Nigerian Medical Journal

Radiation proctitis as a differential of lower GIT bleeding in Nigeria: A case series.

2025-04-09T08:32:31+00:00

Pelvic radiotherapy is an acceptable and promising treatment modality for various pelvic malignancies.
However, it is associated with radiation-induced injury on surrounding structures with a preference for
the rectum, which is characteristically fixed in the pelvic region. Acute radiation proctitis is usually self
limiting, but in its chronic form, it can be debilitating. Recent advances in radiation therapy have
significantly reduced the prevalence of radiation proctitis (RP) in high-income countries, contrary to the
findings in low and middle-income countries witnessing an increasing burden of radiation proctitis. This
observation can be attributed to the increased availability of radiation therapies with limited use of novel
technologies designed to reduce the detrimental effects of radiotherapy and improve the detection of RP
owing to improvements in endoscopic services in developing countries. This is a highlight of the trends in
the presentation of RP, management modalities in various tertiary centers in Nigeria, and the limitations
in care occasioned by the non-availability of argon plasma coagulation (APC) as an effective treatment
modality in most tertiary health facilities in Nigeria.

Spontaneous subgaleal haematoma with severe headache in two children during acute painful sickle cell crisis

2025-04-09T09:22:12+00:00

Sickle cell disease is an inherited disorder of haemoglobin formation, predominantly affecting individuals
of African, Indian, or Mediterranean descent. Acute painful episodes frequently occur in these patients
due to the blockage of small blood vessels by sickled cells, leading to tissue infarction. Two children of
Nigerian descent, presented with severe headaches during a painful crisis episode with associated
swelling on their scalps. CT imaging in both cases showed subgaleal haematoma which was managed
conservatively in addition to managing the painful crisis with a good outcome. This report highlights the
clinical presentation, diagnostic approach, and management of this uncommon complication of sickle cell
anaemia.

Purple urine bag syndrome: A case report of an elderly Nigerian woman

2025-04-09T09:32:04+00:00

Purple urine bag syndrome (PUBS) is an unusual presentation of urinary tract infection (UTI). Few cases
have been reported in Africa. We present a case report of Purple Urine Bag Syndrome from the Niger
Delta region of Nigeria. The patient was a bedridden catheterized 71 -year-old quadriplegic female
patient with a history of hypertension, and ischemic stroke. She was treated with a course of appropriate
antibiotics and by changing her urinary catheter and bag. The patient’s caregiver refused further care and
signed against medical advice after forty-eight hours of admission without doing the requested
investigations. Purple urine bag syndrome (PUBS) is a rare benign condition with a good prognosis.

Bilateral optic atrophy and epiretinal membranes: An atypical presentation of ocular tuberculosis

2025-04-09T09:42:45+00:00

A 15-year-old boy presented himself to the retina clinic with a six-year history of poor vision in both
eyes. Ocular symptoms started with deterioration in the vision of both eyes associated with ocular pain.
There was no history of antecedent trauma, headaches, seizures, or loss of consciousness. The general
and systemic examinations were normal. On ocular examination, the corrected visual acuity was 6/24 and
6/6 in the right and left eyes, respectively. The anterior segment examination was normal except for a
relative afferent pupillary defect in the right eye. Examination of the posterior segment revealed bilateral
optic atrophy worse in the right eye and cup disc ratios of 0.3 bilaterally. The vessels were within normal
limits with epiretinal membranes in both eyes. Yellowish chorioretinal lesions were present temporal to
the disc in both eyes. There was a positive history of tuberculosis in the father and brother. A diagnosis of
bilateral optic atrophy and epiretinal membranes secondary to presumed ocular tuberculosis was made.

A case of lacunar stroke in a patient with possible normal pressure hydrocephalus (NPH)

2025-04-09T09:57:09+00:00

Background: Normal pressure hydrocephalus (NPH) is a condition seen in the elderly, characterized by
gait disturbances, urinary incontinence, and cognitive impairment. However, sudden onset neurological
deficits suggest a vascular event rather than NPH.
Methodology: We report a case of a 65-year-old male who presented with sudden onset gait difficulty
and speech impairment, initially suspected to be idiopathic NPH. The diagnostic process and
management strategies are discussed.
Results: The patient's symptoms, including insidious gait difficulties, speech impairment, and memory
loss, led to a suspected diagnosis of NPH. However, the sudden improvement of neurological deficits
indicated a vascular cause. Computed Tomography (CT) imaging identified supporting evidence of a
lacunar stroke, leading to a revised diagnosis.
Conclusion: This case highlights the importance of considering vascular events in the differential
diagnosis of NPH, especially when sudden neurological deficits improve rapidly. Early identification and
differentiation between NPH and vascular events are crucial for appropriate management, particularly in
low-resource settings.

Knowledge and awareness of dental professionals regarding professional indemnity insurance (PII) in India- A systematic review

2025-04-06T20:42:55+00:00

Background: In recent times, patients have become more aware of their rights, and this has led to significant rise in the
compensation cases against doctors. Due to the nature of the work and costs involved in the treatment, dental
professionals are at high risk of facing such medical negligence cases. Therefore, the present study was conducted to
assess knowledge and awareness regarding professional indemnity insurance (PII) among dental professionals in India.
Methodology: A systematic review of relevant cross-sectional observational studies was conducted among dental
professionals in India to report their knowledge and awareness regarding PII. Eight studies out of 98 were finally
included in the review after conducting both electronic and manual search of scientific databases and making necessary
exclusions. Potential biases were addressed and relevant data regarding PII data was extracted by the investigators
concerned.
Results: More than 60% of subjects had knowledge regarding PII in one of the study reports. Only 0.5% of subjects had
taken PII in one of the studies and merely 8% in the other study. One of the studies mentioned that 76.2% of subjects
paid compensation to their patients for negligence during dental treatment. Main hurdles for not opting PII were
unawareness and considering PII non-mandatory for dentists. More than 90% of subjects in one study showed interest in
buying PII for themselves.
Conclusion: The results of the present review reveal that less than half of the subjects in some studies reported a lack of
knowledge regarding PII and very few had taken PII. Therefore, there is an urgent need to make dental professionals
aware of the benefits of obtaining PII to safeguard themselves from various litigation issues.

Association of gut-microbiome and mental health and effects of probiotics on psychiatric disorders: A meta-analysis and systematic review

2025-04-06T21:05:09+00:00

Background: A correlation between gut microbiome and mental health has drawn significant attention
lately. The effects of microbiome microorganisms and their byproducts on disease states represent a
complex and dynamic field of study. The objective of this article is to review the association of gut
microbes and mental health and the effects of probiotics on psychiatric disorders, if any.
Methodology: This meta-analysis was conducted using the PRISMA standards. We have compiled the
most recent advancements in the field according to human research published in this Systematic review
and meta-analysis.
Results: The forest plot analysis revealed that probiotics or probiotics combined with other intervention
modalities did significantly reduce some extent of mental disorders in comparison to the control group
(Standardized mean difference) SMD = 0.95, 95% Confidence Interval (CI): −6.52 to 8.42, P value<
0.01.
Conclusion: Overall, the reviewed literature supports the importance of gut microbiota–brain interaction
in human mental illnesses, including the impact of probiotics on mental health outcomes and brain
connection.

Beyond grades: Harnessing self-regulated learning to empower underperforming students

2025-04-06T21:22:31+00:00

Self-regulated learning (SRL) represents a critical educational framework through which learners
proactively govern their learning processes using self-motivation, metacognitive reflection, and strategic
task management. This article examines SRL’s transformative role in enhancing academic performance,
particularly for underperforming students who often face significant academic and environmental
challenges. SRL offers a structured approach for these students by promoting resilience and reinforcing
goal-oriented learning behaviors. Key SRL components include establishing structured learning
environments, optimizing resource use, and building self-efficacy. Through SRL instruction, educators
can support underperformers in cultivating sustainable, autonomous learning practices. Specific
strategies, such as peer tutoring and interactive tools like "Betty’s Brain," reinforce understanding as
students teach and apply learned concepts. Integrating SRL among underperforming students cultivates
lifelong learning skills and establishes a foundation for enduring academic and professional success.
Future research should explore innovative SRL approaches tailored to the needs of underperforming
students, with particular emphasis on applications within medical education, where SRL could
significantly enhance both immediate and long-term outcomes.

Quality of sexual life and its correlates among men with diabetes mellitus and erectile dysfunction attending a tertiary hospital in Owerri, Nigeria

2025-04-06T21:30:24+00:00

Background: Erectile dysfunction (ED) is common among men with Diabetes mellitus (DM), with a negative impact on their sexual
satisfaction. There is a paucity of data on this in our locality. Hence this study was to determine the quality of sexual life, its correlates and predictors among such men.
Methodology: One hundred diabetic men with ED as well as 100 without ED were recruited consecutively. Questionnaires were used to
collect relevant information and assess their quality of sexual life. This was followed by a focused physical examination and anthropometric measurements. Blood samples were collected for relevant investigations. Data analysis was with SPSS version 25 while p-value < 0.05 was considered significant.
Result: Participants with ED had a mean IIEF-5 score of 11.97 ± 4.73 while those without ED had 24.06 ± 1.10 (p = 0.000). Among the DM
participants with ED and those without ED, their mean SQoL-M scores were 44.14 ± 10.85% and 89.73 ± 16.23% respectively (p = 0.000).
Correlation between SQoL-M scores and IIEF-5 scores showed (r = 0.374, p = 0.000) while that between SQoL-M scores and HbA1c
showed (r = - 0.205, p = 0.040) in diabetic participants with ED. IIEF-5 scores and HbA1c levels were observed to be the only predictors of
SQoL scores among diabetic participants with ED.
Conclusions: There is a significant difference in the quality of sexual life between diabetic men with ED and those without ED. While there is a positive correlation between SQoL-M and IIEF-5 scores, there is a negative correlation between SQoL-M scores and HbA1c levels among diabetic men with ED. IIEF-5 scores and HbA1c values are predictors of quality of sexual life among diabetic men with ED. Thus, there is a need for evaluation of quality of sexual life among diabetic men with ED.

Correlates of uptake of routine immunization amongst under-five children: comparison of nomadic and non-nomadic fulani in Yobe State, Nigeria

2025-04-07T05:45:32+00:00

Background: Immunization is an important public health intervention that reduces morbidity and mortality associated with vaccine
preventable diseases (VPDs). This study aimed to determine and compare the correlates of routine immunization uptake among under-five children of nomadic and non-nomadic Fulani in Yobe State, Nigeria.
Methodology: A multistage sampling technique was used to study the eligible caregivers and under-five children in the selected households using an interviewer-administered questionnaire, observation for the child immunization card, or a recall of immunization history. Data were analysed using IBM SPSS version 22.0 with a statistical significance set at p≤5%.
Results: The response rate among nomadic and non-nomadic Fulani was (348/348, 100% vs. 345/348, 99%).The Penta 1 uptake based on routine immunization cards among nomadic and non-nomadic under-five children was (23.6% vs.76.4% P<0.001).Availability of the
vaccine (adjusted odds ratio = 22, 95% confidence interval = 13.7–35.5), the purpose of vaccination (adjusted odds ratio = 1.9, 95%
confidence interval = 1.1–3.4), vaccines safety (adjusted odds ratio = 17.3, 95% confidence interval = 10.0–29.8), and friendly healthcare
workers (adjusted odds ratio = 18.8, 95% confidence interval = 11.3–31.3) were found to be independent predictors facilitating uptake of
routine immunization among nomadic and non-nomadic under-five children, while long distance to the health facility (adjusted odds ratio =9.6, 95% confidence interval = 6.6–14.0), lack of knowledge on immunization (adjusted odds ratio = 2.1, 95% confidence interval = 1.42.9), fear of side effect (adjusted odds ratio = 1.6, 95% confidence interval = 1.1–2.5), were independent barriers to uptake of routine
immunization among nomad and non-nomadic under-five children.
Conclusions: Vaccine uptake is still a problem among nomads and non-nomadic under-five children. The government and relevant
stakeholders should ensure a strategy for improved outreach services to all the nomads and hard-to-reach settlements.

Prevalence and diagnostic dilemma of chromosomal abnormalities in the Niger Delta area of Nigeria; Is prenatal diagnosis worthwhile?

2025-04-07T06:11:46+00:00

Background: Early detection of increasing numbers of cases of chromosomal abnormalities (aneuploides) at the Rivers State
University Teaching Hospital (RSUTH) in the Niger Delta will enhance appropriate counseling of patients and early
termination of the affected pregnancies. The study aimed to ascertain the prevalence of aneuploides at the RSUTH and to
determine the necessity for early prenatal diagnosis in the Niger Delta.
Methodology: This was a prospective cross-sectional study carried out over a three-year period (01/01/2018 – 01/01/2021) at
the RSUTH, Nigeria. Newborn babies delivered at 28 weeks and above were assessed at birth for the phenotypes of
aneuploidy and associated birth defects. A convenient sampling method was used to recruit all the babies with chromosomal
abnormalities and their mothers. Data including that of socio-demographic, obstetric characteristics, and the fetuses were taken
and analyzed using Statistical Package for Social Sciences Version 23 (SPSS version 23). Quantitative variables were
summarized using means and standard deviation while qualitative variables were expressed as frequencies and proportions.
Results: The total number of babies that were delivered by the 5868 participants in the study was 6078, out of which 10 cases
of aneuploides were identified – 3 cases of trisomy 18 and 7 cases of Trisomy 21. The prevalence of chromosomal
abnormalities at birth at the RSUTH was 0.165% of the total births, 1:2000 and 1:654 for T18 and T21 respectively. 1:654
mothers had babies with chromosomal abnormalities, 1:2000 and 1:833 for T18 and T21 respectively.
Conclusion: The prevalence of chromosomal abnormalities at birth at the RSUTH of 0.165% represented a gross
underestimation because the diagnosis was based on the outward phenotypical appearance of the neonates and it was made not
from babies delivered at 20 weeks and above as practiced in Europe and other countries, but from 28 weeks. Prenatal diagnosis
was therefore highly recommended in the Niger Delta.

Relationship between maternal diseases and placental morphology among parturient’s in Port Harcourt, River State: A multi-centre study

2025-04-07T06:45:54+00:00

Background Maternal diseases that complicate pregnancies such as Pregnancy induced hypertension (PIH) or Gestational
Diabetes Mellitus (GDM) etc are markedly impressed on the placenta microscopically and macroscopically resulting in in
defective placental development and perinatal morbidity and mortality. This study aimed to study the gross anatomy of the
placenta and its relationship with maternal medical illnesses.
Methodology: This study was a multi-centre hospital-based prospective cross-sectional study of 250 parturient who had term
deliveries in Port Harcourt. The socio-demographic data and the medical history of the parturient were collected using a
proforma. The placenta was collected after delivery and examined, and the morphometric features were noted. Data analysis
was done with SPSS IBM version 23. Correlation and Regression analysis were employed in investigating the relationship
between maternal/neonatal characteristics and placental morphology. Statistical significance was at a p-level of less than 0.05.
Results: The mean age of the women ± SD = 30.44±4.1years and the median parity was para-2. Gestational Hypertension was
the most common medical condition among participants. There was a statistically significant association between the maternal
medical conditions and the placental shape with a preponderance of the oval shape among the women with hypertensive
disorders. There was also, a statistically significant association between maternal medical conditions in pregnancy and other
placental measurements such as weight, number of cotyledons, diameter, thickness, and cord insertion.
Conclusion: Maternal medical conditions in pregnancy was found to have significant macroscopic imprints on the placental
morphology and these can help in the diagnosis and management of medical illnesses that complicate pregnancies in our
environment. More research is needed to establish causation.

Sleep disturbances in healthcare workers during the COVID-19 pandemic

2025-04-07T07:51:18+00:00

Background: Many studies have reported the negative impact of the COVID-19 pandemic on the
rhythms and sleep in various populations. Particularly in frontline healthcare workers, which are highly
susceptible to developing sleep disturbances. Therefore, the present study was conducted to determine the
prevalence and determinants of sleep disturbances in healthcare workers at the regional Hospital Hassan
II in Agadir, Morocco.
Methodology: A cross-sectional study among frontline healthcare workers was conducted at the
Regional Hospital in Agadir, by administering an online questionnaire using the Google Forms platform
distributed through social media. The questionnaire was anonymous, and data confidentiality was
assured. Data analysis was performed using SPSS version 21.
Results: A total of 54 healthcare professionals filled in the questionnaire. The mean age was
28.81±05.35, The two-thirds were female participants (59.3%), and the mean Epworth score was
07.53±04.05, High prevalence rates of sleep disorders were reported as follows; sleep onset insomnia
(27.4), excessive daytime sleepiness (24.1), snoring (24.1).We found that morning headaches and
concentration difficulties are factors associated with sleep disorders among healthcare workers.
Conclusions: COVID-19 has a high risk of poor sleep quality, with many consequences. Measures to
improve the sleep and well-being of healthcare workers are needed.

Mandibular reconstruction with non-vascularized bone graft in a double bridging technique

2025-04-07T08:18:18+00:00

Background: Reconstruction of the mandible following tumor resection or trauma can be challenging due to associated
functional and esthetic problems. Various options have been described in the literature, but non-vascularized bone graft
remain a viable option in middle- and low-income countries, Nigeria inclusive. We hereby report our experience with
the use of non-vascularized bone graft with mandibular reconstruction plates in a double bridging technique for
mandibular reconstruction in our institution.
Methodology: Patients who had mandibular defect reconstruction with non-vascularized bone graft between January
2012 and December 2021 were included in this study. Grafts were harvested from either the rib or contralateral iliac
crest and secured with mandibular reconstruction plate and screws in a double bridging technique. Patients were
followed for a minimum of 12 months and outcomes such as the level of patients’ satisfaction with appearance, graft
take, bony continuity and complications were assessed and analyzed.
Result: Twenty eight patients comprising 18 males and 10 females [M:F 1.8:1] had mandibular defect reconstruction
with double bridging technique during the study period. Donor site distribution revealed that 64.3% [n=18] had their
grafts harvested from the iliac crest while the remaining 10 [35.7%] were taken from the rib. Ameloblastoma [75%,
n=21] was the commonest lesion necessitating resection of the mandible amongst the subjects. The follow up result
showed that appearance was satisfactory in 25 patients [89%], graft take/ restoration of bony continuity in 27 patients
[96%], graft infection occurred in 2 patients [7.1%] while only one case of graft failure was established [3.6%]
Conclusion: A combination of non-vascularized bone graft with reconstruction plate in a bridging technique is a viable
option for mandibular reconstruction in a resource-limited setting.

Ovarian cancers in a northern Nigerian hospital: Epidemiology, clinicopathology and treatment options

2025-04-07T08:28:35+00:00

Background: In Nigeria, Ovarian cancer is the most lethal gynaecologic cancer. The management of disease in
developing countries poses a huge challenge due to late presentation and/or diagnosis, poverty, poor health
insurance coverage, and the dearth of specialists in the region amongst others. Record keeping is poor. Treatment
options are limited with high default rates and mortality. This was a five-year review of clinicopathology and
treatment strategies for ovarian cancers in Ahmadu Bello University Teaching Hospital, Zaria.
Methodology: A retrospective study of all primary ovarian cancers diagnosed and or treated in ABUTH Zaria
from 1st January 2016 to 31st December 2020 was carried out. A total of 38 cases were retrieved and relevant data
was extracted. The data collected were entered into Open Data Kit (ODK) and analysed using descriptive statistics.
Results: Most patients were aged 35 to 54 years with an overall mean age of 51.2 ±13.8 years. Only 34% of
patients were nulliparous and 63.2% were post-menopausal. The commonest symptoms were abdominal swelling
(94.7%), and abdominal pain (68.4%). Epithelial carcinomas (81.8%) were the commonest histotype of which
serous adenocarcinoma (85.1%) was the commonest. There was no distinction between high-grade and low-grade
serous carcinomas. Rare ovarian tumours (germ cell and sex cord/stromal) accounted for 18.2%. Most patients
presented with stage III disease and above (77.7%) with no one presenting at stage I. Thirty-five patients (92.1%)
had surgery, twenty-four (63.2%) had chemotherapy and four patients (10.5%) had targeted therapy. No patient
had hormonal therapy, genetic testing, Poly-adenosine diphosphate-ribose polymerase inhibitors (PARPi),
Hyperthermic intraperitoneal chemotherapy (HIPEC), or palliative radiotherapy. Only 12% had an MDT
discussion. One-year post-diagnosis, the majority were lost to follow-up (73.7%) while 21.1% of patients were still
on follow-up.
Conclusion: Ovarian cancer patients in ABUTH were relatively younger, unemployed, multiparous, and
symptomatic. Some standards of care management practices were omitted.

Comparison of prevalent hypertension by aortic versus brachial blood pressure criteria for - A pulse wave analysis based study from adults of a city of west India

2025-04-07T08:53:56+00:00

Background: Disparities exist in aortic blood pressure (aBP) and brachial blood pressure (bBP) and
between aortic (AH) versus brachial hypertension (BH). While the former is superior, it is studied
scarcely. Pulse wave analysis (PWA) provides objective and simultaneous measurement of both blood
pressures to determine AH and BH. Using PWA, we compared prevalent AH and BH in a sample adult
population.
Methodology: By oscillometric PWA (Mobilograph, IEM, Stolberg, Germany), 1187 participants with
age >18 years were evaluated. Simultaneous aBP and bBP were recorded by standard PWA protocol and
prevalence of AH and BH was estimated. Age and gender-based subgroups were compared for aortic
versus brachial BP differences. Prevalence of Hypertension, Isolated Systolic Hypertension, and Pulse
Pressure ≥40 was compared between aortic versus brachial criteria.
Results: Significant differences were seen between bBP and aBP across all age groups and in both
genders, especially for the younger age groups. As compared to bBP, aBP gave a higher fetch for
prevalent hypertension and a lower fetch for prevalent Isolated Systolic Hypertension (ISH). bPP ≥40
was sensitive but not specific as a surrogate for aPP ≥ 40.
Conclusions: Across ages 18-65 in either sex, disparities exist between bBP and aBP mostly for SBP and
PP with significant differences in prevalent Hypertension, Isolated Systemic Hypertension, and high
pulse pressure. It reaffirms disparities of aBP and bBP and diagnosed brachial or central hypertension
based on them with the need for further work.

Emotional and behavioural problems of HIV-infected children: findings from a southeastern Nigeria tertiary healthcare facility.

2025-04-07T09:07:45+00:00

Background: In children, HIV infection presents with grave consequences, including a predisposition to
emotional and behavioural problems (EBP). These are mental health problems affecting thoughts,
emotions, behaviours and relationships, and may be categorised into emotional problems (EP) and
behavioural problems (BP). Studies have shown a high burden of EBP in children; however, knowledge
gaps still exist regarding the burden of EBP on HIV-infected children. Our study seeks to address these
gaps by determining the prevalence and type of EBP among HIV-infected children.
Methodology: This cross-sectional and comparative study enrolled 386 participants (193 subjects and
193 controls). The subjects were HIV-infected children aged 2-15 years attending the Paediatric HIV
Clinic of Federal Medical Centre, Umuahia. The controls were age and sex-matched HIV-negative
children attending primary or secondary schools in Umuahia. Sociodemographic characteristics were
assessed, and EBP was determined using the strengths and difficulties questionnaire.
Results: Sixty-one subjects (31.6%) had EBP compared to 15 controls (7.8%) and this difference was
significant (p<0.001). The subjects were three times more likely to have EBP than the controls
(aOR=3.03; CI=1.17-7.82). The EBP type showed that, while there was no significant difference in the
multivariate analysis of the behavioural problems, emotional problems were significantly higher in the
subjects than in the controls (p = 0.001). The subjects were six times more likely to have emotional
problems than the controls (aOR=6.26; CI=2.80-13.97).
Conclusion: There is a high burden of EBP among HIV-infected children in Umuahia with emotional
problems as the common type.

Assessment of compliance to preventive measures against COVID-19 using WHO checklist among secondary schools in Nnewi north local government area of Anambra State, Nigeria

2025-04-07T09:20:23+00:00

Background: Coronavirus Disease of 2019 (Covid-19) was arguably the greatest global health threat of our time. Immediately
the pandemic was declared by WHO, countries around the world took broad public health and social measures (PHSM),
including closure of schools, to prevent the spread of the SARS-CoV-2 virus, which causes COVID-19. The COVID-19
pandemic posed an enormous risk to the health and safety of learners, teachers, parents, school administrators, education
practitioners, and the wider community. However, reopening schools carried the public health risk of viral resurgence. This
study aimed to assess the compliance to COVID-19 preventive measures among secondary schools in Nnewi North LGA of
Anambra state, Nigeria using WHO checklist.
Methodology: This was a facility-based cross-sectional observational survey of secondary schools within Nnewi North local
government area of Anambra state. Data was collected through school surveys and observations of compliance measures, both
done during the same school visit. Informed consent was obtained from the principal of each school or their representative
before carrying out the study in their facilities.
Results: Out of the schools sampled, 12 schools (38.71%) had good compliance, 9 schools (29.03%) had moderate
compliance, and 10 schools (32.26%) had poor compliance. The finding of this study thus revealed that the overall compliance
level toward COVID-19 preventive and control measures among secondary schools in Nnewi-North LGA of Anambra state
was 38.71%.
Conclusion: The common restraining factors against compliance to standard COVID-19 preventive measures included the fact
that the students are children (aged between 11 – 18 years) and thus wouldn’t always wear their masks, school ownership,
attitude towards, and risk perception of COVID-19 and these factors significantly influenced the adherence of each school
towards COVID-19 mitigation measures.

Prevalence and pattern of analgesic abuse among undergraduate students of university of Port Harcourt, Rivers State, Nigeria.

2025-04-07T11:24:13+00:00

Background: The habitual or excessive use of painkillers, including prescription and over-the-counter drugs, that
deviates from medical guidelines is known as analgesic abuse, and this includes taking larger doses than
recommended, using the drugs for non-medical purposes, or continuing to take the medication despite adverse
effects on one's physical, mental, and social well-being. Devastating health effects may result from this. The
prevalence and patterns of analgesic abuse among University of Port Harcourt undergraduate students were
evaluated in this study.
Methodology: A descriptive cross-sectional study was conducted, and respondents were selected using a
multistage sampling method. A self-administered, structured questionnaire was used to gather the data, and IBM
Statistical Product for Service Solution (SPSS) version 25 was used to analyze the data; means, frequency,
proportions, chi-square, and regression analysis were used to summarize the results. A p-value of less than 0.05
was deemed statistically significant.
Results: 384 students in all, with a median age of 20, were interviewed. The distribution of results showed that 207
(53.9%) of the respondents were males and 177 (46.1%) were females. The majority of responders, 339 (69.6%),
used paracetamol, with headaches accounting for 316 (57.4%) of all uses. The findings also showed that the
prevalence of analgesic abuse was 9.1%, with paracetamol being the most frequently abused medicine (42.9%).
Conclusion: Although the results indicated that the prevalence of analgesic abuse among University of Port
Harcourt undergraduate students was low, most respondents used analgesic medication without a prescription from
a doctor. The most common reasons for using analgesics were headaches, muscle pain, and menstrual cramps. It is
crucial that the institution implements strategic plans to ensure that students are taught how to use analgesics
properly.

Assessment of serum laminin and hyaluronic acid as markers of hepatic fibrosis in patients with chronic hepatitis B.

2025-04-07T11:51:11+00:00

Background: Hepatitis B virus (HBV) is a major cause of chronic liver disease worldwide. Fibrosis of hepatic parenchyma
has been reported as a common pathway to complications of chronic liver disease. There is a need to monitor fibrosis in these
patients to abort or delay disease progression following treatment. Liver biopsy is recognized as the gold standard for disease
monitoring; however, the procedure is invasive and bedeviled with potential complications. For these reasons, non-invasive
biomarkers of fibrosis are now being evaluated as alternatives to liver biopsy. The study aimed to assess the characteristics of
laminin, and hyaluronic acid as markers of hepatic fibrosis in patients with chronic hepatitis B.
Methodology: One hundred participants with HBV-induced chronic liver disease (CLD) were recruited for the study. A liver
biopsy was conducted, and the degree of hepatic fibrosis was scored using the Metavir scoring system. Serum levels of the
biomarkers were determined using enzyme-linked immunosorbent assay (ELISA) technique. Medians and interquartile ranges
were compared using the Mann-Whitney U test. The degree of correlation between continuous variables was determined using
Spearman’s correlation analysis. Statistical significance was set at p ≤ 0.05.
Results: Serum laminin was significantly higher in participants with hepatic fibrosis: 39.09 (27.6-89.4) ng/ml [median
(interquartile range)], vs 24.3 (21.5-31.9) ng/ml, p = 0.001, Hyaluronic acid was significantly higher in participants with
hepatic fibrosis: 45.1 (26.9-94.4) ng/ml vs 23.1 (12.7-35.7) ng/ml, p < 0.001. There was a strong significant positive
correlation of both serum laminin and hyaluronic acid with Metavir score in the study participants (r=0.766, p<0.001; r=0.708,
p<0.001 respectively). At a serum laminin concentration of 44.6 ng/ml, sensitivity and specificity for detecting moderate to
severe hepatic fibrosis were 86.8% and 88.7% respectively, with an area under the curve (AUC) of 0.943 on the Receiver
Operator Characteristic (ROC) curve. The sensitivity and specificity of hyaluronic acid for detecting moderate to severe
hepatic fibrosis were 81.6% and 85.5% at a serum concentration of 53.5 ng/ml. AUC was 0.930 on the ROC curve.
Conclusion: This study underscores the evidence that laminin and hyaluronic acid may be helpful clinically in identifying
patients with moderate to severe hepatic fibrosis. Serum laminin had a slightly better diagnostic ability than hyaluronic acid in
the study participants. Further studies are needed to elucidate our findings.

Demographic and clinical profile of haemodialysis patients with end-stage renal disease in a northern Nigerian hospital: A retrospective analysis of patterns and outcomes

2025-04-07T12:09:59+00:00

Background: Chronic kidney disease (CKD) is a global health challenge with increasing prevalence and
substantial impacts on healthcare systems, particularly in low- and middle-income countries. Limited access to
resources for managing CKD and end-stage renal disease (ESRD) in these regions exacerbates mortality and
morbidity, highlighting the need for effective and accessible healthcare strategies. This study examines CKD
prevalence, management practices, and outcomes across various populations, with a focus on the challenges faced
in sub-Saharan Africa.
Methodology: This study utilized a retrospective, observational design to examine patient records from the
haemodialysis unit at Yusuf Dantsoho Memorial General Hospital, Kaduna State, Nigeria. The research focused on
the sociodemographic, clinical, and dialysis-related characteristics of patients who underwent haemodialysis
between January 2019 and October 2024.
Results: CKD prevalence has significantly increased worldwide, with ESRD incidence notably in our centre.
Access to dialysis varied greatly, with low-resource settings struggling to meet demand, contributing to poorer
outcomes. In Africa, studies show that less than 10% of patients who needed dialysis accessed it. Additionally,
CKD patients in lower-income regions often present with advanced diseases due to inadequate screening and
preventive care. High mortality rates were linked to limited access to early treatment and a lack of government
support for subsidizing renal care.
Conclusion: There was a pressing need to improve CKD prevention, early diagnosis, and treatment in resource
limited settings to reduce the burden of ESRD. Increased government investment, enhanced screening programs,
and sustainable funding models for dialysis were essential to mitigate the impact of CKD.

Determinants and prevalence of paediatrics return visits to the emergency department in a tertiary hospital in southeast Nigeria: A retrospective study

2025-04-07T12:29:31+00:00

Background: Pediatric Emergency Department (ED) return visits are an essential quality indicator, assessing the
adequacy of care provided during the initial consultation, patient management, and subsequent follow-up. Despite
the high burden of pediatric emergency cases, there is paucity of data on the prevalence and determinants of return
visits in Nigeria. This study therefore aims to determine the prevalence and determinants of pediatric return visits
to the ED in a tertiary hospital in Southeast Nigeria.
Methods: A retrospective review of medical records was conducted for pediatric patients who visited the ED of the
National Obstetric Fistula Center (NOFIC) Abakaliki Ebonyi State, from September 2022 to August 2023. Data on
demographics, presenting complaints, diagnoses, investigations, and treatments from initial and return visits were
collected and analyzed. Statistical analyses were performed to determine the prevalence of return visits and explore
associations with factors such as age, sex, type of caregiver, number of diagnoses, and duration of admission.
Results: Among 181 pediatric patients, 19 (10.5%) had a return visit to the ED. Most of these patients were 0-5
years old (80.7%), with a slightly higher proportion of males (56.9%). The most reported symptoms were fever
(77.3%) and vomiting (44.8%), with malaria being the predominant diagnosis at both initial (65 cases) and return
visits. Although male children (68.4%) and those with multiple diagnoses had higher return rates, statistical
analysis revealed no significant associations between return visits and the examined variables.
Conclusion: The 10.5% prevalence of pediatric return visits to the ED is a clear indicator of the complex
relationship between illness severity, the quality of care provided and the health-seeking behavior of care givers in
a resource limited health care facility. The study helps to understand some causes of return visits and develop
strategies to reduce their occurrence.

Comparing single dose versus multiple doses antibiotic prophylaxis in preventing surgical site infections following open appendicectomy for uncomplicated appendicitis

2025-04-08T11:22:59+00:00

Background: Acute appendicitis is the leading cause of acute surgical abdomen. Studies have shown that
a single dose of antibiotics is as effective as multiple doses in preventing surgical site infections (SSI)
after appendectomy, with advantages such as cost savings, fewer adverse reactions, and reduced risk of
antibiotic resistance. Despite these benefits, multiple doses are still commonly used. This study compared
the efficacy of single-dose versus multiple-dose antibiotic prophylaxis in preventing SSI after open
appendectomy for uncomplicated appendicitis.
Methodology: A one-year prospective study was conducted at the university of Benin teaching hospital
(UBTH), Benin City, involving 62 adult patients with uncomplicated appendicitis. A total of 76 patients
were initially recruited, but after histological evaluation, 62 patients were analyzed, 29 received a single
dose of antibiotics, and 33 received multiple doses following the exclusion of the negative
appendicectomies. All patients were given intravenous 1.5 g cefuroxime and 500 mg metronidazole at
anesthesia induction, with the multiple-dose group receiving two additional doses. Outcomes assessed
included SSI occurrence, cost of antibiotics, and SSI management costs.
Results: SSI rates were similar between groups (3.5% vs. 3.0%), but the cost of multiple-dose regimens
was over twice that of single-dose. Side effects were more frequent with multiple doses. Both SSI cases
were superficial and associated with higher BMI.
Conclusion: Single-dose antibiotic prophylaxis is equally effective, more economical, and safer than
multiple doses.

Hydroxyurea therapy in sickle cell disease: knowledge and prescription patterns among care providers in a low-and middle income setting

2025-04-08T11:46:19+00:00

Background: Hydroxyurea is a safe, effective, and well-tolerated disease-modifying therapy for patients with sickle cell
disease (SCD), leading to reduced morbidity, mortality, and an improved quality of life. However, its underutilization, driven
by inadequate knowledge and variability in use among SCD care providers, may limit its benefits. This study assessed the
knowledge and prescription patterns of hydroxyurea among SCD care providers in Jos, Nigeria.
Methodology: A cross-sectional survey of 132 physicians managing SCD was conducted to collect data on socio
demographics, hydroxyurea knowledge, and prescription patterns using a proforma. Knowledge was assessed using 17
questions (maximum score: 17). Scores above 12 (50th percentile) were classified as “good,” while scores of 12 or below were
categorized as “poor.” Prescription patterns were evaluated against the National Institutes of Health (2014) and British Society
for Haematology (2018) guidelines. Data were analyzed using descriptive and inferential statistics.
Results: Sixty-seven (50.8%) of the 132 physicians had inadequate knowledge of hydroxyurea’s clinical benefits and safety.
Only 35 (26.5%) were aware of available treatment guidelines, and 32 (24.2%) had ever prescribed hydroxyurea. Among
prescribers, nine (28.1%) used inappropriate criteria to initiate treatment and six (18.8%) prescribed below recommended
doses. The median maximum daily prescribed dose was 750mg, whereas five (15.6%) physicians did not exceed 200mg,
irrespective of patient weight. Treatment guidelines were not followed by 25 (78.1%) of prescribers.
Conclusion: This study revealed a high prevalence of inadequate knowledge and inconsistent hydroxyurea prescription
practices among SCD care providers. Targeted training is essential to enhance hydroxyurea utilization and ensure adherence to
standardized treatment guidelines, ultimately improving patient outcomes.

Pattern and outcome of medical admissions at the university of Uyo teaching hospital: A 5-year hospitalization analysis.

2025-04-08T12:09:21+00:00

Background: The pattern of hospital admission is necessary for proper planning and budgeting in health care.
It also provides insights into the burden of disease in a particular community. Additionally, admission patterns
also assist in reviewing the morbidity and mortality over the duration of the study and allow for proper
planning and prevention of these occurrences.
Methodology: This is a five-year retrospective study of patients admitted to the medical wards. Patients' case
notes were retrieved from the hospital's records department. Demographic data such as age, sex, occupation,
and religion were extracted from the case notes. Clinical data such as diagnosis, date of admission and
discharge, duration of stay, and cause of death were also extracted. Kaplan-Meier survival curves were
plotted, and a multivariate Cox proportional hazards model was used to determine the independent predictors
of mortality.
Results: A total of 2634 patient records were retrieved. The ages of patients ranged from 15 to 102 years, with
a mean of 54.8 ± 16.5 years. There were more males 1374 (52.2%) against 1269(47.8%) females), p<0.001.
Noncommunicable diseases (NCDs) accounted for 2286 (86.8%), with 348 (13.2%) being communicable
diseases. Chronic kidney disease (CKD) 21.5%, acute kidney injury (5.0%), Stroke (19.9%), Heart failure
(17.6%), and Diabetes (20.7%) were the leading NCDs. On the other hand, Tuberculosis (4.0%), and
Pneumonia (1.4%), were the leading communicable diseases causing hospitalization. Older age groups ≥60
years (p= 0.02), kidney disease, (p< 0.001). HIV. (p=0.01) were independently associated with mortality.
Conclusion: The epidemiological transition to NCDs is well established in the adult population of Akwa
Ibom State. Older age, kidney diseases, stroke, and HIV infection were independent predictors of mortality.

Quality of life in children with epilepsy: Effect of socio demographic factors and parental awareness of seizure action plan in eastern India

2025-04-08T12:30:17+00:00

Background: Epilepsy is a chronic neurological disorder that disrupts daily life and negatively impacts quality of life
(QOL). While most medical approaches focus on seizure control, there is limited attention to the QOL of children with
epilepsy (CWE) in eastern India. This study aimed to assess QOL among CWE and examine the influence of socio
demographic factors, seizure characteristics, and parental awareness of a seizure action plan (SAP).
Methodology: This cross-sectional study was conducted in the Department of Paediatrics at a tertiary care teaching
hospital in eastern India from December 2020 to May 2022. Eighty children aged 5-15 years, all diagnosed with epilepsy
and on antiepileptic medication for at least six months, participated. Approval was obtained from the Institutional Ethics
Committee of the hospital concerned. The participants were interviewed using a structured pre-tested schedule. The
QOL of the participants was evaluated using the Quality of Life in Childhood Epilepsy (QOLCE-55) questionnaire.
Parental awareness of SAP was assessed based on their knowledge of essential seizure management actions. Kruskal
Wallis test was used to identify factors associated with QOL.
Results: The mean age in the study population was 9.37 ± 3.57 years, with 56.45% males. The mean QOL scores in
cognitive, emotional, social, and physical domains were 59.41, 55.11, 56.40, and 65.11, respectively. QOL steadily
declined with age, with emotional and social domains more impacted on older children. Maternal illiteracy, low
socioeconomic status, and earlier onset of epilepsy were significantly associated with poorer QOL (p<0.001). Only
21.25% of parents had complete awareness of SAP, and the children of these parents had relatively better QOL scores.
Conclusion: QOL was better in CWE who were younger, had late-onset epilepsy, belonged to the upper socioeconomic
class, and whose mothers were educated. Interventions enhancing parental awareness about SAP may lead to
improvement in the QOL of CWE.

Sociodemographic predictors of knowledge and practice of exclusive breastfeeding among mothers attending primary health centres in Ethiope west, Delta State Nigeria.

2025-04-08T12:42:11+00:00

Background: A mother's sociodemographic characteristics influence her practice of breastfeeding and are vital in
determining the overall well-being of the baby. This study assessed the sociodemographic predictors of the knowledge
and practice of exclusive breastfeeding among lactating mothers attending primary health centres in Ethiope West LGA
of Delta State.
Methodology: This cross-sectional questionnaire-based study was conducted among 360 mothers of children aged 6-15
months attending six primary health centres in Ethiope West Local Government Area of Delta State. Data was collected
on sociodemographic factors, knowledge, and practice of exclusive breastfeeding among mothers. There were 8
questions that assessed the knowledge of exclusive breastfeeding. A mother was assessed to have good knowledge of
exclusive breastfeeding when she answered correctly at least 6 out of the 8 questions. Data was analyzed using IBM
SPSS Version 26.0.
Results: The respondents were aged 15-41 years with the majority (47.4%) being 20-29 years and a mean age of
28.92±6.89 years. They were mainly Urhobos (62.8%), married (78.9%), with about half (50.6%) of the participants in
the lowest social class and about 43.3% having at least a secondary education. Most (78%) respondents had a good
knowledge of exclusive breastfeeding but only about one-third (36%) were exclusively breastfed. Logistic regression
analysis showed the odds of practicing EBF to be about twice in married women compared to the unmarried (AOR=
1.90, 95% CI= 1.007-3.591, p=0.014) and that the level of education was predictive of knowledge of EBF (AOR= 12.89,
95% CI= 4.006-40.901; p=0.001).
Conclusion: Despite the good knowledge of EBF, its practice was poor with marital status being the most important
predictor of EBF.

Verification of the HbA1c method on the STANDARD F2400® analyzer in a Nigerian laboratory

2025-04-08T12:58:42+00:00

Background: For methods that report quantitatively, an assessment of their imprecision and bias should be
assessed in the laboratory before their deployment into routine service. This study assessed these parameters of the
HbA1C method on the STANDARD F2400® point of care analyzer. These parameters were further combined to
generate sigma metrics for the method.
Methodology: An external quality assurance (EQA) material from the Randox International Quality Assessment
Scheme (RIQAS) was analysed according to the EP15 protocol of the Clinical Laboratory Standards Institute in
SYNLAB Nigeria Laboratory Quality Assurance Department. Estimates of precision and an assessment of bias
were determined from the data which consisted of 5 replicates per day for 5 consecutive days. Precision estimates
were compared with manufacturer-provided information and estimates of bias were compared with the verification
interval for the target value provided by RIQAS. Sigma metrics were determined for total allowable error (TAE) of
8% and 10%.
Results: The grand mean (standard deviation) for the study was 4.95 (0.15) %. The Within-run CV and within
laboratory CV were 1.28% and 1.86%, respectively. These were within the manufacturer claims of 1.70% and
1.90%, also respectively. The target value by RIQAS was 5.04(0.24) % with a calculated verification interval of
4.95 - 5.13%. The sigma metrics for the method at TAE of 8% and 10% were 4.8/3.3 and 6.3/4.3 within the
run/within laboratory estimates respectively.
Conclusion: The HbA1C method on the STANDARD F2400® Analyzer displayed performance characteristics
that are consistent with manufacturer specifications and are above industry standard quality for a point-of-care
device for HbA1C. These suggest that may be used to support routine monitoring of persons with diabetes mellitus
in Nigeria.

Perception of enrollee health insurance fraud among healthcare workers at a tertiary hospital in Kaduna State, north-western Nigeria

2025-04-08T13:08:11+00:00

Background: Fraud in healthcare is an immense challenge that poses a direct threat to sustainable healthcare
financing across low and high-income countries. Enrollee health insurance fraud is a relatively understudied form
of fraud that thrives in settings characterized by weak and fragmented healthcare systems. This study examined the
knowledge and perception of enrollee health insurance fraud among healthcare workers at a tertiary hospital in
Kaduna State, North-western Nigeria.
Methodology: Using a stratified sampling technique, 232 healthcare workers were interviewed using a structured,
self-administered questionnaire that was developed for the study. Data on knowledge and perception of enrollee
fraud was obtained and analysed using IBM SPSS Statistics. The data was presented using frequency distribution
tables, while figures were drawn using Microsoft Excel.
Results: The majority of the respondents were clinical staff, including medical doctors (29.7%), nurses (31.5%)
and health assistants (14.2%). A total of170 (73.3%) respondents were aware of enrollee fraud and up to 113
(66.5%) encountered at least one case of enrollee fraud. The most common types of enrollee fraud identified by the
respondents were impersonation (67.7%) and faking symptoms (57.1%). Respondents recognised adverse
consequences of enrollee fraud, including depletion of resources (74.1%), blocking eligible patients from accessing
care (73.6%), and exhaustion of healthcare workers (61.8%). A total of 111 (65.3%) agreed that enrollee fraud is
common in the hospital and despite a high level of awareness, only 72 (42.3%) agreed that they are adequately
informed about enrollee fraud.
Conclusion: There was a high level of awareness of enrollee fraud among the respondents with a good perception
of its manifestations and implications on healthcare delivery. It is recommended that immediate steps be taken to
educate healthcare workers and enhance their capacity to detect and deter enrollee fraud while investing in long
term strategic measures and technology-based solutions.

Knowledge, acceptance and willingness to pay for malaria vaccine among residents of a semi-urban community in Kaduna State, north-western Nigeria.

2025-04-08T13:20:45+00:00

Background: Malaria is a life-threatening parasitic infection associated with high morbidity and mortality in
endemic regions. The World Health Organization (WHO) has approved two malaria vaccines for use in children
and as countries begin the phased rollout of these vaccines, uncertainties around community awareness, attitudes,
and willingness to accept the vaccines remain.
Methodology: This study used a multistage sampling to select 200 mostly female caregivers of children under the
age of five years in Samaru, a semi-urban community in Kaduna State, North-western Nigeria. Data on knowledge,
attitude, and willingness to accept the malaria vaccine was obtained using a structured questionnaire and analysed
using IBM SPSS Statistics. Knowledge and attitude were scored and graded into good and poor categories. The
data was presented using frequency tables and a chi-square test was used to check for associations between
willingness to accept malaria vaccine and relevant variables. A P value < 0.05 was considered statistically
significant.
Results: The majority of the respondents were females (65.5%) and married (93.0%), with a mean age of 33.1
(±9.3) years. Fifty-seven (28.5%) caregivers heard of the malaria vaccine mostly through healthcare workers and
traditional media, while 39 (19.5%) showed good knowledge of the vaccine. A total of 194 (97.0%) had a good
attitude towards the vaccine, 188 (94.0%) were willing to accept the vaccine, and 176 (88.0%) said they were
willing to pay for it. Factors associated with vaccine acceptance included the caregiver being vaccinated as a child,
having at least one child who is vaccinated, and having a good attitude toward the vaccine.
Conclusion: Despite low awareness, willingness to accept the malaria vaccine was high in the community. It is
recommended that immediate steps be taken by relevant stakeholders to educate the public and begin the rollout of
the vaccine to avoid the spread of rumours and misconceptions.

Prevalence of hypertension and type 2 diabetes mellitus among patients with metabolic syndrome in rural southern Nigeria: gender and age disparities

2025-04-08T13:35:43+00:00

Background: Metabolic syndrome (MetS) is a cluster of interconnected risk factors, including obesity,
hypertension, elevated blood sugar, and abnormal lipid profiles. Its increasing prevalence globally poses a
significant public health concern. This study investigated the prevalence of hypertension and type 2 diabetes
mellitus (T2DM) in patients with MetS, considering age and gender in a rural teaching hospital.
Methodology: Conducted at Igbinedion University Teaching Hospital, Edo State, the study involved 75 patients
selected through simple random sampling using the 2009 Joint Interim Statement (JIS) criteria of the
IDF/AHA/NHLBI. It utilised an observational, cross-sectional, and retrospective design, focusing on individuals
aged 18 years and older who consented to participate. Data was analysed using IBM SPSS version 23, with p <
0.05 considered significant.
Results: The findings indicated that 60% of patients with MetS had hypertension, 17.3% had T2DM, and 22.7%
were diagnosed with both conditions. Among hypertensive patients, 57.3% were female (P = 0.110). For T2DM,
25.3% of patients were female (P = 0.766). The prevalence of both T2DM (P = 0.106) and hypertension (P =
0.708) was higher in middle-aged patients compared to other age groups.
Conclusion: This study highlights the significant prevalence of hypertension and T2DM among patients with
MetS in a rural teaching hospital, with notable variations across gender and age groups. While hypertension was
more common in females, T2DM showed no significant gender disparity. Middle-aged individuals exhibited a
higher prevalence of both conditions, underscoring the need for targeted screening and intervention strategies in
this demographic.

A call to action: Insights into hypertension prevalence and management in an urban sub-saharan African population

2025-04-08T13:48:29+00:00

Background: Hypertension is a global health challenge, with a disproportionate burden in low- and middle
income countries like Cameroon. Urban centers, such as Yaoundé, face increasing prevalence driven by rapid
urbanization and healthcare disparities. The study objective is to assess hypertension prevalence, associated risk
factors, and barriers to effective management in an urban Cameroonian population.
Methodology: A cross-sectional study was conducted in 2024 as part of the HEAVEN-CIEL Hypertension
Awareness Campaign. Data from 181 adults were collected through structured questionnaires and physical
assessments, including blood pressure measurements. Associations with demographic, socioeconomic, and lifestyle
factors were analyzed using chi-square tests and logistic regression.
Results: Hypertension prevalence was 59.67%, with rates peaking at 75.56% among individuals aged 46–60 years
(p = 0.0019). Medium-income participants showed the highest prevalence at 75.56% (p = 0.043). Obesity (p =
0.0024) and high-fat diets (p = 0.0212) were significant risk factors. Alarmingly, 87.04% of hypertensive
individuals were untreated, highlighting gaps in medication access and adherence.
Conclusion: Hypertension in Yaoundé represents a major public health concern, driven by age, socioeconomic
disparities, and unhealthy lifestyle factors. The low treatment rates reflect systemic healthcare barriers.
Comprehensive, culturally sensitive interventions are urgently needed to improve awareness, prevention, and
management. Future research should focus on the longitudinal impacts of targeted public health strategies.

Learning style preference and its correlation with gender

2025-04-08T14:12:15+00:00

Background: Learning styles have been investigated and classified by several scholars. One of such
investigations is the Gender of the individual which can affect learning style. This study investigated the
difference in the means of learning styles and its correlation with gender among community health officer
trainees at the University of Port Harcourt Teaching Hospital, Nigeria.
Methodology: This is a correlational descriptive study, and a census was carried out. A structured
questionnaire was utilized and a VARK learning style inventory was used.
Results: The reliability of the research instrument using the Cronbach alpha method, the VARK learning style
questionnaire had a reliability coefficient of .755, for the subscales visual .455, aura .351, read/write, and
kinaesthetic .753. With 60 respondents the means were visual 2.633, aura 4.2833, read/write 3.7500, and
kinaesthetic 5.1833 while the standard deviation is visual 1.765, aura 2.429, read/write 2.53534, and
kinaesthetic 2.88474. Multiple Analysis of Variance (MANOVA) was conducted to assess the means of the
four learning styles concerning gender. The F ratios for the univariate analysis show that males and females
did not differ across the four learning styles according to VARK (aural, visual, kinaesthetic, and read/write
learning styles), significantly i.e. p < 0,05. Precisely the computed F = .032, P >.05, i.e., p = .859, i.e., p =
.859 revealed that no statistical difference occurred between males and females with visual learning styles.
Conclusion: The study concluded that community health officer trainees possessed different learning styles
and most of them used the kinaesthetic learning style. However, the community health officer trainees were
significantly different in their responses to the learning style model according to the VARK inventory of
learning styles, but no relationship existed between learning style and gender.

Let’s unravel the association between renal stones and renal variant vasculature in patients with duplex collecting system: A retrospective single institute study

2025-04-08T14:19:53+00:00

Background: Our study aims to explore the association of duplex collecting systems with variable renal vasculature and renal
calculi, given the paucity of published data on the subject.
Methodology: Between 2020 and 2023, retrospective research on patients with a duplex collecting system detected by CT
scans was conducted at the radiology department of Shifa International Hospital. We assessed any gender bias and ascertained
the frequency of this unilateral or bilateral duplex system abnormality. Furthermore, in patients who had received post-contrast
imaging, the prevalence of renal calculi and varied renal vasculature was evaluated. In individuals with a duplex collecting
system, the correlation between renal stones and renal variant vasculature was computed. SPSS version 25 was used to
conduct the chi-square test.
Results: We retrospectively gathered data on patients with duplex collecting systems that showed only 65 patients. According
to our research, bilateral participation is uncommon but the duplex collecting system is not side-specific. According to our
statistics, this aberration has been more common in men as compared to women. Only 36 of the 65 patients in total had post
contrast imaging to check for variances in the vasculature. Of the 36 patients with renal vein variations, 11 had renal vein
variations and 25 did not have any anatomical variations. Of the 25 individuals who did not have a renal vein variation, 19 did
not have calculus, 2 had calculus involving the lower pole, and 4 had calculus involving the upper pole. 8 individuals with
renal variations did not have renal calculus, 2 patients had lower pole calculus, and 1 patient had upper pole calculus. A
negative uncertainty coefficient was seen between renal vein vasculature and calculus formation. 17 of the 36 patients had
renal artery variations, whereas 19 patients had no anatomic variation of the renal artery. 12 of the 19 individuals without a
renal artery variation had no calculus, 2 had calculus involving the lower pole, and 5 had calculus involving the upper pole. 2
individuals had calculus affecting the lower pole, 0 patients had calculus on the upper pole, and 15 patients with renal artery
variations had no renal calculus. A positive uncertainty coefficient was seen between renal arterial vasculature and calculus
formation.
Conclusion: Understanding renal vasculature patterns is vital for effective vascular interventions as well as kidney
transplantations. Patients with a duplex collecting system are at increased risk of stasis, infections, and stone formation. For
urologists and nephrologists, awareness of the association with variant renal vasculature is critical for managing complications
related to this anomaly.

B-mode ultrasound grading of cryptogenic steatotic liver disease and association with the level of sun exposure in Zaria, Nigeria: A case-control study.

2025-04-08T14:32:58+00:00

Background: Cryptogenic Steatotic Liver Disease (CSLD) is a novel subject where the liver has significant steatosis but without a known
cause or abnormal cardiometabolic risk factors. Its aetiology and associations with sunlight exposure remain underexplored, particularly in Nigeria. CSLD is a growing public health concern in Nigeria, characterized by its potential progression to severe liver complications such as cirrhosis and liver cancer, posing significant health risks. This study aimed to determine the association between CSLD and the level of sun exposure.
Methodology: This case-control study involved 181 healthy subjects with CSLD and an equal number of normal subjects without CSLD as controls. This made for a total number of 362 subjects. They were recruited into the study consecutively as they emerged after clinical, laboratory, and imaging screenings. A liver ultrasound scan was done using a 3.5MHz frequency transducer to screen for the steatotic liver. The severity of liver steatosis was evaluated by ultrasound bright liver scores (BLS). A daily sun exposure score based on our local pattern was calculated using the information from the administered questionnaire. The data were analyzed with GraphPad Prism software version 6.

Results: the median (IQR) age of CSLD and control groups were 44.0 (28.5 - 54.0) and 44.0 (30.0 - 55.0) years. Wilcoxon matched pairs
signed rank comparison test showed no significant difference in the ages of the two study groups (p = 0.5578), indicating age matching of the study participants. There was a significant association (χ2 = 59.03, df = 18, p< 0.0001) between age and development of CSLD. One hundred and eighty-one study subjects with CSLD comprised 83 (45.8%) males and 98 (54.1%) females.
The median (IQR) values of the control group's sun exposure score differed significantly from those of the CSLD groups (p = 0.0001) for all categories (mild, moderate, severe steatosis). A multivariate logistic regression analysis model, weighted by years of age and sex, revealed that low sunlight exposure is a significant independent risk factor.
Conclusion: The study shows that limited sun exposure is significantly associated with developing CSLD among Nigerians in Zaria. There is also a significant independent risk factor.

Easing the pain: lignocaine spray in mid-trimester amniocentesis – A randomized double-blind, placebo-controlled trial

2025-04-08T15:01:59+00:00

Background: To evaluate the effect of lignocaine spray on maternal pain perception during mid
trimester amniocentesis compared to placebo.
Methodology: This was a double-blinded, prospective, randomized controlled trial conducted at a tertiary
teaching hospital in Western Rajasthan. Singleton pregnancies between 15- and 24-weeks’ gestation
undergoing amniocentesis were included. Participants were randomly assigned to receive either
lignocaine spray or placebo (normal saline). Pain was assessed using the Visual Analogue Scale (VAS),
Verbal Rating Scale (VRS), and Numerical Rating Scale (NRS). A total of 138 women were enrolled,
with 69 receiving lignocaine spray and 69 receiving placebos.
Results: Pain perception measured by VAS showed no significant difference between the lignocaine and
placebo groups (p = 0.412). VRS and VAS demonstrated a positive correlation (r = 0.692, p < 0.001).
Median VAS scores at 30 minutes post-procedure were significantly lower in the lignocaine group (p =
0.008). The Kappa agreement between VAS and VRS was found to be 59.20%. No significant difference
in procedure-related complications was observed between groups.
Conclusion: The study demonstrates no significant difference in VAS scores or secondary outcomes
between the lignocaine and placebo groups, suggesting that lignocaine spray may not provide additional
benefit for pain relief in amniocentesis.

The pattern of medical admissions at the intensive care unit of the university of Port Harcourt teaching hospital, Nigeria

2025-04-08T15:18:26+00:00

Background. Intensive care units offer specialized care to critically ill patients and are an integral part of
modern health care. In low-income countries, with limited resources, the demand to optimize patient care and
improve outcomes depends on a better understanding of the pattern of medical referrals to the ICU for varying
reasons of resource allocation, staffing, and quality improvement initiatives. This study aims to describe and
provide valuable insights into the patterns of medical admissions to the intensive care unit (ICU), including
case mixes, intensive care interventions, duration of stay, and outcomes to highlight the need for proper
resource allocation
Methodology: A retrospective descriptive study was conducted at the University of Port Harcourt Teaching
Hospital ICU between January 2022 and December 2024. We reviewed all patients from the Department of
Internal Medicine referred to the ICU with a purely medical diagnosis. Data were retrieved from the ICU
admissions register and patients' medical records following ethical exemption approval.
Results: A total of 377 patients with medical referrals were reviewed, accounting for approximately 56.9% of
all ICU admissions. More males were admitted, and the mean age of patients was 48.6 ± 15.3 years. The
emergency unit was the commonest source of referral and offered a significant source of in hospital delays
prior to transfer to the ICU. The most common indication for ICU admission was stroke, with hemorrhagic
stroke, sepsis, and cardiogenic shock associated with the worst outcomes.
Conclusion: Stroke predominated medical referrals and provided the worst outcome. The in-hospital delays at
the emergency unit which became the largest source of referral contributed to the high mortality. This study
highlights the need to strengthen stroke care at the tertiary level of care as well as other medical referrals to
improve care.

Evaluation of mid-palatal suture maturation stage in adolescents and adults using cone beam computed tomography (CBCT)- A comparative study

2025-04-08T15:27:20+00:00

Background: Several methods have been described in orthodontics for the evaluation of the skeletal age.
These include hand-wrist radiography and cervical vertebral maturation (CVM) based on lateral
cephalogram. Computed tomography (CT) scan has emerged as an effective tool for image diagnosis in
situ. The present study was done to assess the stages of the mid-palatal suture in adolescents and adults
utilizing cone beam computed tomography (CBCT).
Methodology: A descriptive and prospective study was done on 110 CBCT scans of individuals aged
between 10-30 years, who visited the Department of Oral Medicine and Radiology, MMCDSR, Ambala,
Haryana. The visualization and classification of the stage of maturation of the mid-palatine suture was
done as per Angelieri’s method using a cross-sectional axial slice.
Results: Stage C was found to be the most prevalent (29.1%) with the majority of cases occurring in the
16–20 age range. Males were more likely to have Stage B, while females had Stage C. In 60 cases (54.5
percent of the overall sample), the mid-palatine suture was found to be open. The Chi-Square test results
for each examiner were highly significant (p< 0.01), indicating a statistically significant association
between age group and Stage distribution.
Conclusion: There is a higher chance that post-adolescents and adults will have an open mid-palatal
suture. When maxillary expansion is necessary, orthodontists may take these consequences into account.
Furthermore, the middle palatal suture's ossification varies, hence using CBCT to rule out this possibility
may be advised.

Is there co-infection of influenza and covid-19 in Jos, north central Nigeria?

2025-04-08T15:39:51+00:00

Background: Influenza virus and severe acute respiratory syndrome virus-2 (SARS CoV-2) are known to
cause respiratory disease in humans that may be fatal. They have caused epidemics and constitute significant
public health challenges because of their ability to spread and cause severe disease. Co-infection with both
viruses has been shown to increase the odds of fatality among affected patients. Our study aimed to
investigate co-infection with influenza among patients with coronavirus disease-2019 (COVID-19) in Jos,
Plateau State.
Methodology: We carried out a cross-sectional study using stored nasopharyngeal and oropharyngeal
samples of patients diagnosed with COVID-19 using GeneXpert. The samples were collected at our institution
and stored at −80 °C. The samples were analysed for influenza co-infection using real-time reverse
transcriptase polymerase chain reaction.
Results: Two-hundred-and-forty-one (241) stored samples of patients diagnosed with COVID-19 were
analysed. None of the samples tested positive for the influenza virus.
Conclusion: We found no case of influenza and SARS-CoV-2 co-infection among the patients studied. This
suggests that the prevalence of influenza virus infection may be low in our setting and partly explains the
relatively benign outcome of SARS-CoV-2 infections in our region.