Nigerian Postgraduate Medical Journal最新文献

In the expanding food processing environment, humans still face risks from certain harmful organisms that cause food contamination. One such ubiquitous organism is Listeria monocytogenes (L. monocytogenes), a facultative anaerobe, one of the infectious bacteria that can cause contamination in food processing settings. Food processing environments have inherent challenges in implementing preventive measures, including sanitation protocols, hygiene practices, advanced detection technologies and regulatory compliance. Advanced technologies and best practices are applied to control and prevent L. monocytogenes contamination in food processing environments. Environmental monitoring programmes and risk assessment strategies are important in identifying and mitigating potential sources of contamination. Employee training and education are important in maintaining a clean and safe food processing environment. By implementing an approach that incorporates both technological advancements and human factors, food manufacturers can effectively try to reduce the risk of contamination by L. monocytogenes and ensure the safety of their products for consumers. This review assesses advanced technologies and best practices to reduce L. monocytogenes contamination within food processing environments.

Background: Sociodemographic characteristics can influence the burden of caring for patients with mental illnesses such as schizophrenia.

Aim: The aim of this study was to ascertain the sociodemographic characteristics implicated in severe caregiver burden among family caregivers of patients with schizophrenia.

Methods: Over 3 months, 300 caregivers of patients with schizophrenia were consecutively recruited at the psychiatry outpatient department in a tertiary hospital in Gauteng province, South Africa. The sociodemographic characteristics of the caregivers were ascertained. The 22-item Zarit Burden Interview (ZBI-22) was administered to the participants to measure the caregiver burden.

Results: The range of ZBI-22 was 0-75 with a median of 19.00 (interquartile range [IQR]: 13.0-30.5). Severe burden occurred in 2.33% (7/300) of the participants. The sociodemographic characteristics that had the highest percentage amongst those with the severe burden (and their median burden score plus IQR) were increasing duration of caregiving 132.0 (72.0-264.0), residing in Northern Gauteng 17.0 (13.0-30.0), age ≥50 years 28.0 (18.0-36.0), female 23.5 (15.0-34.0), married 23.5 (17.0-31.0), parent 27.0 (16.0-36.0), living with the patient 20.0 (14.0-31.0), medical comorbidity 18.5 (14.0-31.0), secondary education 19.0 (13.0-29.0) and having another family member that requires care 27.0 (17.0-42.0).

Conclusion: Caregivers with the implicated characteristics require periodic evaluation of their burden of care to offer them available support including referral to appropriate socioeconomic agencies. A future research agenda is to investigate how these characteristics contribute to the burden of care in the study setting.

Contribution: An array of sociodemographic characteristics is implicated in severe caregiver burden and their interactions in the study setting need further investigation.

Background: Efficient consultation-liaison referrals to psychiatrists are essential in a multidisciplinary healthcare setting to optimise care, reduce unnecessary costs and bridge the treatment gap in mental health.

Aims: The aim of this study is to analytically assess the quality and to identify deficiencies of consultation-liaison referrals from various medical specialties to psychiatry in a teaching hospital in Nigeria.

Methods: A retrospective review of 263 in-hospital referral letters to the Psychiatry Department from January 2022 to April 2024 at the Nnamdi Azikiwe University Teaching Hospital, Nigeria, was conducted. Referrals addressed to clinical psychologists were excluded. An adapted 'Consultation and Referral Request Letter Assessment Tool' was utilised to assess the quality of referrals, which was then categorised into 'poor', 'fair' and 'good'.

Results: The mean patient age was 40.68 years, with a balanced gender distribution. The study demonstrated that only 4.9% of the letters lacked a referral reason. Timing and urgency indicators were lacking in over 95% of the letters, and ongoing treatment information was absent in 77.2% of referrals. Notably, a quarter (25.1%) of the referral letters were objectively rated as poor in quality. The perceived usefulness of the referrals was significantly associated with the objectively assessed quality of the referrals (P = 0.01).

Conclusion: This audit highlights substantial deficiencies in referral letters to psychiatric services, which could complicate efficient triaging. There is a pressing need for a standardised referral template and education to enhance the quality of medical referrals, thus improving patient outcomes and resource utilisation.

Background: Diabetes mellitus is a chronic illness that commonly leads to progressive and incapacitating of patients' condition over the past 20 years.

Aim: The aim of the study was to evaluate the effects of the coughing technique, ShotBlockerTo evaluate the effects of the coughing technique, ShotBlocker and vibration device on pain intensity and patient satisfaction during subcutaneous (SC) insulin injections in hospitalised adults with Type 2 diabetes mellitus (T2DM).

Subjects and methods: The study was conducted at the Imam Al-Hassan Al Mujtaba Teaching Hospital, Al-Imam Al-Hasan Teaching Hospital, Al-Hindia Teaching Hospital, and Imam Al-Hussein Medical City in Holy Karbala. A simple random sampling of adults with T2DM was assigned in the current study from the previously mentioned setting. One hundred and forty patients were classified into 4 groups, 35 patients in the ShotBlocker group, 36 patients in the Vibration group 38 patients in the coughing group and 31 patients in the control group.

Results: There were statistically significant differences in pain scores among the study groups (P = 0.000). The vibration group had significantly lower pain scores (P = 0.000). Similarly, the ShotBlocker group demonstrated significantly lower pain scores (P = 0.000), and the coughing group also exhibited significantly lower pain scores (P = 0.000) compared to the control group. Regarding satisfaction scores, there were statistically significant differences among the groups (P = 0.000). The vibration group had significantly higher satisfaction scores (P = 0.000). Similarly, the ShotBlocker group showed significantly higher satisfaction scores (P = 0.000), and the coughing group had significantly higher satisfaction scores (P = 0.004) compared to the control group.

Conclusions: The coughing technique, ShotBlocker and vibration device are effective, non-invasive methods for reducing pain and enhancing patient satisfaction during SC insulin injections in adults with T2DM.

Background: To bridge the coverage gap of health insurance and the delay in achieving universal health coverage, the State Health Insurance Scheme (SHIS) was established to ensure access to affordable health care for all. The scheme's sustainability and utilisation are largely dependent on the knowledge and satisfaction of its enrolees.

Aim: The study aimed to assess enrolee's knowledge, utilisation and satisfaction with SHIS among public school teachers in Shomolu Local Government Area, Lagos State.

Subjects and methods: This was a descriptive cross-sectional study conducted among 304 public school teachers in Shomolu Local Government Area, Lagos, Nigeria using a multistage sampling method. Data were collected using pre-tested semi-structured self-administered questionnaires and analysed with EPI Info 7.2 statistical software. The level of significance was set at P < 0.05.

Results: Thirty-four per cent of the respondents had good knowledge of health insurance while 66% were not familiar with the benefits and advantages. About 85.9% of the respondents have utilised the scheme and of these 51% were satisfied while 49% were not satisfied. There was a statistically significant association between out-of-pocket (OOP) and satisfaction (P = 0.0003), marital status and utilisation (P = 0.01) and OOP and utilisation (P = 0.03).

Conclusion: The majority of the teachers lacked adequate knowledge of health insurance and half of them are satisfied with the services. There should be increased awareness for enrolees joining the scheme and an urgent need to improve the quality of care/services among enrolees in the scheme.

Background: During the COVID-19 pandemic, before vaccines were available, non-pharmaceutical interventions (NPIs) such as masks and hand hygiene were crucial in controlling SARS-CoV-2 transmission. However, various respiratory viruses continued to infect paediatric patients. This study aimed to detect viral pathogens using respiratory polymerase chain reaction (PCR) panel among hospitalised paediatric patients during the pandemic, compare these findings with pre-pandemic data and assess the impact of NPIs.

Subject and methods: From October 2022 to December 2022, 138 out of 345 hospitalised paediatric patients with respiratory infections were included in this retrospective cohort study. The patients were divided into three age groups: <1 year, 1-5 years and 5-18 years 0-12, 12-60 and 60-216 months, respectively. Statistical analyses were performed to compare the hospitalisation duration, pathogens and laboratory values across these groups.

Results: PCR tests were positive in 89 patients (64.5%) and negative in 49 patients (35.5%). Human bocavirus (HBoV) was the only pathogen showing significant age-related differences, with higher detection in the 13-60 month age group. Patients with HBoV and RSV had notably longer hospital stays.

Conclusion: The study found that HBoV, a small, non-enveloped virus, was more easily transmitted than enveloped viruses like SARS-CoV-2, as it can bypass FFP2 masks. Therefore, NPIs should be designed to target both enveloped and non-enveloped viruses to effectively manage epidemics and pandemics.

Tongue (lingual) cysts occurring on the dorsal or ventral surfaces present as swellings. These swellings could cause difficulty in eating, drinking, speaking or breathing. Lingual cyst with respiratory epithelium (LCRE) is a rare developmental cyst of which about 23 case reports exist in the literature. This report aimed to document a case of LCRE from our centre to update the literature and to distinguish it from other cysts of the tongue with or without respiratory epithelium in addition to other content. We present a case of lingual cyst in a 4-year-old boy of 4 years; histopathologic features revealed a cystic lesion lined by columnar ciliated epithelium with goblet cells, focal areas of squamous epithelium and areas of inflammation in the connective tissue. This confirms a diagnosis of LCRE. A discussion on the clinical and microscopic features that distinguishes it from the other tongue cyst is presented, and the need for an appropriate nomenclature is highlighted.

Background: In many different contexts, cancer vaccination, either by itself or in conjunction with screening has demonstrated potential in lowering the incidence and cancer-attributed mortality.

Aims: The current study was performed with the objectives to assess the knowledge, attitudes and practices of medical students in central India regarding cancer preventive vaccination and to assess the extent of coverage of vaccination and the factors affecting the acceptance of human papillomavirus (HPV) vaccine among medical students.

Methodology: A cross-sectional descriptive study of 2 months duration was conducted in a tertiary care teaching hospital of a university in Central India among 208 undergraduate medical students. Systematic random sampling was used to select the study participants from different professional years. A semi-structured, validated and pilot-tested questionnaire (Google Forms) was used to collect the data. The collected data were analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Descriptive analysis was done using mean and standard deviation for quantitative variables, while frequency and percentages were calculated for categorical variables.

Results: The mean age of the students was 19.15 ± 1.14 years, of which 71 (34.1%) were males and 137 (65.9%) were females. It has been reported that 136 (65.3%) were aware of cancer preventive vaccines, while 169 (81.2%) students knew that cervical cancer is the second most common cancer among females in India. Moreover, 144 (69.2%) of the students felt that the person who has received these cancer preventive vaccines can still develop cancer. Most of the students felt that vaccinated individuals could still develop cancer. Reasons for non-acceptance included high cost, fear of complications and uncertainty about vaccine efficacy.

Conclusion: To conclude, medical students did not have sufficient understanding of cancer prevention vaccination in nearly every area. Students rarely get the cancer preventive vaccine and have a reluctant attitude about them. Vaccination coverage is quite low and a variety of reasons, including misunderstandings, have affected medical students' acceptance of the HPV vaccine.

Background: The post-operative phase is critical among patients who are vulnerable to complications due to psychological and physiological stress. The quality of nursing care provided during this period can directly influence the post-operative outcomes.

Aims: The study was conducted to determine the effectiveness of nursing interventions on post-operative pain and satisfaction among patients undergoing abdominal surgery.

Materials and methods: A quantitative approach was used for the study to evaluate the effectiveness of nursing interventions on post-operative pain and satisfaction among patients undergoing abdominal surgery in a tertiary care hospital in Mangaluru. Patients in the experimental group were given pre-operative health education and were asked to listen to their preferred music. Post-operative pain and patient satisfaction were assessed in both study groups at different time points.

Results: The majority of the study participants in the experimental (62.0%) and treatment-as-usual groups (63.4%) were aged between 41 and 60 years. In the experimental group, the majority (56%) of them were interested in listening to instrumental music, and the remaining participants (44%) were interested in nature sounds. Pain scores significantly decreased in the experimental group than in the treatment-as-usual group. There was a statistically significant difference in the patient satisfaction scores between the study groups (P < 0.05).

Conclusion: Nurses should develop better strategies and protocols in nursing practice for the assessment of the pre-operative needs of the patient and incorporate various evidence-based interventions to improve pain management and satisfaction among patients.

A rare condition known as gastroptosis causes the major curvature of the stomach to shift downward and towards the pelvis. While some are asymptomatic, others experience symptoms. Cross-sectional imaging, or barium X-rays, are diagnostic. The main treatment strategy is conservative, and gastric motility stimulants, including dopamine antagonists, are the mainstay of the treatment. Herein, we describe an elderly patient with multimorbidity, polypharmacy and Parkinson's disease admitted to our clinic with nausea, vomiting and unintentional weight loss complaints who was diagnosed with gastroptosis and treated successfully with itopride, a dopamine antagonist, without worsening Parkinson's disease. This exceedingly rare condition should be kept in mind in patients with gastrointestinal symptoms whose initial diagnostic search is unrevealing. Although the presence of Parkinson's disease casts doubt on the use of dopamine antagonists, itopride has a very low central nervous system (CNS) pass and CNS-related side effects. Moreover, the absence of effective and safe measures other than dopaminergic antagonists and interventional methods renders their use compulsory.