Jos Journal of Medicine

Time to treat the climate and nature crisis as one indivisible global health emergency

Kamran Abbasi — 2024-10-15

No abstract

Factors associated with childhood malnutrition in Melele community of Plateau State, Nigeria

CB Gofung — 2024-10-15

Background: Optimal nutrition during childhood, particularly in the first five years of life, is essential for a healthy and productive adult life. Under-five malnutrition is a serious public health issue because it impairs children's cognitive and physical development and raises their risk of morbidity and death. This study is to determine the prevalence of malnutrition and factors influencing it among under five children in a rural area of Plateau state.
Methods: This cross-sectional community-based survey was conducted in Melele community of Mangu ward II, Mangu Local Government of Plateau State. Data from a total of 167 under-five children was obtained and analyzed using SPSS version 23 to determine the association between the nutritional status and independent variables (age group, sex, immunization status, deworming status within last six months, being given ITN, sleeping under ITN and attainment of developmental mild stone).
Results: There were 56.3% males out of the 167 under-five respondents; about three-quarters of the children were 12months or older with a median age of 24 (5 – 45) months. about half (53.9%) of the participants were exclusively breastfed with most of them starting complimentary feed at a median age 6 (5 – 7) months of age. This study revealed a disproportionately high degree of malnutrition of under-fives in Melele community with 58.1% stunted, 46.7% wasted, and 31.1% underweight. There was a statistically significant relationship between deworming children within the last 6 months (p=0.012) and ownership of ITN (p=0.047) with nutritional status
Conclusion: We recommend that there should be an increase of nutritional interventions in rural communities in Plateau State as presently, most intervention and awareness programmes target urban areas. In addition, further research needs to be done to explore other factors, such as maternal and household characteristics, in relation to under-five malnutrition.

Satisfaction of stakeholders with the implementation of the tertiary institutions social health insurance programme in Jos: a qualitative study

Tyavyar J Akosu — 2024-10-15

Background:The tertiary Institutions Social Health Insurance programme was developed to provide access to quality health care services to students in institutions of higher learning in Nigeria but several authors have reported underutilization by students. The purpose of the study was to determine how the programme is implemented in tertiary institutions in Jos.
Methodology: A two-stage sampling technique was used to select respondents for the study. Data was collected using key informant interviews and focus group discussions with important stakeholders of the programme. The recorded interviews were transcribed and analysed using NVivo 12.
Results: Enrolment fees is compulsorily collected from students but most of them are not aware of the other steps they need to take to access services under the scheme. An initial medical examination is performed as part of the enrolment process in some schools but not in others. The school management collect premium on behalf of the health maintenance organizations but often delay remittance, in some cases, up to two consecutive sessions. There is also the strong belief among school clinic heads that the proportion of premium meant for provision of primary care services in often misappropriated. The Tertiary institution social health insurance programme management committees are non-functional in all the schools studied. Quality of primary care services provided by the school clinic is sub-optimal because of frequent drug stock out and lack of equipment and supplies. Most respondents were not satisfied with the implementation of the programme in their school.
Conclusion: Key stakeholders are dissatisfied with the implementation of TISHIP. The NHIA needs to supervise the implementation of the programme to ensure that the good intentions of the programme are not jeopardized.

Diagnostic yield of plain abdominal radiograph in patients presenting with acute abdominal pain in Jos, North-Central Nigeria

Emmanuel Owoicho Igoh — 2024-10-15

Background: Abdominal pain is one of the most commonly encountered complaints seen in the emergency room and constitutes a significant proportion of emergency department visits. An abdominal radiograph is a noninvasive imaging tool commonly utilized in the evaluation of acute abdominal pain. It is cheap, readily available, reproducible, and a quick and reliable technique for evaluating abdominal pain. The aim of this study was to review the diagnostic yield of plain abdominal radiographs in patients presenting with acute abdominal pain in a peripheral facility in Jos, Plateau State Nigeria.
Methods: A seven-year retrospective review of the archive of abdominal radiographs of 638 consecutive patients presenting with acute abdominal pain between January 2015 and December 2022 was conducted. Only 503 patients with complete documentation who met the inclusion criteria were enrolled. Patients with incomplete documentation were excluded from the study.
Results: The study included 271 (53.9%) males and 232 (46.1%) females, giving a male-to-female ratio of 1.2:1 and a mean age of 31.91± 18.76 years. Abdominal x-ray findings were normal in 57.1% and abnormal in 42.9% of patients. The abnormal abdominal findings were intestinal obstruction (23.7%), bowel perforation (7.8%), degenerative spine disease (3.8%), abdominal mass (2.0%), and renal calculus (1.4%).
Conclusion: Abdominal radiograph is an effective, cheap, and complementary imaging tool in a resource constrained-setting like ours. Its diagnostic yield in acute abdominal pain can be improved by following the American College of Radiologists' guidelines.

Three-year review of childhood and adolescent presentation in the gynaecological emergency unit of the Jos University Teaching Hospital

Andrew Onogwu Akor — 2024-10-15

Background: Gynaecological problems in children and adolescents are often both medically and psychologically unique and require a highly skilled approach differing from those utilized from an adult female population. Gynaecological problems in childhood and adolescence constitute great levels of anxiety in parents. Most presentations are related to unprotected sexual intercourse and its complications. The aim of this study is to determine the prevalence and pattern of gynaecological problems in childhood and adolescence population in gynaecological emergency of JUTH.
Methods:This was a 3-year retrospective study of the records of childhood and adolescent presentation at gynaecological emergency of JUTH between 1st January 2018 and 31st December 2020. A proforma was used to extract information from the file records of all patients aged 1 month to 19 years seen at the gynaecological emergency of JUTH. Information on age and gynaecological condition diagnosis was extracted. Data was analysed using IBM SPSS statistics version 23.0.
Result:The hospital attended to 5025 emergency gynaecological cases over the 3-year period. Children and adolescents made up 133(2.6%) cases, of which (9.8%) were children and (90.2%) were adolescents. The commonest presentations were abortion (24.8%), of which induced abortion is the commonest (64%) form of abortion, and menstrual disorders (21.8%).
Conclusion:Childhood and adolescent gynaecological disorders constitute a significant number of emergency gynaecological presentations. There is a need for gynaecologists to acquaint themselves with the pattern of presentation of these disorders and promote the health of teenagers as this group is often misinformed. Additional attention is needed to safeguard their reproductive health.

Evaluation of background ionizing radiation levels in Jos University Teaching Hospital, North Central Nigeria

Samuel Moses Danjem — 2024-10-15

Background: Exposure of patients to radiographic examination (computerized tomography, fluoroscopic
procedures, dental diagnosis, and routine exposure to x-rays), radioisotope procedures and radiation therapy have contributed to increase in background radiation and radiation levels of patients and many occupational
workers. The aim of this study was to measure and establish the background ionizing radiation level in different parts of Jos University Teaching Hospital.
Methods: Measurement of background ionizing radiation level was performed using a well calibrated Radiation Alert (Inspector+ and Inspector EXP+) monitor manufactured by S.E. International, INC. USA; 2013. The total count was taken for a period of 10 minutes which was carried out three times for each location, the average was calculated and recorded. This was carried out in all 71 locations within the hospital, the values were then converted to Sievert (Sv) using the relation: 1CPM=0.01μSv/hr (Radiation Alert User's manual 2007).
Results: The results obtained range from 0.218±0.0608 ìSv/hr to 0.308±0.01 ìSv/hr with a mean of 0.243±0.02 ìSv/hr within Radiology Department, 0.279±0.017 ìSv/hr for the wards, 0.254±0.026 ìSv/hr for the clinics, and 0.27±0.0382 ìSv/hr for the laboratories and other location in the Hospital.
Conclusion: The mean measurement from the wards is slightly above the standard of 0.274 ìSv/hr recommended as worldwide average natural dose of background ionizing radiation while the average measurement for Radiology Department and the clinics were within permissible allowed values. The results from this study indicates that some locations such as the Radiology Department and the clinics as safe while the wards are relatively unsafe.

Large dermoid cyst of the tongue in a neonate: a case report and review of literature

JD Choji — 2024-10-15

Background: Dermoid cysts of the tongue are very rare masses of the oral cavity derived from ectodermal elements. These tumours are benign and slow-growing, typically asymptomatic but large cysts that fill most of the oral cavity can cause complications of dyspnoea, dysphagia, respiratory obstruction, and difficult intubation. The definitive treatment is surgical excision. The aim of this report is to demonstrate that large intralingual cyst located at the anterior two-thirds of the tongue can present without difficulty in breathing, unlikely to have difficult intubation and, early excision can give a good outcome.
Patient: The patient is a new-born male who was brought to the Emergency Paediatric Unit of the hospital 13 hours after birth with a huge swelling in the tongue protruding outside the oral cavity. There was difficulty feeding, however no difficulty in breathing and no other congenital anomalies. The swelling obliterated most of the anterior two-thirds of the tongue up to the foramen caecum. Ultrasound and magnetic resonance imaging were diagnostic of dermoid cyst.
Intervention: The patient had surgical excision of the cyst under general anaesthesia on the 15th day of life. Histology was in keeping with a lingual dermoid cyst.
Conclusion: This is a rare large intralingual cyst successfully managed by early excision with an uneventful post-operative course.

Septate uterus with bilateral tubal blockage: a case report and literature review

Yetunde Folake Taiwo — 2024-10-15

Septate uterus is a form of congenital anomaly of the müllerian ducts. This anomaly of the female reproductive tract may be associated with various reproductive problems including infertility, recurrent miscarriages, increased risk of preterm delivery, abnormal fetal presentation, delivery by caesarean section, intrauterine fetal growth restriction, low birth weight, and perinatal mortality. Diagnosis of a septate uterus on imaging may be challenging due to its similarity with other congenital uterine anomalies. We present a case of septate uterus with bilateral tubal blockage in a young woman being evaluated for primary infertility who was referred for hysterosalpingography.

Acute uterine inversion in a stable patient: a case report

P.S. Cinjel — 2024-10-18

Acute uterine inversion is a rare and unpredictable obstetric emergency often associated with devastating consequences when not properly treated. Shock and uterine replacement must be addressed simultaneously. Delivery unsupervised by a skilled birth attendant is a risk factor and should be discouraged. We present a case report of a 29 year old Para 4⁺⁰(4 Alive) diagnosed with acute second-degree uterine inversion who presented one hour after home delivery, but in a stable condition.