{"title":"Evaluation of the incidence of central venous catheter-associated infections in patients admitted in the intensive care unit of a tertiary hospital in Nigeria","authors":"Onyekachi Okafor, A. Amucheazi, F. Onyekwulu","doi":"10.4103/ijmh.ijmh_1_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_1_22","url":null,"abstract":"Background: Presence of a central venous catheter (CVC) though useful may lead to CVC-associated bloodstream infections (CVCBSIs), resulting in increased morbidity and mortality. Objectives: The objectives of the study were to determine the incidence of CVCBSIs, the predominant causative microorganisms, the antibiotic sensitivity pattern of the microorganisms, and the associated risk factors. Materials and Methods: This prospective observational study evaluated the incidence of CVCBSIs in patients who had the catheter inserted on admission into the intensive care unit (ICU) of a tertiary hospital in South-East, Nigeria. Sixty-eight patients were recruited for the study. Blood samples were collected aseptically from a peripheral vein on admission, 72 h after the insertion of CVC, and at removal of CVC for blood culture. The distal 5 cm of the CVC was also collected at removal for microscopy, culture, and sensitivity testing. Results: Six out of all the patients recruited developed CVCBSIs, giving an incidence rate of 9.2%, whereas 48% (n = 31) developed catheter bacterial colonization. Over one-fifth (22.7%) of the patients with catheter duration beyond 5 days had CVCBSIs. Patients whose CVC duration was beyond 5 days had a higher risk of CVCBSIs (P = 0.015) than others. The commonest microorganism isolated was Staphylococcus aureus, whereas the most susceptible antibiotic was aminoglycoside (gentamycin). Conclusion: The incidences of CVCBSIs and CVC colonization were 9.2% and 48%, respectively. The duration of catheterization was found to be a major risk factor for CVCBSIs. The most predominant organism isolated was S. aureus. The most sensitive antibiotic agent was the aminoglycoside (gentamycin). It is therefore recommended that catheter care bundle which includes hand hygiene, use of chlorhexidine for skin preparation during insertion, use of barrier precautions during insertion, and the removal of unnecessary central lines should be strictly adhered to. Gentamycin should be used as empirical antibiotics in the ICUs.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"21 6","pages":"43 - 49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91509907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Determinants of female health workers’ attitude toward spouses’ use of vasectomy for family planning","authors":"I. Menuba, E. Asimadu, Sylvester Nweze","doi":"10.4103/ijmh.ijmh_54_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_54_22","url":null,"abstract":"Background: Vasectomy is an effective and safe surgical method of male contraception. It is simpler than female tubal ligation and has fewer complications. Objective: The aim of this study was to determine the effect of selected demographic characteristics on female health workers’ attitudes to spouses’ use of vasectomy for birth controlMaterials and Methods: This was a cross-sectional study of female health workers in two tertiary health institutions in Enugu, Southeast Nigeria. Data were collected using a pretested structured self-administered questionnaire. Data were collected on sociodemographic characteristics and attitudes toward vasectomy. Results: Two hundred and ninety female health workers completed the questionnaire. The mean age of participants was 32.26 ± 9.39 years. Approximately 66.6% of the women were less than 35 years and 53.1% were married. Only 21.0% of the respondents would encourage their spouses or partners to undergo vasectomy after they have had their desired number of children. Half of the women (50.0%) would prefer to have their tubes tied (tubal ligation) and 63.1% had never discussed vasectomy with their spouses or partners. Younger women (<35 years) were significantly more likely to encourage their spouses/partners to have a vasectomy (odds ratio [OR] 2.1289; P = 0.0231). However, ever-married women (OR 0.1296; P = 0.0000) and women who have had children (OR 0.1767; P = 0.0000) were significantly less likely to do the same. Nurses were more likely to encourage their spouses to undertake vasectomy compared to doctors (OR 2.4750; P = 0.0041). Conclusion: Vasectomy is not widely accepted among our female health workers; only a fifth of them would encourage their spouses/partners to have a vasectomy.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"19 1","pages":"50 - 53"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78699746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obinna Remigius Okwesili, E. Nnadi, Johnson Achebe
{"title":"Management of melanoma of the foot in our subregion: Is preliminary biopsy always required?","authors":"Obinna Remigius Okwesili, E. Nnadi, Johnson Achebe","doi":"10.4103/ijmh.ijmh_51_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_51_22","url":null,"abstract":"Background: Majority of patients with melanoma of the foot in our subregion present late. After preliminary excision biopsy for these patients, many of them do not come back for further excision when there is an indication to do so following biopsy result. A better result could be achieved by using wider margins for excision biopsy in patients with low socio-economic status. Objectives: We assessed the role of excision of melanoma of the foot without preliminary biopsy as an option in the management of melanoma of the foot in our subregion. Materials and Methods: This was a 5-year retrospective review of patients with melanoma of the foot that presented to a tertiary health institution in Nigeria from December 1, 2014 to November 30, 2019. Results: Half of the patients with lesions that have not advanced locally (35.3%) had wide local excision with 2–3 cm margin without preliminary biopsy, relying on clinical diagnosis of melanoma. Another 35.3% of same number as those mentioned above were managed by doing a preliminary biopsy. Incision biopsy was employed for those with distant metastasis or lesions where amputation of any form was indicated (29.4%). Conclusion: Melanoma of the foot can be diagnosed clinically with a high degree of accuracy in majority of patients. Preliminary biopsy is essential for lesions requiring amputation or very large lesions. For small lesions, excision biopsy with wider margins than is used for preliminary biopsy is beneficial especially for poor patients who tend to delay having a second surgery that is definitive due to financial constraint, ignorance, or other reasons.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"55 1","pages":"54 - 58"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90247467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multiple subcutaneous nodules leading to a diagnosis of metastatic neuroblastoma in an infant: A case report","authors":"D. Suleiman, Z. Adamu, A. Mohammed","doi":"10.4103/ijmh.ijmh_64_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_64_22","url":null,"abstract":"Neuroblastoma is a childhood malignancy with protean clinical manifestations. One rare presentation is multiple cutaneous nodules, especially in infants. We present a case of multiple cutaneous nodules as the initial presentation in an infant with metastatic neuroblastoma. The patient received chemotherapy with good response and is alive and well 5 years post diagnosis.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"38 1","pages":"77 - 80"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79039948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maternal and perinatal outcomes of abruptio placenta at the Lagos University Teaching Hospital: A five-year retrospective review","authors":"A. Oluwole, A. Ugwu, O. Akinajo","doi":"10.4103/ijmh.ijmh_52_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_52_22","url":null,"abstract":"Background: Abruptio placentae is a form of antepartum hemorrhage that occurs when there is a partial or complete separation of the placenta before the delivery of the fetus. In addition to vaginal bleeding, it is often associated with abdominal pain, uterine tenderness, fetal heart irregularity, and hypertonic uterine contraction. It is a significant cause of maternal and perinatal morbidity and mortality. It is therefore important to review this obstetrics emergency with a view to creating more awareness on its complications. Objectives: The study was aimed to determine the prevalence as well as the perinatal and maternal outcomes of abruption placentae at the Lagos University Teaching Hospital (LUTH), Nigeria. Materials and Methods: This was a retrospective review of records of pregnant women managed in the labor and postnatal wards of LUTH, Idi-Araba, Nigeria, over a 5-year period from January 2015 to December 2019. Relevant data retrieved were entered and analyzed using the IBM Statistical Package for Social Sciences (SPSS Statistics), version 23. Results: A total of 80 pregnancies were complicated with abruptio placentae giving a prevalence of 0.96% of all admissions during the study period. Several maternal complications recorded included acute renal failure (6.25%), disseminated intravascular coagulation (2.08%), postpartum anemia (37.5%), and postpartum hemorrhage (54.7%). Forty six percent (46%) of the neonates had no complication, 11.3% had early neonatal death, 20% had fresh stillbirth, and 22.5% had birth asphyxia. Conclusion: Abruptio placentae contributed a sizeable proportion to maternal morbidity and perinatal morbidity and mortality in the study population.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"29 1","pages":"39 - 42"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76889911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Chijioke, Micheal Okafor, Uzoamaka A Okoli, Imelda Nubia, Bridget Nwokolo, I. Onah, Clinton Ide, Chika Effiong-Essieng, Genevieve Obiefuna, Chikere A. Anusiem
{"title":"Anthropometric effect of a personalized food avoidance dietary approach to stop hypertension","authors":"C. Chijioke, Micheal Okafor, Uzoamaka A Okoli, Imelda Nubia, Bridget Nwokolo, I. Onah, Clinton Ide, Chika Effiong-Essieng, Genevieve Obiefuna, Chikere A. Anusiem","doi":"10.4103/ijmh.ijmh_56_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_56_22","url":null,"abstract":"Background: Body anthropometries are indicators of health and disease. It is universally accepted that it is a useful tool for assessing health status. Objective: The aim of this article is to determine the effect of a personalized food avoidance dietary approach to stop hypertension (PFADASH) on anthropometric parameters: body mass index (BMI), triceps skin fold thickness (TSFT), and abdominal circumference (AC) on study participants. Materials and Methods: This was a longitudinal study and part of an open controlled clinical trial of a PFADASH approved by the University of Nigeria Teaching Hospital Ethics Committee. Anthropometric parameters were compared between study participants with good and poor dietary compliance to a PFADASH. Results: There was no significant difference in the anthropometric parameters: BMI, TSFT, and AC among participants with good and poor dietary compliance to a PFADASH (P > 0.05). Conclusion: There was no negative effect of a PFADASH on anthropometric parameters, despite not being a calorie-restrictive dietary intervention.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"26 1","pages":"25 - 30"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82968027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of resilience in the second wave of the COVID-19 pandemic: A snapshot of experiences of adolescents secondary school children in southeast Nigeria","authors":"A. Chinawa, E. Ossai, A. Aronu, Josephat Chinawa","doi":"10.4103/ijmh.ijmh_40_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_40_22","url":null,"abstract":"Background: The second wave of the COVID-19 pandemic has created much psychological burden on the adolescent child. Resilience is an intertwine of risk and protective factors that may help the adolescent child in growth and development. Objectives: This study aimed to determine the factors that influence resilience among adolescents attending secondary schools in southeast Nigeria. Materials and Methods: This is a cross-sectional study of 496 adolescent students who attend six secondary schools in Enugu city. Results: The majority of the respondents, 79.4%, feel safe when they are with their families. A high proportion of the respondents, 61.5%, were resilient. A comparable proportions of male (59.9%) and female (62.9%) respondents were resilient. (χ2=0.476, P = 0.490). A significantly higher proportion of respondents who were in junior secondary three class, 70.5%, were resilient when compared with those in senior secondary three class, 59.4% (χ2=4.050, P = 0.044). The highest proportion of respondents who had strong social support, 75.8%, were resilient, whereas those who had poor social support were the least, 36.6%. The observed difference was statistically significant (χ2=39.995, P < 0.001). The respondents who had poor social support were about six times less likely to be resilient when compared with those who had strong social support [adjusted odds ratio (AOR)=0.177, 95% confidence interval (CI): 0.099–0.317]. Also, the respondents who had moderate social support were about three times less likely to be resilient when compared with those who had strong social support (AOR=0.369, 95%CI: 0.261–0.601). Conclusion: Resilience in adolescents is enhanced by education, being in junior secondary class, good family structure, and strong social support.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"1 1","pages":"19 - 24"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83642533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ChibuzoC Uguru, N. Uguru, Udochukwu Ugochukwu Ogu, Prince Agwu, C. Okeke, N. Onyejaka, Ogochukwu Forchu, N. Eze
{"title":"Tertiary Institutions’ Social Health Insurance Program: Awareness, knowledge, and utilization for dental treatment among students of a Nigerian University","authors":"ChibuzoC Uguru, N. Uguru, Udochukwu Ugochukwu Ogu, Prince Agwu, C. Okeke, N. Onyejaka, Ogochukwu Forchu, N. Eze","doi":"10.4103/ijmh.ijmh_20_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_20_22","url":null,"abstract":"Background: Awareness and knowledge can play key roles in influencing the utilization of health insurance programs in Nigeria. Objectives: This study aims to investigate the awareness and use of the Tertiary Institutions/Voluntary Participant Social Health Insurance Program (TISHIP) for undergraduate dental services. Materials and Methods: A cross-sectional descriptive study was conducted in the Enugu Campus of the University of Nigeria and the study population comprised full-time undergraduate students of the institution with a total sample size of 400. Results: Majority (66.7%) of the respondents were aware of the TISHIP, but 37% were aware that it covered dental treatments, and 16.1% had received dental treatment under TISHIP. Fifty point eight percent (50.8%) of the respondents were not registered under the insurance program. The reason respondents had not registered was because majority (49.7%) were not aware of the compulsory registration into the scheme. Respondents agreed that TISHIP would promote equity in healthcare delivery (57.5%), promote improved health facilities (39.4%), and 52.5% were willing to participate in the scheme while 47.9% were undecided on whether TISHIP was worth the financial contribution. Presumed high cost of dental treatment (51.9%) and non-availability of materials for dental treatment at dental facilities (50.8%) were factors that affected the utilization of TISHIP (P < 0.05). Conclusion: Despite the positive effect of TISHIP in cushioning the cost of dental care, utilization is poor, thus there is a need to scale up awareness among the students’ population.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"40 1","pages":"337 - 343"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91518002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving access to diabetes care in Nigeria – The GIFSHIP opening","authors":"C. Nwatu","doi":"10.4103/ijmh.ijmh_33_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_33_22","url":null,"abstract":"Diabetes mellitus, has continued on a relentless upward trajectory globally, with profound socio-economic consequences. Not surprisingly, the International Diabetes Federation in collaboration with the World Health Organization and the United Nations; in commemoration of the World Diabetes Day 2021, aptly chose the theme – ‘Access to Diabetes Care - If Not Now, When?’ for the year 2021 (the centenary anniversary of insulin discovery), till 2023; to underscore the difference which having access to diabetes care can make, in relation to diabetes management. The Group, Individual and Family Social Health Insurance Program (GIFSHIP) is a non-formal sector insurance package for individuals; groups; and family units in Nigeria, recently introduced by the federal government, to improve universal health coverage. The inherent positive contributions of the GIFSHIP, towards improving access to diabetes care in Nigeria was reviewed. MEDLINE, Omni and Google Scholar searches were conducted using keywords - access to diabetes care, barriers to diabetes care, GIFSHIP, and Nigeria. Relevant studies were extracted and reviewed. Authors summarized health care access, narrowing down to diabetes care access. The opportunity for improved access to diabetes care, which the GIFSHIP presents was highlighted. The role of the Diabetes Association of Nigeria (DAN) in advancing the uptake of, and utilization of the GIFSHIP package for their members, was explored. The GIFSHIP showed great promise for improving access to diabetes care in Nigeria, while the DAN was projected as an effective channel for dissemination and uptake of the GIFSHIP among individuals with diabetes.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"696 1","pages":"319 - 325"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87200353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ifeoma N. Asimadu, S. Okeke, N. Kizor-Akaraiwe, N. Mbadiwe, Chidi Mbakigwe
{"title":"Perception of ocular complications among patients with diabetes mellitus attending tertiary hospitals in Enugu, Nigeria","authors":"Ifeoma N. Asimadu, S. Okeke, N. Kizor-Akaraiwe, N. Mbadiwe, Chidi Mbakigwe","doi":"10.4103/ijmh.ijmh_44_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_44_22","url":null,"abstract":"Background: Diabetes mellitus can lead to sight and life-threatening complications. It affects people in both developed and developing countries. Many diabetics present to the eye clinics with undetected advanced eye complications. Aim: The study aimed at evaluating the perception of the ocular complications of diabetes and how it influences the attitude and practice of the diabetics attending the eye clinics. Materials and Methods: A cross-sectional study was conducted in two tertiary hospitals in Enugu over a 3-month period. An interviewer-administered questionnaire was used to assess their perception, and hence their attitude and practice toward diabetic eye complications after obtaining their informed consents. Results: A total of 884 diabetics participated. There were 337 (38.1%) males and 547 (61.9%) females. A majority, 523 (59.2%), were in the age range of 51–70 years. Only 40.7% knew that diabetes affects the eyes; 60.2% did not know that good blood sugar control will help prevent eye complications; 41.1% knew they needed to see the eye specialist from time to time but not necessarily for routine check-up. Only 9.1% saw the eye specialists routinely; the remaining 90.9% never went for routine eye check as only 40.72 knew it affects the eyes. Conclusion: There was poor perception of the disease and its complications, which led to poor practice such as no regular, periodic eye examinations. There is a dire need for education of the diabetics, building of multidisciplinary effective strategies and policies with the view to decreasing the burden of the disease especially in the developing countries.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"521 1","pages":"404 - 409"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91127734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}