Nigerian Postgraduate Medical Journal最新文献

{"title":"Comparative Evaluation of Virtual Reality versus Standard Nursing Care in Managing Pain and Fear during Lumbar Puncture Procedures: A Randomised Controlled Trial.","authors":"Amer M Kasim, Ahmed F Hassan","doi":"10.4103/npmj.npmj_630_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_630_25","url":null,"abstract":"<p><strong>Background: </strong>Meningitis is a serious infectious disease that can cause significant morbidity and long-term neurological problems. Although a lumbar puncture is a necessary diagnostic procedure, it is often accompanied by discomfort, anxiety, and fear, which can severely impact the patient's experience. Although there is few data on its application prior to lumbar puncture in adult patients with meningitis, immersive virtual reality (VR) has become a promising non-pharmacological technique for lowering procedural distress. Thus, among individuals undergoing lumbar punctures, this randomized controlled research assessed how well pre-procedural VR reduced pain, anxiety, and fear while enhancing patient satisfaction.</p><p><strong>Objective: </strong>This study aims to evaluate the effectiveness of virtual reality (VR) in reducing pain and fear among adults undergoing lumbar puncture (LP) compared with standard care protocol.</p><p><strong>Methods: </strong>A randomised clinical trial was conducted from May to October 2025, using a single-blind, true experimental design. A total of 85 patients were randomly assigned to either the VR intervention group ( n = 41) or the control group receiving standard care ( n = 44). Pain levels were assessed using a visual analogue scale. Fear was assessed using the Multidimensional Fear-of-Injection Scale. Data were analysed using SPSS version 26.</p><p><strong>Results: </strong>According to the study, the findings revealed a significant reduction in pain levels among the study group following the VR intervention, with mean pain scores dropping from 7.54 ± 1.925 to 2.49 ± 0.675. In contrast, the control group showed increased pain intensity, with mean scores rising from 6.84 ± 1.842 to 8.36 ± 1.348. The VR group showed a significant reduction in fear scores across all domains, whereas no significant changes were observed in the control group. Direct fear decreased from 20.12 ± 1.71 to 9.44 ± 2.00, indirect fear from 17.24 ± 1.46 to 8.66 ± 2.24, physiological response improved from 0.34 ± 0.66 to 3.00 ± 1.00 and avoidance behaviour decreased from 16.71 ± 1.49 to 7.80 ± 1.85.</p><p><strong>Conclusions: </strong>The research shows that the use of VR prior to LP significantly reduces level of pain and fear compared to standard care. These results support VR as a non-pharmacological intervention for fear and pain to improve patient experience during invasive procedures. In contrast, the control group experienced no improvement.Trial Registration: The IRCT code for the trial was IRCT ID 20250803066743N1.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"579-584"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795691","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":"Pineoblastoma in a 5-Year-Old Male: A Case Report and Review of Literature.","authors":"Zainab Ali Adamu, Garba Dahiru Waziri, Abdulrazaq Ajanaku Jimoh, Abdullahi Mohammed, David Harrison Lawan, Gabriel Jonathan Lolo","doi":"10.4103/npmj.npmj_635_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_635_25","url":null,"abstract":"<p><strong>Abstract: </strong>Pineoblastoma (PB) is a rare malignant embryonal tumour arising from the pineal gland. It commonly affects the paediatric age group with a slight male predilection. The typical clinical features include symptoms and signs of raised intracranial pressure, but extracranial metastasis may be seen in poorly differentiated tumours. We present a 5-year-old male who presented with clinical features suggestive of raised intracranial pressure. Radiological investigations revealed a pineal region tumour, and histopathological evaluation confirmed the diagnosis of a PB. The patient was optimised, and he had a right occipital craniotomy and microscopic surgery decompression via interhemispheric transplenial with ventriculoperitoneal shunt inserted. Fever, as a post-operative complication, was noted which necessitated removal of the shunt. The patient did well and was followed up bi-weekly. Unfortunately, the patient presented 5 months later with a recurrence, and he succumbed to his illness.Highlights (Key Messages )• Pineoblastoma is a high-grade aggressive embryonal tumour arising from the pineal gland• It typically affects the paediatric population with a slight male preponderance• Prognosis is poor with high rates of mortality• Imaging studies are necessary but prompt histopathological evaluation is required for a definitive diagnosis of this tumour.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"683-686"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796319","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":"Surgical Management of Post-tuberculous Spinal Deformity in Adults: A Case Series Report from a Nigerian Tertiary Orthopaedic Centre.","authors":"Adetunji M Toluse, Kayode O Odejobi, Taofeek O Adeyemi","doi":"10.4103/npmj.npmj_650_25","DOIUrl":"10.4103/npmj.npmj_650_25","url":null,"abstract":"<p><strong>Abstract: </strong>Post-tuberculous spinal deformity remains an important cause of chronic morbidity following healed spinal tuberculosis, particularly in low- and middle-income countries. Residual kyphosis may result in persistent pain, sagittal imbalance, cosmetic deformity and late neurological deterioration. Surgical correction is technically demanding because of rigid deformity and compromised bone quality, yet it may offer meaningful functional recovery when appropriately indicated. We report a case series of three adult patients with post-tuberculous spinal deformity managed surgically at a Nigerian tertiary orthopaedic centre. All patients underwent single-stage posterior-only decompression, deformity correction and pedicle screw-rod instrumentation. Anterior column reconstruction was performed in all cases using either an expandable titanium cage or a fibular strut graft. Clinical, radiological and neurological outcomes were assessed during follow-up. The patients were aged 24-33 years (median 32 years), with follow-up ranging from 26 to 60 months (median 36 months). Two patients presented with thoracic kyphotic deformity (90° and 92°), while one had lumbar involvement (20°). Postoperatively, thoracic kyphosis improved to 25° and 45°, and lumbar alignment was restored to physiological lordosis. The median angular correction achieved was 47° (range 40°-65°). One patient presented with paraparesis (ASIA D) and achieved complete neurological recovery, while the remaining two maintained intact neurology (ASIA E). All patients demonstrated radiological fusion and maintained deformity correction at the latest follow-up, with no implant-related complications. Single-stage posterior-only surgical correction of post-tuberculous spinal deformity in adults can achieve satisfactory deformity correction, solid fusion and neurological recovery in carefully selected patients.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"678-682"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796330","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":"Erratum: What Predicts Attention-Deficit/Hyperactivity Disorder Literacy in Primary Schoolteachers?","authors":"","doi":"10.4103/npmj.npmj_429_26","DOIUrl":"https://doi.org/10.4103/npmj.npmj_429_26","url":null,"abstract":"","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"689"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796190","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 Impact of Conflict on Maternal and Child Health Services: A Scoping Review.","authors":"Henry Adutomare Okodaso, Oriasotie Moses Ujaddughe, Kenneth Onome Adagba, Felicia Adaobi Ikolo, Teddy Bawo Ikolo, Michael Damilare Adeniyi, Uwaifoh Akpamu, Henry Ososan Oluwaseyi, N Naomi Waiganjo","doi":"10.4103/npmj.npmj_511_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_511_25","url":null,"abstract":"<p><strong>Abstract: </strong>Conflicts are unavoidable aspect of human existence, causing disruptions in livelihoods, infrastructure, socioeconomic systems and healthcare access. Among the most severe effects of conflict are those on maternal and child health (MCH) services, on which there is a notable scarcity of research. Consequently, this scoping review examines the impact of conflict on the accessibility of MCH services and their associated treatment outcomes and identifies limitations. A review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and the Joanna Briggs Institute Methods Manual for scoping review to map works of literature regarding the effects of conflict on MCH across nine databases (PubMed, Scopus, MEDLINE, CINAHL, Web of Science and Google Scholar) published in English between January 2000 and May 2024. The quality of the studies was evaluated using NIH tools, resulting in 17 classified as good, 5 as fair and 1 as poor, which was subsequently excluded. A narrative synthesis was employed to categorise the findings based on predisposing, enabling and need factors. Out of 612 records, 23 studies (from 15 countries, predominantly qualitative) confirmed that conflict limits access due to insecurity and displacement (enabling factors, n = 18 studies), modifies health-seeking behaviours (predisposing, n = 12) and increases mortality and malnutrition rates (need, n = 15). (NGO) Non-Governmental Organisation and community outreach efforts were found to alleviate some of these effects (notably in Pakistan and Afghanistan). In addition, three studies examined the intersections of pandemic and conflict, highlighting compounded disruptions. Given the prevalence of ongoing conflicts, it is crucial to comprehend their effects and mitigate the health repercussions for women and children, a topic that warrants significant academic inquiry.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"553-560"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796239","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":"Association of Tumour Necrosis Factor-Alpha with Periodontitis Patients in North Indian Population.","authors":"Ruchi Pandey, Sumit Bhateja, Dax Abraham, Puneet Batra, Pradeep Koppolu","doi":"10.4103/npmj.npmj_567_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_567_25","url":null,"abstract":"<p><strong>Background: </strong>Periodontitis is a chronic multifactorial disease influenced by genetic susceptibility. Identifying genetic markers may facilitate early detection and improved risk assessment.</p><p><strong>Aim: </strong>To evaluate the association between tumour necrosis factor-alpha (TNF-α) gene polymorphisms and periodontitis in a North Indian population.</p><p><strong>Subjects and methods: </strong>A total of 364 participants were recruited and divided into two groups: Group A (healthy; n = 182) and Group B (periodontitis; n = 182). Detailed case histories were recorded, and buccal swab samples were collected and stored at 4°C in a sterile medium. Genomic DNA was extracted and analysed using tetraprimer amplification refractory mutation system polymerase chain reaction and Sanger sequencing. Allele frequencies were calculated using Hardy-Weinberg equilibrium and Chi-square tests (GenAlEx software). Linkage disequilibrium and haplotype analyses were performed using SHEsis. Correlation analysis was conducted to assess the association between TNF-α polymorphisms and disease prevalence.</p><p><strong>Results: </strong>A high frequency of TNF-α polymorphisms was observed in the North Indian population. Linkage analysis revealed that single-nucleotide polymorphisms (SNPs) loci -278A/C and -378C/T were significantly associated with both healthy and periodontitis groups compared to other SNPs. The -308G/A polymorphism was not detected in the study population.</p><p><strong>Conclusion: </strong>TNF-α gene polymorphisms are prevalent in the North Indian population. SNP loci -278A/C and -378C/T demonstrate significant association with periodontal status and may serve as potential genetic markers for susceptibility to periodontitis. Further studies are warranted to validate these findings in larger and diverse populations.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"630-636"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796386","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":"CD10 - A Matrix Metallopeptidase Expression in Colorectal Carcinogenesis.","authors":"S Vinodini, Vinutha Gali, S Srismitha, Thanka Johnson","doi":"10.4103/npmj.npmj_274_24","DOIUrl":"https://doi.org/10.4103/npmj.npmj_274_24","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the fourth leading cause of cancer-related mortality worldwide. It is more prevalent in developed countries but is increasingly affecting developing nations in Asia and Africa. CD10 is a cell surface zinc-dependent matrix metalloproteinase which may play a crucial role in tumour progression, invasion and metastasis.</p><p><strong>Aims: </strong>The present study was done to analyse the CD10 role and its expression in colorectal Cancer.</p><p><strong>Materials and methods: </strong>This cross-sectional study includes 58 cases, including colorectal adenomas (16) and carcinomas (58) over the period of 1½ years. The staining pattern and intensity of CD10 immunostaining were correlated with clinicopathological features of the cases.</p><p><strong>Results: </strong>The maximum number of cases were over 50 years of age, and the most common site of tumour was the rectosigmoid region. Our study showed increasing expression of CD10 from adenomas to adenocarcinomas, suggesting its role in colorectal tumourigenesis. This study highlights a significant increase in CD10 expression in adenocarcinomas compared to adenomas, reinforcing its importance in malignant transformation.</p><p><strong>Conclusion: </strong>The study concludes that there is a significant association between CD10 expression and colorectal carcinogenesis. CD10 may play a role in colorectal tumour progression and could be a potential target for anti-cancer therapy, particularly in rectosigmoid cancers.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"617-622"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795705","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":"Rising Childhood Obesity in Nigeria: The Need for Urgent Policy Action.","authors":"Adedire Timilehin Adenuga, Nwamaka Chidera Bob-Ume, Olatunde Olufunmilayo Olatomide","doi":"10.4103/npmj.npmj_208_26","DOIUrl":"https://doi.org/10.4103/npmj.npmj_208_26","url":null,"abstract":"","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"687-688"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796257","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":"Social Capital and Willingness to Pay for Community-based Health Insurance in Rural Communities of Delta State, Nigeria.","authors":"Ibobo Mike Enemuwe, Maureen Iru Ntaji, Nyemike Simeon Awunor, Patrick Gold Oyibo, Prosper Obunikem Adogu, Anthony Okeoghene Eguvbe","doi":"10.4103/npmj.npmj_18_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_18_25","url":null,"abstract":"<p><strong>Background: </strong>The amount of social capital in a community can be an asset for the breakthrough and sustainability of community-based health insurance (CBHI), thereby contributing to the demand for it at the community level.</p><p><strong>Aims: </strong>This study aimed to assess the relationship between social capital and willingness to pay (WTP) for CBHI in rural communities of Delta State.</p><p><strong>Materials and methods: </strong>A cross-sectional study design was employed to assess the level of social capital and WTP for CBHI among a sample of 412 households using a multistage sampling technique. Data was collected using an interviewer-administered semi-structured questionnaire. Descriptive and inferential analyses of the data collected were carried out using the IBM SPSS version 22 software.</p><p><strong>Results: </strong>the mean age of respondents was 50.42 ± 14.54 years. Females were about half (50.5%) of the respondents, and 19.9% of respondents had no formal education. The mean individual WTP amount per month was 600.75 ± 419.48 naira (1.30 ± 0.91 US dollar). The association between social capital (χ 2 = 193.043; P < 0.001) and WTP for CBHI was statistically significant. Other factors such as sex (χ 2 = 10.168; P = 0.001), education (χ 2 = 14.06; P < 0.001), religion (χ 2 = 40.565; P < 0.001) and household with younger people <18 years (χ 2 = 14.361; P < 0.001) were also significantly associated with WTP for CBHI.</p><p><strong>Conclusion: </strong>This study reported a significant association between social capital and WTP for CBHI.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"596-604"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796287","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":"Early Outcomes of Open Tibial Shaft Fracture Management at a Tertiary Orthopaedic Hospital in Nigeria: A Prospective, Observational Study.","authors":"Kenneth Nzekwe, Kenechi Anthony Madu, Chisom Oscar Uzuegbunam","doi":"10.4103/npmj.npmj_275_26","DOIUrl":"https://doi.org/10.4103/npmj.npmj_275_26","url":null,"abstract":"<p><strong>Background: </strong>Management of open tibial shaft fractures in resource-poor settings presents significant challenges, yet prospective data on treatment outcomes in Sub-Saharan Africa remain limited. These injuries, often resulting from high-energy trauma, carry substantial risks of non-union, deep infection, and long-term disability. In Nigeria, care pathways are frequently adapted due to constraints including cost, implant availability, and limited access to subspecialist care.</p><p><strong>Aims: </strong>This study prospectively evaluates early (6-month) healing outcomes, infection rates, and associated modifiable factors in patients with open tibial shaft fractures managed at a tertiary orthopaedic hospital in Enugu, Nigeria, to identify targets for quality improvement in trauma care delivery.</p><p><strong>Methodology: </strong>A prospective, observational study was conducted on 71 consecutively enrolled adult patients with 78 open tibial fractures, managed via a standardised protocol. Primary outcomes were early fracture healing status, surgical site infection (SSI), and length of hospital stay (LOHS). Statistical analyses used fracture as the primary unit of analysis, except for demographic comparisons (per patient). Bivariate tests and multivariate regression identified predictors of outcomes.</p><p><strong>Results: </strong>Of 50 fractures completing follow-up, early union was observed in 68%, with delayed healing in 22% and early non-union in 10% at 6 months. Mean time to union was 16.5 weeks. Overall SSI rate was 44% (22/50), of which 5 were superficial and 17 deep infections ( P =0.023). Gustilo-Anderson Grade IIIB injury ( P =0.001) and presentation >24 hours post-injury ( P =0.025) were key factors associated with impaired early healing. SSI was strongly associated with delayed wound cover >7 days ( P =0.003) and severe injury grade. LOHS (mean 38.5 days) was significantly prolonged by infection, severe injury, and treatment delays. Attrition analysis showed no significant demographic differences between patients who completed follow-up and those lost.</p><p><strong>Conclusion: </strong>This study highlights high early complication rates of open tibial fractures in resource-constrained settings. Findings underscore the critical importance of timely patient presentation, expeditious soft-tissue cover, and robust infection prevention protocols. These modifiable factors represent clear targets for systemic improvement in trauma care delivery.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"590-595"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795996","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}