The Nigerian Postgraduate Medical Journal[JOURNAL]
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200 papers
Evaluation of the Evan's Index on Normal Brain Computed Tomography Scans of Adults in Delta State Nigeria.
Ominde BS, Enaohwo MT, Ogholo OD … +3 more , Ikubor JE, Onogbe PO, Jeremiah O
Niger Postgrad Med J · 2025 Jan · PMID 40091471 · Publisher ↗
AIMS: The study aimed at establishing the normal Evans index (EI) in adults residing in Delta State, Nigeria. METHODS: Researchers sought ethical authorisation from a Nigerian University Teaching Hospital in Delta State,...
AIMS: The study aimed at establishing the normal Evans index (EI) in adults residing in Delta State, Nigeria. METHODS: Researchers sought ethical authorisation from a Nigerian University Teaching Hospital in Delta State, where this cross-sectional study was conducted. Computed tomographic images of the brain were retrieved from the hospital's radiological database. Brain computed tomography images of 195 adults (102 males and 93 females) were selected, and their axial slices were retrospectively analysed to determine the maximum width of the frontal horns (MWFHs) and the maximum intracranial transverse diameter (MITD). The ratio of MWFH to MITD was computed as the EI. Statistical Package for the Social Sciences version 27 was employed to evaluate the sex- and age-related differences in the quantitative variables and the association between them. These were regarded significant whenever P < 0.05. RESULTS: Male patients had larger MITD and MWFH than females (P < 0.05). However, the EI lacked significant sexual variances (P = 0.051). As age increased, the mean EI also significantly increased, although, it did not exceed 0.3; the internationally recognised diagnostic cutoff value. The EI and MWFH showed a weak positive relationship with age, whereas the MITD and age had a weak negative association (P < 0.05). Both EI and MITD had a positive correlation with MWFH (P < 0.05). CONCLUSION: The normative EI values established in this study provide reliable references than will aid clinicians to accurately diagnose and monitor patients with ventriculomegaly associated with normal pressure hydrocephalus and neurodegenerative disorders, ensuring more effective management.
Effect of Low-salt Food Preparation Demonstration Compared to Routine Health Education on Salt Intake and Blood Pressure among Patients with Hypertension Seeking Care from a Selected Urban Primary Health Centre, Puducherry.
Gupta S, Sahu SK, Barathi A … +2 more , Gupta R, Basu S
Niger Postgrad Med J · 2025 Jan · PMID 40091470 · Publisher ↗
BACKGROUND: Daily salt consumption is one of the causal factors for hypertension. As per the World Health Organization estimates, 1.28 billion people aged 30-79 years have hypertension worldwide. AIM: The aim of this stu...
BACKGROUND: Daily salt consumption is one of the causal factors for hypertension. As per the World Health Organization estimates, 1.28 billion people aged 30-79 years have hypertension worldwide. AIM: The aim of this study was to assess the effect of a low-salt food preparation demonstration (FPD) in reducing salt intake and blood pressure amongst patients with hypertension. SUBJECTS AND METHODS: It was a pilot parallel-arm non-randomised controlled trial conducted in Puducherry, South India. Eligible participants were patients with hypertension, aged 30-59 years, seeking care at JIPMER Urban Health Centre and involved in home cooking. The data were collected through house-to-house visits. The intervention group (IG) received a low-salt FPD and routine health education (RHE), whereas RHE was given to the control group (CG). Differences-in-difference analysis was performed to assess the mean changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), daily salt intake and household salt consumption (HSC) across the groups. RESULTS: Out of 130 patients enrolled, 101 (77.6%) were included in the final analysis. Post-intervention, results were statistically significant in both IG and CG for SBP, DBP and HSC. However, the IG showed greater mean reduction in SBP of 2.1 mmHg (95% confidence interval [CI]: -3.0, -0.92), DBP of 2.2 mmHg (95% CI: -3.0, -1.4) and HSC of 112.7 g/day (95% CI: -169.4, -56.1). CONCLUSION: Participants who received FPD reported greater reductions in blood pressure compared to those who received only RHE. Further studies with longer follow-up periods may confirm these findings and provide a better understanding of the impact of such interventions.
Clinical Efficacy of a Modified Posteromedial Oblique Incision in the Treatment of Posterior Cruciate Ligament Tibial Avulsion Fractures: A Single-centre, Single-arm, Prospective Study.
Li Z, Chen C, Zheng X … +3 more , Luo J, Wang H, Yao J
Niger Postgrad Med J · 2025 Jan · PMID 40091469 · Publisher ↗
AIMS: The purpose of the study was to evaluate the safety and efficacy of a modified posteromedial oblique incision (POI) in the treatment of posterior cruciate ligament (PCL) tibial avulsion fractures. METHODS: A single...
AIMS: The purpose of the study was to evaluate the safety and efficacy of a modified posteromedial oblique incision (POI) in the treatment of posterior cruciate ligament (PCL) tibial avulsion fractures. METHODS: A single-centre, single-arm, prospective study. Patients who met the inclusion criteria were collected between September 2022 and June 2024 at the First Affiliated Hospital of Guangxi Medical University. Patients were followed up to the study endpoint, and the safety and efficacy of the POI were inferred by analysing the follow-up data. RESULTS: The angle was 67.20 ± 3.16°, the |OM| was 2.48 ± 0.13 cm, the |ON| was 1.33 ± 0.12 cm. The incision length was statistically significant when compared with the two classic incisions, the 'S' and the inverted 'L' (P < 0.05). The difference in the comparison of KT-1000, Lysholm scores, International Knee joint Documentation Committee scores and posterior drawer test negative rate in pre-surgery and 3 months post-surgery were statistically significant (P < 0.05). The KT-1000 of the normal knee, the normal calf circumference, and the pre-surgery calf circumference were compared with the knee 3 months post-surgery, respectively, and the differences were not statistically significant (P > 0.05). Gastrocnemius strength in all patients was determined to be grade 5, which is normal strength. CONCLUSION: The study has shown that using POI to treat PCL tibial avulsion fractures is safe and effective, because it avoids nearby nerves and blood vessels. Therefore, I believe that the modified POI technique is worthy of being considered for use and has a great potential for application.
Assessment of Candidates' Performance Pre- and Post-Adoption of Standard Setting in College Examinations between 2016 and 2023.
Charles-Eromosele TO, Ekekezie OO, Akinyemi PA … +1 more , Arogundade FA
Niger Postgrad Med J · 2025 Jan · PMID 40091468 · Publisher ↗
BACKGROUND: Assessment drives candidates' learning and focuses on the main goals and objectives of the course. Over the years, determination of pass scores in medical education has evolved from the arbitrary 50% to the a...
BACKGROUND: Assessment drives candidates' learning and focuses on the main goals and objectives of the course. Over the years, determination of pass scores in medical education has evolved from the arbitrary 50% to the actual determination of the cut-off scores in the standard setting process in order to make a decision to pass/fail candidates presenting for licensure or credentialing purposes. MATERIALS AND METHODS: The study aimed at assessing and comparing candidates' performance pre- and post-adoption of standard setting in the college. This was a comparative cross-sectional study with a time trend. Examination results of all candidates who registered and sat for examinations in the years 2016-2023 were included in the study. Secondary data from approved results of the various faculties from 2016 to 2023 were used. Data analysis was done using SPSS Version 26. RESULTS: There was a statistically significant difference in the mean pass rates pre- and post-adoption of standard setting in the primary examinations (P < 0.001), Part I examinations (P = 0.002) and Part II examinations (P < 0.001) with a higher mean pass rate post-adoption of standard setting. CONCLUSION: The increased pass rates in the primary, Part I and Part II examinations post-adoption of standard setting may suggest improved examination performance. There is, however, the need to assess the acquired competencies and skills of the candidates post-certification. The significantly higher mean pass rates post-adoption of standard setting are consequent on improvement in the quality and robustness of items/questions and of the examination processes, brought about by the training and retraining of faculty examiners which preceded the implementation.
Determination of the Common Microorganisms Present in the Intensive Care Unit of Federal Teaching Hospital Owerri, Southeast Nigeria: A Prospective, Descriptive Cross-sectional Study.
Anokwute II, Onwudiwe RU, Kalu E … +3 more , Madubuko CG, Egbulem CT, Eluchie EC
Niger Postgrad Med J · 2025 Jan · PMID 40091467 · Publisher ↗
BACKGROUND: Bacterial contamination of inanimate surfaces in the intensive care unit (ICU) and subsequent cross-transmission of the microorganisms may play a significant role in ICU-acquired infections. AIM: The study ai...
BACKGROUND: Bacterial contamination of inanimate surfaces in the intensive care unit (ICU) and subsequent cross-transmission of the microorganisms may play a significant role in ICU-acquired infections. AIM: The study aimed to evaluate the common organisms in the ICU and their sensitivity profile. SUBJECTS AND METHODS: Ethical clearance was obtained from the Institution's Health Research and Ethics Committee. Sampling involved all the equipment and furniture with which the health workers and patients have greater contact within the ICU and also the air. Sample collection was done using the open plate method for air and the swab method for the surfaces of equipment and furniture. Microbial growths were isolated using the standard bacteriological methods such as lactose fermentation and gram stain while antibiotic sensitivity was achieved with the disc diffusion method. RESULTS: A total of 66 samples were collected and 36 (54.5%) yielded microbial growth, 4 (11.1%) were by open plate method, and 32 (88.9%) by swab method. 27 (61.4%) of the isolates were Gram-negative organisms while 9 (20.5%) were Gram-positive organisms. Escherichia coli was the most dominant isolate 26 (59.1%) followed by Staphylococcus spp. 9 (20.5%), fungi 8 (18.2%), and Klebsiella spp. 1 (2.3%). All the isolates were sensitive to ceftriaxone/sulbactam and ofloxacin, but they were resistant to augmentin, cefixime, cefuroxime, cefotaxime, erythromycin, azithromycin, and gentamycin. However, ciprofloxacin, levofloxacin, and imipenem were effective with all the isolates except Klebsiella. CONCLUSION: The bacteria contamination rate in the ICU was relatively high, mostly by Gram-negative organisms. Frequent profiling and sensitivity testing of the microbial load in the ICU are advocated to guide treatment.
Human Immunodeficiency Virus-associated Heart Disease in Nigerian Children: A Persistent and Difficult Clinical Challenge.
Arodiwe IO
Niger Postgrad Med J · 2025 Jan · PMID 40091466 · Publisher ↗
Heart disease is one of the end organ damages noticed in patients with human immunodeficiency virus (HIV)/AIDS. Its incidence globally is 20%-40%. At least 300,000 children were newly infected as of 2020 in Nigeria. This...
Heart disease is one of the end organ damages noticed in patients with human immunodeficiency virus (HIV)/AIDS. Its incidence globally is 20%-40%. At least 300,000 children were newly infected as of 2020 in Nigeria. This review highlights the prevalence and management challenges of childhood HIV-associated heart disease in a developing country. A search for published data on HIV-associated heart disease was done through several search engines. Keywords such as 'HIV', 'heart disease', 'HAART', 'end organ involvement in HIV', 'echocardiography' and 'children' were used. The global prevalence of HIV-associated heart disease ranged from 38.2% to 75.9%. This includes left ventricular (LV) diastolic dysfunction (30.7%-36.4%); mean mitral valve peak E/A ratio 2.09 ± 0.46, Deceleration time (DT) 230.66 ± 36.27 ms and in vitro release test 110.40 ± 10.12 ms were higher in these children than controls (P < 0.001). LV systolic dysfunction was seen in 33.7%-35.4%, dilated cardiomyopathy (6.8%-33.7%) and pericardial effusion (4.5%-14.5%). Other cardiac abnormalities were LV hypertrophy, 7.5%-10%. Management challenges include a dearth of two-dimensional echocardiographic competence in Nigeria, as services are unavailable in some tertiary centres. The comorbidity with anaemia and low systemic vascular resistance from diarrhoeal disease in these children makes diuretics difficult to use. HIV-associated heart disease is one of the common end organ involvements in children with some management challenges. There is a need for routine screening for cardiovascular abnormality at baseline and at follow-up.
Nanoparticles and the Vaginal Microbiota: Diagnostic and Therapeutic Innovations in Human Papilloma Virus-associated Cervical Cancer - A Systematic Review.
Velmurugan S, Ganesan K, Rajasundaram A … +3 more , Thangam C, Cyril R, Subbaraj GK
Niger Postgrad Med J · 2025 Jan · PMID 40091465 · Publisher ↗
Cervical cancer (CC) remains a significant global health challenge, with the interplay between microbiome and cancer progression becoming increasingly evident. A comprehensive literature search was conducted across multi...
Cervical cancer (CC) remains a significant global health challenge, with the interplay between microbiome and cancer progression becoming increasingly evident. A comprehensive literature search was conducted across multiple databases, including Embase, NCBI, Google Scholar, Elsevier, Science Direct and PubMed, utilising the specific keywords such as 'cervical cancer', 'cervical microbiome', 'vaginal microbiome', 'Human papillomavirus', 'nanoparticles', 'drug delivery' and 'dysbiosis'. Studies published over the past 15 years were reviewed. A total of 400 articles were identified and 65 research articles were finally included. This systematic approach identified relevant studies, enabling an in-depth analysis of microbial species, such as Parabacteroides, Escherichia, Shigella, Gardnerella and Fusobacterium which are recognised as the potential biomarkers for CC diagnosis and progression. Dysbiosis is characterised by a reduction in helpful bacteria and a proliferation of harmful ones. It is linked to chronic inflammation and human papillomavirus infection, both of which facilitate the CC progression. Advanced nanotechnology presents innovative therapeutic options for CC treatment, enhancing drug delivery systems and targeting tumour cells more effectively. Moreover, incorporating nanocarriers into treatment regimens aims to improve the bioavailability and efficacy of existing therapies, potentially transforming the clinical approaches to CC management. This review highlights the dual role of the microbiome as both a diagnostic and prognostic biomarker and elucidates the potential of nanotechnology in optimising treatment strategies, advocating for further research on microbial interactions in cancer pathology.
Emergency Medicine as a Medical Speciality in Nigeria: Challenges and Prospects.
Yinusa W
Niger Postgrad Med J · 2024 Oct · PMID 39628338 · Publisher ↗
Emergency medicine (EM) globally is a new medical speciality when compared with traditional medical specialities such as surgery, obstetrics, gynaecology and internal medicine. It is a medical speciality that deals with...
Emergency medicine (EM) globally is a new medical speciality when compared with traditional medical specialities such as surgery, obstetrics, gynaecology and internal medicine. It is a medical speciality that deals with the management of acute illnesses and injuries in a timely and result-oriented manner. The International Federation of EM defines it as a field of practice based on the knowledge and care required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury, affecting patients of all age groups with a full spectrum of episodic, undifferentiated physical and behavioural disorders. Two types of EM are recognised: the out-of-hospital emergency medical services (OHEMS) and the in-hospital emergency medical services (IHEMS). OHEMS was introduced into the country in 1998 by the Lagos state government. IHEMS had been in place for much longer, but it was practised in a heterogeneous and substandard manner. The result of the latter is a casualty department with an overwhelming burden of patients and a high mortality rate. The World Health Assembly (WHA) resolution 60.22 of 2007 mandated every member state government to establish and monitor integrated EM care systems; it is therefore expected that the emergency medical services (EMS) in the country would wear a new look. However, anecdotal reports suggest that both OHEMS and IHEMS in the country are rudimentary and there is no strong evidence to show that EM is embraced by all as a medical speciality. The objective of this study is to examine the challenges and prospects of EM as a medical speciality in Nigeria. A review of the past literature searched in Google, Google Scholar, PubMed and African Journal online was conducted. A total of 40 relevant publications in addition to the authors knowledge and exposure in EM supported the information presented in this manuscript. Our study revealed that inadequate funding and ambulance services, nonavailability of trained bystanders, limited infrastructure and skilled manpower, inadequate and inequitable distribution of health resources, lack of standard emergency department, high out-of-pocket expenses and substandard implementation of EMS policies, are factors militating against a functional EMS in the country. In line with the philosophy of WHA resolution72.16 of 2019, it is recommended that the central government should put in place a mechanism for full and sustainable implementation of the NHIA Act (2022), National Emergency Medical Services and Ambulance System (NEMSAS) and the patient's bill of rights and direct the adoption of EM as a medical speciality in all federal and state hospitals. In addition, the central government should create public awareness, improve road networks, provide funding, and establish collaboration with local and international organisations.
Bilateral Total Hip and Right Knee Arthroplasty in a Sickle Cell Disease Patient with Multiple Joint Osteonecrosis: A Case Report and Literature Review.
Ugbeye ME, Alatishe KA, Okezie C
Niger Postgrad Med J · 2024 Oct · PMID 39628337 · Publisher ↗
Sickle cell disease is an autosomal recessive genetic disorder with the underlying pathology, resulting in sickling of the red blood cells in deoxygenated conditions. Osteonecrosis is a common orthopaedic manifestation o...
Sickle cell disease is an autosomal recessive genetic disorder with the underlying pathology, resulting in sickling of the red blood cells in deoxygenated conditions. Osteonecrosis is a common orthopaedic manifestation of sickle cell disease, and total joint arthroplasty is the preferred option in managing patients with advanced disease. This article describes bilateral total hip arthroplasty and right total knee arthroplasty (TKA) in a 41-year-old woman, a known haemoglobin SS (HBSS) patient who presented to the outpatient clinic of National Orthopaedic Hospital, Igbobi, Lagos, with recurrent bilateral hip and right knee pain of 10-year duration, with associated stiffness, valgus deformity in the knee and severe limitation of function. She had sequential bilateral total hip replacement and right TKA. She had significant improvement in function in the follow-up period. The effectiveness of total hip and knee arthroplasties in HBSS patients with osteonecrosis is well demonstrated in this article.
A Case Series of Diagnostic Challenges in Mycosis Fungoides in Resource-poor Settings: Blood Film Examination - A Useful Tool.
Otrofanowei E, Akinkugbe AO, Adelabu YA … +1 more , Ayanlowo OO
Niger Postgrad Med J · 2024 Oct · PMID 39628336 · Publisher ↗
The prognosis/mortality rate in mycosis fungoides (MF)/cutaneous T-cell lymphomas (CTCL) is alarming in resource-poor countries due to delayed diagnosis in meeting recognised criteria. We highlight the diagnostic accurac...
The prognosis/mortality rate in mycosis fungoides (MF)/cutaneous T-cell lymphomas (CTCL) is alarming in resource-poor countries due to delayed diagnosis in meeting recognised criteria. We highlight the diagnostic accuracy of examining peripheral blood films (PBFs). We reviewed clinically diagnosed MF/CTCL cases in the Dermatology Clinic of Lagos University Teaching Hospital between January and October 2022 and analysed clinical, haematological and histology findings. Eight patients (male:female = 5:3) between 35 and 68 years had blood films with characteristic Sezary cells of <5%. Flow cytometry (FC) in 1 (12.5%) was inconclusive, and immunohistochemistry (IHC) on skin/lymph nodes in 5 (62.5%) was highly suggestive or confirmatory. Three patients had no biopsy. Patients had methotrexate, phototherapy (±psoralen) and systemic steroids with varying improvements. Since immunophenotyping (FC or IHC) is lacking in resource-poor countries or low- and middle-income countries, Sezary cells in PBF of clinically diagnosed patients with MF/CTCL should prompt treatment.
Implementation of Standard setting in the Assessment of Examinations in a Postgraduate Medical College: Opinions, Experiences and Prospects.
Ekekezie OO, Charles-Eromosele TO, Olatona FA … +1 more , Aguwa EN
Niger Postgrad Med J · 2024 Oct · PMID 39628335 · Publisher ↗
CONTEXT: The world over, there has been a paradigm shift in medical education from the traditional curriculum to Competency-Based Medical Education (CBME), of which the application of standard setting in assessments is a...
CONTEXT: The world over, there has been a paradigm shift in medical education from the traditional curriculum to Competency-Based Medical Education (CBME), of which the application of standard setting in assessments is an integral part. Standard setting is the process used to define an acceptable level of performance and to establish a pass score for the defined levels of performance in the competency domains assessed by an examination. AIMS: This study was designed to assess the opinions and experiences of key judges for implementation of standard setting and to outline its prospects from their perspective. SETTINGS AND DESIGN: A descriptive cross-sectional study on the opinions, experiences and prospects for standard setting in the assessment of college examinations. METHODS: A total population survey of Faculty Officers for the year 2024. DATA ANALYSIS: Descriptive statistics using SPSS Version 27. RESULTS: The use of an arbitrary 50% pass mark was not supported as 80% of the respondents felt it was neither just nor equitable; 84% opined that it will not correctly separate competent from incompetent candidates and 76% felt it was not defensible. Over 90% of the respondents supported the shift to standard setting, though 31% and 51%, respectively, believed that it was difficult to implement and strenuous. Training and retraining of faculty and examiners was advocated by 98% of the respondents. CONCLUSION: Standard setting is more appropriate in determining true competence than using arbitrary pass scores. Training and retraining of faculty and examiners is required to improve understanding of the process and concepts.
Epidemiology of Traumatic Brain Injury at a Tertiary Institution in Nigeria.
Ojo OA, Okei JC, Adaramola OG … +7 more , Olajide SO, Awofeso OM, Agbarakwe CA, Arekhandia BJ, Owolabi BS, Ashimi AA, Solahudeen ZO
Niger Postgrad Med J · 2024 Oct · PMID 39628334 · Publisher ↗
INTRODUCTION: Traumatic brain injury (TBI) is devastating to the victims, and an understanding of its prevalence, the demography and the causes help reduce the incidence and outcome. Adequate knowledge of such helps in d...
INTRODUCTION: Traumatic brain injury (TBI) is devastating to the victims, and an understanding of its prevalence, the demography and the causes help reduce the incidence and outcome. Adequate knowledge of such helps in developing preventive and management protocols in the region. The study aims to document the presentation and challenges of TBI in our centre. METHODS: A cross-sectional design was conducted at Lagos University Teaching Hospital, Nigeria. Only adult (≥18 years) patients were recruited consecutively from the emergency room following a diagnosis of TBI. Data were obtained with the aid of a study pro forma which recorded participants' sociodemographic information, pre-hospital indices and clinical examination/investigations. Imaging findings, surgical information and follow-up findings were also recorded. Data obtained were analysed using the IBM SPSS Statistics. RESULTS: A total of 125 TBI patients with male:female of 8:1 were recruited over 12 months. The mean age was 40.8 years standard deviation ± 16.86. Only 9 patients (7.2%) had health insurance. Eighty-four (67.2%) patients had TBI from road traffic accidents (RTAs). Fall from heights, assaults, industrial accidents and gunshots contributed 16%, 9.6%, 5.6% and 1.6% of patients' injuries respectively. One hundred and fourteen (91.2%) were brought to the hospital by non-healthcare workers. CONCLUSION: RTAs remain the most common cause of TBI. Majority of the populace cannot afford the cost of TBI management. The scope of national health insurance needs to be broadened to help victims at the points of need.
Epidemiological, Clinical and Paraclinical Profile of Paediatric Malaria at University Hospital Centre Amissa Bongo in Franceville, Gabon.
Imboumy-Limoukou RK, Biteghe-Bi-Essone JC, Oyegue-Liabagui SL … +6 more , Ekogha-Ovono JJ, Nascimento DNI, Ontoua SS, Ntigui CNMM, Kouna LC, Lekana-Douki JB
Niger Postgrad Med J · 2024 Oct · PMID 39628333 · Publisher ↗
BACKGROUND: Malaria remains the deadliest parasitic disease and continues to cause more than half a million deaths across the world each year, mainly victims are sub-Saharan children. Malaria is a common reason for paedi...
BACKGROUND: Malaria remains the deadliest parasitic disease and continues to cause more than half a million deaths across the world each year, mainly victims are sub-Saharan children. Malaria is a common reason for paediatric hospitalisation. OBJECTIVE: The objective was to characterise malaria and describe the evolution after treatment in the paediatric department of the University Hospital Centre Amissa Bongo de Franceville. METHODS: This was a cross-sectional study conducted from 1 February 2023 to 15 May 2023. A clinical and biological diagnosis was made in febrile children aged from 6 months to 15 years. RESULTS: A total of 306 patients were included. The mean age was 50.4 ± 44.3 months, 94.3% had consulted within ≥48 h and self-medication was practiced by 83.3%. The prevalence of malaria was 17.3%. Fever ˃39°8C (adjusted odds ratios [aOR] = 2.68; 95% confidence interval [CI] = [1.32-5.48]; P < 0.01), chills (aOR = 2.14; 95% CI = [1.13-4.11]; P < 0.01) and nausea-vomiting (aOR = 2.03; 95% CI = [1.06-3.83]; P = 0.03) were the factors associated with the occurrence of malaria. The majority of children were treated for simple malaria with artemisinin-based combination therapy. A total of 16/53 was seen in post-therapeutic consultation. Of them, 2 patients had a positive thick drop. CONCLUSION: Non-compliance with preventive measures and the misuse of antimalarials further complicate the clinical picture, requiring parenteral management for the most part.
Self-reported Myopia in Trinidad and Tobago: A Cross-sectional Study.
Ezinne NE, Kwarteng MA, Tagoh S … +2 more , Jagroo A, Martin D
Niger Postgrad Med J · 2024 Oct · PMID 39628332 · Publisher ↗
OBJECTIVE: The objective of this study was to determine the prevalence of self-reported myopia in Trinidad and Tobago. MATERIALS AND METHODS: This study was a cross-sectional design, and data were collected using a valid...
OBJECTIVE: The objective of this study was to determine the prevalence of self-reported myopia in Trinidad and Tobago. MATERIALS AND METHODS: This study was a cross-sectional design, and data were collected using a validated structured questionnaire from January to April 2024. Systematic random sampling was used to select participants aged 15 and above to participate. Descriptive statistics were used to summarise the variables and the Chi-square test was used to assess for associations (P < 0.05). RESULTS: A total of 350 participated in the study giving a response rate of 91.15%. Majority of the participants were female (n = 197, 56.3%), mixed race (n = 126, 36%), resided in urban areas (n = 172, 49.4%) and aged 18-35 years (n = 168, 48.3%). The prevalence of myopia was 40.9% and the prevalence was significantly associated with age group, ethnicity, level of education and religion (P < 0.05). Myopia was associated with family history, lifestyle, use of spectacles, daily use of computers, near work, outdoor activities, sleeping and having a father or mother with myopia (All P < 0.05). In addition, ocular diseases such as cataracts and glaucoma were among the most frequent reported conditions. CONCLUSION: The myopia prevalence observed in our study validates age-related trends, offers estimates across diverse age groups, and reveals a significant association between myopia rates and family history, with a self-reported myopia rate higher than clinical testing surveys but in line with global prevalence reports.
Assessment of the Prevalence and Patterns of Violence against Healthcare Workers in Nigeria: A Multicentre Study.
Isara AR, Wudiri ZW, Agbo HA … +4 more , Lar LA, Aigbokhaode AQ, Awunor NS, For Association of Public Health Physicians of Nigeria
Niger Postgrad Med J · 2024 Oct · PMID 39628331 · Publisher ↗
BACKGROUND: In Nigeria, violence against healthcare has adversely affected the access to and delivery of healthcare services with serious consequences for healthcare workers (HCWs). This study assessed the prevalence and...
BACKGROUND: In Nigeria, violence against healthcare has adversely affected the access to and delivery of healthcare services with serious consequences for healthcare workers (HCWs). This study assessed the prevalence and patterns of violence against HCWs in areas of armed conflict, areas of other situation of violence and areas not affected by conflict in Nigeria. METHODOLOGY: A cross-sectional study utilising a mixed method approach comprising both quantitative survey and qualitative data collection methods. All the categories of HCWs in public healthcare facilities participated in the study. Ethical approval for this study was obtained from the respective Health and Research Ethics Committees of the respective study sites. RESULTS: A total of 1,218 HCWs comprising Borno State, 407 (33.4%), Plateau State, 401 (32.9%) and the Federal Capital Territory 410 (43.7%) were interviewed. The overall prevalence of physical and psychological violence was 16.7% and 62.4%, respectively. Pushing and slapping were the predominant forms of physical violence. Weaponized violence with weapon was the highest in conflict areas. Verbal abuse, threats, bullying and harassment were the predominant forms of psychological violence. The major consequences of violent attacks on the HCWs were lack of job satisfaction, loss of confidence, low self-esteem, decreased productivity and post-traumatic stress disorder. CONCLUSIONS: The overall prevalence of violent attacks on HCWs was high. The perpetrators of violent attacks were mainly patient relatives and patients/clients. The factors predisposing to violent attacks were patients-related issues, service delivery, working conditions of the hospitals, expectations of patient relatives and impatience of hospital staff.
Pattern of Medication Adherence, Spirituality and Viral Load amongst Adult Patients on Highly Active Antiretroviral Therapy in Rural Southwest Nigeria.
Olanrewaju MT, Olanrewaju OO, Ibrahim AO … +3 more , Ipinnimo TM, Ajayi PO, Sito OK
Niger Postgrad Med J · 2024 Oct · PMID 39628330 · Publisher ↗
INTRODUCTION: Previous studies have been conducted on medication adherence in Southwest Nigeria, but none of these has reported the relationship between highly active antiretroviral therapy (HAART) adherence, spiritualit...
INTRODUCTION: Previous studies have been conducted on medication adherence in Southwest Nigeria, but none of these has reported the relationship between highly active antiretroviral therapy (HAART) adherence, spirituality and viral load (VL) amongst people living with Human immunodeficiency virus (HIV)/AIDS, especially in rural settings of Southwestern Nigeria. This study assessed the pattern of medication adherence, spirituality and VL and ascertained the association of socio-demographics and spirituality on medication adherence amongst patients on HAART in rural Southwestern Nigeria. MATERIALS AND METHODS: A hospital-based cross-sectional study involving 321 consented patients on HAART who were recruited by systematic sampling technique at the adult HIV clinic. Data were collected using an interviewer-administered questionnaire that assessed participants' socio-demographic profiles, medication adherence and spirituality. Their blood samples were collected and their VLs were determined. The data were analysed using SPSS version 20. Logistic regression was done to identify the independent predictors of medication adherence. RESULTS: The majority of the respondents reported a medium level of medication adherence (66.4%), a high level of spirituality (68.8%) and a low level of VL (67.3%). Amongst variables that had a statistically significant association with medication adherence were being educated, married, divorced, separated or widowed (P < 0.05). Furthermore, persons with high spirituality were 2.6 times more likely to be adherent to antiretroviral drugs when compared to persons with low spirituality (P < 0.05). CONCLUSION: It was shown that high spirituality is a positive predictor of medication adherence amongst patients on HAART. It, therefore, suggests that efforts deployed to improve the spirituality of these patients would most likely improve their medication adherence.
Domestic Resource Mobilisation for Sustainable Healthcare Financing in Nigeria: A Review.
Bello AI, Jimoh MA, Tijani AO … +1 more , Ameen HA
Niger Postgrad Med J · 2024 Oct · PMID 39628329 · Publisher ↗
Domestic resource mobilisation (DRM) is vital for achieving sustainable healthcare financing in Nigeria, where dependence on external funding and oil revenues has long hindered health sector progress. The Nigerian health...
Domestic resource mobilisation (DRM) is vital for achieving sustainable healthcare financing in Nigeria, where dependence on external funding and oil revenues has long hindered health sector progress. The Nigerian healthcare system faces persistent challenges, including inadequate funding, inefficiencies and limited access to essential services, particularly in rural areas. This paper explores the challenges and prospects of DRM as a means of financing healthcare in Nigeria. A Medline search and a search of other internet search engines were carried out for published studies on healthcare financing in Nigeria, Africa and worldwide, we also examined policy documents and healthcare financing data to analyse the potential of DRM in Nigeria. A total of 38 publications were reviewed revealing that mechanisms such as general tax revenue, social insurance systems and community-based health insurance are central to DRM efforts. However, challenges such as inadequate budgetary allocations, corruption, poor database management and the emigration of health workers persist. Despite these obstacles, there are promising prospects, including increased tax revenue, development of the domestic capital market and the potential for sustainable and equitable healthcare financing through public-private partnerships. To harness these opportunities, the Nigerian government must implement effective policies, strengthen governance structures and promote transparency and accountability. DRM offers a promising path towards reducing dependency on external aid and achieving a more resilient and equitable healthcare system in Nigeria.
Exploring the Effect of Exercise versus Metformin on Insulin Resistance amongst Nigerians with Pre-diabetes: A Randomised Controlled Trial.
Tambuwal UM, Ahmad SA, Hayatu U … +4 more , Sadiq MA, Kolawale JA, Bello SK, Umar AF
Niger Postgrad Med J · 2024 Jul · PMID 39219352 · Publisher ↗
BACKGROUND: Pre-diabetes is an important risk factor for the development of type 2 diabetes and is common in Nigeria. Effective intervention can reverse the underlying pathogenesis of insulin resistance in pre-diabetes....
BACKGROUND: Pre-diabetes is an important risk factor for the development of type 2 diabetes and is common in Nigeria. Effective intervention can reverse the underlying pathogenesis of insulin resistance in pre-diabetes. This study aimed to determine and compare the impact of moderate exercise and metformin interventions on insulin resistance among participants with pre-diabetes. MATERIALS AND METHODS: Using a randomised placebo-controlled design, 54 Nigerians with pre-diabetes were selected using simple random sampling. They were offered metformin, moderate exercise or placebo treatment and followed up for 12 weeks. Insulin resistance was assessed before and after the interventions and the outcome was compared. RESULTS: Forty-nine participants with pre-diabetes completed the study. Participants in both the exercise and metformin groups had significantly decreased insulin resistance compared to placebo after 12 weeks of intervention. However, there was a decrease in insulin resistance by 77.3% (homeostasis model assessment-insulin resistance [HOMA-IR]) and an increase in insulin sensitivity by 81.2% (quantitative insulin sensitivity check index [QUICKI]) in the exercise group. In comparison, participants in the metformin group had a decrease in insulin resistance by 66.3% (HOMA-IR) and an increase in insulin sensitivity by 76.2% (QUICKI). CONCLUSION: Amongst Nigerians with pre-diabetes, both moderate exercise and metformin have significantly higher efficacy than placebo in improving insulin resistance. However, moderate exercise improved insulin resistance more than the metformin intervention. Participants in this study need to be followed up for a longer period to assess the long-term effects of these interventions.
Naso-mucociliary Clearance Time among Patients with Chronic Rhinosinusitis in Ilorin, North-central Nigeria.
Afolabi OA, Segun-Busari S, Omokanye HK … +8 more , Jimoh M, Iheagwu IO, Omotosho W, Idris SO, Uche-Okonkwo K, Alabi BS, Dunmade AD, Ologe FE
Niger Postgrad Med J · 2024 Jul · PMID 39219351 · Publisher ↗
CONTEXT: The mucociliary clearance system is an important component in the prevention of chronic inflammation of the nasal and paranasal sinus. AIM: The study aims to establish the normal values of mucociliary clearance...
CONTEXT: The mucociliary clearance system is an important component in the prevention of chronic inflammation of the nasal and paranasal sinus. AIM: The study aims to establish the normal values of mucociliary clearance in our region and to study the variation in mucociliary activity in patients with chronic rhinosinusitis in Ilorin, North-central Nigeria. SETTINGS AND DESIGN: This was a prospective, cross-sectional study using consecutive consenting participants in both the control and study groups carried out at both family medicine and otorhinolaryngology clinics among patients attending the clinics. SUBJECTS AND METHODS: After ethical approval was sought, informed consent was obtained from patients, a modified version of the validated health questionnaire was filled, semi-structured questionnaires were also filled after which patient undergo anterior rhinoscopy, nasal patency test and spirometry was done. The saccharine test has been used to measure nasal-mucociliary clearance time in the past. STATISTICAL ANALYSIS: All information were entered into SPSS version 20 and analysed descriptively, and results were presented in tables and figures. RESULTS: Consecutive consenting 125 patients with rhinosinusitis (study group) and those without rhinosinusitis (control group) underwent naso-mucociliary clearance test. There were 34 males and 91 females with a male:female ratio of 1:2.6 among the study group and 55 males and 70 females with a male:female ratio of 1:1.3 for the control group. The age range was from 18 to 68 years with 18-40 years constituting the modal age group. The mean age for the studied group was 35.7 years while that of the control group was 33.1 years. The mean naso-mucociliary clearance time among the study group was 35.1 min standard deviation (SD = 12.32 ± 1.63), while among the control group, it was 14.8 min (SD = 5.59 ± 0.43). CONCLUSION: Compared to the control group, there was a roughly 200% prolonged increase in the duration of naso-mucociliary clearance time among patients with rhinosinusitis. There was also a positive correlation with increasing age. Future studies comparing the pre-operative and post-operative treatment of rhinosinusitis will contribute to knowledge.
Standard-Setting Methods for Assessment in a Post-Graduate Medical College.
Ekekezie OO, Charles-Eromosele TO, Olatona FA … +1 more , Aguwa EN
Niger Postgrad Med J · 2024 Jul · PMID 39219350 · Publisher ↗
CONTEXT: Standard-setting procedures assess candidates' competence in an examination. Different standard-setting methods produce different pass scores, and no gold standard exists currently. The quality of the standard-s...
CONTEXT: Standard-setting procedures assess candidates' competence in an examination. Different standard-setting methods produce different pass scores, and no gold standard exists currently. The quality of the standard-setting process is critical in medical examinations where true competency needs to be determined for safe medical practice. AIMS: This study assessed the standard-setting methods the college uses to determine the pass scores in the various parts of the fellowship examinations and compared these methods with the arbitrary 50% previously used. SETTINGS AND DESIGN: A cross-sectional comparative study to assess the standard-setting methods adopted, which was applied to the September/October/November 2023 fellowship examinations. METHODS: This was a total population survey involving the 16 faculties of the College. Secondary data from a compilation of approved results was used. DATA ANALYSIS: Descriptive and analytical statistics in Microsoft Excel program. RESULTS: The methods for standard-setting adopted by the college were assessed, and their mean pass scores were analysed. The mean pass score for the primary multiple choice questions examinations was 46.7%, lower than the previously used arbitrary 50% mark, and this difference was statistically significant (P < 0.05). The mean pass scores for the other examinations were higher than the previously used arbitrary 50% mark, but these differences were not statistically significant (P > 0.05). CONCLUSION: Implementation of the approved standard-setting methods can be improved with more training and retraining of faculties and examiners so that results that are consistent with their purpose, and that align well with other measures of competency can be produced.
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