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Assessment of Candidates' Performance Pre- and Post-Adoption of Standard Setting in College Examinations between 2016 and 2023.
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2025-03-17 DOI: 10.4103/npmj.npmj_180_24
Titilope Oyinlola Charles-Eromosele, Oyenike Oyeronke Ekekezie, Patrick Ayodeji Akinyemi, Fatiu Abiola Arogundade

Background: Assessment drives candidates' learning and focuses on the main goals and objectives of the course. Over the years, determination of pass scores in medical education has evolved from the arbitrary 50% to the actual determination of the cut-off scores in the standard setting process in order to make a decision to pass/fail candidates presenting for licensure or credentialing purposes.

Materials and methods: The study aimed at assessing and comparing candidates' performance pre- and post-adoption of standard setting in the college. This was a comparative cross-sectional study with a time trend. Examination results of all candidates who registered and sat for examinations in the years 2016-2023 were included in the study. Secondary data from approved results of the various faculties from 2016 to 2023 were used. Data analysis was done using SPSS Version 26.

Results: There was a statistically significant difference in the mean pass rates pre- and post-adoption of standard setting in the primary examinations (P < 0.001), Part I examinations (P = 0.002) and Part II examinations (P < 0.001) with a higher mean pass rate post-adoption of standard setting.

Conclusion: The increased pass rates in the primary, Part I and Part II examinations post-adoption of standard setting may suggest improved examination performance. There is, however, the need to assess the acquired competencies and skills of the candidates post-certification. The significantly higher mean pass rates post-adoption of standard setting are consequent on improvement in the quality and robustness of items/questions and of the examination processes, brought about by the training and retraining of faculty examiners which preceded the implementation.

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引用次数: 0
Evaluation of the Evan's Index on Normal Brain Computed Tomography Scans of Adults in Delta State Nigeria. 评估尼日利亚三角洲州成年人正常脑计算机断层扫描的埃文指数。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2025-03-17 DOI: 10.4103/npmj.npmj_289_24
Beryl Shitandi Ominde, Mamerhi Taniyohwo Enaohwo, Oghenetejiri Denise Ogholo, Joyce Ekeme Ikubor, Precious Oghenefejiro Onogbe, Ogheneyole Jeremiah

Aims: The study aimed at establishing the normal Evans index (EI) in adults residing in Delta State, Nigeria.

Methods: Researchers sought ethical authorisation from a Nigerian University Teaching Hospital in Delta State, where this cross-sectional study was conducted. Computed tomographic images of the brain were retrieved from the hospital's radiological database. Brain computed tomography images of 195 adults (102 males and 93 females) were selected, and their axial slices were retrospectively analysed to determine the maximum width of the frontal horns (MWFHs) and the maximum intracranial transverse diameter (MITD). The ratio of MWFH to MITD was computed as the EI. Statistical Package for the Social Sciences version 27 was employed to evaluate the sex- and age-related differences in the quantitative variables and the association between them. These were regarded significant whenever P < 0.05.

Results: Male patients had larger MITD and MWFH than females (P < 0.05). However, the EI lacked significant sexual variances (P = 0.051). As age increased, the mean EI also significantly increased, although, it did not exceed 0.3; the internationally recognised diagnostic cutoff value. The EI and MWFH showed a weak positive relationship with age, whereas the MITD and age had a weak negative association (P < 0.05). Both EI and MITD had a positive correlation with MWFH (P < 0.05).

Conclusion: The normative EI values established in this study provide reliable references than will aid clinicians to accurately diagnose and monitor patients with ventriculomegaly associated with normal pressure hydrocephalus and neurodegenerative disorders, ensuring more effective management.

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引用次数: 0
Cross-sectional Study to Determine the Diagnostic Accuracy of Cytokeratin-19 Immunomarker in the Diagnosis of Thyroid Malignancy with Histopathology as Gold Standard.
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2025-03-17 DOI: 10.4103/npmj.npmj_3_25
Helena Laishram, Kunda Jagadale, Parineeta Shelke, Reena Bharadwaj

Background: Thyroid cancer, particularly papillary thyroid carcinoma (PTC), is the most common endocrine malignancy, with a growing incidence worldwide. Accurate differentiation between benign and malignant thyroid nodules is crucial for appropriate treatment and management. Histopathological analysis is the gold standard for definitive diagnosis, but immunohistochemistry (IHC) markers such as cytokeratin-19 (CK-19) have shown potential as valuable diagnostic aids in some cases with equivocal morphological appearances and have diagnostic dilemmas. CK-19 is known to be expressed in higher levels in malignant thyroid lesions, especially PTC.

Aims: To study the diagnostic accuracy of CK-19 immunomarker in the diagnosis of thyroid malignancy with histopathology as the gold standard.

Materials and methods: The present study was carried out in Pathology Department, Bharati Vidyapeeth Deemed University Medical College and Bharati Hospital and Research Centre, Pune. It is a cross sectional, analytical, prospective and retrospective study. A total of 42 cases of thyroid nodules were included. IHC staining for CK-19 was performed on the paraffin-embedded tissue sections of these nodules. CK-19 expression levels were evaluated and compared between malignant and benign lesions. Receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity, specificity and overall diagnostic accuracy of CK-19.

Results: The study revealed that CK-19 expression was significantly stronger in malignant thyroid nodules, particularly in PTC, compared to benign nodules. Among the 42 cases included in the analysis, the sensitivity and specificity of CK-19 for detecting malignancy were both 92.9%. The ROC curve analysis showed an area under the curve of 0.971, indicating excellent diagnostic accuracy (P < 0.0001) with a 95% confidence interval of 0.922-1.000.

Conclusions: CK-19 is a highly sensitive and specific immunomarker for distinguishing malignant thyroid nodules from benign ones, particularly in cases of PTC. The findings support the use of CK-19 as an adjunctive diagnostic tool in routine clinical practice to enhance the accuracy of thyroid cancer diagnosis and improve patient outcomes.

{"title":"Cross-sectional Study to Determine the Diagnostic Accuracy of Cytokeratin-19 Immunomarker in the Diagnosis of Thyroid Malignancy with Histopathology as Gold Standard.","authors":"Helena Laishram, Kunda Jagadale, Parineeta Shelke, Reena Bharadwaj","doi":"10.4103/npmj.npmj_3_25","DOIUrl":"10.4103/npmj.npmj_3_25","url":null,"abstract":"<p><strong>Background: </strong>Thyroid cancer, particularly papillary thyroid carcinoma (PTC), is the most common endocrine malignancy, with a growing incidence worldwide. Accurate differentiation between benign and malignant thyroid nodules is crucial for appropriate treatment and management. Histopathological analysis is the gold standard for definitive diagnosis, but immunohistochemistry (IHC) markers such as cytokeratin-19 (CK-19) have shown potential as valuable diagnostic aids in some cases with equivocal morphological appearances and have diagnostic dilemmas. CK-19 is known to be expressed in higher levels in malignant thyroid lesions, especially PTC.</p><p><strong>Aims: </strong>To study the diagnostic accuracy of CK-19 immunomarker in the diagnosis of thyroid malignancy with histopathology as the gold standard.</p><p><strong>Materials and methods: </strong>The present study was carried out in Pathology Department, Bharati Vidyapeeth Deemed University Medical College and Bharati Hospital and Research Centre, Pune. It is a cross sectional, analytical, prospective and retrospective study. A total of 42 cases of thyroid nodules were included. IHC staining for CK-19 was performed on the paraffin-embedded tissue sections of these nodules. CK-19 expression levels were evaluated and compared between malignant and benign lesions. Receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity, specificity and overall diagnostic accuracy of CK-19.</p><p><strong>Results: </strong>The study revealed that CK-19 expression was significantly stronger in malignant thyroid nodules, particularly in PTC, compared to benign nodules. Among the 42 cases included in the analysis, the sensitivity and specificity of CK-19 for detecting malignancy were both 92.9%. The ROC curve analysis showed an area under the curve of 0.971, indicating excellent diagnostic accuracy (P < 0.0001) with a 95% confidence interval of 0.922-1.000.</p><p><strong>Conclusions: </strong>CK-19 is a highly sensitive and specific immunomarker for distinguishing malignant thyroid nodules from benign ones, particularly in cases of PTC. The findings support the use of CK-19 as an adjunctive diagnostic tool in routine clinical practice to enhance the accuracy of thyroid cancer diagnosis and improve patient outcomes.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"32 1","pages":"61-67"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649579","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}
引用次数: 0
Transforming Oncology: Advancing Cancer Management with Three-dimensional Technology. 变革肿瘤学:利用三维技术推进癌症管理。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2025-03-17 DOI: 10.4103/npmj.npmj_11_25
Ankit K Badge, Madhukar Tulshiram Tikas, Nandkishor J Bankar, Obaid Noman
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引用次数: 0
Epidemiological, Clinical and Paraclinical Profile of Paediatric Malaria at University Hospital Centre Amissa Bongo in Franceville, Gabon. 加蓬弗朗斯维尔Amissa Bongo大学医院中心儿童疟疾的流行病学、临床和临床旁概况。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI: 10.4103/npmj.npmj_200_24
Roméo Karl Imboumy-Limoukou, Jean Claude Biteghe-Bi-Essone, Sandrine Lydie Oyegue-Liabagui, Jean Jordan Ekogha-Ovono, D'Alva Noronha Ingrid Nascimento, Steede Seinnat Ontoua, Cherone Nancy Mbani Mpega Ntigui, Lady Charlène Kouna, Jean Bernard Lekana-Douki

Background: Malaria remains the deadliest parasitic disease and continues to cause more than half a million deaths across the world each year, mainly victims are sub-Saharan children. Malaria is a common reason for paediatric hospitalisation.

Objective: The objective was to characterise malaria and describe the evolution after treatment in the paediatric department of the University Hospital Centre Amissa Bongo de Franceville.

Methods: This was a cross-sectional study conducted from 1 February 2023 to 15 May 2023. A clinical and biological diagnosis was made in febrile children aged from 6 months to 15 years.

Results: A total of 306 patients were included. The mean age was 50.4 ± 44.3 months, 94.3% had consulted within ≥48 h and self-medication was practiced by 83.3%. The prevalence of malaria was 17.3%. Fever ˃39°8C (adjusted odds ratios [aOR] = 2.68; 95% confidence interval [CI] = [1.32-5.48]; P < 0.01), chills (aOR = 2.14; 95% CI = [1.13-4.11]; P < 0.01) and nausea-vomiting (aOR = 2.03; 95% CI = [1.06-3.83]; P = 0.03) were the factors associated with the occurrence of malaria. The majority of children were treated for simple malaria with artemisinin-based combination therapy. A total of 16/53 was seen in post-therapeutic consultation. Of them, 2 patients had a positive thick drop.

Conclusion: Non-compliance with preventive measures and the misuse of antimalarials further complicate the clinical picture, requiring parenteral management for the most part.

背景:疟疾仍然是最致命的寄生虫病,每年继续在世界各地造成50多万人死亡,主要受害者是撒哈拉以南的儿童。疟疾是儿童住院的常见原因。目的:目的是描述疟疾的特征,并描述在Amissa Bongo de Franceville大学医院中心儿科治疗后的演变。方法:这是一项横断面研究,于2023年2月1日至2023年5月15日进行。对6个月至15岁的发热儿童进行临床和生物学诊断。结果:共纳入306例患者。平均年龄50.4±44.3个月,就诊时间≥48 h的占94.3%,自行用药的占83.3%。疟疾患病率为17.3%。发热≤39°8C(调整后优势比[aOR] = 2.68;95%置信区间[CI] = [1.32-5.48];P < 0.01)、寒颤(aOR = 2.14;95% ci = [1.13-4.11];P < 0.01)和恶心呕吐(aOR = 2.03;95% ci = [1.06-3.83];P = 0.03)是与疟疾发生相关的因素。大多数儿童接受以青蒿素为基础的联合疗法治疗单纯性疟疾。治疗后咨询共16/53。其中2例厚滴阳性。结论:不遵守预防措施和滥用抗疟药物进一步使临床情况复杂化,大部分需要肠外治疗。
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引用次数: 0
Assessment of the Prevalence and Patterns of Violence against Healthcare Workers in Nigeria: A Multicentre Study. 评估尼日利亚对保健工作者的暴力行为的普遍性和模式:一项多中心研究。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI: 10.4103/npmj.npmj_221_24
Alphonsus Rukevwe Isara, Zara William Wudiri, Hadiza Abigail Agbo, Luret Albert Lar, Adesuwa Queen Aigbokhaode, Nyemike Simeon Awunor

Background: In Nigeria, violence against healthcare has adversely affected the access to and delivery of healthcare services with serious consequences for healthcare workers (HCWs). This study assessed the prevalence and patterns of violence against HCWs in areas of armed conflict, areas of other situation of violence and areas not affected by conflict in Nigeria.

Methodology: A cross-sectional study utilising a mixed method approach comprising both quantitative survey and qualitative data collection methods. All the categories of HCWs in public healthcare facilities participated in the study. Ethical approval for this study was obtained from the respective Health and Research Ethics Committees of the respective study sites.

Results: A total of 1,218 HCWs comprising Borno State, 407 (33.4%), Plateau State, 401 (32.9%) and the Federal Capital Territory 410 (43.7%) were interviewed. The overall prevalence of physical and psychological violence was 16.7% and 62.4%, respectively. Pushing and slapping were the predominant forms of physical violence. Weaponized violence with weapon was the highest in conflict areas. Verbal abuse, threats, bullying and harassment were the predominant forms of psychological violence. The major consequences of violent attacks on the HCWs were lack of job satisfaction, loss of confidence, low self-esteem, decreased productivity and post-traumatic stress disorder.

Conclusions: The overall prevalence of violent attacks on HCWs was high. The perpetrators of violent attacks were mainly patient relatives and patients/clients. The factors predisposing to violent attacks were patients-related issues, service delivery, working conditions of the hospitals, expectations of patient relatives and impatience of hospital staff.

背景:在尼日利亚,针对医疗保健的暴力行为对医疗保健服务的获取和提供产生了不利影响,对医疗保健工作者造成了严重后果。本研究评估了尼日利亚武装冲突地区、其他暴力局势地区和未受冲突影响地区针对卫生工作者的暴力行为的普遍程度和模式。方法:横断面研究,采用混合方法,包括定量调查和定性数据收集方法。公立医疗机构所有类别的医护人员都参与了研究。本研究获得了各自研究地点的健康与研究伦理委员会的伦理批准。结果:共采访了1218名卫生保健工作者,其中博尔诺州407名(33.4%),高原州401名(32.9%),联邦首都地区410名(43.7%)。身体暴力和心理暴力的总体发生率分别为16.7%和62.4%。推搡和打耳光是主要的身体暴力形式。使用武器的武器化暴力在冲突地区是最高的。言语虐待、威胁、欺凌和骚扰是心理暴力的主要形式。暴力袭击卫生保健工作者的主要后果是缺乏工作满意度、丧失信心、低自尊、生产力下降和创伤后应激障碍。结论:卫生保健工作者遭受暴力袭击的总体发生率较高。暴力袭击的施暴者以患者亲属和患者/案主为主。导致暴力袭击的因素是与病人有关的问题、提供的服务、医院的工作条件、病人家属的期望和医院工作人员的不耐烦。
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引用次数: 0
Domestic Resource Mobilisation for Sustainable Healthcare Financing in Nigeria: A Review. 尼日利亚可持续医疗融资的国内资源动员:综述。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI: 10.4103/npmj.npmj_213_24
Amina Idris Bello, Maryam Abimbola Jimoh, Abdul-Rasheed Olalekan Tijani, Hafsat Abolore Ameen

Domestic resource mobilisation (DRM) is vital for achieving sustainable healthcare financing in Nigeria, where dependence on external funding and oil revenues has long hindered health sector progress. The Nigerian healthcare system faces persistent challenges, including inadequate funding, inefficiencies and limited access to essential services, particularly in rural areas. This paper explores the challenges and prospects of DRM as a means of financing healthcare in Nigeria. A Medline search and a search of other internet search engines were carried out for published studies on healthcare financing in Nigeria, Africa and worldwide, we also examined policy documents and healthcare financing data to analyse the potential of DRM in Nigeria. A total of 38 publications were reviewed revealing that mechanisms such as general tax revenue, social insurance systems and community-based health insurance are central to DRM efforts. However, challenges such as inadequate budgetary allocations, corruption, poor database management and the emigration of health workers persist. Despite these obstacles, there are promising prospects, including increased tax revenue, development of the domestic capital market and the potential for sustainable and equitable healthcare financing through public-private partnerships. To harness these opportunities, the Nigerian government must implement effective policies, strengthen governance structures and promote transparency and accountability. DRM offers a promising path towards reducing dependency on external aid and achieving a more resilient and equitable healthcare system in Nigeria.

在尼日利亚,对外部资金和石油收入的依赖长期阻碍了卫生部门的进步,国内资源调动对于实现可持续的卫生保健融资至关重要。尼日利亚卫生保健系统面临着持续的挑战,包括资金不足、效率低下和获得基本服务的机会有限,特别是在农村地区。本文探讨了DRM作为尼日利亚医疗保健融资手段的挑战和前景。Medline搜索和其他互联网搜索引擎对尼日利亚、非洲和世界范围内发表的医疗融资研究进行了搜索,我们还检查了政策文件和医疗融资数据,以分析DRM在尼日利亚的潜力。总共审查了38份出版物,表明一般税收、社会保险制度和社区健康保险等机制是DRM工作的核心。然而,预算拨款不足、腐败、数据库管理不善和卫生工作者移徙等挑战依然存在。尽管存在这些障碍,但仍有良好的前景,包括增加税收、发展国内资本市场以及通过公私伙伴关系实现可持续和公平的保健融资的潜力。为了利用这些机会,尼日利亚政府必须实施有效的政策,加强治理结构,促进透明度和问责制。DRM为尼日利亚减少对外部援助的依赖和实现更有弹性和更公平的卫生保健系统提供了一条有希望的道路。
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引用次数: 0
Emergency Medicine as a Medical Speciality in Nigeria: Challenges and Prospects. 尼日利亚急诊医学作为医学专业:挑战与前景。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI: 10.4103/npmj.npmj_139_24
Wahab Yinusa

Emergency medicine (EM) globally is a new medical speciality when compared with traditional medical specialities such as surgery, obstetrics, gynaecology and internal medicine. It is a medical speciality that deals with the management of acute illnesses and injuries in a timely and result-oriented manner. The International Federation of EM defines it as a field of practice based on the knowledge and care required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury, affecting patients of all age groups with a full spectrum of episodic, undifferentiated physical and behavioural disorders. Two types of EM are recognised: the out-of-hospital emergency medical services (OHEMS) and the in-hospital emergency medical services (IHEMS). OHEMS was introduced into the country in 1998 by the Lagos state government. IHEMS had been in place for much longer, but it was practised in a heterogeneous and substandard manner. The result of the latter is a casualty department with an overwhelming burden of patients and a high mortality rate. The World Health Assembly (WHA) resolution 60.22 of 2007 mandated every member state government to establish and monitor integrated EM care systems; it is therefore expected that the emergency medical services (EMS) in the country would wear a new look. However, anecdotal reports suggest that both OHEMS and IHEMS in the country are rudimentary and there is no strong evidence to show that EM is embraced by all as a medical speciality. The objective of this study is to examine the challenges and prospects of EM as a medical speciality in Nigeria. A review of the past literature searched in Google, Google Scholar, PubMed and African Journal online was conducted. A total of 40 relevant publications in addition to the authors knowledge and exposure in EM supported the information presented in this manuscript. Our study revealed that inadequate funding and ambulance services, nonavailability of trained bystanders, limited infrastructure and skilled manpower, inadequate and inequitable distribution of health resources, lack of standard emergency department, high out-of-pocket expenses and substandard implementation of EMS policies, are factors militating against a functional EMS in the country. In line with the philosophy of WHA resolution72.16 of 2019, it is recommended that the central government should put in place a mechanism for full and sustainable implementation of the NHIA Act (2022), National Emergency Medical Services and Ambulance System (NEMSAS) and the patient's bill of rights and direct the adoption of EM as a medical speciality in all federal and state hospitals. In addition, the central government should create public awareness, improve road networks, provide funding, and establish collaboration with local and international organisations.

与外科、产科、妇科和内科等传统医学专业相比,急诊医学在全球范围内是一门新兴的医学专业。这是一门以及时和结果为导向的方式处理急性疾病和伤害管理的医学专业。国际EM联合会将其定义为一个实践领域,其基础是预防、诊断和管理疾病和损伤的急性和紧急方面所需的知识和护理,影响所有年龄组的患者,他们患有各种偶发性、未分化的身体和行为障碍。有两种类型的紧急医疗服务:院外紧急医疗服务(oems)和院内紧急医疗服务(IHEMS)。oems于1998年由拉各斯州政府引入该国。IHEMS已经存在了很长时间,但它的实践方式是不统一和不合格的。后者的结果是一个病人负担沉重的伤亡科和高死亡率。世界卫生大会(WHA) 2007年第60.22号决议授权每个会员国政府建立和监测综合急诊保健系统;因此,预计该国的紧急医疗服务(EMS)将呈现新的面貌。然而,坊间报道显示,该国的OHEMS和IHEMS都是初级的,没有强有力的证据表明所有人都接受EM作为一种医学专业。本研究的目的是研究尼日利亚作为医学专业的EM的挑战和前景。对谷歌、谷歌Scholar、PubMed和African Journal online中检索到的文献进行了综述。除了作者在EM领域的知识和曝光外,共有40篇相关出版物支持本文提供的信息。我们的研究表明,资金和救护车服务不足,缺乏训练有素的旁观者,基础设施和熟练人力有限,卫生资源分配不充分和不公平,缺乏标准的急诊科,高额的自付费用和不合格的EMS政策实施,是阻碍该国EMS功能的因素。根据世界卫生大会2019年第72.16号决议的理念,建议中央政府建立一个机制,以全面和可持续地实施NHIA法案(2022年)、国家紧急医疗服务和救护车系统(NEMSAS)和患者权利法案,并指导在所有联邦和州立医院采用EM作为医学专业。此外,中央政府应该提高公众意识,改善道路网络,提供资金,并与当地和国际组织建立合作关系。
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引用次数: 0
Bilateral Total Hip and Right Knee Arthroplasty in a Sickle Cell Disease Patient with Multiple Joint Osteonecrosis: A Case Report and Literature Review. 镰状细胞病合并多发性骨坏死患者的双侧全髋关节和右膝关节置换术:1例报告和文献复习。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI: 10.4103/npmj.npmj_237_24
Michael Ebiyon Ugbeye, Kehinde Adesola Alatishe, Chukwuebuka Okezie

Sickle cell disease is an autosomal recessive genetic disorder with the underlying pathology, resulting in sickling of the red blood cells in deoxygenated conditions. Osteonecrosis is a common orthopaedic manifestation of sickle cell disease, and total joint arthroplasty is the preferred option in managing patients with advanced disease. This article describes bilateral total hip arthroplasty and right total knee arthroplasty (TKA) in a 41-year-old woman, a known haemoglobin SS (HBSS) patient who presented to the outpatient clinic of National Orthopaedic Hospital, Igbobi, Lagos, with recurrent bilateral hip and right knee pain of 10-year duration, with associated stiffness, valgus deformity in the knee and severe limitation of function. She had sequential bilateral total hip replacement and right TKA. She had significant improvement in function in the follow-up period. The effectiveness of total hip and knee arthroplasties in HBSS patients with osteonecrosis is well demonstrated in this article.

镰状细胞病是一种常染色体隐性遗传疾病,具有潜在的病理,导致红细胞在缺氧条件下镰状坏死。骨坏死是镰状细胞病常见的骨科表现,全关节置换术是治疗晚期疾病患者的首选方法。这篇文章描述了一名41岁女性的双侧全髋关节置换术和右侧全膝关节置换术(TKA),她是一名已知的血红蛋白SS (HBSS)患者,在拉各斯伊博比国家骨科医院门诊就诊,双侧髋关节和右侧膝关节复发疼痛持续10年,伴有僵硬、膝关节外翻畸形和严重的功能限制。她接受了双侧全髋关节置换术和右侧全髋关节置换术。在随访期间,患者的功能有明显改善。这篇文章很好地证明了HBSS合并骨坏死患者全髋关节和膝关节置换术的有效性。
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引用次数: 0
Pattern of Medication Adherence, Spirituality and Viral Load amongst Adult Patients on Highly Active Antiretroviral Therapy in Rural Southwest Nigeria. 尼日利亚西南部农村接受高效抗逆转录病毒治疗的成年患者的药物依从性、精神状态和病毒载量模式
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI: 10.4103/npmj.npmj_176_24
Moronkeji Temitope Olanrewaju, Olatutu Ololade Olanrewaju, Azeez Oyemomi Ibrahim, Tope Michael Ipinnimo, Paul Oladapo Ajayi, Oluwafunmilayo Kehinde Sito

Introduction: Previous studies have been conducted on medication adherence in Southwest Nigeria, but none of these has reported the relationship between highly active antiretroviral therapy (HAART) adherence, spirituality and viral load (VL) amongst people living with Human immunodeficiency virus (HIV)/AIDS, especially in rural settings of Southwestern Nigeria. This study assessed the pattern of medication adherence, spirituality and VL and ascertained the association of socio-demographics and spirituality on medication adherence amongst patients on HAART in rural Southwestern Nigeria.

Materials and methods: A hospital-based cross-sectional study involving 321 consented patients on HAART who were recruited by systematic sampling technique at the adult HIV clinic. Data were collected using an interviewer-administered questionnaire that assessed participants' socio-demographic profiles, medication adherence and spirituality. Their blood samples were collected and their VLs were determined. The data were analysed using SPSS version 20. Logistic regression was done to identify the independent predictors of medication adherence.

Results: The majority of the respondents reported a medium level of medication adherence (66.4%), a high level of spirituality (68.8%) and a low level of VL (67.3%). Amongst variables that had a statistically significant association with medication adherence were being educated, married, divorced, separated or widowed (P < 0.05). Furthermore, persons with high spirituality were 2.6 times more likely to be adherent to antiretroviral drugs when compared to persons with low spirituality (P < 0.05).

Conclusion: It was shown that high spirituality is a positive predictor of medication adherence amongst patients on HAART. It, therefore, suggests that efforts deployed to improve the spirituality of these patients would most likely improve their medication adherence.

导读:以前的研究已经在尼日利亚西南部进行了药物依从性研究,但没有一项研究报告了人类免疫缺陷病毒(HIV)/艾滋病感染者中高活性抗逆转录病毒治疗(HAART)依从性、精神和病毒载量(VL)之间的关系,特别是在尼日利亚西南部的农村环境中。本研究评估了药物依从性、精神性和VL的模式,并确定了尼日利亚西南部农村HAART患者中社会人口统计学和精神性与药物依从性的关系。材料和方法:一项以医院为基础的横断面研究,涉及321名同意接受HAART治疗的患者,这些患者是在成人HIV诊所通过系统抽样技术招募的。数据收集使用访谈者管理的问卷,评估参与者的社会人口统计资料,药物依从性和灵性。采集了他们的血液样本并测定了他们的VLs。数据采用SPSS version 20进行分析。采用Logistic回归来确定药物依从性的独立预测因素。结果:大多数受访者的药物依从性为中等水平(66.4%),精神性为高水平(68.8%),VL为低水平(67.3%)。与药物依从性有统计学意义相关的变量包括受教育程度、已婚、离婚、分居或丧偶(P < 0.05)。此外,灵性高的人坚持抗逆转录病毒药物的可能性是灵性低的人的2.6倍(P < 0.05)。结论:高精神性是HAART患者药物依从性的积极预测因子。因此,这表明,努力改善这些病人的精神状态最有可能提高他们的药物依从性。
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引用次数: 0
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