Background: The Community-Based Health Insurance Scheme (CBHIS) (National Health Insurance Scheme [NHIS]) pools the risk of high costs of health care across a large number of individuals, and it permits payment of a premium based on the average cost of health care for the group of people. This function of spreading risk in NHIS helps in making the cost of health-care services affordable for many individuals. Aim: This study which is aimed at assessing the knowledge of Community-Based Health Insurance (CBHIS) among artisans in Ekiti State will help in identifying and implementing strategies to widen health insurance services to this group of nonformal sector. Materials and Methods: A descriptive cross-sectional study was conducted among 416 respondents using a systematic random sampling technique among the skilled occupational group vis-a-vis bricklayers, carpenters, electricians, hair stylist, and tailors. Data were collated using an interviewer-administered semi-structured questionnaire and analysed using IBM SPSS version 23. Chi-square and binary logistic regression were used to assess the association between dependent and independent variables. P < 0.05 was taken as statistically significant. Results: The study participant mean age was 29.7 ± 10.9 years, majority were females (57.5%), and 46.9% had tertiary education. 53.1% were aware of health insurance, but only 24% were aware of CBHIS. Just about a fifth of the respondents (18.3%) had good knowledge of CBHIS. Significant factors and predictors of knowledge of CBHIS in this study include female gender, tertiary level of education, higher family income, and higher frequency of illness. Conclusion: The awareness and knowledge of CBHIS among artisans in Ekiti State is still very low. Factors associated with the low knowledge include gender, level of education, frequency of illness, and family income. Therefore, efforts at improving awareness and educating members of the public about the scheme will be beneficial.
{"title":"Knowledge of community-based health insurance and associated factors among artisans in a selected community of Ekiti State","authors":"OE Elegbede, KabirAdekunle Durowade, TaofeekAdedayo Sanni, TopeMichael Ipinnimo, AyoKamal Alabi","doi":"10.4103/NJM.NJM_47_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_47_22","url":null,"abstract":"Background: The Community-Based Health Insurance Scheme (CBHIS) (National Health Insurance Scheme [NHIS]) pools the risk of high costs of health care across a large number of individuals, and it permits payment of a premium based on the average cost of health care for the group of people. This function of spreading risk in NHIS helps in making the cost of health-care services affordable for many individuals. Aim: This study which is aimed at assessing the knowledge of Community-Based Health Insurance (CBHIS) among artisans in Ekiti State will help in identifying and implementing strategies to widen health insurance services to this group of nonformal sector. Materials and Methods: A descriptive cross-sectional study was conducted among 416 respondents using a systematic random sampling technique among the skilled occupational group vis-a-vis bricklayers, carpenters, electricians, hair stylist, and tailors. Data were collated using an interviewer-administered semi-structured questionnaire and analysed using IBM SPSS version 23. Chi-square and binary logistic regression were used to assess the association between dependent and independent variables. P < 0.05 was taken as statistically significant. Results: The study participant mean age was 29.7 ± 10.9 years, majority were females (57.5%), and 46.9% had tertiary education. 53.1% were aware of health insurance, but only 24% were aware of CBHIS. Just about a fifth of the respondents (18.3%) had good knowledge of CBHIS. Significant factors and predictors of knowledge of CBHIS in this study include female gender, tertiary level of education, higher family income, and higher frequency of illness. Conclusion: The awareness and knowledge of CBHIS among artisans in Ekiti State is still very low. Factors associated with the low knowledge include gender, level of education, frequency of illness, and family income. Therefore, efforts at improving awareness and educating members of the public about the scheme will be beneficial.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48056743","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}
Medical negligence and malpractice are becoming a growing concern in Nigeria; even though many victims do not know how to go about seeking redress or demand justice, medical practitioners, too, do not understand the legal implications of their actions. Medical negligence and malpractice are tortious liabilities that can also result in criminal liabilities. It is a fact that health-care practice will occasionally result in circumstances where health seekers suffer some distress or permanent injury in the course of handling by medical practitioners. This distress or injury can be a result of either commission or omission due to the actions or inactions of the medical practitioner. This review was embarked upon using thoroughly studied recent and older literature concentrating on research indications resulting from the fields of medicine and law within and without Nigeria. Common acts that could give rise to lawsuits on medical negligence and medical malpractice include doctor's illegible handwriting, prescription and medication errors, misdiagnosis or failure to diagnose, improper medical treatment, leaving surgical instruments in patients after surgery, lack of informed consent, failure to refer a patient to a specialist, breach of confidentiality, extortion, and deception among others. For liability to come up in negligence, it is imperative that the three main fundamentals of negligence, which include that a duty of care is owed, there was a breach of the duty of care, and injury or permanent disability suffered as a direct consequence of a breach of the duty of care must be well established and proved beyond a reasonable doubt. The inability of a victim to successfully prove a case of negligence against a medical practitioner does not totally absolve a practitioner from charges related to other offences under other aspects of the law, hence the fact that negligence is difficult to prove does not leave a patient deprived of other legal opportunities as may be considered appropriate. Even though the law protects the medical practitioner to the level that liability for medical negligence and medical malpractice has to be proved beyond a reasonable doubt, much more legal protection is needed to allow medical practitioners to discharge their duties of saving lives. Medical practitioners need to be aware of their limits as well as the legal implications of their work; this can be achieved by incorporating medicolegal principles into medical education for medical students, as well as periodic medicolegal lectures for medical practitioners.
{"title":"Legal imperatives of medical negligence and medical malpractice","authors":"Hassan Obaro","doi":"10.4103/NJM.NJM_57_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_57_22","url":null,"abstract":"Medical negligence and malpractice are becoming a growing concern in Nigeria; even though many victims do not know how to go about seeking redress or demand justice, medical practitioners, too, do not understand the legal implications of their actions. Medical negligence and malpractice are tortious liabilities that can also result in criminal liabilities. It is a fact that health-care practice will occasionally result in circumstances where health seekers suffer some distress or permanent injury in the course of handling by medical practitioners. This distress or injury can be a result of either commission or omission due to the actions or inactions of the medical practitioner. This review was embarked upon using thoroughly studied recent and older literature concentrating on research indications resulting from the fields of medicine and law within and without Nigeria. Common acts that could give rise to lawsuits on medical negligence and medical malpractice include doctor's illegible handwriting, prescription and medication errors, misdiagnosis or failure to diagnose, improper medical treatment, leaving surgical instruments in patients after surgery, lack of informed consent, failure to refer a patient to a specialist, breach of confidentiality, extortion, and deception among others. For liability to come up in negligence, it is imperative that the three main fundamentals of negligence, which include that a duty of care is owed, there was a breach of the duty of care, and injury or permanent disability suffered as a direct consequence of a breach of the duty of care must be well established and proved beyond a reasonable doubt. The inability of a victim to successfully prove a case of negligence against a medical practitioner does not totally absolve a practitioner from charges related to other offences under other aspects of the law, hence the fact that negligence is difficult to prove does not leave a patient deprived of other legal opportunities as may be considered appropriate. Even though the law protects the medical practitioner to the level that liability for medical negligence and medical malpractice has to be proved beyond a reasonable doubt, much more legal protection is needed to allow medical practitioners to discharge their duties of saving lives. Medical practitioners need to be aware of their limits as well as the legal implications of their work; this can be achieved by incorporating medicolegal principles into medical education for medical students, as well as periodic medicolegal lectures for medical practitioners.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47029467","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. Abdu, Maigari Ibrahim, Lawal A. Muhammad, Yakubu Audi, U. Sabo, J. Yusuf
Abstract: Lassa fever (LF) is a viral haemorrhagic fever (VHF) endemic in the West African sub-region. It causes regular outbreaks with a significant case fatality rate (CFR). An estimated 100,000–300,000 people are infected with Lassa fever virus (LASV) every year in West Africa. Acute kidney injury (AKI) is a recognized complication of LF and may contribute significantly to the high CFR. We retrospectively studied 187 reverse transcriptase-polymerase chain reaction (RT-PCR)-positive LF patients admitted and managed at the infectious diseases centre of Abubakar Tafawa Balewa University Teaching (ATBUTH), Bauchi, to shed more light on the effect of AKI on the outcome. Materials and Methods: The case files of 187 RT-PCR-positive LF patients admitted between January 2018 and December 2020 at the infectious disease centre of ATBUTH were retrieved. We performed parametric and nonparametric statistical analyses including logistic regression to determine factors associated with poor outcomes. Results: During the study period, 187 RT-PCR-positive LF patients were admitted and treated in our centre; 130 (69.5%) were males and 27 (30.5%) were females. The mean age of presentation was 37.3 ± 15.5 years, and nearly all the patients presented with fevers of varying duration. There were 53 deaths with a CFR of 28.3%. More than 2/3 of the deaths were among the age group of 18–47 years. AKI was observed in 12.8% of the patients whose mean age was 37.17 ± 13.13 years. AKI was significantly associated with poor outcomes. Raised systolic blood pressure (odds ratio [OR] = 1.042, 95% confidence interval [CI] 1.008–1.076, P = 0.014) and serum creatinine (OR = 0.952, 95% CI 0.904–1.002, P = 0.000) were found as significant risk factors for developing AKI. Conclusion: Lassa fever is a multisystemic illness. Kidney involvement occur early and can lead to acute kidney injury with its attendant complications. Our study highlighted the significance of AKI as a contributor to poor outcome among patients with Lassa Fever infection.
摘要:拉沙热(Lassa fever, LF)是西非分区域流行的一种病毒性出血热(VHF)。它引起定期暴发，病死率很高。据估计，西非每年有10万至30万人感染拉沙热病毒。急性肾损伤(AKI)是LF的一种公认的并发症，可能是导致高CFR的重要原因。我们回顾性研究了包奇Abubakar Tafawa Balewa大学教学(ATBUTH)传染病中心收治和管理的187例逆转录聚合酶链反应(RT-PCR)阳性的LF患者，以更多地了解AKI对预后的影响。材料与方法:检索2018年1月至2020年12月在ATBUTH传染病中心收治的187例rt - pcr阳性LF患者的病例档案。我们进行了参数和非参数统计分析，包括逻辑回归，以确定与不良结果相关的因素。结果:在研究期间，我中心共收治了187例rt - pcr阳性的LF患者;男性130例(69.5%)，女性27例(30.5%)。平均发病年龄为37.3±15.5岁，几乎所有患者均有不同时间的发热。死亡53例，CFR为28.3%。超过三分之二的死者年龄在18-47岁之间。12.8%的患者出现AKI，平均年龄为37.17±13.13岁。AKI与不良预后显著相关。收缩压升高(优势比[OR] = 1.042, 95%可信区间[CI] 1.008-1.076, P = 0.014)和血清肌酐升高(OR = 0.952, 95% CI 0.904-1.002, P = 0.000)是AKI发生的显著危险因素。结论:拉沙热是一种多系统疾病。肾脏受累发生早期，可导致急性肾损伤及其并发症。我们的研究强调了AKI作为拉沙热感染患者预后不良的一个因素的重要性。
{"title":"Factors affecting outcome in reverse transcriptase-polymerase chain reaction-positive lassa fever patients with acute kidney injury: A retrospective analysis","authors":"A. Abdu, Maigari Ibrahim, Lawal A. Muhammad, Yakubu Audi, U. Sabo, J. Yusuf","doi":"10.4103/NJM.NJM_78_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_78_22","url":null,"abstract":"Abstract: Lassa fever (LF) is a viral haemorrhagic fever (VHF) endemic in the West African sub-region. It causes regular outbreaks with a significant case fatality rate (CFR). An estimated 100,000–300,000 people are infected with Lassa fever virus (LASV) every year in West Africa. Acute kidney injury (AKI) is a recognized complication of LF and may contribute significantly to the high CFR. We retrospectively studied 187 reverse transcriptase-polymerase chain reaction (RT-PCR)-positive LF patients admitted and managed at the infectious diseases centre of Abubakar Tafawa Balewa University Teaching (ATBUTH), Bauchi, to shed more light on the effect of AKI on the outcome. Materials and Methods: The case files of 187 RT-PCR-positive LF patients admitted between January 2018 and December 2020 at the infectious disease centre of ATBUTH were retrieved. We performed parametric and nonparametric statistical analyses including logistic regression to determine factors associated with poor outcomes. Results: During the study period, 187 RT-PCR-positive LF patients were admitted and treated in our centre; 130 (69.5%) were males and 27 (30.5%) were females. The mean age of presentation was 37.3 ± 15.5 years, and nearly all the patients presented with fevers of varying duration. There were 53 deaths with a CFR of 28.3%. More than 2/3 of the deaths were among the age group of 18–47 years. AKI was observed in 12.8% of the patients whose mean age was 37.17 ± 13.13 years. AKI was significantly associated with poor outcomes. Raised systolic blood pressure (odds ratio [OR] = 1.042, 95% confidence interval [CI] 1.008–1.076, P = 0.014) and serum creatinine (OR = 0.952, 95% CI 0.904–1.002, P = 0.000) were found as significant risk factors for developing AKI. Conclusion: Lassa fever is a multisystemic illness. Kidney involvement occur early and can lead to acute kidney injury with its attendant complications. Our study highlighted the significance of AKI as a contributor to poor outcome among patients with Lassa Fever infection.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45742255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Including patient's evaluation in the comprehensive measurement of primary health-care (PHC) performance is a valid and reliable approach for the assessment and improvement of local PHC system. Aim: This study demonstrates the use of the importance–performance analysis (IPA) for identifying challenges in PHC centers in Obio-Akpor. Materials and Methods: This was a quantitative survey of first-time visitors to four PHC centers in Obio-Akpor. A total of 337 participants were selected from a two-stage sampling approach and administered the Patient Evaluation Scale which was structured to elicit their ratings on the importance of PHC centers' attributes before and the performance on these attributes after their encounter with the facility. Descriptive and inferential statistics were performed using the SPSS version 21, and PHC centers' attributes were aggregated across each of the four IPA quadrants. Results: The response rate was 89% and the Cronbach's alpha coefficient was 0.91 and 0.94 for the importance and performance measurement scales, respectively. More of the respondents were below 40 years (87.7%), female (73.7%), and currently married (69.3%). Observed areas of concentration for PHC improvement were staff availability during operating times, ease of payment, waiting time, convenience of operating hours, and availability of electricity in the facility. Conclusion: Findings provide evidence of patients' concerns in the local PHC system. Subsequent validation and focused interventions aimed at resolving identified challenges can positively influence the demand and social relevance of PHC in this setting.
{"title":"Identifying primary health-care challenges using the importance–Performance analysis: Implications for a low- and middle-income country","authors":"D. Ogaji","doi":"10.4103/NJM.NJM_83_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_83_22","url":null,"abstract":"Background: Including patient's evaluation in the comprehensive measurement of primary health-care (PHC) performance is a valid and reliable approach for the assessment and improvement of local PHC system. Aim: This study demonstrates the use of the importance–performance analysis (IPA) for identifying challenges in PHC centers in Obio-Akpor. Materials and Methods: This was a quantitative survey of first-time visitors to four PHC centers in Obio-Akpor. A total of 337 participants were selected from a two-stage sampling approach and administered the Patient Evaluation Scale which was structured to elicit their ratings on the importance of PHC centers' attributes before and the performance on these attributes after their encounter with the facility. Descriptive and inferential statistics were performed using the SPSS version 21, and PHC centers' attributes were aggregated across each of the four IPA quadrants. Results: The response rate was 89% and the Cronbach's alpha coefficient was 0.91 and 0.94 for the importance and performance measurement scales, respectively. More of the respondents were below 40 years (87.7%), female (73.7%), and currently married (69.3%). Observed areas of concentration for PHC improvement were staff availability during operating times, ease of payment, waiting time, convenience of operating hours, and availability of electricity in the facility. Conclusion: Findings provide evidence of patients' concerns in the local PHC system. Subsequent validation and focused interventions aimed at resolving identified challenges can positively influence the demand and social relevance of PHC in this setting.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48344344","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}
Glaucoma is a leading cause of blindness globally; however, in terms of the irreversibility of blindness, it is the number one cause. Glaucoma treatment aims at slowing the progression and reducing the risk of further structural and functional damage as much as possible. A rare subset of glaucoma is juvenile open-angle glaucoma (JOAG) diagnosed in individuals between 3 and 40 years of age. The JOAG tends to have rapid progression and it is associated with higher intraocular pressure (IOP) and fluctuations compared to primary open-angle glaucoma. The IOP also tends to be refractory to medical therapy control and often requires surgical intervention. In the treatment of glaucoma, functional improvement is not an expectation. This is a case report of a JOAG patient with visual improvement following trabeculectomy. A 17-year-old female presented with a 4-year history of gradual visual loss in both eyes. Diagnosed elsewhere to have glaucoma with no known baseline IOP value and is already on travoprost. Visual acuity (VA) at presentation was counting finger (close to face right eye, 2 m left eye) and IOP were 22 and 19 mmHg, respectively. The patient subsequently underwent trabeculectomy with mitomycin C in both eyes at a single sitting. She had a marked improvement in vision postoperatively. At 6 weeks postoperative review, VA was 6/36 and 6/18 in the right and left eyes, respectively, and pressures were 9 and 8 mmHg, respectively. There is currently no proven mechanism to explain visual recovery; however, visual improvement may have resulted from some reversal of retinal ganglion cell damage following significant IOP lowering. Improvement in vision is not an expectation following treatment for glaucoma; however, some case reports have reported this occurrence following trabeculectomy. Hence, even in very advanced presentations, especially in young individuals as in this case, there should not be hesitation with surgical intervention following appropriate counseling.
{"title":"Visual improvement following trabeculectomy in a 17-year-old","authors":"T. Sarimiye, Joyce Ofuadarho","doi":"10.4103/NJM.NJM_84_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_84_22","url":null,"abstract":"Glaucoma is a leading cause of blindness globally; however, in terms of the irreversibility of blindness, it is the number one cause. Glaucoma treatment aims at slowing the progression and reducing the risk of further structural and functional damage as much as possible. A rare subset of glaucoma is juvenile open-angle glaucoma (JOAG) diagnosed in individuals between 3 and 40 years of age. The JOAG tends to have rapid progression and it is associated with higher intraocular pressure (IOP) and fluctuations compared to primary open-angle glaucoma. The IOP also tends to be refractory to medical therapy control and often requires surgical intervention. In the treatment of glaucoma, functional improvement is not an expectation. This is a case report of a JOAG patient with visual improvement following trabeculectomy. A 17-year-old female presented with a 4-year history of gradual visual loss in both eyes. Diagnosed elsewhere to have glaucoma with no known baseline IOP value and is already on travoprost. Visual acuity (VA) at presentation was counting finger (close to face right eye, 2 m left eye) and IOP were 22 and 19 mmHg, respectively. The patient subsequently underwent trabeculectomy with mitomycin C in both eyes at a single sitting. She had a marked improvement in vision postoperatively. At 6 weeks postoperative review, VA was 6/36 and 6/18 in the right and left eyes, respectively, and pressures were 9 and 8 mmHg, respectively. There is currently no proven mechanism to explain visual recovery; however, visual improvement may have resulted from some reversal of retinal ganglion cell damage following significant IOP lowering. Improvement in vision is not an expectation following treatment for glaucoma; however, some case reports have reported this occurrence following trabeculectomy. Hence, even in very advanced presentations, especially in young individuals as in this case, there should not be hesitation with surgical intervention following appropriate counseling.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45711416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Despite the use of routine thyroid function tests, thyroid dysfunction is often missed in pregnant women, who may have fluctuating iodine reserves and this may be associated with an increased risk of adverse maternal and fetal outcomes due to thyroid dysfunction. Therefore, thyroglobulin (Tg) as a marker of iodine reserve may be added to improve the diagnostic value of the thyroid testing panel. Materials and Methods: This study was a multicenter descriptive cross-sectional study with 501 healthy pregnant women, carried out over 9 months, in which blood and urine (spot) specimens were collected and analysed for serum thyroid-stimulating hormone, free thyroxine, free triiodothyronine, and Tg using enzyme-linked immunosorbent assay, and urinary iodine concentration by modified Sandell–Kolthoff reaction. Results: The prevalence of thyroid dysfunction in pregnant women using thyroid function tests alone was 12.4% (62) with 9.6% (48) being hypothyroid and 2.0% (10) hyperthyroid. The addition of Tg was able to identify more participants with thyroid dysfunction who were iodine deficient, and initially missed using thyroid function tests alone. This newly added biomarker to routine thyroid function tests profile increased the prevalence of thyroid disorders in this study population from 12.4% (62) to 17.6% (88) (P < 0.01), whereas urine iodine concentration was adequate for each trimester falling within the WHO range of 150–249 μg/l. Conclusion: The true prevalence of thyroid dysfunction in pregnant women in Makurdi was 17.6%. The addition of Tg had an impact on thyroid function tests by identifying more participants with iodine-related thyroid dysfunction, who were missed in the initial assessment of the thyroid. The mean urine iodine concentration was adequate, falling within the WHO range of 150–249 μg/l.
{"title":"Thyroglobulin as an evolving biomarker of iodine reserve in thyroid dysfunction assessment in pregnancy","authors":"T. Gbaa","doi":"10.4103/NJM.NJM_82_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_82_22","url":null,"abstract":"Background: Despite the use of routine thyroid function tests, thyroid dysfunction is often missed in pregnant women, who may have fluctuating iodine reserves and this may be associated with an increased risk of adverse maternal and fetal outcomes due to thyroid dysfunction. Therefore, thyroglobulin (Tg) as a marker of iodine reserve may be added to improve the diagnostic value of the thyroid testing panel. Materials and Methods: This study was a multicenter descriptive cross-sectional study with 501 healthy pregnant women, carried out over 9 months, in which blood and urine (spot) specimens were collected and analysed for serum thyroid-stimulating hormone, free thyroxine, free triiodothyronine, and Tg using enzyme-linked immunosorbent assay, and urinary iodine concentration by modified Sandell–Kolthoff reaction. Results: The prevalence of thyroid dysfunction in pregnant women using thyroid function tests alone was 12.4% (62) with 9.6% (48) being hypothyroid and 2.0% (10) hyperthyroid. The addition of Tg was able to identify more participants with thyroid dysfunction who were iodine deficient, and initially missed using thyroid function tests alone. This newly added biomarker to routine thyroid function tests profile increased the prevalence of thyroid disorders in this study population from 12.4% (62) to 17.6% (88) (P < 0.01), whereas urine iodine concentration was adequate for each trimester falling within the WHO range of 150–249 μg/l. Conclusion: The true prevalence of thyroid dysfunction in pregnant women in Makurdi was 17.6%. The addition of Tg had an impact on thyroid function tests by identifying more participants with iodine-related thyroid dysfunction, who were missed in the initial assessment of the thyroid. The mean urine iodine concentration was adequate, falling within the WHO range of 150–249 μg/l.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41865287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There are very few reports of the clinicopathological features of ossifying fibroma (OF) of the jaws in Enugu, South-east Nigeria. Aims: To study the prevalence and clinicopathological features of OF in Enugu. Patients, Materials and Methods: An eight-year retrospective study of patients with OF of the jaws was carried out in a tertiary hospital in Enugu, Nigeria. The clinical records, radiographs, histopathology reports, and slides of 87 patients with fibrous lesions, archived in the department of oral pathology and oral medicine were identified and examined. The cases diagnosed with OF by histological examination were retrieved and studied. The data were analysed using the descriptive statistics and presented in the form of frequency tables. The test for a statistical association was carried out using the Chi-square statistics. Results: There were 644 orofacial lesions and 13.5% (87) of these were fibro-osseous tumours. OF constituted 8.9% (57) of the orofacial lesions and 65.5% (57) of fibro-osseous tumors. The male-to-female ratio was 1:1.7. The overall mean age at tumour-onset was 24.1 ± 13.1 years, (range: 5–60 years). The age group at which OF occurred most frequently (43.9%) was 11–20 years. The mandible was the most common site of occurrence, 64.9% (37), while the radiographic features were well-circumscribed opacity 24.6% (14), and mixed lucency–opacity, 22.8% (13). Conventional 54 (94.7%) and juvenile-psammamatoid 3 (5.3%) subtypes were identified. Conclusion: OF is the most prevalent fibro-osseous lesion, occurred mostly in the second decade and exhibits a lower mean age of onset in male patients.
{"title":"Ossifying fibroma of the jaws: Review of 57 cases in Enugu and of global literature","authors":"C. Okwuosa, M. Nwoga, A. Adisa","doi":"10.4103/NJM.NJM_87_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_87_22","url":null,"abstract":"Background: There are very few reports of the clinicopathological features of ossifying fibroma (OF) of the jaws in Enugu, South-east Nigeria. Aims: To study the prevalence and clinicopathological features of OF in Enugu. Patients, Materials and Methods: An eight-year retrospective study of patients with OF of the jaws was carried out in a tertiary hospital in Enugu, Nigeria. The clinical records, radiographs, histopathology reports, and slides of 87 patients with fibrous lesions, archived in the department of oral pathology and oral medicine were identified and examined. The cases diagnosed with OF by histological examination were retrieved and studied. The data were analysed using the descriptive statistics and presented in the form of frequency tables. The test for a statistical association was carried out using the Chi-square statistics. Results: There were 644 orofacial lesions and 13.5% (87) of these were fibro-osseous tumours. OF constituted 8.9% (57) of the orofacial lesions and 65.5% (57) of fibro-osseous tumors. The male-to-female ratio was 1:1.7. The overall mean age at tumour-onset was 24.1 ± 13.1 years, (range: 5–60 years). The age group at which OF occurred most frequently (43.9%) was 11–20 years. The mandible was the most common site of occurrence, 64.9% (37), while the radiographic features were well-circumscribed opacity 24.6% (14), and mixed lucency–opacity, 22.8% (13). Conventional 54 (94.7%) and juvenile-psammamatoid 3 (5.3%) subtypes were identified. Conclusion: OF is the most prevalent fibro-osseous lesion, occurred mostly in the second decade and exhibits a lower mean age of onset in male patients.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44777754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.
{"title":"Review article: Urethral catheters and catheterization techniques","authors":"N. Agwu, A. Umar, Ugbede Oyibo","doi":"10.4103/NJM.NJM_99_21","DOIUrl":"https://doi.org/10.4103/NJM.NJM_99_21","url":null,"abstract":"Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43809333","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}
B. Abubakar, O. Aliu-Isah, Sanni Musa, K. Abdulsalam, I. Yahaya
Background: Human immunodeficiency virus (HIV) infection affects multiple organs and the kidney is a common target, thereby making renal disease one of the recognised complications of HIV infection. Microalbuminuria represents an early, important marker of kidney damage in several disease conditions including HIV-infected highly active antiretroviral therapy (HAART)-naïve patients. Early detection of microalbuminuria is critical to slowing down the progression of kidney dysfunction to chronic kidney disease in HIV-infected patients. Determination of predictive factors for microalbuminuria in these group of patients may serve as avenues for intervention to prevent HIV-associated renal diseases. Aim: The aim of the study was to determine the prevalence and risk factors of microalbuminuria in HIV/AIDS-infected adults on HAART at Aminu Kano Teaching Hospital, Kano, Nigeria. Patients, Materials and Methods: A descriptive cross-sectional study was carried out among 500 subjects including 250 HAART-treated and 250 HAART-naïve HIV/AIDS participants. An interviewer-administered structured questionnaire was used to collect relevant demographic and clinical information. Blood and urine samples were collected for serum creatinine and urinary albumin and creatinine measurements, respectively, and the results were collated and analysed. Comparison of categorical variables was done using Chi-square/Fisher's exact test, where applicable with level of significance set at P < 0.05. Results: The prevalence of microalbuminuria among the two groups studied was found to be high (22.8% for HAART naïve versus 18.4% for HAART treated, respectively) while the risk factors identified were estimated glomerular filtration rate, low CD4 count, and duration of HIV treatment. Conclusion: The major predictors of microalbuminuria include low CD4 count, duration of HIV infection (<30 months), and duration of HAART treatment (<30 months).
{"title":"Microalbuminuria and its associated risk factors among human immunodeficiency virus-infected patients attending a tertiary care facility in Kano, Northwest Nigeria","authors":"B. Abubakar, O. Aliu-Isah, Sanni Musa, K. Abdulsalam, I. Yahaya","doi":"10.4103/NJM.NJM_86_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_86_22","url":null,"abstract":"Background: Human immunodeficiency virus (HIV) infection affects multiple organs and the kidney is a common target, thereby making renal disease one of the recognised complications of HIV infection. Microalbuminuria represents an early, important marker of kidney damage in several disease conditions including HIV-infected highly active antiretroviral therapy (HAART)-naïve patients. Early detection of microalbuminuria is critical to slowing down the progression of kidney dysfunction to chronic kidney disease in HIV-infected patients. Determination of predictive factors for microalbuminuria in these group of patients may serve as avenues for intervention to prevent HIV-associated renal diseases. Aim: The aim of the study was to determine the prevalence and risk factors of microalbuminuria in HIV/AIDS-infected adults on HAART at Aminu Kano Teaching Hospital, Kano, Nigeria. Patients, Materials and Methods: A descriptive cross-sectional study was carried out among 500 subjects including 250 HAART-treated and 250 HAART-naïve HIV/AIDS participants. An interviewer-administered structured questionnaire was used to collect relevant demographic and clinical information. Blood and urine samples were collected for serum creatinine and urinary albumin and creatinine measurements, respectively, and the results were collated and analysed. Comparison of categorical variables was done using Chi-square/Fisher's exact test, where applicable with level of significance set at P < 0.05. Results: The prevalence of microalbuminuria among the two groups studied was found to be high (22.8% for HAART naïve versus 18.4% for HAART treated, respectively) while the risk factors identified were estimated glomerular filtration rate, low CD4 count, and duration of HIV treatment. Conclusion: The major predictors of microalbuminuria include low CD4 count, duration of HIV infection (<30 months), and duration of HAART treatment (<30 months).","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45436800","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}
C. V. Ugwueze, Bede Nnolim, Nnamdi C. Anikpo, Kenechukwu E. Onyekachi, C. Onah, Oluomachi Chukwu, ChinweubaM Abonyi, B. Ezeokpo, O. Modebe
Background: Type 2 diabetes mellitus is a metabolic disorder arising from insulin resistance and/or decreased insulin secretion and has continued to affect people across all economic levels in society. Due to the high prevalence of undiagnosed diabetes, it has become very imperative to emphasize screening in any given population, especially in developing countries. Aim: The aim of the study was to determine the risk factors and prevalence of diabetes mellitus among participants using the FINDRISC questionnaire. Materials and Methods: The study was a cross-sectional study which involved 200 participants but 197 had complete data. Anthropometric, blood pressure, and fasting/random blood glucose measurements were carried out. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Results: The mean age of respondents was 41.8 ± 16.3 years. There were 104 males and 93 females. Most of the respondents were traders constituting 51.8% of the study population. The 10-year risk categorization of respondents showed that 57.9% had low risk, 17.8% with slightly elevated risk, 12.2% had moderate risk, 10.7% with high risk, and 1.5% with a very high risk of developing diabetes. The average risk score was 7.4 ± 5.4 with a range of 0.0–24.0. The mean weight, height, and body mass index were 69.6 ± 14.4 kg, 165.3 ± 8.6 cm, and 25.5 ± 5.2 kg/m2, respectively. The mean systolic and diastolic blood pressures were 126.9 ± 20.3 mmHg (range: 80–205) and 76.6 ± 12.9 mmHg (range of 50–130), respectively. Conclusion: Approximately, 25% of respondents have a moderate-to-very high risk which emphasizes the need for continuous screening of the population, especially in public gatherings.
{"title":"Risk assessment for type 2 diabetes mellitus among participants in a market survey at Ebonyi State, South East Nigeria, using finnish diabetes risk score questionnaire","authors":"C. V. Ugwueze, Bede Nnolim, Nnamdi C. Anikpo, Kenechukwu E. Onyekachi, C. Onah, Oluomachi Chukwu, ChinweubaM Abonyi, B. Ezeokpo, O. Modebe","doi":"10.4103/NJM.NJM_79_22","DOIUrl":"https://doi.org/10.4103/NJM.NJM_79_22","url":null,"abstract":"Background: Type 2 diabetes mellitus is a metabolic disorder arising from insulin resistance and/or decreased insulin secretion and has continued to affect people across all economic levels in society. Due to the high prevalence of undiagnosed diabetes, it has become very imperative to emphasize screening in any given population, especially in developing countries. Aim: The aim of the study was to determine the risk factors and prevalence of diabetes mellitus among participants using the FINDRISC questionnaire. Materials and Methods: The study was a cross-sectional study which involved 200 participants but 197 had complete data. Anthropometric, blood pressure, and fasting/random blood glucose measurements were carried out. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Results: The mean age of respondents was 41.8 ± 16.3 years. There were 104 males and 93 females. Most of the respondents were traders constituting 51.8% of the study population. The 10-year risk categorization of respondents showed that 57.9% had low risk, 17.8% with slightly elevated risk, 12.2% had moderate risk, 10.7% with high risk, and 1.5% with a very high risk of developing diabetes. The average risk score was 7.4 ± 5.4 with a range of 0.0–24.0. The mean weight, height, and body mass index were 69.6 ± 14.4 kg, 165.3 ± 8.6 cm, and 25.5 ± 5.2 kg/m2, respectively. The mean systolic and diastolic blood pressures were 126.9 ± 20.3 mmHg (range: 80–205) and 76.6 ± 12.9 mmHg (range of 50–130), respectively. Conclusion: Approximately, 25% of respondents have a moderate-to-very high risk which emphasizes the need for continuous screening of the population, especially in public gatherings.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47200620","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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