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   2020| May-June  | Volume 61 | Issue 3  
    Online since July 4, 2020

 
 
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ORIGINAL ARTICLES
Factors affecting undergraduates' participation in medical research in Lagos
Opeyemi Mercy Awofeso, Alero Ann Roberts, Christian Oyor Okonkwor, Chiamaka Elise Nwachukwu, Ifeanyichukwu Onyeodi, Ilerioluwa M. Lawal, Okoro Ebrubaoghene, Gift I. Osakwe, Oluchi Buchi-Njere, Zaynab O. Solahudeen
May-June 2020, 61(3):156-162
DOI:10.4103/nmj.NMJ_94_19  
Background: The current situation regarding the scope and contribution of undergraduate medical research to the health space in Nigeria is still largely unreported in formal literature. This study examined the knowledge, attitudes, and the perceived barriers faced by medical students in Lagos toward research. Materials and Methods: A cross-sectional study design was conducted among all medical students in 200–600 levels of study at the College of Medicine, University of Lagos. With the aid of Self-administered questionnaires, we examined their knowledge of research and the analytical tools used in research, their attitudes and the perceived barriers to their participation in research. Results: The data were obtained from 221 medical students, of whom 52.9% had prior involvement in research and 14.0% and 6.3% had presented or published their research, respectively. The overall knowledge of medical research was low (21.3%) and reported barriers included lack of funding for research' (79.6%), “lack of research and biostatistics curriculum” (76.0%), “inadequate training in research methodology” (74.7%), “insufficient time allocation to undergraduate research” (73.3%), “lack of professional supervisors and proper mentoring” (58.8%), and “lack of equipped laboratory facilities to conduct research” (77.8%). Conclusion: Our results highlight the need for more mentored supervision and training to improve their knowledge of the principles and techniques of clinical research to increase involvement.
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Experience with hysteroscopy in a private specialist hospital in Nigeria
James A. Osaikhuwuomwan, Israel Ikekwuibe, Michael E. Aziken
May-June 2020, 61(3):140-143
DOI:10.4103/nmj.NMJ_82_19  
Background: Hysteroscopy is a standard method for the evaluation and treatment of various gynecological disorders. Its availability and accessibility are limited in our setting owing to resource constraints. Nevertheless, the utilization is on the increase mostly in private health institutions in Nigeria and as an adjunct in infertility management. Objectives: The objective is to document the experience and outcome of hysteroscopy surgeries at a private specialist-assisted reproduction and endoscopy unit. Materials and Methods: A retrospective review of all hysteroscopic procedures conducted at the unit was undertaken. Relevant sociodemographic and clinical information were extracted for analysis. In addition, outcomes of the procedure and outcome for those who eventually had in vitro fertilization (IVF) treatment were documented for analysis. Results: A total of 106 patients had hysteroscopy over the study period. The age of patients ranged from 24 to 55 years. The most common indication for hysteroscopy was uterine synechiae (50%) others were preparatory for IVF (30.2%), uterine fibroid/polyp (10.4%), and abnormal uterine bleeding (9.4%), respectively. The major findings at hysteroscopy were intrauterine adhesions 68.9%. Therapeutic adhesiolysis was done using the scissors in most cases (83%) while two patients (1.9%) had adhesiolysis and resection of uterine polyp. A complication of noncardiogenic pulmonary edema was recorded from fluid overload. Overall most had return to normal menses (65.1%). Thirty-nine (38.8%) women had IVF treatment after hysteroscopy of which outcome was successful in 16 (41%) women. Conclusion: The utilization of hysteroscopic surgeries in management of endometrial pathologies is increasing. It offers a safe and effective treatment and is a useful adjunct for improving IVF outcome especially for those with repeated failed treatment.
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Routine histopathological analysis of the products of conception: Is there a value?
Samuel Robsam Ohayi, Nnaemeka Thaddeus Onyishi
May-June 2020, 61(3):136-139
DOI:10.4103/nmj.NMJ_242_19  
Background: Spontaneous miscarriage is one of the two most common problems encountered in the first trimester of pregnancy. The value of histopathological analysis of products of conception (POC) obtained as a result is a source of controversy. The aim of this study is to evaluate the histopathological characteristics of suspected POC following the first-trimester miscarriage and determine the clinical value of such histopathological analyses. Materials and Methods: This is a retrospective study of the histopathological analysis of POC over a period from January 1st to December 31st of 2016 carried out in the histopathology laboratory of a university teaching hospital. Materials for the study were POC obtained following spontaneous first trimester miscarriage and received in our laboratory. Relevant information about the patients was retrieved from the laboratory database and matched with laboratory request forms and copies of histopathology reports archived in the laboratory. Obtained data were analyzed by simple statistical methods. Results: The most common clinical diagnosis on admission was incomplete abortion (n = 52; 48.6%), followed by complete abortion (n = 31; 29.0%); the lowest was blighted ovum (n = 1; 0.9%). The predominant histopathological type was normal POC which constituted 73 cases (68.2%). Other histopathological diagnoses include hydatidiform mole (9, 8.4%) and no evidence of conception (15, 14%). Clinical and ultrasound evaluation missed 2 (22.2%) of the 9 histopathologically diagnosed hydatidiform moles. Conclusion: Histopathological analysis of POC helps to diagnose molar pregnancies and other conditions which can be missed by clinical and ultrasound evaluation. Therefore, routine histopathological analysis of POC is advocated.
  4,474 17 2
An assessment of antihypertensive medication adherence among hypertensive patients attending the outpatient clinics in the University of Uyo Teaching Hospital, Uyo
Uwemedimbuk Smart Ekanem, Emem Ime Dan, George George Etukudo, Idongesit Ibanga Ndon, Ekemini Essien Etebom, Kingsley Bassey Nkobo
May-June 2020, 61(3):120-125
DOI:10.4103/nmj.NMJ_95_19  
Context: Hypertension is a global cause of significant morbidity, ranking top as a cause of increased disability-adjusted life years. Patients who do not take their prescribed medication show almost a fourfold increase in the risk of dying from stroke by the second year after being prescribed treatment and a nearly threefold increased risk in the 10th year when compared to patients who take their prescribed medication. Medication adherence is a key factor in the control of high blood pressure. Objective: The objective of the study was to assess the antihypertensive medication adherence rate of patients attending the outpatient clinics at the University of Uyo Teaching Hospital (UUTH) and to explore factors that affect their adherence to the medications. Materials and Methods: This was a descriptive cross-sectional study of adult hypertensive patients attending the outpatient clinics at UUTH, from May to July 2018, who had been placed on antihypertensive medication(s) for at least 6 months. A standardized Morisky Medication Adherence 8 Questionnaire for assessing medication adherence was modified and used for the data collection. The questionnaires were administered by trained interviewers. Data were analyzed using SPSS 20.0. Results: A total of 379 hypertensive patients took part in the study; 85.2% were adherent to antihypertensive medication(s), but only 14.2% showed good adherence. Four of the five dimensions considered in the Morisky Assessment greatly affected antihypertensive medication adherence. The mean age of the study participants was 60.8 ± 1.8 years, and 75% were male. Conclusion: Good adherence to antihypertensive medication was quite low in this study population, and it was affected by all dimensions of the Morisky Assessment; health-care providers should pay more attention to their patient's drug adherence, educate them on medication adherence, and get them involved in their care.
  4,407 15 2
EXPERT OPININON
Telemedicine in otorhinolaryngological practice during COVID-19 pandemic
Titus Sunday Ibekwe, Ayotunde James Fasunla
May-June 2020, 61(3):111-113
DOI:10.4103/nmj.NMJ_201_20  
Coronavirus-19 pandemic has impacted significantly on global social, economic, financial, and health institutions. Otolaryngologic (ORL) practice has also been affected by the scourge with the need for modification of practice. The risks of contracting COVID-19 with the regular “patient–doctor physical contact” method of management of cases in ORL practice are high, given the routine examination of nose and throat. The desirability of telemedicine in the handling of most patients is appealing despite the limitations in the technology, especially in the developing countries like Africa. Therefore, otorhinolaryngologists in Sub-Saharan Africa, within limits of applicability, should leverage on telemedicine in their clinical practice during this COVID-19 pandemic and beyond. COVID-19, being a disease of second chance, has provided us with the opportunity to harness this technologically driven method of supportive care in our clime.
  4,353 15 10
CASE REPORT
Lupus vulgaris and lichen scrofulosorum with disseminated tuberculosis
Nnenna Uzunma Okoh, T. Nnaji, Chinwe L. Onyekonwu, Chika Mary Emeka
May-June 2020, 61(3):169-172
DOI:10.4103/nmj.NMJ_135_19  
Cutaneous tuberculosis (CTB) represents only 1%–2% of extrapulmonary forms of tuberculosis (TB). CTB can present in the isolation or coexist with pulmonary and disseminated forms of TB. Pathologically confirmed lupus vulgaris (LV) coexisting with lichen scrofulosorum with disseminated TB is presented and discussed. A 12-year-old boy presented with 2 years history of slowly progressive facial plaque and multiple skin colored papules on the neck. Tuberculin skin test was positive with a reading of > 20 mm. Histopathology revealed ulcerated areas with impetiginisation and keratopurulent debris. The entire skin showed pseudoepitheliomatous hyperplasia with numerous granulomas in the superficial dermis consisting of Langhans-type multinucleated macrophages. Lesions responded to anti-tuberculosis therapy (ATT) with residual facial scar. LV and lichen scrofulosurum are two forms of CTB which rarely occurs together. This case is being presented to highlight the occurrence of this rare presentation and the need to institute ATT to prevent scarring.
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ORIGINAL ARTICLES
Effect of blood donor educational intervention on the knowledge and attitude towards voluntary blood donation among Medical students at a Nigerian University
Ngozi Immaculata Ugwu, Chigozie Jesse Uneke, Collins Nwachi Ugwu, Wilberforce John Otu Oti, Urudinachi Nnenne Agbo, Ifeyinwa Chizoba Akamike
May-June 2020, 61(3):163-168
DOI:10.4103/nmj.NMJ_177_19  
Background: Blood is a veritable tool in many life-saving situations. Despite the increased demand for blood, the supply of safe blood has been inadequate. This study was aimed to determine the effect of educational intervention on the knowledge and attitude of medical students of a Nigerian University to voluntary blood donation. Materials and Methods: This was a cross-sectional study involving 158 undergraduate medical students of Ebonyi State University in South-East Nigeria. Participants were recruited by stratified sampling technique. A pretested semi-structured participant administered questionnaire was used to baseline knowledge and attitude to voluntary blood donation. This was followed by educational intervention in the form of a workshop by experts in blood transfusion medicine. Then, postintervention assessment was done using the initial questionnaire 30 days later. The study was approved by the Research and Ethics Committee of Ebonyi State University, Abakaliki. Data obtained were analyzed using SPSS 20 software, and P value was set at ≤0.05. Results: Of the 158 medical students who participated in the study, there were 90 (57%) males and 68 (43%) females. Baseline proportion of the participants who had good knowledge was high (72.8%), while baseline attitude of the participants was positive to most aspects of voluntary blood donation. Post intervention, the level of knowledge about voluntary blood donation increased to 99.4%, and similarly attitude to voluntary blood donation improved. Conclusion: Educational intervention was effective in improving the knowledge and attitude towards voluntary blood donation among medical students. Continuous enlightenment will influence potential blood donors to have better knowledge and positive attitude toward voluntary blood donation.
  4,074 15 6
Determinants of psychosocial health-related quality of life of adults with sickle cell disease in a Nigerian setting
Theresa Nwagha, Babatunde Ishola Omotowo
May-June 2020, 61(3):114-119
DOI:10.4103/nmj.NMJ_122_19  
Background: With improved understanding of disease mechanism in sickle cell disorder, many persons living with sickle cell disease (SCD) are surviving unto adulthood. There is a growing concern that SCD may impair the psychosocial health-related quality of life (HRQoL), with a resultant lack of psychosocial stability and integration. The objective of this study was to assess the determinants of psychosocial quality of life (QoL) among adults with SCD. Materials and Methods: This was a cross-sectional study of adults with SCD. A multidimensional self-administered instrument, prevalidated for use in adults with chronic disease, was used. It consisted of 31 items that assessed physical function, physical and emotional role function, bodily pain, vitality, social function, mental health, and general health within 2 weeks prior to the time of survey. Questionnaires were administered to adults with sickle cell anemia who presented for their routine visit to the Sickle Cell Clinic at the Hematology Clinic in University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, or during sickle cell support group meetings. Psychosocial HRQoL was the primary outcome measured. Sociodemographic features such as marital status, gender, educational qualification, and SCD were the primary independent variables of interest. Results: A total of I16 adults with SCD were participated in the study. After adjusting for marital status, gender, and educational qualification of adults with SCD, gender and marital status did not significantly affect psychosocial HRQoL (P = 0.619 and P = 0.146), respectively, while educational status significantly affected their HRQoL (P = 0.013). Conclusions: Adults with SCD have impaired psychosocial HRQoL. There is a need to upscale patient-focused interventions to improve self-esteem and overall QoL.
  3,767 15 1
Perceived effect of occupational safety measures on workers' performance in Warri Refining and Petrochemical Company, Delta State, Nigeria
Ayoola Abidemi Agboola, Oluwaseun Taiwo Esan, Temitope Olumuyiwa Ojo, Olorunfemi Sunday Omotosho
May-June 2020, 61(3):144-150
DOI:10.4103/nmj.NMJ_146_19  
Introduction: Occupational safety measures when put in place in organizations are expected to increase the productivity of employees and drive organizations to better performance. This study was aimed at assessing the perception of workers at the Warri Refining and Petrochemical Company (WRPC) on the effect of implemented occupational safety measures on their individual and organizational performance. Materials and Methods: The study was cross-sectional in design conducted at the WRPC, Delta state, Nigeria, among 236 workers of the WRPC selected via a simple random sampling technique across different job cadres (junior, senior, and management) in the organization. Data were collected using a semi-structured self-administered questionnaire and analyzed using the descriptive and inferential statistical tests of the SPSS version 20 with statistical significance set at P < 0.05. Results: The mean age of respondents was 43 ± 2.26 years with a male-to-female ratio of 1.8:1. More than 50% of the respondents attested that occupational safety measures had been well implemented at the WPRC. Almost all the respondents, 219 (92.8%) and 224 (94.9%), agreed that occupational safety measures in place and trainings on safety measures had improved individual worker's performance, respectively. Respondents' length of service and job cadres were significantly associated with their perceived effect of the existing occupational safety measures at the WRPC on individual worker and organizational performance (P < 0.001). They were also significantly associated with their perceived effect of the neglect of these safety measures on high labor turnover rate (P < 0.001). Conclusion: Occupational safety measures were perceived to have positively affected workers' and organizational performance.
  3,756 15 -
Distribution of medical conditions among dental patients
Elijah Olufemi Oyetola, Olufunlola Motunrayo Adesina, Kayode Ogunbameru, Shola Egunjobi, Adewale Francis Adejobi
May-June 2020, 61(3):129-135
DOI:10.4103/nmj.NMJ_80_19  
Aims: The aim of the study was to determine the distribution of medical conditions among dental patients in our local environment. Settings and Design: This is a descriptive cross-sectional study conducted at the Oral Diagnosis (OD) Clinic of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State. Materials and Methods: Participants were selected using a simple random method from the pool of dental patients who presented at the OD Clinic of OAUTHC during the study period. Information was obtained from each participant using a structured questionnaire organized into sections. Section 1 collected information on participants' biodata such as age, sex, and weight. Section 2 recorded data on the history of the presence of relevant oral and systemic symptoms, while section 3 collected information on findings from intraoral and extraoral examination. Statistical Analysis Used: The results were analyzed using STATA 13 statistical software. Results: Of the 1503 patients who visited dental hospital during the study period, 176 (11.7%) had medical problems. The mean age of patients with medical problems was 48.5 ± 21.0 years. The mean age was higher in men compared to women (P = 0.013). More than one-fifth (21.6%) of the patients were first diagnosed in the dental clinic. Hypertension was the most frequently seen medical condition, closely followed by peptic ulcer and diabetes mellitus. Patients whose medical problems were first diagnosed following dental consultation were significantly older than those with known medical conditions. Conclusions: Prevalence of medical conditions in dental patients is high. Hypertension is the most frequently associated systemic conditions among dental patients. Medical conditions were common among older age group (>50 years), males, and those with gum problems.
  3,584 17 3
Pattern of heart diseases in gombe and environs: A 5-year echocardiographic review
Christian Ekholose Omoaghe, Henry Ifeanyichukwu Okolie, Ayoola Yekeen, Adamu Adamu, Ejeagba Okezie
May-June 2020, 61(3):126-128
DOI:10.4103/nmj.NMJ_150_19  
Background: Heart disease in the developing world is mainly due to nonischemic causes-hypertensive heart disease, valvular and myocardial damage from rheumatic fever, and heart muscle diseases caused by certain infectious agents, for example, cardiomyopathy from HIV infection. Peripartum cardiomyopathy is also a well-recognized cause of heart disease in developing countries. However, there is evidence of epidemiological transition toward the increasing prevalence of atherosclerotic cardiovascular disease in Sub-Saharan Africa largely because of the increasing prevalence of traditional risk factors, such as hypertension, diabetes mellitus, dyslipidemia, obesity, and cigarette smoking. Aim: The aim of this study was to determine the pattern of heart diseases among patients undergoing transthoracic echocardiographic evaluation between February 2012 and February 2017 at the Cardiology Unit of the Department of Medicine, Federal Teaching Hospital, Gombe, Gombe State. Materials and Methods: Echocardiographic data of patients from February 2012 to February 2017 were retrieved. A total of 2265 patient records were analyzed. All patients had standard resting transthoracic echocardiography including Doppler modalities where appropriate. Descriptive statistics were used in assessing the distribution of different heart diseases. Results: The age range of the 2265 patients was 14–89 years, with a mean age of 47.3 ± 20.1 years and a female preponderance (58%). The most common heart disease among these patients was hypertensive heart disease (41.8%) followed by cardiomyopathies (15.4%). Ischemic heart disease remains rare (0.7%) probably due to the investigative modality used in this study (resting transthoracic echocardiography). Conclusion: Hypertensive heart disease remains the most common heart disease among men and women in Gombe and its environs. Cardiomyopathies, although rare in certain regions of Nigeria, are quite common in Northeast Nigeria.
  3,256 15 1
The frequency and risk factors of human T-cell lymphotropic virus type I among blood donors in Khorasan-e Razavi, Iran, from 2002 to 2013
Shamsoreza Tabriznia Tabrizi, Marzieh Gholampour, Azam Moradi Zarmehri, Mohammad Hadi Sadeghian, Mohammad Reza Keramati
May-June 2020, 61(3):151-155
DOI:10.4103/nmj.NMJ_127_19  
Introduction: Human T-cell lymphotropic virus (HTLV-I) is the causative agent for adult T-cell lymphoma/leukemia (ATLL) and HTLV-I-associated myelopathy/tropical spastic paraparesis. The virus is endemic in the parts of Iran. This study is conducted to determine the trends in the frequency of HTLV-I in Mashhad, a city in Khorasan-e Razavi province, Iran, over 11 years. Materials and Methods: Blood bank records of blood donors positive for HTLV-I were collected from different blood banks across Mashhad between 2002 and 2013. Obtained data were first entered into paper versions and then were analyzed by SPSS version 11.5. HTLV-I antibody was firstly measured by enzyme-linked immunosorbent assay (ELISA) method and later confirmed by the Western Blot (WB). Results: During the study period, 983,000 donors were examined by ELISA and WB, among whom 2921 cases (0.297%) were positive HTLV-I carriers. The highest and lowest frequency of carriers was 0.451% and 0.098%, respectively. The most significant factor was related to marital status (85.2%) and the smallest significant factor was associated with the history of acupuncture (0.3%) according to the different risk factors. Conclusion: The frequency of HTLV-I carriers among blood donors was significantly decreased in this period. Screening of blood donors for HTLV-I infection played a significant role in this reduction.
  3,110 15 2
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