Pub Date : 2024-04-21eCollection Date: 2024-01-01DOI: 10.60787/nmj-v65i1-450
Michel Bokolo, Adil Mansouri, Sarah Michaud
Background: To deal with COVID-19, vaccination is a strategy adopted by many countries including the Democratic Republic of the Congo (DRC). The first phase of vaccination was conducted in 2021 as part of the country's Expanded Program on Immunization (EPI). To evaluate it, an intra-action review was conducted. It identified a low proportion of vaccinated vulnerable populations, namely health professionals (1.8%), chronically ill (0.09%), and older adults aged ≥ 55 (0.4%). The objective was to explore perceptions and barriers to acceptance of the COVID-19 vaccine in the DRC among the vulnerable populations targeted by the EPI.
Methodology: A qualitative study was conducted between September 2021 and June 2022 in Kinshasa, DRC. Semi-structured focus groups were conducted with each group separately using a single interview guide. It included five categories: socio-demographic information, COVID-19 vaccine status, perceptions towards the COVID-19 vaccination, vaccine hesitancy and perceptions towards the COVID-19 vaccination campaign.
Results: Three focus groups were conducted. In total, we had 16 participants with eight health professionals, four chronically ill participants, and four older adults. The majority were married (68.7%) and came from urban areas (68.7%). The sex ratio was at 1 and more than one-third had an education level equivalent to a master's degree (37.5%). Half were vaccinated against the COVID-19 (50.0%). The main perceptions and hesitancy factors were the lack of trust and knowledge of the vaccine's properties, benefits, and risks. Adjustment of the information messages which, according to participants, were not clear and poorly adapted to the needs of each group is the main element to improve the vaccination campaign.
Conclusion: This study represents an important step to improve the COVID-19 vaccination campaign in the DRC. It showed the different barriers to the COVID-19 vaccines acceptance among vulnerable populations.
{"title":"Perceptions and hesitancy towards the COVID-19 vaccination campaign among three vulnerable populations in the Democratic Republic of the Congo: A qualitative study.","authors":"Michel Bokolo, Adil Mansouri, Sarah Michaud","doi":"10.60787/nmj-v65i1-450","DOIUrl":"10.60787/nmj-v65i1-450","url":null,"abstract":"<p><strong>Background: </strong>To deal with COVID-19, vaccination is a strategy adopted by many countries including the Democratic Republic of the Congo (DRC). The first phase of vaccination was conducted in 2021 as part of the country's Expanded Program on Immunization (EPI). To evaluate it, an intra-action review was conducted. It identified a low proportion of vaccinated vulnerable populations, namely health professionals (1.8%), chronically ill (0.09%), and older adults aged ≥ 55 (0.4%). The objective was to explore perceptions and barriers to acceptance of the COVID-19 vaccine in the DRC among the vulnerable populations targeted by the EPI.</p><p><strong>Methodology: </strong>A qualitative study was conducted between September 2021 and June 2022 in Kinshasa, DRC. Semi-structured focus groups were conducted with each group separately using a single interview guide. It included five categories: socio-demographic information, COVID-19 vaccine status, perceptions towards the COVID-19 vaccination, vaccine hesitancy and perceptions towards the COVID-19 vaccination campaign.</p><p><strong>Results: </strong>Three focus groups were conducted. In total, we had 16 participants with eight health professionals, four chronically ill participants, and four older adults. The majority were married (68.7%) and came from urban areas (68.7%). The sex ratio was at 1 and more than one-third had an education level equivalent to a master's degree (37.5%). Half were vaccinated against the COVID-19 (50.0%). The main perceptions and hesitancy factors were the lack of trust and knowledge of the vaccine's properties, benefits, and risks. Adjustment of the information messages which, according to participants, were not clear and poorly adapted to the needs of each group is the main element to improve the vaccination campaign.</p><p><strong>Conclusion: </strong>This study represents an important step to improve the COVID-19 vaccination campaign in the DRC. It showed the different barriers to the COVID-19 vaccines acceptance among vulnerable populations.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21eCollection Date: 2024-01-01DOI: 10.60787/nmj-v65i1-448
Ayodeji Oluwaseun Ogungbemi, Babatunde Adeola Afolabi, Joshua Falade, Akindele Amos Ajayi, Adeola Olajumoke Ajayi, Adejare Adedire, Ibukunoluwa Victoria Falope, Olanrewaju Olayemi, Adebimpe Ajibola Afolabi, Oyinkansola Arin Ogungbemi, Seun Stephen Anjorin
Background: Depression affects individuals across all age groups, genders, and socio-economic backgrounds. Socio-demographic correlates of depression may include factors such as age, gender, education level, income, and marital status. These factors, including the presence of chronic diseases, have been shown to impact the prevalence and severity of depression. This study assessed the prevalence of depressive symptoms and its association with socio-demographic correlates and co-morbid chronic medical conditions among adult patients attending a National Health Insurance Clinic of a tertiary health facility in Southwest Nigeria.
Methodology: A hospital-based descriptive cross-sectional study was conducted between April - May 2023 in which 250 consenting adult patients were recruited using a systematic random sampling technique. Respondents' information on socio-demographic profiles and awareness of co-morbid medical conditions were assessed using semi-structured interviewer-administered questionnaires. Depressive symptoms were determined using the Patient Health Questionnaire. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using chi-square and the p-value was set as <0.05.
Results: The mean age of respondents was 38.96±13.096 years (range: 18-80 years). There were 159 (63.6%) females. The prevalence of depressive symptoms was 44.8%. There was a statistically significant association between age, gender, marital status, monthly income, presence of chronic diseases, and depressive symptoms.
Conclusion: The prevalence of depressive symptoms among adult patients attending the National health insurance clinic was 44.8%. These findings call for health policies to integrate and strengthen mental health in NHIA primary care.
{"title":"Assessment of Depressive Symptoms and Sociodemographic Correlates of Adult Patients Attending a National Health Insurance Clinic at a Tertiary Hospital, Southwest Nigeria.","authors":"Ayodeji Oluwaseun Ogungbemi, Babatunde Adeola Afolabi, Joshua Falade, Akindele Amos Ajayi, Adeola Olajumoke Ajayi, Adejare Adedire, Ibukunoluwa Victoria Falope, Olanrewaju Olayemi, Adebimpe Ajibola Afolabi, Oyinkansola Arin Ogungbemi, Seun Stephen Anjorin","doi":"10.60787/nmj-v65i1-448","DOIUrl":"10.60787/nmj-v65i1-448","url":null,"abstract":"<p><strong>Background: </strong>Depression affects individuals across all age groups, genders, and socio-economic backgrounds. Socio-demographic correlates of depression may include factors such as age, gender, education level, income, and marital status. These factors, including the presence of chronic diseases, have been shown to impact the prevalence and severity of depression. This study assessed the prevalence of depressive symptoms and its association with socio-demographic correlates and co-morbid chronic medical conditions among adult patients attending a National Health Insurance Clinic of a tertiary health facility in Southwest Nigeria.</p><p><strong>Methodology: </strong>A hospital-based descriptive cross-sectional study was conducted between April - May 2023 in which 250 consenting adult patients were recruited using a systematic random sampling technique. Respondents' information on socio-demographic profiles and awareness of co-morbid medical conditions were assessed using semi-structured interviewer-administered questionnaires. Depressive symptoms were determined using the Patient Health Questionnaire. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using chi-square and the p-value was set as <0.05.</p><p><strong>Results: </strong>The mean age of respondents was 38.96±13.096 years (range: 18-80 years). There were 159 (63.6%) females. The prevalence of depressive symptoms was 44.8%. There was a statistically significant association between age, gender, marital status, monthly income, presence of chronic diseases, and depressive symptoms.</p><p><strong>Conclusion: </strong>The prevalence of depressive symptoms among adult patients attending the National health insurance clinic was 44.8%. These findings call for health policies to integrate and strengthen mental health in NHIA primary care.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The presence of other respiratory pathogens in patients with SARS-CoV-2 infection has been described as a striking feature. However, data on adenovirus co-infection rates and clinical impacts in COVID-19 patients is limited. The purpose of this study is to compare the prevalence of respiratory adenoviruses in children under 15 years of age in Positive and Negative SARS-CoV-2 patients.
Methodology: From September 2020 to January 2021, nasopharyngeal swabs were obtained from 280 patients below 15 years old with influenza-like infection symptoms suspected to be COVID-19 and referred to hospitals in Hamadan province. Nucleic acid was extracted using a High Pure Viral Nucleic acid extraction kit for both viral RNA and DNA. Reverse transcription real-time PCR for detecting SARS-CoV-2 and Real-time PCR for Human Adenoviruses were used.
Results: Out of 280 examined samples, 11.7% tested positive for AdV, of which 18 samples originated from the SARS-CoV-2 positive group and 15 samples were from the SARS-CoV-2 negative group. Of 18 co-infected samples, which were categorized in three different ranges of age including, 0-5, 6-10, and 11-15 years old were 11, 4, and 3 patients respectively. Also, 14 patients were hospitalized. Compared with AdV-positive patients, children with Co-infection with SARS CoV-2 had lower levels of white blood cell (WBC) count while erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) had increased levels.
Conclusion: We report a substantial burden of AdV co-infection in pediatric COVID-19 patients. This study revealed most AdV infections lead to hospitalization and change in paraclinical parameters.
{"title":"High frequency of co-infection between SARS-CoV-2 and respiratory Adenoviruses in the Pediatric population in Hamadan, Iran.","authors":"Nazaridoost Ali, Ansari Nastaran, Teimoori Ali, Azizi Jalilian Farid","doi":"10.60787/nmj-v65i1-449","DOIUrl":"10.60787/nmj-v65i1-449","url":null,"abstract":"<p><strong>Introduction: </strong>The presence of other respiratory pathogens in patients with SARS-CoV-2 infection has been described as a striking feature. However, data on adenovirus co-infection rates and clinical impacts in COVID-19 patients is limited. The purpose of this study is to compare the prevalence of respiratory adenoviruses in children under 15 years of age in Positive and Negative SARS-CoV-2 patients.</p><p><strong>Methodology: </strong>From September 2020 to January 2021, nasopharyngeal swabs were obtained from 280 patients below 15 years old with influenza-like infection symptoms suspected to be COVID-19 and referred to hospitals in Hamadan province. Nucleic acid was extracted using a High Pure Viral Nucleic acid extraction kit for both viral RNA and DNA. Reverse transcription real-time PCR for detecting SARS-CoV-2 and Real-time PCR for Human Adenoviruses were used.</p><p><strong>Results: </strong>Out of 280 examined samples, 11.7% tested positive for AdV, of which 18 samples originated from the SARS-CoV-2 positive group and 15 samples were from the SARS-CoV-2 negative group. Of 18 co-infected samples, which were categorized in three different ranges of age including, 0-5, 6-10, and 11-15 years old were 11, 4, and 3 patients respectively. Also, 14 patients were hospitalized. Compared with AdV-positive patients, children with Co-infection with SARS CoV-2 had lower levels of white blood cell (WBC) count while erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) had increased levels.</p><p><strong>Conclusion: </strong>We report a substantial burden of AdV co-infection in pediatric COVID-19 patients. This study revealed most AdV infections lead to hospitalization and change in <i>paraclinical</i> parameters.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21eCollection Date: 2024-01-01DOI: 10.60787/nmj-v65i1-452
Marwa M Suliman, Amira E Raslan, Saeda A Salih, Salah M Soliman, Salwa S Abdullah, Entesar H Elnoor, Mohamed B Ibrahim, Ahmed M Elnaggar, Marwan M Badawi
Background: Acute appendicitis is currently considered one of the most common acute surgical diseases of the abdomen and requires emergency surgery. It is also one of the most common abdominal emergencies in both developed and developing countries. The current study is aimed at assessing the specificity and sensitivity of Ultrasound and Computed Tomography in the diagnosis of appendicitis as well as the prevalence of its complications. The association of appendicitis with several laboratory findings will also be evaluated.
Methodology: A retrospective study was conducted at Dallah-Namar Hospital, Riyadh City, Saudi Arabia.
Results: 720 patients were differentially diagnosed with appendicitis in the study area. Of these, 618 patients had US abdomen/pelvis, with 15 (2.4%) showing positive findings. Amongst the 203 patients noted to have undergone abdominal CT,8 (4.0%) was found to have positive findings.
Conclusion: The sensitivity of the US was determined to be relatively low. Also, serum creatinine was found to be elevated among all patients diagnosed with appendicitis. Further research with a larger sample size is needed to be conducted to further support the current findings.
背景:急性阑尾炎目前被认为是腹部最常见的急性外科疾病之一,需要进行急诊手术。它也是发达国家和发展中国家最常见的急腹症之一。本研究旨在评估超声波和计算机断层扫描诊断阑尾炎的特异性和敏感性,以及阑尾炎并发症的发生率。此外,还将评估阑尾炎与几种实验室检查结果之间的关联:沙特阿拉伯利雅得市达拉-纳马尔医院进行了一项回顾性研究:结果:在研究区域内,720 名患者被确诊为阑尾炎。其中,618 名患者接受了腹部/骨盆 US 检查,15 名患者(2.4%)的检查结果呈阳性。在203名接受过腹部CT检查的患者中,有8人(4.0%)的检查结果呈阳性:结论:腹部 US 的灵敏度相对较低。此外,所有被诊断为阑尾炎的患者的血清肌酐均升高。要进一步证实目前的研究结果,还需要进行样本量更大的进一步研究。
{"title":"Acute Appendicitis Incidence, Diagnostic Markers, and Sequelae; Dallah Hospital-Based Study in Riyadh, Saudi Arabia.","authors":"Marwa M Suliman, Amira E Raslan, Saeda A Salih, Salah M Soliman, Salwa S Abdullah, Entesar H Elnoor, Mohamed B Ibrahim, Ahmed M Elnaggar, Marwan M Badawi","doi":"10.60787/nmj-v65i1-452","DOIUrl":"10.60787/nmj-v65i1-452","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is currently considered one of the most common acute surgical diseases of the abdomen and requires emergency surgery. It is also one of the most common abdominal emergencies in both developed and developing countries. The current study is aimed at assessing the specificity and sensitivity of Ultrasound and Computed Tomography in the diagnosis of appendicitis as well as the prevalence of its complications. The association of appendicitis with several laboratory findings will also be evaluated.</p><p><strong>Methodology: </strong>A retrospective study was conducted at Dallah-Namar Hospital, Riyadh City, Saudi Arabia.</p><p><strong>Results: </strong>720 patients were differentially diagnosed with appendicitis in the study area. Of these, 618 patients had US abdomen/pelvis, with 15 (2.4%) showing positive findings. Amongst the 203 patients noted to have undergone abdominal CT,8 (4.0%) was found to have positive findings.</p><p><strong>Conclusion: </strong>The sensitivity of the US was determined to be relatively low. Also, serum creatinine was found to be elevated among all patients diagnosed with appendicitis. Further research with a larger sample size is needed to be conducted to further support the current findings.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21eCollection Date: 2024-01-01DOI: 10.60787/nmj-v65i1-463
Kevin Bassey, Frances SamOkpokowuruk, Ifunanya Ularinma Ebiekpi, Idorenyin Diana Etebong
Systemic Lupus erythematosus (SLE) is an autoimmune disorder characterized by the proliferation of autoantibodies and immune dysregulation resulting in damage to many body organs. Pediatric SLE usually presents with fever, joint pain, rashes, and lupus nephritis. It is uncommon to have large pericardial effusions in children with SLE and cardiac tamponade as the initial presentation of SLE is even rarer. An 11-year-old female presented to our Children Emergency Unit with fever and fast breathing for two weeks, bilateral leg swelling of four days, and cough of two days duration. She was acutely ill, tachypneic, and dyspneic with marked orthopnea, bilateral leg edema, and raised JVP. She was tachycardic with a diffuse apex beat. Chest X-ray showed a large globular heart. 2D-Echocardiography showed a large circumferential pericardial effusion with a dilated non-collapsing IVC and diastolic collapse of the right ventricle. She had a pericardiotomy done and 650mls of serous pericardial fluid was drained. The inner pericardium had a fibrinoid exudate with a "bread-and-butter" appearance. Pericardial fluid cytology showed no malignant cells while pericardial biopsy showed suppurative granulomatous inflammation. Antinuclear antibody (ANA) was strongly positive. The patient was managed with corticosteroids, colchicine, and hydroxychloroquine, and has remained stable on follow-up. While cardiac tamponade as an initial presenting complaint in SLE is rare, it is important that children presenting with large pericardial effusions and tamponade be evaluated for rheumatologic disorders. This can be crucial to revealing the correct diagnosis and instituting appropriate care.
系统性红斑狼疮(SLE)是一种自身免疫性疾病,其特点是自身抗体增殖和免疫调节失调,导致身体多个器官受损。小儿系统性红斑狼疮通常表现为发热、关节痛、皮疹和狼疮性肾炎。系统性红斑狼疮患儿出现大量心包积液的情况并不多见,而以心脏填塞作为系统性红斑狼疮的首发症状则更为罕见。一名 11 岁的女孩因发热和呼吸急促两周、双腿浮肿四天、咳嗽两天而到我院儿童急诊科就诊。她发病急、呼吸急促、呼吸困难,伴有明显的呼吸困难、双侧腿部水肿和JVP升高。她心动过速,伴有弥漫性心尖搏动。胸部 X 光片显示心脏呈球状。二维超声心动图显示心包周缘有大量积液,心内静脉扩张不塌陷,右心室舒张期塌陷。她接受了心包切开术,引流出650毫升浆液性心包积液。心包内部有纤维素渗出物,外观呈 "面包和黄油 "状。心包积液细胞学检查未发现恶性细胞,而心包活检显示有化脓性肉芽肿炎症。抗核抗体(ANA)呈强阳性。患者接受了皮质类固醇、秋水仙碱和羟氯喹治疗,随访期间病情保持稳定。虽然以心脏填塞作为系统性红斑狼疮的首发症状并不多见,但对出现大量心包积液和心脏填塞的患儿进行风湿性疾病评估非常重要。这对正确诊断和采取适当的治疗至关重要。
{"title":"Cardiac Tamponade as The Initial Presentation of Childhood Systemic Lupus Erythematosus: A Case Report.","authors":"Kevin Bassey, Frances SamOkpokowuruk, Ifunanya Ularinma Ebiekpi, Idorenyin Diana Etebong","doi":"10.60787/nmj-v65i1-463","DOIUrl":"10.60787/nmj-v65i1-463","url":null,"abstract":"<p><p>Systemic Lupus erythematosus (SLE) is an autoimmune disorder characterized by the proliferation of autoantibodies and immune dysregulation resulting in damage to many body organs. Pediatric SLE usually presents with fever, joint pain, rashes, and lupus nephritis. It is uncommon to have large pericardial effusions in children with SLE and cardiac tamponade as the initial presentation of SLE is even rarer. An 11-year-old female presented to our Children Emergency Unit with fever and fast breathing for two weeks, bilateral leg swelling of four days, and cough of two days duration. She was acutely ill, tachypneic, and dyspneic with marked orthopnea, bilateral leg edema, and raised JVP. She was tachycardic with a diffuse apex beat. Chest X-ray showed a large globular heart. 2D-Echocardiography showed a large circumferential pericardial effusion with a dilated non-collapsing IVC and diastolic collapse of the right ventricle. She had a pericardiotomy done and 650mls of serous pericardial fluid was drained. The inner pericardium had a fibrinoid exudate with a \"bread-and-butter\" appearance. Pericardial fluid cytology showed no malignant cells while pericardial biopsy showed suppurative granulomatous inflammation. Antinuclear antibody (ANA) was strongly positive. The patient was managed with corticosteroids, colchicine, and hydroxychloroquine, and has remained stable on follow-up. While cardiac tamponade as an initial presenting complaint in SLE is rare, it is important that children presenting with large pericardial effusions and tamponade be evaluated for rheumatologic disorders. This can be crucial to revealing the correct diagnosis and instituting appropriate care.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21eCollection Date: 2024-01-01DOI: 10.60787/nmj-v65i1-453
Nasir Oyelowo, Abdullahi Sudi, Mudi Awaisu, Musliu Adetola Tolani, Ahmad Tijani Lawal, Muhammed Ahmed, Ahmad Bello, Hussaini Yusuf Maitama
Background: Bladder spasms due to involuntary contraction of the bladder occur frequently following Transurethral resection of the prostate (TURP). They may be aggravated by the presence of a catheter, blood clots, preoperative overactive bladder, or preoperative ingestion of bladder stimulants like caffeine. These bladder spams are painful, associated with peri-catheter leakage of urine, increased post-operative bleeding, and often refractory to postoperative analgesia. The incidence and risk factors for the occurrence of bladder spasms following TURP need to be reviewed and validated to ensure adequate patient counseling and possible lifestyle modification before surgery. We conducted a prospective review of the determinants of bladder spasms in our patients following TURP.
Methodology: The study population was patients with benign prostatic obstruction scheduled for TURP between March 2022 and April 2023. Monopolar transurethral resection of the prostate was done using a continuous flow resectoscope. The primary endpoint of the study was occurrences of bladder spasms postoperatively before the trial without a catheter. Pain perception during the spasms was assessed using a visual analog scale. Clinical data were collected and analyzed to determine their association with the occurrence of bladder spasms postoperatively using regression analysis. Sub-group analysis was also done to correlate significant variables with the severity of pain in patients with spasms.
Results: The mean age of the 80 patients reviewed was 66.9 ±8 years. Bladder spasms were seen in 41(51.2%) of the patients. The presence of overactive bladder (OAB) symptoms and the use of bladder stimulants were statistically significant determinants with a p-value of 0.003 and 0.026 respectively. The age of the patient, preoperative indwelling catheter, prostate volume, and resection time were not statistically determinant variables in the occurrence of bladder spasms post-operatively. 61% had severe pains and 39% had mild pains. There was no significant correlation between the presence of OAB or the use of bladder stimulants with the severity of pains in patients with bladder spasms after TURP.
Conclusions: Half of the patients are likely to have bladder spasms after TURP. The risk of having these spasms is higher in patients with preoperative OAB or patients who are exposed to bladder stimulants. The severity of spasms is however independent of these risk factors.
{"title":"Incidence and Determinants of Catheter-Related Bladder Spasms Following Transurethral Resection of the Prostate; A Prospective Review of 80 Cases.","authors":"Nasir Oyelowo, Abdullahi Sudi, Mudi Awaisu, Musliu Adetola Tolani, Ahmad Tijani Lawal, Muhammed Ahmed, Ahmad Bello, Hussaini Yusuf Maitama","doi":"10.60787/nmj-v65i1-453","DOIUrl":"10.60787/nmj-v65i1-453","url":null,"abstract":"<p><strong>Background: </strong>Bladder spasms due to involuntary contraction of the bladder occur frequently following Transurethral resection of the prostate (TURP). They may be aggravated by the presence of a catheter, blood clots, preoperative overactive bladder, or preoperative ingestion of bladder stimulants like caffeine. These bladder spams are painful, associated with peri-catheter leakage of urine, increased post-operative bleeding, and often refractory to postoperative analgesia. The incidence and risk factors for the occurrence of bladder spasms following TURP need to be reviewed and validated to ensure adequate patient counseling and possible lifestyle modification before surgery. We conducted a prospective review of the determinants of bladder spasms in our patients following TURP.</p><p><strong>Methodology: </strong>The study population was patients with benign prostatic obstruction scheduled for TURP between March 2022 and April 2023. Monopolar transurethral resection of the prostate was done using a continuous flow resectoscope. The primary endpoint of the study was occurrences of bladder spasms postoperatively before the trial without a catheter. Pain perception during the spasms was assessed using a visual analog scale. Clinical data were collected and analyzed to determine their association with the occurrence of bladder spasms postoperatively using regression analysis. Sub-group analysis was also done to correlate significant variables with the severity of pain in patients with spasms.</p><p><strong>Results: </strong>The mean age of the 80 patients reviewed was 66.9 ±8 years. Bladder spasms were seen in 41(51.2%) of the patients. The presence of overactive bladder (OAB) symptoms and the use of bladder stimulants were statistically significant determinants with a p-value of 0.003 and 0.026 respectively. The age of the patient, preoperative indwelling catheter, prostate volume, and resection time were not statistically determinant variables in the occurrence of bladder spasms post-operatively. 61% had severe pains and 39% had mild pains. There was no significant correlation between the presence of OAB or the use of bladder stimulants with the severity of pains in patients with bladder spasms after TURP.</p><p><strong>Conclusions: </strong>Half of the patients are likely to have bladder spasms after TURP. The risk of having these spasms is higher in patients with preoperative OAB or patients who are exposed to bladder stimulants. The severity of spasms is however independent of these risk factors.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21eCollection Date: 2024-01-01DOI: 10.60787/nmj-v65i1-457
Rex Friday Ogoronte A Ijah, Okechukwu Ibeabuchi, ChinemereJ Onyema, Somiari L Harcourt, Ajibola Alabi, Friday E Aaron
Background: Tax relief and incentives are utilized to encourage the private health sector to provide services that are advantageous to community health. The aim of this study was to explore the issues related to taxes paid, incentives provided, returns on investment, satisfaction with practice, and plans of private health practitioners who were conference attendees in Port Harcourt in 2021.
Methodology: A descriptive cross-sectional study was carried out at two national events in Port Harcourt, Rivers State, Nigeria in October, and December 2021, among conference attendees using self-administered questionnaires. Data obtained was analyzed using the IBM Statistical Package for the Social Sciences (SPSS) version 20.0 and presented in tables.
Results: A total of one hundred and sixty-six (166) respondents were involved in the study. One hundred and four (62.7%) respondents believed they experienced multiple taxation from agencies of government. Most respondents paid at least fifty thousand and above as taxes to various levels of government. One hundred and forty-two (85.5%) respondents believed they did not receive any incentive from governments for their private health businesses. Fifty-three (31.9%) were not satisfied, while55 (33.1%) respondents were managing to survive in the business environment.
Conclusion: Private healthcare practitioners in Nigeria experience multiple taxation and a lack of incentives from governments. Dissatisfaction with the return on investment is prevalent. Inclusive health sector reform that will partly reduce the potential for brain drain is therefore needed.
{"title":"Taxation and Incentives in Private Health Services Delivery in Nigeria: Opinion of Private Health Practitioners.","authors":"Rex Friday Ogoronte A Ijah, Okechukwu Ibeabuchi, ChinemereJ Onyema, Somiari L Harcourt, Ajibola Alabi, Friday E Aaron","doi":"10.60787/nmj-v65i1-457","DOIUrl":"10.60787/nmj-v65i1-457","url":null,"abstract":"<p><strong>Background: </strong>Tax relief and incentives are utilized to encourage the private health sector to provide services that are advantageous to community health. The aim of this study was to explore the issues related to taxes paid, incentives provided, returns on investment, satisfaction with practice, and plans of private health practitioners who were conference attendees in Port Harcourt in 2021.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was carried out at two national events in Port Harcourt, Rivers State, Nigeria in October, and December 2021, among conference attendees using self-administered questionnaires. Data obtained was analyzed using the IBM Statistical Package for the Social Sciences (SPSS) version 20.0 and presented in tables.</p><p><strong>Results: </strong>A total of one hundred and sixty-six (166) respondents were involved in the study. One hundred and four (62.7%) respondents believed they experienced multiple taxation from agencies of government. Most respondents paid at least fifty thousand and above as taxes to various levels of government. One hundred and forty-two (85.5%) respondents believed they did not receive any incentive from governments for their private health businesses. Fifty-three (31.9%) were not satisfied, while55 (33.1%) respondents were managing to survive in the business environment.</p><p><strong>Conclusion: </strong>Private healthcare practitioners in Nigeria experience multiple taxation and a lack of incentives from governments. Dissatisfaction with the return on investment is prevalent. Inclusive health sector reform that will partly reduce the potential for brain drain is therefore needed.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22eCollection Date: 2023-11-01DOI: 10.60787/nmj-64-6-332
Murtala Audu Ngabea, Moses I Durotoluwa
Background: The activities of Health maintenance organizations (HMO) are central to the achievement of universal health coverage. This study sought to examine the number of HMOs actively operating in the FCT and to determine whether the HMOs are promoting or inhibiting universal coverage and proffer recommendations for the overall progress of the scheme.
Methodology: A descriptive prospective cross-sectional study design was used and mixed (qualitative and quantitative) methods A pre-tested interviewer-administered questionnaire make was used to collect quantitative data while qualitative data were collected through a review of literature and in-depth interviews to examine the roles of HMOs from stakeholders' points of view. A total of 250 participants comprised predominantly 230 enrollees into three major programs of the NHIS that is the formal sector social insurance program (FS-SHIP), tertiary institution social health insurance program (TI-SHIP), and community-based social health insurance program (CB-SHIP). The remaining 20 (twenty) enrollees comprised NHIA desk officers, HMO managers, community-based representatives, and healthcare providers.
Results: The majority of the respondents (64.8%) reported a high level of awareness of the knowledge of NHIS, while fewer than 19% indicated a lack of awareness as compared to 17% who did not respond to the question. Similarly, most of the respondents (62.2%) reported having satisfactory knowledge of the structure-function modalities of HMOs, while 20.4% were not aware of the mode of operation of HMOs.Contrasting contributions of HMOs to NHIS implementation, approximately half of the respondents (50%) reported dissatisfaction. Likewise, about 50% of the study subjects were of the view that HMOs are not putting the desired commitment towards achieving this goal of universal health coverage. The report from the in-depth interview reiterated that the enrollees were not well satisfied due to the perceived poor and inadequate operational mechanisms of both the HMOs and NHIS.
Conclusions: The study revealed a high level of awareness of the knowledge of NHIS and good working knowledge of the structure and function of the HMOs. However, this study demonstrated a low understanding of the working interactions between the NHIS and HMO, among the respondents. Understanding HMOs and how they work is critical for choosing a health plan during open enrollment, hence, there is a need for more client enlightenment.
{"title":"The Impact of Health Maintenance Organizations in the Implementation of the Nigeria National Health Insurance Scheme in the Federal Capital Territory (Abuja), Nigeria.","authors":"Murtala Audu Ngabea, Moses I Durotoluwa","doi":"10.60787/nmj-64-6-332","DOIUrl":"10.60787/nmj-64-6-332","url":null,"abstract":"<p><strong>Background: </strong>The activities of Health maintenance organizations (HMO) are central to the achievement of universal health coverage. This study sought to examine the number of HMOs actively operating in the FCT and to determine whether the HMOs are promoting or inhibiting universal coverage and proffer recommendations for the overall progress of the scheme.</p><p><strong>Methodology: </strong>A descriptive prospective cross-sectional study design was used and mixed (qualitative and quantitative) methods A pre-tested interviewer-administered questionnaire make was used to collect quantitative data while qualitative data were collected through a review of literature and in-depth interviews to examine the roles of HMOs from stakeholders' points of view. A total of 250 participants comprised predominantly 230 enrollees into three major programs of the NHIS that is the formal sector social insurance program (FS-SHIP), tertiary institution social health insurance program (TI-SHIP), and community-based social health insurance program (CB-SHIP). The remaining 20 (twenty) enrollees comprised NHIA desk officers, HMO managers, community-based representatives, and healthcare providers.</p><p><strong>Results: </strong>The majority of the respondents (64.8%) reported a high level of awareness of the knowledge of NHIS, while fewer than 19% indicated a lack of awareness as compared to 17% who did not respond to the question. Similarly, most of the respondents (62.2%) reported having satisfactory knowledge of the structure-function modalities of HMOs, while 20.4% were not aware of the mode of operation of HMOs.Contrasting contributions of HMOs to NHIS implementation, approximately half of the respondents (50%) reported dissatisfaction. Likewise, about 50% of the study subjects were of the view that HMOs are not putting the desired commitment towards achieving this goal of universal health coverage. The report from the in-depth interview reiterated that the enrollees were not well satisfied due to the perceived poor and inadequate operational mechanisms of both the HMOs and NHIS.</p><p><strong>Conclusions: </strong>The study revealed a high level of awareness of the knowledge of NHIS and good working knowledge of the structure and function of the HMOs. However, this study demonstrated a low understanding of the working interactions between the NHIS and HMO, among the respondents. Understanding HMOs and how they work is critical for choosing a health plan during open enrollment, hence, there is a need for more client enlightenment.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Considering the high cost of Magnetic Resonance Imaging and the high risk of radiation exposure to growing children from Computed tomography scans, we aim to evaluate the neuroimaging findings in children with chronic headaches, determine the frequency of significant remediable pathologies, and establish the need for neuroimaging.
Methodology: This is a cross-sectional study of clinical data and neuroimaging findings in 41 children who were imaged in a tertiary hospital and a private diagnostic center in Abuja on account of chronic headaches. Twenty-two children were referred for brain Computed Tomography scan while 19 had brain Magnetic resonance Imaging. Collected data was statistically analyzed using SAS software version 9.3 with the level of significance set at 0.05.
Results: The age range of patients was 4 -18years.Thirty-three patients (80.5%) had chronic primary headaches while eight (19.5%) patients had additional "red flag" indications. Normal findings and extracranial lesions accounted for 89.5% of MRI (17/19) and 72.7% (16/22) in CT. Intracranial lesions were seen in 75% of patients with "red flag" and 6.1% of patients with primary headache with significant differences (p=0.0001) between the subsets. The commonest abnormalities were chronic sinusitis (17.1%) and intracranial tumors (9.6%) with no significant difference in the overall neuroimaging findings across the age groups. Chronic sinusitis was found predominantly in adolescent females (85.7%).
Conclusions: Neuroimaging has a low yield of significant remediable intracranial lesions in children with chronic headaches without additional "red flag" symptoms thereby necessitating the call to reconsider the use of neuroimaging with a view to imaging gently.
{"title":"Neuroimaging Findings in Pediatric Chronic Headaches: Is Imaging Always Necessary?","authors":"Ukamaka Dorothy Itanyi, Joshua Oluwafemi Aiyekomogbon","doi":"10.60787/nmj-64-6-389","DOIUrl":"10.60787/nmj-64-6-389","url":null,"abstract":"<p><strong>Background: </strong>Considering the high cost of Magnetic Resonance Imaging and the high risk of radiation exposure to growing children from Computed tomography scans, we aim to evaluate the neuroimaging findings in children with chronic headaches, determine the frequency of significant remediable pathologies, and establish the need for neuroimaging.</p><p><strong>Methodology: </strong>This is a cross-sectional study of clinical data and neuroimaging findings in 41 children who were imaged in a tertiary hospital and a private diagnostic center in Abuja on account of chronic headaches. Twenty-two children were referred for brain Computed Tomography scan while 19 had brain Magnetic resonance Imaging. Collected data was statistically analyzed using SAS software version 9.3 with the level of significance set at 0.05.</p><p><strong>Results: </strong>The age range of patients was 4 -18years.Thirty-three patients (80.5%) had chronic primary headaches while eight (19.5%) patients had additional \"red flag\" indications. Normal findings and extracranial lesions accounted for 89.5% of MRI (17/19) and 72.7% (16/22) in CT. Intracranial lesions were seen in 75% of patients with \"red flag\" and 6.1% of patients with primary headache with significant differences (<i>p=</i>0.0001) between the subsets. The commonest abnormalities were chronic sinusitis (17.1%) and intracranial tumors (9.6%) with no significant difference in the overall neuroimaging findings across the age groups. Chronic sinusitis was found predominantly in adolescent females (85.7%).</p><p><strong>Conclusions: </strong>Neuroimaging has a low yield of significant remediable intracranial lesions in children with chronic headaches without additional \"red flag\" symptoms thereby necessitating the call to reconsider the use of neuroimaging with a view to imaging gently.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22eCollection Date: 2023-11-01DOI: 10.60787/nmj-64-6-388
Usman Muhammad Ibrahim, Salisu Muazu Babura, Zahrau Zubairu, Faruk Abdullahi Namadi, Usman L Shehu, Sadiq Hassan Ringim, Rabiu Ibrahim Jalo, Fatimah Ismail Tsiga-Ahmed, Nuruddeen Abubakar, Kabiru Abdussalam, Luka Fitto Buba, Mustapha Zakariyya Karkarna, Abubakar Mohammed Jibo
Background: Obesity is a preventable public health problem associated with a significantly increased risk of non-communicable diseases. This study aimed to find the socio-demographic and nutritional factors associated with obesity amongst adults from high-burden kidney disease areas of Jigawa State, Nigeria.
Methodology: A cross-sectional survey was conducted to assess the socio-demographic and nutritional factors associated with obesity among 361 adults from four local government areas (LGAs) of Jigawa state identified to have a high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed, and data were analyzed using IBM SPSS version 22.0.
Results: The minimum age of the respondents was 18, and the maximum was 102 with a median of 45 (interquartile range = 30-80) years. The prevalence of obesity and overweight in the high-burden LGAs of Jigawa state was 33.0% and 27.1% respectively. Hadejia LGA had the highest (68.1%) prevalence of obesity. The prevalence of overweight was higher in Jahun LGA (38.9%). About one-third (38.2%) had a waist circumference (WC) greater than 88cm. Up to half of the female respondents had a waist-hip ratio (WHR) greater than 0.85. For male respondents, many (74.3%) had a WHR of greater than 0.9, and obesity was significantly higher (39.8%, P s< 0.001) among those ≥40 years of age. Obesity was significantly higher (39.8%,P < 0.001) among those ≥40 years of age, known diabetic, (57.1%, P=0.02), and rare consumption of vegetables, (45.8%, P<0.001).The odds of developing obesity were significantly higher among those who were known diabetics and were 3 times more likely to be obese than those who were not known to be diabetics (adjusted odds ratio [aOR] = 3.1, 95% CI = [1.1-8.9].
Conclusions: The prevalence of obesity was high in the areas with high burdens of kidney disease. The government and relevant stakeholders should develop a cost-effective prevention, early diagnosis, and treatment model.
{"title":"Socio-demographic and Nutritional Factors Associated with Obesity amongst Adults from High Burden Kidney Diseases Areas of Jigawa State, Nigeria: A Community-based Survey.","authors":"Usman Muhammad Ibrahim, Salisu Muazu Babura, Zahrau Zubairu, Faruk Abdullahi Namadi, Usman L Shehu, Sadiq Hassan Ringim, Rabiu Ibrahim Jalo, Fatimah Ismail Tsiga-Ahmed, Nuruddeen Abubakar, Kabiru Abdussalam, Luka Fitto Buba, Mustapha Zakariyya Karkarna, Abubakar Mohammed Jibo","doi":"10.60787/nmj-64-6-388","DOIUrl":"10.60787/nmj-64-6-388","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a preventable public health problem associated with a significantly increased risk of non-communicable diseases. This study aimed to find the socio-demographic and nutritional factors associated with obesity amongst adults from high-burden kidney disease areas of Jigawa State, Nigeria.</p><p><strong>Methodology: </strong>A cross-sectional survey was conducted to assess the socio-demographic and nutritional factors associated with obesity among 361 adults from four local government areas (LGAs) of Jigawa state identified to have a high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed, and data were analyzed using IBM SPSS version 22.0.</p><p><strong>Results: </strong>The minimum age of the respondents was 18, and the maximum was 102 with a median of 45 (interquartile range = 30-80) years. The prevalence of obesity and overweight in the high-burden LGAs of Jigawa state was 33.0% and 27.1% respectively. Hadejia LGA had the highest (68.1%) prevalence of obesity. The prevalence of overweight was higher in Jahun LGA (38.9%). About one-third (38.2%) had a waist circumference (WC) greater than 88cm. Up to half of the female respondents had a waist-hip ratio (WHR) greater than 0.85. For male respondents, many (74.3%) had a WHR of greater than 0.9, and obesity was significantly higher (39.8%, P s< 0.001) among those ≥40 years of age. Obesity was significantly higher (39.8%,P < 0.001) among those ≥40 years of age, known diabetic, (57.1%, P=0.02), and rare consumption of vegetables, (45.8%, P<0.001).The odds of developing obesity were significantly higher among those who were known diabetics and were 3 times more likely to be obese than those who were not known to be diabetics (adjusted odds ratio [aOR] = 3.1, 95% CI = [1.1-8.9].</p><p><strong>Conclusions: </strong>The prevalence of obesity was high in the areas with high burdens of kidney disease. The government and relevant stakeholders should develop a cost-effective prevention, early diagnosis, and treatment model.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}