Subjects -> HEALTH AND SAFETY (Total: 1535 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (721 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (387 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (108 journals)
    - PHYSICAL FITNESS AND HYGIENE (128 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (721 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 3)
Acta Informatica Medica     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 27)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 2)
African Health Sciences     Open Access   (Followers: 4)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 43)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 6)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 19)
American Journal of Health Education     Hybrid Journal   (Followers: 34)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 10)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 29)
American Journal of Public Health     Full-text available via subscription   (Followers: 267)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 7)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 12)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 14)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 4)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 8)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 5)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 12)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 1)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 12)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 50)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 12)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 22)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 23)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 1)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 4)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 5)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 15)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 24)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 22)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 8)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 3)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 14)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 17)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Frontiers of Health Services Management     Partially Free   (Followers: 4)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gestão e Desenvolvimento     Open Access   (Followers: 1)
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Annual Review     Open Access   (Followers: 1)
Global Health Journal     Open Access   (Followers: 1)
Global Health Promotion     Hybrid Journal   (Followers: 17)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 8)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 13)
Health and Human Rights     Open Access   (Followers: 10)
Health and Research Journal     Open Access   (Followers: 1)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 68)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)

        1 2 3 4 | Last

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African Health Sciences
Journal Prestige (SJR): 0.446
Citation Impact (citeScore): 1
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1680-6905
Published by African Journals Online Homepage  [263 journals]
  • NCD epidemic and sexual reproductive health issues in the infectious
           disease world

    • Authors: James K Tumwine
      Abstract: Nil.
      Issue No: Vol. 19, No. 4
       
  • Association of Vitamin D deficiency and Vitamin D Receptor Gene
           Polymorphisms with Type 2 diabetes mellitus Saudi patients

    • Authors: Ayman S Al-Hazmi
      Abstract: Background: Type 2 diabetes mellitus (T2DM) is a global problem. Association of multiple genes in T2DM becomes a hot point recently. This study was aimed to evaluate association of vitamin D receptor gene polymorphisms with susceptibility to T2DM.
      Subjects and methods: One hundred T2DM Saudi male patients were included in this study and one hundred healthy Saudi men were used as control. For each individual, fasting blood glucose, cholesterol, HDL-C, LDL-C, HbA1c, insulin and 25-(OH) vitamin D were measured. In addition, Apal, BsmI and TaqI genotypes were performed for each subject. Data was analyzed by SPSS version 16, using Spearman's rho and ANOVA tests.
      Results: There was significant inverse correlation between 25-(OH) vitamin D level and T2DM (p<0.01). HbA1c was inversely correlated with 25-(OH) vitamin D level (P<0.05). Genotype study showed that tt of TaqI genotype was higher in T2DM group compared with control group (p<0.05). Moreover, tt genotype has higher HbA1c than both TT and Tt genotypes (p<0.05).
      Conclusion: An association was confirmed between TaqI genotypes and T2DM but there is no correlation between BsmI, ApaI and T2DM. In addition, HbA1c is positively correlated with tt genotype of TaqI.Keywords: Vitamin D receptor, diabetes type 2, polymorphism.
      Issue No: Vol. 19, No. 4
       
  • Predictors of poor glycemic control in adult with type 2 diabetes in
           South-Eastern Nigeria

    • Authors: Innocent Chidi Anioke, Azubike Nnamdi Ezedigboh, Ogechukwu Calista Dozie-Nwakile, Ikechukwu Johnpaul Chukwu, Peculiar Ngozi Kalu
      Abstract: Background: The study investigated predictors of poor glycemic control in type 2 diabetes (T2DM).
      Methods: Data on demographics, anthropometric and clinical parameters were collected in a cross-section survey from 140 adults with T2DM, using standard tools/instruments. Glycated hemoglobin (A1C) was assessed as a measure of glycemic control.
      Results: Majority (83.3%) had poor glycemic control status of which about 95% constitute the elderly. The elderly (OR= 5.90, 95% Cl: 1.66-20.96) were more likely associated with poor glycemic control than the non-elderly (p = 0.006). Adjustment for significant predictor variables: Age, waist-hip ratio (WHR), Fasting plasma glucose (FPG) and Systolic blood pressure (SBP), although attenuated the odds (OR= 5.00, 95% CI: 1.19-20.96) of poor glycemic control, it still remained significantly (p = 0.028) higher in the elderly. Patients outside tight FPG control significantly (p = 0.001) showed poor glycemic cotrol than those within tight FPG (OR= 17.39, 95%Cl: 5.83-51.90), even with attenuated OR (OR= 10.85, 95%Cl: 3.10-37.96) and (OR=12.08, 95%Cl: 3.64-40.09) when non- significant and significant predictor variables were accounted for, respectively.
      Conclusion: Age, WHR, FPG, and SBP were significantly associated with differences in glycemic control. The elderly and FPG outside tight control showed significantly increased odds of poor glycemic control status.Keywords: Type 2 Diabetes Mellitus; glycemic control status; A1C; Elderly; Fasting plasma glucose; glycemic control predictors.
      Issue No: Vol. 19, No. 4
       
  • Prevalence of ECG abnormalities among adults with metabolic syndrome in a
           Nigerian Teaching Hospital

    • Authors: Adeoye Abiodun, Adebayo Oladimeji, Tayo Bamidele, Adebiyi Adewole, Owolabi Mayowa
      Abstract: Background: Co-existence of metabolic syndrome (MetS) and electrocardiography (ECG) abnormalities heightens the risk of sudden cardiac death. However, there is a gap in evidence of how ECG changes cluster among continental Africans with or without MetS.
      Methods: We included 491 participants with interpretable ECG tracings who were consecutively recruited into the Cardiovascular Risk Prediction Registry (CRP). CRP is a registry of newly presenting patients into cardiology clinic of the University College Hospital, Nigeria, with a main objective of cardiovascular risk stratification to prevent cardiovascular morbidity and mortality. Using the International Diabetic Federation (IDF) criteria they were divided into those with metabolic syndrome and non-metabolic syndrome.
      Results: Four hundred and ninety-one participants comprising 48.3% women with mean age 53.72±15.2 years who met the IDF criteria with complete ECG interpretations were analyzed with 44.2% (men 38.6%; women 50.2%) of the participants having MetS while 74% had ECG abnormalities. Compared to women, men had higher mean serum total cholesterol, creatinine, smoking, and alcohol use, family history of hypertension and diabetes mellitus, QT prolongation, LVH plus or minus strain pattern, and ECG abnormalities in general. Women were heavier, had higher heart rate and proportions of MetS. ECG findings among those with or without MetS were not significantly different. In men, IDF metabolic score was associated with conduction abnormalities (p=0.039) and combined ECG abnormality (p=0.042) which became more significant with an exclusion of QT prolongation (p=0.004). Also, IDF abdominal obesity was associated with QT prolongation (p=0.017), combined ECG abnormality (p=0.034) while HDLc correlated with ECG abnormalities (0.037) in men. There was no significant associations of components of metabolic syndrome with ECG abnormalities among women.
      Conclusion: There was a high prevalence of MetS and abnormal ECG among the studied population. Abnormal ECG findings were more common in men with no differential association in people with or without MetS. However, a significant association existed between certain components of MetS and ECG abnormalities in men only. Male gender and HDLc were independent predictors of ECG Abnormalities.Keyword: Electrocardiography, metabolic syndrome, africans.
      Issue No: Vol. 19, No. 4
       
  • Tear electrolyte assessment of diabetic patients in Southern Nigeria

    • Authors: Juno Okukpon, Oziegbe Okukpon
      Abstract: Background: Tears are a critical body extracellular fluid coating the surface epithelial cells of the cornea and conjunctiva, and providing the optically smooth surface necessary for refraction of light onto the retina. The biological and chemical properties of tears change in response to systemic disease.
      Objectives: This study assessed the concentration of calcium, magnesium and phosphate levels in tears of diabetics.
      Methods: A comparative cross-sectional study involving twenty diabetics visiting Department for Health Services, University of Benin and forty non-diabetics within the University between 35 to 65 years participated in the study. Calcium, magnesium and phosphorous were analysed in tears sample collected with 75mm glass capillary tubes.
      Results: The fasting blood sugar (FBS) and age of diabetic patients was 7.48±1.88mmol/l and 56.75±5.82years and non-diabetics was 4.83±0.52mmol/l and 53.58±6.16years respectively. Magnesium showed no differences (P<0.05) between diabetics (0.76±0.45mmol/l) and non-diabetics (0.93±0.59mmol/l). Calcium was elevated (P=0.041) and phosphate (P=0.044) was decreased in diabetics (3.14±1.65mmol/l and 0.074±0.058mmol/l) than non-diabetics (2.41±1.05mmol/l and 0.11±0.081mmol/l).
      Conclusion: This study concluded that being diabetic can affect the levels of some tear electrolytes in the tear fluid which may lead to an increased risk of diabetic ocular complications.Keywords: Tears, diabetics, mag nesium, calcium, phosphorus.
      Issue No: Vol. 19, No. 4
       
  • Exploration of hypoglycemic effect of an extract from leaves of a plant
           from Tunisian pharmacopeia: artemisia campestris (asteraceae)

    • Authors: Amel Belgacem, Neyla Ben Gdara, Ikram Khemiri, Lotfi Bitri
      Abstract: Background and objectives: A lot of research has been directed towards medicinal plants which are considered as a source of multiple phytotherapic substances endowed with hypoglycemic activities that could be used to treat diabetes and its complications. Our study was carried out in Wistar rats to investigate the hypoglycemic effect of n-Butanol Fraction from Artemisia campestris leaf Methanolic Extract (BFACME).
      Methods: Two experimental models were used in rats: orally induced hyperglycemia (OGTT) and isolated perfused liver (IPRL).
      Results: BFACME at 550 mg/kg BW dose significantly reduced fasting glucose level in normal rats as compared to controls. The decrease of glycaemia was 12.6% more significant than that obtained with the standard drug glibenclamide (10 mg/kg BW), an oral antidiabetic preparation belonging to sulfonylurea class. In OGTT model, BFACME at the highest doses of 550 and 400 mg/kg BW significantly reduced the postprandial hyperglycemic peak compared to controls. In the IPRL model, treatment with BFACME significantly decreased glucose concentrations after 30 min of perfusion with 30 mM glucose solely when insulin was present. The higher doses of BFACME lead to glucose concentration at basal level as early as 90 min, while the lowest dose does not restore this concentration even to t = 120min. The best initial glucose concentration retrieval was obtained with 0.7 mg BFACME/mL/g liver. At this dose, BFACME improves the decrease of glucose level caused by only insulin by about 18%.
      Conclusion: The BFACME appears to exert a hypoglycemic activity by potentiating the insulin action. Keywords: Artemisia campestris; hypoglycemic activity; isolated perfused rat liver; rats.
      Issue No: Vol. 19, No. 4
       
  • Prevalence and determinants of hypertension among students of the
           University of Kinshasa, Democratic Republic of Congo: a cross-sectional
           study

    • Authors: Guy I Wanghi, Paulin B Mutombo, Ernest K Sumaili
      Abstract: Background: The 2017 ACC/AHA Guideline categorized blood pressure into 4 levels:normal (SBP<120 and DBP <80mm Hg), elevated (SBP of 120–129 or DBP< 80 mmHg) and stage 1 (SBP of 130–139 or DBP of 80–89 mm Hg) or 2 (SBP≥140 orDBP≥90mmHg). Compared with the JNC7 guideline, the 2017 ACC/AHA guideline recommends using lower SBP and DBP levels to define hypertension.
      Objective: To determine the prevalence of hypertension as well as associated factors among students of the University of Kinshasa.
      Methods: This was a cross-sectional study conducted at the University of Kinshasa and including 1 281 students aged between 18 and 30. Blood pressure was assessed according to the WHO STEPwise approach, which is a standardized method of data collection, analysis and dissemination for the surveillance of non-communicable diseases in WHO member countries.The Chi-square and Student's t-tests and a multivariate logistic regression analysis have been used to evaluate the results. Statistical analyses were done using IBM SPSS version 21.
      Results: The prevalence of hypertension according to the guidelines from the 2017 ACC/AHA and the JNC 7 was 26.4 % (CI 95%; 23.9 - 28.9) and 7.3 % (CI 95%; 5.8 -8.8), respectively. The results of multivariate logistic regression analysis showed that smoking, alcohol abuse, overweight, male sex, age ≥ 24 years old and low physical activity were associated with hypertension (p < 0.0001).
      Conclusion: At least one out of four students had hypertension. These data should encourage public health authorities to develop strategies for screening of BP and topromote the adoption of healthy lifestyle in young adults.Keywords: Hypertension, risk factors, student, prevalence.
      Issue No: Vol. 19, No. 4
       
  • Renal risk profiling in newly diagnosed hypertensives in an urban
           population in Nigeria

    • Authors: Aderoju Gbadegesin, Oluyomi Okunola, Olugbenga Ayodele, Fatiu Arogundade, Abubakre Sanusi, Adewale Akinsola
      Abstract: Introduction: Hypertension is a cause and consequence of chronic kidney disease globally. The other factors that work in concert with hypertension to cause CKD are yet to be clearly elucidated. Studies have identified proteinuria, dyslipidemia, obesity, smoking and family history of CKD as renal risk factors. Due to the high morbidity and mortality associated with occurrence of CKD including the enormous financial burden involved in its management, the knowledge of prevention and understanding of the risk factors for development of CKD is highly essential. Therefore, Identifying well defined risk factors that display strong graded association with the occurrence and progression of CKD can help in elucidating potential targets for disease modification.
      Objective: The aim of this study was to determine the prevalence of renal risk factors and their impact on kidney function in newly diagnosed hypertensive Nigerians.
      Methods: This was a case control study of two hundred and fifty newly diagnosed hypertensive Nigerians recruited from two contiguous hospitals in an urban setting in south western Nigeria. Another group of two hundred and fifty apparently healthy age and sex matched normotensive Nigerians in the same community were recruited as controls.
      Results: Seventy (28%) of the newly diagnosed hypertensives had estimated glomerular filtration rate of less than 60ml/min, while 42.4% and 18.8% of the subjects and the controls had microalbuminuria respectively. The newly diagnosed hypertensives had significantly higher prevalence of analgesic use (86.4% versus 41.6%, p < 0.001), alcohol consumption (20.8% versus 12%, p = 0.008), use of canned salted food (18.8% versus 8.4%, p= 0.001) and central obesity (36.1% versus 26.8%, p= 0.025) compared to controls.
      Conclusion: There is a significant occurrence of modifiable renal risk factors in newly diagnosed hypertensives and this offers a platform for instituting preventive strategies in the community.Keywords: Renal risk, hypertensives, urban population, Nigeria.
      Issue No: Vol. 19, No. 4
       
  • Impact of aerobic exercise versus resisted exercise on endothelial
           activation markers and inflammatory cytokines among elderly

    • Authors: Shehab M Abd El-Kader, Fadwa M Al-Shreef, Osama H Al-Jiffri
      Abstract: Background: Aging is the major risk factor for the development of cardiovascular diseases as aging increases plasma levels of pro-inflammatory mediators and endothelial dysfunction. Physical exercise is a potential strategy for improving the endothelial dysfunction and chronic inflammation that accompanies aging. However, there is a need to differentiate between aerobic and resistance exercise training regarding endothelial activation markers and systemic inflammation among elderly population.
      Objective: The aim of this study was to compare the impact of six months of aerobic versus resisted exercise training on inflammatory cytokines and endothelial activation markers among elderly.
      Material and methods: Eighty previously sedentary elderly subjects participated in this study, their age ranged from 61-66 years. All subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or resistance exercise group (group B, n=40).
      Results: The mean value of interleukin-10 (IL-10) was significantly increased, where the mean value of inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), E-selectin, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) were significantly decreased in group (A) and group (B). In addition, there were significant differences in the mean levels of the investigated parameters between group (A) and group (B) at the end of the study.
      Conclusion: The current study provides evidence that aerobic exercise is more appropriate in modulate entering altered endothelial activation and inflammatory markers than resisted exercise among elderly population.Keywords: Endothelial activation markers; inflammatory cytokines; aerobic exercise; resistance exercise; aging.
      Issue No: Vol. 19, No. 4
       
  • Impact of aerobic versus resisted exercise training on systemic
           inflammation biomarkers and quality of Life among obese post-menopausal
           women

    • Authors: Shehab M Abd El-Kader, Osama H Al-Jiffri
      Abstract: Background: Although post-menopausal obesity is an important public national health problem in Saudi Arabia, to date no study has evaluated the effects of weight reduction on biochemical & clinical parameters and quality of Life for obese Saudi post-menopausal women.
      Objective: The aim of this study was examine the effects of aerobic versus resisted exercise training effects upon systemic inflammation biomarkers and quality of life for obese post-menopausal Saudi women.
      Material and Methods: One hundred Saudi post-menopausal obese women participated in this study, their age ranged from 50-58 years and their body mass index (BMI) ranged from 30-35 kg/m2. All participants were divided into two equal groups: The first group received aerobic exercise training on treadmill where, the second group received resisted exercise training. Health-related quality of life (SF-36 HRQL), tumor necrosis factor– alpha(TNF-α), Interleukin-2(IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6) and C-reactive protein (CRP) were measured before and after 3 months at the end of the study.
      Results: The mean values of SF-36 HRQL subscale scores were significantly increased, while the mean value of TNF-α, Il-2, IL-4, IL-6,CRP and BMI were significantly decreased in both groups after treatments. There were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment with more changes in patients received aerobic exercise training.
      Conclusion: The current study provides evidence that aerobic exercise is more appropriate than resisted exercise training in modulating inflammatory cytokines and quality of life among obese post-menopausal women.Keywords: Aerobic exercise; resisted exercises; inflammatory cytokine; quality of life; obesity; menopause.
      Issue No: Vol. 19, No. 4
       
  • Estimation of hospital admission respiratory disease cases attributed to
           exposure to SO2 and NO2 in two different sectors of Egypt

    • Authors: Atef MF Mohammed, Yasser H Ibrahim, Inas A Saleh
      Abstract: Air Q 2.2.3 was used to predicted hospital admissions respiratory disease cases due to SO2 and NO2 exposure in two sectors of Egypt during December 2015 to November 2016. Levels were 19, 22 μg/m3 at Ain Sokhna sector and 92, 78 μg/m3 at Shoubra El-Khaima sector for SO2 and NO2, respectively. These levels were less than the Egyptian Permissible limits (125 µg/m³ in urban and 150 µg/m³ in industrial for SO2, 150 µg/m³ in urban and industrial for NO2). Results showed that relative risks were 1.0330 (1.0246 - 1.0414) and 1.0229 (1.0171 - 1.0287) at Ain Sokhna sector while they were 1.0261 (1.0195 -1.0327) and 1.0226 (1.0169 - 1.0283) at Shoubra El-Khaima sector for SO2 and NO2, respectively.
      The highest cases of HARD were found in Shoubra El-Khaima sector; 311 cases at 120 - 129 μg/m3 of SO2 and 234 cases at 120 - 129 μg/m3 of NO2. While, in Ain Sokhna, HARD were 18 cases at 50 - 59 μg/m3 of SO2 and 15 cases at 60 - 69 μg/m3 of NO2. The excess cases found in Shoubra El-Khaima sector as compared to those in Ain Sokhna sector, may be attributed to the higher density of population and industries in Shoubra El-Khaima sector.Keywords: AirQ2.2.3 model; Hospital admissions respiratory disease (HARD); Nitrogen dioxide (NO2); Sulfur dioxide (SO2); Coastal Sectors.
      Issue No: Vol. 19, No. 4
       
  • Determinants of harmful use of alcohol among urban slum dwelling adults in
           Kenya

    • Authors: Mariam Gitatui, Samuel Kimani, Samuel Muniu, Okubatsion Okube
      Abstract: Background: Harmful alcohol use is a public health problem associated with negative health and socio-economic impacts. However, patterns and dynamics of alcohol use among slum-dwellers in Kenya are poorly understood.
      Objective: To establish determinants of harmful alcohol use among adults in an urban slum setting in Kenya.
      Materials and methods: Cross-sectional study involving a consecutively selected sample (N=215) from Githurai, in Nairobi. A pre-tested questionnaire that captured data on socio-demographics, drinking patterns, type, reasons, initiator, and support system.
      Results: Of the respondents, those above 31 years, married, separated/divorced/widowed, of high education, earning above 50 USD, and from dysfunctional families consumed more alcohol. Low earners consumed (p < 0.05) unrecorded while high earners drank (p< 0.001) recorded alcohol. Adults from families with a drinking father and sibling consumed more alcohol (p=0.001). Single, low educational attainment/earners, and those in dysfunctional families (p <0.05) drank due to stress and reported alcohol-related problems. Young, unmarried, and casual laborers were introduced (p < 0.05) to alcohol by friends.
      Conclusion: Socio-demographic, economic, familial, social interactions, and stress are associated with harmful alcohol use among adults from slums calling for interventions targeting these factors.Keywords: Determinants; urban slum dwelling; alcohol use; alcohol abuse; adults; informal.
      Issue No: Vol. 19, No. 4
       
  • A pre-test post-test assessment of non-invasive keratograph break up time
           and corneal epithelial thickness after vaping

    • Authors: Alvin Munsamy, Bhavna Bhanprakash, Amina Sirkhot, Lufun Mlambo, Samukelisiwe Dlamuka, Ndumiso Mhlongo, Ronelle Naidoo
      Abstract: Background: The effects of electronic cigarettes on the ocular surface has yet to be shown. The purpose of the study was to assess the impact of e-cigarette use on the anterior corneal surface integrity.
      Methods: Forty three males and 21 females with an average of 21years were required to vape 0.05ml of e-liquid of 8mg nicotine concentration. Corneal epithelial thickness (CET) and Non Invasive Keratograph Tear Break up Time (NIKBUT) measurements were obtained prior to and post vaping. The Optovue iVue optical coherence topographer was used to measure central; superior; inferior; nasal and temporal CET and NIKBUT was assessed using the Oculus Keratograph 5M.
      Results: There was a mean increase for central corneal epithelial thickness of 0.3448 microns. The superior CET increased by 0.2414 microns. The inferior CET increased by 0.2931microns. The nasal CET increased by 0.2069 microns. The temporal CET increased by 0.2759 microns. The mean change in NIKBUT post-vaping was an increase of 1.40 seconds. All observations occurred at p > 0.05.
      Conclusion: The acute effect of e-cigarette use does not impact corneal epithelial thickness and non-invasive keratography tear break up time after 10 puffs mild exposure but more research is needed to assess if this remains the case with more frequent, higher exposure.Keywords: Pre-test post-test assessment, non-invasive keratograph breakup time, corneal epithelial thickness, vaping.
      Issue No: Vol. 19, No. 4
       
  • Relationship between sleep characteristics and depressive symptoms in last
           trimester of pregnancy

    • Authors: Gülçin Nacar
      Abstract: Background: Sleep problems during pregnancy may cause many complications that reduce quality of life.Aim: This study aims to determine the relationship between pregnant women's sleep characteristics and depressive symptoms.Methods: A hospital-based, cross-sectional study was conducted. Pregnant women were selected from the population by using the an improbable random sampling method. This study sample included 436 pregnant women who met the study’s inclusion criteria. To collect data, this study used an information form that was developed by the researcher after reviewing relevant literature, the Women's Health Initiative Insomnia Rating Scale (WHIIRS), and the Beck Depression Inventory (BDI). The researchers used face-to-face interviews method to collect data from the participants, pregnant women who were examined in the polyclinic.Results: This study found that 36% of participating pregnant women reported insomnia, and 38.1% experienced depressive symptoms. It also determined that participants who had problems with insomnia, who experienced a change in sleep habits, and who did not wake up feeling rested experienced depressive symptoms 1.64, 2.79, and 2.59 times more than those who didn’t have these problems, respectively. who experienced a decrease in sleep, who experienced an increase in sleep, and who did not wake up feeling rested experienced depressive symptoms 1.61, 3.22, 3.53, and 2.59 times more, respectively, than those who did not have insomnia, who did not experience a change in sleep habits in pregnancy, and who woke up feeling rested, respectively.Conclusion: This study determined that there is a relationship between insomnia and depressive symptoms and that pregnant women experiencing insomnia presented with more depressive symptoms.Keywords: Depressions, last trimester, pregnancy, sleep characteristics.
      Issue No: Vol. 19, No. 4
       
  • Development and Validation of the Minnesota Low Vision Reading Test
           (MNRead) Acuity Chart for the Asante Twi Language

    • Authors: Samuel Bert Boadi-Kusi, Michael Agyemang Kwarteng, Emmanuel Asubonteng
      Abstract: Aim: To design and validate a MNREAD Asante Twi version reading chart, to aid in the assessment of near visual acuity of natives Ghanaians.
      Methods: Cross-sectional and experimental designs were employed in phases I and II respectively of this study. The chart was developed using 20 transited pupils in class four in the Kumasi metropolis in phase I and validated in a clinical setting at the Manhyia District Hospital, Kumasi, using students in phase II.
      Results: A total of 100 participants (mean age; 22.19 ± 1.61 years) were involved in the second phase of this study. A Pearson product-moment correlation coefficient was computed to assess the relationship between MNREAD Asante Twi charts logMAR scores in both eyes. The MNREAD-Asante Twi acuity charts had very strong correlations (r = 0.94, p < 0.001) for MNREAD set 1A (black on white background) scores and MNREAD set 2A (black on white background) for acuity scores. Correlation between MNREAD set 1B (white on black background) scores and MNREAD set 2B (white on black background) scores was r = 0.95, p < 0.001.
      Conclusion: MNREAD Asante Twi reading chart will enhance the measurement of near visual function in native Ghanaians.Keywords: Asante Twi, MNREAD, Visual Acuity, Near chart, Ghana.
      Issue No: Vol. 19, No. 4
       
  • Effect of removal of AuraOnceTM laryngeal mask in awake or deep
           anaesthesia: a randomized controlled trial

    • Authors: Ronald Ombaka, Vitalis Mung’ayi, David Nekyon, Samina Mir
      Abstract: Background: The manufacturer Ambu® recommends that the AuraOnce™ laryngeal mask be removed once the patient is fully awake. Studies have shown benefit in removal of the laryngeal mask airway while a patient is deeply anaesthetized. Current evidence is inconclusive, as to which approach is preferable and safer in adults.
      Methods: one hundred and sixteen adult patients were randomly assigned to two groups of 58. For the deep arm; The AuraOnceTM laryngeal mask was removed after attaining an end tidal minimum alveolar concentration of Isoflurane of 1.15%. Occurrence of airway complication(s) (One or more of the following; Airway obstruction requiring airway manipulation; Laryngospasm; Desaturation to 90% or less on pulse oximetry) was noted until the subject was fully awake (appropriate response to command) in the post-anaesthesia care unit. For the awake arm; The AuraOnceTM laryngeal mask was removed on attaining an end tidal minimum alveolar concentration of Isoflurane of <0.5% and an appropriate response to command or obtaining appropriate response to command irrespective of end tidal concentration. Occurrence of airway complication(s) in theatre and post anaesthesia care unit was recorded. Time to theatre exit was recorded for both groups.
      Results: Baseline demographic characteristics were similar between the groups. More airway complications were encountered in the Deep arm - 13 (22.4%) relative to the Awake arm -5 (8.6%), this was found to be statistically and clinically significant, P value P=0.040, odds ratio 3.0622; 95% CI, 1.0139 to 9.2483.
      Conclusion: The removal of the AuraOnceTM laryngeal mask while the patient is still deeply anaesthetised is not as safe as or safer than awake removal.Keywords: AuraOnceTM laryngeal mask, deep anaesthesia.
      Issue No: Vol. 19, No. 4
       
  • Trends and gender differences in age at sex debut among adolescents and
           young adults in urban Cape Area, South Africa

    • Authors: Evans Muchiri, Clifford Odimegwu
      Abstract: Background: Adolescents and young adults in South Africa are at increased risk of experiencing negative outcomes from early sex initiation due to the context they develop in. This study aimed at investigating trends and gender differences in early age at sexual debut.
      Methods: Data from the Cape Area Panel Study (CAPS) of young adults’ conducted between 2002 and 2009 in urban Cape Town were used. Correlates of early sex using ecological risk factors were analysed.
      Results: Overall mean age at sexual debut at follow-up was 17.5 years (standard deviation (SD) =2.5), with males at 16.8 years (SD=2.5) and 18.1 years (SD=2.4) for females. Males consistently reported an earlier age at sex debut across the five waves of the survey. Significant risk factors for early sex appeared at all levels of the ecology to include individual, household, and community factors.
      Conclusions: Integrated interventions for delaying early sex debut should consider factors within the ecology of the young adults’ development context.Keywords: Sex debut, adolescents and young adults, contextual risk factors, cumulative risk.
      Issue No: Vol. 19, No. 4
       
  • Sexual dysfunction: prevalence and associated factors in patients with
           mental illness receiving psychotropic medication in Nigeria

    • Authors: Samuel Obateru Osasona, Mary Ehimigbai
      Abstract: Objectives: The objectives were to determine the prevalence of total and specific sexual dysfunction among psychiatric out-patients taking psychotropic medication, assess its relationship with some demographic and clinical variables, determine the effect of sexual dysfunction on subject’s self- esteem and compliance with medication.
      Methods: This descriptive, cross-sectional study was conducted in the psychiatric out-patient clinic of a Tertiary Care Teaching Hospital in Benin City. The International Index of Erectile Functioning (IIEF), Rosenberg’s self esteem scale and a socio-demographic and clinical data questionnaire were administered to 300 participants; 150 (50%) psychiatric male patients and 150 (50%) controls.
      Results: The prevalence of total sexual dysfunction was 48.7%, while that of the specific SDs ranged from 20.0% to 39.3%, with erectile dysfunction having the highest proportion. Age, marital status, class, dose of psychotropic medication, poly-pharmacy and duration of treatment were significantly associated with SD. Majority of patient with SD reported poor compliance with medication. Self-esteem scores had significant inverse relationship with total SD scores.
      Conclusion: Sexual dysfunction is prevalent amongst psychiatric patients taking psychiatric medication and has negative implications for self-esteem and medication compliance. Routine enquiry about sexual symptoms by physicians and prompt treatment of SD might enhance overall treatment success.Keywords: Sexual dysfunction, psychiatric patients, psychotropic medication, Nigeria.
      Issue No: Vol. 19, No. 4
       
  • High risk human papillomavirus (HPV) common among a cohort of women with
           female genital mutilation

    • Authors: Jeremiah Ogah, Olatunji Kolawole, Daniel Awelimobor
      Abstract: Background: Nigeria accounts for 25% of cases of Female genital mutilation (FGM) worldwide, with increased incidence of cervical cancer.
      Objective: This study was aimed at evaluating the relationship between FGM and HPV in a locality with high prevalence of FGM.
      Methods: Papanicolaou test, DNA hybridization using Polymerase Chain Reaction (PCR), and flow-through hybridization was done to determine the genotypic variants of the HPV. Physical examination and questionnaires were also used to ascertain presence of FGM.
      Results: FGM was found among 98(49%) subjects, while 23(11.5%) had one or more genotype of HPV. Majority of the cases of HPV (78.3%) occurred in FGM subjects. Seventeen Genotypes of HPV were found among subjects with FGM consisting of 11 high risk (16, 18, 31, 33, 35, 39, 52, 56, 73, 81, 82) and 6 low risk (43, 44, 6, 26, 84, 70). A correlation (p value = 0.0052 at 95% CI) was found between FGM and HPV prevalence with a positive result for post hoc analysis. Results show the first reported case of quintuple HPV infection in a single subject in Nigeria.
      Conclusion: FGM needs to be halted as it has no known health benefit yet may increase the risk for cervical cancer.Keywords: HPV, female genital mutilation.
      Issue No: Vol. 19, No. 4
       
  • Risk factors for dysmenorrhea among Ghanaian undergraduate students

    • Authors: Ayokunle Osonuga, Martins Ekor
      Abstract: Background: Menstrual pain is one of the common gynaecological presentations of women of reproductive age to health care physicians. In Ghana, there exist a paucity of research on the risk factors of dysmenorrhea among older females.
      Objectives: Very few studies in Ghana have addressed the risk factors for severe dysmenorrhea among University students. This study aims to identify the common risk factors and associated symptoms of menstrual pain which have been previously not caught the attention of researchers in Ghana.
      Methodology: The study was a descriptive cross-sectional study involving to two hundred female undergraduate students of the University of Cape Coast (UCC), Ghana. Data collected and analysed using standardized and acceptable statistical tools. Verbal multidimensional scoring system for assessment of dysmenorrhoea severity was used in this study to assess the severity of dysmenorrhoea
      Results: More than half (57.3%) of the respondents having pain beginning within the first two days of their menses. The common risk factors that predicted severity of dysmenorrhea (p<0.05) were quantity of menstrual flow and family history of menstrual pain. The common symptoms that accompanied dysmenorrhea were tiredness, loss of appetite, backache, dizziness, diarrhoea and mood changes (p<0.05).
      Conclusion: Dysmenorrhea is a serious public health problem which can be incapacitating. We advocate for more attention to reduce the burden of its negative consequences.Keywords: Dysmenorrhea, Ghana, risk factors, burden. 
      Issue No: Vol. 19, No. 4
       
  • Complementary and alternative treatment methods for menopausal hot flashes
           used in Turkey

    • Authors: Handan Ozcan, Pınar Çolak, Berna Oturgan, Esra Gülsever
      Abstract: Objective: Study was planned to determine complementary and alternative treatment methods for menopausal hot flashes.
      Methods: Women who reported their discomfort of hot flashes as a degree of discomfort of 4 or more according to the Visual Analogue Scale (VAS) were included in the study (n:356). In data collection, Questionnaire Form and Complementary and Alternative Medicine Approaches Scale were used.
      Results: The average age of the women was 56.65±6.05 and the average age of menopause was 46.39±5.25. According to VAS, the average severity of hot flashes was 7.85±1.83.
      Women with obesity and any chronic disease were more likely to have hot flashes. It was determined that 73.6% of women in the menopausal period were using Complementary and Alternative Medicine (CAM). It was determined that women were using herbal supplements, dietary supplements, mind-body practices and religious practices against the discomfort of hot flashes. 72% of women using CAM stated that the method used was effective.
      Conclusion: Women who use CAM usually use it with information that is out of the knowledge of health profession and lack of information. It is recommended to carry out extensive studies for CAM methods and the mechanisms of action that women use.Keywords: Menopause, hot flashes, complementary and alternative medicine.
      Issue No: Vol. 19, No. 4
       
  • How do reproductive age women perceive breast cancer screening in
           Ethiopia' A qualitative study

    • Authors: Feleke Doyore Agide, Gholamreza Garmaroudi, Roya Sadeghi, Elham Shakibazadeh, Mehdi Yaseri, Zewdie Birhanu Koricha
      Abstract:
      Background: Breast cancer remains one of the deadliest non-communicable diseases in the world. In Ethiopia, breast cancer accounts for 33.4% of total cancer diagnosis in women.
      Objective: This study aims to explore perception about breast screening behavior among reproductive age women.
      Methods: This qualitative study was conducted as a baseline to identify gaps to design interventions that will enhance breast screening uptake among reproductive age women. Six focus group discussions and 9 in-depth interviews were conducted with women and health workers respectively. Semi-structured questions were used. Data analysis was analyzed by Atlas.ti. 7 and the ideas were put in direct quotation and narration.
      Results: Lack of awareness is the preceding problem for self-susceptibility to breast cancer as well as for having breast screening. Majority of women thought that the cause of breast cancer was a sin (supernatural power). Self-efficacy and cues to action were the most important correlates of the perception owing to fear of socio-cultural stigma and discrimination.
      Conclusion: All health belief model constructs identified a critical problem for adaptation of behavior. Therefore, this gives the opportunity to design and develop community-based intervention and explore new intervention mechanism with an accurate method.Keywords: Behavior, breast, perception, qualitative data, Ethiopia.
      Issue No: Vol. 19, No. 4
       
  • Attitude of women in a Nigerian local government to reproductive health
           following health education intervention

    • Authors: Chinedu Arthur Idoko, Chinelo Ifeoma Idoko, Ikechukwu Christian Chidolue
      Abstract: Background: Health Education on reproductive health issues is indispensible in fostering safe sexual and reproductive health more so in rural populations. This study aimed at reflecting the role of health education in improvement of attitude of women to reproductive health in a rural Nigerian Local Government (LG).
      Methods: There was a pre-intervention, intervention and post-intervention stages in this cross-sectional study. Baseline data was collected from study and control groups after which health education was only administered to study group. Post-intervention data was collected thereafter. Chi-square Test was used to test for any significant differences while multiple regression analysis was done for factors affecting reproductive health.
      Results: We found a statistically significant increase in parameters relating to study respondents’ attitude to reproductive health post intervention, (p = 0.000 for condoms use and concern about risk of STIs). This was not same for the control group.
      Conclusion: A significant number of women proved a better and positive attitude to reproductive health after intervention such as improved use of condoms to evade risks associated with unprotected sex, concern about risk of HIV and STIsKeywords: Health Education, Reproductive Health, Attitude, women, Nigerian LG.
      Issue No: Vol. 19, No. 4
       
  • Evaluation of the level of awareness of congenital toxoplasmosis and
           associated practices among pregnant women and health workers in
           Tanzania’s Temeke district in Dar es Salaam

    • Authors: Onduru Gervas Onduru, Susan Fred Rumisha, Musso Munyeme, Andrew Malata Phiri
      Abstract: Background: Toxoplasmosis caused by the obligate intracellular coccidian protozoan Toxoplasma gondii (T. gondii) infects all warm-blooded animals including humans. This parasite may develop in both immune-compromised and immunocompetent hosts but usually the disease manifestations strongly differ according to immune status. Immunocompromised hosts develop more severe disease than immunocompetent hosts. Infections in pregnancy carry the risk of foetal involvement and can lead to serious clinical outcomes including psychomotor and ocular disorders in congenitally infected foetuses and children.
      Objective: To assess the level of awareness and practices towards congenital toxoplasmosis among health workers and pregnant women in Tanzania’s Temeke municipality.
      Methods: This was a cross-sectional study involving 371 pregnant women and 22 health workers from six healthcare facilities in Temeke municipality of Dar es Salaam, Tanzania. A structured questionnaire and review of prenatal screening forms were used to collect information. The questionnaire focused on knowledge of disease aetiology, signs and symptoms, modes of transmission, treatment and management.
      Results: Of the pregnant women, 96% (95% CI: 0. 94-0.98) were unaware of the disease, had never heard, read or seen any information regarding toxoplasmosis. The majority of respondents including those who had heard, read or seen information concerning toxoplasmosis were unaware of the disease aetiology, signs and symptoms. However, 90% (95% CI: 0.86–0.93) of respondents unknowingly observed preventive practices towards the disease including avoiding eating raw, cured or rare meat. There was a significant statistical relationship between practices towards toxoplasmosis and age of pregnant women, such that for every increase in age by ten years the risk practices towards toxoplasmosis increased by 41% (OR=1.41, 95%, C.I. 1.05-1.90). Preventive practices towards toxoplasmosis decreased significantly by 74% and 78% for the age of 19-25 and 26-35 years old pregnant women respectively, as compared to those < 19 years. No significant difference was observed for those aged > 35 years. Multigravidae was associated with at-risk practices towards toxoplasmosis (OR=2.65, CI: 1.38-5.08). Of the 22 health workers who participated in the study, 36% (95% CI: 0.15–0.58) were aware of the congenital toxoplasmosis and its clinical outcomes. None of them had diagnosed the disease before.
      Conclusion: Due to general lack of awareness towards toxoplasmosis observed among both health workers and pregnant women in Temeke Municipality, we recommend health policy on maternal and child healthcare to address prenatal screening that is aimed at providing early diagnosis for any possible congenital toxoplasmosis as well as diseases that are currently screened in Tanzania such as HIV, syphilis and malaria. Integrating a One Health approach in educating medical professionals and the vulnerable population of pregnant women on the importance of congenital zoonoses will promote awareness and preventive practices towards the disease.Keywords: Toxoplasmosis awareness, pregnant women, health workers, Dar es Salaam, Tanzania.
      Issue No: Vol. 19, No. 4
       
  • Impact of parity and gestational age of mothers with hypertension on birth
           weight, red blood cells and mode of delivery of their babies

    • Authors: Helen Chioma Okoye, Chilota Chibuife Efobi, Josephat Maduabuchi Chinawa, Odutola Israel Odetunde, Awoere Tamunosiki Chinawa, Elias Chikee Aniwada
      Abstract: Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies.
      Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables.
      Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20.
      Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)
      For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287).
      Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.Keywords: Hypertension; neonate; gestational age; parity.
      Issue No: Vol. 19, No. 4
       
  • The current pattern of facility-based perinatal and neonatal mortality in
           Sagamu, Nigeria

    • Authors: Tinuade A Ogunlesi, Victor A Ayeni, Olusoga B Ogunfowora, Edward O Jagun
      Abstract: Background: Perinatal and neonatal mortality rates have been described as sensitive indices of the quality of health care services. Regular audits of perinatal and neonatal mortalities are desirable to evaluate the various global interventions.
      Objective: To describe the current pattern of perinatal and neonatal mortality in a Nigerian tertiary health facility.
      Methods: Using a prospective audit method, the socio-demographic parameters of all perinatal and neonatal deaths recorded in a Nigerian tertiary facility between February 2017 and January 2018 were studied.
      Results: There were 1,019 deliveries with stillbirth rate of 27.5/1000 total births and early neonatal death (END) rate among in-born babies of 27.2/1000 live births. The overall perinatal mortality rate for in-facility deliveries was 53.9/1000 total births and neonatal mortality (till the end of 28 days) rate of 27.2/1000 live births. Severe perinatal asphyxia and prematurity were the leading causes of neonatal deaths while obstructed labour and intra-partum eclampsia were the two leading maternal conditions related to stillbirths (25.0% and 21.4% respectively).
      Gestational age < 32 weeks, age < 24 hours and inborn status were significantly associated with END (p = 0.002, p <0.001 and p = 0.002 respectively).
      Conclusion: The in-facility perinatal mortality rate was high though stillbirth rate was relatively low. There is a need to improve the quality of emergency obstetric and neonatal services prior to referral to tertiary facilities.Keywords: Asphyxia, neonatal death, obstructed labour, perinatal death, stillbirth.
      Issue No: Vol. 19, No. 4
       
  • Prevalence and maternal socio-demographic factors associated with
           stillbirth in health facilities in Anambra, South-East Nigeria

    • Authors: Nonye E Anyichie, Evelyn N Nwagu
      Abstract: Background: Stillbirth is a major adverse perinatal outcome especially in low and middle income countries across the globe. Certain factors relating to mothers from such countries may be associated with this adverse condition.
      Objectives: To determine the prevalence of stillbirth and also explore the maternal socio-demographic factors associated with stillbirth among mothers in rural communities in Anambra Central Senatorial District of Anambra State Nigeria who gave birth between January 2012 and December 2016.
      Methods: All case files of mothers who were delivered of their babies were accessed at the sampled health facilities in the district. Data were collected using a structured proforma. A total of 313 stillbirth cases were recorded across the health facilities from 2012-2016.
      Results: The highest prevalence of stillbirth was recorded in 2012 (38.07 per 1,000 total births). The prevalence of stillbirth was significantly associated with the maternal level of education, occupation, age and type of health facility the mother utilized (p<0.05).
      Conclusions: We recommend that women empowerment should be a priority at both family and community levels to enable women to seek and obtain necessary care during pregnancy and delivery.Keywords: Stillbirth; mothers; prevalence; health facilities.
      Issue No: Vol. 19, No. 4
       
  • Adequacy of macro and micronutrients in infants and young children’s
           diets in Zanzibar, Tanzania

    • Authors: Joyce Kinabo, Peter Mamiro, Akwilina Mwanri, Nyamizi Bundala, Kissa Kulwa, Janeth Picado, Julius Ntwenya, Aneth Nombo, Rehema Mzimbiri, Fatma Ally, Asha Salmini, Abuu Juma, Elizabeth Macha, Edith Cheung, John Msuya
      Abstract: Background: A study was conducted in Zanzibar using ProPAN software to assess nutrient adequacy of foods given to infants and children aged 6-23 months old in Zanzibar.
      Methodology: The 24-hr dietary recall method embedded in ProPAN software was used to determine the adequacy of energy, protein, iron, calcium, zinc and vitamin A in foods consumed by children. Sample of 200 mothers/caretakers with children aged 6-23 months were interviewed.
      Results: Most frequent foods given to infants and children were tea, bread, white rice and fish. Key nutrients such as iron, zinc and vitamin A were below the recommended levels except for vitamin C from the diets consumed by children aged 11-23 months. Energy and protein were considered to be adequate as more than 90% of the children received enough of these nutrients. Mean age of introduction of complementary foods was four months.
      Conclusion: Children diets were limited in fruits and vegetables that caused micronutrients of nutritional importance such as iron, zinc and vitamin A to be supplied below recommended level. Equally, fat intake was below recommended level. Nutrition education on appropriate complementary foods should be given to caregivers. Promotion of consumption of diversified diets and locally available nutrient dense foods should be emphasized so as to achieve adequate intake of nutrients to infants and young children. Keywords: ProPAN, children, nutrient adequacy, Zanzibar.
      Issue No: Vol. 19, No. 4
       
  • Under-five malnutrition in a South-Eastern Nigeria metropolitan city

    • Authors: Chukwuemeka Kenechukwu Jude, Agozie Ubesie Chukwunedum, Kunle Obidike Egbuna
      Abstract: Background: Malnutrition (under and overnutrition) presents significant threats to child health. The co-existence of under and overnutrition in a population is increasingly being described in the literature .
      Objective: To identify the prevalence of malnutrition among under-five children in Enugu metropolis.
      Methods: A cross-sectional study of pre-primary school children conducted from January to May 2016. using stratified sampling technique. Caregiver-administered questionnaire was used to obtain relevant information. Weights and heights were measured using a standard weight scale and stadiometer/ length mat respectively. Wasting, stunting, overweight and obesity were determined based on the recommended WHO Growth Standard. Data analysis was done with SPSS version 20.0. The associations between nutritional status on one hand, and categorical variables such as age grouping, sex, socio-economic status, and maternal educationwere determined using chi square. . P-value < 0.05 were reported as statistically significant.
      Results: Eighteen (2.4%) and 26 (3.5%) subjects were wasted and stunted respectively. Eleven (1.5%) subjects were overweight while another 11(1.5%) subjects were obese. Risk factors for undernutrition were maternal education and low socioeconomic class while risk factor for overnutrition was upper socioeconomic class..
      Conclusion: There is a low rate of malnutrition in the area of study. However, sustained efforts must continue to prevent further rise and possibly eliminate the scourge of malnutrition.Keywords: Malnutrition, Nigeria.
      Issue No: Vol. 19, No. 4
       
  • A review of clinical presentation and physiotherapy management of cerebral
           palsy patients in Esut teaching hospital, Enugu, Nigeria

    • Authors: Wilfred Okenwa, Anthony Edeh
      Abstract: Background: Cerebral palsy affects the general neurological development of those involved. This usually culminates into various muscular deficits some of which are amenable to physiotherapy intervention and rehabilitation.
      Method: A 6 year retrospective study was conducted to find out the clinical presentation and physiotherapy management of cerebral palsy patients in ESUT Teaching Hospital Enugu, Nigeria, between June 2009 and May, 2015.
      Result: 146(30.2%) cases of cerebral palsy were noted out of 483 children seen within the period. There was male predominance n- 86(58.9%) and the commonest cause of cerebral palsy was birth asphyxia n- 56(38.4%).
      Several physiotherapy treatment modalities were applied, the common ones being neurodevelopment therapy, trans-cutaneous electric nerve stimulation, and passive and active exercise modules.
      Majority of the patients’ accessed treatment less than 5 times n- 86(59%) and were lost to follow up subsequently. Slightly more than 10% of the patients accessed treatment consistently for 3 months.
      Conclusion: High level of abandonment of treatment and lack of more modern physiotherapy modalities were noted. There is need to emphasize better health education of parents/guardians of the patients and improve social welfare benefits for the patients.Keywords: Cerebral palsy, rehabilitation, social welfare.
      Issue No: Vol. 19, No. 4
       
  • An empirical study exploring the determinants of stress among medical
           healthcare professionals

    • Authors: Amna Anjum, Ali Anjum, Umaira Anjum, Xu Ming
      Abstract: Background: Medical profession is considered as one of the stressful professions. Work related stress level among the general working population is around 18% while the stress level among the healthcare practitioners is around 28%. Multiple stressors contribute to the stress of doctors resulting in negative consequences.
      Objective: The objective of the current study was to determine, categorize and to rank the existing stressors according to their significance for medical healthcare professionals in Pakistan.
      Method: A self-administered questionnaire was used to collect data from 327 doctors. 47.2% were males while 52.8% were females. A structured questionnaire was developed and convenience sampling technique was applied to collect the data from the different positions of healthcare professionals. Exploratory factor analysis (EFA) was performed to categorize and to analyse the underlying structure of stressors. Finally, the stressors were ranked according to their significance.
      Results: Appropriateness of factor model was judged through Kaiser, Meyer and Olkin (KMO) index which was 0.905, and by Bartlett’s Test of Sphericity which resulted significant (Approx. Chi- Square= 1111.529, Df =136, Sig.=0.000). Seventeen stressors were converted into four categories by factor analysis and were supported by both scree plot and eigen values. The variance explained by the first, second, third and fourth component was 20.89%, 19.09%, 16.33%, and 11.72% respectively. The 4 components cumulatively explained 68.03% of the total variability in the data, hence supported the extraction of 4 components.
      Conclusion: There are number of factors which enhance the stress of healthcare professionals. In Pakistan, the major stressor of medical healthcare professionals is “career & reward prospects” followed by “workplace environmental stressor”. “Job demand & performance stressor’’ ranks third among the list of stressors and “interpersonal stressor’’ ranks fourth according to significance for healthcare professionals.Keywords: Stress, stressors, medical healthcare professionals, Pakistan.
      Issue No: Vol. 19, No. 4
       
  • Core competencies acquired in indigenous training of traditional health
           practitioners in Kwazulu-Natal

    • Authors: Mbatha Nompumelelo, Exnevia Gomo, Nceba Gqaleni, Mlungisi Ngcobo
      Abstract: Introduction: Despite the recognition of Traditional Medicine systems as a critical component of health care by the WHO and the African Union, its integration into the health care mainstream remains very subdued in South Africa. This is partly due to the lack of empirical data pertinent to traditional healer training that could inform the accreditation process.
      Objective: To determine core competencies acquired by Traditional Health Practitioners (THP) of KwaZulu-Natal Province, South Africa during their apprenticeship.
      Materials and methods: Purposeful, convenient and snowballing sampling and the sequential data collection methods of questionnaires, journaling and focus groups was used to collect data from the THP tutors and their trainees in rural, peri-urban and urban areas of eThekwini and uThungulu Districts of Kwa Zulu Natal (KZN).
      Results: Eleven core competencies were identified: consultation, diagnoses, holistic patient care and treatment, integrative and holistic healing, application of healing procedures and cultural rituals, spiritual development, ethical competencies, problem solving, herbalism, ancestral knowledge and end of life care.
      Conclusion: The apprenticeship of THPs in KZN is based on eleven core competencies. These competencies are fundamental pillars for critical health care provided by THPs and are crucial for setting standards for the accreditation of traditional training in South Africa if the THP Act 22 of 2007 is to achieve its purpose of providing for the management of and control over the registration, training and conduct of the practitioners. Hence, the appointed interim THP Council should include the identified competencies when articulating bases for accreditation of the training and assessments.Keywords: Indigenous training, traditional health practitioners, Kwazulu-Natal.
      Issue No: Vol. 19, No. 4
       
  • Medical error reporting among physicians and nurses in Uganda

    • Authors: Gideon Mauti, Margaret Githae
      Abstract: Background: Patient safety is a fundamental component of health care quality and medical errors continue to occur, placing patients at risk. Medical error reporting systems could help reduce the errors.
      Purpose: This study assessed “Medical error reporting among Physicians and Nurses in Uganda”. The objectives were; (1) identify the existing medical error reporting systems. (2) Assess the types of medical errors that occurred. (3) Establish factors influencing error reporting.
      Methods: A cross-sectional, descriptive study in Kisubi and Entebbe hospitals between March to August 2013, with quantitative methods.
      Results: Medical errors occurred in the two hospitals (53.2%), with overdoses (42.9%) leading. Neither hospital had a medical error reporting system. More than two thirds, 42(64.6%), would not report. Almost half, 29(44.6%) believe reporting a medical error is a medical obligation. Majority, 50(76.9%), believed the law does not protect medical error reporting. Not punishing health workers who report medical errors, (53.8%) and ‘training on error reporting (41.70%) are the greatest measures to improve medical error reporting among nurses and physicians respectively.
      Conclusion: Medical errors occur in the two hospitals and there are no reporting systems. Health workers who report medical errors should not be punished.Keywords: Medical error reporting, physicians, nurses, Uganda.
      Issue No: Vol. 19, No. 4
       
  • Pseudoscience in medicine: cautionary recommendations

    • Authors: Chris Callaghan
      Abstract: Introduction: Certain real life applications of scientific and social science ideas that knowingly reject accumulated empirical biomedical evidence have been termed ‘pseudoscience,’ or empirical rejectionism. An uncritical acceptance of empiricism, or even of evidence-based medicine, however, can also be problematic.
      Objectives: With reference to a specific type of medical denialism associated with moral failure, justified by dissident AIDS and anti-vaccine scientific publications, this paper seeks to make the argument that this type of denialism meets certain longstanding definitions for classification as pseudoscience.
      Methods: This paper uses a conceptual framework to make certain arguments and to juxtapose arguments for evidence-based approaches to medicine against literature that highlights certain limitations of an unquestioning approach to empiricism.
      Results: Discussions of certain real life examples are used to derive the important insight that, under certain conditions, moral failure can result in the violation both Type I and Type II scientific error types, with catastrophic consequences.
      Conclusion: It is argued that the validity of all theory should not be assumed before sufficient empirical evidence has accumulated to support its validity across contexts. However, caution is required, to avoid the consequences of an unquestioning approach to empiricism.Keywords: Pseudoscience; denialism; medical practice; medical theory; empiricism.
      Issue No: Vol. 19, No. 4
       
  • Intra-operative low-dose ketamine does not reduce the cost of
           post-operative pain management after surgery: a randomized controlled
           trial in a low-income country

    • Authors: Luca Ragazzoni, Arthur Kwizera, Marta Caviglia, Moran Bodas, Jeffrey Michael Franc, Hannington Ssemmanda, Alba Ripoll-Gallardo, Francesco Della-Corte, Annet Alenyo-Ngabirano
      Abstract: Background: In developing countries, post-operative pain remains underestimated and undertreated due to economic constraints, lack of awareness and limited resources. In contrast, ketamine is an effective, readily available, easy to use and inexpensive drug frequently used in poor settings.
      Objectives: The aim of this study was to explore the overall reduction in the medication treatment cost of acute post-operative pain by adding intra-operative low-dose ketamine to traditional intravenous morphine for surgery in a low-income country.
      Methods: A double blind randomized controlled trial with placebo-controlled parallel group was performed in Mulago National Hospital (Uganda). Consenting adults scheduled for elective surgery were randomized into two study arms: Group K received ketamine 0.15mg/kg bolus at induction and a continuous infusion of 0.12 mg/kg/hour till start of skin closure; Group C (control) received normal saline. Both groups received Morphine 0.1 mg/kg IV at debulking. The total medication cost was registered. NRS pain scores and other measurements such vital signs and incidence of major and minor side effects were also recorded.
      Results: A total of 46 patients were included. Patients’ baseline characteristics were comparable in both groups. No statistically significant difference was found between the groups concerning the overall medication cost of post-operative pain management. Pain scores, patients’ satisfaction in the first 24 hours after surgery and hospital length of stay were similar in both groups.
      Conclusion: Our results do not support the utilization of intra-operative low dose ketamine as a cost-saving post-operative pain treatment strategy for all types of surgery in low-resource settings.Keywords: Post-operative pain management, ketamine, low-income country, RCT.
      Issue No: Vol. 19, No. 4
       
  • Effect of target controlled propofol infusion versus intermittent boluses
           during oesophagogastroduodenoscopy: a randomized controlled trial

    • Authors: Catherine Ndosi, Vitalis Mung’ayi, Ednah Gisore, Samina Mir
      Abstract: Background: Propofol is administered as intermittent boluses to achieve deep sedation to facilitate oesophagogastroduodenoscopy. Target controlled infusion (TCI) can be employed for this purpose.
      Methods: 176 adults were randomly allocated into two groups of 88 patients. Control group: Received an initial bolus of propofol 1mg/kg, with repeat boluses of 0.25mg/kg. Intervention group: Received an initial target effect-site concentration of 4mcg/ml, followed by maintenance target effect-site concentration of 2.5mcg/ml, titrated by 0.5mcg/ml from baseline infusion rate as needed. Oxygen saturation, blood pressure and heart rate were evaluated immediately before administering the sedative and at 2.50, 5.00, 7.50 and 10.00 minutes. Oxygen desaturation below 90% in both study groups was recorded. Sedation starting time, stopping time, waking up time and overall duration of time to recovery of participants in each study arm was recorded.
      Results: More hypoxic episodes were observed in the intermittent bolus group with statistically significant association between control and the incidence of hypoxia: Chi square test, p=0.037. There were more hypotensive episodes in the TCI group but not achieving statistical significance: Chi square test for association X2(1) = 0.962, p=0.327.The time to recovery between the two groups was comparable, with 18.84 ± 10.76 minutes in the bolus group and 19.72 ± 9.27 minutes in the TCI group; no statistically significant difference was shown: Student’s t-test, p=0.0564.
      Conclusion: TCI of propofol was associated with fewer episodes of hypoxia compared to intermittent bolus administration. Similar hemodynamic profiles and comparable time to recovery were demonstrated by these two sedation techniques.Keywords: Target controlled propofol infusion, intermittent boluses, oesophagogastroduodenoscopy.
      Issue No: Vol. 19, No. 4
       
  • Self-rated oral health status and social and health determinants among
           community dwelling adults in Kenya

    • Authors: Supa Pengpid, Karl Peltzer
      Abstract: Background: The aims of this study were to estimate the self-rated oral health status and its associated factors in a national community dwelling population in Kenya.
      Methods: A cross-sectional study based on a stratified cluster random sampling was conducted in 2015. The total sample included 4,459 individuals 18-69 years (M=40.4 years, SD=13.9). Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted, including questions on the oral health status, general health status, oral health behaviour and socio-demographic information.
      Results: Overall, 13.7% of participants reported poor self-rated oral health. In adjusted logistic regression analysis, older age (Odds Ratio-OR: 1.70, Confidence Interval-CI: 1.07, 2.69), having a lower number lover number of teeth (OR: 0.19, CI: 0.06, 0.62), having dentures (OR: 1.92, CI: 1.22, 3.03), having pain in the mouth or teeth (OR: 5.62, CI: 3.58, 8.90), impaired Oral Health Related Quality of Life (OR: 3.01, CI: 2.03, 4.47) and frequent soft drink consumption (OR: 3.62, CI: 1.89, 6.97) were associated with poor self-rated oral health.
      Conclusion: High unsatisfied self-rated oral health status was found and several risk factors for poor self-rated oral health were identified that can help in guiding oral health care programming in Kenya. Keywords: Self-rated oral health status, oral conditions, oral health behaviour, general health status, general health behaviour, adults, Kenya.
      Issue No: Vol. 19, No. 4
       
  • A retrospective clinico-pathologic analysis of cemento-osseous dysplasia
           in a South African patient population

    • Authors: Mouna M Benaessa, Farzana Mahomed, Sizakele P Ngwenya
      Abstract: Background: Cemento-osseous dysplasia (COD) is a fibro-osseous jaw bone lesion. The affected bone in COD progressively becomes sclerotic, poorly vascularized and susceptible to secondary osteomyelitis.
      Objective: To provide a clinico-pathologic appraisal of COD in a South African patient population.
      Methods: Archived records of 133 patients diagnosed with COD were reviewed for patient demographics, COD location, COD type, osteomyelitis or simple bone cyst secondary to COD.
      Results: The mean age was 53.4 ± 13.5 years with a 94.7% female predilection. COD mainly affected the mandible (57.1%), followed by involvement of both jaws (38.3%) and maxilla (4.5%). Florid COD was the most prevalent (69.9%), followed by focal COD (18%) and periapical COD (12%). Florid COD showed a clear trend of increasing with age, peaking in the sixth decade and decreasing thereafter. Osteomyelitis and simple bone cyst presented as complications of COD in 74.4% and 5.3% of cases respectively, while 21.8% of all cases of jaw osteomyelitis during the study period were secondary to COD.
      Conclusion: A higher frequency of jaw osteomyelitis secondary to COD was found compared to previous studies. No significant association was shown between any of the COD types and secondary osteomyelitis.Keywords: Cemento-osseous dysplasia, South Africa, patient population.
      Issue No: Vol. 19, No. 4
       
  • Stigmatization and discrimination as predictors of self-esteem of people
           living with HIV and AIDS in Nigeria

    • Authors: Dorothy Ebere Adimora, Eucharia Nchedo Aye, Immaculata Nwakaego Akaneme, Edith Nwakaego Nwokenna, Francis Ekenechukwu Akubuilo
      Abstract: Background: Self-esteem is a major psychological health issue. People living with HIV and AIDS have been found to be victims of discrimination and stigmatization which affect their self-esteem.
      Objectives: The study investigated the influence of stigma and discrimination on self-esteem of people living with HIV and AIDS (PLHIV).
      Methods: The design was a cross-sectional study carried out in four teaching hospitals in south-eastern Nigeria between 13th July 2016 - 11th May 2017. Four hundred and eighty-four (174 males and 310 females) PLHIV participated in the study. Quantitative study supplemented by qualitative in-depth interviews were used to collect data regarding discrimination, stigma and self-esteem of PLHIV whilst a structured questionnaire was used to elicit information about the socio-demographic variables.
      Results: Stigmatization and discrimination were found to have significant influence on self-esteem of PLHIV. The results indicate that stigmatization and discrimination, together with income, work status, AIDS diagnosis status, and medication use status significantly influence self-esteem of PLHIV. These results imply that stigmatization and discrimination influences on self-esteem among PLHIV.
      Conclusion: Conclusively, intervention programmes should evolve enlightenment through television, movies, and educational programs that incorporate the ill effects of discrimination and stigma so as to boost self-esteem of PLHIV.Keywords: Intervention; psychological health; poverty; pocial isolation.
      Issue No: Vol. 19, No. 4
       
  • Psychometric validity of the distress thermometer and problem check list
           in ART-naïve HIV infected patients in Northern Nigeria

    • Authors: Victor Olisah Obiajulu, Tajudeen Abiola, Christopher Okpataku Izehinosen, Reginald O Obiako, Ishaq Audu Aveka, Bashir Yakasai Adam, Taiwo Sheikh Lateef
      Abstract: Background: HIV diagnosis comes with a lot of worry and distress. Ability to objectively estimate this distress by non-psychiatrist will enhance early detection of psychological distress for intervention.
      Objectives: To investigate the validity of the Distress Thermometer (DT) and its problem checklist in achieving early detection of mental distress among ART-naïve HIV infected patient.
      Materials and Methods: A total of 90 ART-naïve HIV infected patients completed the DT and its problem check list, Hospital Anxiety Depression Scale (HADS), Oslo Social Support Scale and the 14-item Resilience Scale.
      Results: The DT was positively correlated with all the measures of distress and reversely correlated with all the positive wellness in this study. The correlations were only significant for the negative measures of psychological wellness. The internal consistency of the DT’s problem list overall and sub-categories were within acceptable range (i.e. α > 0.50). The Receiver Operating Characteristic (ROC) curves and Area Under the Curves (AUC) analysis were significant and found the DT and Problem List to respectively differentiate between cases of distress, anxiety and depression. The DT’s cut-off was >5.0 with AUC range (0.754 – 0.709); sensitivity range (81.0% – 70.4%); specificity range (68.3% – 65.2%) for distress, anxiety and depression as determined by HADS. And the Problem List cut-off was >6.0 with AUC range (0.854 – 0.821); sensitivity range (90.5% - 85.7%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as measured by HADS.
      Conclusion: The DT and Problem List were found to be valid measures of distress in ART-naïve HIV infected patients. Keywords: Distress thermometer, validity, psychological distress, ART-naïve, Northern Nigeria.
      Issue No: Vol. 19, No. 4
       
  • Knowledge about modifiable risk factors for non-communicable diseases
           adults living with HIV in Rwanda

    • Authors: Juvenal Biraguma, Eugene Mutimura, José M Frantz
      Abstract: Background: Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV’s NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes.
      Objective: To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda.
      Methods: A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients’ public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23.
      Results: Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count (< 350 cells/mm3) and normotension.
      Conclusion: The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases’ risk factors for adults living with HIV in Rwanda.Keywords: Non-communicable diseases, Risk factors, HIV infection, Knowledge, Rwanda.
      Issue No: Vol. 19, No. 4
       
  • Uptake and utilization of institutional voluntary HIV testing and
           counseling services among students aged 18-24 in Kenya’s public
           Universities

    • Authors: Caliph Cheruiyot, Dennis Magu, Patrick Mburugu, Daniel Sagwe
      Abstract: Background: Kenya is home to an estimated 1.7 million people living with HIV/AIDS. According to the Kenya AIDS Indicator survey KAIS 2012, HIV prevalence in the age group 15-24 stood at 2.2%. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, uptake of HIV testing and counseling services among the youth in Kenya has been reportedly low. Youths at Universities are among the priority populations in HIV/AIDS programs.
      Objectives: This study aimed to determine the barriers to uptake and utilization of institution-based voluntary counseling and testing VCT services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the factors associated with uptake and utilization and the association between various socio-demographic factors and service uptake in institutional VCT facilities.
      Methods: This research utilized a descriptive cross-sectional study design where primarily, data was collected using semi-structured questionnaires and through focus group discussions held with the students in the sampled Universities. Data available at Jomo Kenyatta University of Agriculture and Technology JKUAT Hospital VCT were reviewed for the period 2010 and 2016 to give an insight into service utilization rates among students. Multi-stage sampling technique was utilized to reach a student sample size of 305 from the selected public Universities in Kenya.
      Results: Uptake of institutional VCT services among University students sampled stood at 45% from a population where 84.4% were aware of the presence of these services on their campuses. More males than females utilized the services. Emerging themes from the study indicated that participants utilized the services for different reasons. Accessibility to test site, testing hours, fear to be seen at site and fear of test result were also identified as factors affecting service uptake. These factors also were also reported when students were asked about their desired characteristics of a VCT facility on campus.
      Conclusion: This study has unraveled the factors that are associated with testing and counseling in institutional facilities. University students seem to seek and utilize VCT services for different reasons. It is also clear that patterns of services utilization vary from group to another as observed in the case of year of study, gender and age category.
      Recommendations: It is necessary for policy makers in institutions of higher learning together with those tasked with managing healthcare services in these institutions to adopt approaches that will overcome the barriers to utilization of VCT services among students. With knowledge of the factors associated with uptake and utilization of VCT services in institutional facilities, efforts to tackle the barriers and maximize on enhancers should be utilized fully in order to improve uptake and utilization of services. More research should also focus on the persisting risky sexual behaviors among University students despite the high knowledge they have on HIV/AIDS.Keywords: Higher learning institutions, voluntary counseling and testing, HIV, barriers and uptake.
      Issue No: Vol. 19, No. 4
       
  • An overview of Pneumocystis jirovecii pneumonia for the African generalist
           practitioner

    • Authors: I Govender, O M Maphasha, S Rangiah, C Steyn
      Abstract: Introduction: Pneumocystis jirovecii is the causative organism of Pneumocystis pneumonia (PCP) in humans, which is more common among immunocompromised patients. Classically patients present with fever, non-productive cough, and dyspnoea. In the HIV-infected individuals the symptoms may be subtle at first, but gradually progress over several weeks. In the HIV-uninfected patient, however, the duration of symptoms is shorter and more severe, mainly due to the increased inflammatory response of the HIV-uninfected patient.
      Methods: This article focuses on the diagnostic methods and then the management and prophylaxis principles of PCP by reviewing the best current practices and guidelines in Africa.
      Conclusion: This overview is presented by clinicians who have experience with PCP and is directed mainly at first-line healthcare providers.Keywords: Pneumocystis jirovecii pneumonia, african generalist practitioner.
      Issue No: Vol. 19, No. 4
       
  • Seroprevalence, risk factors and comorbidities associated with
           Helicobacter pylori infection amongst children receiving care at
           Kilimanjaro Christian Medical Center

    • Authors: Amos Msekandiana, Levina Msuya, Rune Philemon, Blandina M'mbaga, Grace Kinabo
      Abstract: Background: Helicobacter pylori frequently causes gastritis and peptic ulcers, and affected children are at risk of developing gastric carcinoma later in adulthood.
      Methods: This was a Hospital based cross sectional study. A total of 200 children aged 6 months to 14 years were enrolled. Study subjects were tested for H. pylori using a standard serology rapid test measuring immunoglobulin G for H. pylori. For risk factors, Chi-square tests were used to test for association and then, odds ratios and their corresponding 95% confidence intervals and p-values were computed using logistic regression.
      Results: The overall seroprevalence of H. pylori was 11.5%. The following factors were associated with H. pylori infection: Age group above 10 years, keeping a dog and household size. The independent predictors of H. pylori were: Fathers’ occupation, keeping a dog, indoor tap water, age group, household size and diabetes mellitus type 1.
      Conclusion: The seroprevalence of H. pylori antibodies was lower compared to most developing countries. Keeping a dog, household size, indoor tap water, fathers’ occupation and diabetes mellitus type 1 were found to be independent predictors of presence of H. pylori antibodies.Keywords: Helicobacter Pylori.
      Issue No: Vol. 19, No. 4
       
  • C - reactive protein and urinary tract infection due to Gram-negative
           bacteria in a pediatric population at a tertiary hospital, Mwanza,
           Tanzania

    • Authors: Martha F Mushi, Vaileth G Alex, Mwanaisha Seugendo, Vitus Silago, Stephen E Mshana
      Abstract: Introduction: Gram-negative bacteria are the major cause of urinary tract infections (UTI) in children. There is limited data on UTI systemic response as measured using C-reactive protein (CRP). Here, we report the association of CRP and UTI among children attending the Bugando Medical Centre, Mwanza, Tanzania.
      Methods: A cross-sectional study was conducted between May and July 2017. Urine and blood were collected and processed within an hour of collection. Data were analyzed using STATA version 13.
      Results: Of 250 enrolled children, 76(30.4%) had significant bacteriuria with 56(22.4%, 95%CI; 11.5-33.3) having gram-negative bacteria infection. There was dual growth of gram-negative bacteria in 3 patients. Escherichia coli (32.2%, 19/59) was the most frequently pathogen detected. A total of 88/250(35.2%) children had positive CRP on qualitative assay. By multinomial logistic regression, positive CRP (RRR=4.02, 95%CI: 2.1-7.7, P<0.001) and age ≤ 2years (RRR=2.4, 95%CI: 1.23-4.73, P<0.01) significantly predicted the presence of significant bacteriuria due to gram-negative enteric bacteria.
      Conclusion: C-reactive protein was significantly positive among children with UTI due to gram-negative bacteria and those with fever. In children with age ≤ 2 years, positive CRP indicates UTI due to gram-negative enteric bacteria.Keywords: C - reactive protein, urinary tract infection, Gram-negative bacteria, Mwanza, Tanzania.
      Issue No: Vol. 19, No. 4
       
  • The diagnostic accuracy of routine clinical findings for detection of
           esophageal varices in rural sub-Saharan Africa where schistosomiasis is
           endemic

    • Authors: Christopher K Opio, Lalitha Rejani, Francis Kazibwe, Ponsiano Ocama
      Abstract: Background: Variceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices.
      Objectives: We determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among patients with UGIB in rural SSA where schistosomiasis is endemic.
      Methods: We studied patients with a history of UGIB. The index tests included routine clinical findings and the reference test was diagnostic endoscopy. Multivariable regression with post-estimation provided measures of association and diagnostic accuracy.
      Results: We studied 107 participants with UGIB and 21% had active bleeding. One hundred and three (96%) had liver disease and 86(80%) varices. Factors associated with varices (p-value <0.05) were ≥ 4 lifetime episodes of UGIB, prior blood transfusion, splenomegaly, liver fibrosis, thrombocytopenia, platelet count spleen diameter ratio <909, and a dilated portal vein. Two models showed an overall diagnostic accuracy of > 90% in detection of varices with a number needed to misdiagnose of 13(number of patients who needed to be tested in order for one to be misdiagnosed by the test).
      Conclusion: Where access to endoscopy is limited, routine clinical findings could improve the diagnosis of patients with UGIB in Africa.Keywords: The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic.
      Issue No: Vol. 19, No. 4
       
  • The effect of myometrial invasion on prognostic factors and survival
           analysis in endometrial carcinoma

    • Authors: Cem Dane, Sait Bakir
      Abstract: Background: We investigated the relationship between myometrial invasion and the prognostic factors on overall and progression free survival in endometrial carcinoma.
      Methods: 122 cases operated with endometrial cancer were included into the study. Progression-free survival and overall survival were evaluated according to degree of myometrial invasion. We also investigated the relationship between myometrial invasion and prognostic factors.
      Results: The 5- year progression-free survival rate was 90 % in stage I, 66 % in stage II, 32 % in stage III and 60 % in stage IV. The 5- year overall survival rate was 95 % in stage I, 89 % in stage II, 49 % in stage III and 30 % in stage IV. The progression free survival and overall survival for patients with more than 50 % myometrial invasion were detected 67 % at 58 months and 66 % at 60 months, respectively. The clinicopathological variables that significantly correlated with myometrial invasion of more than 50 % were as follows: pelvic lymph node metastasis (p: 0,00029-OR: 11.2), cervical stromal invasion (p: 0008-OR:7.9), LVSI (p< 0.0001-OR: 16.5).
      Conclusion: The depth of myometrial invasion is one of the most important prognostic indicators and determinants of therapy in endometrial cancer.
      Keywords: Endometrial carcinoma; Progression free survival; Overall survival; Prognostic factors.
      Issue No: Vol. 19, No. 4
       
  • Immunoglobulin heavy variable (IgHV) gene mutation and micro-RNA
           expression in Burkitt’s lymphoma at Moi Teaching and Referral Hospital
           in Western Kenya

    • Authors: Isaac Ndede, S K Mining, K Patel, F M Wanjala, C Tenge
      Abstract: Introduction: Burkitt’s lymphoma (BL) is a virus associated childhood B-cell cancer common in Eastern Africa. Continued survival of B-cells in germinal centres depend on expression of high affinity immunoglobulins (Ig) to complementary antigens by somatic hypermutation of Ig genes. Cellular microRNAs, non-coding RNAs have been reported to play role in cell cycle regulation. Both viral antigen dependent mutation and micro-RNA expression maybe involved in BL pathogenesis.
      Objective: To describe immunoglobulin heavy variable (IgHV) rearrangement and micro-RNA expressions in BL tumours.
      Methods: Genomic DNA were extracted and purified from BL tissue blocks at Moi Teaching and Referral Hospital, before amplification using IgHV consensus primers and sequencing. The sequences were then aligned with germline alleles in IMGT/V-QUEST® database. Total RNA extracted from tissue blocks and cell lines were used to determine relative expression of hsa-miR-34a and hsa-miR-127.
      Results: In all tumours, allele alignment scores and number of mutations range were 89.2-93.2%, 15-24 respectively. The range of IgHV amino acid changes were higher in EBER-1+ (15-25) than EBER-1- (9-15). In MYC+ tumours, the relative expression were: hsa-miR-127(2.09);hsa-miR-34a (2.8) and MYC- hsa-miR-127 (1.2), hsa-miR-34a (1.0).
      Conclusion: B-cell in BL contained somatic mutated IgHV gene and upregulated cellular microRNAs with possible pathogenetic role(s).Keywords: IgHV; somatic hypermutation; microRNA; Burkitt’s lymphoma.
      Issue No: Vol. 19, No. 4
       
  • Generalized lymphadenopathy: an unusual presentation of Burkitt lymphoma
           in a Nigerian child: a case report

    • Authors: Osita U Ezenwosu, Barth F Chukwu, Okechukwu C Okafor, Anthony N Ikefuna, Ifeoma J Emodi
      Abstract: Intoduction: Burkitt Lymphoma is the fastest growing tumor in human and the commonest of the childhood malignancies. Generalized lymphadenopathy is a common feature of immunodeficiency associated Burkitt lymphoma but an uncommon presentation of the endemic type in Human Immunodeficiency Virus (HIV) negative children.
      Case presentation: The authors report a 6 year old HIV negative boy who presented with generalized lymphadenopathy, cough, weight loss, fever and drenching night sweat and had received native medication as well as treatment in private hospitals. His examination revealed hepatosplenomegaly, bull neck with generalized significant massive lymphadenopathy. Diagnosis was missed initially until a lymphnode biopsy for histology confirmed Burkitt lymphoma. He was managed on combination chemotherapy with complete resolution and now on follow up.
      Conclusion: To the best of our knowledge, this is the first documented report of its kind of endemic Burkitt lymphoma involving lymphnodes generally as the primary site. High index of suspicion and early biopsy are the key in this uncommon presentation.Keywords: Burkitt lymphoma, generalized lymphadenopathy, Nigerian child.
      Issue No: Vol. 19, No. 4
       
  • Carcinoma ex pleomorphic adenoma: a case report and review of literature

    • Authors: Deepak Khanna, Tanay Chaubal, Ranjeet Bapat, Anshad Mohamed Abdulla, Sunil Thomas Philip, Suraj Arora
      Abstract: Background: Carcinoma ex pleomorphic adenoma (CA-ex-PA) is extremely unusual in minor salivary glands of oral cavity. CA-ex-PA is a carcinomatous change as a primary or as a recurrence of pleomorphic adenoma.
      Objective: Due to resemblance of clinical symptoms of Ca ex PA and benign pleomorphic adenoma, it is mandatory for surgeons to keep high degree of clinical alertness, considering the peculiarity of this tumor.
      Case Report: 54-year-old male presented with swelling on left side in the pre-auricular region from the middle of zygomatic arch to mastoid process and from tragus of the ear up to angle of mandible. Fine needle aspiration cytology revealed a mixture of benign and malignant components. Total left parotidectomy with left radical neck dissection followed by reconstruction with cervicodeltopectoral flap was performed. Combination of chemotherapy and radiotherapy were given to patient. Histologic examination and pre-operative fine needle aspiration cytology confirmed the diagnosis of Carcinoma ex pleomorphic adenoma (CA-ex-PA). Two-year follow-up of patient showed no recurrence of the lesion.
      Conclusion: Due to the similarity in the clinical symptoms of CA-ex-PA and benign pleomorphic adenoma, it is vital that clinicians maintain a high degree of clinical vigilance, considering the oddity of this malignancy.Keywords: Carcinoma ex pleomorphic adenoma, Fine needle aspiration cytology, parotidectomy.
      Issue No: Vol. 19, No. 4
       
 
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