Nigerian medical journal : journal of the Nigeria Medical Association最新文献

Background: Obesity and vascular ageing are two facets of type 2 diabetes (T2Ds) to study. The former can be studied by qualitative body fat analysis using bio-electrical impedance (BIA) and later with blood pressure by pulse wave analysis (PWA). We studied the association between BIA and PWA parameters in T2Ds.

Methodology: One hundred and fifty-six T2Ds on treatment were evaluated for BIA (Omron Karada Scan, China) and PWA (IEM, Stolberg, Germany). BIA parameters (weight, BMI, total body fat, visceral fat, subcutaneous fat, skeletal muscle mass) and PWA parameters (arterial stiffness, brachial haemodynamics, aortic blood pressures, central haemodynamics) were studied. Comparison, correlation, risk association, and predictions were done with a p-value < 0.05 as statistically significant.

Results: The mean age was 57.7 years, while the mean BMI was 22.8 kg/m2. The prevalence of hypertension was 50%, while the prevalence of glycaemic control was 10%. The correlation between BIA and PWA parameters in >75% instants was weak and insignificant (especially for aortic parameters and central haemodynamics). Female gender, BMI < 22.5 kg/m2, VF< 10, and low/normal TBF were associated with comparatively high PWA parameters, but inconsistently. High BMI or VF did not impose a significant Odds risk of high aortic pulse wave velocity or central pulse pressure. Visceral fat and aortic pulse wave velocities were not significantly predicted by blood pressure, BMI, and heart rate.

Conclusion: Among rural type 2 diabetics with a mean BMI of 22.8 kg/m2 and poor glycaemic control, there is largely a lack of association between obesity and vascular aging, suggesting differences in time course and pathology of the two entities in type 2 diabetics. Further studies are recommended.

Background: The prevalence and usefulness of MetS in determining CVD risk in at-risk populations are influenced by its definition. In a cohort of HIV-positive Nigerians, we evaluated MetS based on various defining criteria, their agreement with one another, and their association to a CVD endpoint, Carotid-Intimal-Media-Thickness (CIMT).

Methodology: In this cross-sectional study, 145 HIV-positive individuals who were enrolled in HIV clinics at the Faith Alive Foundation and Jos University Teaching Hospital in Jos, Nigeria, were randomly chosen. Biophysical and anthropometric measurements including blood pressure, height, weight, waist circumference, and hip-circumference, as well as clinical records, CIMT, fasting plasma glucose, and lipid profile, were assessed.

Result: The median (Interquartile range) age of the participants was 41 (35-88) years, and the majority (71.7%) were females. The prevalence of metabolic syndrome (MetS) by the Adult Treatment Panel-III (ATP), International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria were 30.3%, 32.4%, and 35.2% respectively. MetS by all criteria was more prevalent among females and participants ≥ 40 years, p<0.05. Low HDLc (93.6-95.5%), Central obesity (86.3-95.5%), and hypertension (80.9-86.4%) were the most frequent components of MetS. HIV-related parameters were not associated with MetS. The overall agreement among MetS criteria was almost perfect between IDF and JIS criteria (k=0.94); and strong between IDF vs., ATP (k=0.82) and ATP vs. JIS (k=0.89). There was no significant difference in the median CIMT in PLHIV with and without MetS across all defining criteria.

Conclusion: The prevalence of MetS in PLHIV is relatively high, particularly among females and older individuals. The correlations between the defining criteria were fairly strong and consistent across subpopulations of PLHIV. MetS based on these criteria, however, do not significantly correlate with rising CIMT.

Background: The burden of food-borne diseases is becoming a global problem. The aim of this study was to assess and compare personal hygiene knowledge among street food vendors and canteen food handlers in the Kano metropolis.

Methodology: An explanatory sequential mixed methods study was carried out using a structured interviewer-administered questionnaire, focus group discussion guide and observation checklist, to assess and compare personal hygiene knowledge among street food vendors and canteen food handlers in Kano metropolis, Nigeria. Quantitative data was analyzed at univariate, bivariate and multivariate levels using SPSS version 20.0 at a 5% α level of significance. Thematic analysis was used to analyze verbatim transcripts from qualitative interviews.

Results: The response rates were 305/310 (98.4%) and 288/310 (92.9%) among street food vendors and canteen food handlers, respectively. The proportions of street food vendors and canteen food handlers with poor, fair and good knowledge of personal hygiene were (29.5% versus 19.8%), (51.8% versus 54.2%) and (18.7% versus 26.0%), respectively (p=0.009). There was a statistically significant association between education and knowledge of personal hygiene among street food vendors (p=0.03) and canteen food handlers (p=0.04). Though slightly better among canteen food handlers, narratives by the two groups of food handlers pointed to the general lack of awareness of basic personal hygiene which was supported by the findings from observation.

Conclusion: Personal hygiene knowledge was poor among the two groups of food handlers; therefore, the Government should ensure legislation and enforcement involving training of food vendors, periodic medical examination, and issuance of fitness certificate to all food vendors.

Background: Low back pain (LBP) is the 5th leading cause of physician consultation and is a significant cause of lost workforce hours with tremendous economic implications in every society. These findings suggest that medical practice in Nigeria is a potential risk factor for developing low back pain. Few studies have attempted to evaluate the medical specialties as risk factors for LBP. This study evaluates the prevalence of low back pain among various Specialist Medical Consultants in a typical Teaching Hospital.

Methodology: This is a descriptive cross-sectional study performed using self-administered questionnaires. The study population comprised Specialist Medical Consultants working at the University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State. The questionnaires were distributed among consultant physicians regardless of their departments. Information about their age, sex, medical specialties, presence frequency and severity of LBP; interventions received, and outcome were obtained.

Result: There were 98 respondents, 56 (57%) males and 42 (43%) females who participated in the study. The modal age of the respondents is the 41-50 years age group (45%). 44%, were from the surgical specialties (surgery, anaesthesia, oral and maxillofacial surgery, ophthalmology); 33% from the internal and family medicine specialties; (11) 11% pediatricians and (12) 12.2 % were pathologists. The prevalence of low back pain was 60.2%, slightly more prevalent in males (62%) than females (58%). Of those who have experienced low back pain, 35.6% suffered mild pain (VAS 1-4), 49% suffered moderate pain (VAS 5-7) while 17% suffered severe pain (VAS 8-10). The majority (57.6%) had suffered more than 3 episodes of LBP while 84.8% sought treatment for their symptom mostly using NSAIDS.

Conclusion: LBP has a high prevalence among Specialist Medical Consultants in UPTH potentially affecting patient treatment and student education. Most consultants take NSAIDS as treatment for low back pain.

This is a report of a 29-year-old female with a history of Schizophrenia and Cannabis Use Disorder who presented with auditory hallucinations that asked her to kill her immediate supervisor. She presented the ethical dilemma many healthcare providers face in balancing the principles of patient confidentiality with the duty to protect and beneficence. The clinicians breached the patient's right to confidentiality to protect her supervisor by informing the supervisor, their manager, and the police. However, they also ensured her job security, which she risked in an environment where mental illness is highly stigmatized. This case highlights the importance of considering the ethical principles of disclosing confidential information, such as the Tarasoff I and II, and beneficence (as her job was protected) in making clinical decisions. It also summarizes the legal precedents established by the Tarasoff cases and the implications for clinical practice.

Climate change has become a global issue and affects various regions at different levels. The hydro-climatic conditions and the natural fragility of Sub-Saharan Africa (SSA) make it prone to floods. The review was intended to comprehensively explore the determinants of floods in the continent and their effects on public health. An extensive systematic literature search in English was conducted for peer-reviewed papers, abstracts and internet articles, grey literature, and official Government documents and analysed to identify common themes, findings, and outcomes. Finally, the findings were categorized into common themes. The review revealed that the frequency and intensity of precipitations have increased in recent decades in SSA. This is worsened by anthropogenic activities including urban sprawl, population growth, and land use changes. The health effects of floods are diverse, varied, and specific to a particular context which can be immediate and long-term. The economic losses due to the flood events in the continent are huge. In conclusion, Governments across the continent need to give flood management a top priority as part of national disaster preparedness, response, and mitigation. Floods cannot be managed in isolation; it has to be incorporated into national urban planning with urbanization to make cities resilient and sustainable.

Background: Domestic violence (DV) occurs in all settings, transcending socio-cultural and demographic profiles. It is pervasive, insidious, carried out in private domain, and usually inflicted by family members. It continues over long period and limits avenues of escape for victims. The aim of this study was to assess the perception and experience of DV among rural women in Sabon Gari LGA of Kaduna State, Nigeria.

Methodology: A cross-sectional descriptive study conducted in Tohu community, Sabon Gari LGA, Kaduna State. Sample size of 365 was determined using Fisher's formula, at p-value, reliability coefficient, confidence interval, degree of freedom, and possible attrition rate of 0.5, 1.96, 95%, 0.05, and 16% respectively. The study population comprised all women of reproductive age group in Tohu. Eligible respondents who had been in the community for at least one year were included in the study, while those who were ill were excluded. A semi-structured, interviewer-administered questionnaire was administered by female research assistants, and data collected was analyzed using SPSS version 21.0. Frequencies and percentages were reported for categorical data. Respondents' perception of DV was assessed using 19 questions across 5domains. Composite score of 0-19 was expected for each respondent. Scores of >10, and <10 were considered to be good, and poor perception of DV respectively. Relationships between variables were determined using appropriate test statistics at p-value <0.05.

Results: Fifty-three percent of respondents have good perception of DV, with age, marital status, and occupation affecting respondents' perception. Seventeen percent of respondents had experienced physical and/or verbal abuse. Marital status and level of education were found to affect respondents' experience of DV.

Conclusion: DV is still rife in rural parts of Nigeria. Civil rights groups should intensify efforts toward awareness creation so that victims can report to the appropriate authorities and the perpetrators prosecuted.

Background: Tooth wear lesion, otherwise known as tooth surface loss, is an insidious cumulative and multifactorial condition causing irreversible destruction of tooth enamel and dentine. Over time this lesion can threaten the affected individual's Oral Health-Related Quality of Life (OHRQoL). OHRQoL entails interaction among oral health systems: social factors, psychological factors, and the rest of the body. Though, previous studies done decades ago also reported a high prevalence of tooth wear among the elderly in Nigeria, before now there has been no study on the impact of tooth wear types and severity on the OHRQoL of the elderly in this environment, which is necessary for their comprehensive management. The study was done to assess the impacts of tooth wear lesions on the Oral Health-Related Quality of Life of the elderly in Ibadan.

Methodology: It was a cross-sectional study, involving 1,200 elderly individuals. Using a multistage random sampling technique, participants were randomly selected from 2 Local Government Areas in Ibadan. Data were obtained using a structured interviewer-administered questionnaire and oral examination using the Simplified Tooth Wear Index, as well as Geriatric Oral Health Assessment Index. Data were analysed using descriptive statistics at p ≤ 0.05.

Result: Out of these elderly participants with Tooth wear lesions, 667 (55.6%) had good Oral Health-Related Quality of Life and 552 (43.5%) had poor Oral Health-Related Quality of Life. Attrition and Abfraction were the most common 1,189(99.1%) and least 5(0.4%) types of tooth wear lesions respectively. The lesions were more severe on the posterior teeth than the anterior teeth and more on the lower than the upper teeth.

Conclusion: The majority of the elderly with Tooth wear lesions had good OHRQoL, as more of them had mild to moderate grade of tooth wear.

Background: Tuberculosis is a major public health problem worldwide, and in Morocco, it is the leading cause of hospitalization in the Pneumology department. Hospitalized patients are often accompanied by family members who primarily act as caregivers. This study aimed to describe the knowledge related to the disease among the companions of tuberculosis patients hospitalized in the pneumology department of Hassan II Hospital in Agadir, Morocco.

Methodology: We conducted a cross-sectional observational study with the objective of evaluating the knowledge of the companions of tuberculosis patients.

Results: One hundred companions participated in this study, with an average age of 33.8 +/- 10.1. The male-to-female sex ratio was 1.5. More than half of our participants had a low socio-economic level, and over a third were illiterate. Knowledge was assessed through questions related to the disease. Results showed that 82.0% of participants declared that they were aware of the disease called "tuberculosis," and 46.0% knew about its infectious origin. Almost all of them were aware of the contagious nature of the disease and its airborne transmission. Schooling was found to be associated with knowledge of the disease, its infectious nature, contagiousness, and free treatment. The associations were statistically significant with p-values of <0.001, 0.004, <0.001, and 0.002, respectively.

Conclusion: The low level of schooling appears to be a hindrance to TB education. This observation could explain the very poor level of knowledge found in our study, despite the efforts made by various programs.

Background: The testes are the male reproductive glands and the homolog of the ovary in females performing critical functions. Pathologic conditions could arise from the testes and blunt or completely obliterate these functions leading to clinically overt or covert sequelae. The aim of this research is to study the pattern of histologically diagnosed testicular disease in relation to clinical features at the Jos University Teaching Hospital between January 2012 and December 31st, 2021.

Methodology: This study is a retrospective analysis of all cases of testicular biopsies. All histologically diagnosed testicular lesions were identified from the departmental records and clinical data obtained further from the patients' folder at the Medical Records Department.

Results: Four hundred and thirty (430) biopsies were seen, of which 304 (70.7%) were orchidectomy specimens. The commonest histological diagnosis was testicular atrophy accounting for 328(76.3%) cases. Testicular torsion is followed by 42(9.8%) cases. Together, inflammatory conditions accounted for 36(8.4%) cases out of which granulomatous inflammation made up 52.3% of cases. There were 16(3.7%) neoplastic conditions all of which were malignant, out of which 6(37.5%) were seminomas. The age range, mean, median and modal age was 1-90 years, 53.4 +21.3years, 60 years and 70 years respectively. Prostatic carcinoma therapy in the form of bilateral orchidectomy was the major indication for surgery.

Conclusion: The majority of testicular lesions in our locality are atrophies and most of these lesions are obtained as orchidectomies for therapy of prostatic cancer.