Tropical Journal of Health Sciences

Editorial

A.B. Okesina — 2024-09-09

No abstract.

Serum Anti-mullerian Hormone, Follicle Stimulating Hormone, Luteinizing Hormone, LH/FSH ratio, Estradiol and their correlations with age in Infertile Women in Nigeria

O.F. Adewolu — 2024-09-09

Infertility is a cause of concern because of its psychosocial effect. Globally, infertility is said to affect 8%-10% of couples. This study aimed at evaluating serum levels of Anti- mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), Luteinizing Hormone ( L H ) , E stradiol , Luteinizing Hormone/Follicle Stimulating Hormone (LH/FSH) ratio and their correlation with age in women with infertility. Treated in the University of Benin Teaching Hospital, Benin City, Nigeria.This was a retrospective study. Data of 458 women seen in the ARRT Clinic of the Obstetrics and Gynaecology Department between May 2021 and June 2023 were analyzed. Subjects were stratified into four age groups. Serum levels of AMH, FSH, LH, Oestradiol and LH/FSH ratio were statistically analyzed and their correlation with age determined. Biochemical assays were done using the ELISA method. Statistical analysis was done using SPSS version 21. Students' t-test and Pearson's correlation determined. Statistical significance was established at p≤0.05.Mean Serum AMH, FSH, LH, Oestradiol, LH/FSH ratio was 1.1±1.4ng/ml, 7.7±6.3mIU/ml, 4.4±3.9mIU/ml, 50.9±37.4pg/ml, 0.62±0.35 respectively. Serum AMH decreased significantly with age (from 3.09±2.4 to 0.63±0.86,p=0.003). Serum FSH and LH increased significantly with age (from 5.63±2.7 to 11.94±11.0 (p=0.001) (3.56±2.0 to 5.88±5.59 (p=0.001) respectively. Mean LH/FSH Ratio values decreased from 0.64 ± 0.36 to 0.55 ± 0.37 (p=0.201). Serum AMH showed a statistically significant negative correlation with age (r=-0.422, p=0.001). Serum FSH and LH showed a statistically positive correlation with age (r=0.268, P=0.001), (r=0.156, P=0.001) respectively. Oestradiol showed a weak negative correlation and LH/FSH ratio show weak positive correlation with age. Serum AMH showed a stronger level of negative correlation with age compared with the other hormones evaluated, therefore it may be a more reliable marker of ovarian reserve, hence, useful in the assessment of response to treatment protocols in Assisted Reproduction.

Alcohol use among elderly primary care attendees in North Central Nigeria

O.I.N. Buhari — 2024-09-09

Given the growing global population of elderly individuals and the potential increase in alcohol-related issues among this group, it is essential to explore the factors that influence alcohol consumption in older adults. A descriptive cross sectional study was carried out in 3 primary health care centres in Ilorin, Northcentral Nigeria, involving consenting patients aged 60 years and above. Each participant completed a proforma designed by the researchers which had sections on socio-demographic variables and alcohol use. The Geriatric Depression Scale (short form) was used thereafter with a cut-off score of ≥ 6 to screen for a presence of depression. A total of 463 elderly patients participated in the study. Alcohol use was statistically significantly higher among males (x = 44.483, p<0.001), those who are married (x = 7.300, p <0.007) and elderly Christians (x = 7.121, p<0.008). The trend though not statistically significant was that those who lived alone, and those who felt lonely were more likely to use alcohol (x = 1.579, p< 0.209 and x = 0.094, p < 0.759 respectively). Probable depression was however not found to be statistically associated with alcohol use (x = 0.025, P < 0.874). There should be an increased index of suspicion by the primary care physicians to identify elderly patients who are at risk of engaging in alcohol use. This will assist in instituting early intervention programmes aimed at preventing alcohol related problems.

Knowledge and practice of HIV post exposure prophylaxis among health care workers in a tertiary hospital, North-West, Nigeria

M.A. Ogunsina — 2024-09-09

Health care workers (HCW) might be exposed to different infectious agents like the human immunodeficiency virus while performing their duties otherwise called occupational exposure. The knowledge and practice of these workers about postexposure prophylaxis (PEP) can effectively prevent HIV infection in such individuals. World Health Organization (WHO) recommends that every individual exposed should be treated within 72 hours. We aimed to assess the knowledge and practice of HIV PEP among the healthcare workers in a tertiary facility in Northwest, Nigeria. A cross-sectional study was conducted from April to June 2021 among healthcare workers at Barau Dikko Teaching Hospital (BDTH). A semi structured pre-tested self-administered questionnaire was used for the collection of data. This was however divided into sections including socio-demographic status of the respondents, knowledge and practice related to PEP of HIV. Analysis of data was done using IBM SPSS version 23 Software. Out of 236 questionnaires administered, 225 were adequately completed and returned, with a response rate of 95.3% of which majority of the respondents were females (67.1%) and majority were (63.6%) 40 years and below. More than half of the respondents 133 (59.1%) had poor knowledge of PEP, knowledge of PEP was found to be statistically associated with occupation P<0.000, gender p=0.042 and formal training on PEP. On the other hand, variables, like age, marital status and years of service did not show any significant association with knowledge of PEP. Among the HCW, 71 (31.6%) had been exposed to sources of HIV at the workplace via splash of blood, needle pricks and so on, 29 (40.8%) started PEP and up to 18 (62.1%) of them completed the required treatment.A significant number of the HCW had poor knowledge of PEP, suboptimal use of the treatment when exposed but fairly good completion rate for those that commenced treatment.

Depression and anxiety disorders among Deaf young people

P. C. Onuegbu — 2024-09-09

Mental health of Deaf young people has received negligible attention. This study determined the prevalence of depression and anxiety disorders among Deaf young people. Seventy-five Deaf young people participated in this mixed method descriptive cross-sectional study, participants were drawn from special education centers and mainstream schools. A structured, interviewerassisted questionnaire consisting of Beck Depression Inventory and Beck Anxiety Inventory was used for quantitative data collection, and semi-structured interview questions used for qualitative data collection. The data was analyzed using descriptive and inferential statistics, and narrative content analysis of the qualitative data. The mean age of respondents was 15.7 4.05 years. The prevalence of depression and anxiety disorder among respondents was 8% and 33% respectively, with a strong positive correlation between anxiety and depression. Only 10.7% of respondents had family members who could communicate using sign language. Educational level was the sole predictive factor of increased prevalence of depression and anxiety disorders, the higher the educational level, the higher the anxiety and depression score among the respondents. The attention and care received in special schools, at home with parents and other social support groups helped Deaf young people to cope with pressure and anxiety. Depression and anxiety disorder amongst Deaf young people is high, yet only a few have families that are attentive/responsive to their needs. There is need for greater access to services that would improve the mental health and promote social inclusion of Deaf young people.

Orbital mucormycosis in Africa: A review of epidemiology, clinical presentation, diagnosis, and management

D.A. Oronsaye — 2024-09-09

Orbital mucormycosis refers to group of rare, diverse and life-threatening (frequently fatal) fungal orbital infection. The cases are linked to diabetes, malnutrition, and limited healthcare access in Africa. The symptoms include periorbital oedema, proptosis, pain, and ophthalmoplegia. Atypical presentations are observed, necessitating early diagnosis vigilance. Limited access to diagnostics and antifungal medications pose hurdles to timely intervention. A multidisciplinary approach involving surgery and antifungal therapy is essential, yet resource constraints can hinder treatment. Diabetes control and healthcare infrastructure improvement are vital prevention strategies. This article aims to highlight key aspects of orbital mucormycosis in Africa. We conducted a literature search using Google Scholar, Pubmed and African Journal Online to identify published papers on orbital mucormycosis from Africa. The following search terms were used: 'mucormycosis and Africa','invasive rhinoorbital mucormycosis'. We included retrospective studies,
prospective studies, and case series predominantly. Twenty-one articles were reviewed and subdivided into epidemiology, clinical presentation, diagnosis, risk factors and treatment. Orbital mucormycosis is emerging in Africa, requiring improved diagnosis, treatment access, and preventive measures. Collaboration among healthcare professionals and policymakers is crucial to address this evolving public health issue.

Ulnar hemimelia with humero-radial synostosis and oligodactyly: A rare congenital skeletal malformation

S.E. Obirija — 2024-09-09

Ulnar hemimelia is a rare congenital anomaly of the upper extremity which denotes the partial or complete absence of the distal half of a limb. This clinical condition has been classified into 4 types, with the rare Type 4 variant involving humeroradial synostosis. Notably, it is also strongly linked with extension or acute flexion of the elbow joint, variable length, and contour of the remnant of the ulnar in cases of incomplete hemimelia, oligodactly, and atrophy of the shoulder muscle. It may present clinically as functional deformity or cosmetic deformity. Thus, present a unique case of complete ulna hemimelia, humeroradial synostosis, and oligodactyly, in a 2-month-old male with upper limb shortening and restricted elbow movement since birth. He presented to the children's outpatient department of the hospital with a complaint of a small right upper limb, reduced muscle bulk, and limb activities of the same limb. The right upper limb was noted at birth to be shorter and less active than the left. Upon further evaluation, plain radiographs of the limbs revealed the right upper limb micromelia, with a single forearm bone. The right forearm bone has an expanded distal end (consistent with radial end), bowed with radial convexity, with the proximal end fused to the metaphysis of the adjoining right humerus. A diagnosis of right ulnar hemimelia with humero-radial synostosis, and oligodactly was made based on these findings. The patient has been on six monthly follow-ups for 2 years and no new complaints or complications have been recorded. The rarity of this clinical condition in our prevailing environment warranted this case report.

Acceptance of emergency contraception use among university students in Ogbomoso

O.O. Aworinde — 2024-09-09

Emergency contraception (EC) are methods of contraception used to prevent unintended pregnancy after sexual intercourse or contraceptive failure. The available methods include oral pills and intrauterine contraceptive device. This study aimed to assess the level of knowledge, attitude and practice of university students in Ogbomoso concerning emergency contraception. descriptive cross-sectional study was carried out among students of Ladoke Akintola University of Technology (LAUTECH) and Bowen University, Ogbomoso. The minimum sample size of four hundred and forty-eight was calculated using Kish Leslie formula. Multistage sampling was used to select the participants. Data was collected using a self administered questionnaire. Seven hundred and seventy two questionnaires were completed and analysed. Majority of the respondents were aged 20-29 (71.9%); females (59.2%); Yoruba (85.5%) and single (97.2%). 375 (48.6%) were aware of EC. Unprotected sexual intercourse was the commonest indication with 313 (83.5%) being aware of it as an indication. 158 (42.2%) got their information from friends. 181 (64.9%) knew the correct dose of COCP to use as EC. 237 (63.2%) of total respondents had a positive attitude towards EC and were willing to use it and recommend to friends. 122 (32.5%) of those aware of EC were sexually active. 37 (30.3%) of the sexually active female respondents had used EC. This puts EC uptake among the female respondents at 8.1%. This study shows that there is a need to improve on the knowledge of the respondents about emergency contraception. This may increase the uptake of emergency contraception when indicated.

Hypocalcemia after commencing cetuximab in a patient with oesophageal cancer at Baze University Hospital, Abuja.

Z.A. Mustapha — 2024-09-09

Currently, there is increasing use of epidermal growth factor receptor (EGFR) monoclonal antibodies in the management of cases with advanced cancers. These medications are found to be associated with complications, including dyselectrolytaemia. Cetuximab, an EGFR monoclonal antibody is known to cause electrolyte abnormalities, including hypomagnesemia, hypokalemia, and hypocalcemia. We report a female patient admitted to our Hospital with advanced oesophageal cancer who developed symptomatic hypocalcemia after commencing cetuximab. Hypocalcaemia was confirmed by measurement of serum total calcium level. Monitoring of electrolyte levels before and after commencement of cetuximab is therefore recommended for early identification of any derangement.