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Table of Contents
July-September 2021
Volume 28 | Issue 3
Page Nos. 149-231
Online since Friday, October 22, 2021
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ORIGINAL ARTICLES
Perception and practices towards Covid-19 amongst residents in Southern Nigeria
p. 149
Christie Divine Akwaowo, Catherine Sebastian Eyo, Idongesit Odudu Umoh, Victory Israel Ekpin, Nneeka Uneabasi Esubok
DOI
:10.4103/npmj.npmj_554_21
PMID
:34708700
Background:
Within a short duration, coronavirus disease 2019 (COVID-19) spread globally, affecting all facets of life and causing widespread panic. This study set out to assess the perception and practices towards COVID-19 of urban and rural residents in Akwa Ibom State, Nigeria.
Materials and Methods:
A cross-sectional study design and multistaged sampling technique were used. Data were collected using an interviewer-administered questionnaire between October and December 2020. Scores assessing perception and practices were allocated and graded based on specific stratified demarcations.
P <
0.05 was considered statistically significant.
Results:
A total of 822 individuals from the selected households were interviewed (urban: 401, 48.8%; rural: 421, 51.2%). Majority of respondents urban (99.8%) and rural (97.9%) were aware of COVID-19. Most respondents had low risk-perception of COVID-19 (62.4%), with significantly more rural respondents having low-risk perception (70.6% rural vs. 54.0% urban). The general perception of COVID-19 amongst the respondents was good (79.2%) with no statistically significant difference between urban and rural residents. Most of the participants had good practices towards COVID-19, with significantly higher proportion of urban respondents having good practice (93.8%) compared to their rural counterparts (83.1%). Amongst rural residents, high-risk perception was associated with higher proportion of good practice (93.4%) compared to 84.5% of low-risk perception (
P
= 0.015).
Conclusions:
The participants had high level of awareness, low risk perception, good general perception and good practices toward COVID-19. However, urban respondents showed better practices towards COVID-19. More attention should be directed towards improving COVID-19 perception and practices particularly amongst rural residents.
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Nutritional status and morbidity patterns of the elderly in a Northwestern Nigerian hospital: A cross-sectional study
p. 160
Abdulgafar Lekan Olawumi, Bukar Alhaji Grema, Abdullahi Kabir Suleiman, Yakubu Sule Omeiza, Godpower Chinedu Michael, Abdulrahman Shuaibu
DOI
:10.4103/npmj.npmj_545_21
PMID
:34708701
Context:
Nutrition is a significant factor in determining the health of older people because it affects almost all organs and systems, which could lead to varieties of diseases and premature death.
Aim:
To determine the nutritional status and its association with the morbidity patterns of elderly patients.
Settings and Design:
A cross-sectional hospital-based descriptive study involving 348 patients aged 60 years and above who presented at the Family Medicine Clinic.
Subjects and Methods:
Data of the socio-demographic profile, anthropometric measurements and clinical diagnosis were collected. The co-morbidities were classified based on the number, duration and affected organ or system. The nutritional status was assessed with the Mini-Nutritional Assessment tool.
Statistical Analysis:
Chi-square test and logistic regression analysis were used to determine associations between nutritional status and morbidity patterns of the elderly. The level of significance was set at a
P
≤ 0.05.
Results:
A total of 348 respondents were recruited with 60.9% of females and mean age of 67.83 (standard deviation ± 7.53) years. The prevalence of malnutrition was 25.3% and of risk of malnutrition 56.6%. Furthermore, the prevalence of multi-morbidity was 74.4%. Advanced age (odd ratio = 8.911, confidence interval [CI] = 1.992–39.872,
P
= 0.004), underweight (OR = 1.167, CI = 0.291–37.846,
P
< 0.001), lack of formal education, (OR = 1.569, CI = 0.357–0.908,
P
= 0.018), low monthly income (OR = 1.975, CI = 1.376–2.836,
P
< 0.001), chronic respiratory diseases (OR = 4.250, CI = 4.025–4.492,
P
< 0.001) and physical inactivity (OR = 2.466, CI = 1.063–5.722,
P
= 0.036) were the predictors of malnutrition. Furthermore, the duration of chronic disease for more than 10 years (OR = 1.632, CI = 0.408–0.979,
P
= 0.040) was significantly associated with at-risk of malnutrition.
Conclusion:
The study revealed advanced age, underweight, low educational status, chronic respiratory diseases and physical inactivity as independent risk factors for malnutrition among the elderly.
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Quality of life impairment amongst persons living with vitiligo using disease specific vitiligo quality of life index: A Nigerian perspective
p. 169
Umar Abdullahi, Tahir Turaki Mohammed, Bolanle O P. Musa
DOI
:10.4103/npmj.npmj_579_21
PMID
:34708702
Background:
Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes which manifests as white macules and patches due to selective loss of melanocytes. This condition can affect the patients' psychology, leading to an impairment of quality of life (QOL). Recently, much attention is been given to the emotional and psychological issues in the affected subjects.
Aim of the Study:
This was to assess the QOL impairment among Nigerian patients with vitiligo using a disease-specific quality of life index questionnaire (VitiQoL).
Materials and Methods:
Seventy seven adults aged 18 years and above with vitiligo attending the Dermatology Clinic of a tertiary health center were included in this cross-sectional study. The QOL was assessed using the vitiligo quality of life questionnaire (VitiQoL). Disease severity was assessed using Vitiligo Area Severity Index (VASI).
Results:
The mean age of the study participants was 38.97 ± 13.2 years, comprising of 32 (41.6%) and 45 (58.4%) females. Almost half of the vitiligo patients belong to the lower socioeconomic class, 37 (48.1%). The mean age of first onset of vitiligo was 33.5 ± 14.84 years, with 32 (41.6%) of the participants having age of first onset between 24 and 42 years. The mean VitiQoL score was 30.51 ± 15.74 (range 3–64). There was a significant relationship between VASI score and VitiQoL (
P
= 0.036,
r
= 0.517). Other factors such as age, gender, socioeconomic status, disease activity, family history of vitiligo, duration of the disease and educational attainment were significantly associated with VitiQoL score (
P
< 0.05).
Conclusion:
QOL is impaired significantly in Nigerian patients with vitiligo. Focusing on patient's QOL is an essential aspect in the management of patients with vitiligo.
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Monopolar transurethral resection of the prostate using water as the irrigation fluid: Our initial experience
p. 175
Emmanuel A Jeje, Taiwo O Alabi, Rufus W Ojewola, Moses A Ogunjimi, Kehinde H Tijani, Gabriel K Asiyanbi
DOI
:10.4103/npmj.npmj_502_21
PMID
:34708703
Background:
Monopolar transurethral resection of the prostate (M-TURP) has been the gold standard of surgical intervention in patients with benign prostatic hyperplasia with the indication for surgery. This can be achieved using varieties of irrigation fluids.
Objectives:
To document our experience with M-TURP using water as irrigation fluid in 123 consecutive patients.
Materials and Methods:
A retrospective study of all patients who had M-TURP with water as irrigation fluid was performed between January 2017 and July 2019. Information retrieved from theatre records and case notes includes patient's socio-demographic data, indications for surgery, intra-operative findings, the volume of resected chips and irrigation fluid used, post-operative complications and patient's satisfaction with the outcome of the procedure. These data were analysed using SPSS version 23.
Results:
Data from 123 patients were analysed and presented. The age range was 44–96 years with a mean of 69 years. Prostate volume ranges from 13.9 to 276.00 mls with a mean of 95.69 mls while resected prostate volume ranges from 2.0 to 158.0 mls with a mean of 56.68 mls. Volume of the sterile water used as irrigation fluid ranged from 5.0 L to 174.0 L with a mean of 68.7 L. Mean reduction in International Prostate Symptoms Score, improvement in Q-max and reduction in post-void residual urine were 22.1, 16.9 and 141.6 mls, respectively. Transfusion rate was 6.5% while the duration of admission ranges from 1 to 6 days, with a mean of 2.5 days. The overall complication rate was 26.0%. Ninety-six percent were satisfied with the outcome.
Conclusion:
M-TURP using water as irrigation fluid is safe and is as good as using the more rather expensive glycine or normal saline in bipolar TURP.
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Low plasma vitamin D as a predictor of uterine fibroids in a nigerian population
p. 181
Karima Abubakar Tunau, Jamila Abubakar Garba, Abubakar Abubakar Panti, Constance Egondu Shehu, Aisha Nana Adamu, Muhammad Bashir AbdulRahman, Mohammad Kaoje Ahmad
DOI
:10.4103/npmj.npmj_495_21
PMID
:34708704
Background:
Uterine fibroid is the most common benign tumour of the uterus and the exact cause is unknown. Vitamin D has been found to inhibit cell proliferation and enhance apoptosis
in vitro
.
Aim:
The aim of this study is to compare the plasma level of Vitamin D among women with uterine fibroids and those without uterine fibroids.
Materials and Methods:
This was an analytical cross-sectional study conducted among women with uterine fibroids and those without uterine fibroids. An interviewer-administered questionnaire was used to obtain relevant information. Five millilitres of venous blood was obtained for plasma Vitamin D assay. Data analysis was performed using the SPSS version 22. Level of significance was set at
P
< 0.05.
Results:
There were 100 participants recruited for the study. The mean age of the participants with uterine fibroid was 35.06 ± 6.6 years and that of controls was 33.28 ± 7 years. The mean plasma level of Vitamin D for all the participants was 12.47 ± 7.53 ng/ml. The mean plasma level of Vitamin D in those with uterine fibroids was significantly lower than in those without uterine fibroid (10.16 ± 7.78 vs. 14.35 ± 6.8;
t
= 2.517,
P
= 0.014). It also shows that 1 unit increase in Vitamin D level will reduce the risk of developing uterine fibroids by 8% (odds ratio = 0.92, 95% confidence interval = 0.86–0.99).
Conclusion:
The predictors of uterine fibroids were fewer hours spent outdoors, middle social class and low Vitamin D levels.
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The efficacy of pentazocine + diclofenac versus paracetamol + diclofenac for post- caesarean section analgesia
p. 187
Jamila Abubakar Garba, Abubakar Abubakar Panti, Daniel C Nnadi, Ibrahim G Ango, Karima A Tunau, Saratu Bello, Saad Zubairu, Asmau'u Muhammad Nasir, Rukayya Ibrahim
DOI
:10.4103/npmj.npmj_404_21
PMID
:34708705
Background:
The most common major obstetric procedure is caesarean section (CS) and one of the greatest concerns for women after CS is to have optimal pain relief.
Aim:
This study aims to compare the efficacy of pentazocine + diclofenac and paracetamol + diclofenac on post-operative analgesia after CS.
Methodology:
This was a single-blind, randomised trial. Pregnant women that had CS were randomized into two groups. Group A received intramuscular pentazocine + rectal diclofenac postoperatively. Group B received intramuscular paracetamol + rectal diclofenac postoperatively. Post-operative pain was assessed by numeric rating scale at 1 h after the surgery, at 6 h, 12 h and 24 h. The result obtained was analysed using SPSS Version 22 and
P
< 0.05 was considered statistically significant.
Results:
The median pain scores in both groups ranged from 2 to 3 across all periods of assessment. The pain relief was slightly better in the pentazocine + diclofenac group with no significant difference in the pain score between the two groups at all periods of assessment. The satisfaction level was good in 66.3% and 69.5% of the participants in the pentazocine + diclofenac and paracetamol + diclofenac group respectively but the difference was not statistically significant (χ
2
= 4.14,
P
= 0. 12). Nausea, vomiting and drowsiness were significantly more in the pentazocine + diclofenac combination (
P
< 0.001).
Conclusion:
Both combination of analgesics provided adequate analgesia but pentazocine + diclofenac combination had better pain relief but was more associated with side effects.
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The efficacy of oral naproxen and cervical lidocaine spray on perceived pain during hysterosalpingography
p. 193
David Kehinde Jayeola, Temitope Olugbenga Bello, Victor Olufemi Oyedepo, Olusola Comfort Famurewa
DOI
:10.4103/npmj.npmj_577_21
PMID
:34708706
Objective:
This study was carried out to evaluate the efficacy of the combined use of oral naproxen and cervical lidocaine spray during hysterosalpingography (HSG) compared to the use of oral naproxen or cervical lidocaine spray alone. Materials and Methods: This prospective randomised controlled study was carried out using a total of 240 patients who were randomly assigned to four groups. Group 1 received cervical lidocaine spray only, Group 2 received oral naproxen only, Group 3 received cervical lidocaine spray and naproxen tablet, whereas Group 4 was the control group. A visual analogue scale was used for subjective pain assessment at three pre-defined steps.
Results:
The mean pain scores of the patients in each of the four groups are Group 1 (3.6 ± 2.0, 5.1 ± 1.8, 5.8 ± 2.2); Group 2 (2.7 ± 1.4, 3.6 ± 2.0 and 3.9 ± 1.9); Group 3 (2.8 ± 1.5, 3.4 ± 2.0 and 4.2 ± 2.3); Group 4 (4.7 ± 1.7, 5.9 ± 1.7 and 5.3 ± 1.7) at T1, T2 and T3, respectively. Pain perception was statistically significantly reduced by naproxen and combined naproxen plus lidocaine spray at all the stages of HSG while cervical lidocaine spray had a statistically significant reduction in pain perception only during cervical instrumentation.
Conclusion:
Oral naproxen and combined naproxen plus cervical lidocaine spray were effective in reducing HSG-associated pain during all the stages of HSG. However, combined oral naproxen and lidocaine spray did not show superior efficacy over oral naproxen alone. Cervical lidocaine spray was not an effective method.
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Prevalence and factors associated with depression among medical students in Nigeria
p. 198
Sani Salihu Suraj, Bello Ibrahim Umar, Auwal Umar Gajida, Musa Usman Umar
DOI
:10.4103/npmj.npmj_414_21
PMID
:34708707
Background:
Depression among medical students has been partly attributed to the nature of medical education, and may lead to poor academic and professional adjustment. The objectives of the study were to assess the prevalence of depression and its relationship to socio-demographic and clinical risk factors among medical students of Bayero University in Kano, Nigeria.
Methodology:
A descriptive cross-sectional study was performed. Two hundred and seventy-nine medical students were selected using a multi-stage sampling technique. The respondents were given a self-reporting questionnaire, which included sociodemographic details and 3-item Oslo Social Support Rating Scale. Depression was assessed using the Mini-International Neuropsychiatric Interview (7.0).
Results:
The prevalence of depression among medical students was 15.1%. Depression was more in females, <22 years, those at the lower level of study, poor social support, family history of depression and history of depression. After logistic regression, only being female (
P
= 0.008) and history of depression (
P
= 0.007) differentiated medical students with depression from those with no depression with odds ratio (OR) of 2.88 (95% confidence interval [CI] = [1.31, 6.33]) and OR of 2.79 (95% CI = [1.33, 5.84]), respectively. There was no association between depression and poor financial state (
P
= 0.175), self-reported academic performance (
P
= 0.719) and use of psychoactive substances (
P
= 0.311).
Conclusion:
Depression is an important condition among medical students in Nigeria. There is a need to help students with mental health challenges by providing preventive measures, early identification and treatment mechanisms in medical schools in the country.
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Prevalence and factors associated with energy drink consumption amongst undergraduate students in Kano, Nigeria
p. 204
Usman Muhammad Ibrahim, Hafsat Umar Sani, Aminatu Kwaku Ayaba, Hadiza Musa Abdullahi, Rabiu Ibrahim Jalo, Fatimah Ismail Tsiga Ahmed, Aishatu L Adamu, Abubakar Mohammed Jibo
DOI
:10.4103/npmj.npmj_553_21
PMID
:34708708
Background:
Overconsumption of energy drinks (EDs) is a global public health concern because of its potential health consequence.
Objectives:
This study aimed to determine the prevalence and factors associated with ED consumption amongst undergraduate students in Kano, Northwest Nigeria.
Methodology:
A descriptive cross-sectional study design was used to study 381 undergraduate students, selected using a two-stage sampling technique. Data were collected using interviewer-administered questionnaires and analysed using SPSS version 22.0 with
P
≤ 0.05 considered to be statistically significant.
Results
: A total of 381 students were studied. The mean ± standard deviation age of the students was 23.1 ± 3.6 years with male-to-female distribution of about 1:1. Period prevalence of 67.0% within the last 30 days and point prevalence of 23.9% were found. The commonly used ED was Power Horse 44.6%. Up to 59.6% consumed EDs to boost their physical and mental capacity. Odds of ever-consuming EDs were lower in female undergraduates (adjusted odds ratio [aOR]: 0.5, 95% confidence interval [CI]: 0.3–0.7) and higher in Hausa/Fulani ethnic group (aOR: 1.7, 95% CI: 1.04–2.7). Amongst those who were currently consuming EDs, being 24 years or less (aOR: 1.9, 95% CI: 1.04–3.4) and coming from the Hausa/Fulani tribe (aOR: 2.5, 95% CI: 1.4–4.4) were associated with increased consumption. Male undergraduates (aOR: 0.2, 95% CI: 0.1–0.4) and students who were residing on campus were less likely to be current consumers of EDs (aOR: 0.5, 95% CI: 0.3–0.9).
Conclusion:
Consumption of EDs is increasing amongst students and therefore relevant government agencies should ensure regulated advertisement and consumption to avert the health consequences.
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A comparative study on the prevalence and intensity of urinary schistosomiasis among primary (formal) and almajiri (informal) school pupils in kura local government area of Kano State, Nigeria
p. 211
Safiya Gambo, Muutasim Ibrahim, Oyeku A Oyelami, Belonwu Raymond
DOI
:10.4103/npmj.npmj_605_21
PMID
:34708709
Background:
Urinary schistosomiasis remains one of the most prevalent neglected tropical diseases in the world today, particularly in developing countries including Nigeria. Chronic infection can affect the genitourinary system. School pupils, particularly the informal Almajiri school pupils are at increased risk of the infection.
Study Objectives:
The objective of this study was to determine and compare the prevalence and intensity of urinary schistosomiasis among primary and Almajiri school pupils in Kura Local Government Area (LGA) aged 5–15 years. We also aim to determine the presence of haematuria and proteinuria among these pupils.
Subjects and Methods:
It was a cross-sectional comparative study involving 200 primary and 200 Almajiri school pupils aged 5–15 years in Kura LGA who met the inclusion criteria. Urine samples were analysed by the dipstick urinalysis and microscopically examined for the egg
S. haematobium
.
Results:
The Almajiri school pupils had a significantly higher infection (55.5%) than the primary school pupils (43.0%). The infection was predominantly of light intensity in both school types (67%). The overall mean egg intensity was 51.6 ± 35 EPC. The infection was higher among boys and those aged 10 years and above. Majority of the pupils had microhaematuria (88.3%) and and proteinuria (71.1%), which were statistically significantly associated with the infection with P < 0.1 and P < 0.001, respectively.
Conclusion:
The prevalence of urinary schistosomiasis is higher among the Almajiri school pupils compared to the primary school pupils. Control programmes should focus on these Almajiri pupils in addition to the primary school pupils.
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Profile of bacterial pathogens causing infections in children with sickle cell anaemia in Maiduguri
p. 218
Halima Abubakar Ibrahim, Yakubu Mohammed Yakubu, Abubakar Garba Farouk, Pwavimbo Ambe, Galadima Bala Gadzama
DOI
:10.4103/npmj.npmj_531_21
PMID
:34708710
Background:
Sickle cell disease (SCD) is a major cause of morbidity and mortality in African children. Infection has been found to be a major cause of hospitalisation, a major precipitant of crises and one of the greatest causes of death among SCD patients at all ages.
Objectives:
The objective of the study was to determine the prevalence of bacterial infection, pattern of the isolates and the antibiotic sensitivity of isolated bacteria among children with sickle cell anaemia (SCA).
Materials and Methods:
A cross-sectional study carried out in the University of Maiduguri Teaching Hospital. A total of 242 hospitalised children with SCA with symptoms and signs of infection were recruited for the study using consecutive sampling technique. Sociodemographic and clinical data were obtained. Blood, urine, aspirates, swabs and cerebrospinal fluid samples were collected based on their clinical presentation and subjected to microbiological analysis.
Results:
A total of 242 patients were studied. The age range was 9 months–15 years, with a mean age of 6.36 years ± 3.75 years. Male-to-female ratio was 1:1.14, with 41.7% of them belonging to low social class. Seventy seven of the 242 had confirmed bacterial infection giving an incidence of bacterial infection in SCA patients of 31.8%. Gram-negative organisms accounted for 64.5% of the isolates and they include
Salmonella, Klebsiella, Escherichia coli
and
Coliforms
. However,
Staphylococcus aureus
(32.9%) was the most frequent microorganism isolated, followed by
Salmonella,
(20.3%)
, Klebsiella
(12.6%) and
Coliforms (12.6%)
. Amoxicillin-clavulanate, cefixime and gentamicin showed more than 50% activity against the isolated bacterial pathogens while chloramphenicol was found to have low activity against
Salmonella
.
Conclusion:
High index of suspicion of bacterial infection should be borne in mind of the attending physician when children with SCA present with features of infection. Detailed clinical evaluation and appropriate sample collection for microbiological analysis are recommended. Empirical treatment should be started on SCA patients who have clinical evidence of infection and should be broad enough to cover for common bacterial pathogens.
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Factors determining sexual behaviour amongst siddi tribe migrating to Udupi district, India: A cross-sectional study
p. 225
Mackwin Kenwood Dmello, Sudeep Kumar, Sanjeev Badiger, Jagannath Purushottam
DOI
:10.4103/npmj.npmj_606_21
PMID
:34708711
Background:
Afro-Indians, locally known as Siddi, are the tribal community descended from the Bantu populace from eastern Africa found in Goa, Gujarat and Karnataka along the Indian west coast. This study determines knowledge, attitude and sexual behaviour amongst the Siddi population in the Udupi district.
Materials and Methods:
A cross-sectional study was conducted from October 2018 to September 2019; men and women aged above 18 years who lived in the locality at the time of the survey were included in the study.
Results:
A total of 108 Siddi individuals participated in this study. The mean age of the respondents was 31.8 ± 9.5 years. More than half (51.8%) of the respondents received information on sexual matters through friends. Awareness regarding the usage of condoms and other preventive measures was poor (34.7%). Around 65.7% of the respondents felt that sex education in school encourages sex amongst youngsters. The mean age at the first sexual intercourse amongst men and women was 20.3 years and 16.2 years, respectively. About 18.7% of the respondents had sex with a new partner in the migrated place within the last 1 month, of which 80% were married. Only 5% of the respondents used condoms while indulging in sex with a new partner at the migrated place. Factors such as age at marriage, age at the first sexual act and attitude towards sexual activity were significantly associated with a new sex partner at the arrival site.
Conclusion:
There is a high prevalence of unsafe sexual practices amongst the migrated Siddi tribe at the place of destination. This poses the risk of sexually transmitted infections amongst the migrant tribes and local communities at the place of destination and the location of origin. The study finding shows that measures should be taken to create awareness, and change in attitude towards sexual matter should be channelised at an early age amongst the Siddi population.
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Online since 2
nd
July, 2015