Nigerian Journal of Medicine最新文献

{"title":"Scalp Reconstruction following Excision of Malignant Tumors in Southeastern Nigeria","authors":"Obinna Remigius Okwesili, Uchechukwu Johnson Achebe, Okechukwu Oliver Onumaegbu, Wilfred Chukwuemeka Mezue, Mark Chukwunweike Chikani, Ephraim Eziechina Onyia","doi":"10.4103/njm.njm_32_23","DOIUrl":"https://doi.org/10.4103/njm.njm_32_23","url":null,"abstract":"Abstract Background: Malignant scalp tumors are not common and constitute a small percentage of all scalp tumors. Reconstruction of the scalp defects following oncological resection presents peculiar challenges. Aim: The aim of the study is to report our experience in reconstructing scalp defect of varying sizes after the excision of malignant tumours using a variety of techniques. Materials and Methods: This was a retrospective review of patients who had scalp reconstruction after oncological resections from June 2010 to May 2014 (four years) at our teaching hospital in the South-east of Nigeria. Data on the demographics, nature of the scalp tumors, site, size of the defects, mode of scalp reconstruction, and outcomes were collected and analyzed. Results: Of the 17 patients who had scalp reconstruction, 29.4% of them were men and 70.6% were women (M:F = 5:2). The mean age of the patients was 41.2 ± 4.98 years (range: 19–85 years). The majority of the patients (47.1%) were young adults between 20 and 40 years, and the least involved age group (11.8%) was 13–19 years. The most common etiology of malignant scalp tumors was squamous cell carcinoma (52.9%). The temporal region was the most common site (41.2%) affected. Most of the defects were between 6.1 and 9.0 cm in diameter, followed by defects that were <3 cm in diameter. Neurosurgical assistance was required in 5 (29.4%) patients where the tumor had involved the skull bone. Tumor recurrence was noted in 3 (17.6%) patients within one year of follow-up. Conclusion: Scalp reconstruction after oncological resection presents a peculiar esthetic challenge due to the hair-bearing skin of the scalp and the need to maintain the hairline. The use of local flaps from the scalp remains the first and the best option. For very large scalp defects, free flap through microvascular surgery is the preferred option.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650882","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 spectrum of otorhinolaryngology, head and neck emergencies: Our experience","authors":"S. Aremu","doi":"10.4103/njm.njm_3_23","DOIUrl":"https://doi.org/10.4103/njm.njm_3_23","url":null,"abstract":"Background: Emergencies in otorhinolaryngology are common in health-care facilities. Early detection and treatment of a disease can result in the reduction of morbidity and mortality in patients. Aim: This study was carried out in the southwest region of Nigeria over 10 years to depict the epidemiology, gender, and age-wise distribution of otorhinolaryngology emergencies. Materials and Methods: Using a cross-sectional study design, a semi-structured questionnaire was administered and information was collected on the medical histories of the patients examined. The age and gender of patients, their clinical diagnosis at the time of admission, and the progress of the patient's health after emergency treatment were listed. Results: The total number of patients who visited the ear, nose, and throat (ENT) emergency department was 12,931 from January 2011 to December 2021. On average, three emergency patients/day and 1293 emergency patients per year visited ENT emergency department. The ages of patients ranged between 1 month and 70 years. The number of male patients was 8657 (66.94%), and the number of female patients was 4274 (33.05%). The ratio of males to females was 2:1. The most common emergency cases were of nose bleed (25.57%). Then, we had cases of earache and ear discharge on our list. Conclusion: The otorhinolaryngology emergency department plays a vital part in managing life-threatening situations such as acute nose bleed, bleeding after removal of tonsils, upper airway, neck boils, severe middle ear infection, and acute fungal sinus infection. These conditions require urgent and effective treatment from an ENT Specialist. The ENT emergency department plays a vital part in managing life-threatening situations which require urgent and effective treatment from otorhinolaryngology specialists. There is a dire need to create standards for prioritising and reducing the number of nonurgent/fake emergency cases appearing in ENT emergencies so that the proper treatment could be given to the deserving emergency cases.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"32 1","pages":"88 - 92"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45395133","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":"Patient’s Perceived Satisfaction and Quality of Life with Fixed Partial Denture: A 10-Year Retrospective Assessment in a Tertiary Institution, South-West, Nigeria","authors":"Shakeerah Olaide Gbadebo, Osaro Charles Okeaya-Inneh, Olayinka David Adeosun, Deborah Mojirade Ajayi","doi":"10.4103/njm.njm_48_23","DOIUrl":"https://doi.org/10.4103/njm.njm_48_23","url":null,"abstract":"Abstract Background: Tooth loss is a disease of public health concern and defines the oral health status and quality of life of an individual. Aim: This study assessed the level of satisfaction and the oral health-related quality of life (OHRQoL) of patients that received fixed partial denture (FPD), for the replacement of teeth, at a Nigerian tertiary health facility. Materials and Methods: A cross-sectional retrospective evaluation of the clinical records of patients who received FPD within a period of 10 years was done. The eligible participants (44) were contacted by telephone and data on satisfaction and OHRQoL (using Oral Health Impact Profile [OHIP]-14 questionnaire) were collected. Descriptive analysis was used to report satisfaction and OHRQoL. The association between categorical variables was tested with Chi-square. P value was set at ≤ 0.05. Results: The conventional fixed–fixed prostheses supported mostly with porcelain-fused-to-metal crowns were the most used. High satisfaction with the appearance was reported by 22 (48.9%) at delivery as against 14 (31.1%) after use. Decementation was the most recorded failure, (26, 57.8%) and the total OHIP-14 score was 21.71 ± 9.47, indicating poor quality of life. Forty-four participants (18, 40.9% males and 26, 59.1% females) underwent oral rehabilitation with FPD within the study period. The age range and mean age of the participants were 21–72 years and 46.8 ± 13.8 (standard deviation) years, respectively. Significantly higher aesthetic satisfaction was reported at delivery of FPD compared to the present time of assessment ( P < 0.001) showing a decline in satisfaction. However, long-term posttreatment satisfaction on aesthetics, masticatory ability, and phonetics was significantly higher compared to their pretreatment satisfaction ( P < 0.001, 0.001, and P = 0.003, respectively). Furthermore, OHIP-14 scores showed statistically significant ( P < 0.05) improved OHRQoL posttreatment except for OHIP8 and OHIP12 subdomains with P > 0.05. Conclusion: A decline in satisfaction with aesthetics of FPD postdelivery was observed and the psychological domains of OHIP-14 were mostly affected showing a better quality of life.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650529","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":"Case Series: Uterine Rupture with a Life Baby after Two Previous Caesarean Sections: An Incidental Finding at Elective Caesarean Sections at Term","authors":"Obiora Asiegbu, Darlington-Peter Chibuzor Ugoji, Uzoma Vivian Asiegbu, Bobbie C. Iwe, Paschal Chijioke Okoye, Kelvin Emeka Ortuanya, Chidebe Christian Anikwe","doi":"10.4103/njm.njm_65_23","DOIUrl":"https://doi.org/10.4103/njm.njm_65_23","url":null,"abstract":"Abstract We present three cases of the absence of lower uterine segment (LUS) muscles with a life baby covered by the fetal membrane after two previous caesarean sections (CS) at elective CSs at term. The first case was a 30-year-old booked multipara with bad obstetrics history and two previous CS at a secondary facility on account of unexplained three serial stillbirths at term. There were no histories of maternal obesity, hypertension, or diabetes mellitus. She then had an elective CS at 37 weeks on account of two previous CS. Intraoperatively, it was noted that the LUS was covered by the fetal membranes with visceral peritoneum and no muscle layer. The second case was a 33-year-old booked G4P2 + 1A2 with two previous CSs on account of fetal distress and breech presentation with one previous scar at term, respectively. Pregnancy was uneventful till the presentation. At presentation, there was no history or examination finding suggestive of uterine rupture. She had an elective CS at 39 weeks on account of two previous CS. Intraoperatively, a thin membrane at the LUS with no muscular tissue exposing the fetal membranes was seen, with good fetomaternal outcomes. The third case was a 30-year-old booked G3P2 + 0A2 with two previous elective CSs on account of primigravida with breech presentation and placenta praevia, respectively. The course of the pregnancy was uneventful. At presentation, there was no clinical sign or symptom suggestive of uterine rupture. She had an elective CS at 37 weeks on account of two previous CS. Intraoperatively, a thin membrane at the LUS with visceral peritoneum and no muscular tissue was seen. The pregnancy outcome was favorable. Silent scar rupture as seen in our case series is one of the common complications of previous CS. Early detection with the introduction of imaging techniques, although not done for our cases and prompt intervention reduces morbidity and mortality.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650889","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 factors affecting treatment adherence in patients with chronic kidney disease in Nigeria: A survey from a tertiary health-care centre","authors":"R. Braimoh, A. Busari, A. Akinyede, Akinyemi Ogunsakin, S. Olayemi","doi":"10.4103/njm.njm_49_22","DOIUrl":"https://doi.org/10.4103/njm.njm_49_22","url":null,"abstract":"Background: Chronic kidney disease (CKD) is a growing global public health problem with the poorest populations being at the highest risk. Strict adherence to treatment has been found to reduce and may halt progression to end-stage kidney disease. Unfortunately, no data on this is available in this clime. The study was carried out to evaluate factors associated with treatment adherence in patients with CKD attending Lagos University Teaching Hospital. Patients, Materials and Methods: This was a cross-sectional study of 124 previously diagnosed CKD patients being managed at the nephrology unit of Lagos University Teaching Hospital, Nigeria. Using a semi-structured questionnaire, data were collected to evaluate the factors affecting treatment adherence in these patients. Results: The mean age of participants was 50.47 ± 13.7 years. Majority were male 71 (57.3%), married 84 (67.7%), employed 71 (57.3%), Christians 85 (68.5%), and had tertiary education 92 (74.1%). More than half of the population (57%) adhered to the prescribed treatment. However, the majority (69%) of the study population also practiced alternative treatment. Major reasons for nonadherence included alternative medications (69%), forgetfulness 30 (24.2%), high cost of medication 28 (22.6%), high pill burden 28 (22.6%), and being tired of drugs (22%). Conclusion: There is an appreciable level of adherence to treatment among our study population mainly affected by high education and income levels with being gainfully employed. However, a lot more needs to be done to further improve compliance through continuous counseling, reduced pill burden, and lowering the cost of treatment.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"32 1","pages":"49 - 54"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42410121","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":"Amendment of the Nigerian medical residency training act","authors":"O. Olaopa","doi":"10.4103/njm.njm_135_22","DOIUrl":"https://doi.org/10.4103/njm.njm_135_22","url":null,"abstract":"","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"32 1","pages":"106 - 107"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47958423","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":"Risk and protective factors influencing multiple sexual partners among adolescents in Rivers State","authors":"V. Ogbonna, F. Adeniji, Z. Iliyasu","doi":"10.4103/njm.njm_132_22","DOIUrl":"https://doi.org/10.4103/njm.njm_132_22","url":null,"abstract":"Introduction: The period of adolescence is characterised by changes and experimentations such as early sexual debut and multiple sexual partners (MSP). That might create issues with sexual and reproductive health that persist throughout one's life such as sexually transmitted infections plus HIV, unsafe abortion, and death. To inform contextualised and culturally appropriate preventive strategies, this study identified the forecasters of MSP among pubescents/adolescents in Rivers State. Materials and Methods: Using a cross-sectional research design, and multistaged sampling technique, 671 adolescents were interviewed with structured interviewer-administered questionnaires. Data were analysed using IBM SPSS version 26. Chi-square test analysis was performed to test for association in proportions between explanatory (sociodemographic variables, factors at the individual, peer, family, community, and national domains) and outcome (MSP) variables. The proportion of sexually experienced respondents with MSP was determined and adjusted odd ratios of predictors derived from multivariate logistic regression models. Results: Out of the 671 adolescents (10–19 years) surveyed, 53.1% were female, and 29 (4.3%) are married. The median age and the interquartile range were 18.0 years. Nearly half 313 (46.6%) of the respondents were sexually experienced, of which 148 (47.3%) had MSP. After adjusting for covariates, religion, sex, employment, father's education, individual perceptions, peer, family, and community norms predicted MSP (P < 0.05). Specifically, respondents with religious affiliations were less likely (adjusted odds ratio [aOR] =0.43, 95% confidence interval [CI]: 0.22–0.87, P = 0.019) than nonreligious/catholic respondents to have several sexual partners. Similarly, female adolescents were less likely to have MSP (aOR = 0.57, 95% CI: 0.33–0.98, P = 0.042). Relative to those whose fathers have no formal education, respondents whose fathers have secondary (crude odds ratio = 0.48, 95% CI: 0.26–0.83, P = 0.001) and tertiary education have lower odds of having MSP. Respondents with higher individual, peer, and community domain scores had at least a threefold raised likelihood of having MSP. Conclusion: A large proportion of sexually experienced adolescents have MSP; religious affiliations were shown to be protective and should be encouraged. Employed adolescents and males are more at risk. Gender-appropriate reproductive health actions for adolescents need to be contextualised at different levels.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"32 1","pages":"73 - 79"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70834505","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":"Immunization of Children in Africa: Strides and Challenges","authors":"Dimeji Abdulsobur Olawuyi, Daniel Olaloye Esanju, Samuel Adedolapo Olowolayemo, Chukwuebuka Stanley Asogwa, Olajire Oluwagbenga Salako, Anjolaoluwa Esther Kolajo, Olatokun Shamsudeen Akano, Jonas Paul Ibekwe, Adaeze Nancy Mbey, Abayomi Hassan Raji","doi":"10.4103/njm.njm_42_23","DOIUrl":"https://doi.org/10.4103/njm.njm_42_23","url":null,"abstract":"Abstract Background: The African continent is behind by a wide margin in the childhood vaccination race which contributes significantly to the high childhood morbidity and mortality rate from vaccine-preventable diseases in the continent. Some African countries are still struggling to achieve routine immunization coverage for all recommended expanded program on immunization vaccines. Aim: In this study, we aimed to identify the barriers hindering childhood immunization in Africa and to identify the remarkable progress made so far. Materials and Methods: Peer-reviewed articles published in English that focused on the barriers to childhood immunization in Africa and the progress made so far was reviewed. This was achieved by searching relevant search terms in PubMed, Google Scholar, Wiley Online Library, and CINAHL databases dating back from January 2000 to June 2022. Result: A total of 30 papers were reviewed. The barriers include parents’ education status, economic status, and gender/age; place of birth and place of residence; cultural beliefs and religious affiliations; fear of contracting diseases and lack of trust in health public institutions; vaccine awareness and delivery; and dose-specific delays. The achievements include international support and oriented actions, plans for technological integration and its implementation, and domestic immunization-oriented actions and research work. Conclusion: Childhood immunization is still low in Africa with the majority of the countries yet to realize the global immunization targets. Technologies and immunization-related interventions have been implemented to support Africa but more concerted effort and aid are required to reduce vaccine-preventable deaths to the bare minimum.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649387","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":"Ocular Morbidity in Children with Allergic Conjunctivitis: A Rural-urban Survey","authors":"Valerie Nawem Ihinose Abiola, Mary Ogbenyi Ugalahi, Eniola Olubukola Cadmus, Aderonke Mojisola Baiyeroju","doi":"10.4103/njm.njm_45_23","DOIUrl":"https://doi.org/10.4103/njm.njm_45_23","url":null,"abstract":"Abstract Background: Allergic conjunctivitis occasionally may result in some ocular morbidities. This ranges from innocuous to severe forms of ocular disorders. Aim: This study reports and compares ocular morbidities among children with ocular allergies living in an urban and rural community. Materials and Methods: A comparative cross-sectional study conducted in urban and rural schools among children aged 5–15 years using a multistage sampling method. Sociodemographic data, past ocular history, history of ocular allergies, and treatment were collected with an interviewer-based questionnaire and were analysed using the Statistical Package for the Social Sciences (SPSS) software version 25. Descriptive analyses of sociodemographic variables and associated ocular morbidity were carried out. The Chi-square test was used to test associations between rural and urban groups. A P = 0.05 or less was considered significant. Results: Associated ocular morbidities were seen in 8% (19/238) of the children with allergic conjunctivitis. There was no statistically significant difference in the proportion of ocular morbidities observed between both locations (8.1 vs. 7.9 in the rural and urban location, respectively, with a P = 1.000). Children with mild forms of allergic conjunctivitis were 197 (82.8%), and only 1.7% had severe forms. The moderate and severe form of allergic conjunctivitis were more prevalent in the rural area ( P = 0.002) while untreated allergic conjunctivitis was found in 168 (70.6%) of those affected. Conclusion: This study demonstrated a higher proportion of moderate-to-severe forms of allergic conjunctivitis among school children in the rural region with the majority being untreated.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135651101","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":"Foreign-trained early-career doctors and dynamics in Nigeria: Findings from the charting studies","authors":"U. Enebeli, A. Adelola, O. Adebayo, O S Ilesanmi, S. Umar, D. Ishaya","doi":"10.4103/njm.njm_98_22","DOIUrl":"https://doi.org/10.4103/njm.njm_98_22","url":null,"abstract":"","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":"31 1","pages":"716 - 718"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45871049","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}