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2017| January-June | Volume 16 | Issue 1
Online since
July 5, 2017
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ORIGINAL ARTICLES
Determinants of occupational health and safety: Knowledge, attitude, and safety practices toward occupational hazards of sawmill workers in Egor Local Government Area, Edo State
Amenze O Onowhakpor, Gabriel O Abusu, Bunmi Adebayo, Hendrith A Esene, Obehi H Okojie
January-June 2017, 16(1):58-64
DOI
:10.4103/2384-5589.209487
Background:
Sawmilling operations involve a lot of manual handling which exposes the workers to numerous occupational health hazards, which can impact on their occupational health and safety. The knowledge, attitude and safety practices of sawmill workers are paramount for the mitigation and control of these hazards to ensure optimal health and safety.
Objectives:
This study assessed the knowledge, attitude and safety practices of sawmill workers towards occupational health hazards in Egor Local Government Area, Edo State.
Materials and methods:
A descriptive cross sectional study was carried out amongst 178 sawmills workers selected using stratified sampling technique. Structured interviewer’s administered questionnaires were used for data collection. Data was analysed with statistical package for scientific solutions version 21.0 software. Univariate and bivariate analysis were done and level of significance was set at
P
<0.05.
Results:
The mean age (standard deviation) of respondents was 34.69±9.91. One hundred and seventy five (98.3%) of the respondents were males. A majority 165 (92.7%) of the respondents were aware of dust and noise 160 (89.9%), as occupational hazards in sawmill. One hundred and forty eight (83.1%) of the respondents had positive attitude towards occupational health hazards in sawmill while almost three fifth 103 (57.9%) of the respondent had poor work safety practices.
Conclusion:
Majority of the sawmill workers had fair knowledge of occupational hazards and positive attitudes towards occupational hazards. However, poor safety practices were evident. There is need to improve the knowledge of sawmill workers in relation to occupational hazards and safety practices so as to mitigate its negative consequences.
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Knowledge of malaria and adherence to its preventive measures among adults attending out-patient clinics of a Nigerian tertiary hospital: Has anything changed?
Godpower C Michael, Ibrahim Aliyu, Bukar A Grema
January-June 2017, 16(1):43-51
DOI
:10.4103/ajmhs.ajmhs_81_16
Background:
Despite global control efforts, malaria still accounts for preventable morbidity and mortality in Africa. Reported knowledge of its preventive measures appears high, but disparity exists between knowledge and uptake of preventive practices in Nigeria. It becomes necessary to evaluate adherence to use of insecticide-treated nets (ITN) and other malaria preventive measures at peak periods of malaria transmission as the Millennium Development Goal era terminates.
Materials and Methods:
A cross-sectional study was conducted at the general and pediatric out-patient clinics of Aminu Kano Teaching Hospital, among 413 adult patients and caregivers of children selected by systematic sampling technique and using a validated interviewer-administered questionnaire. Their knowledge of malaria and utilization of and adherence to preventive measure utilization were assessed.
Results:
The respondents’ mean age was 33.6 ± 8.9 years. Majority (90.6%) had adequate knowledge of malaria. Their mean malaria knowledge score was 78.7%. Among those who used ITNs, only 54.1% adhered to daily use. For other preventive measures, 65.3, 52.3, 46.5, and 25.2% adhered to environmental sanitation, insecticide spraying, wearing protective clothing, and mosquito repellent use, respectively. Hot weather was the main barrier to ITNs and wearing protective clothing adherence, whereas cost, lack of time, fear of side effects was the barrier to adherence to insecticide spraying, environmental sanitation, and mosquito repellent, respectively. Tertiary education was associated with adequate knowledge of malaria (
χ
2
= 8.36,
P
= 0.004). There was also association between adequate knowledge of malaria and monthly environmental sanitation participation (
χ
2
= 9.06,
P
= 0.003).
Conclusion:
Knowledge of malaria was high but adherence to practice was low. Nonadherence with preventive measures is an obstacle to achieving malaria control and could be overcome by effective mass education and addressing adherence barriers.
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A 4-year retrospective review of stillbirths at the Federal Teaching Hospital, Abakaliki, Southeast Nigeria
Anthony T Agbata, Justus N Eze, Chukwuemeka I Ukaegbe, Bartholomew N Odio
January-June 2017, 16(1):19-24
DOI
:10.4103/ajmhs.ajmhs_82_16
Objective:
Stillbirth is one of the most common adverse outcomes of pregnancy, yet among the least studied. The objective of this study was to estimate stillbirth rate and describe maternal and obstetric characteristics of stillbirths at the Federal Teaching Hospital, Abakaliki (FETHA), Ebonyi State, southeast Nigeria.
Material and Methods:
This was a 4-year review of stillbirths at the FETHA, from January 2012 to December 2015. All stillbirth folders were retrieved and relevant information entered in a proforma designed for the study. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 24.0 (IBM Corp., Armonk, NY). Stillbirth rate was calculated as a proportion of total births. Results were presented as mean ± standard deviation, rates, and percentages/proportions.
Results:
A stillbirth rate of 41.4 was calculated for this study. The mean age for stillbirth was 28.8 years ± 5.4 (range 17–45 years). The median parity was 3, with a range of 0 to 13. About 68.8% or 276/401 of the women were unbooked. Among women who had stillbirths, only about 14% had tertiary education. Women of low social class constituted the greatest percentage (73.5%) who experienced stillbirth. The proportion of male stillbirths was higher than female stillbirth (54.1% or 216/392). About 58.4% or (230/394) of the stillbirths turned out to be macerated. In about 22.4% of cases, the immediate complication leading to stillbirth was not indicated. None of the stillbirths had autopsy performed.
Conclusion:
The stillbirth rate of 41.4 per 1000 observed at the study center was high. This reflects the overall picture in developing countries. A major finding from the study is the absence of postmortem examination to determine cause of stillbirth. This may be a major challenge in the effort to reduce stillbirth rate in resource-poor setting like ours.
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Qualitative study on determinants of HIV risk behaviors among Nigerian seafarers
Ibitein N Okeafor, Chukwuma U Okeafor
January-June 2017, 16(1):6-11
DOI
:10.4103/ajmhs.ajmhs_85_16
Background:
Seafarers constitute a highly mobile population who are vulnerable to acquiring and transmitting human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) due to their engagement in HIV risk behaviors. Hence, this study aimed to identify the determinants of HIV risk behaviors among seafarers.
Materials and Methods:
The study was conducted among Nigerian seafarers in Port Harcourt Seaport, Rivers State Nigeria. A qualitative study was employed using a total of four focus group discussions (FGDs) and comprised of three male groups and one female group. Snow-ball method of sampling was used to recruit participants. Data were collected using a FGD guide. Thematic analysis was performed using QSR NVivo version 10 software (QSR International Pty Ltd., Melbourne, Australia). Data were presented as quotes and charts.
Results:
The study had a total of 28 participants and comprised of 24 males and four females. The mean age of all participants was 39.3 ± 7.8 years. The participants were knowledgeable on HIV/AIDS risk behaviors. The major determinants of these behaviors as revealed by the participants were lack of self-discipline and not being God-fearing (individual-level factors). Other determinants were long duration (more than 6 months) on sea and not traveling with spouse during sea voyage (seafaring-related factors). The determinants on environment of the port and government-related factors included the presence of brothels in port areas and the absence of sensitization visits, respectively.
Conclusion:
The study noted varying determinants of HIV risk behaviors from individual level to the government level. The authors advocate the need for peer education among seafarers as well as the implementation of HIV enlightenment programs to discourage HIV risk behaviors.
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Glaucoma medication adherence in an adult population in Nigeria
Jennifer A Ebeigbe
January-June 2017, 16(1):12-18
DOI
:10.4103/ajmhs.ajmhs_80_16
Introduction:
Glaucoma is a common and potentially blinding condition, which can be managed with the use of appropriate medication therapy. For the medication to be effective, there has to be strict adherence to drug regimen. However, this is not usually the case for many glaucoma patients. The aim of this study was to identify the barriers and facilitators related to glaucoma medication adherence among an adult population.
Materials and Methods:
Forty-nine participants who had been diagnosed with glaucoma and had been on glaucoma medications for at least a year were recruited and interviewed. They were aged between 18 and 70 years with a mean age of 54 years. The one-on-one in-depth interviews were recorded using an audio recorder. Data obtained were transcribed and analysed using rank ordering to determine the degree of importance.
Results:
Results identified eight barriers to drug adherence among which were finance/cost of medication (195), forgetfulness (160) and side effects of drops (155). Other barriers were difficulty with drop administration (143), busy schedule (130) and non-availability of eye drops (122) among others. Facilitators identified included fear of blindness (185), desire for improved vision (152) and knowledge about the disease (112). Other facilitators were convenience of eye drop schedule (99), availability of drops (91) and use of alarms (89) among others.
Conclusion:
Understanding these factors would help eye care practitioners to advice their patients better and greatly slow down the progression of the disease.
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Neural tube defects and maternal characteristics in a North Indian Province
Yogender S Kadian, Roopa Malik, Nirmala Duhan, Kamal N Rattan
January-June 2017, 16(1):25-29
DOI
:10.4103/2384-5589.209484
Background:
Neural tube defects (NTD) affect fewer than 2 per 1000 pregnancies, account for a major burden on healthcare globally and have wide geographic prevalence. The present study was carried out with the aim to evaluate the maternal characteristics in cases of babies born with various neural tube defects in a tertiary care centre in Northern India.
Methods:
This retrospective analytical study was carried out by accessing and analyzing the medical case records of women who delivered babies with neural tube defects between January 2005 to December 2008 in the Department of Obstetrics and Gynaecology at Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.
Results:
Sixty seven babies had neural tube defects thus accounting for a NTD prevalence of 2.62/1000 births. Among these, there were 48 cases of anencephaly, 15 cases of meningocele and/or meningomyelocele, 4 cases of spina bifida occulta. Anencephaly was most prevalent in primiparous women of low literacy aged between 21–25 years. Similar trends were visible in meningomyelocele and spina bifida groups. Most women in the study were homemakers with almost equitable distribution in rural and urban areas. No preponderance of any particular blood group was evident for any of the neural tube defects.
Conclusion:
Neural tube defects affect a substantial number of newborns in India. Lower age and parity, low literary and rural residence are some of the maternal factors associated with increased risk of these disorders. Preventive strategies like periconceptional folic acid supplementation and health education may help reduce the incidence of these conditions even in low resource settings.
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LETTER TO THE EDITOR
Stocking and sale of misoprostol by patent and proprietary medicine vendors in Nigeria
Abubakar Ibrahim Jatau, Abubakar Sha'aban, Najib Yahaya Sani, Ahmed Tijjani Mora
January-June 2017, 16(1):78-79
DOI
:10.4103/ajmhs.ajmhs_5_17
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ORIGINAL ARTICLES
Computed tomography findings in pediatric traumatic head injury in Abuja, Nigeria
Ukamaka D Itanyi, Hadijat O Kolade-Yunusa
January-June 2017, 16(1):52-57
DOI
:10.4103/ajmhs.ajmhs_13_17
Background:
Pediatric traumatic brain injury (TBI) remains one of the leading causes of acquired disability and death in children. The morbidity and mortality associated with significant intracranial injury may be ameliorated by early diagnosis and treatment. Cranial computed tomography (CT) is a reliable imaging method for identification of intracranial lesions in patients with head trauma.
Aim:
To document the radiologic features of cranial CT in pediatric head trauma patients in a Tertiary Hospital in Abuja, Nigeria.
Method:
This was a retrospective, cross-sectional study of cranial CT findings in 104 pediatric head trauma patients visiting a tertiary referral hospital in Abuja Nigeria from January 2014 to January 2017. Numerical and graphical descriptors were used to summarize the data. In all statistical tests, significance level was set at an alpha level of 0.05.
Result:
Ages of studied patients ranged from 3 months to 18 years with mean age of 9.7 (SD 5.4) years with males dominating (66.35%). Road traffic accident, RTA occurred in 82 (79.6%) as the commonest etiologic factor across all age groups with slight dominance in children older than 16 years. Radiologic abnormalities were seen in 89 (85.6%), especially in males. Fractures coexisting with intracranial lesions were the most prevalent findings occurring in 43 (41.3%) patients. Hemorrhagic contusion was the commonest intracranial pathology. Diffuse brain lesions were seen exclusively in patients with clinically severe brain injury.
Conclusion:
RTA is the commonest etiology of pediatric TBI in our environment with combined fractures and coexisting intracranial hemorrhages as the prevalent finding.
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Arthroscopic outside-in meniscal repair: A short-term clinical experience
Ranti O Babalola, Emmanuel A Laiyemo, Shopekhai E Itakpe, Christian Madubueze, Olaoluwa M Shodipo
January-June 2017, 16(1):1-5
DOI
:10.4103/ajmhs.ajmhs_2_17
Objective:
Meniscal injuries are very common knee injuries that are presented to an orthopaedic surgeon. The goal of our study was to assess the early outcome of outside-in meniscal repair in the management of meniscal tears.
Patients and Methods:
This study was a prospective case series conducted at the National Orthopaedic Hospital, Lagos. Consecutive cases of patients with meniscal tears who met the inclusion criteria were recruited. Anterior cruciate ligament reconstruction was performed with semitendinosus autograft. Meniscal repair was performed arthroscopically by only two surgeons using the outside-in technique with size 2 polydioxanone suture. The Western Ontario and McMaster University Evaluation Tool (WOMET) score was computed during the pre-operative stage and at least 6-months post-operatively as outcome measure. The visual analogue scale (VAS) and WOMET scores in the pre- and post-operative periods were noted.
Results:
Five patients with injured menisci underwent meniscal repair. The median duration of follow-up was 14 months (range 8–30 months). Using Barret’s criteria, we determined that a clinically healed meniscus was obtained in only 2 (40%) patients. The WOMET score improved from a mean of 46 (±18) to 20 (±10.7) between the pre- and post-operative stages, and the mean VAS score decreased from 4.6 (±0.5) to 2.5 (±1.3).
Discussion:
The poor health-seeking behaviour in our environment would explain the delayed presentations of our patients. However, it has been established that chronic tears do heal. Outside-in technique remains at the moment our method of choice for meniscal repair because of the challenges we face for equipment and funding of health care in our environment. Trephination of the meniscus was performed to improve the chances of healing. Using Barret’s criteria, we had a healing rate of 40% (2).
Conclusions:
The outside-in technique remains an option for the treatment of chronic tears with good clinical improvement in the short term.
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CASE REPORTS
Musculoskeletal hydatid masquerading as malignancy: A diagnostic dilemma
Mir Abdul Wahid, Sheikh Zahoor Ahmed, Haji Altaf Gowher, Azhar Jan Butoo, Syed Arshad Ahmed, Mushood Ghulam Nabi
January-June 2017, 16(1):75-77
DOI
:10.4103/2384-5589.209546
Hydatid cyst in the iliac bone is rare and is usually an incidental finding at any site other than liver and lung. It is a zoonotic disease which is due to infection with larval stage of Echinococcus granulosus. The disease is chronic, and cysts can be lodged in different organs. It has cosmopolitan distribution and impacts on health and economic indices in many countries throughout the world. Therefore, accurate information on the distribution of the disease is first step for the control and prevention. We present an unusual case of hydatid cyst found in the right iliac bone extending into the gluteal region.
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Incidental gravid adult filarial worm in the spermatic cord and the axillary tissue: Report of two cases
Preeti Agarwal, Shweta Katiyar, Mala Sagar, Anushree Rai, Babli Gupta, Madhu M Goel
January-June 2017, 16(1):72-74
DOI
:10.4103/ajmhs.ajmhs_1_17
Gravid adult female worm of
Wuchereria bancrofti
was seen in the histology sections of axillary dissection of a radical mastectomy specimen in a patient with infiltrating ductal carcinoma and in sections from spermatic cord lesion in a 4-year-old boy. Careful observation and recognition of histologic features are important for the diagnosis in hematoxylin and eosin stained sections. In the present report, we highlight the salient morphologic features of the adult worm.
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A case report of complete tibia diaphysis extrusion in chronic osteomyelitis
Thaddeus C Agu
January-June 2017, 16(1):68-71
DOI
:10.4103/ajmhs.ajmhs_7_17
Late presentation to hospital is still a common occurrence in Nigeria. Chronic osteomyelitis of the tibia is not an uncommon infective condition in a 4-year-old boy, but delaying the search for hospital treatment until a full length of the diaphysis is extruded is uncommon. He complained of pain and fever and was noticed by the mother to be listless and was no longer playful. Over several months, his condition seemed to be improving, but a large bone was sticking out of a sinus. It was at this advanced stage that the patient was brought to our level II surgical facility. The entire tibia diaphysis was removed as a sequestrum, and the boy was ambulant again after 11 weeks. The aim of this report is to highlight this unusual condition and the need for continued health education as well as for the clinician not to despair in the management of similar neglected cases in a resource-poor setting.
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ORIGINAL ARTICLES
Chronic kidney disease risk factors in workers of an agricultural research institute in Southern Nigeria
Enajite I Okaka, Bibiana O Eiya, Afeaje B Olokor, Ikponmwosa O Iyawe, Chimezie G Okwuonu, Oluseyi A Adejumo, Odigie E Ojeh-Oziegbe, Frank A Imarhiagbe, Evelyn I Unuigbe
January-June 2017, 16(1):30-35
DOI
:10.4103/ajmhs.ajmhs_12_17
Background:
The incidence and prevalence of chronic kidney disease (CKD) is on the increase worldwide. Treatment for end-stage kidney disease constitutes a huge burden on the economy of nations affected. Early identification, modification, and treatment of CKD risk factors are the best options.
Objective:
This study assessed common CKD risk factors in a population of workers in an organization.
Materials and Methods:
A cross-sectional survey that involved 242 workers in an agricultural research institute. CKD risk factors assessed were hypertension (HTN), hyperglycemia, abdominal obesity using waist–hip ratio (WHR), general obesity using body mass index (BMI), proteinuria, and serum creatinine.
Results:
The prevalence of HTN, elevated blood sugar, general obesity, abdominal obesity, proteinuria, and elevated serum creatinine were 47.1, 9.7, 14.2, 66.5, 5.9, and 20.4%, respectively. Older participants were more likely to have elevated blood pressure, BMI, WHR, and blood sugar serum creatinine. Being a known hypertensive was associated with elevated BMI, WHR, and blood sugar compared with those without a previous diagnosis of HTN.
Conclusion:
The presence of HTN and being middle aged to elderly was associated with higher CKD risk. Workers in organizations should have mandatory annual screening for CKD and its risk factors to aid risk modification, early detection, and treatment.
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CASE REPORTS
A case report of acute kidney injury following the use of herbal vaginal pessary
Oluseyi A Adejumo, Ayodeji A Akinbodewa, Adeyemi Ogunleye, Oluwaseun F Agoi, Olatunji S Abolarin
January-June 2017, 16(1):65-67
DOI
:10.4103/2384-5589.209485
The demand and use of complementary and alternative medicine (CAM) is on the increase in many countries. Majority of the population using these herbal medicines are ignorant of their potential toxicities. We present an uncommon case of a 22 year old female who developed oliguric AKI following the use of herbal vaginal pessary. She was managed with haemodialysis and had complete renal recovery. This case highlights the potential nephrotoxicity of some herbal medication even when used locally and the urgent need to regulate CAM practice.
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ORIGINAL ARTICLES
Socio-demographic and clinical predictors of hypoxaemia among high-risk term neonates in Ilesa, Nigeria
Bankole P Kuti, Tolulope A Ogundele, Demilade K Kuti
January-June 2017, 16(1):36-42
DOI
:10.4103/2384-5589.209488
Background:
Hypoxaemia is a common feature occurring in ill neonates. Prompt identification and intervention are important to ameliorate deleterious consequences. This study set out to determine the socio-demographic and clinical predictors of hypoxaemia among ill babies at the Wesley Guild Hospital, Ilesa, Nigeria.
Patients and Methods:
Term neonates admitted to the special care baby unit were consecutively recruited over a 7-month period. Peripheral oxygen saturation (SpO
2
) was measured at presentation using a portable pulse oximeter (Nellcor
®
N-200, USA), and hypoxaemia was defined as SpO
2
< 90%. Relevant history and examination findings were compared among hypoxaemic and non-hypoxaemic babies. Multivariate analysis was used to identify predictors of hypoxaemia.
Results:
Two hundred and two babies (male-to-female ratio of 1.3:1) were recruited. The predominant presentations were perinatal asphyxia (51.5%), sepsis (31.7%) and jaundice (28.2%). Thirty-nine (19.3%) babies were hypoxaemic at admission. Female sex, infants of primigravidae, delivery outside health facilities, lack of antenatal care (ANC), grunting respiration and cyanosis were associated with hypoxaemia (
P
< 0.05). Grunting [odds ratios (OR) = 14.535;
P
< 0.001] and cyanosis at presentation (OR = 11.143;
P
= 0.005) independently predicted hypoxaemia. Twenty (7.5%) babies died, and hypoxaemia at presentation was significantly associated with mortality (
P
< 0.001).
Conclusion:
Hypoxaemia was common among the study participants and was significantly associated with mortality. Efforts should be made to make essential obstetric care affordable and widely available, as babies delivered outside the health facility to mothers with no ANC and those with grunting and cyanosis are at increased risk of having hypoxaemia.
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