Journal of Medicine in the Tropics最新文献

{"title":"Correlation between functional disability grade and radiographic severity among Nigerian patients with knee osteoarthritis","authors":"U. Abdulaziz, O. Adelowo, B. Usman","doi":"10.4103/jomt.jomt_39_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_39_18","url":null,"abstract":"Background: Knee osteoarthritis (OA) is the most common form of degenerative arthritis in human and a leading cause of functional disability in the middle aged and elderly. The diagnosis of knee OA is often based on clinicoradiographic criteria. And in spite of the widespread utilization of knee radiograph in the diagnosis of knee OA, studies on the correlation between clinical and radiographic findings have been discordant. Although most studies of knee OA patients in Nigeria have incorporated knee radiograph in the diagnosis of the disease, the contribution of radiographic severity to functional disability in Nigerian patients is not well described. Objective: The aim of this article is to determine the pattern of radiographic knee OA in Nigerian patients and the correlation between radiographic grades of knee OA and functional disability. Materials and Methods: One hundred forty consecutive patients with knee OA attending the Rheumatology Clinic of Ahmadu Bello University Teaching Hospital were recruited for the study. Patients biodata and anthropometric parameters were ascertained. Patients had general and musculoskeletal examination. Knee radiographs were done for all patients and graded using the Kellgren-Lawrence (K-L) grading system. Pain and functional disability grades were measured using Likert 3.0 Western Ontario McMaster University index. Results: All 140 patients had definite knee OA on radiograph (K-L grade 2 and above). Grade 2 radiographic knee OA was noted in 51 (36.4%) patients, grade 3 in 71 (50.7%) patients, and grade 4 in 18 (12.9%) patients. Eighty-nine (63%) patients had severe radiographic knee OA. The mean pain and disability scores were significantly higher in patients with grade 3 or 4 radiographic knee OA compared to those with grade 2 radiographic knee OA. Both pain and functional disability moderately correlated with radiographic grades (rs = 0.36, P = 0.000) and (rs = 0.48, P = 0.000), respectively. Conclusion: The point prevalence of severe radiographic knee OA (K-L grade 3 or 4) is 63% in Nigerian knee OA patients. There is a moderate correlation between radiographic severity and functional disability in knee OA patients, with radiographic severity being an independent predictor of functional disability.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"10 1","pages":"14 - 19"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72634283","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":"Craniofacial morphology of HIV infected adolescents on highly active antiretroviral therapy (HAART): An original research","authors":"M. Neeraja, Amit Nimkar, M. Ratnam, R. Naidu, B. Kumar, Humera Ayesha, A. Nayyar","doi":"10.4103/jomt.jomt_6_19","DOIUrl":"https://doi.org/10.4103/jomt.jomt_6_19","url":null,"abstract":"Background: Numerous studies have illustrated the therapeutic effects of the highly active antiretroviral therapy (HAART) while simultaneously leading to a plethora of associated adverse effects including changes in the craniofacial growth and development. The present study was planned to analyze the craniofacial morphology in adolescents by evaluating the skeletal cephalometric profile of the human immunodeficiency virus (HIV)-infected patients in this age group and comparing them with the HIV-negative controls. Methods: The present study was a planned case–control study that included 25 HIV-positive adolescent patients aged between 10 and 19 years (study group) who were compared with 25 age and sex-matched HIV-negative adolescent controls (control group). All the patients had been HIV-infected via vertical transmission with positive serology confirmed in two different tests and had been on HAART since they were born. Results: In the 10 to 12-year age group, positions of maxilla and mandible in the study group were found to be retruded in relation to the skull base when compared with the control group whereas in the 13 to 15 and 16 to 18-year age groups, maxilla was retruded slightly while the mandible was found to be protruded in the study group in relation to the skull base. Conclusion: Although the differences in majority of the measurements made were not found to be significant enough, the study highlighted the significance of further studies to be conducted in this regard, especially, the longitudinal study designs wherein the said variables can be studied on a follow-up basis to have an idea of the exact changes observed and their pattern in the included groups.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"30 1","pages":"42 - 50"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87242807","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":"Role of healthcare personnel attire in the spread of healthcare-associated infections: Knowledge of healthcare workers in a tertiary hospital in northwest Nigeria","authors":"B. Nwankwo, Victor Bako, K. Hamza, M. Onoja-Alexander, L. Amadu, A. Olorukooba","doi":"10.4103/jomt.jomt_20_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_20_18","url":null,"abstract":"Background: Healthcare facilities are workplaces where healthcare-associated infections (HCAIs) predominate and disease pathogens are harbored by fomites. This situation could be aggravated by increase in number of resistant organisms and inadequate knowledge especially in developing countries. Objective: The aim of this article was to assess the knowledge on role of healthcare personnel attire in spread of HCAIs among healthcare workers (HCWs). Methodology: A descriptive cross-sectional study was carried out using a pretested structured interviewer-administered questionnaire. A total of 127 respondents were interviewed. Data was collected and analyzed using IBM Statistical Package for Social Sciences (SPSS) version 23. Data was presented using frequencies and percentages for categorical variables. Results: All respondents (100.0%) had heard of fomites and 124 (97.6%) of them knew that HCAIs could be spread through fomites. Among the respondents who wore ward coats/uniforms, 91.3% perceived that ward coats/uniforms have the potential of spreading infections. The rate of HCAIs was said to be low in about half (56.7%) the respondents and 54 (42.5%) reported that they did not have a HCAIs reporting system in their unit. Most respondents, 114 (89.8%), had good knowledge. Conclusion: Although knowledge of the role of HCWs’ attire in spread of HCAIs was good among HCWs, it can still be improved upon by training and retraining of HCWs by management. Most respondents reported lack of HCAIs reporting system in their units. Therefore, HCAIs reporting systems should be established in all units of the hospital by the management.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"31 1","pages":"123 - 127"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80011240","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":"The effect of health insurance on maternal and child health: A systematic review","authors":"S. Aderibigbe, F. Wit, M. V. van Hensbroek, G. Osagbemi, T. Akande","doi":"10.4103/jomt.jomt_17_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_17_18","url":null,"abstract":"Background: There has been increased interest in improving access of the rural poor to essential healthcare through community-based health insurance schemes to create an alternative from the dominant OOP expenditure being currently experienced. Aim: We performed a systematic review with the aim to determine the global effect of health insurance systems on maternal and child health. Methods: A search for primary studies reporting on the effect of health insurance on maternal and child health was done. Results: Eight articles met the inclusion criteria with four of them from low-income countries. We found that the cesarean section rates (P = 0.01) and proportion of women with low birth weight babies (P < 0.0001) were statistically significantly better in the insured women. However, the prevalence of (pre)eclampsia, the proportion of women with anemia/excessive blood loss at delivery, and mean birth weight at delivery were similar between the insured and uninsured women (P > 0.05). The risk of wasting among insured children was also reduced, although not statistically significant (P = 0.26). Conclusions: The findings suggest that health insurance probably has a beneficial effect in reducing the number of low birth weight babies born. Insurance also seems to reduce the risk for cesarean section. More research on the impact of health insurance on both maternal and child health outcomes need to be done to further establish these outcomes.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"55 1","pages":"83 - 92"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84957761","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":"Fever: A friend or a foe","authors":"NY Shehu, AS Omololu","doi":"10.4103/jomt.jomt_4_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_4_18","url":null,"abstract":"The concept of fever is an interesting subject that has intrigued clinicians for centuries. As pain is an important stimuli to withdraw from a noxious stimuli that may be potentially harmful, so is fever an important sign of a possible microbial invasion. Back and forth, there has been arguments and debates about whether fever is deleterious, a foe, or actually beneficial. There has also been question about whether or not to treat it, and when to treat it. This review article tries to paint a broad picture of both sides of this coin.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"6 1","pages":"79 - 82"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72710281","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 delay in presentation and clinico-laboratory features of newborns admitted for neonatal jaundice in a tertiary hospital in south-east Nigeria","authors":"U. Ekwochi, C. Osuorah, I. Ndu","doi":"10.4103/jomt.jomt_21_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_21_18","url":null,"abstract":"Background: Neonatal jaundice (NNJ) is one of the most common causes of hospital visit in the first 30 days of life. It is one of nine danger signs of neonatal illness recognized by the World Health Organization. Understanding its clinical and laboratory features will enhance early diagnosis and management to forestall associated morbidities. This study explored the clinical and laboratory features of newborns admitted for NNJ in a tertiary hospital in the south-eastern Nigeria. Methods: It is a descriptive study carried out prospectively over a 18-month period on all newborns admitted for jaundice at the Enugu State University Teaching Hospital. Patients were enrolled consecutively at presentation and relevant clinical and laboratory features in these newborns were documented in a structured admission register designed for this study. These data were subsequently transferred to Microsoft Excel and analyzed with SPSS version 20. Results: A total of 83 (17.0%) out of 487 newborns were admitted for NNJ during the study period. More female newborns (P = 0.321), newborns delivered outside Enugu State University Teaching Hospital (P = 0.09), mothers ≤ 30 years (P = 0.648), and mothers with lower educational attainment (P = 0.502) had delayed presentation to hospital. Poor suckling (42%), fever (38%), and depressed primitive reflexes (38%) were the most common clinical features seen in admitted newborns. Yellowish discoloration of newborns was noticed within the first 24 h of life in only 13%, between 2 and 7 days in 81%, and after the seventh day of life in 6% of newborns. The median (interquartile range, IQR) of the age jaundice was first noticed and when infant was brought to the hospital for evaluation was 3.0 days (IQR 2–5) and 5.0 days (IQR 4–7), respectively. This resulted to a mean onset–presentation delay time of 2.8 ± 2.3 days (∼67.2 h). The mean total serum bilirubin and unconjugated hyperbilirubinemia was 307 ± 145.2 and 257.5 ± 127.6 μmol/L, respectively. Malaria parasite (17%), glucose-6-phosphate deficiency (5%), and ABO incompatibility was seen in 8% of newborns surveyed. Conclusions: NNJ remains a common health problem in our setting. This underscores the need to upscale education of the mothers and caregivers especially those that prefer to deliver outside a tertiary health institution on the need for early presentation in newborns with jaundice associated with poor suckling and reduced activities.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"40 1","pages":"128 - 134"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76962482","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":"Pregnancy-associated breast cancer: An institutional experience","authors":"S. Olatoke, S. Agodirin, A. Adenuga","doi":"10.4103/jomt.jomt_14_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_14_18","url":null,"abstract":"Introduction: Breast cancer is the second most common malignancy in pregnant women. Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy and the first postpartum year. PABC is associated with difficulty in detection, diagnosis, and definitive management. Management of these patients is centered on the wellbeing of both the fetus and the mother. We report the epidemiology, pathology, treatment, and outcome of patients with PABC managed at our institution. Patients and Methods: Twelve patients were managed for PABC by the Division of General Surgery from January 2012 to December 2017. Their records were retrieved and relevant information extracted. Results: Nine patients were diagnosed during pregnancy and three while lactating. All patients presented with stage III and IV disease, with all stage IV patients dying within 6 months of presentation. None of the children born to patients who had neoadjuvant chemotherapy had any obvious congenital anomaly at birth. Conclusion: The late stage at presentation of our patients means that antenatal screening of pregnant women for PABC should be strongly encouraged. Treatment of PABC in our setting should be aggressive and similar to that of nonpregnant patients. The use of taxane-based chemotherapy may improve outcome.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"20 1","pages":"104 - 110"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88028735","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":"What’s in your hands? A systematic review of dietary assessment methods and estimation of food sizes in a Primary Care Clinic","authors":"A. Ogunbode, M. Owolabi, O. Ogunbode, A. Ogunniyi","doi":"10.4103/jomt.jomt_22_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_22_18","url":null,"abstract":"Introduction: Many patients with noncommunicable diseases such as obesity are attended to in Family Practice Clinics where quick dietary assessment along with estimation of food sizes as part of lifestyle modification and appropriate intervention could be offered. We performed a systematic review to determine the dietary assessment methods with the best evidence that can be employed in a Family Practice Clinic. Methods: Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines were used to conduct a systematic review of PubMed, Google, and Google Scholar databases from 1992 to 2017. Results: We found 730 original research articles, case–control studies, review articles, proceedings, transactions, and textbooks. Thirty-seven articles were selected out of which two were secondary data, 12 were review articles, 10 were descriptive surveys, and one was a prospective cohort study. There were two randomized controlled trials, two mixed study designs, one working paper, and seven guides. Food portion size estimation using household objects and the hand guide, then the food pyramid guide along with the food-sized plate intervention was documented. Conclusion: In view of the busy nature of Family Practice Clinics in several countries, in performing dietary assessment, food portions can be estimated using household measures and the hand portion guide. The pyramid guide and the portion-sized plate can then be used for intervention.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"50 1","pages":"93 - 103"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91295184","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":"Ultrasound features of placental changes and their obstetric correlates among HIV patients and controls at Aminu Kano Teaching Hospital, Kano","authors":"A. Rabiu, A. Ismail, Y. Lawal, J. Mu'uta","doi":"10.4103/jomt.jomt_15_18","DOIUrl":"https://doi.org/10.4103/jomt.jomt_15_18","url":null,"abstract":"Background: One of the serious health problems in the world today is the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome pandemic, with Nigeria having the second largest number of new cases. During pregnancy, HIV-infected women face more adverse effects than uninfected women. This study aimed at evaluating ultrasound features of placentas of HIV-positive women and controls to demonstrate a difference in vasculoplacental complications between the two groups. Methods: A comparative study was conducted among HIV-positive women and their matched controls. Informed consent was obtained and a pretested interviewer-administered questionnaire was used. The women had ultrasound assessment of the placenta and an obstetric ultrasound scan. Results: There were no differences in placental surface area (t = −1.122, df = 6, P = 0.305, 95% confidence interval: −17.46 to 15.56) and placental thickness (t = 1.846, df = 58, P = 0.07, 95% confidence interval: −0.405 to 9.99). Calcifications were found but not related to HIV status. The most common complication among the HIV-infected women was miscarriage. No complications were recorded among the controls. Conclusion: There was no difference in the vasculopathological changes detectable by ultrasound scan in the placentas of HIV-infected and uninfected pregnant women.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"20 1","pages":"117 - 122"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72937404","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":"Comparative sonographic assessment of renal dimensions and clinicobiochemical parameters among diabetic and nondiabetic adults in Benin City, Nigeria","authors":"E. John, B. Igbinedion, A. Akhigbe","doi":"10.4103/JOMT.JOMT_27_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_27_17","url":null,"abstract":"Background: Diabetes mellitus affects all major organs of the body including the kidneys. One of its effects on the kidney is alteration of renal volume. Aim: The aim of this study was to sonographically evaluate and compare the renal volume in patients with diabetes and nondiabetic controls. This study also correlated the effect of biochemical and anthropometric measurements with the renal volume. Materials and Methods: The study is prospective, comparative, and cross-sectional involving ultrasonic measurement of renal dimensions of 150 adults with diabetes and 150 nondiabetic adults at the University of Benin Teaching Hospital, Benin City, using a Sonace X6 ultrasound machine (Medison Inc., Seoul, South Korea). The anthropometric measurements and biochemical estimation of fasting blood sugar, glycosylated hemoglobin, plasma creatinine, and urinary protein were performed. Results: The right and average renal volumes were higher in the diabetics than that in the nondiabetics. The left renal volume, although higher in diabetics, was, however, not statistically significant (P = 0.219). The renal volumes (right, left, and average) showed positive correlation with height, weight, and body mass index for the group of adults with diabetes and the nondiabetic groups. The renal volumes also correlated negatively with a duration of diabetes at significant statistical levels (r = −0.453, P = 0.012; r = −0.424, P = 0.020; r = −0.404, P = 0.027 for right, left, and average kidney volumes, respectively). Conclusion: Renal changes in diabetics that affect its dimensions are demonstrable sonographically. Hence, ultrasound plays some role in monitoring diabetics.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"13 1","pages":"17 - 23"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74988648","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}