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Relationship of maximum follicular size, age of woman, and reproductive implications in women attending fertility clinic in St. Margaret's Hospital, Lokoja, using Creighton Model FertilityCare™ System and NaProTECHNOLOGY
Francis Udoka Achebe
July-December 2019, 17(2):51-63
Background: Some authorities have found that, when the mean follicular diameter is >25 mm, the follicle is considered large, and these authorities are convinced that large follicles are biomarkers to ovarian pathology. Several studies have been carried out to determine the optimal maximum follicular size (MFS) that will be adequate before the use of human chorionic gonadotropin trigger to induce ovulation. None of these studies have considered the woman's age as a factor. An in vitro fertilization-based study has also shown that large leading follicles did not result in higher percentage of matured oocytes, and they even result in a lower live birth rate; however, we note that the ages of the women were not specifically mentioned in connection with the problems of large follicle. Subjects and Methods: We set out in this study to evaluate the relationship between the MFS and the woman's age both in our control group (fertile women) Group (A) and in the women attending fertility clinic Group (B). Using the Creighton Model Fertility Care System and NaProTECHNOLOGY, it was possible to determine when to start follicular tracking and also determine ultrasound diagnosis of ovulation by recording the MFS and the reduced size. Results: In both Group A and Group B, we discovered that the MFS reduces as woman's age increases. We also discovered that the average MFS in the Group B was higher for age compared with the Group A (P = 0.0043). There was also an association between these bigger follicles for age and low mid-luteal progesterone. This is probably the first study that describes the association of follicular size and woman's age and its possible link with ovulation defects. Recommendation: We have proposed that this phenomenon of large matured maximum follicle for age could be a contributory factor to infertility and miscarriages. We propose further studies to verify this hypothesis. Conclusion: Despite the high percentage of complete rupturing of follicles in the AB cycles in the Group (B) there are very high proportion having low mid luteal (P+7) Progesterone. This may be due to pathologies associated with big follicles for woman's age. The E2/Pg ratio study in luteal phase strongly suggested that the women in Group (B) that may have fertility challenge are those in subgroup of AB in Group (B). Therefore matured follicular size should be considered with the woman's age. If the follicles grows bigger away from the range for a woman's age it may be the marker for infertility or reproductive health challenges.
  31,482 292 -
Pattern and factors associated with hemoglobin genotype testing among children attending a University Teaching Hospital in Lagos, Nigeria
Samuel Olufemi Akodu, Elizabeth Aruma Disu, Olisamedua Fidelis Njokanma
January-June 2015, 13(1):16-20
Background: Sickle cell disorders are chronic debilitating genetic disorders affecting the red cells. Sickle cell disorders were originally found in the tropics and subtropics but are now common worldwide due to migration of people from tropical to temperate zones. Objective: The objective was to describe pattern and factors associated with hemoglobin (Hb) genotype testing among children attending a University Teaching Hospital in Lagos, Nigeria. Methodology: The study was conducted at the General Children Outpatient Clinics of Lagos State University Teaching Hospital, Ikeja, Lagos in South west Nigeria. It is a cross-sectional study using research administered questionnaire to obtain information from caregivers. Results: A total of 202 subjects aged 6 months to 15 years were conveniently recruited. Overall, the Hb genotype uptake rate was 17.8%. The overall prevalence of Hb disorders was 25.8%. One-ninth of the subjects with known Hb genotype status at commencement of the study had their Hb genotype status confirmed before the age of 1 year. First birth order and upper social stratum were significantly associated with younger age at Hb genotype uptake. Conclusion: Fewer children had Hb genotype uptake during infancy and this underscores the need for early Hb genotype testing of infants. This screening can be during the prenatal, neonatal or at most in infancy during immunization, and infant welfare clinics visit.
  13,644 573 -
Factors associated with the use of traditional birth attendants in Nigeria: A secondary analysis of 2013 Nigeria national demography and health survey
Joseph Odirichukwu Ugboaja, Charlotte Blanche Oguejiofor, Emmanuel Okwudili Oranu, Anthony Osita Igwegbe
July-December 2018, 16(2):45-52
Background: A large number of women in Africa deliver without skilled birth attendants with profound consequences for maternal and perinatal outcomes. This study evaluated the factors associated with traditional birth attendants in Nigeria. Methodology: We conducted a weighted analysis of data from the 2013 Nigeria Demographic and Health Survey that included women aged 15–49 years using STATA software, version 12.0 SE (Stata Corporation, TX, USA) to investigate the factors associated with the utilization of traditional birth attendants in Nigeria using logistic regression models. The result was presented in odds ratio and 95% confidence interval (CI). Results: The rate of delivery with Ttaditional birth attendants among the respondents was 23.4% (n = 7,267), and this was significantly associated with low maternal education (adjusted odds ratio [aOR]: 1.75;95% CI: 1.49–2.06), rural residence (aOR: 1.3 95% CI: 1.12–1.51), poor family wealth index (aOR: 1.29; 95% CI: 1.09–1.54), unemployed status (aOR: 3.01; 95% CI: 1.50–6.03), and having >5 living children (aOR: 1.23; 95% CI: 1.06–1.44). Factors that significantly reduced the rate include age category 35–44 years (aOR: 0.82; 95% CI: 0.69–0.98), having visited a health facility in the past 12 months (aOR: 0.86; 95% CI: 0.76–0.98), and watching television at once a week (aOR: 0.75; 95% CI: 0.64–0.88). Conclusion: The risk factors for delivery with traditional birth attendants in Nigeria include low maternal education, large family size, rural residence, and noninvolvement of women in decision about their health care while exposure to media and contact with a health facility reduced the risk. Women empowerment through education and employment may reduce the rate of use of traditional birth attendants at delivery.
  12,193 819 3
Evaluation of effects of artemether + lumefantrine (artemisinin-based combination therapy) on women's reproductive cycle using Creighton Model Fertilitycare System and NaProTECHNOLOGY
Francis Achebe
July-December 2017, 15(2):31-41
Background: Malaria is prevalent in Nigeria, and artemether + lumefantrine (artemisinin-based combination therapy [ACT]) is drug of choice in treatment of uncomplicated cases. ACT is contraindicated in early pregnancy. They release-free radicals that can compromise female fertility. Infertility and its associated complications such as miscarriages, abnormal gestation, and unstable marriages seem to be on the increase. This study aims at evaluating the effect of ACT on female fertility. The significance of this research is to draw the attention of fertility care givers to this possible cause of infertility and fertility challenges. Subjects and Methods: Creighton Model FertilityCare System and NaProTECHNOLOGY are simply technologies that can be used to assess female fertility. They are used in this study to assess the effect of ACT administered at different stages of menstrual cycles of three selected fertile adult females. The results are interpreted on the background of standard Creighton model chart. Results: This study has shown that ACT has a significant fertility deteriorating effect on the women. It caused ovulation defect and diagnosed as partial rupture syndrome in the very cycle of use and in the first cycle after use. It also significantly reduced cervical mucus production and significantly reduced luteal phase progesterone production with an associated significant increase of luteal phase estrogen production. Conclusion: ACT use as antimalarial may be a possible cause of infertility and fertility challenges in women.
  12,457 475 -
The danger of failure to recognize injury in cervical spine X-ray for trauma
Biodun Ogungbo, Olatunde Olawoye, Mary Idowu, Caleb Sabo Bishop
July-December 2016, 14(2):38-41
We present a female with an acute traumatic fracture dislocation of the cervical spine. She sustained bilateral facetal dislocation at the C7/T1 junction without neurological deficit. This was not diagnosed on initial X-rays of the cervical spine. We highlight the danger of this failure and conducting dynamic X-rays in such a situation. The patient presented after 4 months and was operated upon safely with anterior/posterior fixation across the fracture site. She remains neurologically intact.
  10,569 308 -
Misuse of mobile phone conversation while driving: Driver distraction a major public health problem
Abdulbari Bener, Funda Çatan, Erkut Bolat, Erol Yildirim, David Crundall
July-December 2016, 14(2):17-22
Aim: The aim of the present study is to determine the frequency of mobile phone use while driving and associated factors in a sample of road traffic among Turkish drivers in Istanbul. Design: This is a cross-sectional study design. Subjects and Methods: The study included a representative sample of 1200 drivers. However, 891 drivers agreed to participate and completed the driver behavior questionnaire (DBQ). Methods: The Manchester DBQ was used to measure the aggressive and aberrant driving behaviors causing accidents in terms of sociodemographics, driving attitudes, and behaviors, adherence to traffic laws, and mobile phone use. Results: The present study expressed that the frequency of mobile phone use while driving was very high among Turkish drivers who were involved with traffic crashes. There was a significant difference found between mobile phone users and nonusers while driving in age group (P < 0.01), education (P < 0.001), occupation (P < 0.001), seat belt use (P < 0.001), vehicle type (P < 0.001), and excessive speed (P < 0.001). Furthermore, attempting to overtake, missing give way signal, and turning right/left nearly hitting other car were reported as errors. For lapses, there was no significant association found between correct and incorrect parking for drivers in all of the DBQ items. The data showed that the drivers reported higher mean scores of violations such as driving close to the car to go faster, running a red light, disregarding speed limit at night or early in the morning. Conclusion: Together, the results provide important insights into mobile phone use and its related factors among Turkish drivers. The type of vehicle, excessive speeding, occupational status, educational level, age group, seat belt use, and crossing a red light were statistically significant associated with mobile phone use among drivers who were involved in the road crashes. When drivers use a mobile phone, there is an increased likelihood of the road accidents that result in injury. There is no doubt that hands-free phone use while driving may not minimize the risk totally. In fact, advancing technology will increase mobile phone use in motor vehicles so it may cause more crashes and fatalities.
  4,496 3,746 2
A five year review of ovarian cancer at a tertiary institution in Lagos, South-West, Nigeria
Kehinde Sharafadeen Okunade, Halima Okunola, Adeyemi A Okunowo, Rose Ihuoma Anorlu
July-December 2016, 14(2):23-27
Background: Ovarian cancer constituted 7% of gynecological malignancies seen in Lagos, Nigeria and was the second most common cause of death among women in Lagos, Nigeria. Objectives: The aim is to determine the prevalence of ovarian cancer and characteristics of patients with ovarian cancer at a Tertiary Institution in Lagos. Patients and Methods: This was a retrospective review of all the patients with histologically confirmed ovarian cancer admitted to the gynecological ward of the hospital over a period of 5 years. Relevant information was extracted from the ward register and patients medical case records. Data were analyzed using Epi-info statistical software package and results were then presented in tables and chart. Results: Fifty cases of ovarian cancer were admitted during the period under review. This constituted 1.7% of the gynecological admission cases and 8.2% of the gynecological malignancies managed in the hospital during the study. It was the second most common gynecological malignancy. The mean age of the ovarian cancer patients was 45.7 ± 4.3 years with the majority of the patients (58%) being premenopausal, 34% being nulliparous and only 16% having one or more risk factors. The abdominal swelling was the most common presenting symptom with 80% of the patients presenting with advanced disease. Epithelial ovarian cancer was the most common histological variant. The most common treatment modality was surgery and chemotherapy. The patient default rate was 64%. Conclusion: Ovarian cancer cases are on the increase. Failure of optimal management is worsened by the delay in presentation and poor compliance to treatment with high patients' default rate.
  5,395 1,881 3
Prevalence and risk factors of bacterial vaginosis in a cohort of women seeking child spacing services in nigeria
Nyengidiki Kennedy Tamunomie, Goddy Bassey
July-December 2015, 13(2):35-39
Background: The sustenance of reproductive potential of patients seeking contraceptive options is essential. The risk of bacterial vaginosis is increased by the choice of contraceptive options, which may affect postcontraception fertility. Objective: To determine the prevalence and risk factors of bacterial vaginosis in a cohort of women seeking child spacing services. Materials and Methods: A cross-sectional prospective study of women seeking fertility regulation services was conducted in a tertiary health facility in Nigeria between March and September 2014. Interviews were conducted to collect data on sociodemographic characteristics, characteristics of vaginal discharge, and sexual practices engaged by these women. Bacterial vaginosis was diagnosed using the Amsel criteria. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to assess the predisposing factors. Results: One-hundred seventy-eight clients were recruited. Bacterial vaginosis was noted in 7.87% of these women. Patients had increased risk of bacterial vaginosis when they were of low socioeconomic class (OR 8.17; 95% CI 2.30–29.81), used vaginal drying agents (OR 9.70; 95% CI 2.35–46.15), had an early sexual debut (OR 9.56; 95% CI 2 54–38.92), a history of previous sexually transmitted infections (OR 21.39; 95% CI 4.99–105.30), and practiced vaginal douching (OR 19.23; 95% CI 3.82–130.43). Conclusion: The prevalence of bacterial vaginosis in this cohort raises the need for a high index of clinical suspicion in patients seeking fertility regulation services in the presence of notable risk factors. Avoidance of contraceptive methods that may increase the risk of bacterial vaginosis and the need for treatment to maintain reproductive potentials is advised.
  3,178 3,993 -
Polycystic ovarian syndrome: Analysis of management outcomes among infertile women at a public health institution in nigeria
LO Omokanye, OA Ibiwoye-Jaiyeola, A. W. O. Olatinwo, IF Abdul, KA Durowade, SA Biliaminu
July-December 2015, 13(2):44-48
Background: Infertility remains an issue of concern especially to the female partner who bears the brunt of the stigma attributed to the disease in this environment. Among the identified etiological factors for infertility, polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age that impact on ovulation and conception. Aims and Objectives: The objective of this study was to determine pregnancy outcome following the various modalities of management of PCOS at the University of Ilorin Teaching Hospital (UITH). Materials and Methods: This is a nonrandomized (nonblinded) clinical trial of five therapeutic options for infertile women with PCOS from the Assisted Reproductive Technology (ART) Clinic and Gynaecology Clinic of UITH between January 1, 2011 and December 31, 2013. Results: Of 624 infertile women who presented at ART and general gynecology clinic of UITH, 76 met the Rotterdam criteria for PCOS, giving a prevalence rate of 12.2%. The patients aged 20–44 years with a mean age of 31.5 years. Most 49 (64.5%) of the patients were nulliparous, and more than half (56.6%) belong to the middle social class. Thirty-four (44.8%) were obese while 22 (28.9%) were overweight. Of the various management options, 48.7% had laparoscopic ovarian drilling; other treatment options offered were the use of clomiphene citrate (CC) alone, CC with metformin, weight reduction, and gonadotropin. Patients were followed-up within 6–12 months (mean 5.5 ± 1.2 months) following the initial treatment for evidence of laboratory/clinical pregnancy. An overall pregnancy rate of 46.0% was recorded. However, a total of 13 (17.1%) were lost to follow-up. The highest pregnancy rate (75%) was reported in women managed with CC alone (P = 0.229). Conclusion: PCOS occurs commonly in reproductive age and management outcomes are promising in Nigeria. CC, metformin, and laparoscopic ovarian drilling are of great benefit. Further studies on PCOS in low resource countries are needed.
  5,584 798 -
Reduced sexual activity in pregnancy among Nigerian women: Assessing the associated factors
Joseph Odirichukwu Ugboaja, Chika Florence Ubajaka, Emmanuel Okwudili Oranu, Charlotte Blanche Oguejiofor, Chinekwu Sochukwu Anyaoku, Chukwunonso Isaiah Enenchukwu, Anthony Osita Igwegbe
July-December 2019, 17(2):37-42
Background: Studies show reduced sexual activity during pregnancy. This study aims to evaluate the associated factors with a view to guiding current efforts at improving sexual activity during pregnancy. Methods: This is a cross-sectional study of 430 pregnant mothers attending Antenatal Care clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, using questionnaires. Data were analyzed with STATA software, version 12.0 SE (Stata Corporation, TX, USA) utilizing multiple logistic regression model to evaluate the predictors of reduced sexual activity. Results: Reduced frequency of sex was reported by 331 (77.2%) of the women. Women, who belonged to the Anglican denomination (adjusted odds ratio [aOR] = 3.84; 95% confidence interval [CI]: 1.53–9.59) and those in whom the husbands were worried about the safety of sex in pregnancy (aOR = 2.24; 95% CI: 1.11–4.50), were more likely to report reduced sexual activity in pregnancy. Women, who had information about sex in pregnancy (aOR = 0.40; 95% CI: 0.24–0.60) and who were aged 30 years and above (aOR = 0.47; 95% CI: 0.25–0.89), were less likely to report reduced sexual activity in pregnancy. There was no influence by education, occupation, and social class or having had a discussion on sex in pregnancy with a physician. Conclusion: The Anglican Christian denomination and partner's worry about the safety of sex in pregnancy are the key drivers of reduced sexual activity in pregnancy. We recommend that reproductive health managers take cognizance of this finding in designing strategies to improve sexual activity in pregnancy.
  5,602 268 -
Profile and outcome of primary health workers' referrals in a cosmopolitan state in Nigeria
Elizabeth A Disu, Samuel O Akodu, Olisamedua F Nkokanma
July-December 2017, 15(2):26-30
Background: Referral system is any process in which healthcare providers at lower levels of the health system seek the assistance of providers who are better equipped or specially trained to guide them in managing or to take over responsibility for a particular episode of a clinical condition in a patient. Objective: To evaluate the profile and outcome of referrals from primary healthcare levels. Materials and Methods: This was a descriptive cross-sectional study undertaken with the aid of a structured questionnaire administered to all referred pregnant mothers and parents of children at three General Hospitals and one tertiary hospital. Results: Nearly all the participants were informed about the reason for their referral. Four-fifths of the participants were not accompanied by a health worker, whereas 90% were not expected on arrival. About 80% of the participants went to the referred hospital on the same day. The most common mode for transporting referred patients was public bus followed private vehicle. Conclusion: Although there are good practices with regard to referred patients being informed about the reason for their referral, work is still pending to ensure that the referral systems are effectively functioning in the referring of patients from primary health facilities.
  5,524 340 -
Traditional bone setters' gangrene: An avoidable catastrophe, 8 years retrospective review in a private orthopedic and trauma center in South-East Nigeria
Agu Thaddeus Chika, Jide Onyekwelu
January-June 2016, 14(1):1-5
Background: Traditional bone setters apply tight splints on the limbs of patients in their practice settings. Most of the times, these tight splints will result in compartment syndrome and when they are not recognized on time, they will deteriorate into gangrene. Design: This is a retrospective study covering a period between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east of Nigeria. Results: A total of ten patients out of sixty seven patients had amputations on account of traditional bone setters' gangrene constituting 14.9%. All of the patients with bone setters' gangrene had two stage amputations. One of the patients refused amputation and he was referred to another centre. There was zero mortality. Conclusion: Traditional bone setters' gangrene is an avoidable orthopaedic disaster that is common in our environment. Genuine efforts should be made by all the stakeholders to reduce and possibly to eliminate this catastrophe.
  4,921 440 -
Giant lipomas. A report of two cases
CD Emegoakor, CN Echezona, ME Onwukamuche, HO Nzeakor
July-December 2017, 15(2):46-49
Lipomas can be found in any region of the body and are the most common benign tumors of the adipose tissue. Giant lipomas have been reported to be any lipoma more than 10 cm in size along its widest diameter or more than 10 g in weight. Here we present two case reports of otherwise healthy patients who presented with unusually large tumors at different points in the same facility. Hence, it was needed to report our findings: A 27-year-old man with a 3-year history of a huge right gluteal swelling; A 56-year-old man with a 30-year history of a right lower limb mass. Physical examination and relevant radiological investigations were conducted to characterize and ascertain the extent of the two masses. They were excised surgically and underwent histology to confirm diagnosis. Despite the availability of improved health services, giant lipomas still exist.
  4,922 213 1
Vaccine hesitancy in Nigeria: Contributing factors – way forward
Olorunfemi Akinbode Ogundele, Tolulope Ogundele, Omolola Beloved
January-June 2020, 18(1):1-4
Vaccination coverage and program in Nigeria has continued to suffer setback in spite of various interventions. Vaccine hesitancy defined as a delay in the acceptance or refusal of vaccines despite the availability of vaccination services may be a cause of the poor trend in childhood immunization observed in Nigeria. The reasons why individuals hesitate or choose not to vaccinate vary across cultures and contexts. There is a need to develop context-specific strategies generated from local research to reduce vaccine hesitancy and improve vaccination uptake in the country.
  4,054 617 -
Diagnosing and treating Malaria in Nigeria. Unitaid project defeat - Change of guard at the editorial desk of the Nigerian journal of general practice
Jide Onyekwelu
July-December 2014, 12(2):8-12
Full text not available  [PDF]
  922 3,655 -
An evaluation of the characteristics of patients with gestational choriocarcinoma in south-south, nigeria
TK Nyengidiki, G Bassey
July-December 2015, 13(2):40-43
Background: Gestational trophoblastic diseases have been generally associated with the good outcome, especially in developed countries where early presentation and diagnosis is the norm. Objective: This study seeks to determine the characteristics of patients with gestational choriocarcinoma at the University of Port Harcourt Teaching Hospital(UPTH), Nigeria. Methods: This was a retrospective study of women who were treated for gestational choriocarcinoma at the UPTH over a 5-year period from January 1, 2008 to December 31, 2012. Results: Atotal of 13 cases of gestational choriocarcinoma were treated in UPTH during the study period, and there were 16,720 deliveries giving a prevalence of 0.8/1000 deliveries. The majority of patients (76.9%) were of low socioeconomic class. 92.3% of patients presented with amenorrhea for 28 weeks. Histological examination of tissues extracted from previous miscarriages was not performed in 100% of patients. Eighty percent of all mortalities were associated with antecedent pregnancies being miscarriages. All patients managed were lost to follow-up within 32 weeks. Conclusion: Gestational choriocarcinoma in Port Harcourt is associated with high mortality. Most patients with choriocarcinoma were of low socioeconomic class, presented late with lack of histological examination of previously extracted products of conception. Most of the patients were lost to follow-up within 32 weeks.
  2,753 1,803 -
Clinical governance: Quality Health-Care System for 21st Century
Mustapha A Danesi
January-June 2019, 17(1):1-7
Clinical governance is a system through which all organizations in the health system are accountable for continuously improving the quality of their clinical services and ensuring high standard of care by creating a facilitative environment in which excellence flourishes. Clinical governance has not been an important component of healthcare delivery in Nigeria. Clinical Governance has become the most important component of health care system for the 21st century. The aim is that, health care should be safe, effective, patient centered, timely, efficient and equitable.
  4,063 422 -
Hypertension prevalence and body mass index correlates among patients with diabetes mellitus in Oghara, Nigeria
Anizor Chinedu, Azinge Nicholas
January-June 2015, 13(1):12-15
Background: Hypertension and abnormal body mass index (BMI) are a cause of increased morbidity and mortality in patients with diabetes mellitus (DM). The aim of this study is to determine the prevalence of hypertension with correlates to BMI among patients with DM seen in a tertiary hospital in Oghara, Delta State. Materials and Methods: Two hundred and forty-four diabetic subjects were retrospectively evaluated at the Endocrinology Clinic of the Delta State University Teaching Hospital, Oghara, Nigeria. Data obtained from medical records included presence of hypertension confirmed by presence of elevated blood pressure >140/90 mmHg on two consecutive clinic visits or known hypertensive on medications, age, sex, type of diabetes, weight and height with computation of BMI. Results: The prevalence of hypertension among the diabetic patients was 57.4%. Eighty-two males (58.5%) were hypertensive compared with 58 (41.5%) in female subjects. The prevalence of hypertension was higher in overweight and obese diabetic subjects than in normal weight subjects and also higher in type 2 diabetic patients compared to type 1, which were both statistically significant (P < 0.05). Conclusion: Hypertension is a common co-morbidity arising diabetic patients in this study. The focus must be on health education, lifestyle modification and adherence to anti-hypertensive therapy to control hypertension in diabetic patients.
  3,989 457 3
Etiological pattern, clinical presentation, and management challenges of proptosis in a tertiary hospital in South West Nigeria
TO Otulana, OA Sogebi, HA Ajibode, OT Bodunde, OO Onabolu
July-December 2016, 14(2):28-32
Background: The etiology of proptosis is diverse ranging from orbital problem to infiltrative disease and spread from contiguous sites including nasopharynx, paranasal sinuses, and sometimes distant structures. It can also be part of systemic illness affecting multiple tissues and organs. Aim: This study aims to determine the demographic pattern and etiology of proptosis in a tertiary health facility in South Western Nigeria and to discuss the management challenges. Methods: This is a clinic-based retrospective descriptive analysis of all patients that presented with proptosis at the Eye Clinic of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun state, Nigeria, over a 13-year period from 2000 to 2012. The hospital records of patients was used which was analyzed using Statistical package for Social sciences version 15. Results: A total of 175 cases of proptosis out of 15,266 new cases gave a hospital prevalence of 1.2%. The average age of the 138 patients analyzed was 37.8 years with a male to female ratio of 1:1. Children constituted 27.5%. Eighty-one (58.7%) patients presented within 1 month of onset of proptosis. Twenty-three (16.7%) had bilateral proptosis. Half of the studied population was secondary to orbital inflammation. The common causes of proptosis were infective 38.4%, mass/tumor 18.8%, noninfective inflammation 13%, and sinonasal diseases 10.9%. Eight (5.8%) were mucocele of paranasal sinuses. Thyroid-related eye disease and proptosis of vascular etiology were common in females. Computerized tomographic scan of the orbit and/or sinus/cranium was done in 11.4% of the patients. Thirty-seven (26.8%) patients defaulted. Conclusion: Infective process is the most common cause of proptosis from orbital cellulitis. Majority were unilateral with no sex predilection. Proptosis due to thyroid eye disease and vascular abnormality were found mostly in females. The management challenges were poor record keeping and inadequate personnel. Despite the threat to life and vision posed by some etiology of proptosis, a large number of the patients were unable to fund investigation and treatment while others defaulted from the facility.
  4,059 379 -
Knowledge and practice of disease notification among private medical practitioners in Osun State, Southwestern Nigeria
Wasiu Olalekan Adebimpe, Adeolu Sunday Oluremi
January-June 2019, 17(1):16-22
Introduction: Disease surveillance and notification (DSN) in Nigeria had been largely public sector driven. This study assessed knowledge and practice of the private health-care facilities in DSN and explored models for private sector engagement DSN of communicable diseases in Southwestern Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out among medical directors of 60 private health-care facilities in Osun State, using a semi-structured self-administered questionnaire. Data were analyzed using the SPSS software version 17.0. Results: All the respondents have heard about DSN, while 80% had good knowledge of DSN. Thirty-two (53.3%) of facilities have ever notified the Local Government Authorities (LGA) health authority, 23 (38.3%) of facilities notified in the last 3 months, while 54 (90.0%) were willing to participate with government on DSN. Only 9 (15.0%) regularly share their disease prevalence data with government on monthly basis. Recommendations to circumvent listed barriers to public–private participation were suggested by the respondents. Predictors of a good notification practice include having good knowledge score of DSN, having received feedback from government or notified centers, and having a designated DSN officer. Conclusions: High awareness and knowledge but poor practices of DSN were recorded. Reasons for not reporting were surmountable while recommendations given were feasible toward engaging the private sector toward improvement of DSN in Nigeria.
  3,896 370 -
Assessing the influence of mass media on contraceptive use in Nigeria: A secondary analysis of 2013 Nigerian national demographic and health survey
Joseph Odirichukwu Ugboaja, Charlotte Blanche Oguejiofor, Emmanuel Okwudili Oranu, Anthony Osita Igwegbe
July-December 2018, 16(2):39-44
Background: The low contraceptive use in Africa has been severally linked to ignorance and misconceptions. Media platforms provide potential avenues for addressing these misconceptions. This study is aimed at evaluating the influence of media exposure on contraceptive use among Nigerian women. Materials and Methods: We conducted a weighted analysis of data from the 2013 Nigerian Demographic and Health Survey that included 38,948 women aged 15–19 years using STATA software, version 12.0 SE (Stata Corporation, TX, USA) to investigate the influence of media exposure on contraceptive use among Nigerian women using logistic regression models. The result was presented in odds ratio (OR) and 95% confidence interval (CI). Results: The contraceptive use among the respondents was 14.88%, comprising mainly of modern methods (64.2%; n = 3006). After controlling for age, educational status, religion, wealth status, and other potential confounding variables, the use of contraceptives was significantly associated with reading newspapers for at least once a week (OR = 1.16; 95% CI = 1.03–1.32), listening to radio for at least once a week (OR = 1.16; 95% CI = 1.01–1.32), and watching television for at least once a week (OR = 1.39; 95% CI = 1.20–1.61). There was an improvement in the odds in favor of contraceptive use among the women when the frequency of media exposure was increased to at least once a week. Conclusion: Contraceptive use among women in Nigeria is positively influenced by exposure to media which improves with increasing frequency of exposure. This finding provides a potential opportunity for improving contraceptive utilization in the country using the various mass media platforms.
  3,552 585 1
Assessment of level of adherence to antiretroviral therapy among human immune deficiency virus/acquired immune deficiency syndrome patients at Imo State University Teaching Hospital, Orlu, Nigeria
HN Chineke, Prosper O.U. Adogu, KA Uwakwe, MU Ewuzie
January-June 2015, 13(1):21-25
Background: Antiretroviral therapy (ART) is not a cure for human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS), but rather it is used for optimal suppression of the viral load to an undetectable serum level, hence it remains a palliative measure to improve the quality of life and longevity by impeding the rate of disease progression. Objective: The objective was to evaluate the level of adherence, the prevailing contributory factors to adherence as well as nonadherence of HIV/AIDS patients to ART at Imo State University Teaching Hospital (IMSUTH), Orlu, Nigeria. Methodology: A descriptive cross-sectional study of HIV/AIDS patients receiving anti-retroviral drugs at IMSUTH, Orlu. It was carried out using interviewer - administered questionnaire involving 400 respondents. The collected data was analyzed manually using electronic calculator and results were presented in frequency tables. Results: The result showed a high level of adherence of HIV/AIDS patients to anti-retroviral drugs as 383 (96.2%) were adherent, while 15 (3.8%) were not adherent. Some reasons given for nonadherence to treatment were self-discouragement, toxicity of the drugs especially skin rashes, attitude of health workers, stigma, and distance to the hospital hence they may not be able to access their medications as and at when due. Conclusion: There is a significant high level of adherence of HIV/AIDS patients to ART at IMSUTH, Orlu, probably due to their high level of formal education as majority of the respondents 333 (83.0%) achieved at least a secondary level of education.
  3,726 383 -
Atypical presentations of hiatal hernia in two pediatric patients
Mohemmed Ajij, Shambhavi , Shalu Gupta
January-June 2017, 15(1):10-12
Hiatal hernia is an uncommon condition in children. Its symptoms can vary markedly from none to life-threatening condition, thereby making its diagnosis challenging. We reported two different cases, first a 15-month-old child presenting with respiratory distress, second a 7-year-old boy presenting with resistant iron deficiency anemia. Surgical management was done in both cases, following which both of them improved. To the best of our knowledge, this is the first case report of hiatus hernia in children in this region, with such contrasting presentation. A stepwise and methodical approach to the patients led to early diagnosis.
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Antihypertensive prescription patterns of nonspecialist general practitioners in Lagos, Nigeria
Babawale Taslim Bello, Cashmir Ezenwa Amadi, Christiana Oluwatoyin Amira, Amam Chinyere Mbakwem
January-June 2016, 14(1):6-10
Context: Concerns have been expressed about the antihypertensive prescription patterns of nonspecialist physicians who care for the majority of patients with hypertension in developing countries. Aims: The aim of the study was to assess the antihypertensive prescription pattern of nonspecialist general medical practitioners in Lagos, Nigeria. Settings and Design: This was a cross-sectional survey carried out among nonspecialist general medical practitioners within Lagos State, Nigeria. Subjects and Methods: A total of 132 doctors completed questionnaires about their demographics, duration and location of practice, and antihypertensive prescription patterns. Statistical Analysis Used: Continuous variables are presented as means or medians while categorical variables are presented as percentages. Comparison between means was done using the Student's t-test, while comparison between percentages was carried out using Chi-square test. Results: Majority (61.2%) considered thiazide diuretics their first choice antihypertensive. The most frequently prescribed antihypertensives were calcium channel blockers (CCBs) (88.6%), thiazide diuretics (85.6%), and angiotensin converting enzyme inhibitors (ACEIs) (84.8%). These were also the most frequently combined with the CCB-thiazide diuretic combination being the most frequently prescribed (81.1%) followed by the ACEIs - thiazide diuretic combination (65.9%). The most frequently considered factors when prescribing antihypertensive medications were side effects of the medications (92.4%), additional benefits beyond blood pressure (BP) lowering (90.9%), patients' BP at the time of presentation (89.4%), dosage frequency of the drug (87.9%), and available scientific evidence for efficacy in lowering BP (87.1%). Conclusions: The antihypertensive prescription pattern of nonspecialist physicians practicing in Lagos aligns with current hypertension treatment guidelines.
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Blood pressure pattern among adults in Lagos: Analysis of data from public health screenings
Babawale Taslim Bello, Yemi Raheem Raji, Christiana Oluwatoyin Amira, Rotimi William Braimoh, Olamide Olutosin Olowoyo, Babatunde Abdulmajeed Akodu
January-June 2018, 16(1):10-14
Background: Knowledge of the pattern of blood pressure (BP) in a population is useful in documenting within-population differences in hypertension prevalence as well as identifying groups at increased risk of complications. Materials and Methods: BP data obtained from 1061 participants in population screenings carried out in five local government areas within Lagos were analyzed. BPs were measured in both arms with individuals seated and the limb supported on a table by medical interns using a mercury sphygmomanometer. The higher of the two recordings was taken as the patient's BP. Results: The study population was made up of 54.5% females with an overall mean age of 39.2 ± 15.0 years and a range of 18–84 years. Mean systolic and diastolic BPs increased significantly and progressively with age in both male and female participants. BP was elevated in 35.6% of the study population with 48.3% of those having moderate-to-severely elevated BP. The prevalence of elevated BP increased with age; however, there was no significant difference in the prevalence of elevated BP between male and female participants. Between 11% and 20% of individuals aged 18–29 years had elevated BP, with the proportion being much higher among males than females. Conclusion: The study provides further evidence supporting the fact that hypertension is highly prevalent, is severe, and may have an onset earlier in life among African populations. There is need to institute polices focused on prevention, early detection, and prompt treatment of hypertension.
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