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

Background: Restless leg syndrome is a sensorimotor, sleep-related neurological disorder that is still an underdiagnosed condition characterized by an irresistible urge to move legs at rest, especially at night. Sleep being a vital component of comprehensive health is affected in RLS. The study was conducted to estimate the prevalence of restless leg syndrome (RLS) and its impact on sleep disturbance in patients presenting to the psychiatry clinic (outpatient psychiatric department).

Methodology: The present study was a cross-sectional, observational, single-center, interview-based study, conducted on 600 patients diagnosed with psychiatric illness. A questionnaire of the International Restless Leg Syndrome Scale (IRLS) was applied to assess the severity of RLS and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale.

Results: It was found that among 600 psychiatric patients, the prevalence of RLS was 41.2% (247 patients). Major depressive disorder, migraine, and anxiety disorders show a high prevalence of RLS with a prevalence of 42.9%, 19.40%, and 15%respectively whereas alcohol use disorder has a low prevalence of 2.4%. The association between sleep and RLS was found to be statistically significant.

Conclusion: RLS is a highly prevalent disorder, and it needs to be evaluated in patients with sleep disturbance especially those presenting with symptoms of mood, migraine, and anxiety. Individuals with RLS suffer difficulty falling asleep and have shorter and more fragmented sleep experiences, leading to poorer overall sleep quality.

Sports betting, once confined to physical venues, has experienced an explosive surge in the popularity of online participation, particularly captivating young adults. This narrative review explores the current global perspectives of sports betting and its attendant implications for youths. We examined the prevalence, factors, potential risks, and effects such as financial losses, psychosocial issues, and problem gambling. This review presents current evidence on sports betting among youths and identifies trends, factors, potential harms, regulatory framework, and research gaps while recommending future directions to mitigate the challenge. Sports betting is a predominant form of gambling in the Americas and Europe. Interestingly, Nigeria also has a considerable proportion of youth involvement in this activity. Preferences for the type of sports vary across countries and depend on the most popular sports in the region, with football being a top choice in Spain and Nigeria. Online bet platforms are gaining traction due to convenience. Socio-demographic factors like age, gender, income levels, unemployment rates, and marketing campaigns play pivotal roles in sports betting. Participants can be motivated by monetary, recreational, social, or enhancement and coping reasons. Aside from obvious financial losses, sports betting has been implicated in academic failures, depression, suicidal ideation, and other social vices. Problem gambling and its attendant issues have also become an emerging problem for many countries as it poses a threat to their most productive population. However, it is crucial to note that the legalization and regulation of sports betting remains a highly contested subject in different countries. There is a need for stringent regulation and a collaborative approach to address gambling harms. Betting companies can take responsibility for creating public awareness of responsible gambling and harm reduction in sports betting. Additionally, they can make financial commitments toward the rehabilitation of problem gamblers.

Background: Helicobacter Pylori (H. pylori) infection occurs worldwide. Patients with Sickle Cell Disease (SCD) may present with abdominal symptoms due to different pathophysiological mechanisms. SCD patients are predisposed to infections due to immune deficiency, abdominal symptoms like dyspepsia and recurrent abdominal pain have been associated with H. pylori infection. This study determined H. pylori prevalence in adult SCA patients and its relationship with socio-demographic, clinical, and laboratory parameters.

Methodology: Adult patients with SCA in Steady State were enrolled after informed consent. Sociodemographic, clinical, and laboratory parameters were documented using a structured questionnaire. H. pylori IgG antibody was detected using lateral flow Rapid Diagnostic Test (FaStep USA). Data were analyzed using EpiInfo 7.2.

Results: The median age of participants was 23(20, 26) years. Most of the participants (56.8%) were from lower socioeconomic classes. Sickle cell painful vaso-occlusive crises and blood transfusion in the previous 12 months were 2(1, 4) and 0(0, 1) respectively. Ninety (53.3%) of the participants had abdominal symptoms. Non-specific abdominal pain was the most common. The median frequency of abdominal pains was 1(0, 2). H pylori infection was found in 23.1%. The Odds for H. Pylori infection was high in participants with abdominal symptoms, antacid use, and multiple abdominal symptoms {OR=1.552, 1.306, and 2.584 respectively) though not statistically significant. At the same time those with recurrent abdominal pain and male sex had lower Odds (OR=0.875 and 0.831respectively), though not statistically significant.

Conclusion: H. pylori infection is not uncommon among SCA patients. Physicians should be vigilant in SCD patients with multiple abdominal symptoms by screening early and instituting management.

Background: The diagnosis of thyroid neoplasms is steadily increasing due to the widespread use of sensitive diagnostic techniques. While histopathologic evaluation using Hematoxylin and Eosin (H&E) staining is considered the "gold standard," it often faces challenges due to morphological overlap between benign and malignant follicular patterned lesions. This led to diagnostic uncertainties, underscoring the need for Immunohistochemistry (IHC) as a valuable adjunct. This study aims to evaluate the expression of IHC markers, Hector Battifora Mesothelial Cell-1 (HBME-1), Cluster of Differentiate (CD56 also known as Neural Cell Adhesion Molecule) and Cytokeratin-19 (CK19), in follicular patterned neoplasms of thyroid to aid in the diagnosis of malignant thyroid neoplasms.

Methodology: The study was a descriptive analysis and it included 60 thyroidectomy specimens diagnosed as neoplastic by histopathology were studied after satisfying the inclusion and exclusion criteria. The IHC results were interpreted semi-quantitatively. Statistical analysis was performed using Chi-square test and Fisher's-exact tests. P-value of <0.05 was considered as significant. Sensitivity and specificity for each marker and their combination in diagnosis were calculated.

Results: Among the sixty cases, 31.67% were benign neoplasms, and 68.33% were malignant. Loss of CD56 expression was noted in 75.68% of malignant cases. The specificity of CD56, HBME-1, and CK19 in identifying malignant neoplasms was 84.21%, 84.21%, and 89.47%, respectively. The accuracy of CD56 and CK19 in diagnosing follicular variant papillary thyroid carcinoma (FVPTC) from follicular adenoma (FA) was 79.31% and 93.10%, respectively. The specificity of CK19 in distinguishing FVPTC from FA was 89.47%. The specificity of CD56, CK19, and HBME-1 in diagnosing follicular thyroid carcinoma (FTC) from FA was 84.21%, 85%, and 84.21%, respectively.

Conclusion: Our study highlights the diagnostic utility of CD56, CK19, and HBME-1 in thyroid neoplasms incorporating these markers into routine diagnostic panels can significantly enhance the accuracy and reliability of thyroid malignancy assessments.

Background: Stigmatizing and discriminatory attitudes have been reported as factors militating against the control of the spread of HIV infection and ending the HIV epidemic. Women of reproductive age identified as a vulnerable group to HIV infection require comprehensive knowledge of HIV transmission and prevention to prevent contracting HIV infection. Therefore, this study aimed to determine the association between reproductive-age women's comprehensive knowledge of HIV transmission and prevention and their stigmatizing and discriminatory attitudes toward individuals living with HIV/AIDS.

Methodology: Secondary data from the 2018 Nigerian Demographic and Health Survey was used for this study. We used in each analysis a weighted sample of women of reproductive age with complete data on the comprehensive knowledge of HIV transmission and prevention and stigmatizing and discriminatory attitudes towards persons living with HIV/AIDS. Bivariable and multivariable logistic regression analysis was done to predict the effects of the comprehensive knowledge of HIV transmission and prevention of women of reproductive age on their stigmatizing and discriminatory attitudes toward persons living with HIV/AIDS. Predictor variables with a p-value of ≤ 0.05 were considered statistically significant determinants of HIV/AIDS stigmatizing and discriminatory attitudes.

Results: The number of respondents with HIV/AIDS stigmatizing and discriminatory attitudes was 22821 (77.0%). The multivariable regression models showed that women with an average household wealth index, of Islamic faith, and no access to media were more likely to have positive attitudes toward persons living with HIV at Alpha = .05.

Conclusion: Having comprehensive knowledge of HIV transmission and prevention by women of reproductive age did not affect their HIV stigmatizing and discriminatory attitudes towards individuals living with HIV/AIDS differently when compared to those without comprehensive knowledge. The findings that women with no access to media and those with an average household wealth index were more likely to have a positive attitude towards persons living with HIV/AIDS than those with access to media and a rich household wealth index, respectively, require further validation using primary data.

Background: Persistent exposure to psychosocial stress is linked to an increased risk of metabolic disease, including obesity, cardiovascular disease (CVD), and Type-2 diabetes mellitus (T2DM). Metabolic syndrome is driven by an unhealthy lifestyle encompassing a sedentary lifestyle and unhealthy diet as well as psychological distress, which potentially triggers these metabolic derailments. Various mind-body practices, such as postures, breathing, meditation, and relaxation, are included in yoga. Studies suggest that even one yoga session can improve cognitive function, oxygen saturation, baroreflex sensitivity, sympathovagal balance, and the body's ability to recover from stressful stimuli. Therefore, this study aimed to explore the stress attenuation effect of a combined approach of yoga and diet intervention among metabolic syndrome patients.

Methodology: In this study we randomized 200 subjects diagnosed with metabolic syndrome as per the Joint interim statement 2009 into control and combined (yoga+diet) groups according to their intervention which was given for 6 months. Anthropometric, physiological, perceived stress score and biochemical parameters were collected at baseline, 3 months and 6 months.

Results: The study's findings show that, at three and six months from baseline, the combined yoga with diet approach significantly reduced metabolic risk factors (waist circumference, SBP, DBP, fasting blood glucose, and triglycerides) and improved HDL. At three and six months following the combined (yoga+diet) intervention, the perceived stress score also showed a substantial reduction.

Conclusion: Combined (yoga+diet) interventions are effective in lowering the risk of metabolic syndrome and perceived stress.

Background: The National Health Insurance Scheme (NHIS) now named National Health Insurance Authority (NHIA) was launched to achieve easy access to affordable quality healthcare for all Nigerians. This study aimed at evaluating patients' satisfaction with the services accessed at the NHIS clinic in a tertiary teaching hospital in Southwest, Nigeria.

Methodology: This cross-sectional study carried out at the Federal Teaching Hospital, Ido-Ekiti, Nigeria included all adult patients (> 18 years) who have been enrolled in the scheme for at least one year and have accessed healthcare at the clinic within three months preceding the study. Data was collected from 391 patients using a semi-structured interviewer-administered questionnaire in an exit interview. Data on patients' satisfaction with the quality of care was adapted from the Patient Satisfaction Questionnaire (PSQ 18). Data entry and analyses were done with the SPSS version 26.0.

Results: The mean age (±SD) of the respondents was 43.5±14.5 years. More than half 204 (52.2%) of the patients were male, 291 (74.4%) were married, and 319 (81.6%) had attained tertiary level education. The overall satisfaction score was 75.02 ± 6.37, with communication (78.5 ± 11.6) and interpersonal manner (79.6 ± 10.0) having the highest scores. Predictors of overall satisfaction were longer travel time (p < 0.001) and readiness to return to the clinic for treatment (p = 0.001).

Conclusion: There was a high level of patient's satisfaction with the quality of healthcare services rendered at the NHIS clinic, with domains related to interpersonal and communication ranked highest. Travel time and willingness to return were factors significantly associated with patients' satisfaction. There is the need for the management of NHIS clinics to continuously improve on the quality of healthcare services provided.

Background: demand for public prepared food with numerous food handlers creates uncertainties in the quality of safe foods and possible food contamination. This study aimed to ascertain the food safety hygiene practices, and associated factors among public food handlers in Enugu Metropolis, Nigeria.

Methodology: This was a cross-sectional study conducted among 400 public food handlers in Enugu Metropolis, Nigeria. Samples were selected using a multistage sampling technique. Data was collected using pretested structured interviewer administered questionnaire and analyzed using percentage, mean and multiple regression. Statistical significance was set at p< 0.05.

Results: The mean age of respondents were 31.16 ± 8.242 years. About two - thirds, 66.5% of respondents were found to have good knowledge of food hygiene safety practices. The overall food safety hygiene practice mean score was 80.10 ± 10.25 with 70.5% showing good practice. Environmental safety hygiene had good practice of 35.0% and mean score of 24.17 ± 2.29. The factors which statistically significantly predicted overall food safety practices, F (11, 388) = 42.957, P < 0.0001, R² = 0.536 were educational level (β = 0.148, C.I = 0.860 - 3.082), knowledge level (β = 8.594, C.I = 5.635 - 8.979) and safety trainings (β = 0.517, C.I = 4.102 - 5.474).

Conclusion: There were good safety hygiene practices except on environmental safety hygiene practices component. Safety training, knowledge level and educational level were the predictors of good practices. Frequent training is most needed to prevent or control food contamination and consequent food borne diseases.

Ileal perforation is a fatal surgical complication of typhoid fever. Acute psychosis occurring together with perforation presents a fatal outlook. This is made worse by these patients presenting late for appropriate intervention. A patient with sickle cell disease in addition to ileal perforation and psychosis presents a clinical picture the outcome of which is unpredictable. It could occasionally cause diagnostic dilemma and a great clinical challenge. Typhoid fever, a bacterial disease of low- income countries could be prevented by an improvement in socioeconomic conditions of the people. This will prevent or reduce to the barest minimum the occurrence of these fatal outcomes associated with its complications. This is the case report of a 19-year-old Haemoglobin SC (HbSC) with ileal perforation and acute psychosis.

Background: Patient centred care has a correlation to effectiveness of patient engagement, patient care, and perceived quality of care. Even in the emergency room, awareness of diagnosis and treatment plan is a critical component in every doctor-patient interface as it enhances patient-centred care. This study aims to assess awareness of diagnosis and treatment plan among patients in the accident and emergency department.

Methodology: This is a cross-sectional study conducted at the accident and emergency department of the University of Port Harcourt Teaching Hospital.

Result: One hundred and ninety-seven respondents were recruited into this study comprising of 51.3% males and 48.8% females. Most 86.8% of the respondents were aware of their diagnosis, of which 91.8% knew the accurate diagnosis. Majority 84.8% of the respondents were aware of the treatment, while 68.8% of the respondents were aware of the names of the medications, most of the respondents 59.4% had no knowledge of the side effects of the medications. The majority, 61.4% were involved in the management decision. No significant relationship existed between the socio-demographic characteristics and knowledge of diagnosis and treatment plan.

Conclusion: The chaotic and overcrowded nature of the accident and emergency department should not hamper the delivery of patient centred care. Although, findings obtained from this study reveal that majority of the respondents are aware of their diagnosis and treatment plan, a portion of respondents do not understand their plan of care; this indicates the need for further studies to identify interventions that would ensure that gaps in the physician -patient communication are filled as this optimizes patients' satisfaction of care received, gives better sense of control of their total situation and better quality of life.