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Scalp Reconstruction following Excision of Malignant Tumors in Southeastern Nigeria 尼日利亚东南部恶性肿瘤切除后的头皮重建
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_32_23
Obinna Remigius Okwesili, Uchechukwu Johnson Achebe, Okechukwu Oliver Onumaegbu, Wilfred Chukwuemeka Mezue, Mark Chukwunweike Chikani, Ephraim Eziechina Onyia
Abstract Background: Malignant scalp tumors are not common and constitute a small percentage of all scalp tumors. Reconstruction of the scalp defects following oncological resection presents peculiar challenges. Aim: The aim of the study is to report our experience in reconstructing scalp defect of varying sizes after the excision of malignant tumours using a variety of techniques. Materials and Methods: This was a retrospective review of patients who had scalp reconstruction after oncological resections from June 2010 to May 2014 (four years) at our teaching hospital in the South-east of Nigeria. Data on the demographics, nature of the scalp tumors, site, size of the defects, mode of scalp reconstruction, and outcomes were collected and analyzed. Results: Of the 17 patients who had scalp reconstruction, 29.4% of them were men and 70.6% were women (M:F = 5:2). The mean age of the patients was 41.2 ± 4.98 years (range: 19–85 years). The majority of the patients (47.1%) were young adults between 20 and 40 years, and the least involved age group (11.8%) was 13–19 years. The most common etiology of malignant scalp tumors was squamous cell carcinoma (52.9%). The temporal region was the most common site (41.2%) affected. Most of the defects were between 6.1 and 9.0 cm in diameter, followed by defects that were <3 cm in diameter. Neurosurgical assistance was required in 5 (29.4%) patients where the tumor had involved the skull bone. Tumor recurrence was noted in 3 (17.6%) patients within one year of follow-up. Conclusion: Scalp reconstruction after oncological resection presents a peculiar esthetic challenge due to the hair-bearing skin of the scalp and the need to maintain the hairline. The use of local flaps from the scalp remains the first and the best option. For very large scalp defects, free flap through microvascular surgery is the preferred option.
背景:恶性头皮肿瘤并不常见,仅占所有头皮肿瘤的一小部分。肿瘤切除后头皮缺损的重建提出了特殊的挑战。目的:本研究的目的是报告我们在恶性肿瘤切除后使用各种技术重建不同大小的头皮缺损的经验。材料和方法:本研究回顾性分析了2010年6月至2014年5月(四年)在尼日利亚东南部我们的教学医院进行肿瘤切除后头皮重建的患者。收集和分析了人口统计学、头皮肿瘤的性质、部位、缺陷的大小、头皮重建模式和结果等数据。结果:17例头皮重建患者中,男性占29.4%,女性占70.6% (M:F = 5:2)。患者平均年龄41.2±4.98岁(范围:19 ~ 85岁)。大多数患者(47.1%)为20 - 40岁的青壮年,13-19岁的患者最少(11.8%)。恶性头皮肿瘤以鳞状细胞癌最常见(52.9%)。颞区是最常见的部位(41.2%)。大多数缺陷的直径在6.1 - 9.0 cm之间,其次是直径为3cm的缺陷。肿瘤累及颅骨的5例(29.4%)患者需要神经外科辅助治疗。随访1年内肿瘤复发3例(17.6%)。结论:肿瘤切除后的头皮重建由于头皮上有毛发,需要保持发际线,因此对美学提出了特殊的挑战。使用头皮的局部皮瓣仍然是首选也是最好的选择。对于非常大的头皮缺损,通过微血管手术游离皮瓣是首选的选择。
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引用次数: 0
The spectrum of otorhinolaryngology, head and neck emergencies: Our experience 耳鼻喉科、头颈部急诊的范围:我们的经验
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_3_23
S. Aremu
Background: Emergencies in otorhinolaryngology are common in health-care facilities. Early detection and treatment of a disease can result in the reduction of morbidity and mortality in patients. Aim: This study was carried out in the southwest region of Nigeria over 10 years to depict the epidemiology, gender, and age-wise distribution of otorhinolaryngology emergencies. Materials and Methods: Using a cross-sectional study design, a semi-structured questionnaire was administered and information was collected on the medical histories of the patients examined. The age and gender of patients, their clinical diagnosis at the time of admission, and the progress of the patient's health after emergency treatment were listed. Results: The total number of patients who visited the ear, nose, and throat (ENT) emergency department was 12,931 from January 2011 to December 2021. On average, three emergency patients/day and 1293 emergency patients per year visited ENT emergency department. The ages of patients ranged between 1 month and 70 years. The number of male patients was 8657 (66.94%), and the number of female patients was 4274 (33.05%). The ratio of males to females was 2:1. The most common emergency cases were of nose bleed (25.57%). Then, we had cases of earache and ear discharge on our list. Conclusion: The otorhinolaryngology emergency department plays a vital part in managing life-threatening situations such as acute nose bleed, bleeding after removal of tonsils, upper airway, neck boils, severe middle ear infection, and acute fungal sinus infection. These conditions require urgent and effective treatment from an ENT Specialist. The ENT emergency department plays a vital part in managing life-threatening situations which require urgent and effective treatment from otorhinolaryngology specialists. There is a dire need to create standards for prioritising and reducing the number of nonurgent/fake emergency cases appearing in ENT emergencies so that the proper treatment could be given to the deserving emergency cases.
背景:耳鼻喉科急诊在医疗机构中很常见。疾病的早期发现和治疗可以降低患者的发病率和死亡率。目的:这项研究在尼日利亚西南地区进行了10多年,以描述耳鼻喉科急诊的流行病学、性别和年龄分布。材料和方法:采用横断面研究设计,进行半结构化问卷调查,并收集所检查患者的病史信息。列出了患者的年龄和性别、入院时的临床诊断以及紧急治疗后患者的健康状况。结果:2011年1月至2021年12月,耳鼻喉科急诊就诊的患者总数为12931人。平均每天有三名急诊患者和每年1293名急诊患者到耳鼻喉科急诊科就诊。患者年龄在1个月至70岁之间。男性患者8657人(66.94%),女性患者4274人(33.05%),男女比例为2:1。最常见的急诊病例是鼻出血(25.57%)。然后,我们的名单上有耳痛和耳分泌物的病例。结论:耳鼻喉科急诊科在处理急性鼻出血、扁桃体摘除后出血、上呼吸道、颈部疖子、严重中耳感染和急性真菌窦感染等危及生命的情况方面发挥着重要作用。这些情况需要耳鼻喉科专家进行紧急有效的治疗。耳鼻喉科急诊科在处理危及生命的情况方面发挥着至关重要的作用,这些情况需要耳鼻咽喉科专家进行紧急有效的治疗。迫切需要制定标准,优先考虑并减少耳鼻喉科急诊中出现的非紧急/假急诊病例的数量,以便为值得治疗的急诊病例提供适当的治疗。
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引用次数: 0
Patient’s Perceived Satisfaction and Quality of Life with Fixed Partial Denture: A 10-Year Retrospective Assessment in a Tertiary Institution, South-West, Nigeria 固定部分义齿患者的感知满意度和生活质量:尼日利亚西南部一所高等教育机构的10年回顾性评估
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_48_23
Shakeerah Olaide Gbadebo, Osaro Charles Okeaya-Inneh, Olayinka David Adeosun, Deborah Mojirade Ajayi
Abstract Background: Tooth loss is a disease of public health concern and defines the oral health status and quality of life of an individual. Aim: This study assessed the level of satisfaction and the oral health-related quality of life (OHRQoL) of patients that received fixed partial denture (FPD), for the replacement of teeth, at a Nigerian tertiary health facility. Materials and Methods: A cross-sectional retrospective evaluation of the clinical records of patients who received FPD within a period of 10 years was done. The eligible participants (44) were contacted by telephone and data on satisfaction and OHRQoL (using Oral Health Impact Profile [OHIP]-14 questionnaire) were collected. Descriptive analysis was used to report satisfaction and OHRQoL. The association between categorical variables was tested with Chi-square. P value was set at ≤ 0.05. Results: The conventional fixed–fixed prostheses supported mostly with porcelain-fused-to-metal crowns were the most used. High satisfaction with the appearance was reported by 22 (48.9%) at delivery as against 14 (31.1%) after use. Decementation was the most recorded failure, (26, 57.8%) and the total OHIP-14 score was 21.71 ± 9.47, indicating poor quality of life. Forty-four participants (18, 40.9% males and 26, 59.1% females) underwent oral rehabilitation with FPD within the study period. The age range and mean age of the participants were 21–72 years and 46.8 ± 13.8 (standard deviation) years, respectively. Significantly higher aesthetic satisfaction was reported at delivery of FPD compared to the present time of assessment ( P < 0.001) showing a decline in satisfaction. However, long-term posttreatment satisfaction on aesthetics, masticatory ability, and phonetics was significantly higher compared to their pretreatment satisfaction ( P < 0.001, 0.001, and P = 0.003, respectively). Furthermore, OHIP-14 scores showed statistically significant ( P < 0.05) improved OHRQoL posttreatment except for OHIP8 and OHIP12 subdomains with P > 0.05. Conclusion: A decline in satisfaction with aesthetics of FPD postdelivery was observed and the psychological domains of OHIP-14 were mostly affected showing a better quality of life.
背景:牙齿脱落是一种公共卫生关注的疾病,它决定了一个人的口腔健康状况和生活质量。目的:本研究评估了在尼日利亚一家三级医疗机构接受固定局部义齿(FPD)置换牙齿的患者的满意度和口腔健康相关生活质量(OHRQoL)。材料和方法:对10年内接受FPD治疗的患者的临床记录进行了横断面回顾性评估。通过电话联系44名符合条件的参与者,收集满意度和OHRQoL(使用口腔健康影响问卷[OHIP]-14)数据。采用描述性分析报告满意度和OHRQoL。分类变量间的相关性采用卡方检验。P值设为≤0.05。结果:传统固定-固定修复体以金属烤瓷冠为主。22人(48.9%)在分娩时对外观满意,而14人(31.1%)在使用后对外观满意。手术失败最多(26.57.8%),OHIP-14总分为21.71±9.47分,生活质量较差。44名参与者(男性18.40.9%,女性26.59.1%)在研究期间接受了FPD口腔康复治疗。年龄范围21 ~ 72岁,平均年龄46.8±13.8岁(标准差)。与目前的评估时间相比,在FPD交付时报告的美学满意度显着提高(P <0.001),显示满意度下降。然而,长期治疗后对美学、咀嚼能力和语音的满意度显著高于治疗前满意度(P <0.001、0.001和P = 0.003)。OHIP-14评分差异有统计学意义(P <0.05)除OHIP8和OHIP12子域P >外,改善了OHRQoL后处理;0.05. 结论:产后FPD美学满意度下降,OHIP-14心理领域受影响最大,生活质量有所改善。
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引用次数: 0
Case Series: Uterine Rupture with a Life Baby after Two Previous Caesarean Sections: An Incidental Finding at Elective Caesarean Sections at Term 病例系列:两次剖宫产后子宫破裂伴生命婴儿:足月择期剖宫产的偶然发现
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_65_23
Obiora Asiegbu, Darlington-Peter Chibuzor Ugoji, Uzoma Vivian Asiegbu, Bobbie C. Iwe, Paschal Chijioke Okoye, Kelvin Emeka Ortuanya, Chidebe Christian Anikwe
Abstract We present three cases of the absence of lower uterine segment (LUS) muscles with a life baby covered by the fetal membrane after two previous caesarean sections (CS) at elective CSs at term. The first case was a 30-year-old booked multipara with bad obstetrics history and two previous CS at a secondary facility on account of unexplained three serial stillbirths at term. There were no histories of maternal obesity, hypertension, or diabetes mellitus. She then had an elective CS at 37 weeks on account of two previous CS. Intraoperatively, it was noted that the LUS was covered by the fetal membranes with visceral peritoneum and no muscle layer. The second case was a 33-year-old booked G4P2 + 1A2 with two previous CSs on account of fetal distress and breech presentation with one previous scar at term, respectively. Pregnancy was uneventful till the presentation. At presentation, there was no history or examination finding suggestive of uterine rupture. She had an elective CS at 39 weeks on account of two previous CS. Intraoperatively, a thin membrane at the LUS with no muscular tissue exposing the fetal membranes was seen, with good fetomaternal outcomes. The third case was a 30-year-old booked G3P2 + 0A2 with two previous elective CSs on account of primigravida with breech presentation and placenta praevia, respectively. The course of the pregnancy was uneventful. At presentation, there was no clinical sign or symptom suggestive of uterine rupture. She had an elective CS at 37 weeks on account of two previous CS. Intraoperatively, a thin membrane at the LUS with visceral peritoneum and no muscular tissue was seen. The pregnancy outcome was favorable. Silent scar rupture as seen in our case series is one of the common complications of previous CS. Early detection with the introduction of imaging techniques, although not done for our cases and prompt intervention reduces morbidity and mortality.
摘要:我们提出了三个病例的缺席下子宫段(LUS)肌肉与一个生命的婴儿被胎膜覆盖后,两次以前的剖宫产(CS)择期CSs足月。第一个病例是一位30岁的多产妇女,她有不良的产科病史,并因不明原因的三次足月连续死产而在二级医院接受过两次产科检查。母亲无肥胖、高血压或糖尿病病史。由于之前的两次CS,她在37周时进行了选择性CS。术中,我们注意到LUS被胎儿膜和内脏腹膜覆盖,没有肌肉层。第二个病例是一名33岁的G4P2 + 1A2患者,分别因胎儿窘迫和臀位在足月时出现一处疤痕而出现过两次CSs。怀孕期间一切都很平静,直到这次展示。在就诊时,没有病史或检查发现提示子宫破裂。由于之前的两次CS,她在39周时进行了选择性CS。术中,在LUS处可见一薄膜,没有肌肉组织暴露胎儿膜,胎母结局良好。第三例患者为30岁,预约G3P2 + 0A2,既往两次选择性CSs,分别为臀位和前置胎盘。怀孕的过程平安无事。在出现时,没有临床体征或症状提示子宫破裂。由于之前的两次CS,她在37周时进行了选择性CS。术中,左侧翼有一层薄薄的膜和内脏腹膜,未见肌肉组织。妊娠结局良好。在我们的病例系列中所见的无声瘢痕破裂是既往CS的常见并发症之一。虽然我们的病例没有采用成像技术,但早期发现和及时干预可以降低发病率和死亡率。
{"title":"Case Series: Uterine Rupture with a Life Baby after Two Previous Caesarean Sections: An Incidental Finding at Elective Caesarean Sections at Term","authors":"Obiora Asiegbu, Darlington-Peter Chibuzor Ugoji, Uzoma Vivian Asiegbu, Bobbie C. Iwe, Paschal Chijioke Okoye, Kelvin Emeka Ortuanya, Chidebe Christian Anikwe","doi":"10.4103/njm.njm_65_23","DOIUrl":"https://doi.org/10.4103/njm.njm_65_23","url":null,"abstract":"Abstract We present three cases of the absence of lower uterine segment (LUS) muscles with a life baby covered by the fetal membrane after two previous caesarean sections (CS) at elective CSs at term. The first case was a 30-year-old booked multipara with bad obstetrics history and two previous CS at a secondary facility on account of unexplained three serial stillbirths at term. There were no histories of maternal obesity, hypertension, or diabetes mellitus. She then had an elective CS at 37 weeks on account of two previous CS. Intraoperatively, it was noted that the LUS was covered by the fetal membranes with visceral peritoneum and no muscle layer. The second case was a 33-year-old booked G4P2 + 1A2 with two previous CSs on account of fetal distress and breech presentation with one previous scar at term, respectively. Pregnancy was uneventful till the presentation. At presentation, there was no history or examination finding suggestive of uterine rupture. She had an elective CS at 39 weeks on account of two previous CS. Intraoperatively, a thin membrane at the LUS with no muscular tissue exposing the fetal membranes was seen, with good fetomaternal outcomes. The third case was a 30-year-old booked G3P2 + 0A2 with two previous elective CSs on account of primigravida with breech presentation and placenta praevia, respectively. The course of the pregnancy was uneventful. At presentation, there was no clinical sign or symptom suggestive of uterine rupture. She had an elective CS at 37 weeks on account of two previous CS. Intraoperatively, a thin membrane at the LUS with visceral peritoneum and no muscular tissue was seen. The pregnancy outcome was favorable. Silent scar rupture as seen in our case series is one of the common complications of previous CS. Early detection with the introduction of imaging techniques, although not done for our cases and prompt intervention reduces morbidity and mortality.","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":"135650889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of factors affecting treatment adherence in patients with chronic kidney disease in Nigeria: A survey from a tertiary health-care centre 评估影响尼日利亚慢性肾病患者坚持治疗的因素:来自某三级保健中心的调查
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_49_22
R. Braimoh, A. Busari, A. Akinyede, Akinyemi Ogunsakin, S. Olayemi
Background: Chronic kidney disease (CKD) is a growing global public health problem with the poorest populations being at the highest risk. Strict adherence to treatment has been found to reduce and may halt progression to end-stage kidney disease. Unfortunately, no data on this is available in this clime. The study was carried out to evaluate factors associated with treatment adherence in patients with CKD attending Lagos University Teaching Hospital. Patients, Materials and Methods: This was a cross-sectional study of 124 previously diagnosed CKD patients being managed at the nephrology unit of Lagos University Teaching Hospital, Nigeria. Using a semi-structured questionnaire, data were collected to evaluate the factors affecting treatment adherence in these patients. Results: The mean age of participants was 50.47 ± 13.7 years. Majority were male 71 (57.3%), married 84 (67.7%), employed 71 (57.3%), Christians 85 (68.5%), and had tertiary education 92 (74.1%). More than half of the population (57%) adhered to the prescribed treatment. However, the majority (69%) of the study population also practiced alternative treatment. Major reasons for nonadherence included alternative medications (69%), forgetfulness 30 (24.2%), high cost of medication 28 (22.6%), high pill burden 28 (22.6%), and being tired of drugs (22%). Conclusion: There is an appreciable level of adherence to treatment among our study population mainly affected by high education and income levels with being gainfully employed. However, a lot more needs to be done to further improve compliance through continuous counseling, reduced pill burden, and lowering the cost of treatment.
背景:慢性肾脏病(CKD)是一个日益严重的全球公共卫生问题,最贫穷的人群面临的风险最高。严格坚持治疗已被发现可以减少并可能阻止终末期肾病的进展。不幸的是,在这种气候下没有这方面的数据。本研究旨在评估拉各斯大学教学医院CKD患者治疗依从性的相关因素。患者、材料和方法:这是一项对尼日利亚拉各斯大学教学医院肾脏科124名先前诊断的CKD患者进行的横断面研究。使用半结构化问卷,收集数据以评估影响这些患者治疗依从性的因素。结果:参与者的平均年龄为50.47±13.7岁。大多数是男性71人(57.3%),已婚84人(67.7%),就业71人(5.73%),基督徒85人(68.5%),受过高等教育92人(74.1%)。超过一半的人口(57%)坚持接受规定的治疗。然而,大多数(69%)的研究人群也采用了替代治疗。不依从性的主要原因包括替代药物(69%)、健忘30(24.2%)、高药物成本28(22.6%)、高药丸负担28(22.7%)和厌倦药物(22%)。结论:在我们的研究人群中,有相当程度的坚持治疗,主要受高教育水平和收入水平的影响,并有报酬地工作。然而,还需要做更多的工作,通过持续的咨询、减少药物负担和降低治疗成本来进一步提高依从性。
{"title":"Assessment of factors affecting treatment adherence in patients with chronic kidney disease in Nigeria: A survey from a tertiary health-care centre","authors":"R. Braimoh, A. Busari, A. Akinyede, Akinyemi Ogunsakin, S. Olayemi","doi":"10.4103/njm.njm_49_22","DOIUrl":"https://doi.org/10.4103/njm.njm_49_22","url":null,"abstract":"Background: Chronic kidney disease (CKD) is a growing global public health problem with the poorest populations being at the highest risk. Strict adherence to treatment has been found to reduce and may halt progression to end-stage kidney disease. Unfortunately, no data on this is available in this clime. The study was carried out to evaluate factors associated with treatment adherence in patients with CKD attending Lagos University Teaching Hospital. Patients, Materials and Methods: This was a cross-sectional study of 124 previously diagnosed CKD patients being managed at the nephrology unit of Lagos University Teaching Hospital, Nigeria. Using a semi-structured questionnaire, data were collected to evaluate the factors affecting treatment adherence in these patients. Results: The mean age of participants was 50.47 ± 13.7 years. Majority were male 71 (57.3%), married 84 (67.7%), employed 71 (57.3%), Christians 85 (68.5%), and had tertiary education 92 (74.1%). More than half of the population (57%) adhered to the prescribed treatment. However, the majority (69%) of the study population also practiced alternative treatment. Major reasons for nonadherence included alternative medications (69%), forgetfulness 30 (24.2%), high cost of medication 28 (22.6%), high pill burden 28 (22.6%), and being tired of drugs (22%). Conclusion: There is an appreciable level of adherence to treatment among our study population mainly affected by high education and income levels with being gainfully employed. However, a lot more needs to be done to further improve compliance through continuous counseling, reduced pill burden, and lowering the cost of treatment.","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":"42410121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amendment of the Nigerian medical residency training act 尼日利亚住院医师培训法修正案
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_135_22
O. Olaopa
{"title":"Amendment of the Nigerian medical residency training act","authors":"O. Olaopa","doi":"10.4103/njm.njm_135_22","DOIUrl":"https://doi.org/10.4103/njm.njm_135_22","url":null,"abstract":"","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":"47958423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk and protective factors influencing multiple sexual partners among adolescents in Rivers State 影响河流州青少年多个性伴侣的风险和保护因素
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_132_22
V. Ogbonna, F. Adeniji, Z. Iliyasu
Introduction: The period of adolescence is characterised by changes and experimentations such as early sexual debut and multiple sexual partners (MSP). That might create issues with sexual and reproductive health that persist throughout one's life such as sexually transmitted infections plus HIV, unsafe abortion, and death. To inform contextualised and culturally appropriate preventive strategies, this study identified the forecasters of MSP among pubescents/adolescents in Rivers State. Materials and Methods: Using a cross-sectional research design, and multistaged sampling technique, 671 adolescents were interviewed with structured interviewer-administered questionnaires. Data were analysed using IBM SPSS version 26. Chi-square test analysis was performed to test for association in proportions between explanatory (sociodemographic variables, factors at the individual, peer, family, community, and national domains) and outcome (MSP) variables. The proportion of sexually experienced respondents with MSP was determined and adjusted odd ratios of predictors derived from multivariate logistic regression models. Results: Out of the 671 adolescents (10–19 years) surveyed, 53.1% were female, and 29 (4.3%) are married. The median age and the interquartile range were 18.0 years. Nearly half 313 (46.6%) of the respondents were sexually experienced, of which 148 (47.3%) had MSP. After adjusting for covariates, religion, sex, employment, father's education, individual perceptions, peer, family, and community norms predicted MSP (P < 0.05). Specifically, respondents with religious affiliations were less likely (adjusted odds ratio [aOR] =0.43, 95% confidence interval [CI]: 0.22–0.87, P = 0.019) than nonreligious/catholic respondents to have several sexual partners. Similarly, female adolescents were less likely to have MSP (aOR = 0.57, 95% CI: 0.33–0.98, P = 0.042). Relative to those whose fathers have no formal education, respondents whose fathers have secondary (crude odds ratio = 0.48, 95% CI: 0.26–0.83, P = 0.001) and tertiary education have lower odds of having MSP. Respondents with higher individual, peer, and community domain scores had at least a threefold raised likelihood of having MSP. Conclusion: A large proportion of sexually experienced adolescents have MSP; religious affiliations were shown to be protective and should be encouraged. Employed adolescents and males are more at risk. Gender-appropriate reproductive health actions for adolescents need to be contextualised at different levels.
青少年时期的特点是变化和实验,如早期的性处子期和多个性伴侣(MSP)。这可能会造成贯穿一生的性健康和生殖健康问题,如性传播感染和艾滋病毒、不安全堕胎和死亡。为了提供情境化和文化上适当的预防策略,本研究确定了河流州青少年中MSP的预测者。材料与方法:采用横断面研究设计和多阶段抽样技术,对671名青少年进行了结构化问卷调查。数据分析采用IBM SPSS version 26。采用卡方检验分析来检验解释(社会人口变量,个人、同伴、家庭、社区和国家领域的因素)和结果(MSP)变量之间的关联比例。确定有过性经验的MSP受访者的比例,并调整来自多变量logistic回归模型的预测因子的奇比。结果:671名受访青少年(10 ~ 19岁)中,女性占53.1%,已婚29人(4.3%)。年龄中位数和四分位数范围为18.0岁。313名受访者中有近一半(46.6%)有过性经验,其中148人(47.3%)有过MSP。调整协变量后,宗教、性别、就业、父亲教育程度、个人认知、同伴、家庭和社区规范预测MSP (P < 0.05)。具体而言,有宗教信仰的受访者比无宗教信仰/天主教的受访者更不可能拥有多个性伴侣(调整后的优势比[aOR] =0.43, 95%可信区间[CI]: 0.22-0.87, P = 0.019)。同样,女性青少年患MSP的可能性较低(aOR = 0.57, 95% CI: 0.33-0.98, P = 0.042)。与父亲未受过正规教育的受访者相比,父亲受过中等教育(粗比值比= 0.48,95% CI: 0.26-0.83, P = 0.001)和高等教育的受访者患MSP的几率较低。个人、同伴和社区领域得分较高的受访者患MSP的可能性至少提高了三倍。结论:有过性经历的青少年中有较大比例存在MSP;宗教信仰已被证明具有保护作用,应予鼓励。有工作的青少年和男性面临的风险更大。针对青少年的适合性别的生殖健康行动需要在不同层次上结合具体情况。
{"title":"Risk and protective factors influencing multiple sexual partners among adolescents in Rivers State","authors":"V. Ogbonna, F. Adeniji, Z. Iliyasu","doi":"10.4103/njm.njm_132_22","DOIUrl":"https://doi.org/10.4103/njm.njm_132_22","url":null,"abstract":"Introduction: The period of adolescence is characterised by changes and experimentations such as early sexual debut and multiple sexual partners (MSP). That might create issues with sexual and reproductive health that persist throughout one's life such as sexually transmitted infections plus HIV, unsafe abortion, and death. To inform contextualised and culturally appropriate preventive strategies, this study identified the forecasters of MSP among pubescents/adolescents in Rivers State. Materials and Methods: Using a cross-sectional research design, and multistaged sampling technique, 671 adolescents were interviewed with structured interviewer-administered questionnaires. Data were analysed using IBM SPSS version 26. Chi-square test analysis was performed to test for association in proportions between explanatory (sociodemographic variables, factors at the individual, peer, family, community, and national domains) and outcome (MSP) variables. The proportion of sexually experienced respondents with MSP was determined and adjusted odd ratios of predictors derived from multivariate logistic regression models. Results: Out of the 671 adolescents (10–19 years) surveyed, 53.1% were female, and 29 (4.3%) are married. The median age and the interquartile range were 18.0 years. Nearly half 313 (46.6%) of the respondents were sexually experienced, of which 148 (47.3%) had MSP. After adjusting for covariates, religion, sex, employment, father's education, individual perceptions, peer, family, and community norms predicted MSP (P < 0.05). Specifically, respondents with religious affiliations were less likely (adjusted odds ratio [aOR] =0.43, 95% confidence interval [CI]: 0.22–0.87, P = 0.019) than nonreligious/catholic respondents to have several sexual partners. Similarly, female adolescents were less likely to have MSP (aOR = 0.57, 95% CI: 0.33–0.98, P = 0.042). Relative to those whose fathers have no formal education, respondents whose fathers have secondary (crude odds ratio = 0.48, 95% CI: 0.26–0.83, P = 0.001) and tertiary education have lower odds of having MSP. Respondents with higher individual, peer, and community domain scores had at least a threefold raised likelihood of having MSP. Conclusion: A large proportion of sexually experienced adolescents have MSP; religious affiliations were shown to be protective and should be encouraged. Employed adolescents and males are more at risk. Gender-appropriate reproductive health actions for adolescents need to be contextualised at different levels.","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":"70834505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immunization of Children in Africa: Strides and Challenges 非洲儿童免疫接种:进展与挑战
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_42_23
Dimeji Abdulsobur Olawuyi, Daniel Olaloye Esanju, Samuel Adedolapo Olowolayemo, Chukwuebuka Stanley Asogwa, Olajire Oluwagbenga Salako, Anjolaoluwa Esther Kolajo, Olatokun Shamsudeen Akano, Jonas Paul Ibekwe, Adaeze Nancy Mbey, Abayomi Hassan Raji
Abstract Background: The African continent is behind by a wide margin in the childhood vaccination race which contributes significantly to the high childhood morbidity and mortality rate from vaccine-preventable diseases in the continent. Some African countries are still struggling to achieve routine immunization coverage for all recommended expanded program on immunization vaccines. Aim: In this study, we aimed to identify the barriers hindering childhood immunization in Africa and to identify the remarkable progress made so far. Materials and Methods: Peer-reviewed articles published in English that focused on the barriers to childhood immunization in Africa and the progress made so far was reviewed. This was achieved by searching relevant search terms in PubMed, Google Scholar, Wiley Online Library, and CINAHL databases dating back from January 2000 to June 2022. Result: A total of 30 papers were reviewed. The barriers include parents’ education status, economic status, and gender/age; place of birth and place of residence; cultural beliefs and religious affiliations; fear of contracting diseases and lack of trust in health public institutions; vaccine awareness and delivery; and dose-specific delays. The achievements include international support and oriented actions, plans for technological integration and its implementation, and domestic immunization-oriented actions and research work. Conclusion: Childhood immunization is still low in Africa with the majority of the countries yet to realize the global immunization targets. Technologies and immunization-related interventions have been implemented to support Africa but more concerted effort and aid are required to reduce vaccine-preventable deaths to the bare minimum.
背景:非洲大陆在儿童疫苗接种竞赛中落后于很大的差距,这是非洲大陆疫苗可预防疾病的高儿童发病率和死亡率的重要原因。一些非洲国家仍在努力实现所有推荐的扩大免疫疫苗规划的常规免疫覆盖。目的:在这项研究中,我们旨在确定阻碍非洲儿童免疫的障碍,并确定迄今为止取得的显著进展。材料和方法:对以英文发表的同行评议文章进行了审查,这些文章的重点是非洲儿童免疫接种的障碍以及迄今取得的进展。这是通过在PubMed、Google Scholar、Wiley Online Library和CINAHL数据库中搜索2000年1月至2022年6月的相关搜索词来实现的。结果:共审阅论文30篇。障碍包括父母的教育程度、经济状况、性别/年龄;出生地点和居住地;文化信仰和宗教信仰;害怕感染疾病和对公共卫生机构缺乏信任;对疫苗的认识和提供;以及剂量特异性延迟。这些成就包括国际支持和定向行动、技术整合及其实施计划以及国内面向免疫的行动和研究工作。结论:非洲儿童免疫水平仍然较低,大多数国家尚未实现全球免疫目标。已经实施了技术和与免疫有关的干预措施,以支持非洲,但需要更加协调一致的努力和援助,以将疫苗可预防的死亡减少到最低限度。
{"title":"Immunization of Children in Africa: Strides and Challenges","authors":"Dimeji Abdulsobur Olawuyi, Daniel Olaloye Esanju, Samuel Adedolapo Olowolayemo, Chukwuebuka Stanley Asogwa, Olajire Oluwagbenga Salako, Anjolaoluwa Esther Kolajo, Olatokun Shamsudeen Akano, Jonas Paul Ibekwe, Adaeze Nancy Mbey, Abayomi Hassan Raji","doi":"10.4103/njm.njm_42_23","DOIUrl":"https://doi.org/10.4103/njm.njm_42_23","url":null,"abstract":"Abstract Background: The African continent is behind by a wide margin in the childhood vaccination race which contributes significantly to the high childhood morbidity and mortality rate from vaccine-preventable diseases in the continent. Some African countries are still struggling to achieve routine immunization coverage for all recommended expanded program on immunization vaccines. Aim: In this study, we aimed to identify the barriers hindering childhood immunization in Africa and to identify the remarkable progress made so far. Materials and Methods: Peer-reviewed articles published in English that focused on the barriers to childhood immunization in Africa and the progress made so far was reviewed. This was achieved by searching relevant search terms in PubMed, Google Scholar, Wiley Online Library, and CINAHL databases dating back from January 2000 to June 2022. Result: A total of 30 papers were reviewed. The barriers include parents’ education status, economic status, and gender/age; place of birth and place of residence; cultural beliefs and religious affiliations; fear of contracting diseases and lack of trust in health public institutions; vaccine awareness and delivery; and dose-specific delays. The achievements include international support and oriented actions, plans for technological integration and its implementation, and domestic immunization-oriented actions and research work. Conclusion: Childhood immunization is still low in Africa with the majority of the countries yet to realize the global immunization targets. Technologies and immunization-related interventions have been implemented to support Africa but more concerted effort and aid are required to reduce vaccine-preventable deaths to the bare minimum.","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":"135649387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ocular Morbidity in Children with Allergic Conjunctivitis: A Rural-urban Survey 儿童过敏性结膜炎的眼部发病率:一项城乡调查
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_45_23
Valerie Nawem Ihinose Abiola, Mary Ogbenyi Ugalahi, Eniola Olubukola Cadmus, Aderonke Mojisola Baiyeroju
Abstract Background: Allergic conjunctivitis occasionally may result in some ocular morbidities. This ranges from innocuous to severe forms of ocular disorders. Aim: This study reports and compares ocular morbidities among children with ocular allergies living in an urban and rural community. Materials and Methods: A comparative cross-sectional study conducted in urban and rural schools among children aged 5–15 years using a multistage sampling method. Sociodemographic data, past ocular history, history of ocular allergies, and treatment were collected with an interviewer-based questionnaire and were analysed using the Statistical Package for the Social Sciences (SPSS) software version 25. Descriptive analyses of sociodemographic variables and associated ocular morbidity were carried out. The Chi-square test was used to test associations between rural and urban groups. A P = 0.05 or less was considered significant. Results: Associated ocular morbidities were seen in 8% (19/238) of the children with allergic conjunctivitis. There was no statistically significant difference in the proportion of ocular morbidities observed between both locations (8.1 vs. 7.9 in the rural and urban location, respectively, with a P = 1.000). Children with mild forms of allergic conjunctivitis were 197 (82.8%), and only 1.7% had severe forms. The moderate and severe form of allergic conjunctivitis were more prevalent in the rural area ( P = 0.002) while untreated allergic conjunctivitis was found in 168 (70.6%) of those affected. Conclusion: This study demonstrated a higher proportion of moderate-to-severe forms of allergic conjunctivitis among school children in the rural region with the majority being untreated.
背景:变应性结膜炎偶尔会导致一些眼部疾病。这包括从无害到严重形式的眼部疾病。目的:本研究报告并比较了城市和农村地区眼部过敏儿童的眼部发病率。材料与方法:采用多阶段抽样方法,在城市和农村学校对5-15岁儿童进行比较横断面研究。社会人口统计数据、既往眼部病史、眼部过敏史和治疗情况通过基于访谈者的问卷收集,并使用社会科学统计软件包(SPSS)软件版本25进行分析。对社会人口学变量和相关眼部发病率进行描述性分析。卡方检验用于检验农村和城市群体之间的相关性。A P = 0.05及以下被认为是显著的。结果:过敏性结膜炎患儿中有8%(19/238)存在眼部相关病变。两个地区之间观察到的眼部发病率比例无统计学差异(农村和城市地区分别为8.1比7.9,P = 1.000)。轻度变应性结膜炎患儿197例(82.8%),重度变应性结膜炎患儿仅1.7%。中重度变应性结膜炎以农村地区多见(P = 0.002),未治疗的变应性结膜炎168例(70.6%)。结论:本研究表明,在农村地区的学龄儿童中,中重度变应性结膜炎的比例较高,且大多数未得到治疗。
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引用次数: 0
Foreign-trained early-career doctors and dynamics in Nigeria: Findings from the charting studies 外国培训的早期职业医生和尼日利亚的动态:来自图表研究的发现
Pub Date : 2022-11-01 DOI: 10.4103/njm.njm_98_22
U. Enebeli, A. Adelola, O. Adebayo, O S Ilesanmi, S. Umar, D. Ishaya
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引用次数: 0
期刊
Nigerian Journal of Medicine
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