Nigerian Postgraduate Medical Journal最新文献

Background: Hypertension is a significant global public health concern, with unique risk factors affecting those in the banking sector due to their work environment. This study aimed to determine the prevalence of hypertension among bank employees and identify specific contributing risk factors.

Materials and methods: A cross-sectional survey of 250 bank employees used pretested structured questionnaires. Various measurements, including body mass index (BMI), blood pressure, lipid profile parameters and cardiovascular events, were recorded. Data were analysed using SPSS software. Categorical variables are presented as frequencies and percentages. Binary logistic regression was employed to identify independent predictors of hypertension (P < 0.05).

Results: The study participants had a mean age of 37.56 ± 8.98, with 54.5% being female. The majority (98.8%) had tertiary education, and 94.7% resided in urban areas. The prevalence of hypertension was 33.3%. Higher BMI is significantly associated with increased odds of hypertension. For each unit increase in BMI, the odds of having hypertension are approximately 1.98 times higher. Hypertension was also significantly more prevalent in those participants with prior hypertension diagnosis, those with a family history of hypertension, smokers and those who added salt to their food on the table (P < 0.05).

Conclusion: The alarmingly high prevalence of hypertension underscores the need for targeted intervention and health promotion initiatives. With recognised risk factors, emphasis must be placed on the importance of lifestyle modifications and workplace wellness programmes to mitigate the burden of hypertension.

Background: Fibroadenoma (FA) is documented as the most common benign breast disease typically presenting as a lump. A wide variety of other diseases including breast cancer can similarly present as lumps hence the need for further differentiation. Ultrasonography plays a vital role in the evaluation and treatment of breast lumps with histological analysis as the gold standard.

Objective: This study compared the physical and sonographic features of the breast in women with FA and women with breast lumps due to other diseases.

Materials and methods: This is a single-centre comparative study. Clinical and sonographic breast evaluations of the recruited patients with lumps were done and reported using the American College of Radiology Breast Imaging Reporting and Data System score. The lumps were biopsied, and histological diagnosis was documented. Clinical and imaging features of the breasts of women with FA were then compared with those of women with lumps from other breast diseases, and collated data were analysed using SPSS Statistical version 23.0.

Results: Data from 118 subjects (59 in each group) were used for this study. There was a significant difference in the physical and sonographic appearance of FA concerning the patient's age, parity, change in lesion size, perilesional architecture, echogenicity, borders, capsule and background breast density. No FA was found in women with less dense breasts.

Conclusion: The sonographic features of breasts showed some differences from the corresponding features of FA and other breast lesions. This has the potential to increase the efficiency of pre-operative diagnosis of FA and could be further applied in developing diagnostic criteria for FA in our environment.

Background: Adequate levels of calcium, phosphate and Vitamin D are essential for bone physiology and growth, as well as preventing some common childhood illnesses. This study aimed to determine the prevalence of the deficiencies of these nutrients and factors affecting their serum levels in Nigerian children.

Methods: This was a cross-sectional study that involved 220 apparently healthy children aged 6-24 months in Ikenne Local Government Area of Ogun State, Nigeria. Serum calcium and phosphate were assayed using the calorimetric method, while Vitamin D (25-OH Vitamin D) was assayed with ELISA.

Results: The mean (±standard deviation [SD]) serum Vitamin D level was 55.07 ± 16.53 ng/ml, while the mean (±SD) serum calcium and phosphate were 2.27 ± 0.13 mmol/l and 1.28 ± 0.18 mmol/l, respectively. Eleven (5%) of the children had hypovitaminosis D, 23 (10.5%) had hypocalcaemia and 12 (5.5%) had hypophosphataemia. Factors found to be significantly associated with hypovitaminosis D included low consumption of milk and the use of a hijab veil, while malnutrition (both undernutrition and overnutrition) was significantly associated with hypocalcaemia.

Conclusion: The prevalence levels of hypovitaminosis D and hypophosphataemia were low, while hypocalcaemia was more common. Low milk consumption and use of a hijab veil were risk factors for hypovitaminosis D, while malnutrition was a risk factor for hypocalcaemia. Malnourished children, especially overnourished ones, should be routinely screened for hypocalcaemia because of its high prevalence among them.

Context: Standard-setting procedures assess candidates' competence in an examination. Different standard-setting methods produce different pass scores, and no gold standard exists currently. The quality of the standard-setting process is critical in medical examinations where true competency needs to be determined for safe medical practice.

Aims: This study assessed the standard-setting methods the college uses to determine the pass scores in the various parts of the fellowship examinations and compared these methods with the arbitrary 50% previously used.

Settings and design: A cross-sectional comparative study to assess the standard-setting methods adopted, which was applied to the September/October/November 2023 fellowship examinations.

Methods: This was a total population survey involving the 16 faculties of the College. Secondary data from a compilation of approved results was used.

Data analysis: Descriptive and analytical statistics in Microsoft Excel program.

Results: The methods for standard-setting adopted by the college were assessed, and their mean pass scores were analysed. The mean pass score for the primary multiple choice questions examinations was 46.7%, lower than the previously used arbitrary 50% mark, and this difference was statistically significant (P < 0.05). The mean pass scores for the other examinations were higher than the previously used arbitrary 50% mark, but these differences were not statistically significant (P > 0.05).

Conclusion: Implementation of the approved standard-setting methods can be improved with more training and retraining of faculties and examiners so that results that are consistent with their purpose, and that align well with other measures of competency can be produced.

Obesity was mainly regarded as a disease of developed countries, but currently there is a growing rise in the population of patients with obesity in developing countries of Africa. A body mass index of 30 kg/m2 or higher is regarded as obesity, and this may be associated with comorbidities such as metabolic and cardiovascular diseases, orthopaedic and psychiatric conditions, and cancer. There is conclusive scientific evidence that shows that obesity is caused by complex psychosocial, genetic and environmental factors. Diet and exercise are not effective as sole management of severe obesity. Bariatric surgery is the most cost-effective definitive treatment for all classes of obesity, and the associated weight reduction causes improvement or complete resolution of obesity-associated comorbidity, improves the quality of life and reduces all-cause mortality. It is estimated that about 15% of adults in Nigeria are obese, and in the year 2023, it was reported that only 214 bariatric procedures were done locally, with 134 (62.6%) being gastric balloon insertions, 75 (35.1%) primary weight loss surgeries and 5 revisional surgeries (2.3%). In this article, we discussed the existing weight loss options in Nigeria, the current state of bariatric surgery and the need to improve the practice of bariatric surgery for obese Nigerians and complications of obesity.

Background: Advancements in the medical field have made organ transplantation an attractive treatment option for patients when indicated. Shortage of organs and commodification of organs are major challenges encountered in organ donation and transplantation. These could potentially breed unethical practices, if the process is not well regulated.

Aim: The aim of this study was to assess the knowledge of healthcare workers (HCWs) on the legal provisions regulating organ donation and transplantation in Nigeria.

Methodology: This cross-sectional study was conducted amongst physicians and nurses across Nigeria. Knowledge of legal provisions on organ donation and transplantation was assessed using a validated questionnaire that had 21 questions derived from the National Health Act. Each correctly answered question was given 1 point with a total obtainable score of 21 points. A score of ≥14 points was classified as good knowledge. P <0.05 was considered significant.

Results: A total of 836 physicians and nurses with a mean age of 37.61 ± 9.78 years participated in the study. Females and physicians constituted 53.3% and 62.9% of the respondents, respectively. The mean knowledge score of the respondents was 9.70 ± 2.91 points. Eighty-three (9.9%) respondents had a good knowledge score. There was a significantly higher proportion of male HCWs (P < 0.037) and older HCWs (P = 0.017) with good knowledge of legal provisions. On logistic regression, age was the only factor found to be associated with good knowledge of legal provision (adjusted odds ratio: 3.92; confidence interval: 1.33-11.59; P = 0.01).

Conclusion: The overall knowledge of legal provisions on organ donation and transplant was very poor amongst HCWs in Nigeria. There is a need to educate them on these provisions to curb unethical practices.

This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like 'androgenetic alopecia', 'androgenic alopecia', 'pattern baldness' and 'pattern hair loss' AND each term like 'epidemiology', 'pathophysiology', 'genetics', 'hormones', 'micronutrient', 'stress and inflammation', 'growth factors', 'clinical features', 'staging', 'cardiovascular associations', 'diagnosis' and 'management' were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.

Background: The thickness of extraocular muscles (EOMs) is important in the management of several conditions associated with EOM enlargement. This study determined the normative values of EOM diameters in adult patients seen at a teaching hospital in Nigeria.

Materials and methods: The study measured the thickness of the EOMs and the interzygomatic line (IZL) on brain images of 300 patients with non-orbital conditions (150 computed tomography [CT] and 150 magnetic resonance imaging [MRI]) archived in the radiological database of Delta State University Hospital, Nigeria, after ethical clearance. The Statistical Package for the Social Sciences (version 23) was used to obtain descriptive statistics and further compare the variables based on gender, age groups and laterality. The association between parameters was tested using Pearson's correlation test. A probability value of <5% was considered significant.

Results: The thickest muscles were the medial rectus (0.42 ± 0.08 cm) and superior muscle group (0.42 ± 0.33 cm) on CT and the inferior rectus (0.40 ± 0.08 cm) on MRI. The diameters were symmetrical with sexual dimorphism in the superior muscle group on CT, medial and lateral recti on MRI and sum of all EOMs on both imaging groups (P < 0.05). The superior muscle group and the sum of all EOMs showed significant age group variations and a positive correlation with age. We noted a positive correlation between each EOM diameter and the sum of all EOMs besides the IZL (P < 0.05).

Conclusion: This study offers normative data regarding EOMs that radiologists and ophthalmologists can use to diagnose disease conditions that cause EOM enlargement and further assess their response to treatment.

Pelvic organ prolapse refers to the descent of pelvic floor organs resulting from the weakening of pelvic muscles, fascia and connective tissue. The overall prevalence of pelvic organ prolapse is approximately 41%, including bladder prolapse (25%-34%), uterine prolapse (4%-14%) and rectal prolapse (13%-19%). Various methods are currently employed to repair damaged structures and improve patient symptoms, consequently enhancing their quality of life. This report focuses on a 94-year-old female diagnosed with pelvic organ prolapse, specifically Grade 3 bladder prolapse, Grade 3 uterine prolapse and complete rectal prolapse. A comprehensive surgical treatment was carried out to repair the pelvic organs on all three levels (rectum, uterus and bladder) by combining the Delorme procedure with synthetic graft implants. The surgical outcomes were good, illustrating immediate improvement in symptoms without early complications. A multispeciality approach helps functionally repair pelvic organ prolapse while preserving structural integrity.

Age-related macular degeneration (AMD) is a prevalent and incurable condition affecting the central retina and posing a significant risk to vision, particularly in individuals over the age of 60. As the global population ages, the prevalence of AMD is expected to rise, leading to substantial socioeconomic impacts and increased healthcare costs. The disease manifests primarily in two forms, neovascular and non-neovascular, with genetic, environmental and lifestyle factors playing a pivotal role in disease susceptibility and progression. This review article involved conducting an extensive search across various databases, including Google Scholar, PubMed, Web of Science, ScienceDirect, Scopus and EMBASE, to compile relevant case-control studies and literature reviews from online published articles extracted using search terms related to the work. SIRT1, a key member of the sirtuin family, influences cellular processes such as ageing, metabolism, DNA repair and stress response. Its dysregulation is linked to retinal ageing and ocular conditions like AMD. This review discusses the role of SIRT1 in AMD pathology, its association with genetic variants and its potential as a biomarker, paving the way for targeted interventions and personalised treatment strategies. In addition, it highlights the findings of case-control studies investigating the relationship between SIRT1 gene polymorphisms and AMD risk. These studies collectively revealed a significant association between certain SIRT1 gene variants and AMD risk. Further studies with larger sample sizes are required to validate these findings. As the prevalence of AMD grows, understanding the role of SIRT1 and other biomarkers becomes increasingly vital for improving diagnosis, treatment and, ultimately, patient outcomes.