Pub Date : 2024-02-22eCollection Date: 2023-11-01DOI: 10.60787/nmj-64-6-372
Ikechukwu Kelechukwu Chukwuocha, Simon Mafuka Johnson, Ezinne Pamela Aguoru
Background: Tuberculosis (TB) and the Human Immune Deficiency Virus (HIV) represent major public health challenges and are intricately linked to each other. This is more prevalent in the sub-Saharan African region, where about 80% of this co-infection is recorded. This study aimed to review the prevalence, profile, and treatment outcome of TB-HIV co-infected patients.
Methodology: A hospital-based retrospective study was conducted in a tertiary center in southeast Nigeria for the period 2015-2017. Information elicited from participant's medical records included socio-demographic profile (age, sex, residential area, and occupation), Cluster of Differentiation 4 (CD4) count level at the time of diagnosis of co-infection, weight, treatment outcome, as well as the record of the number of TB patients who presented within this same period.
Results: The total number of TB/HIV co-infected patients who participated in the study during this period was 207, with a prevalence of TB/HIV co-infection of 33.9%. The highest proportion of cases was recorded among participants within the age group of 31-40, and the cases of co-infection were more common in males (58.9%) and students (27.5%). The results also showed a significant relationship between gender, occupation, residential area, and TB/HIV co-infection. Most of the co-infected participants had a CD4 count of <300 cells/mm3 and an associated poor treatment outcome of 41.1%.
Conclusions: TB/HIV co-infection needs to be properly addressed, and screening for HIV among TB patients should be a priority. This will help in early diagnosis and subsequently improve the treatment outcome of both diseases.
{"title":"Prevalence, Profile and Treatment Outcome of Tuberculosis-Human Immunodeficiency Virus Co-Infection in South Eastern Nigeria: A 3-Year Retrospective Study.","authors":"Ikechukwu Kelechukwu Chukwuocha, Simon Mafuka Johnson, Ezinne Pamela Aguoru","doi":"10.60787/nmj-64-6-372","DOIUrl":"10.60787/nmj-64-6-372","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) and the Human Immune Deficiency Virus (HIV) represent major public health challenges and are intricately linked to each other. This is more prevalent in the sub-Saharan African region, where about 80% of this co-infection is recorded. This study aimed to review the prevalence, profile, and treatment outcome of TB-HIV co-infected patients.</p><p><strong>Methodology: </strong>A hospital-based retrospective study was conducted in a tertiary center in southeast Nigeria for the period 2015-2017. Information elicited from participant's medical records included socio-demographic profile (age, sex, residential area, and occupation), Cluster of Differentiation 4 (CD4) count level at the time of diagnosis of co-infection, weight, treatment outcome, as well as the record of the number of TB patients who presented within this same period.</p><p><strong>Results: </strong>The total number of TB/HIV co-infected patients who participated in the study during this period was 207, with a prevalence of TB/HIV co-infection of 33.9%. The highest proportion of cases was recorded among participants within the age group of 31-40, and the cases of co-infection were more common in males (58.9%) and students (27.5%). The results also showed a significant relationship between gender, occupation, residential area, and TB/HIV co-infection. Most of the co-infected participants had a CD4 count of <300 cells/mm3 and an associated poor treatment outcome of 41.1%.</p><p><strong>Conclusions: </strong>TB/HIV co-infection needs to be properly addressed, and screening for HIV among TB patients should be a priority. This will help in early diagnosis and subsequently improve the treatment outcome of both diseases.</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/PMC11227634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560720","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: The Maslach Burnout Inventory (MBI) is the most widely accepted tool for assessing burnout among students worldwide. However, no studies have yet tested the validity of the student version of the MBI in Nigeria. The study aimed to assess the factorial structure and cross-cultural validity of the Maslach Burnout Inventory-Student Version MBI-GS (S) in a Nigerian university.
Methodology: An online cross-sectional study was conducted among 536 undergraduate students from three departments in the Faculty of Basic Medical Science at a Nigerian university. Data were collected using MBI-GS (S) and a confirmatory factor analysis was performed to explore its factor structure.
Results: The results revealed that the three-factor, 15-item structure of the MBI-GS (S) demonstrated a valid factorial structure among Nigerian undergraduate students, evidenced by the extraction of three components with eigen values exceeding 1, accounting for 73.7% of the variance, in line with the three-factor structure of the original MBI. The internal consistency of the questionnaire was high, with a Cronbach's alpha value of 0.901. The Cronbach's alpha for emotional exhaustion, cynicism, and academic efficacy were 0.901, 0.841, and 0.941, respectively. A weak negative correlation was observed between emotional exhaustion and cynicism, and a moderate negative correlation was found between emotional exhaustion and academic efficacy, and cynicism and academic efficacy.
Conclusions: These findings suggest that the MBI-GS (S) is a reliable tool for assessing burnout levels among Nigerian university students. They provide strong evidence for the factorial validity and reliability of the MBI-GS (S), supporting its cross-cultural validation for assessing burnout.
背景:马斯拉赫职业倦怠量表(Maslach Burnout Inventory,MBI)是全球最广泛接受的学生职业倦怠评估工具。然而,还没有研究对尼日利亚学生版 MBI 的有效性进行过测试。本研究旨在评估马斯拉赫职业倦怠量表学生版 MBI-GS (S) 在尼日利亚一所大学中的因子结构和跨文化有效性:对尼日利亚一所大学基础医学院三个系的 536 名本科生进行了在线横断面研究。使用 MBI-GS (S) 收集了数据,并进行了确证因子分析以探索其因子结构:结果显示,MBI-GS(S)的三因素 15 题结构在尼日利亚本科生中显示出有效的因素结构,表现为提取出特征值超过 1 的三个成分,占方差的 73.7%,与原始 MBI 的三因素结构一致。问卷的内部一致性很高,Cronbach's alpha 值为 0.901。情绪耗竭、犬儒主义和学习效能的 Cronbach's alpha 值分别为 0.901、0.841 和 0.941。情绪耗竭与犬儒主义之间呈弱负相关,情绪耗竭与学业效能感之间呈中度负相关,犬儒主义与学业效能感之间呈中度负相关:这些研究结果表明,MBI-GS(S)是评估尼日利亚大学生职业倦怠水平的可靠工具。这些研究结果为 MBI-GS (S) 的因子效度和信度提供了有力的证据,支持其在评估职业倦怠方面的跨文化验证。
{"title":"The Maslach Burnout Inventory-Student Version's Factorial Structure and Cross-Cultural Validity in a Nigerian University.","authors":"Kehinde Sunday Oluwadiya, Adekunle Olatayo Adeoti, Oluwakemi Christie Ogidan, Olawande Damilola Bamisi, Olabode Oluwadare Akintoye","doi":"10.60787/nmj-64-6-344","DOIUrl":"10.60787/nmj-64-6-344","url":null,"abstract":"<p><strong>Background: </strong>The Maslach Burnout Inventory (MBI) is the most widely accepted tool for assessing burnout among students worldwide. However, no studies have yet tested the validity of the student version of the MBI in Nigeria. The study aimed to assess the factorial structure and cross-cultural validity of the Maslach Burnout Inventory-Student Version MBI-GS (S) in a Nigerian university.</p><p><strong>Methodology: </strong>An online cross-sectional study was conducted among 536 undergraduate students from three departments in the Faculty of Basic Medical Science at a Nigerian university. Data were collected using MBI-GS (S) and a confirmatory factor analysis was performed to explore its factor structure.</p><p><strong>Results: </strong>The results revealed that the three-factor, 15-item structure of the MBI-GS (S) demonstrated a valid factorial structure among Nigerian undergraduate students, evidenced by the extraction of three components with eigen values exceeding 1, accounting for 73.7% of the variance, in line with the three-factor structure of the original MBI. The internal consistency of the questionnaire was high, with a Cronbach's alpha value of 0.901. The Cronbach's alpha for emotional exhaustion, cynicism, and academic efficacy were 0.901, 0.841, and 0.941, respectively. A weak negative correlation was observed between emotional exhaustion and cynicism, and a moderate negative correlation was found between emotional exhaustion and academic efficacy, and cynicism and academic efficacy.</p><p><strong>Conclusions: </strong>These findings suggest that the MBI-GS (S) is a reliable tool for assessing burnout levels among Nigerian university students. They provide strong evidence for the factorial validity and reliability of the MBI-GS (S), supporting its cross-cultural validation for assessing burnout.</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/PMC11227636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560675","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-64-6-351
Oluyemi Oluwatosin Akanni, Leroy Chuma Edozien
A new Mental Health law was recently enacted in Nigeria to replace the Lunacy Ordinance of 1958. The passage of the new law was a major leap from the old. It was received with excitement because the former law was not only outdated but failed to address core issues such as the promotion of mental health and the protection of the rights of the mentally ill. Though the new law adequately makes provisions for these, it has considerable flaws that may hinder implementation. Parts of it lack clarity and other parts are somewhat overzealous in safeguarding the mentally ill, thus potentially defeating its purpose. It appears that certain aspects were not well thought out, or there was no 'looking well' before leaping to legislate. This paper aims to critically review flawed aspects of the new law and make recommendations on the way forward.
{"title":"The New Nigerian Mental Health Act: A Huge Leap Before Looking Closely?","authors":"Oluyemi Oluwatosin Akanni, Leroy Chuma Edozien","doi":"10.60787/nmj-64-6-351","DOIUrl":"10.60787/nmj-64-6-351","url":null,"abstract":"<p><p>A new Mental Health law was recently enacted in Nigeria to replace the Lunacy Ordinance of 1958. The passage of the new law was a major leap from the old. It was received with excitement because the former law was not only outdated but failed to address core issues such as the promotion of mental health and the protection of the rights of the mentally ill. Though the new law adequately makes provisions for these, it has considerable flaws that may hinder implementation. Parts of it lack clarity and other parts are somewhat overzealous in safeguarding the mentally ill, thus potentially defeating its purpose. It appears that certain aspects were not well thought out, or there was no 'looking well' before leaping to legislate. This paper aims to critically review flawed aspects of the new law and make recommendations on the way forward.</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/PMC11227633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560676","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: Gestational Diabetes mellitus (GDM) is fast becoming an important cause of maternal and perinatal morbidity and mortality. The objective of this study is to assess the prevalence and the perinatal outcome of gestational diabetes in an antenatal population.
Methodology: This was a cross-sectional study. The patients were pregnant women between 24-28 weeks of gestation without a prior diagnosis of diabetes mellitus. The consenting women were evaluated using fasting plasma glucose and oral glucose tolerance testing using 75 grams of glucose in 300ml of water orally.
Results: Two hundred and fifteen women participated in the study and the prevalence of GDM was 9%. The mean fasting plasma glucose was 4.04mmol/l at the time of the Oral glucose tolerance test (OGTT) and 5.78mmol/l after the oral glucose load. When compared with pregnant normoglycaemic patients, GDM patients had significantly fewer vaginal deliveries (p=0.05), higher birth weight (3.71kg), and more neonatal admissions (50%).
Conclusions: Gestational diabetes mellitus is an important disease entity, and it is a cause of maternal and perinatal morbidities.
{"title":"Prevalence of Gestational Diabetes and Pregnancy Outcome of antenatal patients in Ilorin.","authors":"Akinyosoye Deji Ajiboye, Kikelomo Temilola Adesina, Ishaq Funso Abdul, Grace Gwabachi Ezeoke, Abayomi Sikiru Biliaminu, Akintunde Olusegun Fehintola, Ekundayo Oluwole Ayegbusi","doi":"10.60787/nmj-64-6-320","DOIUrl":"10.60787/nmj-64-6-320","url":null,"abstract":"<p><strong>Background: </strong>Gestational Diabetes mellitus (GDM) is fast becoming an important cause of maternal and perinatal morbidity and mortality. The objective of this study is to assess the prevalence and the perinatal outcome of gestational diabetes in an antenatal population.</p><p><strong>Methodology: </strong>This was a cross-sectional study. The patients were pregnant women between 24-28 weeks of gestation without a prior diagnosis of diabetes mellitus. The consenting women were evaluated using fasting plasma glucose and oral glucose tolerance testing using 75 grams of glucose in 300ml of water orally.</p><p><strong>Results: </strong>Two hundred and fifteen women participated in the study and the prevalence of GDM was 9%. The mean fasting plasma glucose was 4.04mmol/l at the time of the Oral glucose tolerance test (OGTT) and 5.78mmol/l after the oral glucose load. When compared with pregnant normoglycaemic patients, GDM patients had significantly fewer vaginal deliveries (p=0.05), higher birth weight (3.71kg), and more neonatal admissions (50%).</p><p><strong>Conclusions: </strong>Gestational diabetes mellitus is an important disease entity, and it is a cause of maternal and perinatal morbidities.</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/PMC11227641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560719","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-64-6-343
Thelma Alalbila Aku, Eugene Kobla Dordoye, Theodore Ofori Apraku, Adwoa Ansomaa Gyamera, Peter Yamoah, Patrick Adjei
The World Health Organization declared the Coronavirus disease of 2019 (COVID-19) a public health emergency of international concern on 30 January 2020, and a pandemic on 11 March 2020. Vaccines have proven to be vital in the effort to control and possibly eventually eradicate this viral infection. There have been reports of thromboembolic events associated with the use of vaccine but from available information, no reported case of atypical Hemolytic Uremic syndrome (HUS) in a black male has been described. We report a case of a 43-year-old black male Sub-Saharan African c5dwho presented with chills, fever, and generalized body aches of 3 days duration after receiving the second booster dose of the COVID-19 vaccine. He developed thrombocytopenia, hemolytic anaemia, and acute kidney injury on admission, and an initial diagnosis of malaria was made. He was managed with parenteral artesunate and then oral artemether/lumefantrine. His hemolytic anaemia was thought to be from malaria-associated hemolysis. This diagnosis was however later re-evaluated to hemolytic uremic syndrome and managed with 50mg daily oral prednisolone which resolved, and he resumed work a week later. Although mass vaccination is a key strategy to control the spread of COVID-19, critical observations should be made to confirm the risk of trigger for abnormal complement activation. Further observations should be made especially if it is a chimpanzee adenovirus-vectored vaccine.
{"title":"Hemolytic Uremic Syndrome: A COVID-19 Vaccine Reaction Case Report.","authors":"Thelma Alalbila Aku, Eugene Kobla Dordoye, Theodore Ofori Apraku, Adwoa Ansomaa Gyamera, Peter Yamoah, Patrick Adjei","doi":"10.60787/nmj-64-6-343","DOIUrl":"10.60787/nmj-64-6-343","url":null,"abstract":"<p><p>The World Health Organization declared the Coronavirus disease of 2019 (COVID-19) a public health emergency of international concern on 30 January 2020, and a pandemic on 11 March 2020. Vaccines have proven to be vital in the effort to control and possibly eventually eradicate this viral infection. There have been reports of thromboembolic events associated with the use of vaccine but from available information, no reported case of atypical Hemolytic Uremic syndrome (HUS) in a black male has been described. We report a case of a 43-year-old black male Sub-Saharan African c5dwho presented with chills, fever, and generalized body aches of 3 days duration after receiving the second booster dose of the COVID-19 vaccine. He developed thrombocytopenia, hemolytic anaemia, and acute kidney injury on admission, and an initial diagnosis of malaria was made. He was managed with parenteral artesunate and then oral artemether/lumefantrine. His hemolytic anaemia was thought to be from malaria-associated hemolysis. This diagnosis was however later re-evaluated to hemolytic uremic syndrome and managed with 50mg daily oral prednisolone which resolved, and he resumed work a week later. Although mass vaccination is a key strategy to control the spread of COVID-19, critical observations should be made to confirm the risk of trigger for abnormal complement activation. Further observations should be made especially if it is a chimpanzee adenovirus-vectored vaccine.</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/PMC11227635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560714","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-64-6-378
Obinna Joseph Ugwu, Ferdinand Ibu Ogbaji, Tobechukwu Ojiugo Tony-Okeke, Bashir Omeiza Ismaila, Onome Chidinma Nnorom, Joy Hyelni Zoakah, Sarah Kwaghdoo Aule, Suleiman Mshelia
Background: Globally, the incidence and mortality from gallbladder diseases is on the rise. The gold standard for the management of symptomatic gallbladder disease is laparoscopic cholecystectomy. The practice of laparoscopic cholecystectomy is at a nascent stage in Low and middle-income countries like Nigeria despite its obvious advantages over traditional open cholecystectomy. This systematic review aims to assess the extent to which laparoscopic cholecystectomy is performed for the management of gallbladder diseases in Nigeria.
Methodology: The review was guided by the PRISMA model. We searched MEDLINE, Embase, CINAHL, Scopus, and Global health databases. All searches were conducted in August 2023. All study designs reporting laparoscopic cholecystectomy in Nigeria, in the past 10 years were included. Three authors conducted the data extraction using data extraction tables and two authors independently assessed the data for accuracy and completeness. The Joanna Briggs Institute critical appraisal tool was used to assess the data quality. Twenty-two articles with 1569 patients were included in this review.
Results: Females accounted for 69.5% of the patients and 30.5% were males. Twelve (54.5%) of the studies were from the Southwest of the country, 3 (13.6%) each from the South East and North Central regions, 2 (9.1%) South-South, and 1 (4.5%) each from the North East and North West. Study designs were mostly cross-sectional with sample sizes from 1 to 400. The highest and lowest number of laparoscopic cholecystectomies reported were 300 and 1 respectively. The majority (95.2%) of laparoscopic cholecystectomies were on account of calculous cholecystitis and the methods reported were the 4-port and 3-port techniques. The follow-up period ranged from 3 weeks to 2 years with 54 (3.4%) complications reported.
Conclusions: Laparoscopic cholecystectomy in Nigeria is relatively safe with minimal complications. Its demand and uptake are on the rise, though slowly owing to its relatively high cost.
{"title":"Laparoscopic Management of Gall Bladder Diseases in Nigeria: A Systematic Review.","authors":"Obinna Joseph Ugwu, Ferdinand Ibu Ogbaji, Tobechukwu Ojiugo Tony-Okeke, Bashir Omeiza Ismaila, Onome Chidinma Nnorom, Joy Hyelni Zoakah, Sarah Kwaghdoo Aule, Suleiman Mshelia","doi":"10.60787/nmj-64-6-378","DOIUrl":"10.60787/nmj-64-6-378","url":null,"abstract":"<p><strong>Background: </strong>Globally, the incidence and mortality from gallbladder diseases is on the rise. The gold standard for the management of symptomatic gallbladder disease is laparoscopic cholecystectomy. The practice of laparoscopic cholecystectomy is at a nascent stage in Low and middle-income countries like Nigeria despite its obvious advantages over traditional open cholecystectomy. This systematic review aims to assess the extent to which laparoscopic cholecystectomy is performed for the management of gallbladder diseases in Nigeria.</p><p><strong>Methodology: </strong>The review was guided by the PRISMA model. We searched MEDLINE, Embase, CINAHL, Scopus, and Global health databases. All searches were conducted in August 2023. All study designs reporting laparoscopic cholecystectomy in Nigeria, in the past 10 years were included. Three authors conducted the data extraction using data extraction tables and two authors independently assessed the data for accuracy and completeness. The Joanna Briggs Institute critical appraisal tool was used to assess the data quality. Twenty-two articles with 1569 patients were included in this review.</p><p><strong>Results: </strong>Females accounted for 69.5% of the patients and 30.5% were males. Twelve (54.5%) of the studies were from the Southwest of the country, 3 (13.6%) each from the South East and North Central regions, 2 (9.1%) South-South, and 1 (4.5%) each from the North East and North West. Study designs were mostly cross-sectional with sample sizes from 1 to 400. The highest and lowest number of laparoscopic cholecystectomies reported were 300 and 1 respectively. The majority (95.2%) of laparoscopic cholecystectomies were on account of calculous cholecystitis and the methods reported were the 4-port and 3-port techniques. The follow-up period ranged from 3 weeks to 2 years with 54 (3.4%) complications reported.</p><p><strong>Conclusions: </strong>Laparoscopic cholecystectomy in Nigeria is relatively safe with minimal complications. Its demand and uptake are on the rise, though slowly owing to its relatively high cost.</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/PMC11227640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560716","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: There is a paucity of organized human biomonitoring, including that of carbon monoxide (CO) in the Niger Delta, Nigeria. The study aims to quantify the impact of maternal exposure to CO in the first trimester of pregnancy and its modification by maternal demographic and obstetric factors.
Methodology: It was of cross-sectional design conducted at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. Four hundred and ninety consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Demographic, social, and obstetric characteristics were recorded. Maternal exhaled CO concentration (ECOC) and maternal and fetal carboxyhaemoglobin concentrations (MCOHC and FCOHC) were measured with the aid of a smokelyzer. Data were analyzed, using SPSS version 25.0 software. Ethical approval was obtained from the RSUTH Ethics Committee.
Results: The mean values of ECOC, MCOHC, and FCOHC were 3.25±2.51 ppm, 1.15±0.40%, and 0.93±0.72% respectively and the severity (mild, moderate, and severe) of the impact was inversely proportional to the number of women affected. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in the following maternal characteristics: age, educational levels, BMI, gravidity, and parity. In the case of FCOHC, the measures of the differences were as follows: p:<0.019, <0.020, <0.0001, <0.0001, and <0.038 for age categories, educational levels, BMI, gravidity, and parity respectively. There were statistically significant positive correlations between the BMI and the mean values of ECOC, MCOHC, and FCOHC.
Conclusion: The higher the severity of exposure to CO (mild, moderate, and severe), the lower the number of impacted pregnant women. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in women of different ages, educational levels, BMI, gravidity, and parity categories.
{"title":"Medical Biomonitoring of Maternal and Fetal Exposure to Carbon Monoxide and its Modification by Demographic and Obstetric Characteristics.","authors":"Abbey Mkpe, Amadi Simeon Chijioke, Olufemi Adebari Oloyede, Rose Sitonma Iwo-Amah, Paul Ledee Kua, Eghuan Kenneth Okagua, Basil Omieibi Altraide, Faithwin Horsfall, Esther Ijeoma Nonye-Enyidah, Ngozi Joseph Kwosah, Alpheaus Gogo Mba, Uduak Solomon Ocheche, Leesi Sapira-Ordu, Dickson H John, Nestor Mininyo Inimgba","doi":"10.60787/nmj-64-6-192","DOIUrl":"10.60787/nmj-64-6-192","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of organized human biomonitoring, including that of carbon monoxide (CO) in the Niger Delta, Nigeria. The study aims to quantify the impact of maternal exposure to CO in the first trimester of pregnancy and its modification by maternal demographic and obstetric factors.</p><p><strong>Methodology: </strong>It was of cross-sectional design conducted at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. Four hundred and ninety consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Demographic, social, and obstetric characteristics were recorded. Maternal exhaled CO concentration (ECOC) and maternal and fetal carboxyhaemoglobin concentrations (MCOHC and FCOHC) were measured with the aid of a smokelyzer. Data were analyzed, using SPSS version 25.0 software. Ethical approval was obtained from the RSUTH Ethics Committee.</p><p><strong>Results: </strong>The mean values of ECOC, MCOHC, and FCOHC were 3.25±2.51 ppm, 1.15±0.40%, and 0.93±0.72% respectively and the severity (mild, moderate, and severe) of the impact was inversely proportional to the number of women affected. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in the following maternal characteristics: age, educational levels, BMI, gravidity, and parity. In the case of FCOHC, the measures of the differences were as follows: p:<0.019, <0.020, <0.0001, <0.0001, and <0.038 for age categories, educational levels, BMI, gravidity, and parity respectively. There were statistically significant positive correlations between the BMI and the mean values of ECOC, MCOHC, and FCOHC.</p><p><strong>Conclusion: </strong>The higher the severity of exposure to CO (mild, moderate, and severe), the lower the number of impacted pregnant women. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in women of different ages, educational levels, BMI, gravidity, and parity categories.</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/PMC11227630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560717","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-64-6-373
Nathaniel Birdling Noel, Maryam Birdling Noel, Eric Yila, Chibuzo Anne-Lise Nkala, Mathilda Edmund Banwat
Background: Telemedicine has promising potential to address the challenges faced by healthcare systems in developing countries, in providing equitable access to quality care. However, the practice of telemedicine is generally poor in these countries. The success of telemedicine like any technology depends on numerous factors including users' knowledge and perceptions. Hence, this study aimed to examine the knowledge and perceptions of telemedicine among medical students at the University of Jos.
Methodology: This was a cross-sectional study among 305 clinical medical students selected through a stratified sampling technique. A self-administered questionnaire consisting of a 28-item 5-point Likert response scale was used to collect data, comprising 13 items for knowledge, 8 for the perception of benefits, and 7 for the perception of ease of use of telemedicine. Data was analyzed using IBM-SPSS.
Results: One hundred and eleven (36.4%) participants had good knowledge of telemedicine, while 113 (37.1%) had a good perception of the benefits and 103 (33.8%) had a good perception of the ease of use. Respondents with a good knowledge of telemedicine were about five times more likely (OR = 5.24, 95% CI = 3.15 - 8.69) to have a good perception of the benefits and about eight times more likely (OR = 8.33, 95% CI = 4.57 - 14.26) to have a good perception of ease of use.
Conclusions: Few medical students possess desirable levels of knowledge and perceptions of telemedicine which portrays a gap in the medical education curriculum. Therefore, training, and educational opportunities are recommended to improve their knowledge and perception of telemedicine.
{"title":"Knowledge and Perception of Telemedicine among Medical Students of the University of Jos, Plateau State, Nigeria.","authors":"Nathaniel Birdling Noel, Maryam Birdling Noel, Eric Yila, Chibuzo Anne-Lise Nkala, Mathilda Edmund Banwat","doi":"10.60787/nmj-64-6-373","DOIUrl":"10.60787/nmj-64-6-373","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine has promising potential to address the challenges faced by healthcare systems in developing countries, in providing equitable access to quality care. However, the practice of telemedicine is generally poor in these countries. The success of telemedicine like any technology depends on numerous factors including users' knowledge and perceptions. Hence, this study aimed to examine the knowledge and perceptions of telemedicine among medical students at the University of Jos.</p><p><strong>Methodology: </strong>This was a cross-sectional study among 305 clinical medical students selected through a stratified sampling technique. A self-administered questionnaire consisting of a 28-item 5-point Likert response scale was used to collect data, comprising 13 items for knowledge, 8 for the perception of benefits, and 7 for the perception of ease of use of telemedicine. Data was analyzed using IBM-SPSS.</p><p><strong>Results: </strong>One hundred and eleven (36.4%) participants had good knowledge of telemedicine, while 113 (37.1%) had a good perception of the benefits and 103 (33.8%) had a good perception of the ease of use. Respondents with a good knowledge of telemedicine were about five times more likely (OR = 5.24, 95% CI = 3.15 - 8.69) to have a good perception of the benefits and about eight times more likely (OR = 8.33, 95% CI = 4.57 - 14.26) to have a good perception of ease of use.</p><p><strong>Conclusions: </strong>Few medical students possess desirable levels of knowledge and perceptions of telemedicine which portrays a gap in the medical education curriculum. Therefore, training, and educational opportunities are recommended to improve their knowledge and perception of telemedicine.</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/PMC11227638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560715","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: Acute kidney injury (AKI) is a quite common problem in critically ill patients. Serum cystatin C has emerged as a marker of AKI. This study was aimed to evaluate the diagnostic ability of serum Cystatin-C and Renal Resistive Index in prediction of AKI among critically ill patients.
Methodology: This prospective observational study was carried out in the department of Medicine, over a period of one year. After informed consent and ethical clearance total 120 critically ill patients suffering from sepsis were enrolled, out of which 70 patients developed AKI while 50 did not develop AKI during treatment in Intensive care unit (ICU). Serum cystatin C was measured on day 1 by particle-enhanced immune nephelometric assay, Renal resistive index (RRI) calculated by ratio of the velocities of arterial perfusion throughout the cardiac phase and glomerular filtration rate was measured on days 1, 3, and 7 respectively.
Results: S. cystatin C value was significantly higher(>3times) in AKI patients (14.07±4.8 mcg/ml) as compared to those who did not develop AKI (4.28±3.27 mcg/ml) (p<0.001). After ROC analysis it was found that day1, S. cystatin C, at cut off value of ≥9.29 mcg/ml had diagnostic accuracy 90% with sensitivity 91%, specificity89% and PPV 95.5%. While RRI value on day 7, at cut-off value of ≥0.72, had diagnostic accuracy 98%, sensitivity (98.6%) and specificity (96.7%) for AKI with 98.6% PPV, 96.7% NPV.
Conclusion: Serum cystatin C appears to be a promising bio- markers for early diagnosis of AKI in critically ill patients. Whereas, RRI although non-invasive had good diagnostic accuracy but it diagnosed AKI after few days thus diagnosis of kidney injury delayed.
背景:急性肾损伤(AKI)是危重病人的常见问题。血清胱抑素 C 已成为急性肾损伤的标志物。本研究旨在评估血清胱抑素 C 和肾脏阻力指数在预测重症患者 AKI 方面的诊断能力:这项前瞻性观察研究在医学系进行,为期一年。经过知情同意和伦理审查,共有 120 名脓毒症重症患者被纳入研究,其中 70 名患者在重症监护室(ICU)接受治疗期间出现了 AKI,50 名患者没有出现 AKI。第 1 天采用颗粒增强免疫肾图测定法测量血清胱抑素 C,第 1、3 和 7 天分别测量肾脏阻力指数(RRI)(根据整个心动期动脉灌注速度与肾小球滤过率的比值计算得出):结果:与未发生 AKI 的患者(4.28±3.27 mcg/ml)相比,AKI 患者的血清胱抑素 C 值(14.07±4.8 mcg/ml)明显升高(>3 倍)(p 结论:血清胱抑素 C 值的升高可能与 AKI 有关:血清胱抑素 C 似乎是一种很有前途的生物标记物,可用于危重病人 AKI 的早期诊断。而 RRI 虽然是非侵入性的,但诊断准确性很高,但它在几天后才诊断出 AKI,从而延误了肾损伤的诊断。
{"title":"Diagnostic Accuracy of Plasma Cystatin C and Renal Resistive Index for Acute Kidney Injury in Critically Ill Patients: A Prospective Observational Study.","authors":"Munna Lal Patel, Himanshu Mishra, Rekha Sachan, Vipin Kumar Singh, Radheyshyam Gangwar, Wahid Ali","doi":"10.60787/NMJ-64-5-292","DOIUrl":"10.60787/NMJ-64-5-292","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a quite common problem in critically ill patients. Serum cystatin C has emerged as a marker of AKI. This study was aimed to evaluate the diagnostic ability of serum Cystatin-C and Renal Resistive Index in prediction of AKI among critically ill patients.</p><p><strong>Methodology: </strong>This prospective observational study was carried out in the department of Medicine, over a period of one year. After informed consent and ethical clearance total 120 critically ill patients suffering from sepsis were enrolled, out of which 70 patients developed AKI while 50 did not develop AKI during treatment in Intensive care unit (ICU). Serum cystatin C was measured on day 1 by particle-enhanced immune nephelometric assay, Renal resistive index (RRI) calculated by ratio of the velocities of arterial perfusion throughout the cardiac phase and glomerular filtration rate was measured on days 1, 3, and 7 respectively.</p><p><strong>Results: </strong>S. cystatin C value was significantly higher(>3times) in AKI patients (14.07±4.8 mcg/ml) as compared to those who did not develop AKI (4.28±3.27 mcg/ml) (p<0.001). After ROC analysis it was found that day1, S. cystatin C, at cut off value of ≥9.29 mcg/ml had diagnostic accuracy 90% with sensitivity 91%, specificity89% and PPV 95.5%. While RRI value on day 7, at cut-off value of ≥0.72, had diagnostic accuracy 98%, sensitivity (98.6%) and specificity (96.7%) for AKI with 98.6% PPV, 96.7% NPV.</p><p><strong>Conclusion: </strong>Serum cystatin C appears to be a promising bio- markers for early diagnosis of AKI in critically ill patients. Whereas, RRI although non-invasive had good diagnostic accuracy but it diagnosed AKI after few days thus diagnosis of kidney injury delayed.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500121","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 : 2023-12-28eCollection Date: 2023-09-01DOI: 10.60787/NMJ-64-5-189
Ibrahim Danladi Muhammad, Umar Suleiman Sabo, Sa'idu Adamu Ibrahim, Aliyu Dayyabu Labaran, Idris Usman Takai
Background: Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital.
Methodology: A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale.
Results: The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1).
Conclusion: This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility.
{"title":"Comparative Study Between Hysterosalpingo-Contrast Sonography and Hysterosalpingography in Evaluating Tubal Patency at Aminu Kano Teaching Hospital, Kano.","authors":"Ibrahim Danladi Muhammad, Umar Suleiman Sabo, Sa'idu Adamu Ibrahim, Aliyu Dayyabu Labaran, Idris Usman Takai","doi":"10.60787/NMJ-64-5-189","DOIUrl":"10.60787/NMJ-64-5-189","url":null,"abstract":"<p><strong>Background: </strong>Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital.</p><p><strong>Methodology: </strong>A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale.</p><p><strong>Results: </strong>The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1).</p><p><strong>Conclusion: </strong>This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500119","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}