMI)] of participants (cigarette smokers) and control (non-cigarette smokers). Twenty-nine (58%) non-cigarette smokers were overweight/obese as against 35 (23.3%) participants among cigarette smokers observed to be equally overweight/obese. Mean values of the ventilatory function indices except FVC were low among study participants as compared with control. Furthermore, the mean FEV1/FVC between participants (75.60 ± 7.53) and control (82.48 ± 6.11) was statistically significant (P = 0.001). A significant correlation between anthropometric parameters (height and BMI) and ventilatory function indices (FEV1 and FVC) was observed among study participants and control. Conclusion: Ventilatory function indices are associated with anthropometric parameters among cigarette smokers. Although, BMI did not significantly affect decline in ventilatory function indices among cigarette smokers, an inverse relationship was observed between them.
背景:通气功能指标[用力肺活量(FVC)、1呼气容积(FEV1)和FEV1/FVC]是基本人体测量参数(体重和身高)的函数。吸烟是影响通气功能指标和基本人体测量参数关系的一个重要因素。目的:探讨成年男性吸烟者的人体测量参数与通气功能的关系。材料和方法:这是一项基于社区的横断面研究,纳入200名男性参与者(150名吸烟者和50名非吸烟者),采用分层随机抽样技术,符合纳入标准。与会者来自构成索科托大都市的地方政府。随后,参与者接受了一份改编自欧洲共同体呼吸健康调查的问卷,以收集人口统计、临床和吸烟数据。采用Clement Clarke One Flow Spirometer, version 1.3 Revision 0 (Clement Clarke International, Edinburgh, UK)进行通气功能测试。选取各通气功能指标(FEV1、FVC、FEV1/FVC)的最高值进行分析。对数据进行汇总,并使用statistical Package for Social Sciences, version 19 (IBM SPSS Inc., Chicago, IL, USA)软件进行统计检验。结果:吸烟者和对照组中的大多数研究参与者都是年轻人,单身,受过正规教育。参与者(吸烟者)和对照组(不吸烟者)的人体测量指数(体重、身高、身体质量指数(BMI))的平均值无显著差异。29名(58%)非吸烟者超重/肥胖,而35名(23.3%)吸烟者被观察到同样超重/肥胖。除FVC外,其他通气功能指标的平均值均低于对照组。此外,参与者的平均FEV1/FVC(75.60±7.53)与对照组的平均FEV1/FVC(82.48±6.11)差异有统计学意义(P = 0.001)。在研究参与者和对照组中观察到人体测量参数(身高和BMI)与呼吸功能指数(FEV1和FVC)之间存在显著相关性。结论:吸烟人群的通气功能指标与人体测量参数相关。虽然BMI对吸烟者通气功能指数的下降没有显著影响,但两者之间呈反比关系。
{"title":"Basic anthropometric parameters and ventilatory function indices among current cigarette smokers","authors":"M. Isah, M. Makusidi, A. Sabir, J. Okpapi, C. Njoku, A. Abba","doi":"10.4103/jomt.jomt_24_17","DOIUrl":"https://doi.org/10.4103/jomt.jomt_24_17","url":null,"abstract":"Background: Ventilatory function indices [forced vital capacity (FVC), expiratory volume in 1 (FEV1), and FEV1/FVC] are a function of the basic anthropometric parameters (weight and height). Cigarette smoking is an important confounder in the relationship between ventilatory function indices and basic anthropometric parameters. Aim: To determine the relationship between anthropometric parameters and ventilatory function among male adult cigarette smokers. Materials and Methods: This is a community-based cross-sectional study incorporating 200 male participants (150 cigarette smokers and 50 non-smokers) who met inclusion criteria using stratified random sampling technique. Participants were drawn from local governments that constituted Sokoto metropolis. Subsequently, participants had a questionnaire adapted from European Community Respiratory Health Survey administered to collect demographic, clinical and cigarette smoking data. Ventilatory function test was performed using Clement Clarke One Flow Spirometer, version 1.3 Revision 0 (Clement Clarke International, Edinburgh, UK). The highest value of each ventilatory function indices (FEV1, FVC, FEV1/FVC) was chosen for analysis. Data were summarized, and statistical tests were applied using the software Statistical Package for Social Sciences, version 19 (IBM SPSS Inc., Chicago, IL, USA). Result: The majority of study participants among cigarette smokers and control were young, single and had a form of formal education. There was no significant difference in the mean of anthropometric indices [weight, height, body mass index (BMI)] of participants (cigarette smokers) and control (non-cigarette smokers). Twenty-nine (58%) non-cigarette smokers were overweight/obese as against 35 (23.3%) participants among cigarette smokers observed to be equally overweight/obese. Mean values of the ventilatory function indices except FVC were low among study participants as compared with control. Furthermore, the mean FEV1/FVC between participants (75.60 ± 7.53) and control (82.48 ± 6.11) was statistically significant (P = 0.001). A significant correlation between anthropometric parameters (height and BMI) and ventilatory function indices (FEV1 and FVC) was observed among study participants and control. Conclusion: Ventilatory function indices are associated with anthropometric parameters among cigarette smokers. Although, BMI did not significantly affect decline in ventilatory function indices among cigarette smokers, an inverse relationship was observed between them.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"2 1","pages":"6 - 10"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79820449","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}