Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 31567

 

Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Advertise Contacts Reader Login
     
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Citation statistics : Table of Contents
   2020| March-April  | Volume 61 | Issue 2  
    Online since May 7, 2020

 
 
  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Cited Viewed PDF
ORIGINAL ARTICLES
Prevalence and factors associated with neonatal sepsis in a tertiary hospital, North West Nigeria
Abdulhakeem Abayomi Olorukooba, Williams Richard Ifusemu, Muhammed Sani Ibrahim, Muhammad Bashar Jibril, Lawal Amadu, Bola Biliaminu Lawal
March-April 2020, 61(2):60-66
DOI:10.4103/nmj.NMJ_31_19  
Context: Neonatal sepsis is an important cause of morbidity and mortality of newborns, especially in developing countries. Aims: Our study determined the prevalence of neonatal sepsis and its predisposing factors among neonates admitted in Ahmadu Bello University Teaching Hospital (ABUTH). Settings and Design: This was a cross-sectional descriptive study conducted in ABUTH. Subjects and Methods: The data were abstracted from the case notes of neonates admitted from May 2017 to May 2018. A pretested pro forma was used to abstract the data. Statistical Analysis Used: Odds ratios and multivariate logistic regression were used to determine the factors associated with neonatal sepsis among the study population. Results: The prevalence of neonatal sepsis was 37.6%. Escherichia coli was the most commonly isolated organism. Neonates 0–7 days of age were 2.8 times less likely to develop neonatal sepsis than older neonates. Babies born with an Apgar score of <6 within the 1st min were 2.4 times more likely to develop neonatal sepsis than those whose Apgar score was higher. Neonates of mothers who had urinary tract infection during pregnancy were 2.3 times more likely to have had sepsis and those whose mothers had premature rupture of membranes were 4.6 times more likely. Conclusions: The prevalence of neonatal sepsis was high among the neonates studied. Neonatal and maternal factors were associated with sepsis in the neonates. These findings provide guidelines for the selection of empirical antimicrobial agents in the study site and suggest that a continued periodic evaluation is needed to anticipate the development of neonatal sepsis among neonates admitted.
  11 10,400 17
Pesticide risk and recurrent pregnancy loss in females of subhumid region of India
Akancha Pandey, Shyam Pyari Jaiswar, Nasreen Ghazi Ansari, Sujata Deo, Pushplata Sankhwar, Shriya Pant, Sushil Upadhyay
March-April 2020, 61(2):55-59
DOI:10.4103/nmj.NMJ_117_18  
Objective: The objective of this study is to determine the level of pesticides and their role in cases of recurrent pregnancy loss (RPL). Materials and Methods: This was designed as a case–control study. Gas chromatography was used to characterize the pesticide level in 70 cases and 70 controls. Case refers to women with RPL, whereas controls refer to women with full-term delivery. Results: A higher level of pesticide, namely beta-hexachlorocyclohexane, malathion, chlorpyrifos, and fenvalerate was found in the case group as compared to control group (P < 0.05). Conclusions: The present study suggests that high exposure of pesticide (organochlorine and organophosphates) may increase the risk of RPL in females of the subhumid region of India.
  9 3,800 17
Awareness and utilization of adolescent reproductive health services among in-school adolescents in urban and rural communities in Oyo state
Oluwatosin Ruth Ilori, Phillip Oluwatobi Awodutire, Oluwatosin Stephen Ilori
March-April 2020, 61(2):67-72
DOI:10.4103/nmj.NMJ_38_19  
Introduction: Adolescents require a range of scientifically accurate sexual and reproductive health information and services. Adolescent reproductive health services (ARHSs) are an integral part of adolescent health and it is pertinent that adolescents know about them to be able to benefit from them. This study was to assess the awareness and utilization of adolescents in Oyo State about ARHSs. Materials and Methods: A descriptive cross-sectional study carried out among in-school adolescents where 225 respondents each were selected for the rural and urban groups using a multi-stage sampling technique. Data were collected using a semi-structured questionnaire, and analysis was performed with SPSS version 22. Results: A total of 225 rural and 225 urban respondents participated in this study, with a mean age of 14.3 ± 1.93 and 13.9 ± 2.03 for rural and urban respondents, respectively. Few of the respondents (59, 13.1%) were aware of the existence of ARHS, of which, 34 (57.6%) were of the urban respondents and 25 (42.4%) were from the rural respondents. Only 36 (7.8%) of respondents had ever utilized ARHS with 22 (61.1%) from urban communities. The major reason why almost half of 207 (49.6%) of the adolescents had never been to a facility rendering ARHS before was that they did not know where to go, which was higher among the rural respondents. Conclusions: Awareness of ARHSs was lower among rural respondents, leading to poor utilization of such service. It is, therefore, recommended that more youth-friendly environments should be made available and accessible to adolescents, especially in rural areas (114, 53.3%).
  7 4,968 15
Assessment of resources for primary health care: Implications for the revitalization of primary health care in Akwa Ibom, Nigeria
Christie Divine Akwaowo, Olugbemi Oluseyi Motilewa, Anyiekere Morgan Ekanem
March-April 2020, 61(2):90-95
DOI:10.4103/nmj.NMJ_113_19  
Context: Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy. Aims: The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS. Settings and Design: A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria. Subjects and Methods: A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables. Results: A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities. Conclusions: There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.
  5 4,113 15
Review of episiotomy and the effect of its risk factors on postepisiotomy complications at the University of Port Harcourt Teaching Hospital
Chidiebere N Ononuju, Rosemary N Ogu, Tamunomie K Nyengidiki, Michael I Onwubuariri, Simeon C Amadi, Elizabeth C Ezeaku
March-April 2020, 61(2):96-101
DOI:10.4103/nmj.NMJ_121_19  
Aim: This study aimed to determine the prevalence of episiotomy and postepisiotomy complications and to assess the relationship between the risk factors and postepisiotomy complications in the University of Port Harcourt Teaching Hospital. Methodology: This was a descriptive longitudinal study, in which 403 consecutive women who had episiotomy in the labor ward were recruited for the study. They were followed up and reviewed at the postnatal clinic on the 1st and 6th weeks postdelivery. Data regarding age, marital status, occupation, educational status, address, parity, booking status, postepisiotomy complications, and the associated risk factors were entered adequately into a prestructured pro forma, and statistical analysis was done using statistical software (SPSS for Windows® version 19.0). t-test was used to explore the association of risk factors to postepisiotomy complications. Results: The episiotomy rate was 22.1%. The prevalence of postepisiotomy complications was 52.1%. The mean age of the women was 23.8 (standard deviation ± 3.2) years. Seventy-two (34.3%) patients had perineal pain, which lasted for 72 h or more; 61 (29.1%) had difficulty in walking, while 37 (17.6%) had perineal discomfort. Four (1.9%) had wound infection and only one (0.4%) had wound dehiscence. The development of postepisiotomy complications was not statistically significantly associated with risk factors such as gestational age (T = 1.4, P = 0.1), packed cell volume on admission (T = 1.0, P = 0.2), duration of first stage of labor (T = 0.5, P = 0.1), duration of second stage of labor (T = 0.7, P = 0.3), duration of rupture of fetal membranes (T = 0.8, P = 0.4), delivery repair interval (T = 0.6, P = 0.2), estimated blood loss (T = 0.9, P = 0.2), duration of Sitz bath (T = 1.0, P = 0.2), duration of analgesic (T = 1.2, P = 0.1), duration of antibiotics (T = 1.3, P = 0.1), or the operator who performed or repaired the episiotomy (P = 0.2). Conclusion: The prevalence of episiotomy and postepisiotomy complications in this study was high. Necessary attention should be given to ensure adequate pain relief for all parturients who had episiotomy, and the policy of restrictive use of episiotomy should be fully implemented in the department in line with the best practices and evidence-based recommendations. This will further reduce the incidence of episiotomy rate as well complications that may arise from it and ensure a positive pregnancy experience for pregnant women.
  4 5,556 21
Convergent validity of self-administered addiction severity index in a sample of Nigerian patients in a residential treatment facility
Mukhtar Mohammed Yerima, Peter Olutunde Onifade, Ibrahim Abdu Wakawa, Sadique Kwajaffa Pindar, Mohammed Said Jidda, Umar Baba Musami, Fatima Abba Ali
March-April 2020, 61(2):73-77
DOI:10.4103/nmj.NMJ_59_19  
Background: Substance use disorders present with multiple drug-related problems that need to be evaluated with a view to planning and administering holistic interventions that could potentially improve addiction treatment outcomes. Many valid instruments are available for assessing the problems that occur in addiction but most of them require some training and they take a lot of time to administer. This study validates a shorter self-administered version of the Addiction severity Index (ASI) against the Clinician-administered ASI with a view to cutting the time needed to administer the instrument. Methods: The study recruited 142 patients in a residential treatment center. Correlation coefficient and t-test were used to assess for the convergence of the two version. Results: The correlation coefficients ranged from 0.52 to 0.97 for the different domain of the ASI with higher endorsement of problems in the self-administered than clinician administered version in most domains. Conclusion: The self-administered ASI is a valid alternative to the clinician-administered ASI and it saves valuable time especially in resource-constrained settings.
  1 3,786 17
Assessment of use of national guidelines for malaria case management among pediatric resident doctors attending an update course in Benin City, Nigeria
Damian U Nwaneri, Ayebo E Sadoh, Michael O Ibadin
March-April 2020, 61(2):78-83
DOI:10.4103/nmj.NMJ_72_19  
Introduction: The National Malaria Guideline is a veritable tool for appropriate case management of malaria. Whether the pediatric residents who are the primary caregivers of children know and make use of this guideline in their routine practice is not yet assessed. Aim: The aim of the study is to assess the awareness of the Nigerian pediatric residents of the national guidelines for malaria case management (including antimalarial prescription for uncomplicated and severe malaria). Settings and Design: The descriptive study carried out during the 2017 National Postgraduate Medical College of Nigeria, Faculty of Paediatrics Update Course in Benin City. Subjects and Methods: Data were obtained using a self-administered questionnaire which was given to all pediatric residents who participated at the update course and who had given written informed consent. Statistical Analysis Used: The statistical analysis was done using the Statistical Package for the Social Sciences version 16.0 (Inc., Chicago, Illinois, USA). Results: Of the 108 participants whose questionnaires were analyzed, 75.0% were Part 1 candidates and 25.0% Part 2 candidates; mean age 34.0 ± 4.5 years (range 26–51 years) and 42 (39.0%) males while 66 (61.0%) were female. Ninety-four (87.0%) were aware of the current national guidelines for management of malaria and 45 (41.7%) had read the guidelines. Correctness of prescription was obtained from 39 (36.0%) respondents in uncomplicated malaria cases and 44 (40.7%) in severe malaria cases. This finding did not significantly associate with the years of practice, level of practice, practicing institutions, awareness, and reading of the national guideline. Conclusions: Most pediatric residents have not read nor use the national guidelines for management of malaria which reflected in poor prescription pattern of antimalarial drugs in routine practice.
  1 3,835 15
CASE REPORTS
Minor blunt injury-induced rhabdomyolysis from a road traffic accident in Nigeria
Ernest Ndukaife Anyabolu, Innocent Chukwuemeka Okoye, Innocent Ijezie Chukwuonye, Arthur Ebelenna Anyabolu, Kenneth Chukwueloka Dike, Chinyelu Uchenna Ufoaroh
March-April 2020, 61(2):102-105
DOI:10.4103/nmj.NMJ_114_19  
Rhabdomyolysis, though not a common complication of minor blunt trauma, may result in life-threatening acute kidney injury (AKI). Here is illustrated a case of a young male who sustained minor blunt injuries in a road traffic accident, which he overlooked and presented with features of severe AKI. The patient is a 24-year-old male, who presented with progressive weakness, difficulty in walking, and features of uremia, 14 days after he sustained minor blunt injuries and lacerations in a road traffic accident. Evaluation showed elevated serum creatine kinase, serum myoglobin, and severe azotemia. He was commenced on hemodialysis. He was also commenced on antibiotics, analgesic, and 5% dextrose/saline. He had three sessions of hemodialysis on alternate days. His condition improved remarkably after the first session of dialysis. He was discharged after 18 days on admission. Follow-up in the clinic showed a normal renal function. This case report shows rhabdomyolysis from minor blunt injuries sustained in a road traffic accident and complicated by severe AKI. The patient almost recovered full renal function with management.
  - 3,301 15
Hemoglobin SS Nigerian woman first diagnosed at the age of 52 years with manifestation mimicking tuberculosis of the spine
Ngozi Immaculata Ugwu, Emmanuel Okechukwu Nna, Agama Nnachi Egwu, Ejike Augustine Okoye
March-April 2020, 61(2):106-109
DOI:10.4103/nmj.NMJ_220_19  
Sickle cell anemia (SCA) is an inherited disorder of hemoglobin due to the presence of abnormal hemoglobin in a homozygous state. Manifestation is usually in infancy or early childhood due to gradual decrease in hemoglobin F level as age advances. Diagnosis in middle age is unusual. We present a woman who was diagnosed of SCA for the first time at middle age. The aim was to bring to the knowledge of physicians that patients with SCA can also present late so high index of suspicion is required to make diagnosis. A 52-year-old woman presented to orthopedic clinic with complaints of generalized bone pain and low back pain. There was no history of trauma prior to the onset of the pain. There was no associated fever, weight loss, loss of appetite, nor weakness of the lower limbs. X-ray of the spine done showed wedge collapse of the 12th thoracic and first lumbar vertebrae with posterior angulation of the thoracolumbar junction giving dorsal kyphosis. Her mode of presentation raised a suspicion of tuberculosis of the spine to rule out multiple myeloma. However, investigations for tuberculosis and multiple myeloma were all negative. This necessitated the investigation for SCA and the diagnosis was confirmed. The diagnosis of SCA is usually made in infancy or early childhood. High index of suspicion is required to make the diagnosis at middle age.
  - 3,169 15
ORIGINAL ARTICLES
The perception of people living with human immunodeficiency virus/acquired immunodeficiency syndrome toward human immunodeficiency virus infection: A single-center experience
Chilota Chibuife Efobi, Emmanuel Chukwunonye Azuike, Basil Elochukwu Nwankwo, Uzoma Nnenna Chidolue, Helen Chioma Okoye
March-April 2020, 61(2):84-89
DOI:10.4103/nmj.NMJ_90_19  
Background: The prevention and control of human immunodeficiency virus (HIV) infection depend on the prevention of new infections as well as treating currently infected individuals. Adequate knowledge of HIV infection among person living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) may be an important tool in reducing spread of the virus. Objective: The objective of the study was to evaluate knowledge and attitude of PLWHA on HIV infection. Methodology: This was a cross-sectional study conducted at the Chukwuemeka Odumegwu Ojukwu Teaching Hospital. Knowledge of infection, spread, control, and effect was sought from HIV-positive respondents using a structured questionnaire. Information about their attitude and beliefs was also obtained. Collected data were analyzed using the Statistical Package for Social Sciences for Windows, Version 21.0. Results: A total of 70 HIV-positive patients, including 23 (32.9%) males and 47 (67.1%) females with a mean age of 37.7 years were participated. The overall knowledge on HIV transmission, clinical effects, complications, and controls was good in 15.7%, average in 72.9%, and poor in 11.4%. Knowledge of means of transmission was appropriate in majority of them. Majority of 66 (94.3%) patients showed a positive attitude to life. Conclusion: Most of the HIV-positive patients had average knowledge on HIV, and majority had a positive attitude to life.
  - 2,920 15
REVIEW ARTICLE
Common design concepts in randomized controlled trials
Bolaji Emmanuel Egbewale
March-April 2020, 61(2):51-54
DOI:10.4103/nmj.NMJ_112_19  
It is a known fact that Randomized Controlled Trials (RCTs) are the gold standard design methods in medical investigations particularly when the aim is comparison of medical therapies or effectiveness of intervention between treatment groups. This design method, once carefully followed, presents the highest level of evidence attainable in the measurement of treatment effect. Oftentimes, researchers confuse concepts related to the design of RCTs and thereby jeopardizing its benefits. Furthermore, in resource-poor settings, a very limited access to educational materials on design, conduct, and reporting of clinical trials exists. This among other reasons explains why most studies in such settings are observational in nature as RCTs are not as popular. This review adopted a narrative synthesis approach to aggregate current knowledge scattered in literatures in respect of selected common design concepts in RCTs so as to elucidate on their meaning and demands. Overall, 25 literatures drawn majorly from the PubMed database including 8 textbook materials were involved in examining the following concepts; Study Population in RCTs Setting, Primary and Secondary Outcome Measures, Single and Multicenter Trials, Pragmatic and Explanatory trials, and Blinding. Appropriate search terms for each of the concepts were entered into the PubMed database and relevant articles accessed. This review article, intended for educational purposes could also serve as a guide, especially for new entrants, in the design of RCTs. It is hoped that this educational material would contribute immensely toward maximizing the benefits of this all-important design method.
  - 3,516 15
  Feedback 
  Subscribe