Nigerian Medical Journal

The urgent need for a multi-dimensional campus mental health intervention in Nigerian universities: The case of unilorin tim-healthcare programme

Oluwabunmi Idera Nimata Buhari — 2024-11-20

The mental health of university students has become a significant cause for worry and public health concerns
globally. Studies suggest that many mental health problems for example, depression, anxiety, phobia, suicidal
behaviour, and substance use disorder among others, typically arise within the age bracket of 15-25 years, which
coincides with the period when many individuals are pursuing higher education. Implementing structural
interventions and broad organizational reforms to address student mental health has proven to be advantageous.
The potential benefits that can be achieved from investing in students' mental health are improved academic
performance, student success, and a reduction in discontinuous school enrolment or dropout especially in resource-limited environments. This report presents a research-based multidisciplinary mental health program being
implemented at a Nigerian University called the University of Ilorin Tertiary Institution Mental Health
Programme (Unilorin TIM Healthcare Programme), aimed at addressing the mental health needs of tertiary
institution students. The programme which incorporates preventive education such as enlightenment programs on
campus, workshops on stress management, resilience building, and coping strategies, amongst other initiatives has
recorded significant benefits with positive feedback from the beneficiaries. It is hoped that it will be a model for
other institutions within and outside Nigeria.
Newborn jaundice (NNJ), especially due to ABO incompatibility, is a major global health concern. Phototherapy is
the standard treatment, with exchange transfusions reserved for severe cases. However, in some babies these
therapies may be ineffective, requiring additional immunomodulatory treatments. Limited access to these.

The growing trend of surrogacy in Nigeria: Implications for quality newborn care: A case report

Ezenwa Beatrice Nkolika — 2024-11-20

Surrogacy involves a woman (surrogate) who consents to carry a pregnancy on behalf of an individual or a couple
who cannot conceive for medical reasons. Surrogacy is gaining popularity in Nigeria among infertile couples,
partly because surrogacy provides an easier means to having children than adoption. Surrogacy can be either
gestational or traditional. Though surrogacy gives hope to infertile individuals, it also comes with peculiar
challenges that affect the newborn with medical, ethical, and legal dimensions that caregivers need to be aware of.
We present three sets of preterm triplets conceived by Invitro fertilization (IVF), carried by gestational surrogacy,
and managed in our facility. This case report highlights challenges encountered while managing these neonates to
create awareness and suggest solutions and guidance to neonatal practitioners.
Topmost challenges include the unsustainability of feeding with the mother’s own milk, lack of kangaroo mother
care, abandonment of care by commissioning parents, delay in getting consent for treatment/procedures,
determining the legal status of the child vis-à-vis simple issues such as changing the name of the child from that of
the surrogate to that of the commissioning parents. The hospital’s legal and welfare departments were key resource
units and were involved early in managing these neonates. One baby from each set of triplets was successfully
discharged home to the commissioning parents.
In conclusion, surrogacy is becoming increasingly common as a means of becoming parents for infertile
individuals. There is an urgent need for proper regulation and legal framework for surrogacy and assisted
reproduction in Nigeria.

Neonatal hyperbilirubinemia: A case of complex management involving ABO incompatibility, sepsis, and suspected G6PD deficiency treated with methyl prednisolone.

Aishatu Zaidu Musa — 2024-11-20

Newborn jaundice (NNJ), especially due to ABO incompatibility, is a major global health concern. Phototherapy is
the standard treatment, with exchange transfusions reserved for severe cases. However, in some babies these therapies
may be ineffective, requiring additional immunomodulatory treatments. Limited access to these treatments in
developing countries creates a critical gap, worsening jaundice severity. A 22-hour-old term neonate presented with
rapidly progressive severe neonatal hyperbilirubinemia (NNJ) within 15 hours of life, consistent with ABO
incompatibility based on discordant maternal and infant’s blood types (mother: O, baby: B-positive). Despite
aggressive initial management with phototherapy and exchange transfusions, the NNJ exhibited limited
improvement. Sepsis and G6PD deficiency were considered as potential contributing factors, although
confirmatory testing for G6PD deficiency was deferred due to unavailability of the diagnostic test in our setting.
Given a sibling's documented successful response to methylprednisolone for a similar presentation, a brief course
of low-dose intravenous methylprednisolone (1mg/kg/day in 2 divided doses) (off-label use) was cautiously
initiated. This resulted in a rapid and significant improvement in the neonate's hyperbilirubinemia.
Methylprednisolone was prescribed for 3 days after which it was discontinued. Following close observation for 3
days and confirmation of no neurological sequelae, the neonate was discharged home in stable condition.
Managing severe, worsening NNJ, especially with multiple aetiologies, is complex. Standard therapies may be
inadequate. While promising, immunomodulatory therapies like IVIG may be limited in resource-poor settings.
Methylprednisolone shows potential but lacks strong clinical evidence. Well-designed studies are essential to
explore its safety and efficacy, particularly in developing countries with limited treatment options.

Youth sports betting and problem gambling in the global and Nigerian context: A review

Faithful Miebaka Daniel — 2024-11-20

Sports betting, once confined to physical venues, has experienced an explosive surge in the popularity of online participation, particularly captivating young adults. This narrative review explores the current global perspectives of sports betting and its attendant implications for youths.

We examined the prevalence, factors, potential risks, and effects such as financial losses, psychosocial issues, and problem
gambling. This review presents current evidence on sports betting among youths and identifies trends, factors, potential harms, regulatory framework, and research gaps while recommending future directions to mitigate the challenge.
Sports betting is a predominant form of gambling in the Americas and Europe. Interestingly, Nigeria also has a considerable proportion of youth involvement in this activity. Preferences for the type of sports vary across countries and depend on the most popular sports in the region, with football being a top choice in Spain and Nigeria. Online bet platforms are gaining traction due to convenience. Socio-demographic factors like age, gender, income levels, unemployment rates, and marketing campaigns play pivotal roles in sports betting.
Participants can be motivated by monetary, recreational, social, or enhancement and coping reasons. Aside from obvious financial losses.
sports betting has been implicated in academic failures, depression, suicidal ideation, and other social vices. Problem gambling and its
attendant issues have also become an emerging problem for many countries as it poses a threat to their most productive population.
However, it is crucial to note that the legalization and regulation of sports betting remains a highly contested subject in different countries.
There is a need for stringent regulation and a collaborative approach to address gambling harms. Betting companies can take responsibility for creating public awareness of responsible gambling and harm reduction in sports betting. Additionally, they can make financial commitments toward the rehabilitation of problem gamblers.

Influence of knowledge of stigmatization and discriminatory practices against HIV-positive persons on pregnant women’s HIV testing in Nigeria

Charles Echezona Nzelu — 2024-11-20

Background: Stigmatizing and discriminatory attitudes have been reported as factors militating against the control of the spread of
HIV infection and ending the HIV epidemic. Women of reproductive age identified as a vulnerable group to HIV infection require
comprehensive knowledge of HIV transmission and prevention to prevent contracting HIV infection. Therefore, this study aimed to
determine the association between reproductive-age women's comprehensive knowledge of HIV transmission and prevention and
their stigmatizing and discriminatory attitudes toward individuals living with HIV/AIDS.
Methodology: Secondary data from the 2018 Nigerian Demographic and Health Survey was used for this study. We used in each
analysis a weighted sample of women of reproductive age with complete data on the comprehensive knowledge of HIV transmission
and prevention and stigmatizing and discriminatory attitudes towards persons living with HIV/AIDS. Bivariable and multivariable
logistic regression analysis was done to predict the effects of the comprehensive knowledge of HIV transmission and prevention of
women of reproductive age on their stigmatizing and discriminatory attitudes toward persons living with HIV/AIDS. Predictor
variables with a p-value of ≤ 0.05 were considered statistically significant determinants of HIV/AIDS stigmatizing and
discriminatory attitudes.
Results: The number of respondents with HIV/AIDS stigmatizing and discriminatory attitudes was 22821 (77.0%). The multivariable
regression models showed that women with an average household wealth index, of Islamic faith, and no access to media were more
likely to have positive attitudes toward persons living with HIV at Alpha = .05.
Conclusion: Having comprehensive knowledge of HIV transmission and prevention by women of reproductive age did not affect
their HIV stigmatizing and discriminatory attitudes towards individuals living with HIV/AIDS differently when compared to those
without comprehensive knowledge. The findings show that women with no access to media and those with an average household wealth index were more likely to have a positive attitude toward persons living with HIV/AIDS than those with access to media and a rich household wealth index, respectively, which requires further validation using primary data.

Prevalence and determinants of diabetes in Saudi Arabia: A cross-sectional analysis

Anas Ali Alhur — 2024-11-20

Background: Diabetes is a major public health challenge in Saudi Arabia, with rising prevalence and significant
associated complications. The increasing burden of diabetes in the region necessitates a comprehensive
understanding of its prevalence, determinants, and the effectiveness of public health strategies. This study aimed to
assess the prevalence and determinants of diabetes using online assessment tools.
Methodology: A cross-sectional design was employed, utilizing online surveys to collect data from adults across
various regions of Saudi Arabia. The survey included questions on demographics, diabetes status, lifestyle habits,
and self-reported health outcomes. Data analysis involved logistic regression to identify risk factors and chi-square
tests to explore associations between diabetes knowledge and management practices.
Results: The study found a diabetes prevalence of 27% among participants, with a higher prevalence in females
(26%) compared to males (20%). Young adults (ages 18-35) showed a prevalence rate of 19%. Significant
associations were observed between diabetes and lifestyle factors; smokers had a 30% higher likelihood of diabetes
than non-smokers. Only 40% of respondents demonstrated adequate knowledge regarding diabetes management,
which correlated negatively with effective disease control (p<0.05).
Conclusion: This study highlights the high prevalence of diabetes in Saudi Arabia, particularly among females and
young adults. The regression analysis revealed significant predictors of diabetes diagnosis, including awareness of
risk factors, physical activity levels, gender, and education level. The findings highlight the need for targeted
educational and public health strategies to enhance diabetes awareness and promote healthier lifestyles. Further
research is needed to evaluate the impact of these strategies on diabetes outcomes.

Histopathologic and immunohistochemical analysis of neurofibromas in a North-Western Nigerian tertiary hospital: A ten-year retrospective study.

Zainab Ali Adamu — 2024-11-20

Background: Neurofibromas are the most common benign nerve sheath tumours occurring as solitary sporadic
tumours or multiple Syndromic tumours associated with neurofibromatosis type 1(NF1). In Nigeria and West
Africa, there is a paucity of literature and studies on neurofibromas. This study aims to analyse the histopathologic
and immunohistochemical patterns of neurofibromas and determine the frequency, demographic and anatomic
distributions.
Methodology: The study was a hospital-based retrospective study, and the study population constituted all surgical
specimens submitted for histological examination to the Department of Pathology between 1st January 2010 to 31st
December 2019 reported as neurofibroma. Records were retrieved from the archives and subjected to
histopathologic and immunohistochemical analysis following standard protocols. Collated data was analysed,
slides were reviewed, and results were presented in frequency distribution tables and statistical charts.
Results: A total of 125 cases were seen constituting 8.3% of all soft tissue tumours seen. Neurofibromas were
more prevalent in females with a male-to-female ratio of 1:1.15. The age ranged between 2-70 years with a mean
age of 25.38 years and the highest frequency of occurrence was in the second decade of life. The most frequent
anatomic site of occurrence was the head and neck region. Most of the tumours 103 (82.4%) were sporadic while
22(17.6%) were Syndromic and associated with NF1. A malignant transformation of a pre-existing neurofibroma
in an NF1 patient was seen. The most common histologic variant seen was the conventional variant. Ninety percent
of these tumours showed SOX10 immunopositivity, 91% showed S100 immunopositivity and 95% showed CD34
immunopositivity. Calretinin expression was low showing 16%. No hot spots labeling index seen with Ki67
antibody.
Conclusion: Neurofibromas are more common in females in our environment and the most frequent anatomic site
of involvement is the head and neck region.

Upper urinary tract stone characteristics and outcome of retrograde intra renal surgery with laser lithotripsy in a Nigerian tertiary hospital: A retrospective study.

Ehiremhen Ozah — 2024-11-20

Background: This study is therefore aimed at assessing upper urinary tract stone characteristics, the
outcome of retrograde intrarenal surgery with laser lithotripsy, and factors predicting stone-free status.
Methodology: This was a retrospective cross-sectional study carried out on all patients who had
retrograde intra-renal surgery with laser lithotripsy for upper urinary tract stones from 2021-2023 at the
Urology unit, department of Surgery, University of Benin Teaching Hospital. Electronic medical records
were retrieved with data on demographics, serum calcium level, and non-contrast computed tomography
scans assessing stone size, location, laterality, multiplicity, density, and renal anatomy.
Results: The data Thirty- three patients were extracted and analysed with a mean age of 43,70+/- 11.44
years, 54.5% of patients were male. The mean duration of admission was 2.4+/-1.5 days. The mean body
mass Index was 26.84+/- 4.37 kg/m2. All patients had flank pains; 7(41.2%) patients had bilateral renal
stones. The majority of renal stones 8(47.1%) were located in the lower pole of the kidney. A greater
proportion of calculus was ureteric 23(69.7%), mean stone size was 13.2+/- 15.2mm, while mean stone
density was 817+/- 285.5 HU. Fifteen participants (45.5%) had multiple stones. Stone clearance assessed
on imaging was 75.8%. Age, sex, stone size, density and location, and multiplicity of stones were
statistically significant determinants of stone clearance (p= 0210, 1.000, 0.220, 0.380. 0.366 and 1.000) respectively.
Similarly, no statistically significant predictors of stone clearance were found in this study.
Conclusion: The study revealed a predominance of upper urinary tract stones in males, with most
patients being overweight. There was a weak correlation between stone density and serum calcium level
in this study. Findings in this study revealed no statistically significant determinant or predictors of stone
clearance.

Assessment of patients’ satisfaction with healthcare services provided under the Nigeria national health insurance authority.

Innocent Achanya Otobo Ujah — 2024-11-20

Background: The Nigeria National Health Insurance Authority (NHIA) is the official Social Health Insurance Agency of the
Federal Government was established to provide quality healthcare services to Nigerians at affordable cost, sufficient to address
catastrophic health expenditures. One key indicator of quality healthcare services is patient satisfaction. This National Survey
aimed to assess enrollees’ satisfaction with healthcare services under this organization.
Methodology: This was a cross-sectional, observational study conducted among enrollees of NHIA in four Nigerian cities
(Aba, Kano, Lagos, and Onitsha) from three randomly selected geopolitical zones of the federation. A sample size of 1,043
was proportionately allocated to the study states based on the number of enrollees in the state (Aba 204; Kano 250; Lagos 359
and Onitsha 230). Data were collected as exit interviews with adapted validated interviewer-administered questionnaires.
Quantitative data were analyzed using a statistical package for social science (SPSS v. 21). Logistic regression was done to
determine predictors of satisfaction with services. A p-value of <0.05 was considered statistically significant.
Results: A total of 1043 respondents were interviewed, with 451 from private healthcare facilities and 592 from public
facilities. There were 599 (57.49) dependents and 444 (42.62) principal enrollees. The majority, 608 (58.3%) were females.
The mean age of respondents was 38.83 years and 679 (65.1%) had tertiary education. Overall, 928 (89%) of the respondents
were satisfied with NHIA healthcare services with the following predictors: marital status, time spent in the hospital, and
services received from healthcare providers.
Conclusion: Most of the study participants were satisfied with the services provided by the Authority. However, there are
identified limitations and administrative challenges at the facility levels that need attention to further enhance quality services
and overall patients’ satisfaction.

Prevalence and determinants of singleton stillbirths at a tertiary hospital in Port-Harcourt, Nigeria.

Peter Abiye Awoyesuku — 2024-11-20

Background: Nigeria makes a substantial contribution to the global burden of stillbirths. Stillbirth accounts for about
50% of perinatal mortality and the stillbirth rate is an indicator of the quality of antenatal and intrapartum care. The
study sought to determine the prevalence and determinants of stillbirths.
Methodology: This was a retrospective, unmatched case-control study over two years from May 2022 to April 2024.
Cases were women with stillbirths that occurred at a gestational age of ≥28 weeks, while controls were women with
livebirths, in a 1 case for 2 controls ratio. Data extracted from the hospital records, using a predesigned collection form,
included demographic, medical, obstetric, and neonatal characteristics as exposure variables. Data was analysed with
SPSS version 25, using descriptive and inferential statistics. Multivariate logistics regression was used to determine
adjusted odds ratios with 95% confidence intervals and a P-value of <0.05.
Results: There were 3,425 live births and 120 stillbirths, giving a stillbirth rate of 35 per 1000 livebirths. Analysis was
performed for 114 cases and corresponding 228 controls, 6 cases were excluded for incomplete data. Maternal age
ranged from 20-48 years and parity from 0-7, with no statistical difference between either group (P=0.982 and P=0.638
respectively). There were 58(50.9%) macerated and 56(49.1%) fresh stillbirths, with 21(37.5%) of the fresh stillbirths
alive at presentation. Factors associated with stillbirth after multivariate analysis included unbooked status (aOR=9.64;
P=0.0001), vaginal delivery (aOR=2.04; P=0.034), abruption placenta (aOR=25.58; P=0.007), preterm delivery at GA
≤36weeks (aOR=3.26; P=0.012), and low birth weight <2500g (aOR=3.53; P=0.016). Obstructed labour and ruptured
uterus were significant in bivariate analysis but could not be fitted into multivariate analysis because of non-occurrence
in controls.
Conclusion: The stillbirth rate at our Centre was 35 per 1000 livebirths. Associated factors for stillbirth were unbooked
status, vaginal delivery, abruption placenta, preterm delivery, and birth weight <2500g.

Cholera outbreak in a rural south - south Nigerian community: a case-control study

Ebikonbowei Okaba — 2024-11-20

Background: Cholera remains a disease of public health importance in Nigeria associated with high morbidity and
mortality. On the 4th of June 2024, the Nigeria center for disease and control prevention (NCDC) through the Disease
Surveillance and Notification Officer (DSNO) reported an increase in the number of reported cases of vomiting and
diarrhea in Toru-Orua village, Sagbama Local Government Area Council, Bayelsa State, Nigeria. A team of researchers
was deployed to investigate the outbreak with the objectives of verifying the diagnosis, identifying risk factors and
instituting appropriate control measures to control the outbreak.
Methodology: We conducted a case-control study. We defined a cholera case as any person aged ≥5 years with acute
watery diarrhea in Toru - Orua community. We identified community controls. A total of 93 cases and 118 controls were
recruited. Structured questionnaires were administered to both cases and controls. Four stool samples from case-patients
and two water samples from the community water source were collected for laboratory investigation. We performed
univariate and bivariate analysis using Epi-Info version
Results: The mean age of cases and controls was 20.3 years and 25.4 respectively (p value 0.09). Females constituted
50% (cases) and 60% (controls). The attack rate was 4.3% with a case fatality rate of 13%. Four stool (100%) specimen
tested positive for Vibrio cholerae. The water source and environment were polluted by indiscriminate defecation.
Compared to controls, cases were more likely to have drunk from the river forcados (OR 14.2, 95% CI: 5.5–36.8) and
living in households (HH) with more than 5 persons/HH (OR 5.9, 95% CI: 1.3–27.2). Good hand hygiene was found to
be protective (OR 0.3, 95% CI: 0.1–0.7).
Conclusion: Vibrio cholerae was the cause of the outbreak in Toru - Orua. Drinking water from river forcados, living in
overcrowded HH and poor hand hygiene were significantly associated with the outbreak. We initiated hand hygiene and
water treatment to control the outbreak.

“From preparation to consumption.” food safety practices among public food handler’s in Enugu metropolis.

Chukwukasi Wilson Kassy — 2024-11-20

Background: Increased demand for publicly prepared food with numerous food handlers creates uncertainties in the quality of
safe foods and possible food contamination. This study aimed to ascertain the food safety hygiene practices, and associated
factors among public food handlers in Enugu Metropolis, Nigeria.
Methodology: This was a cross-sectional study conducted among 400 public food handlers in Enugu Metropolis, Nigeria.
Samples were selected using a multistage sampling technique. Data was collected using a pretested structured interviewer-administered questionnaire and analyzed using percentage, mean, and multiple regression. Statistical significance was set at p<
0.05.
Results: The mean age of respondents was 31.16 ± 8.242 years. About two–thirds, 66.5% of respondents were found to
have good knowledge of food hygiene safety practices. The overall food safety hygiene practice mean score was 80.10 ± 10.25
with 70.5% showing good practice. Environmental safety hygiene had good practice of 35.0% and a mean score of 24.17 ± 2.29.
The factors that statistically significantly predicted overall food safety practices, F (11, 388) = 42.957, P < 0.0001, R2 =
0.536 were educational level (β = 0.148, C.I = 0.860 – 3.082), knowledge level (β = 8.594, C.I = 5.635 – 8.979) and safety
trainings (β = 0.517, C.I = 4.102 – 5.474).
Conclusion: There were good safety hygiene practices except for the environmental safety hygiene practices component. Safety
training, knowledge level, and educational level were the predictors of good practices. Frequent training is most needed to
prevent or control food contamination and consequent food-borne diseases.

Tongue print as a valuable biometric and forensic tool: A digital photographic study.

Nupur Hingad — 2024-11-20

Background: Surface features present on the dorsal surface of the tongue along with colour and shape are unique
characteristics of every individual. Tongue print is being considered as a new biometric and forensic authentication tool. This
digital photographic study was conducted to analyze and compare morphological differences on the dorsal surface of the
tongue which can serve as a valuable tool in forensic odontology.
Methodology: The present study utilized a digital photographic method. Patients who visited the outpatient department (OPD)
of the dental institution for availing necessary dental treatment were included in the study. The final study sample comprised
316 subjects which were recruited by systematic random sampling. The shape, surface texture, colour etc. of the tongue were
recorded. Descriptive statistics and chi-square tests were used for statistical analysis. Significance was set at p≤0.05.
Results: The majority of the subjects (60.13%) had a ‘U-shaped’ tongue. ‘Tongue fissures/cracks’ and ‘Smooth Tongue’ were
the two prominent surface textures present among 59.18% and 35.13% of the study subjects respectively. The shape and
surface texture of the tongue were significantly associated with the gender of the study subjects. Non-visibility of median
septum was found more among females than males. More than two-thirds of the subjects (77.51%) belonging to the age group
of 18-30 years had pink-coloured tongues and the findings were highly significant (p=0.00).
Conclusion: In addition to rugoscopy and cheiloscopy, the study of lingual morphology may be one of the secure methods for
identification in forensic dentistry.

Prevalence and possible predictors of helicobacter pylori infection among adult patients with sickle cell disease in Ahmadu Bello university teaching hospital North-West, Nigeria

Abdulaziz Hassan — 2024-11-20

Background: Helicobacter Pylori (H. pylori) infection occurs worldwide. Patients with Sickle Cell Disease (SCD)
may present with abdominal symptoms due to different pathophysiological mechanisms. SCD patients are
predisposed to infections due to immune deficiency, abdominal symptoms like dyspepsia and recurrent abdominal
pain have been associated with H. pylori infection. This study determined H. pylori prevalence in adult SCA
patients and its relationship with socio-demographic, clinical, and laboratory parameters.
Methodology: Adult patients with SCA in Steady State were enrolled after informed consent. Sociodemographic,
clinical, and laboratory parameters were documented using a structured questionnaire. H. pylori IgG antibody was
detected using lateral flow Rapid Diagnostic Test (FaStep USA). Data were analyzed using EpiInfo 7.2.
Results: The median age of participants was 23(20, 26) years. Most of the participants (56.8%) were from lower
socioeconomic classes. Sickle cell painful vaso-occlusive crises and blood transfusion in the previous 12 months
were 2(1, 4) and 0(0, 1) respectively. Ninety (53.3%) of the participants had abdominal symptoms. Non-specific
abdominal pain was the most common. The median frequency of abdominal pains was 1(0, 2). H pylori infection
was found in 23.1%. The Odds for H. Pylori infection were high in participants with abdominal symptoms, antacid
use, and multiple abdominal symptoms {OR=1.552, 1.306, and 2.584 respectively) though not statistically
significant. At the same time, those with recurrent abdominal pain and male sex had lower Odds (OR=0.875 and
0.831respectively), though not statistically significant.
Conclusion: H. pylori infection is not uncommon among SCA patients. Physicians should be vigilant in SCD
patients with multiple abdominal symptoms by screening early and instituting management.

Extent of research involvement and influencing factors among resident doctors at a tertiary health facility in Osun State, Nigeria

Oluwaseun T. Esan — 2024-11-20

Background: This study assessed the knowledge, attitude, and extent of research involvement among
resident doctors at a tertiary health facility in Osun state, Nigeria, and identified its associated factors.
Methodology: This was a cross-sectional study of 199 resident doctors selected via a simple random
sampling technique. A structured self-administered questionnaire was used to obtain data with the outcome
variable being the resident doctors’ total score on the extent of research involvement. Data analysis was done
using the Stata 17 software.
Result: The respondents’ mean age was 34.1±4.6. Only 34(39.1%) of those receiving mentorship in
research ranked the support received as good, with the majority 177(88.9%) still desirous of a mentor in
research. About 121(60.8%) of the residents had good knowledge of basic research but only 58(29.2%) of
them had a positive attitude towards research. Only 23(11.6%) reported confidence in research and needed no guidance. Their mean perceived research ability and extent of research involvement scores were
40.3±8.9 and 4.9±2.8 respectively. Their perceived ability to conduct research (β=0.10, 95% CI: 0.07 to
0.14, P<0.000), being dental residents (β=1.23, 95% CI: 0.45 to 2.02, P=0.002), a perceived need for
assistance in research, (β=1.08, 95% CI: 0.16 to 2.01, P=0.022), and the types of research designs ever
conducted significantly influenced positively their extent of research involvement.
Conclusion: The majority of the resident doctors studied are poorly involved in research despite their
knowledge of basic research, with a gross unmet need for guidance in conducting research. Innovative
efforts are needed to link their knowledge about research to conducting one.

Prevalence of restless leg syndrome, associated variables and impact on sleep quality in a cohort of patients with neuropsychiatric disorders

Ramita Goel — 2024-11-20

Background: Restless leg syndrome is a sensorimotor, sleep-related neurological disorder that is still an
underdiagnosed condition characterized by an irresistible urge to move legs at rest, especially at night. Sleep being
a vital component of comprehensive health is affected in RLS. The study was conducted to estimate the
prevalence of restless leg syndrome (RLS) and its impact on sleep disturbance in patients presenting to the
psychiatry clinic (outpatient psychiatric department).
Methodology: The present study was a cross-sectional, observational, single-center, interview-based study,
conducted on 600 patients diagnosed with psychiatric illness. A questionnaire of the International Restless Leg
Syndrome Scale (IRLS) was applied to assess the severity of RLS and sleep disturbance was assessed using the
Pittsburgh Sleep Quality Index (PSQI) scale.
Results: It was found that among 600 psychiatric patients, the prevalence of RLS was 41.2% (247 patients). Major
depressive disorder, migraine, and anxiety disorders show a high prevalence of RLS with a prevalence of 42.9%,
19.40%, and 15%respectively whereas alcohol use disorder has a low prevalence of 2.4%. The association between
sleep and RLS was found to be statistically significant.
Conclusion: RLS is a highly prevalent disorder, and it needs to be evaluated in patients with sleep disturbance
especially those presenting with symptoms of mood, migraine, and anxiety. Individuals with RLS suffer difficulty
falling asleep and have shorter and more fragmented sleep experiences, leading to poorer overall sleep quality.

The role of CD56, HBME-1, and CK19 immunohistochemical markers in the differential diagnosing of thyroid neoplasms

Abilash Sasidharannair Chandrakumari — 2024-11-20

Background: The diagnosis of thyroid neoplasms is steadily increasing due to the widespread use of sensitive
diagnostic techniques. While histopathologic evaluation using Hematoxylin and Eosin (H&E) staining is
considered the "gold standard," it often faces challenges due to morphological overlap between benign and
malignant follicular patterned lesions. This led to diagnostic uncertainties, underscoring the need for
Immunohistochemistry (IHC) as a valuable adjunct. This study aims to evaluate the expression of IHC markers,
Hector Battifora Mesothelial Cell-1 (HBME-1), Cluster of Differentiate (CD56 also known as Neural Cell
Adhesion Molecule) and Cytokeratin-19 (CK19), in follicular patterned neoplasms of the thyroid to aid in the
diagnosis of malignant thyroid neoplasms
Methodology: The study was a descriptive analysis and it included 60 thyroidectomy specimens diagnosed as
neoplastic by histopathology were studied after satisfying the inclusion and exclusion criteria. The IHC results
were interpreted semi-quantitatively. Statistical analysis was performed using Chi-square test and Fisher’s-exact
tests. A P-value of <0.05 was considered as significant. Sensitivity and specificity for each marker and their
combination in diagnosis were calculated.
Results: Among the sixty cases, 31.67% were benign neoplasms, and 68.33% were malignant. Loss of CD56
expression was noted in 75.68% of malignant cases. The specificity of CD56, HBME-1, and CK19 in identifying
malignant neoplasms was 84.21%, 84.21%, and 89.47%, respectively. The accuracy of CD56 and CK19 in
diagnosing follicular variant papillary thyroid carcinoma (FVPTC) from follicular adenoma (FA) was 79.31% and
93.10%, respectively. The specificity of CK19 in distinguishing FVPTC from FA was 89.47%. The specificity of
CD56, CK19, and HBME-1 in diagnosing follicular thyroid carcinoma (FTC) from FA was 84.21%, 85%, and
84.21%, respectively.
Conclusions: Our study highlights the diagnostic utility of CD56, CK19, and HBME-1 in thyroid neoplasms
incorporating these markers into routine diagnostic panels can significantly enhance the accuracy and reliability of
thyroid malignancy assessments.

Patient satisfaction with quality of care in NHIS clinic in a federal tertiary hospital in southwest Nigeria

Demilade Olusola Ibirongbe — 2024-11-20

Background: The National Health Insurance Scheme (NHIS) now named the National Health Insurance Authority
(NHIA) was launched to achieve easy access to affordable quality healthcare for all Nigerians. This study aimed at
evaluating patients' satisfaction with the services accessed at the NHIS clinic in a tertiary teaching hospital in
Southwest, Nigeria.
Methodology: This cross-sectional study carried out at the Federal Teaching Hospital, Ido-Ekiti, Nigeria included
all adult patients (> 18 years) who have been enrolled in the scheme for at least one year and have accessed
healthcare at the clinic within three months preceding the study. Data was collected from 391 patients using a
semi-structured interviewer-administered questionnaire in an exit interview. Data on patients’ satisfaction with the
quality of care was adapted from the Patient Satisfaction Questionnaire (PSQ 18). Data entry and analyses were
done with the SPSS version 26.0.
Results: The mean age (±SD) of the respondents was 43.5±14.5 years. More than half 204 (52.2%) of the patients
were male, 291 (74.4%) were married, and 319 (81.6%) had attained tertiary level education. The overall
satisfaction score was 75.02 ± 6.37, with communication (78.5 ± 11.6) and interpersonal manner (79.6 ± 10.0)
having the highest scores. Predictors of overall satisfaction were longer travel time (p < 0.001) and readiness to
return to the clinic for treatment (p = 0.001).
Conclusion: There was a high level of patient’s satisfaction with the quality of healthcare services rendered at the
NHIS clinic, with domains related to interpersonal and communication, ranked highest. Travel time and willingness
to return were factors significantly associated with patients’ satisfaction. There is a need for the management of
NHIS clinics to continuously improve the quality of healthcare services provided.

An evaluation of haemodynamic responses to tracheal intubation following intravenous dexmedetomidine and fentanyl in patients undergoing laparoscopic cholecystectomy

Monica Pandey — 2024-11-20

Background: Laryngoscopy and tracheal intubation are related to sympathetic stimulation and lead to
hypertension and tachycardia. These changes in hemodynamics may increase the risk of myocardial ischemia. As a
result, effective blunting of these unpleasant responses is required. This study aimed to compare the effects of
dexmedetomidine and fentanyl bolus administration on the attenuation of hemodynamic response to tracheal intubation
in patients undergoing laparoscopic cholecystectomy surgeries.
Methodology: A total of 136 patients of both genders undergoing elective laparoscopic cholecystectomy surgeries
satisfying inclusion criteria were randomly allocated into 2 groups (group D and group F). Group D received
1mcg/Kg of dexmedetomidine (Dexa) intravenous (IV) in 100ml of normal saline over 10 minutes and 5ml of
normal saline over 3 minutes before induction. Group F received Inj. Fentanyl 2mcg/Kg diluted in 100 ml of
normal saline over 10 minutes and 5ml of normal saline 3 minutes before induction. The patients were ventilated
for 3 minutes by bag and mask. After 3 minutes of ventilation, endotracheal intubation was done. Vitals (systolic
blood pressure, diastolic blood pressure, mean arterial blood pressure, heart rate) were recorded from the time of
intubation to 10 minutes after that at 1-minute intervals.
Results: In both groups, heart rate increased significantly immediately following intubation (p = 0.002). In
dexmedetomidine group heart rate, mean arterial pressure, systolic and diastolic blood pressures were significantly
controlled at various time points in comparison to the fentanyl group after laryngoscopy and intubation.
Conclusions: Dexmedetomidine in a dose of 1mcg/kg causes greater and sustained attenuation of haemodynamic
response to endotracheal intubation among the patients of cholelithiasis undergoing laparoscopic cholecystectomy
surgeries as compared to fentanyl. Therefore, it can be used as an effective alternative to opioids for the induction of
general anaesthesia in patients undergoing laparoscopic cholecystectomy surgery.

Serum prolactin levels and clinical features of hyperprolactinaemia in obese and non- obese infertile women in Kano, Northwest Nigeria: A comparative study

Ifesinachi Joy Omeje — 2024-11-20

Background: Hyperprolactinaemia can cause infertility. Serum prolactin and clinical features of hyperprolactinaemia
may vary between obese and non-obese infertile women. Identifying the differences may inform changes in the
management of obese women with hyperprolactinaemia. This study aimed to compare the serum prolactin levels and the
clinical features of hyperprolactinaemia in obese and non-obese infertile women in Kano.
Methodology: This was a comparative cross-sectional study comprising 160 obese infertile women (study group) and
another 160 non-obese infertile women (control group). Participants were recruited in the gynaecology clinics of Aminu
Kano Teaching Hospital (AKTH) and Murtala Muhammed Specialist Hospital (MMSH). Serum prolactin and clinical
features of those with hyperprolactinaemia were analysed using SPSS 23. P-values ≤ 0.05 were considered significant.
Odd ratios at 95% confidence were calculated.
Results: The mean serum prolactin levels were 28.18 ± 10.53ng/ml and 17.50 ±8.00 ng/ml in the obese and non-obese
women respectively (P=0.0001). All categories of hyperprolactinaemia were more common (P=0.001) amongst the
obese infertile women. The prevalence of hyperprolactinaemia was 37.5% and 18.1% in the obese and non-obese arms
respectively (P=0.0001). However, 23.1% of obese hyperprolactinaemic infertile women presented with galactorrhoea
compared to 64.0% of their non-obese counterparts (P= 0.0001). Abnormal menstrual flow and galactorrhoea were
observed more in moderate-markedly elevated serum prolactin levels as seen in 65.2% and 69.6% respectively compared
to those with mildly elevated serum prolactin levels.
Conclusion: Obese infertile women have a higher baseline and prevalence of hyperprolactinaemia than their non-obese
counterparts. However, non-obese hyperprolactinaemic infertile women presented more with galactorrhoea.

Stress attenuation effect of combined approach of yoga and diet intervention among metabolic syndrome patients.

Jitender Sorout — 2024-11-20

Background: Persistent exposure to psychosocial stress is linked to an increased risk of metabolic disease, including
obesity, cardiovascular disease (CVD), and Type-2 diabetes mellitus (T2DM). Metabolic syndrome is driven by an
unhealthy lifestyle encompassing a sedentary lifestyle and unhealthy diet as well as psychological distress, which
potentially triggers these metabolic derailments. Various mind-body practices, such as postures, breathing, meditation,
and relaxation, are included in yoga. Studies suggest that even one yoga session can improve cognitive function, oxygen
saturation, baroreflex sensitivity, sympathovagal balance, and the body's ability to recover from stressful stimuli.
Therefore, this study aimed to explore the stress attenuation effect of a combined approach of yoga and diet intervention
among metabolic syndrome patients.
Methodology: In this study, we randomized 200 subjects diagnosed with metabolic syndrome as per the Joint interim
statement 2009 into control and combined (yoga+diet) groups according to their intervention which was given for 6
months. Anthropometric, physiological, perceived stress score, and biochemical parameters were collected at baseline, 3
months and 6 months.
Results: The study's findings show that, at three and six months from baseline, the combined yoga with diet approach
significantly reduced metabolic risk factors (waist circumference, SBP, DBP, fasting blood glucose, and triglycerides)
and improved HDL. At three and six months following the combined (yoga+diet) intervention, the perceived stress score
also showed a substantial reduction.
Conclusions: Combined (yoga+diet) interventions are effective in lowering the risk of metabolic syndrome and
perceived stress.

Prevalence and factors associated with zero-dose children amongst nomadic and non-nomadic fulani in Yobe State, NorthEast Nigeria

Usman Muhammad Ibrahim — 2024-11-20

Background: Immunization is a very cost-effective and readily available intervention capable of preventing Vaccines
Preventable Diseases (VPDs). This study aimed to identify and compare the prevalence and factors associated with zero-dose
immunization status among children of nomadic and non-nomadic Fulani in Yobe State, North-East Nigeria.
Methodology: A comparative cross-sectional design was used to study 348 nomadic, and 345 non-nomadic under-five children,
selected using a multi-staged sampling technique. Data were collected using interviewer-administered questionnaires, observation
of child immunization card, and recall by the caregivers, and were analysed using IBM SPSS version 22.0 with a statistical
significance set at P ≤5%.
Results: The maximum age of the nomadic caregivers was 60 and the minimum was 17 years with a mean ±SD of 28.2±7.7
years. The maximum age of the non-nomadic caregivers was 78 and the minimum was 17 years with a mean ±SD of 33.0±10.0
years. The prevalence of zero-dose children among nomadic and non-nomadic Fulani were (70.1%, 242), (61.8%, 63)
respectively. The zero-dose children were significantly higher among nomads (87.2%, p<0.001) and non-nomad (54.4%,
p<0.001) with no available child immunization card. The children of vaccines hesitant caregivers of nomads and non-nomads
were 10 or more times more likely to be zero doses than non-hesitant caregivers (adjusted odds ratio [aOR] =477, 95% CI =
[177–13031]), and (Adjusted odds ratio [aOR] =9.7, 95% CI = [2.1–44.3]) respectively.
Conclusions: The burden of zero-dose was alarmingly high among nomads compared to non-nomad Fulani despite widespread
immunization outreach services in the study area. The government and relevant stakeholders should intensify Context-specific
health promotion activities and outreach services targeting these underserved populations.