Journal of Health Sciences and Practice

Calcium Intake and tThe Risk of Developing Preeclampsia Among Pregnant Women Receiving Antenatal Care at the Jos University Teaching Hospital

C. Obikili, P.H. Daru, A. Ocheke — Tue, 19 Dec 2023 00:00:00 -0700

ABSTRACT

Background: Pre-eclampsia is a significant cause of maternal and fetal morbidity and mortality and steps have been made towards its prevention. In 2013 the WHO came up with a recommendation that calcium supplementation for prevention of pre-eclampsia be added as part of the antenatal care in populations with low calcium intake. However, calcium intake in our population is not known.

Method: It was a hospital based cross sectional descriptive study. In this study 206 women were recruited by convenience sampling technique, 24-hour dietary recall was taken from them after which dietary calcium was calculated using the West African food composition table. Their serum calcium levels were derived from samples taken in the antecubital vein without tourniquet. They were then followed up to determine the maternal and neonatal outcomes. Analysis was done using SPSS software version 20 and results calculated.

Results: The mean calcium intake for the studied population was 529.6 +/- 312.08 mg/day, the mean serum calcium was 2.185 +/- 0.212 mmol/L. The incidence of pregnancy induced hypertension was 15.5% and the incidence of Pre-eclampsia was 2.8%. There was no statistically significant relationship between Calcium intake and Serum Calcium. Women who developed PIH and preeclampsia had an average lower calcium intake than those who had normotensive pregnancies but this relationship was not statistically significant. There was no noted relationship between calcium intake, serum calcium and neonatal outcome.

Conclusion: The oral calcium intake of women in our environment is lower than the recommended threshold of 900mg, thus, calcium supplementation should be given routinely as part of our ante-natal care in this environment. There appears to be a relationship between calcium intake and risk of pre-eclampsia in our environment, but no relationship between each of them and neonatal outcomes, though larger studies might be needed to confirm this assertion.

Key Words: Pre-eclampsia, Calcium intake, Calcium supplementation, Serum Calcium, Prevention.

Prevalence and Determinants of Asymptomatic Bacteriuria in Children with Sickle Cell Anaemia in Jos, North-Central Nigeria

Tue, 19 Dec 2023 00:00:00 -0700

Background: In Sickle cell anaemia (SCA), renal dysfunction including symptomatic and asymptomatic bacteriuria (ASB) usually starts in childhood. Children with ASB need to be identified early to forestall disease progression and attendant consequences. Jos that has peculiar conditions that could predispose to accentuated morbidities in children with SCA lack current data on ASB.

Objectives: The study therefore assessed the prevalence of ASB in children with SCA, its determinants and offending pathogens and compared it to findings in apparently healthy haemoglobin AA (HbAA) counterparts.

Methods: This was a comparative cross-sectional study involving 136 SCA and 136 HbAA children aged 2-17 years. Urinalysis, urine microscopy, culture and sensitivity were performed on samples from all the participants. The diagnosis of ASB was based on urine culture. Data on socio-demographics was obtained using a proforma. The association between the socio-demographic characteristics and asymptomatic bacteriuria was determined using chi squares test. A p-value <0.05 was considered statistically significant.

Results: Prevalence of ASB in SCA children was 8.1% compared to 1.5% in HbAA children. Prominent isolated organisms were Escherichia coli (45.5%) and Staphylococcus aureus (27.3%) in SCA children; and Proteus spp (50%) and Providencia spp (50%) in HbAA counterparts. The female gender was significantly associated with the occurrence of ASB (p = 0.003).

Conclusion: The prevalence of ASB in children with SCA in Jos is high. Escherichia coli is the dominant organism responsible for ASB in children with SCA in Jos. Girls with SCA are more predisposed to asymptomatic bacteriuria than boys.

Keywords: Sickle cell disease, asymptomatic bacteriuria, urinary tract infection, Nigeria

Demographic, Clinical and Microbiological Characteristics of Patients with Periodontitis in a Tertiary Hospital in Nigeria

P. Ameh, P.O. Ayanbadejo, K.A. Umeizudike, F.O. Nwaokrie — Tue, 19 Dec 2023 00:00:00 -0700

Background: Periodontitis is a global health problem and plays a major role in both oral and systemic health. The aim of the study was to assess the demographic, clinical features and, the association of six periodontopathogens of periodontitis in patients in Nigeria.

Methods: A cross-sectional study among systemically healthy patients with periodontitis at Lagos University Teaching Hospital. Participants completed a semi-structured questionnaire and underwent a full periodontal examination. Subgingival dental plaque biofilm was assessed for the presence of six periodontopathogens using both culture and polymerase chain reaction (PCR). Data were analyzed with SPSS to determine the association of demographic, behavioural, clinical, and microbiological features with the severity of the disease.

Results: Forty-two patients were recruited with a mean age of 56.7 ± 13.4 years. The peak age group was 40 - 59 years (61.9%). Most of them (71.4%) brushed their teeth once a day, with only a few (11.9%) having good oral hygiene. The mean periodontal probing depth of diseased sites was 5.53 ± 0.98mm. A little over half of them (52.4%) had localized periodontitis. Very few (9.5%) of the patients had severe periodontitis. All six periodontopathogens were detected and Porphyromonas gingivalis was the most commonly occurring (17.6%) in deep periodontal probing sites (≥7mm) in severe periodontitis.

Conclusion: In this study, periodontitis was more common in males and the middle-aged. Oral hygiene practices and oral hygiene were poor. Severe periodontitis was not a common feature of periodontitis. The majority of the periodontopathogens were detected in mild/moderate periodontitis.

Keywords: Periodontitis, oral hygiene, periodontopathogens, Porphyromonas gingivalis, Nigeria

Six Strategies for Optimizing Linear Growth through Improving Awareness of Breastfeeding, Dietary Diversity in Complementary Feeding, and Growth Monitoring during Early Life

Tue, 19 Dec 2023 00:00:00 -0700

Only one-fourth of the countries under the Sustainable Development Goal are ‘on track’ to reduce the burden of malnutrition as of 2020. A deficit in linear growth during the first 5 years of life is mainly due to growth faltering in the first 1000 days. This deficit has been consistently reported to be linked to suboptimal cognitive neurodevelopment, while its improvement in early childhood has been reported to offer an opportunity for rescuing neurocognitive potential. This paper describes the perspectives of multidisciplinary experts, representing a range of disciplines related to child growth and nutrition, from Nigeria, Indonesia, and Malaysia, who convened virtually to review and discuss measures aimed at preventing a further increase in growth faltering, including stunting, among children aged 0-3 years under the current prevailing circumstances. Based on the latest evidence of practices and knowledge, the expert panel proposed six strategies to support linear growth in early life: 1) stimulating initiatives to support breastfeeding during the first 6 months of life; 2) improving quality of complementary feeding; 3) strengthening growth monitoring to detect suboptimal growth in early childhood; 4) increasing knowledge transfer among HCP; 5) increasing knowledge transfer from HCPs to caregivers; and 6) optimizing public-private engagement. The recommended solutions presented herein are the culmination of the collective insights of the expert panel. These recommendations offer invaluable approaches on addressing the critical public health issue of malnutrition, specifically growth faltering, and can benefit not only the three countries concerned but also other low and middle-income countries facing similar nutritional challenges.

The Predictors of Response to Intra-Articular Steroid Injections in Patients with Osteoarthritis of the Knee, in Jos University Teaching Hospital Jos Plateau State.

Tue, 19 Dec 2023 00:00:00 -0700

Intra-articular injection of steroids is one of the armamentariums available for the clinical treatment of osteoarthritis. However, response to this modality varies in different patients, there is a need to determine which patients are likely to have a good response to IAIS. This is a randomized controlled trial study, patients with knee osteoarthritis who met the inclusion criteria where randomly divided into two groups. Baseline parameters were measured for each subject, before 40 mg methylprednisolone acetate mixed with 2 % lignocaine was injected into the knee either via the palpation technique or the ultrasound guided technique. VAS and WOMAC were calculated at 2 weeks, 4 weeks, and 3 months post IASI administration. Each participant was followed up for 3 months.

There was no significant difference between the sonography group and the conventional palpation technique group except in alcohol consumption with P values of 0.025 respectively. This study shows that intraarticular steroid injection is effective in reducing the WOMAC and VAS score by 50% in the first two weeks after the steroid injection in 78.4% using WOMAC and 100% using VAS score for the subjects in both groups. We found an association that could predict a 50% reduction in pain at 3 months. These variables are age, sex, alcohol, medial collateral ligament laxity, radiographic score, and range of motion. However, after running a logistic regression. none of the variables identified could predict the response at 3 months.

Comparison of Airtraq Laryngoscope and Macintosh Laryngoscope in Patients Undergoing Tracheal Intubation with Simulated Cervical Spine Immobilization

S. Nuhu, G. Buma, H.Y. Embu, E.S. Isamade, Y.M. Usman — Tue, 19 Dec 2023 00:00:00 -0700

ABSTRACT

Introduction

Cervical spine immobilization using cervical collar is part of the recognized protocol of managing patients with actual or suspected cervical spine injury. The Airtraq laryngoscope makes it possible to intubate the airway with minimal optimization manoeuvre. This study sought to assess and compare tracheal intubation using Airtraq and Macintosh laryngoscopes in patients with simulated cervical spine immobilization.

Methodology

This was a randomized single blind prospective study among 58 consenting adults with ASA I and II scheduled for elective surgeries requiring intubation in Jos University Teaching Hospital (JUTH). Patients who had cervical collar were randomized into two equal groups; one group had tracheal intubation using Macintosh laryngoscope and the other with Airtraq laryngoscope. Duration of laryngoscopy and intubation, ease of intubation, haemodynamic response and complications were noted. Data was analysed using SPSS with students t-test and Chi square being statistical tests of choice. Significance was set at p=0.05.

Results

The study groups were comparable in characteristics (p=0.02). No significant statistical difference in intubation difficulty scale (IDS) between groups (p=0.08) with ease in intubation of 93.1% and 72.4% patients in Macintosh and Airtraq groups respectively. The duration of laryngoscopy and intubation was shorter in the Macintosh group compared with the Airtraq group (p=0.001). The intergroup differences in the haemodynamic responses to laryngoscopy was not statistically significant as well as the recorded complications between the study groups.

Discussion

The comparable ease of intubation between Airtraq and Macintosh laryngoscopes is similar to those reported by some authors but at variance to other reports. Experience of laryngoscopist influences ease of intubation. Shortened duration of laryngoscopy and intubation with the Macintosh laryngoscope is reported in some studies but contrary findings were found in others. The fact that haemodynamic responses and complications were similar between Macintosh and Airtraq laryngoscope groups means that either can be used where proficiency is not in doubt.

Keywords: Airtraq, Macintosh, Laryngoscope

Refraction services in a mission Tertiary Hospital in North-central Nigeria: A 5 years retrospective review

R.J. Alfin, O.M. Adejoh , K.N. Malu — Tue, 19 Dec 2023 00:00:00 -0700

Background: Globally, uncorrected refractive error (URE) is the leading cause of visual impairment. This condition can be treated simply through provision of eye examination and corrective spectacles. Hence, periodic evaluation is vital for safeguarding the quality and sustainability of refractive services.

Aim: To evaluate the refraction services at a mission Tertiary Hospital in Jos, between 2017 and 2021.

Materials and methods: Records of consecutive refractions and spectacles dispensed between January 2017 and December 2021 were reviewed. Data regarding age, gender, type of refractive error, number of spectacles dispensed and cost of spectacles for each year were retrieved from the records. The eye with the better vision was used to classify the patient’s refraction status. Data was analyzed using Statistical Package for the Social Sciences 21.

Results: A total of 4904 refractions were performed within the five years under review. Presbyopia co-existing with other forms of refractive errors was 1517 (30.9%) and presbyopia alone1252 (25.5%). Myopia was seen in 1206 cases (24.6%), astigmatism in 791 (16.1%) and hypermetropia in 138 (2.8%). The total number of spectacles dispensed was 4352 (88.7%) and 2731 (62.7%) cost less than N10,000 ($22.6). Type of refractive error was the only factor found to significantly influence the uptake of spectacles. The highest uptake was for presbyopia alone (91.4%), followed by compound astigmatism (89.2%) and and the least being hypermetropia (84.1%).

Conclusion

The five-year review of refraction services revealed a steady rise in the total number of refractions performed with corresponding increase in uptake of spectacles.

A Umbilical Artery Doppler Velocimetry as A Diagnostic Tool for Foetal Growth Restriction Among Women with High-Risk Pregnancy in Jos, North Central Nigeria.

D. Nyango, S. Alada, M. Kahansim — Tue, 19 Dec 2023 00:00:00 -0700

Abstract

Background: Fetal growth is a common challenge among high-risk pregnancies as a result of placental insufficiency. Current evidence shows that umbilical artery Doppler velocimetry is the clinical standard for distinguish between IUGR and SGA.

Objective-To determine the prevalence of IUGR among SGA fetuses in women with high-risk pregnancies using umbilical artery Doppler velocimetry

Design: It was a Hospital based prospective study.

Methods and Materials

This was a prospective study conducted from 1^st February, 2021 to 31^st January, 2022. A total of 161 women with high-risk pregnancies between 28 weeks and 38 weeks of gestation were recruited. A convenience sampling method was used, and interviewer-administered semi-structured questionnaire was administered. Data on socio demographic characteristics, obstetric history, LMP, gestational age, previous history of contraceptive use, irregular menstrual periods, and co-morbidities were obtained. The ultrasound was performed by a single investigator using 3.5MHz convex probe of GE Voluson P8 4D ultrasound machine. The fetal biometric parameters were measured in 2D mode before the Doppler mode was activated for the velocimetry of the umbilical artery. Fetuses with EFW below the 10^th percentile for their GA were adjudged SGA, while those with abnormal umbilical Doppler in addition were tagged growth restricted (IUGR). The data was analysed using SPSS software version 20.

Results: The prevalence of SGA and IUGR in this study was 19.9% (32) and 17.4% (28) respectively. All the 28 IUGR fetuses were among SGA fetuses, giving a prevalence of 87.5%. This was statistically significant (p ≤ 0.0001). Majority (69.2%) of the IUGR were among women with pre-eclampsia. This was also statistically significant (p ≤ 0.0001). Majority (89.3%) of the IUGR fetuses had reduced umbilical artery Doppler velocimetry.

Conclusion: Umbilical artery Doppler is a useful antenatal surveillance tool in women with high-risk pregnancies. Majority of SGA fetuses in women with high-risk pregnancies are growth restricted. Umbilical artery Doppler should be a routine practice in high-risk pregnancies complicated by fetal growth challenges.

Keywords: Umbilical artery Doppler Velocimetry, Fetal surveillance, SGA, IUGR, High-risk pregnancy

Huge Right Thigh Plexiform Neurofibroma in A 25-Year-Old Male With von Recklinghausen’s Disease. A Case Report

P. Nzekwe, I. Emmanuel, P.O. Akpa, A.N. Manasseh — Tue, 19 Dec 2023 00:00:00 -0700

Neurofibromas are benign tumours of the peripheral nerve sheath origin. This is a case of a 25 year old man with neurofibromatosis type 1 who presented with a 20 year history of a huge right lower limb mass that overtime led to significant morbidity. Excision biopsy of the mass revealed a plexiform Neufibroma on histology. Neufibromas present with lesions that could develop over time into huge masses, leading to mass effect with significant morbidity. Early diagnosis, prompt treatment via a multidisciplinary approach, and a good follow up care are essential for excellent outcome.

Sexual Dysfunction Among Women with Diabetes Mellitus: A Review

J.O. Edah, G. Odoh, F.H. Puepet — Tue, 19 Dec 2023 00:00:00 -0700

Background: Sexual health which remains a much neglected area in clinical medicine is important for psychological and social well-being. Female sexual dysfunction (FSD) which is described as a complex problem is classified as sexual desire disorders, sexual arousal disorders, orgasmic disorders and sexual pain disorders. Although the study of sexual dysfunction (SD) in diabetes mellitus (DM) is widely explored in men, there is limited literature regarding FSD and DM and it is often a neglected health issue in women.

Objective: To bring to light the importance of this neglected and under-reported complication of DM among women, highlighting the epidemiology, pathogenesis, diagnosis and management of female sexual dysfunction.

Method: Available literature on the topic from PubMed, Google Scholar and Medline were accessed for review.

Conclusion: It is clear that women with DM are at higher risk of FSD compared with women without DM. The women with this condition should be encouraged to speak freely about their sexual difficulties with their physicians and the doctors should intentionally address the issue of sexual health when evaluating women with DM

Key words: Female, sexual dysfunction, diabetes mellitus, complication, health.

Violence against healthcare professionals in the emergency department in Nigeria: a narrative review of Pattern and Aetiology

D.Y. Buowari Dabota — Tue, 19 Dec 2023 00:00:00 -0700

Background: Workplace violence is commonly experienced by healthcare professionals. Healthcare professionals of different categories and cadres can be victims of violence in the workplace although some medical specialties are more predisposed to violence. The objective of this review is to investigate workplace violence in the emergency units of Nigerian hospitals.

Method: This is a review article on violence against healthcare professionals in the emergency department in Nigeria. A literature search was done using Google Scholar, PubMed, Ajol and Medline.

Result: Several studies have been conducted on violence against healthcare professionals. Violence against healthcare professionals in the emergency department in Nigeria is common and there are several factors responsible for it. Overcrowding in the emergency department can lead to long waiting times which makes patients impatient and agitated, angry and may want to assault the healthcare professionals.

Conclusion: In the emergency departments in Nigeria, healthcare professionals are susceptible to violence from patients and caregivers. This comes in the form of verbal abuse, psychological abuse, and physical assault.