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   Table of Contents - Current issue
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January-March 2021
Volume 28 | Issue 1
Page Nos. 1-73

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ORIGINAL ARTICLES  

Volunteering during the COVID-19 pandemic: Attitudes and perceptions of clinical medical and dental students in Lagos, Nigeria Highly accessed article p. 1
Adebola Afolake Adejimi, Babatunde Adeniran Odugbemi, Oluwakemi Ololade Odukoya, Kehinde Sharafadeen Okunade, Aminah Oluwatamilore Taiwo, Akin Osibogun
DOI:10.4103/npmj.npmj_379_20  PMID:33642318
Background: Volunteering within the health-care sector is crucial during pandemics. This study aimed to assess the attitudes and perceptions of clinical medical and dental students in Lagos, Nigeria, about volunteering during the coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: A descriptive cross-sectional study was conducted amongst medical and dental students undergoing clinical postings at the two public universities in Lagos, Nigeria, using total population sampling. Data were collected using a web-based questionnaire and analysed using Statistical Package for the Social Sciences. Chi-square test and logistic regression analysis were used to test for association at the level of significance of 5%. Results: The mean age of the respondents was 23.3 years ± 2.6 standard deviation and 62.5% were females. The majority (82.9%) of the respondents agreed to volunteer if provided with adequate personal protective equipment (PPE) and if adequately trained to do so (79.3%). Although perceived as dangerous, the majority (91.2%) of the respondents considered volunteering during the COVID-19 pandemic as a form of educational experience. Compared to the final-year students, penultimate year students were more likely to volunteer in the event of a health manpower shortage. The final-year students were more likely to volunteer if government made the request. Female students were more likely than male students to volunteer even if they were not compensated but would require parental approval. Conclusion: Medical and dental students perceived their involvement during the COVID-19 pandemic as a form of educational experience but would require adequate training and PPE. There is a need to train and provide adequate PPE for them to function as volunteers.
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Community mitigation strategies for coronavirus disease 2019: An assessment of knowledge and adherence amongst residents of Benin City, Edo State, Nigeria Highly accessed article p. 14
Esohe Olivia Ogboghodo, Iriagbonse Iyabo Osaigbovo, Darlington Ewaen Obaseki, Obiageli Henrietta Nneka Okwara, Orezimena Temitope Omo-Ikirodah, Funmilayo Adio, Ewere Scholastica Ehinze
DOI:10.4103/npmj.npmj_321_20  PMID:33642319
Background: In the absence of effective vaccines and definitive treatment, non-pharmaceutical interventions, also known as community mitigation strategies (CMS), are needed to reduce the transmission of respiratory virus infections such as coronavirus disease 2019 (COVID-19). However, the effectiveness of these strategies depends on a knowledgeable population cooperating and adhering strictly to recommended strategies. Objective: The objective of the study was to determine the knowledge and adherence to CMS against COVID-19 in Benin City, the capital of Edo State, Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted amongst adult residents in Benin City using a self-administered questionnaire for data collection. Eighteen questions addressed knowledge of CMS, while adherence was assessed using 14 questions on a graded scale. Each correct answer was scored giving maximum and minimum scores of 18 and 0 for knowledge and 28 and 0 for adherence, respectively. Scores were converted to percentages with scores 70% and above adjudged as good knowledge of CMS and scores 50% and above adjudged as good adherence to CMS. Data were analysed with IBM SPSS version 25.0 software. The level of significance was set at P < 0.05. Results: The mean age (standard deviation) of 577 respondents who participated in the study was 32.5 ± 11.7 years. Overall, 532 (92.2%) respondents had good knowledge, while only 165 (28.6%) demonstrated good compliance with CMS against COVID-19. Christianity was a statistically significant predictor of knowledge of CMS. Income was found to be a significant predictor of adherence to CMS amongst respondents. Conclusion: Respondents demonstrated good knowledge but poor adherence with CMS against COVID-19 in Benin City, Edo State. Behaviour change communication is advocated to ensure that mitigation strategies are effective.
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Clinical, endoscopic and histological profile of colorectal cancers seen on colonoscopy in Kano, North-Western Nigeria p. 22
Yusuf Musa, Mansur Femi Mohammed, Nurudeen Olalekan Muhammad, Ibrahim Yusuf, Abdulrashid Onimisi Abdulrahim, Adamu Alhaji Samaila, Musa Muhammad Borodo
DOI:10.4103/npmj.npmj_288_20  PMID:33642320
Background: Colorectal cancer (CRC) is the most prevalent gastrointestinal (GI) cancer. With 5% risk of developing CRC in life, it became the third leading cause of cancer death in developed nations. In Nigeria, it is the most common GI cancer. However, there are limited data on CRC in the study area (North-Western part of Nigeria). The aim of this study was to identify the clinical, endoscopic and histological profile of CRC seen on colonoscopy. Methodology: This was a retrospective descriptive study where colonoscopic and histological records of suspected CRC in the study centre between January 2008 to December 2017 were evaluated. Results: Records of 135 patients were reviewed, and males constituted 63.7%. The mean age was 46.61 ± 16.80 years, with 30–39 years as a modal group. Common presentations were diarrhoea (86.7%) and bleeding per rectum (68.9%). Areas affected were rectosigmoid colon (63%), ascending colon (14.1%), descending colon (8.9%), transverse colon (7.4%) and anal canal (6.7%). Histologically, adenocarcinoma was reported in 57.8%, mucinous adenocarcinoma in 8.1% and signet ring cell adenocarcinoma in 3.7%. Tubular and villous adenomas were 3% each. Others were carcinoid tumours (1.5%), metastatic adenocarcinoma, squamous cell carcinoma, basal cell carcinoma, GI stromal tumour, inflammatory myofibroblastic tumour, angiosarcoma and adenoid cyst carcinoma reported in 0.7% each. Conclusion: Majority of the patients with CRC were in their young age. The most common presentations were diarrhoea, weight loss and anaemia. The most common site of affectation was in the left colon, while the most common histological finding was adenocarcinoma.
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An audit of parotid gland surgeries in Kano, Nigeria: A review of 34 cases p. 27
Abdulrazak Ajiya, Iliyasu Yunusa Shuaibu, Uchenna Kelvin Omeje
DOI:10.4103/npmj.npmj_309_20  PMID:33642321
Background: Neoplasms both benign and malignant are the most common indications for parotidectomy. About 70%–80% of all salivary gland tumours are located in the parotid gland with up to 80% being benign. Parotidectomy is a common surgical procedure performed by the otorhinolaryngologist and oral and maxillofacial surgeons. Aims: This study aimed to document our experience on parotid gland surgeries, and occurrence of facial nerve palsy. Materials and Methods: The records of all patients that had parotidectomy between January 2014 and December 2018 were evaluated. Demographic, clinical and operative data were retrieved and analysed using Statistical Product and Service Solution version 23.0 software (SPSS Inc., Chicago, Illinois, USA). Results: A total of 34 cases were reviewed and there were 12 (35.3%) males and 22 (64.7%) females with a male-to-female ratio of 1:1.8 and mean age ± standard deviation of 39.3 ± 18.4 years. Patients with primary disease constituted the majority 29 (85.3%) in this series. Most of them (26, 76.5%) had superficial parotidectomy. Cervicomastoidfacial incision was the most preferred incision employed among 33 (97.1%) of our patients. Complication following surgery was observed in 12 (35.3%) patients. Majority, 7 (63.6%), had temporary facial nerve paresis. Pleomorphic adenoma was the most common histological diagnosis noted in 19 (55.9%) patients postoperatively. There is a statistically significant association between fine-needle aspiration cytology (FNAC) findings and final histological diagnosis. Conclusion: Pre-operative FNAC could be a reliable tool in the evaluation of our patients being prepared for parotidectomy even in our resource-poor setting.
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Prevalence, pattern and predictors of sexual abuse among young female hawkers in Kano metropolis, Nigeria p. 33
Taiwo Gboluwaga Amole, Hadiza Abdullahi, Nafisa Tijjani Abdullahi, Abubakar Sadiq Abubakar, Abdullahi Onimisi Ajayi, Fatimah Ismail Tsiga-Ahmed
DOI:10.4103/npmj.npmj_295_20  PMID:33642322
Context: Sexual abuse of young female hawkers is a subject of public health importance with resultant long-lasting physical and mental consequences. Aims: This study assessed the prevalence, pattern and predictors of sexual abuse among female hawkers in Kano State, Nigeria. Settings and Design: Using a descriptive cross-sectional design and two-stage sampling technique, female hawkers in Kano metropolis were studied. Subjects and Methods: An adapted and pre-tested semi-structured interviewer-administered questionnaire was used to obtain information from 236 female hawkers. Data were analysed with SPSS Statistics, version 24.0 software. Prevalence and pattern of sexual abuse was determined and adjusted odds ratios of predictors derived from binary logistic regression models. Results: The prevalence of sexual abuse was 68.6%. Forms of sexual abuse reported included verbal abuse (38.1%), inappropriate touch (64.0%) and rape (25.8%). Predictors of sexual abuse included respondents' age (adjusted odds ratio [aOR] = 10.65, 95% confidence interval [CI] [2.92–38.84]), ethnicity (aOR = 4.26, 95% CI [1.30–14.00]), highest educational attainment (aOR = 0.38, 95% CI [0.15–0.99]), residence with parent (s) (aOR = 0.07, 95%CI [0.01–0.54]) and parents being alive (aOR = 6.79, 95%CI [1.41–32.62]). Conclusions: Sexual abuse is prevalent among female hawkers and the forms experienced ranged from verbal abuse to inappropriate touch and rape. Interventions that delay age at the commencement of hawking, ensure the education of the girl child and support parental care could foster more matured and smart female hawkers who can avoid sexual abuse.
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Ionised serum calcium reference interval among rural women of reproductive age in Abuja, Nigeria p. 39
Angus Chukwuemeka Onyekwelu, Habiba Ibrahim Abdullahi, Aliyu Yabagi Isah, Abubakar Mustapha Jamda, Maxwell Maduekwe Nwegbu
DOI:10.4103/npmj.npmj_274_20  PMID:33642323
Background: Various medical conditions in pregnancy may be traced to suboptimal levels of serum calcium during pregnancy. Communities' derivation of normal serum calcium reference interval is imperative. Objective: The objective was to determine the normal free (ionised) serum calcium reference interval among women of reproductive age in the federal capital territory (FCT) of Nigeria. Materials and Methods: This was a cross-sectional study of 240 women from six primary health-care facilities in Abuja, Nigeria. Their blood samples were collected in serum separator bottles. The outcome measure was the determination of the reference interval of free (ionised) serum calcium among the participants. Results: The obtained normal reference interval of ionised serum calcium (iCa) was 0.88–1.4 mmol/L. The accompanying reference intervals for total protein and albumin were 5.7–9.4 mg/dl and 3.3–5.2 mg/dl, respectively. Conclusion: The derived reference interval of iCa in this study was 0.88–1.4 mmol/L, while the total calcium range was 2.18–2.82 mmol/L. These intervals are recommended for use in the Nigerian FCT and its environs as it provides lower intervals compared to the operational values. There is a need for a national derived value as this may change the practice.
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Prevalence of anaemia and compliance to weekly iron-folic acid supplementation programme amongst adolescents in selected schools of urban Puducherry, India p. 44
Sneha Anil Wangaskar, Swaroop Kumar Sahu, Marie Gilbert Majella, Sathish Rajaa
DOI:10.4103/npmj.npmj_336_20  PMID:33642324
Context: Adolescents constitutes 21% of total Indian population. Iron deficiency anaemia has remained as a major nutritional problem amongst adolescents. To overcome this problem, Government of India started weekly iron-folic acid supplementation (WIFS) in 2012. Aims: Amongst adolescents in selected schools of urban Puducherry, to determine the prevalence of anaemia, proportion of those compliant to WIFS and to assess the sociodemographic and clinical factors associated with anaemia and compliance to WIFS. Subjects and Methods: A cross-sectional analytical study was conducted amongst school-going adolescents (10–18 years) in selected schools of Urban Puducherry. Data were collected using semi-structured, self-administered and pretested questionnaire. Haemoglobin estimation was done using a digital haemoglobinometer. Details regarding intake of iron and albendazole tablets were recorded. The anaemia status was evaluated as per World Health Organization guidelines. Results: The prevalence of anaemia was found to be 62.7% (95% confidence interval [CI]: 58.2–67.0). Proportion having mild, moderate and severe anaemia were 27.3%, 32.5% and 2.8% respectively. The proportion of adolescents compliant to WIFS was 67.7%. Late adolescents were significantly more associated with anaemia (adjusted prevalence ratio [aPR]: 1.7 95% CI: 1.0–3.0) as compared to early adolescents. Males were more compliant to iron-folic acid (IFA) tablets (aPR 1.4 95% CI: 1.0–1.8). Conclusions: More than half of adolescents were anaemic. This study emphasises on the fact that stricter supervision by teachers will result in better compliance to WIFS program. Strategies to improve WIFS compliance, imparting knowledge regarding IFA intake and involvement of school teachers will help to tackle anaemia amongst adolescents.
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Preference on prenatal sex determination and its associated factors among currently married women of reproductive age group in Puducherry, India p. 51
Ganesh Kumar Saya, Kariyarath Cheriyath Premarajan, Gautam Roy, Sonali Sarkar, Sitanshu Sekhar Kar, Yuvaraj Krishnamoorthy, Jeby Jose Olickal, Revathi Ulaganeethi
DOI:10.4103/npmj.npmj_269_20  PMID:33642325
Background: Sex determination refers to knowing the sex of foetus during prenatal period for non-medical reasons. Attitude of married women to sex determination is important to improve the sex ratio at birth. Aim and Objectives: This study aimed to assess preference on sex determination and associated factors among currently married reproductive age group women. Materials and Methods: This cross-sectional community-based study was done during 2016–2017 among 2228 currently married women of 18–49 years' age group in urban and rural Puducherry, India. Information on the demographic characteristics, level of awareness and preference for sex determination was obtained. Multiple logistic regression was used to identify factors influencing preference for sex determination. Unadjusted and adjusted odds ratio (AOR) as a measure of effects was used. Results: Of 1979 respondents, all were aware that sex determination is possible. Majority of them did not prefer sex determination (95.4%, 1888). About 80 (4.0%) preferred, while 11 (0.6%) were undecided about it. Majority of them were aware that sex determination without medical indication is a crime. Common source of information was healthcare workers (76.4%). After adjusting for confounders, age group (18–24, AOR = 5.334; 25–29, AOR = 3.249; 30–34, AOR = 3.857; 35–39, AOR = 2.279), middle level education (AOR = 2.3), those with unmet need for family planning (AOR = 2.970) and urban area (AOR = 67.679) subjects were preferred more; housewife (AOR = 0.481) and those without living son (AOR = 0.406) had preferred lesser for sex determination compared to their counterparts. Conclusion: About one in 25 currently married women preferred sex determination. It is comparatively more in urban areas. High-risk groups should be educated to develop correct awareness and attitude on prenatal sex determination.
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Quality of life and its determinants among sewage workers: A cross-sectional study in Puducherry, South India p. 57
D Madhumithra, Ganesh Kumar Saya, Jeby Jose Olickal, Srikanta Kanungo, Palanivel Chinnakali
DOI:10.4103/npmj.npmj_351_20  PMID:33642326
Background: There is a paucity of information on sewage worker's quality of life (QoL). Hence, we aimed to assess the QoL and its associated factors among sewage workers in Puducherry, coastal south India. Materials and Methods: A total of 210 sewage workers were included in the study. QoL was assessed using a validated Tamil version of WHO QoL-BREF. The association of QoL with age, educational status, residence area, self-reported chronic illness, use of protective measures, tobacco and alcohol use was assessed by univariate analysis. Multiple linear regression analysis was used to assess the independent factors associated with QoL. Results: Overall mean (standard deviation) score of QoL was 56.9 (9); mean score of social relationship domain was comparatively lower than physical, psychological and environmental domains. Current tobacco and alcohol uses were 17% and 67%, respectively, while alcohol use during work (entering sump) was 5%. At least one morbidity was present among 94 (45%) subjects. About half (47%) used at least one protective measure while entering the drainage sump. Age group above 50 years, below primary level education, presence of chronic illness, smokers and alcohol users had significantly lower QoL score. Conclusions: Social relationships' domain of QoL was very low among sewage workers. The majority of them do not use any personal protective devices and almost half had chronic illnesses.
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Non-exclusive breastfeeding amongst high-risk children: Factors and barriers associated with non-exclusive breastfeeding at a tertiary care hospital in Southern India p. 62
Mary Magdalene Rynjah, Jayaseelan Venkatachalam, B Adhisivam, Jeby Jose Olickal, Shanthosh Priyan Sundaram, Palanivel Chinnakali
DOI:10.4103/npmj.npmj_294_20  PMID:33642327
Background: In the first 6 months of life, non-exclusive breastfeeding (NEBF) is estimated to be the cause of 1.4 million deaths worldwide and contributes to 10% of the disease burden in under-five children. Aims and Objectives: The objective of the study was to determine the prevalence of NEBF amongst the high-risk children and the factors associated with NEBF. Methods: This cross-sectional study was conducted amongst high-risk babies admitted between August 2016 and February 2018 who also attended the high-risk follow-up clinic at the neonatology department. Data were collected using a pre-tested structured questionnaire. Chi-square test was used to determine the factors associated with NEBF and prevalence ratios (PR) with 95% confidence interval (CI) were calculated. Results: Amongst 304 children, 56.3% were male and 87% had birth weight <2500 g. Nearly three-fourth of the mothers were <30 years of age. The prevalence of NEBF was 49.3% (95% CI: 43.7–55.0). There was a significant association of NEBF with employment status of the mother (PR = 1.45; 95% CI: 1.1–1.9), NEBF in previous child (PR = 2.3; 95% CI: 1.4–3.9) and EBF at the point of discharge (PR = 2.3; 95% CI: 2–2.6). The barriers reported by the mothers leading to NEBF were insufficient or less milk secretion, poor breastfeeding attachment, perceived thirst and poor maternal health. Conclusion: One out of every two children admitted in neonatal intensive care unit were non-exclusively breastfed before 6 months of age. The employment status of mother, practice of exclusively breastfeeding the previous child and EBF at the time of discharge were significantly associated with NEBF.
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CASE REPORT Top

Anticoagulation in pregnant women with mechanical heart valve prostheses: Case reports and a literature review p. 68
Philip Alaba Adebola, Folasade A Daniel, Yusuf A Oshodi, Abidoye Gbadegesin, Olagoke K Ale, Ayodeji O Oluwole, Olabode Falase, Mobolaji A Oludara, Jonathan Nwiloh
DOI:10.4103/npmj.npmj_344_20  PMID:33642328
The choice and regimen of anticoagulation therapy in pregnant women with mechanical valve prostheses have always been a daunting task. It is a delicate balance that takes into consideration the risk of thromboembolic complications in the mother and the risk of potential Warfarin embryopathy to the foetus. Medical practice in a low socioeconomic setting also has the peculiar challenge of financial constraints on the part of the patients and difficulties in monitoring the efficacy of anticoagulation therapy. We report our experience in managing two pregnant women with mechanical valve prostheses and review the existing literature on this complex but interesting subject.
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PERSPECTIVE ARTICLE Top

Are there evidence to support the informal sector's willingness to participate and pay for statewide health insurance scheme in Nigeria? p. 71
Oladimeji Akeem Bolarinwa, Munirat Ayoola Afolayan, Bosede Folashade Rotimi, Bilqis Alatishe-Mohammad
DOI:10.4103/npmj.npmj_392_20  PMID:33642329
In recent times, many states of the federation have attempted to implement a social health insurance scheme. This is with a view to achieving universal health coverage in their states. One of the main target populations of the scheme is the informal sector workers. There are still concerns about whether enough pieces of evidence were used to establish the scheme across the country. This perspective article briefly highlights some evidence to support the informal sectors willingness to participate and pay for a statewide health insurance scheme in Nigeria.
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