Background: Ocular manifestation of human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) affects various ocular structures including the anterior segment and ocular adnexae and may be a cause of ocular morbidity. The aim of the study is to determine the pattern of lesions affecting the anterior segment and ocular adnexae in patients diagnosed with HIV/AIDS whether on highly active antiretroviral therapy or not and confirmed positive for retroviral disease by western blot attending an antiretroviral therapy clinic in Southwestern Nigeria. It is a prospective, cross-sectional study on anterior segment and ocular adnexae lesions in patients with HIV/AIDS. Materials and Methods: A total of 318 consecutive patients with the confirmation of a diagnosis of HIV/AIDS attending the antiretroviral therapy clinic within the study period from 2009 to 2010 had visual acuity evaluation, a detailed ocular examination by slit-lamp biomicroscopy, and binocular indirect ophthalmoscopy. The data generated were analysed using SPSS (Statistical Package for the Social Sciences) version 16. Ethical clearance was obtained from the hospital research ethics committee. Results: Two hundred and ninety-five (92.8%) patients of the 318 recruited had anterior segment manifestations, whereas ocular adnexal lesions were present in 134 (42.1%) patients. Multiple ocular pathology of the anterior segment and ocular adnexal was present in some of the respondents recruited. There were more female respondents. One hundred and twenty-three patients (38.7%) recruited for the study were in the 40–49 years of age group with a mean age of 47.2 years (SD = 9.42 years). The most common anterior segment lesion was corneal opacity in 18 patients (5.6%), and the most common ocular adnexal lesion was pingueculum in 56 respondents (17.6%). Other HIV/AIDS-associated adnexal lesions present include hypertrichosis in 25 patients (7.9%), herpes zoster ophthalmicus (HZO) in 13 (4.1%), and squamous cell carcinoma of the conjunctiva in 4 (1.3%) patients. The most common HIV-associated anterior segment pathology was HZO-associated keratouveitis seen in four patients (1.3%) and herpes simplex keratitis in one patient (0.3%). Conjunctival microangiopathy was the most common HIV-associated ocular adnexal lesion. The relationship between viral load values and lesions involving both anterior segment and ocular adnexal disease was statistically significant as these patients tended to have higher viral loads when compared with those without lesions (P < 0.05). Conclusion: Anterior segment and ocular adnexal lesions were frequent in patients with HIV/AIDS attending a tertiary health institution in urban Nigeria. HIV/AIDS-defining ocular illnesses including HZO, conjunctival microangiopathy, and ocular surface squamous cell neoplasia are not uncommon in these patients. Potentially debilitating ocular disorders may be avoided by instituting periodic ocular examinations.
{"title":"Anterior segment and ocular adnexal lesions in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome at a tertiary hospital in Southwestern Nigeria","authors":"Y. Babalola","doi":"10.4103/njm.njm_128_22","DOIUrl":"https://doi.org/10.4103/njm.njm_128_22","url":null,"abstract":"Background: Ocular manifestation of human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) affects various ocular structures including the anterior segment and ocular adnexae and may be a cause of ocular morbidity. The aim of the study is to determine the pattern of lesions affecting the anterior segment and ocular adnexae in patients diagnosed with HIV/AIDS whether on highly active antiretroviral therapy or not and confirmed positive for retroviral disease by western blot attending an antiretroviral therapy clinic in Southwestern Nigeria. It is a prospective, cross-sectional study on anterior segment and ocular adnexae lesions in patients with HIV/AIDS. Materials and Methods: A total of 318 consecutive patients with the confirmation of a diagnosis of HIV/AIDS attending the antiretroviral therapy clinic within the study period from 2009 to 2010 had visual acuity evaluation, a detailed ocular examination by slit-lamp biomicroscopy, and binocular indirect ophthalmoscopy. The data generated were analysed using SPSS (Statistical Package for the Social Sciences) version 16. Ethical clearance was obtained from the hospital research ethics committee. Results: Two hundred and ninety-five (92.8%) patients of the 318 recruited had anterior segment manifestations, whereas ocular adnexal lesions were present in 134 (42.1%) patients. Multiple ocular pathology of the anterior segment and ocular adnexal was present in some of the respondents recruited. There were more female respondents. One hundred and twenty-three patients (38.7%) recruited for the study were in the 40–49 years of age group with a mean age of 47.2 years (SD = 9.42 years). The most common anterior segment lesion was corneal opacity in 18 patients (5.6%), and the most common ocular adnexal lesion was pingueculum in 56 respondents (17.6%). Other HIV/AIDS-associated adnexal lesions present include hypertrichosis in 25 patients (7.9%), herpes zoster ophthalmicus (HZO) in 13 (4.1%), and squamous cell carcinoma of the conjunctiva in 4 (1.3%) patients. The most common HIV-associated anterior segment pathology was HZO-associated keratouveitis seen in four patients (1.3%) and herpes simplex keratitis in one patient (0.3%). Conjunctival microangiopathy was the most common HIV-associated ocular adnexal lesion. The relationship between viral load values and lesions involving both anterior segment and ocular adnexal disease was statistically significant as these patients tended to have higher viral loads when compared with those without lesions (P < 0.05). Conclusion: Anterior segment and ocular adnexal lesions were frequent in patients with HIV/AIDS attending a tertiary health institution in urban Nigeria. HIV/AIDS-defining ocular illnesses including HZO, conjunctival microangiopathy, and ocular surface squamous cell neoplasia are not uncommon in these patients. Potentially debilitating ocular disorders may be avoided by instituting periodic ocular examinations.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47218547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Eromon, Tijani Ahmad Oseni, N. Fuh, C. Affusim, Osagie Lawani, Bolanle Adewuyi, Abel Ibharokhonre, Augustine Ikwu, P. Imomoh
Background: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality. Reducing the burden of CVD particularly among rural dwellers will require a wholistic approach involving health education, and strengthening of primary health care to provide affordable primary care to the people. Aim: To access the knowledge of CVD and its risk factors among the people. Materials and Methods: This was a descriptive cross-sectional study of 360 adult residents of Igueben, a rural community in Edo State South-South Nigeria, selected through a multistage sampling technique. An interviewer-administered semi-structured questionnaire was used to collect data which were analysed using SPSS version 20.0. Results: Respondents were mostly female (67.78%) with a mean age of 45 ± 08 years. Over half of the respondents were farmers (58.33%), and 57.78% of respondents did not have secondary education. Over 50% had knowledge of stroke, and more than two-third of them were able to recognise common stroke symptoms such as difficulty speaking, facial weakness, and sudden limb weakness. Most respondents had knowledge of common risk factors for CVD, especially smoking, alcohol use, and hypertension. Respondents demonstrated a good knowledge of the preventive and control measures of CVD like healthy diet (60.56%), regular exercise (60.56%), alcohol and smoking cessation (60.56%), good sleep (55.56%), good health-seeking behaviour (55.55%), and avoidance of stress (54.44%). Furthermore, 78.89% of the participants recognised the need for hospital care in the event of a CVD. However, one-third of them had a poor health-seeking behaviour. Conclusion: We have found that this rural population had knowledge of stroke as a CVD as well as other common ones such as heart attack and heart failure. They also had a good health-seeking behaviour. However, while CVD awareness alone is no guarantee for positive cardiovascular outcomes, a good knowledge is clearly necessary for individuals to make informed decisions about their health by potentially adopting risk-free behaviours.
{"title":"Knowledge of common cardiovascular diseases and its risk factors among members of a community in South-South Nigeria","authors":"P. Eromon, Tijani Ahmad Oseni, N. Fuh, C. Affusim, Osagie Lawani, Bolanle Adewuyi, Abel Ibharokhonre, Augustine Ikwu, P. Imomoh","doi":"10.4103/njm.njm_124_22","DOIUrl":"https://doi.org/10.4103/njm.njm_124_22","url":null,"abstract":"Background: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality. Reducing the burden of CVD particularly among rural dwellers will require a wholistic approach involving health education, and strengthening of primary health care to provide affordable primary care to the people. Aim: To access the knowledge of CVD and its risk factors among the people. Materials and Methods: This was a descriptive cross-sectional study of 360 adult residents of Igueben, a rural community in Edo State South-South Nigeria, selected through a multistage sampling technique. An interviewer-administered semi-structured questionnaire was used to collect data which were analysed using SPSS version 20.0. Results: Respondents were mostly female (67.78%) with a mean age of 45 ± 08 years. Over half of the respondents were farmers (58.33%), and 57.78% of respondents did not have secondary education. Over 50% had knowledge of stroke, and more than two-third of them were able to recognise common stroke symptoms such as difficulty speaking, facial weakness, and sudden limb weakness. Most respondents had knowledge of common risk factors for CVD, especially smoking, alcohol use, and hypertension. Respondents demonstrated a good knowledge of the preventive and control measures of CVD like healthy diet (60.56%), regular exercise (60.56%), alcohol and smoking cessation (60.56%), good sleep (55.56%), good health-seeking behaviour (55.55%), and avoidance of stress (54.44%). Furthermore, 78.89% of the participants recognised the need for hospital care in the event of a CVD. However, one-third of them had a poor health-seeking behaviour. Conclusion: We have found that this rural population had knowledge of stroke as a CVD as well as other common ones such as heart attack and heart failure. They also had a good health-seeking behaviour. However, while CVD awareness alone is no guarantee for positive cardiovascular outcomes, a good knowledge is clearly necessary for individuals to make informed decisions about their health by potentially adopting risk-free behaviours.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41392410","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}
Abstract The World Health Organisation declared the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 a pandemic in March 2020. This virus has led to the deaths of more than 6 million people worldwide. Besides causing pneumonia, COVID-19 is linked to multiple organ dysfunction, including the kidneys, especially in individuals whose immune systems are already compromised. Consequently, individuals who are currently on a waiting list for a kidney transplant or who have recently received a kidney transplant are at a significantly increased risk for developing acute kidney injury and are severely impacted by the COVID-19 infection. The pandemic has negatively affected the transplantation process and led to a decrease in the number of organ donations as well as the volume of renal transplants. This review summarises the outcomes of COVID-19 infection in renal transplant patients, its pathophysiology, the challenges faced by the transplant community, and the management of immunosuppression.
{"title":"COVID-19 in Renal Transplant Patients – A Narrative Review","authors":"Jayesh Valecha, Vasu Gupta, Vaidehi Mendpara, Carson Eric Snyder, Fnu Anamika, Kinna Parikh, Talha Mahmood, Shreya Garg, Rohit Jain","doi":"10.4103/njm.njm_23_23","DOIUrl":"https://doi.org/10.4103/njm.njm_23_23","url":null,"abstract":"Abstract The World Health Organisation declared the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 a pandemic in March 2020. This virus has led to the deaths of more than 6 million people worldwide. Besides causing pneumonia, COVID-19 is linked to multiple organ dysfunction, including the kidneys, especially in individuals whose immune systems are already compromised. Consequently, individuals who are currently on a waiting list for a kidney transplant or who have recently received a kidney transplant are at a significantly increased risk for developing acute kidney injury and are severely impacted by the COVID-19 infection. The pandemic has negatively affected the transplantation process and led to a decrease in the number of organ donations as well as the volume of renal transplants. This review summarises the outcomes of COVID-19 infection in renal transplant patients, its pathophysiology, the challenges faced by the transplant community, and the management of immunosuppression.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The complex pattern of development of the branchial arches predisposes to a myriad of congenital anomalies of the head-and-neck region. The ear, nose and throat (ENT) are by no means spared. The birth of a child with congenital anomaly elicits emotion, anxiety, the feeling of guilt, and dejection in the parents, especially the mother. They are worried and anxiously seek for the explanation which the attending doctor who is ill-equipped to venture into it. The etiological factors are many and vary. ENT anomalies are often associated with malformations of other organs and systems and should be searched for and detected. Any treatment offered should aim at restoring normal or near-normal appearance and function and allay the fears and apprehensions of the parents. Aim: The aim of the study was to review and document the incidence, variety, and presentation of ENT congenital anomalies seen and treated in the Otolaryngology Department of our institution and formulate a baseline for the future. Materials and Methods: It was a retrospective review of ENT anomalies handled in our hospital from January 2015 to December 2019. The case notes of the eligible cases were retrieved and the relevant data were extracted. The data collected were analysed with descriptive statistics and presented in tables and prose as deemed fit. Ethical Consideration: The study protocol was reviewed and approved by the hospital records department. Results: Forty-six cases were studied, 24 males and 22 females. Their ages ranged from 0.019 years (one week) to 55 years, average of 7.84 ± 10.38, 95% confidence interval of 4.75682–10.92318. There was no significant difference in the ages of the males and females P = 0.8809, t = 0.1507, dt = 44. Fourteen different malformations were detected most common of which was deafness 15 (32.61%), followed by thyroglossal cyst 7 (15.22%) with 5 different anomalies coming last with 2.17% each. Conclusion: ENT malformations are common in our locality. Adequate history and examination with appropriate investigations will help get the diagnosis and associated conditions. Multi-disciplinary approach to management will offer a better outcome. Parents and caregivers need to be properly counselled.
{"title":"Review of congenital anomalies of ear, nose, and throat in a resource-challenged facility","authors":"J. Nwosu, E. Chime","doi":"10.4103/njm.njm_127_22","DOIUrl":"https://doi.org/10.4103/njm.njm_127_22","url":null,"abstract":"Introduction: The complex pattern of development of the branchial arches predisposes to a myriad of congenital anomalies of the head-and-neck region. The ear, nose and throat (ENT) are by no means spared. The birth of a child with congenital anomaly elicits emotion, anxiety, the feeling of guilt, and dejection in the parents, especially the mother. They are worried and anxiously seek for the explanation which the attending doctor who is ill-equipped to venture into it. The etiological factors are many and vary. ENT anomalies are often associated with malformations of other organs and systems and should be searched for and detected. Any treatment offered should aim at restoring normal or near-normal appearance and function and allay the fears and apprehensions of the parents. Aim: The aim of the study was to review and document the incidence, variety, and presentation of ENT congenital anomalies seen and treated in the Otolaryngology Department of our institution and formulate a baseline for the future. Materials and Methods: It was a retrospective review of ENT anomalies handled in our hospital from January 2015 to December 2019. The case notes of the eligible cases were retrieved and the relevant data were extracted. The data collected were analysed with descriptive statistics and presented in tables and prose as deemed fit. Ethical Consideration: The study protocol was reviewed and approved by the hospital records department. Results: Forty-six cases were studied, 24 males and 22 females. Their ages ranged from 0.019 years (one week) to 55 years, average of 7.84 ± 10.38, 95% confidence interval of 4.75682–10.92318. There was no significant difference in the ages of the males and females P = 0.8809, t = 0.1507, dt = 44. Fourteen different malformations were detected most common of which was deafness 15 (32.61%), followed by thyroglossal cyst 7 (15.22%) with 5 different anomalies coming last with 2.17% each. Conclusion: ENT malformations are common in our locality. Adequate history and examination with appropriate investigations will help get the diagnosis and associated conditions. Multi-disciplinary approach to management will offer a better outcome. Parents and caregivers need to be properly counselled.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45881919","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. Olaopa, C. Emeka, J. Idowu, R. Oluwakuyide, Adedamola Dada, G. Adebayo, O. Towolawi, Fehintolu Kolawole, O. A. Adebimpe
Bronchogenic cysts are primary cysts of the mediastinum. In rare situations, it can present in the oral cavity as a swelling of the tongue and the floor of the mouth. Usually, it is not a life-threatening clinical entity. In this report, we present a massive sublingual bronchogenic cyst with life-threatening clinical characteristics in an adult patient of a Nigerian tertiary-level medical center and the management of the case.
{"title":"Massive sublingual bronchogenic cyst with airway compromise","authors":"O. Olaopa, C. Emeka, J. Idowu, R. Oluwakuyide, Adedamola Dada, G. Adebayo, O. Towolawi, Fehintolu Kolawole, O. A. Adebimpe","doi":"10.4103/njm.njm_6_23","DOIUrl":"https://doi.org/10.4103/njm.njm_6_23","url":null,"abstract":"Bronchogenic cysts are primary cysts of the mediastinum. In rare situations, it can present in the oral cavity as a swelling of the tongue and the floor of the mouth. Usually, it is not a life-threatening clinical entity. In this report, we present a massive sublingual bronchogenic cyst with life-threatening clinical characteristics in an adult patient of a Nigerian tertiary-level medical center and the management of the case.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46654006","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}
Uchenna Anthony Umeh, Chioma Roseline Umeh, Samuel Nnamdi Obi, Theophilus Ogochukwu Nwankwo, Chudi Igwe Obuba, Euzebus Ezugwu
Abstract Background: Placenta praevia is one of the leading causes of obstetric haemorrhages and a major contributor to maternal and fetal morbidity and mortality. Although low-lying placentae are common during routine midtrimester anomaly scans, the incidence of placenta praevia at term remains low, probably due to placenta migration. It is important to follow-up pregnant women with low-lying placentae to identify the few whose placenta will remain in the lower segment and hence at risk of major obstetric haemorrhage. Aim: The objectives of this study were to determine the prevalence, predictors, and pregnancy outcome of low-lying placenta diagnosed in the midtrimester. Materials and Methods: The study was a cohort study with longitudinal follow-up of 416 pregnant women from the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, and Mother of Christ Specialist Hospital who had an ultrasound diagnosis of low-lying placentae between 16 weeks and 20 weeks of gestation. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22. P < 0.05 was considered statistically significant. Results: The prevalence of low-lying placenta at 20, 24, 28, 32, and 36 weeks of gestation was 51%, 41.3%, 22.3%, 12.7%, and 10.5%, respectively. 87.3% of those with low-lying placenta had normally situated placenta at term. Previous caesarean section and male gender were significant predictors of placenta praevia at delivery ( P < 0.001 and P = 0.03, respectively). Conclusion: Despite the high prevalence of low-lying placenta before 20 weeks of gestation, only a few of these placentas remain low-lying at term. Previous caesarean section and male gender were significant predictors of placenta praevia at delivery. This study recommends a routine ultrasound scan in the second or third trimester for placenta localisation.
{"title":"Prevalence, Outcome, and Predictors of Placenta Migration among Pregnant Women with Placenta Praevia in Enugu Nigeria","authors":"Uchenna Anthony Umeh, Chioma Roseline Umeh, Samuel Nnamdi Obi, Theophilus Ogochukwu Nwankwo, Chudi Igwe Obuba, Euzebus Ezugwu","doi":"10.4103/njm.njm_36_23","DOIUrl":"https://doi.org/10.4103/njm.njm_36_23","url":null,"abstract":"Abstract Background: Placenta praevia is one of the leading causes of obstetric haemorrhages and a major contributor to maternal and fetal morbidity and mortality. Although low-lying placentae are common during routine midtrimester anomaly scans, the incidence of placenta praevia at term remains low, probably due to placenta migration. It is important to follow-up pregnant women with low-lying placentae to identify the few whose placenta will remain in the lower segment and hence at risk of major obstetric haemorrhage. Aim: The objectives of this study were to determine the prevalence, predictors, and pregnancy outcome of low-lying placenta diagnosed in the midtrimester. Materials and Methods: The study was a cohort study with longitudinal follow-up of 416 pregnant women from the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, and Mother of Christ Specialist Hospital who had an ultrasound diagnosis of low-lying placentae between 16 weeks and 20 weeks of gestation. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22. P < 0.05 was considered statistically significant. Results: The prevalence of low-lying placenta at 20, 24, 28, 32, and 36 weeks of gestation was 51%, 41.3%, 22.3%, 12.7%, and 10.5%, respectively. 87.3% of those with low-lying placenta had normally situated placenta at term. Previous caesarean section and male gender were significant predictors of placenta praevia at delivery ( P < 0.001 and P = 0.03, respectively). Conclusion: Despite the high prevalence of low-lying placenta before 20 weeks of gestation, only a few of these placentas remain low-lying at term. Previous caesarean section and male gender were significant predictors of placenta praevia at delivery. This study recommends a routine ultrasound scan in the second or third trimester for placenta localisation.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135651094","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. Solomon, K. Igbekoyi, C. Oluwadare, K. Oluwadiya
Background: COVID-19 pandemic has been a turbulent crisis that took the globe by surprise, killing thousands of people. Nonetheless, individuals with underlying conditions are considered to be at risk. Aim: The study examined public perceptions of the vulnerability influencing the spread of COVID-19 in Ekiti State, Nigeria. Materials and Methods: The study used a qualitative method in which 65 participated in focus group discussions to elicit information about the subject matter. Thematic analysis was used to analyse field data. Results: The study found that vulnerability to COVID-19 was based on the following themes: immunity, imported, complications, lack of knowledge, recklessness and anyone. As a result, the study concluded that individuals can be vulnerable to COVID-19 if the person has weakened or impaired immunity and that the virus was imported from other countries. Conclusion: In addition, having any of the following underlying conditions such as asthma, diabetes, heart or liver or being ignorant of the spread of the virus, and failing to follow COVID-19 containment guidelines can make people more vulnerable to the virus. Recommendations: The study, therefore, recommends that health education about the virus be implemented. This could be directed towards strengthening beliefs that conform to accepted scientific views of COVID-19 and weakening those that do not. Notably, the public should be encouraged to follow COVID-19 containment guidelines, which include wearing a face masks, washing and sanitising our hands, and social distancing.
{"title":"Public perceptions and experiences of COVID-19 pandemic in Ekiti: A qualitative study using thematic analysis","authors":"O. Solomon, K. Igbekoyi, C. Oluwadare, K. Oluwadiya","doi":"10.4103/njm.njm_90_22","DOIUrl":"https://doi.org/10.4103/njm.njm_90_22","url":null,"abstract":"Background: COVID-19 pandemic has been a turbulent crisis that took the globe by surprise, killing thousands of people. Nonetheless, individuals with underlying conditions are considered to be at risk. Aim: The study examined public perceptions of the vulnerability influencing the spread of COVID-19 in Ekiti State, Nigeria. Materials and Methods: The study used a qualitative method in which 65 participated in focus group discussions to elicit information about the subject matter. Thematic analysis was used to analyse field data. Results: The study found that vulnerability to COVID-19 was based on the following themes: immunity, imported, complications, lack of knowledge, recklessness and anyone. As a result, the study concluded that individuals can be vulnerable to COVID-19 if the person has weakened or impaired immunity and that the virus was imported from other countries. Conclusion: In addition, having any of the following underlying conditions such as asthma, diabetes, heart or liver or being ignorant of the spread of the virus, and failing to follow COVID-19 containment guidelines can make people more vulnerable to the virus. Recommendations: The study, therefore, recommends that health education about the virus be implemented. This could be directed towards strengthening beliefs that conform to accepted scientific views of COVID-19 and weakening those that do not. Notably, the public should be encouraged to follow COVID-19 containment guidelines, which include wearing a face masks, washing and sanitising our hands, and social distancing.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45754429","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}
Abstract Background: Over the decades, the management of renal stones has shifted from the undesirably invasive open nephrolithotomy to the more effective and less invasive approaches with lower morbidity. These less invasive options include extracorporeal shock wave lithotripsy, percutaneous lithotripsy, and flexible ureterorenoscopy (fURS). Aim: This study seeks to evaluate the outcomes of flexible ureterorenoscopy with holmium: yttrium-aluminum-garnet (holmium:YAG) laser lithotripsy for the treatment of renal stones <2.0 cm in our patients. Patients and Methods: Records of 23 patients who underwent flexible ureteroscopy and holmium: YAG laser lithotripsy between October 2020 and September 2022 were reviewed retrospectively. The patients who had the flexible ureteroscopy and laser lithotripsy for renal stones <2.0 cm for various indications were the subjects of this study. All patients had computed tomographic urography preoperatively to locate the stone. Stone-free rate (SFR) was deduced from no stone detected on imaging and resolution of the patient’s preoperative complaints related to the renal stones at follow-up. Data on patients’ demographics, indication for the surgery, location of the stone, size of the stone, preoperative double J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and the SFR were retrieved and subjected to the statistical analysis. Results: A total of 23 patients had fURS and laser lithotripsy during the two-year study period. All the patients had solitary stone in the renal unit operated. The mean stone size for all the patients was 1.3 cm (range: 0.5–1.9 cm). Fifteen (65.2%) patients had DJ stent preoperatively. Postoperative DJ stent was placed in all our patients. Four (17.4%) patients had Grade 1 ureteric injury while none had high Grades (2, 3, and 4) ureteral injuries. Two (9.5%) patients had intraoperative bleeding, 1 (4.8%) had transient haematuria postoperatively while 2 (9.5%) patients had urinary tract infection. The SFR was 91.3% in a single surgery. Two patients (8.7%) had residual fragments in the lower calyx. Conclusion: Flexible ureteroscopy and laser holmium lithotripsy give a satisfactory SFR, with few complications. It is a safe and effective treatment modality for the treatment of stones <2.0 cm in the renal pelvicalyceal system.
{"title":"Outcome of Flexible Ureteroscopy and Holmium Laser Lithotripsy in the Management of Renal Stones: A two-year Retrospective Study","authors":"Idorenyin Cletus Akpayak, Chukwudum Dennis Ikeh","doi":"10.4103/njm.njm_43_23","DOIUrl":"https://doi.org/10.4103/njm.njm_43_23","url":null,"abstract":"Abstract Background: Over the decades, the management of renal stones has shifted from the undesirably invasive open nephrolithotomy to the more effective and less invasive approaches with lower morbidity. These less invasive options include extracorporeal shock wave lithotripsy, percutaneous lithotripsy, and flexible ureterorenoscopy (fURS). Aim: This study seeks to evaluate the outcomes of flexible ureterorenoscopy with holmium: yttrium-aluminum-garnet (holmium:YAG) laser lithotripsy for the treatment of renal stones <2.0 cm in our patients. Patients and Methods: Records of 23 patients who underwent flexible ureteroscopy and holmium: YAG laser lithotripsy between October 2020 and September 2022 were reviewed retrospectively. The patients who had the flexible ureteroscopy and laser lithotripsy for renal stones <2.0 cm for various indications were the subjects of this study. All patients had computed tomographic urography preoperatively to locate the stone. Stone-free rate (SFR) was deduced from no stone detected on imaging and resolution of the patient’s preoperative complaints related to the renal stones at follow-up. Data on patients’ demographics, indication for the surgery, location of the stone, size of the stone, preoperative double J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and the SFR were retrieved and subjected to the statistical analysis. Results: A total of 23 patients had fURS and laser lithotripsy during the two-year study period. All the patients had solitary stone in the renal unit operated. The mean stone size for all the patients was 1.3 cm (range: 0.5–1.9 cm). Fifteen (65.2%) patients had DJ stent preoperatively. Postoperative DJ stent was placed in all our patients. Four (17.4%) patients had Grade 1 ureteric injury while none had high Grades (2, 3, and 4) ureteral injuries. Two (9.5%) patients had intraoperative bleeding, 1 (4.8%) had transient haematuria postoperatively while 2 (9.5%) patients had urinary tract infection. The SFR was 91.3% in a single surgery. Two patients (8.7%) had residual fragments in the lower calyx. Conclusion: Flexible ureteroscopy and laser holmium lithotripsy give a satisfactory SFR, with few complications. It is a safe and effective treatment modality for the treatment of stones <2.0 cm in the renal pelvicalyceal system.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650237","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}
Udochukwu Ugochukwu Ogu, N. Uguru, N. Ude, Nwadiuto C Ojielo, SO Onah, C. Okeke, BenjaminS Chudi Uzochukwu, O. Onwujekwe
Background: Nigeria is in short supply of health workforce and equipment needed to manage the infected COVID-19 individuals. The rate of occurrence of new cases of infection has the capacity to further deplete the human resources in the sector, putting a dent in the fight against the spread of the virus. This study aims to determine the capacity of Nigerian health systems to respond to COVID-19. Materials and Methods: This was a scoping review of media documents, official documents and journals, published from 1st December 2019 to 31st December 2021. Online media reports were sourced from major newspapers on FACTIVA (Vanguard, Punch, Guardian, The Nation, Business Day, and Premium Times) that reported national and state level health system responses to COVID-19. We also reviewed other online news sources that have consistently reported health systems response to COVID-19 in Nigeria. Some of these are Nigeria Health Watch, APO Africa Newsroom, Federal Ministry of Health newsletter, and national media. Results: By December 31st, 2020, Nigeria had 70 free laboratories controlled by the government. These comprised 31 federal laboratories, 30 state, 3 military, 2 Non-Governmental Organization (NGO), 2 UN and 2 private labs. In 2019, Nigeria's IHR score at point of entry 1 & 2 was 3 and 1. Routine capacities established at points of entry was improved, however, effective public health response at point of entry, remained the same. Which supports the low response capacity of the country. Nigeria's average score across the JEE 2019 had increased to 7% (from 39% in 2017 to 46% in 2019) - four new indicators and 20 indicators with improved scores from 2017. Conclusion: Nigeria's health system response and capacity to handle COVID-19 is quite poor and grossly inadequate. There is a need to increase the number of health workforce in the country and institute adequate accountability mechanisms to ensure prudent and focused management of health funds.
{"title":"Health system responses and capacities for COVID-19 in Nigeria: A scoping review","authors":"Udochukwu Ugochukwu Ogu, N. Uguru, N. Ude, Nwadiuto C Ojielo, SO Onah, C. Okeke, BenjaminS Chudi Uzochukwu, O. Onwujekwe","doi":"10.4103/njm.njm_123_22","DOIUrl":"https://doi.org/10.4103/njm.njm_123_22","url":null,"abstract":"Background: Nigeria is in short supply of health workforce and equipment needed to manage the infected COVID-19 individuals. The rate of occurrence of new cases of infection has the capacity to further deplete the human resources in the sector, putting a dent in the fight against the spread of the virus. This study aims to determine the capacity of Nigerian health systems to respond to COVID-19. Materials and Methods: This was a scoping review of media documents, official documents and journals, published from 1st December 2019 to 31st December 2021. Online media reports were sourced from major newspapers on FACTIVA (Vanguard, Punch, Guardian, The Nation, Business Day, and Premium Times) that reported national and state level health system responses to COVID-19. We also reviewed other online news sources that have consistently reported health systems response to COVID-19 in Nigeria. Some of these are Nigeria Health Watch, APO Africa Newsroom, Federal Ministry of Health newsletter, and national media. Results: By December 31st, 2020, Nigeria had 70 free laboratories controlled by the government. These comprised 31 federal laboratories, 30 state, 3 military, 2 Non-Governmental Organization (NGO), 2 UN and 2 private labs. In 2019, Nigeria's IHR score at point of entry 1 & 2 was 3 and 1. Routine capacities established at points of entry was improved, however, effective public health response at point of entry, remained the same. Which supports the low response capacity of the country. Nigeria's average score across the JEE 2019 had increased to 7% (from 39% in 2017 to 46% in 2019) - four new indicators and 20 indicators with improved scores from 2017. Conclusion: Nigeria's health system response and capacity to handle COVID-19 is quite poor and grossly inadequate. There is a need to increase the number of health workforce in the country and institute adequate accountability mechanisms to ensure prudent and focused management of health funds.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46152186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Yunus, M. Odigbo, S. Tasiu, SM Babangida, Yakubu Yunusa, Am Kabiru, MM Yusuf
Background: Inhalational anaesthetics are used for the induction and maintenance of general anaesthesia in children. More agents are evolving in an effort to discover the agent of choice in this age group, considering the safety margin, availability, affordability, and accessibility of the anaesthetics. Aim: The aim of our study was to compare the qualities of halothane and sevoflurane in paediatric patients. Materials and Methods: This was a prospective randomised study of 100 children within the age group of 5–12 years, scheduled for elective surgery in Ahmadu Bello University Teaching Hospital, Zaria, from January to October 2022, and satisfied the study inclusion criteria. The following variables (heart rate, blood pressure, arrhythmias, and complications) were recorded and analysed using IBM SPSS version 25 (Chicago) USA. P ≤ 0.05 was considered statistically significant. Results: The incidence of tolerability at induction of anaesthesia, hypoxaemia (SpO2 <90%), and airway responses (laryngospasm, coughing, and breath holding) was similar in both the groups. However, at induction of anaesthesia, the degree of muscle rigidity in the sevoflurane group was statistically significant compared with the halothane group (P = 0.028), but the difference was not statistically significant at the recovery period (P = 0.59). More so, the incidence of arrhythmias was higher in the halothane group than in the sevoflurane group. Conclusion: The overall qualities of halothane were commensurate with that of sevoflurane. However, where available and affordable, sevoflurane will be a better agent of choice in paediatric anaesthesia.
{"title":"Comparison of the Qualities of Sevoflurane and Halothane in Paediatric Anaesthesia","authors":"A. Yunus, M. Odigbo, S. Tasiu, SM Babangida, Yakubu Yunusa, Am Kabiru, MM Yusuf","doi":"10.4103/njm.njm_126_22","DOIUrl":"https://doi.org/10.4103/njm.njm_126_22","url":null,"abstract":"Background: Inhalational anaesthetics are used for the induction and maintenance of general anaesthesia in children. More agents are evolving in an effort to discover the agent of choice in this age group, considering the safety margin, availability, affordability, and accessibility of the anaesthetics. Aim: The aim of our study was to compare the qualities of halothane and sevoflurane in paediatric patients. Materials and Methods: This was a prospective randomised study of 100 children within the age group of 5–12 years, scheduled for elective surgery in Ahmadu Bello University Teaching Hospital, Zaria, from January to October 2022, and satisfied the study inclusion criteria. The following variables (heart rate, blood pressure, arrhythmias, and complications) were recorded and analysed using IBM SPSS version 25 (Chicago) USA. P ≤ 0.05 was considered statistically significant. Results: The incidence of tolerability at induction of anaesthesia, hypoxaemia (SpO2 <90%), and airway responses (laryngospasm, coughing, and breath holding) was similar in both the groups. However, at induction of anaesthesia, the degree of muscle rigidity in the sevoflurane group was statistically significant compared with the halothane group (P = 0.028), but the difference was not statistically significant at the recovery period (P = 0.59). More so, the incidence of arrhythmias was higher in the halothane group than in the sevoflurane group. Conclusion: The overall qualities of halothane were commensurate with that of sevoflurane. However, where available and affordable, sevoflurane will be a better agent of choice in paediatric anaesthesia.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47333146","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}
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