Pub Date : 2022-07-06DOI: 10.1101/2022.07.04.22276588
O. Akande, M. Fasiku, O. A. Bolarinwa, T. Akande
Background: Caregivers play an important role in informal patient management. Identification of the support types and the financial challenges faced by caregivers will provide information on strategies to ease this burden. This study aimed to describe the support types and financial burden amongst caregivers in a tertiary hospital in North Central Nigeria. Methods: This was a cross-sectional study conducted amongst caregivers of inpatients in a tertiary hospital in North Central Nigeria. Data were collected using a pre-tested interviewer-administered questionnaire and were analysed using the Statistical Package for the Social Sciences package version 23. Results were reported in frequencies and proportions and presented in prose, tables and charts. Results: A total of 400 caregivers were recruited. The mean age was 38.32 ± 12.82 years and most (66.0%) were females. Caregivers supported their patients by running errands (96.3%) and 85.3% reported caregiving as stressful. The reported errands were purchase of medications (92.3%), supply of non-medical needs (63.3%), submission of laboratory samples and collection of results (52.3%) and service payment (47.5%). About two-thirds (63.2%) reported loss of income while caregiving and about half (50.8%) provided financial support to the patients. Conclusion: This study suggests that majority of caregivers experience significant physical and financial burden while caregiving. This burden can be eased off by the simplification of payment and laboratory processes and employment of more staff to support patients admitted to the wards. The financial burden experienced by caregivers reinforces the need to encourage more Nigerians to enrol in a health insurance scheme.
{"title":"Caregiving in a tertiary health institution in North Central Nigeria: Support types and financial burden","authors":"O. Akande, M. Fasiku, O. A. Bolarinwa, T. Akande","doi":"10.1101/2022.07.04.22276588","DOIUrl":"https://doi.org/10.1101/2022.07.04.22276588","url":null,"abstract":"Background: Caregivers play an important role in informal patient management. Identification of the support types and the financial challenges faced by caregivers will provide information on strategies to ease this burden. This study aimed to describe the support types and financial burden amongst caregivers in a tertiary hospital in North Central Nigeria. Methods: This was a cross-sectional study conducted amongst caregivers of inpatients in a tertiary hospital in North Central Nigeria. Data were collected using a pre-tested interviewer-administered questionnaire and were analysed using the Statistical Package for the Social Sciences package version 23. Results were reported in frequencies and proportions and presented in prose, tables and charts. Results: A total of 400 caregivers were recruited. The mean age was 38.32 ± 12.82 years and most (66.0%) were females. Caregivers supported their patients by running errands (96.3%) and 85.3% reported caregiving as stressful. The reported errands were purchase of medications (92.3%), supply of non-medical needs (63.3%), submission of laboratory samples and collection of results (52.3%) and service payment (47.5%). About two-thirds (63.2%) reported loss of income while caregiving and about half (50.8%) provided financial support to the patients. Conclusion: This study suggests that majority of caregivers experience significant physical and financial burden while caregiving. This burden can be eased off by the simplification of payment and laboratory processes and employment of more staff to support patients admitted to the wards. The financial burden experienced by caregivers reinforces the need to encourage more Nigerians to enrol in a health insurance scheme.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"30 1","pages":"119 - 125"},"PeriodicalIF":1.1,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44332259","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}
Pub Date : 2022-04-01DOI: 10.4103/npmj.npmj_733_21
N. Anfinan, Eman Shaldoom, H. Sait, O. Baghlaf, Ahmad Alwazzan, Ahmed Mousa, M. Sait, B. Alkhalili, K. Sait
Objective: To report a single-center experience in non-epithelial malignant ovarian tumours (NEMOT), by presenting different clinical and pathological characteristics, management and outcomes. Methods: We retrospectively reviewed electronic files of all female patients who underwent surgery for NEMOT at the Gynecology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from July 2003 to July 2019. We collected baseline demographic, anthropomorphic and clinical data; pathological characteristics; management and follow-up data; and outcomes including residual disease, recurrence and last follow-up status (deceased or alive). Results: Thirty-three women were included; mean (standard deviation) age = 33.24 (17.72) years, range = 4, 86 years. Granulosa cell tumor was the most frequent subtype diagnosed in 17 (51.5%) patients, followed by germ cell tumours 13 (39.4%). The majority of patients were diagnosed at FIGO Stage I (22, 66.7%) and with tumor Grade 1 (23, 69.7%), while 8 (24.2%) were diagnosed with Grade 3 tumors. Granulosa cell and Sertoli-Leydig cell tumours were diagnosed at an older age (mean age = 39.30 vs. 23.92 years) compared to germ cell tumours, respectively (P = 0.012). Two-third of the patients benefited from conservative surgery including oophorectomy + staging, and 16 (48.5%) benefited from chemotherapy with bleomycin, etoposide and platinum being the most common protocol (13, 39.4%) for germ cell tumours. Postoperatively, only 2 (6.1%) patients had residual disease. Recurrence and mortality were reported in one and four patients, respectively, resulting in recurrence rate = 3.0% (95% confidence interval [CI] = 0.01%, 15.8%) and mortality rate = 12.1% (95% CI = 3.4%, 28.2%). Conclusions: The present series of NEMOT was predominated by sex cord-stromal cell tumors, which were diagnosed in patients with older age, while germ cell tumours were underrepresented. Although survival rates were comparable to those reported internationally, more consideration should be given to following up patients regarding fertility outcomes to provide a more comprehensive evaluation of treatment success and quality of care.
{"title":"Clinical and pathological patterns of non-epithelial malignant ovarian tumours in Western Saudi Arabia","authors":"N. Anfinan, Eman Shaldoom, H. Sait, O. Baghlaf, Ahmad Alwazzan, Ahmed Mousa, M. Sait, B. Alkhalili, K. Sait","doi":"10.4103/npmj.npmj_733_21","DOIUrl":"https://doi.org/10.4103/npmj.npmj_733_21","url":null,"abstract":"Objective: To report a single-center experience in non-epithelial malignant ovarian tumours (NEMOT), by presenting different clinical and pathological characteristics, management and outcomes. Methods: We retrospectively reviewed electronic files of all female patients who underwent surgery for NEMOT at the Gynecology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from July 2003 to July 2019. We collected baseline demographic, anthropomorphic and clinical data; pathological characteristics; management and follow-up data; and outcomes including residual disease, recurrence and last follow-up status (deceased or alive). Results: Thirty-three women were included; mean (standard deviation) age = 33.24 (17.72) years, range = 4, 86 years. Granulosa cell tumor was the most frequent subtype diagnosed in 17 (51.5%) patients, followed by germ cell tumours 13 (39.4%). The majority of patients were diagnosed at FIGO Stage I (22, 66.7%) and with tumor Grade 1 (23, 69.7%), while 8 (24.2%) were diagnosed with Grade 3 tumors. Granulosa cell and Sertoli-Leydig cell tumours were diagnosed at an older age (mean age = 39.30 vs. 23.92 years) compared to germ cell tumours, respectively (P = 0.012). Two-third of the patients benefited from conservative surgery including oophorectomy + staging, and 16 (48.5%) benefited from chemotherapy with bleomycin, etoposide and platinum being the most common protocol (13, 39.4%) for germ cell tumours. Postoperatively, only 2 (6.1%) patients had residual disease. Recurrence and mortality were reported in one and four patients, respectively, resulting in recurrence rate = 3.0% (95% confidence interval [CI] = 0.01%, 15.8%) and mortality rate = 12.1% (95% CI = 3.4%, 28.2%). Conclusions: The present series of NEMOT was predominated by sex cord-stromal cell tumors, which were diagnosed in patients with older age, while germ cell tumours were underrepresented. Although survival rates were comparable to those reported internationally, more consideration should be given to following up patients regarding fertility outcomes to provide a more comprehensive evaluation of treatment success and quality of care.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"116 - 122"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49469707","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}
O. Olatosi, A. Oyapero, Kehinde M. Akinwande, Oladipupo Ayedun, E. Aladenika, Olorunfemi Obe
Background: Dental anomalies are craniofacial abnormalities in the size, structure or number of the teeth. This study was conducted to assess the prevalence of dental anomalies among children aged 0–16 years attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: A cross-sectional design was used and data were obtained from the dental records of the Dental Clinic from January 2014 to August 2019 by two calibrated examiners, who are co-authors of the manuscript. To test for statistical differences, Chi-squared test was utilised for the categorical variables. The prevalence of the different dental anomalies was estimated and presented with frequencies. P < 0.05 was considered statistically significant. Results: Among the 6175 patients' dental records reviewed, 50.85% (n = 3150) were male and the highest proportion of 45.4% (n = 2807) were aged between 6 and 10 years, with a mean age of 8.62 ± 3.85 years. A total of 1090 (17.52%) had dental anomalies; 465 (7.53) anomalies were in the maxilla, 263 (4.6) were in the mandible while 360 (5.83) were in both. The most common anomaly was hypoplasia 550 (9.06%), followed by retained primary tooth 546 (8.84%) and hypodontia 84 (1.36%). Dentinogenesis imperfecta 1 (0.02) and transposition 1 (0.02) were the least prevalent anomalies. Retained primary teeth (5.8%) and the cusp of Carabelli (0.4%) were slightly more prevalent among males. However, females had a higher prevalence of natal/neonatal teeth (0.4%), fusion/germination (0.4%), hypodontia (1.5%) and peg-shaped lateral incisors (0.9%). Conclusion: Dental anomalies' prevalence in this study was 17.52%, with a higher occurrence of anomalies in the maxilla. Hypoplasia was the most prevalent anomaly, after which was retained primary tooth, then hypodontia. Prompt diagnosis and preventive interventions are crucial for the appropriate management of these dental anomalies.
{"title":"Pattern and prevalence of dental anomalies among a paediatric population in Lagos, Nigeria","authors":"O. Olatosi, A. Oyapero, Kehinde M. Akinwande, Oladipupo Ayedun, E. Aladenika, Olorunfemi Obe","doi":"10.4103/npmj.npmj_23_22","DOIUrl":"https://doi.org/10.4103/npmj.npmj_23_22","url":null,"abstract":"Background: Dental anomalies are craniofacial abnormalities in the size, structure or number of the teeth. This study was conducted to assess the prevalence of dental anomalies among children aged 0–16 years attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: A cross-sectional design was used and data were obtained from the dental records of the Dental Clinic from January 2014 to August 2019 by two calibrated examiners, who are co-authors of the manuscript. To test for statistical differences, Chi-squared test was utilised for the categorical variables. The prevalence of the different dental anomalies was estimated and presented with frequencies. P < 0.05 was considered statistically significant. Results: Among the 6175 patients' dental records reviewed, 50.85% (n = 3150) were male and the highest proportion of 45.4% (n = 2807) were aged between 6 and 10 years, with a mean age of 8.62 ± 3.85 years. A total of 1090 (17.52%) had dental anomalies; 465 (7.53) anomalies were in the maxilla, 263 (4.6) were in the mandible while 360 (5.83) were in both. The most common anomaly was hypoplasia 550 (9.06%), followed by retained primary tooth 546 (8.84%) and hypodontia 84 (1.36%). Dentinogenesis imperfecta 1 (0.02) and transposition 1 (0.02) were the least prevalent anomalies. Retained primary teeth (5.8%) and the cusp of Carabelli (0.4%) were slightly more prevalent among males. However, females had a higher prevalence of natal/neonatal teeth (0.4%), fusion/germination (0.4%), hypodontia (1.5%) and peg-shaped lateral incisors (0.9%). Conclusion: Dental anomalies' prevalence in this study was 17.52%, with a higher occurrence of anomalies in the maxilla. Hypoplasia was the most prevalent anomaly, after which was retained primary tooth, then hypodontia. Prompt diagnosis and preventive interventions are crucial for the appropriate management of these dental anomalies.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"167 - 172"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43061967","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}
Pub Date : 2022-04-01DOI: 10.4103/npmj.npmj_556_21
Victoria I. Olafimihan, A. Ariba, Iyabode Florence Dedeke
Background: Babies birth anthropometric measurements are useful for retrospective assessment of foetal in utero health status, anticipatory care and growth monitoring. At community level, measurements other than birth weight (BW) may help predict low BW (LBW). Aim: The aim of the study was to determine the mean anthropometric measurements of term babies, its comparability with standard values, acceptable cutoff and surrogate for LBW. Materials and Methods: A cross-sectional study involving 257 term babies delivered by booked mothers at the Sacred Heart Hospital Abeokuta and selected by systematic random sampling. BW, occipitofrontal circumference (OFC), chest circumference (CC), mid-upper arm circumference (MUAC) and crown-heel length (CHL) were measured, and data were analysed using SPSS version 21 with significant P < 0.05 and confident interval of 95%. Results: Mean BW, CC, OFC, CHL and MUAC were 3.25 ± 0.47 kg, 33.32 ± 1.98 cm, 34.7 ± 1.93 cm, 48.16 ± 2.87 cm and 11.57 ± 1.41 cm, respectively, with no significant mean difference between male and female babies. The mean OFC was higher than the national standard, World Health Organization Multicentre Growth Reference Study (WHO-MGRS) and INTERGROWTH-21. The mean cutoff for LBW was OFC – 31.89 cm, CC – 29.56 cm, CHL– 43.33 cm and MUAC – 9.35 cm (P = 0.000) with OFC being the best surrogate of LBW at Sensitivity, Specificity and Degree of Accuracy/area under the curve of 66.7%, 97.6% and 82.1% respectively. Conclusions: LBW babies had lower mean anthropometric cutoff values at variance from the WHO-MGRS and INTERGROWTH-21. Mean OFC was higher than both standards reflecting the need for cautious interpretation to prevent misdiagnosis of macrocephaly. We recommend OFC as an alternative for predicting LBW when access to weighing scale is a challenge.
{"title":"Anthropometric measurements of term babies delivered in a mission hospital in Southwest Nigeria","authors":"Victoria I. Olafimihan, A. Ariba, Iyabode Florence Dedeke","doi":"10.4103/npmj.npmj_556_21","DOIUrl":"https://doi.org/10.4103/npmj.npmj_556_21","url":null,"abstract":"Background: Babies birth anthropometric measurements are useful for retrospective assessment of foetal in utero health status, anticipatory care and growth monitoring. At community level, measurements other than birth weight (BW) may help predict low BW (LBW). Aim: The aim of the study was to determine the mean anthropometric measurements of term babies, its comparability with standard values, acceptable cutoff and surrogate for LBW. Materials and Methods: A cross-sectional study involving 257 term babies delivered by booked mothers at the Sacred Heart Hospital Abeokuta and selected by systematic random sampling. BW, occipitofrontal circumference (OFC), chest circumference (CC), mid-upper arm circumference (MUAC) and crown-heel length (CHL) were measured, and data were analysed using SPSS version 21 with significant P < 0.05 and confident interval of 95%. Results: Mean BW, CC, OFC, CHL and MUAC were 3.25 ± 0.47 kg, 33.32 ± 1.98 cm, 34.7 ± 1.93 cm, 48.16 ± 2.87 cm and 11.57 ± 1.41 cm, respectively, with no significant mean difference between male and female babies. The mean OFC was higher than the national standard, World Health Organization Multicentre Growth Reference Study (WHO-MGRS) and INTERGROWTH-21. The mean cutoff for LBW was OFC – 31.89 cm, CC – 29.56 cm, CHL– 43.33 cm and MUAC – 9.35 cm (P = 0.000) with OFC being the best surrogate of LBW at Sensitivity, Specificity and Degree of Accuracy/area under the curve of 66.7%, 97.6% and 82.1% respectively. Conclusions: LBW babies had lower mean anthropometric cutoff values at variance from the WHO-MGRS and INTERGROWTH-21. Mean OFC was higher than both standards reflecting the need for cautious interpretation to prevent misdiagnosis of macrocephaly. We recommend OFC as an alternative for predicting LBW when access to weighing scale is a challenge.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"131 - 137"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45450041","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}
Objectives: Associations between the occurrence of dentine hypersensitivity (DH) and dental fluorosis (DF) have been suggested. Testing this association requires studies among populations with both conditions. This study aimed to determine the association between DF and the experience of DH among a population endemic for DF. Methods: This was a cross-sectional study conducted in 2021 over 6 months among 428 adult patients. Participants' demographics were collected, followed by verbal screening for DH and oral examinations. Clinical assessment for DH was carried out by tactile and evaporative methods. The presence and severity of DF were also assessed using the Thylstrup and Fejerskov Index. Data analysis included Chi-square and correlation statistics to assess the presence and strength of associations. Results: The overall prevalence of DH was 31.1%. A higher proportion (41.1%, P < 0.001) of participants with DF had DH than those without DF. The association between DH and DF was minimal but statistically significant (r = 0.174, P < 0.001). Among those with DF, the prevalence of DH was highest in participants with severe fluorosis (50%, P = 0.740). The proportion of sensitive teeth to the teeth examined was significantly higher (P < 0.0001) for participants with DF (289/4167, 6.9%) than participants without DF (267/6758, 4%). This proportion was also highest for severe DF (20/254, 7.9%, P = 0.572) than the mild and moderate forms. Conclusion: DH was more prevalent among individuals with DF. The prevalence of DH was not dependent on the severity of DF.
{"title":"Are there associations between the occurrence of dental fluorosis and the experience of dentine hypersensitivity? A cross-sectional study","authors":"P. Idon, O. Ikusika, O. Sotunde, T. Ogundare","doi":"10.4103/npmj.npmj_7_22","DOIUrl":"https://doi.org/10.4103/npmj.npmj_7_22","url":null,"abstract":"Objectives: Associations between the occurrence of dentine hypersensitivity (DH) and dental fluorosis (DF) have been suggested. Testing this association requires studies among populations with both conditions. This study aimed to determine the association between DF and the experience of DH among a population endemic for DF. Methods: This was a cross-sectional study conducted in 2021 over 6 months among 428 adult patients. Participants' demographics were collected, followed by verbal screening for DH and oral examinations. Clinical assessment for DH was carried out by tactile and evaporative methods. The presence and severity of DF were also assessed using the Thylstrup and Fejerskov Index. Data analysis included Chi-square and correlation statistics to assess the presence and strength of associations. Results: The overall prevalence of DH was 31.1%. A higher proportion (41.1%, P < 0.001) of participants with DF had DH than those without DF. The association between DH and DF was minimal but statistically significant (r = 0.174, P < 0.001). Among those with DF, the prevalence of DH was highest in participants with severe fluorosis (50%, P = 0.740). The proportion of sensitive teeth to the teeth examined was significantly higher (P < 0.0001) for participants with DF (289/4167, 6.9%) than participants without DF (267/6758, 4%). This proportion was also highest for severe DF (20/254, 7.9%, P = 0.572) than the mild and moderate forms. Conclusion: DH was more prevalent among individuals with DF. The prevalence of DH was not dependent on the severity of DF.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"161 - 166"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48523420","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: The novel coronavirus pandemic has influenced the working practice of health-care professionals who come across symptomatic and asymptomatic COVID patients in their day-to-day practice. Especially, among HCWs in otorhinolaryngology, with the risk of exposure being high, hence were mandated to use personal protective equipment (PPE). Materials and Methods: The change in perceptions and patterns of PPE use throughout the COVID-19 pandemic was studied in detail through interviews conducted among 15 key informants, and the data were analyzed using health belief model in our study. Results: A health belief model explains the trajectory of PPE use by otorhinolaryngology health care providers during the COVID-19 pandemic. The course of usage of PPE by otorhinolaryngology health-care professionals during the COVID-19 pandemic was explained through the health belief model. During the initial days of the COVID-19 pandemic, intense perceived severity and susceptibility to COVID infection led to PPE use, and otorhinolaryngology HCWs resorted to higher grade PPEs which gave optimal protection; but in course of time with a better understanding of the natural course of illness, minimal PPEs without compromising HCW safety were used with minimal discomfort. Perceived severity of COVID infection on self and family, health knowledge, influence of peers, and support from the institution encouraged them in using PPEs. Conclusion: We found that various aspects of health belief model such as the perceived susceptibility, perceived severity of the disease, perceived barriers and benefits in PPE use, self-efficacy, health-related knowledge, and the cues to action influence PPE use among otorhinolaryngology HCWs. The key findings can be applied in behavior change models to promote the use of PPE in the hospitals, especially during the time of pandemic.
{"title":"‘Shifting from anxiety to the new normal’: A qualitative exploration on personal protective equipment use by otorhinolaryngology health-care professionals during COVID-19 pandemic","authors":"Ganesan Sivaraman, Jijitha Lakshmanan, Britzer Paul, Mahalakshmy Thulasingam, Bitty Raghavan, Nipun Raghu, Kalaiarasi Raja, S. Saxena","doi":"10.4103/npmj.npmj_10_22","DOIUrl":"https://doi.org/10.4103/npmj.npmj_10_22","url":null,"abstract":"Background: The novel coronavirus pandemic has influenced the working practice of health-care professionals who come across symptomatic and asymptomatic COVID patients in their day-to-day practice. Especially, among HCWs in otorhinolaryngology, with the risk of exposure being high, hence were mandated to use personal protective equipment (PPE). Materials and Methods: The change in perceptions and patterns of PPE use throughout the COVID-19 pandemic was studied in detail through interviews conducted among 15 key informants, and the data were analyzed using health belief model in our study. Results: A health belief model explains the trajectory of PPE use by otorhinolaryngology health care providers during the COVID-19 pandemic. The course of usage of PPE by otorhinolaryngology health-care professionals during the COVID-19 pandemic was explained through the health belief model. During the initial days of the COVID-19 pandemic, intense perceived severity and susceptibility to COVID infection led to PPE use, and otorhinolaryngology HCWs resorted to higher grade PPEs which gave optimal protection; but in course of time with a better understanding of the natural course of illness, minimal PPEs without compromising HCW safety were used with minimal discomfort. Perceived severity of COVID infection on self and family, health knowledge, influence of peers, and support from the institution encouraged them in using PPEs. Conclusion: We found that various aspects of health belief model such as the perceived susceptibility, perceived severity of the disease, perceived barriers and benefits in PPE use, self-efficacy, health-related knowledge, and the cues to action influence PPE use among otorhinolaryngology HCWs. The key findings can be applied in behavior change models to promote the use of PPE in the hospitals, especially during the time of pandemic.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"110 - 115"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48485146","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}
Agiriye M. Harry, C. Edet, N. Ekanem, Chinonye J Kemdirim, A. Uduak
Context: Coronavirus disease (COVID-19) has led to over 2,589,638 deaths globally as of March 2021 and speedy discovery of vaccines. Nigeria started the phase one COVID-19 vaccination in March 2021 using the Oxford AstraZeneca vaccine. Reports of severe adverse events with the Oxford AstraZeneca vaccine resulted in its suspension in some countries necessitating the need to determine its safety. Aims: To assess the prevalence, types and severity of the adverse events following COVID-19 vaccination in Rivers State, Nigeria. Settings and Design: A cross-sectional study design was adopted. Subjects and Methods: Simple random sampling method was used to select a total of 428 adults from recipients of the first dose of COVID-19 vaccine within 28 days of vaccination. A questionnaire adapted from World Health Organisation was interviewer-administered through phone calls; responses were recorded on Kobo Toolbox. Statistical Analysis Used: Descriptive analysis of variables was done and the association between adverse events and age, allergy and medical history were determined. The level of statistical significance was predetermined at a P < 0.05. Results: In this study, 50.5% of respondents reported post-vaccination adverse events out of which 10 (4.6%) were severe (30% of the severe cases were life-threatening, 60% were hospitalised and 10% were placed on bed rest). The most common side effects were fever (73.0%), pain at the injection site (41.2%), fatigue (33.3%), body ache (17.5%) and headache (13.8%). No significant association was observed between the incidence of severe adverse events and participants with allergies or medical history. Conclusions: The adverse events associated with the COVID-19 vaccine were largely mild and resolved within a few days. Further research is required to classify adverse events into categories.
{"title":"Adverse Events Following COVID-19 Vaccination in Rivers State, Nigeria: A Cross-Sectional Study","authors":"Agiriye M. Harry, C. Edet, N. Ekanem, Chinonye J Kemdirim, A. Uduak","doi":"10.4103/npmj.npmj_11_22","DOIUrl":"https://doi.org/10.4103/npmj.npmj_11_22","url":null,"abstract":"Context: Coronavirus disease (COVID-19) has led to over 2,589,638 deaths globally as of March 2021 and speedy discovery of vaccines. Nigeria started the phase one COVID-19 vaccination in March 2021 using the Oxford AstraZeneca vaccine. Reports of severe adverse events with the Oxford AstraZeneca vaccine resulted in its suspension in some countries necessitating the need to determine its safety. Aims: To assess the prevalence, types and severity of the adverse events following COVID-19 vaccination in Rivers State, Nigeria. Settings and Design: A cross-sectional study design was adopted. Subjects and Methods: Simple random sampling method was used to select a total of 428 adults from recipients of the first dose of COVID-19 vaccine within 28 days of vaccination. A questionnaire adapted from World Health Organisation was interviewer-administered through phone calls; responses were recorded on Kobo Toolbox. Statistical Analysis Used: Descriptive analysis of variables was done and the association between adverse events and age, allergy and medical history were determined. The level of statistical significance was predetermined at a P < 0.05. Results: In this study, 50.5% of respondents reported post-vaccination adverse events out of which 10 (4.6%) were severe (30% of the severe cases were life-threatening, 60% were hospitalised and 10% were placed on bed rest). The most common side effects were fever (73.0%), pain at the injection site (41.2%), fatigue (33.3%), body ache (17.5%) and headache (13.8%). No significant association was observed between the incidence of severe adverse events and participants with allergies or medical history. Conclusions: The adverse events associated with the COVID-19 vaccine were largely mild and resolved within a few days. Further research is required to classify adverse events into categories.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"89 - 95"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41670667","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}
Pub Date : 2022-04-01DOI: 10.4103/npmj.npmj_697_21
H. Yahya, Halima Umar, Bulus Shekari, Kalli Sani, Muhammad Yahya
Background: Upper gastrointestinal endoscopy (UGIE) using pharyngeal anesthesia, with or without sedation to improve tolerance and acceptance, is now standard practice but the unsedated examination is easier to perform, costs less and is associated with fewer complications. It is, therefore, attractive in resource-limited settings like sub-Saharan Africa but studies about tolerance and acceptance of unsedated UGIE there are limited. Objective: The objective of this study was to report the tolerance and acceptance of unsedated UGIE in a tertiary institution in Kaduna, Nigeria. Methods: Consecutive patients referred for diagnostic UGIE were requested to report the overall level of discomfort for the procedure on verbal and visual analogue scales and to indicate whether they would accept the procedure in the future. Their pulse rate, oxygen saturation and blood pressure were monitored. Results: Of 306 patients (mean age: 45.5 years, 39.2% <40 years, 57.5% of females), 51.3% reported no or mild discomfort and only 5.6% reported severe and intolerable discomfort. Overall, 232 (75.8%) tolerated the procedure well and 229 (79.5%) accepted to have the same procedure in the future. Patients <40 years and those with secondary/post-secondary education were significantly less likely to tolerate the procedure well than older patients (81.1% vs. 87.9%, P = 0.006) and those with lower education (72.7% vs. 86.2%, P = 0.032), respectively. 79.5% accepted to have the procedure in the future, with males significantly more so than females (86.9% vs. 74.4%, P = 0.019). Conclusion: Most patients undergoing unsedated diagnostic UGIE in Kaduna, Nigeria, tolerated the procedure well and accepted to have the same procedure in the future.
{"title":"Tolerance and acceptance for unsedated diagnostic upper gastrointestinal endoscopy in Kaduna, North-West Nigeria","authors":"H. Yahya, Halima Umar, Bulus Shekari, Kalli Sani, Muhammad Yahya","doi":"10.4103/npmj.npmj_697_21","DOIUrl":"https://doi.org/10.4103/npmj.npmj_697_21","url":null,"abstract":"Background: Upper gastrointestinal endoscopy (UGIE) using pharyngeal anesthesia, with or without sedation to improve tolerance and acceptance, is now standard practice but the unsedated examination is easier to perform, costs less and is associated with fewer complications. It is, therefore, attractive in resource-limited settings like sub-Saharan Africa but studies about tolerance and acceptance of unsedated UGIE there are limited. Objective: The objective of this study was to report the tolerance and acceptance of unsedated UGIE in a tertiary institution in Kaduna, Nigeria. Methods: Consecutive patients referred for diagnostic UGIE were requested to report the overall level of discomfort for the procedure on verbal and visual analogue scales and to indicate whether they would accept the procedure in the future. Their pulse rate, oxygen saturation and blood pressure were monitored. Results: Of 306 patients (mean age: 45.5 years, 39.2% <40 years, 57.5% of females), 51.3% reported no or mild discomfort and only 5.6% reported severe and intolerable discomfort. Overall, 232 (75.8%) tolerated the procedure well and 229 (79.5%) accepted to have the same procedure in the future. Patients <40 years and those with secondary/post-secondary education were significantly less likely to tolerate the procedure well than older patients (81.1% vs. 87.9%, P = 0.006) and those with lower education (72.7% vs. 86.2%, P = 0.032), respectively. 79.5% accepted to have the procedure in the future, with males significantly more so than females (86.9% vs. 74.4%, P = 0.019). Conclusion: Most patients undergoing unsedated diagnostic UGIE in Kaduna, Nigeria, tolerated the procedure well and accepted to have the same procedure in the future.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"138 - 145"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43683298","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}
Pub Date : 2022-04-01DOI: 10.4103/npmj.npmj_779_21
E. Otrofanowei, I. Akase, B. Olopade, P. Akintan, U. Ima-Edomwonyi, Y. Akinbolagbe, O. Agabi, Danladi Nmadu, G. Akinbode, A. Opawoye, C. Olasope, A. Ogundare, B. Bolarinwa, Oluwakemi Awojumobi-Otokiti, P. Enajeroh, M. Karami, C. Esezobor, G. Olorunfemi, Y. Oshodi, A. Oluwole, W. Adeyemo, C. Bode
The use of reverse transcription–polymerase chain reaction (RT-PCR) is the gold standard laboratory test for diagnosing SARS-CoV-2 infection. However, it has the disadvantage of a long turnaround time and cost. The Nigeria Centre for Disease Control (NCDC) formulated a case definition for COVID-19. We sought to determine the utility of a 14-item, point-weighted clinical screening questionnaire adapted from the NCDC case definition in identifying patients more likely to have the disease. This was to aid prompt clinical decision-making. Methods: We retrospectively reviewed the data of 113 non-surgical patients presenting to the Accident and Emergency Department (A and E) of Lagos University Teaching Hospital, Lagos, Nigeria. Patients were stratified based on screening scores into low (0–2), moderate (3–5) and high (6) pre-test categories. Patients with low and high scores ≥6 were admitted to the A and E and the COVID-19 holding ward, respectively, while the moderate group had chest computed tomography scans to aid further decision-making, pending the outcome of their RT-PCR results. The validity of the triage score as compared to the RT-PCR test result was calculated and the kappa score of agreement was utilised to evaluate the concordance between two triage scores. The optimum cut-off score was also obtained based on the maximal Younden's index. Results: The frequencies of low, moderate and high pre-test scores were 34 (30%), 43 (38.1%) and 36 (31.9%), respectively. Overall, 38.1% (43/113) were RT-PCR positive. RT-PCR was positive in 26.5% (9/34) with low screening scores, 55.8% (24/43) with moderate scores and 27.8% (10/36) with high scores. The sensitivity and specificity of a high score of 6 were 25% and 92.86%, while the lower score of 3 had sensitivity and specificity of 62.5% and 58.6%, respectively. Conclusion: The screening tool showed a high specificity in its initial design, which suggests that anyone with a low score using this tool has a high probability of testing negative. We recommend a cut-off score of 4 (score A) or 6 (score B) of the current screening tool be used to increase the chances of identifying persons with COVID-19 for RT-PCR testing.
{"title":"Assessment of the utility of a screening tool for COVID-19 diagnosis in an accident and emergency department in Lagos, Nigeria: A pilot study","authors":"E. Otrofanowei, I. Akase, B. Olopade, P. Akintan, U. Ima-Edomwonyi, Y. Akinbolagbe, O. Agabi, Danladi Nmadu, G. Akinbode, A. Opawoye, C. Olasope, A. Ogundare, B. Bolarinwa, Oluwakemi Awojumobi-Otokiti, P. Enajeroh, M. Karami, C. Esezobor, G. Olorunfemi, Y. Oshodi, A. Oluwole, W. Adeyemo, C. Bode","doi":"10.4103/npmj.npmj_779_21","DOIUrl":"https://doi.org/10.4103/npmj.npmj_779_21","url":null,"abstract":"The use of reverse transcription–polymerase chain reaction (RT-PCR) is the gold standard laboratory test for diagnosing SARS-CoV-2 infection. However, it has the disadvantage of a long turnaround time and cost. The Nigeria Centre for Disease Control (NCDC) formulated a case definition for COVID-19. We sought to determine the utility of a 14-item, point-weighted clinical screening questionnaire adapted from the NCDC case definition in identifying patients more likely to have the disease. This was to aid prompt clinical decision-making. Methods: We retrospectively reviewed the data of 113 non-surgical patients presenting to the Accident and Emergency Department (A and E) of Lagos University Teaching Hospital, Lagos, Nigeria. Patients were stratified based on screening scores into low (0–2), moderate (3–5) and high (6) pre-test categories. Patients with low and high scores ≥6 were admitted to the A and E and the COVID-19 holding ward, respectively, while the moderate group had chest computed tomography scans to aid further decision-making, pending the outcome of their RT-PCR results. The validity of the triage score as compared to the RT-PCR test result was calculated and the kappa score of agreement was utilised to evaluate the concordance between two triage scores. The optimum cut-off score was also obtained based on the maximal Younden's index. Results: The frequencies of low, moderate and high pre-test scores were 34 (30%), 43 (38.1%) and 36 (31.9%), respectively. Overall, 38.1% (43/113) were RT-PCR positive. RT-PCR was positive in 26.5% (9/34) with low screening scores, 55.8% (24/43) with moderate scores and 27.8% (10/36) with high scores. The sensitivity and specificity of a high score of 6 were 25% and 92.86%, while the lower score of 3 had sensitivity and specificity of 62.5% and 58.6%, respectively. Conclusion: The screening tool showed a high specificity in its initial design, which suggests that anyone with a low score using this tool has a high probability of testing negative. We recommend a cut-off score of 4 (score A) or 6 (score B) of the current screening tool be used to increase the chances of identifying persons with COVID-19 for RT-PCR testing.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"96 - 101"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45236100","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}
Pub Date : 2022-04-01DOI: 10.4103/npmj.npmj_716_21
O. Akinmokun, E. Alabi, G. Enweluzo, Akindele Balogun, I. Oyebiyi
Background: Total knee arthroplasty (TKA) is performed worldwide. TKA is performed to relief pain, correct deformities and improve mobility in patients with debilitating diseases of their knee joints. Templating is done as pre-operative planning for TKA. Certain parameters, such as shoe size, had been studied as predictor (s) for implant size. This study aimed to determine if the tibial length (TL) can also be as a predictor of a tibial component of TKA. Materials and Methods: TL and tibial plateau width (TPW) measurements were done on dry adult tibiae. Proximal tibiae were traced on tracing paper, to obtain anterior–posterior and lateral tracings. Length of tracings confirmed with measurement on dry bones. A TKA template, converted to 100% scale was used to estimate the tibial baseplate by two orthopaedic surgeons. Results: A total of 51 matured, non-sexed, non-paired tibiae were studied. There was a statistically significant positive relationship between the TL and the TPW (P = 0.0001). Furthermore, a statistically significant positive relationship was also observed between the TL and the tibial implant baseplate (P = 0.0001). The study showed that a particular range of tibia length will accommodate certain sizes of the tibial implant baseplate. Conclusion: The tibia length can be used as a predictor of the size of tibial baseplate of TKA.
{"title":"Can the tibial length predict the size of tibial component of total knee arthroplasty?","authors":"O. Akinmokun, E. Alabi, G. Enweluzo, Akindele Balogun, I. Oyebiyi","doi":"10.4103/npmj.npmj_716_21","DOIUrl":"https://doi.org/10.4103/npmj.npmj_716_21","url":null,"abstract":"Background: Total knee arthroplasty (TKA) is performed worldwide. TKA is performed to relief pain, correct deformities and improve mobility in patients with debilitating diseases of their knee joints. Templating is done as pre-operative planning for TKA. Certain parameters, such as shoe size, had been studied as predictor (s) for implant size. This study aimed to determine if the tibial length (TL) can also be as a predictor of a tibial component of TKA. Materials and Methods: TL and tibial plateau width (TPW) measurements were done on dry adult tibiae. Proximal tibiae were traced on tracing paper, to obtain anterior–posterior and lateral tracings. Length of tracings confirmed with measurement on dry bones. A TKA template, converted to 100% scale was used to estimate the tibial baseplate by two orthopaedic surgeons. Results: A total of 51 matured, non-sexed, non-paired tibiae were studied. There was a statistically significant positive relationship between the TL and the TPW (P = 0.0001). Furthermore, a statistically significant positive relationship was also observed between the TL and the tibial implant baseplate (P = 0.0001). The study showed that a particular range of tibia length will accommodate certain sizes of the tibial implant baseplate. Conclusion: The tibia length can be used as a predictor of the size of tibial baseplate of TKA.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"29 1","pages":"146 - 150"},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43723689","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：