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

Background: Infertility is one of the major medical problems seen in the Gynaecology clinic. Herbal medicine (HM) has become one of the treatment options used to circumvent infertility problems. This study aims to explore the prevalence and predictors for HM use in the management of infertility in our region.

Methodology: The method used was a cross-sectional study of 117 women attending the infertility clinic at Central Hospital Agbor, Delta State, Nigeria. The interviewer administered a questionnaire comprised of socio-demographic characteristics, infertility-related aspects, and information on herbal medicine usage. The main outcome measure was the Prevalence of HM use for infertility treatment and the possible predictors. Analysis was done using SPSS version 22.

Results: The mean age of participants was 34.1 with a standard deviation of 6.66 years. The minimum age of participants was 23 years while the maximum age was 48 years. The prevalence of HM use was 79.9%. The factors that were significantly associated with the use of HM were marital status (p 0.033), history of primary infertility (0.026) and having used HM for the management of other ailments (0.000). Women who were married and having fertility issues were more likely to seek alternative methods like the use of HM.

Conclusion: The prevalence of use of HM among participants attending the fertility clinic was high at 79.9%. We recommend that health professionals should enquire about the use of HM as this may help in educating the patients about the health risks of using HM. There is a need to explore the potential benefits and risks of HM use.

Background: Nigeria has a relatively large scientific community that produces an adequate research output among African countries. Not many studies have analysed the research output in orthopaedics and sports medicine from Nigeria and Africa. Hence, we aimed to analyze the research output in orthopaedics and sports medicine from Nigeria and Africa.

Methodology: We used the SCOPUS data from the Scimago Journal & Country Rank website. It allows us to draw various journal metrics for research.

Results: Between 1996 and 2022, Nigerian research publications in orthopaedics and sports medicine had grown from 4 in 1996 to 39 in 2022 (a 10-fold growth) but overall is 62nd in the world representing 0.07% of publications in the period. In the same period, Africa published 8297 papers in orthopaedics and sports medicine representing only 1.24% of the global publications in this field.

Conclusion: There is low research output in Orthopaedics and Sports Medicine from Nigeria and, the whole African continent. However, there has been a growth in the publications from Africa.

Background: Most patients with epithelial ovarian cancers (EOC) present with advanced-stage disease because of non-specific symptoms and lack of reliable strategies for early diagnosis. Cancer antigen 125 (CA-125) is suggested as a useful prognostic biomarker, its serum level is raised in over 80.0% of patients with EOC. Primary debulking surgery (PDS) followed by chemotherapy is the conventional treatment, but neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) is offered to patients with unresectable disease. There are inconsistencies regarding the role of preoperative CA-125 serum levels to adopt in stratifying patients for treatment choice that offers the most benefit. This review aimed to determine the role of preoperative CA-125 levels in predicting optimal cytoreduction and the association between optimal cytoreduction and survival outcome in patients with EOC.

Methodology: Three electronic databases CINAHL, Cochrane library and PubMed were searched for potentially relevant articles from 2016 to 2021 on the role of preoperative CA-125 levels in predicting optimal cytoreduction and survival in patients with epithelial ovarian carcinomas.

Conclusion: In patients who underwent NACT-IDS, a lower preoperative CA-125 value is a predictor of optimal cytoreduction and an increase in preoperative CA-125 value is consistently associated with a decrease in optimal cytoreduction. There was insufficient data to assess overall survival. However, a raised preoperative CA-125 level is poor predictor of chance of achieving optimal cytoreduction and the rate of optimal cytoreduction was a weak predictor of overall survival in women who had primary debulking surgery.

Background: Health-related fitness directly depends on the level of physical activity of the individual. Inactivity contributes to around 3.3% of all deaths, making the lack of exercise and sedentary lifestyles among the young generation a current source of concern. There is a paucity of research on the association between PA and health-related physical fitness among young people. In the perspective of this, the objective of this research was to find out the effect of PA levels on physical fitness in healthy adults.

Methodology: A total of 419 students between the ages of 18 and 25 participated in this cross-sectional survey. The "Global Physical Activity Questionnaire (GPAQ)" was used to evaluate the PA. Their body fat percentage was measured using a skin fold caliper, followed by measurement of VO₂max using a gas analyzer and hand grip strength and endurance assessment with the help of a computerized dynamometer. For statistical analysis, Karl Pearson's correlation coefficients and the ANOVA test were utilized.

Results: PA was positively correlated with VO2 max (r=0.429), and handgrip strength (r=0.408) while negatively correlated with body fat % (r=-.315). VO2 max, body fat, and hand grip strength differ significantly amongst participants having different physical activity levels. (p-value =<0.05).

Conclusion: This research concludes that PA is associated with physical fitness. PA will lead to a definite improvement in overall physical fitness. With the help of the results of this study, young adults can be motivated for physical fitness.

Background: Patients' satisfaction with service delivered at the healthcare facility is a critical index of quality of care in the health industry. Hence, it is paramount to ascertain patients' satisfaction to improve service delivery.

Methodology: The study was a cross-sectional design conducted among 104 patients aged 18 to 65 years who were on follow-up for chronic diseases at the Family Medicine Clinics. Data was collected from the participants via interviewer administered questionnaire. Statistical significance was determined using paired samples t-test, Chi-square, and logistic regression was set at a p-value of ≤ 0.05.

Results: The study used104 patients with chronic diseases. The mean age of the study population (N = 104) was 51.83± 9.37years. The ages ranged from 21-69 years.65 (62.5%) were females; male to female ratio was 1:1.7. The majority of them had formal education 59 (56.7%). There were no statistically significant differences in the socio-demographic characteristics. Waiting time was found to be the most significant predictor of patient satisfaction in this study (P=0.003; O. R=3.17, CI=1.03-1.15). The overall satisfaction score with service delivery in the study area was 71.4%.

Conclusion: Patients recorded a high level of satisfaction with service delivery 71.4% for the care received at the study site, particularly during their experiences with the physicians, pharmacists, lab scientists, nurses, and record officers, and the neatness of the clinic's environment. The results indicate that good communication has a positive effect on patients' level of satisfaction. Henceforth, service providers should employ patient-centered communication to improve quality of care.

Background: Healthcare workers globally are at an increased risk of workplace violence. Adverse effects such as physical injury, reduced quality of care to patients and lower productivity with associated costs to employers occur. Non-reporting hinders the implementation of effective prevention. This study aimed to assess the prevalence, reasons for non-reporting of workplace violence, and knowledge of prevention prior to designing intervention strategies in the study location where there is a paucity of research on this issue.

Methodology: This cross-sectional study was conducted at a Teaching Hospital in Abakaliki, Ebonyi State, for 4 weeks in 2020 among 205 employees. The hospital was stratified into Clinical, Nursing Services, Pharmacy, Laboratory, and administrative divisions; proportionate allocation and random sampling were used to select the allocated samples. A structured questionnaire was used to collect data. Descriptive statistics determined the measures of central tendencies and dispersion, while bivariate analysis of the variables was done using Pearson's Chi-Square test. Statistical significance was set at p ≤ 0.05 with a confidence level of 95%.

Results: The mean age of the participants was 39.1 ± 7.8 years. The prevalence of workplace violence was 70%. The most common reason for non-reporting was complexities and time-consuming reporting procedures (26.5%) followed by fear of reprisal on career (22.4%). The proportion of respondents with good knowledge of workplace violence prevention strategies was high (69.8%). Gender (p = 0.03), work setting (p = 0.006), previous workplace violence training (p = 0.005) and knowledge of workplace violence preventive strategies (p = 0.04) had statistically significant associations with experience of workplace violence.

Conclusion: The high prevalence of workplace violence suggests a need for a workplace violence prevention program which should include a simple process of reporting and training. The improved awareness from previous training may account for the significant association with workplace violence.

Background: Flexible naso-pharyngo-laryngoscopy (NPL) has become an essential clinic tool for evaluating patients with upper airway disorders in otorhinolaryngology. It has been established to be a simple, cost-effective, and minimally invasive technique with good diagnostic yields. This study aimed to audit the procedure of flexible NPL done in our clinic over 2 years and analyse the technique, indications, and findings of the procedure.

Methodology: A retrospective cross-sectional study among all the patients who presented to our ENT clinic in ABUTH Zaria, from July 2021 to June 2023 with upper airway symptoms or neck swelling who had flexible NPL done in the clinic. The records of these patients were reviewed, and information extracted including age, sex, use of anaesthesia, indications and findings of the procedure were entered in SPSS and analysed.

Results: Flexible NPL was done in 266 patients aged 4 months to 85 years. Only 3% of the patients required local anaesthesia. The commonest indications were for preoperative evaluation of goitre (26.7%), suspected adenoid hypertrophy (18.4%), complaints of hoarseness (18.8%), and foreign body sensation (12%). The commonest diagnoses made were adenoid hypertrophy (19.9%), laryngeal tumour (5.3%), nasopharyngeal tumour (4.9%), vocal cord palsy (4.9%), rhinitis (4.5%) and pharyngitis (4.1%), laryngitis (3.0%), laryngopharyngeal reflux disease (3.0%) and vocal cord nodule (2.3%).

Conclusions: Office flexible NPL was done commonly for preoperative evaluation of goitre, suspected adenoid hypertrophy, hoarseness, and foreign body sensation. The commonest pathologies were adenoid hypertrophy, laryngeal tumour, nasopharyngeal tumour, vocal cord palsy, rhinitis, pharyngitis, and laryngitis.

Background: Cataract surgery has evolved over the years. This study aims to highlight the profile of the patients that underwent cataract surgery at a tertiary hospital with emphasis on patient demographics, surgical techniques performed, intraocular lens powers implanted, and the complications managed.

Methodology: A retrospective cross-sectional descriptive study of all patients who had undergone cataract surgery within two years at the National Eye Centre, Kaduna, Nigeria. Data extracted from the electronic version of the manual cataract surgical records included the patient's age, sex, comorbidities, technique of cataract surgery performed, the intraocular lens powers implanted, and complications encountered. Intraoperative and postoperative complications up to the twelfth week were considered. All patients had biometry-guided intraocular lens implantation.

Results: One thousand four hundred and seventy- two (1,472) patient records of all ages met the inclusion criteria with a male-female ratio of 1.4:1. The mean age was 51.4 ± 22.6 years. The difference in the mean age of the sexes was statistically significant (p=0.01) and 95% CI was 7.37- 10.40 years. Glaucoma was the commonest ocular comorbidity 142(9.65%) and only 5% (74) had systemic comorbidities. The mean intraocular lens (IOL) power was 19.25 ± 1.8Diopters (Range 10.5D to 26D). The commonest surgery performed was small incision cataract extraction with posterior chamber intraocular lens implant (SICS + PCIOL) 91.2% followed by Trabeculectomy with SICS + PCIOL (3.87%). Phacoemulsification accounted for 2.72% of surgeries. Intra-operative complications were posterior capsular rent in 7.1% (104) and vitreous loss in 4% (58). The commonest post-operative complications were corneal edema6.9% (103) and striae keratopathy 4.6% (68).

Conclusion: Most cataract patients were male, above 50years of age and likely to be older than the females at surgery. The most performed surgical technique was small incision cataract surgery with posterior chamber intraocular lens implantation (SICS + PCIOL) while the mean intra-ocular lens power was 19.25 ± 1.8Dioptres. Globally accepted cataract surgical techniques utilizing recent technological advancements were employed with biometry-guided intraocular lens power calculation and implantation. Complications fell within the accepted global rates.

Background: The risk of stroke in individuals with Sickle Cell Anaemia (SCA) can be assessed by routine non-invasive measurement of their cerebral blood flow using a Transcranial Doppler (TCD) ultrasound scan. This study aimed to determine the difference in blood flow velocity parameters in the middle cerebral artery (MCA) of children with sickle cell anaemia compared to a normal age-matched population.

Methodology: This was a hospital-based comparative cross-sectional study among 40 SCA patients aged 3-16 years, in steady state and 40 age and sex-matched HbAA healthy subjects. This study lasted from June to October 2019. Medical history was retrieved using a structured questionnaire. The time-averaged mean of maximum velocity (TAMMV) of the right and left MCA was measured using non-imaging TCD.

Results: The mean age ± SD of the SCA patients was 9.1 ± 4.4 years. The SCA patients and sex and age-matched HbAA group consisted of 23 (57.5%) males and 17 (42.5%) females respectively. SCA patients had a significantly lower mean ± SD haemoglobin (Hb) than the controls (7.1 ± 1.1g/dl vs 11.1 ± 1.4g/dl; p<0.001). The right MCA of the patients with SCA had a significantly higher mean flow velocity compared to the controls (94.1 ± 23.1 vs 55.0 ± 8.8cm/sec, p<0.001).

Conclusion: The mean TAMMV recorded in the SCA subjects were significantly higher than that of the non-SCA subjects. There is a need to ensure that TCD ultrasound is employed as a routine screening tool for stroke risk among SCA patients in Nigerian tertiary health institutions.

Background: Snake bite is a neglected public health issue in many tropical and subtropical countries of the world. About 5.4 million snakebites occur each year, resulting in 1.8 to 2.7 million cases of envenomation yearly. Hepatic markers have been reported to rise 3-6 hours after injection of venom in experimental animals. This study aims to biochemically assess ALT, AST and GGT levels as biomarkers of Echis ocellatus envenomation in victims of snake bite presenting at JUTH Comprehensive Health Centre Zamko 6hours post-bite and compare with values in those bitten by non-venomous snakes.

Methodology: The study was a comparative cross-sectional study where serum levels of AST, ALT and GGT were compared between the study group and the control group.

Results: Of the 150 respondents, 75 from each study group, 90(60.0%) were Male while 60(40.0%) were Female, with a Male to Female ratio of 1.5:1. The most predominant age group was 20-29 years 57(38.0%), the mean age was 39 years. The most predominant occupation was farming 82(54.7%). The majority 82(54.7%) had a secondary level of education. 91(60.7%) were married. A large majority of 123(82.0) had Christianity as their religion. We found a significant increase in the levels of AST (47.45IU/L) and GGT (61.62 IU/L) in the study group compared to AST (25.88IU/L), GGT (29.61IU/L) in the control group at p<0.05, while the level of ALT was similar in both groups at p>0.05.

Conclusion: This implies that serum levels of AST and GGT can be used to diagnose envenomation in snakebite patients.