Journal of Health Sciences and Practice

The Burdens, impediments and Challenges of Gynaecologic Cancer Care in Africa: Perspective

Dr. Jonah Musa — 2024-08-02

The global burden of cancer reports suggests that cancers in general and female reproductive cancers such as cervical, ovarian, and endometrial cancers are a growing burden and a major cause of suffering, premature mortality, disability adjusted life-years, and a huge economic loss to individuals, families, and society. Challenges in effective management of these cancers ranges from underdeveloped strategies for upstream prevention, screening and early detection, late diagnosis, and limited capacity for pathologic support services with paucity of trained human resource for management of these cancers in the African continent.

Anti-Retroviral Therapy Adherence at a Rural Hospital in Plateau State, Nigeria.

Mark Gyang — 2024-08-02

Background: The harmful use of alcohol is a significant factor responsible for non-adherence to AntiRetroviral Therapy (ART) among HIV infected patients but there is paucity of data on the effect of both local and commercially brewed alcohol on ART adherence in low and middle income countries. This study sought to determine the prevalence of harmful alcohol use and its association with ART adherence among HIV infected patients in a rural setting in Plateau State, Nigeria.

Method: This was a descriptive cross-sectional study carried out among HIV sero-positive adults receiving anti-retroviral therapy medication at Vom Christian Hospital between February and July 2018. A structured interviewer-administered questionnaire was used to obtain relevant data from 297 randomly selected persons. Alcohol Use Disorders Identification Test tool was used to determine the level of alcohol consumption while Self-Reported Adherence tool was used to measure drug adherence. Data was analysed using IBM Statistical Product and Service Solution (SPSS) Statistics version 25. Probability values of p < 0.05 was considered statistically significant.

Results: The prevalence of harmful use of alcohol was more than half (56.0%) of those that drank alcohol at the time of the study and 14.3% of the overall study population. Bivariate analysis did not show any significant relationship between the harmful use of alcohol with ART adherence. Binary logistic regression showed those who take more than a pill/day were less likely to adhere to ART compared to those who take one. (OR 0.15 95% CI = 0.03-0.91)

Conclusion: The prevalence of harmful Alcohol use was high but the harmful use of alcohol had no effect on ART adherence in the study population.

Assessment of Thoracodorsal Artery Perforators of Adults: A Comparative Study Between Hand-Held Doppler and Colour Doppler Ultrasound

Joshua Choji — 2024-08-02

ABSTRACT

Background: The thoracodorsal artery perforator flap has emerged as a versatile workhorse flap for reconstruction. The popular assessment tools for the assessment of perforators are the Hand-Held Doppler (HHD) and colour Doppler ultrasound (CDU). HHD has gained an important place as a diagnostic tool in the field of perforator flaps because of its ease of use, low cost and availability. This study aimed at comparing the HHD and CDU in the assessment of the number of thoracodorsal artery perforators.

Methodology: This was a comparative cross-sectional study, two scanning modalities were used to assess the thoracodorsal artery perforators in the same group of patients that were selected by a consecutive sampling method. The Plastic Surgeon assessed the perforators using the HHD, with a re-evaluation of the same locations by a Consultant Radiologist using the CDU. The assessment was on both sides for those who met the inclusion criteria. Thus, the total number of lateral thoracic areas assessed was 140. The data generated was analysed using the statistical package for the Social Sciences (SPSS) version 20, and statistical significance was determined using a dependent sample t-test and p-value of <0.05 was considered significant.

Results: Seventy subjects were assessed, 58 (82.9%) males and 12 (17.1%) females. The male-to-female ratio was 4.8: 1. The age range was 18 - 65 years with a mean of 31.77 years ± 11.72 years. Overall (right and left lateral thoracic sides), CDU (M = 0.94, SD = 0.48) identified more perforators than HHD (M = 0.85, SD = 0.51) and was statistically significant, t (419) = 3.667, p = 0.000.

Conclusion: This Study demonstrated that the CDU identified more perforators when compared with the HHD and was statistically significant. The CDU has to be used pre-op or made available in the theatre, which is cumbersome.

The Prevalence and Pattern of Hearing Impairment in Children With Epilepsy

Aderonke Uhunmwangho- Courage — 2024-08-02

Background: In developed countries, hearing impairment is ten times more common in children with epilepsy (CWE) compared to the general population. They may exist in the same individual due to shared aetiology, recurrent seizures or use of antiepileptic drugs. This comorbidity may impact the quality of life of children with epilepsy.

Aim: This study aimed to determine the prevalence, pattern and predictors of hearing impairment among CWE in North-Central Nigeria to increase awareness and encourage early screening and intervention.

Methods: A cross-sectional comparative study was carried out in children with epilepsy at the Jos University Teaching Hospital (JUTH) and their apparently healthy age and sex-matched counterparts. Hearing assessment was performed using pure tone audiometry, free field audiometry, and otoacoustic emission on the study subjects.

Results: Twenty-four (24%) of the CWE had hearing impairment compared to seven (7%) of the controls (c2 11.03, p= 0.001). The severity of hearing impairment was mild, moderate, severe, and profound in five (5.0%), twelve (12.0%), three (3.0%), and four (4.0%) of the 100 CWE. No cases of severe or profound hearing impairment were found in the control group.

There was no statistically significant association between factors such as age group, age at onset of seizure, age at first presentation, school history, severity of seizures, intracranial infection, use of AED and hearing impairment in CWE.

Conclusion: Hearing impairment is more common among children with epilepsy compared to their age and sex-matched controls. Screening for hearing impairment should be done as part of the initial assessment of CWE.

Percutaneous Trigger Finger Release as an Outpatient Procedure: Our Initial Experience at Jos University Teaching Hospital

Femi Taiwo — 2024-08-02

Abstract.

Trigger finger or stenosing tenosynovitis, is a common hand disorder. It is a tendinopathy that affects the digital flexor tendon sheath. It can be treated via open and percutaneous surgical methods.

Aim: To report our experience with percutaneous trigger finger release as a clinical procedure and its mid-term outcomes.

Materials and Methods: Our study was conducted on 33 trigger fingers in 30 patients with mechanical symptoms of triggering. Patients were diagnosed, and consent was given. After cleaning, a 21-gauge hypodermic needle was inserted through the skin, confirmed by observing the needle's swing, and the A1 pulley was released. All patients were reviewed at six weeks and 12 weeks.

Results: We had 33 trigger fingers in 30 patients. There were 27 women and three men, with a mean age of 49 (range, 39 to 67 years). Of the 33 digits treated by this technique, 33(100%) were completely free of triggering (grade 0) at the 6-week follow-up. At 12 weeks, there had been no recurrences.

Discussion: In our study, we found that percutaneous trigger finger release can be conveniently carried out in the office. In 100% of our patients, there was complete relief from their symptoms; this percentage aligns with the best outcomes obtained in other studies. There was no complication after 12 weeks.

Conclusions: Percutaneous surgery is one cost-effective and efficient way to manage trigger fingers in a clinical setting.

Keywords: Percutaneous release, Trigger finger, midterm, outcome, trigger finger

Knowledge, Attitude and Practice Towards Sexually Transmitted Infections Among Kaduna State University Students.

HADIZA SANI — 2024-08-02

ABSTRACT

Introduction

Sexually transmitted disorders (STI) are infections caused by bacteria, viruses or parasites that are spread through sexual contact. Transmission may be through genitals (commonly), anal or oral routes. It is a significant health problem seen in the sexually active/reproductive age group and spans across different socio-economic, regional/cultural and geographical variations.¹

Methodology

This was a cross sectional descriptive study. A total of 257 undergraduate students were selected using multi-stage sampling technique. Data was collected using semi-structured interviewer-administered questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Variables were presented by means of frequency tables, quantitative data was summarized using mean and standard deviation and bivariate analysis was carried out using chi-square to test for associations between independent and dependent variables. The level of statistical significance was set at p-value of <0.05%.

Results

The mean age of the respondents was 21±3.2 years. About two-third of the respondents were females (66%). More than three-quarters are aware of STIs but only one-tenth of the respondents have a good knowledge. The commonest STIs known by the respondents were HIV (84.7%) and gonorrhea (78.8%). Unprotected sexual encounter was identified as the most common route of transmission (96.7%). Only one-tenth of the participants know that some STIs can present without symptoms. Two-third of the respondents used condoms and one quarter had a past history of STIs. There was a statistically significant relationship between age of the respondents (p=0.0000); gender (p=0.019), attitude (p=0.001) and STIs. About two-fifths of the respondents underwent screening for STIs annually.

Conclusion

There is a poor knowledge and preventive attitude towards STIs despite a high rate of awareness in students in this university.

AN Assessment of the Availability and Use of Standing Orders in Primary Healthcare Cen-tres in Jos Metropolis

Tyavyar J. Akosu — 2024-08-02

Abstract

Background: Standing orders are intended (meant) to support healthcare workers in Primary healthcare facilities in Nigeria to provide quality services to their clients. The purpose of the study was to determine their availability and use by these healthcare workers.

Methodology: A cross-sectional study design was used to collect data from primary healthcare facilities in Jos metropolis. Data was collected using an interviewer-administered questionnaire and observation checklist. Data was analysed using WINPEPI Statistical software. Chi-square test was used to test for the relationship between availability/use of standing orders and related factors. A P-value ≤ 0.05 was considered statistically significant.

Results: Fifty-eight healthcare facilities were studied. Most (39.7%) of the respondents were CHEWS and the majority (67.2%) had been in service for at least twenty years. A copy of the standing orders was available in 20.7% of the health facilities studied and 12.1% of respondents consistently used it. There was no relationship between standing order usage and the age, sex, cadre, years of experience or number of daily consultations. The reason given by most (87.9%) respondents for non-adherence to standing order guidelines was lack of ownership.

Conclusion: Copies of standing orders are available in very few health facilities in Jos and most healthcare workers do not follow the guidelines of the standing orders. Measures should be put in place to address these to protect patients from avoidable harm.

Necrotizing Fasciitis of the Breast Involving the Abdomen and the Back in a Lactating Woman: A Case Report

Joshua D. Choji — 2024-08-02

Necrotizing fasciitis of the breast is rare but associated with high morbidity and mortality. If there is delayed presentation and inappropriate intervention, it results in prolonged hospital stay and multiple surgical procedures. Early diagnosis, prompt surgical treatment, and broad-spectrum antibiotic therapy are of immense importance to prevent mortality. In this report, we present a 28 year old lactating mother with delayed presentation of bilateral necrotizing fasciitis of the breast involving the anterior abdominal wall and the back.