Nigerian medical journal : journal of the Nigeria Medical Association最新文献

{"title":"Predictors of Optimal Uptake of Intermittent Preventive Treatment in Pregnancy (IPTp3+) in Nigeria: Survey-Weighted Regression and Exploratory Machine-Learning Analysis of the 2021 Nigeria Malaria Indicator Survey.","authors":"Happiness Opeyemi Agboola, Adewale Jamiu Lasisi, Olufisayo Elugbadebo, Salim Khan, Olatunde Aremu","doi":"10.71480/nmj.v67i5.1537","DOIUrl":"10.71480/nmj.v67i5.1537","url":null,"abstract":"<p><strong>Background: </strong>Malaria in pregnancy remains a public health challenge in Nigeria despite the effectiveness of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). Uptake of the WHO-recommended minimum of three doses (IPTp3+) remains below national targets. This study examined factors associated with optimal uptake of IPTp and explored machine-learning-based prediction.</p><p><strong>Methodology: </strong>We analysed 2021 Nigeria Malaria Indicator Survey data for 3,103 women aged 15-49 years with a live birth, guided by Andersen's Behavioural Model. Descriptive and regression analyses were conducted in R. Descriptive summaries were unweighted, whereas the primary regression incorporated sampling weights, strata, and primary sampling units. Following a survey-adjusted nonlinearity test, ANC visits were categorised as 0-3, 4-7, and ≥8. Random Forest and XGBoost were fitted in Python as unweighted exploratory models, with calibration, permutation importance, and SHAP assessed on held-out data.</p><p><strong>Results: </strong>Overall, 52.4% of women in the unweighted analytic sample reported IPTp3+ uptake. The association with ANC was nonlinear (F(2,84) = 18.12; p < 0.001). Compared with 0-3 visits, adjusted odds ratios were 2.10 (95% CI: 1.64-2.68) for 4-7 visits and 2.05 (95% CI: 1.49-2.83) for ≥8 visits; both p < 0.001. Geopolitical zone was associated with uptake. XGBoost and Random Forest showed modest discrimination (ROC-AUC: 0.661 and 0.640) and Brier scores of 0.225 and 0.228.</p><p><strong>Conclusion: </strong>Only about half of women achieved optimal IPTp uptake. ANC attendance was strongly associated with IPTp3+ uptake, while geographic disparities persisted after adjustment. The exploratory machine-learning models showed modest predictive performance. Strengthening ANC access and improving IPTp delivery remain important priorities.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1801-1818"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Fetal Hemoglobin on Hematological Parameters and Clinical Severity in Patients with Homozygous Sickle Cell Disease.","authors":"Shweta S Talhar, Bharat U Patil, Dipak Kumar Das, Prafulla Ambulkar, Jwalant E Waghmare, Jyoti Jain, Manish Jain, Nitin M Gangane","doi":"10.71480/nmj.v67i5.1469","DOIUrl":"10.71480/nmj.v67i5.1469","url":null,"abstract":"<p><strong>Background: </strong>In Sickle cell disease (SCD), fetal hemoglobin (HbF) influences clinical severity, resulting in variable disease phenotypes. This study evaluated HbF levels, hematological parameters, and clinical severity in homozygous SCD patients.</p><p><strong>Methodology: </strong>A cross-sectional observational study with the prospective recruitment of 40 patients with homozygous SCD was conducted. A standardized questionnaire collected demographic data. Clinical and laboratory assessments calculated the clinical severity scores. Analyses used Stata/MP version 17.0; significance was set at p < 0.05.</p><p><strong>Results: </strong>HbF levels were inversely correlated with age (ρ = -0.998) and clinical severity (ρ = -0.928) but positively correlated with Hb (ρ = 0.999), RBC count (ρ = 0.999), and Packed Cell Volume (PCV) (ρ = 0.965) (all p < 0.001). Clinical severity was positively associated with age (ρ = 0.929) but negatively associated with Hb (ρ = -0.930), RBC count (ρ = -0.930), and PCV (ρ = -0.916) (all p < 0.001). HbF was the only independent predictor of disease severity (β = -0.14, 95% CI: -0.22 to -0.05, p = 0.002).</p><p><strong>Conclusion: </strong>Increased HbF levels were associated with improved hematological parameters and reduced clinical manifestations and clinical severity in homozygous SCD patients, supporting the role of HbF as a biomarker for disease severity.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1869-1879"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrients in Cardiovascular Disease: A Comprehensive Review of Vitamins, Trace Minerals, and Electrolytes.","authors":"Tobechukwu Chigha Iyidobi, Theclar Ogochukwu Iyidobi, Chisom Oscar Uzuegbunam, Emmanuel Chino Iyidobi","doi":"10.71480/nmj.v67i5.1505","DOIUrl":"10.71480/nmj.v67i5.1505","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is a leading cause of global mortality, accounting for approximately 17.3 million deaths annually. The antioxidant effects of certain micronutrients may play a role in CVD prevention. This systematic review critically evaluates the evidence on antioxidant vitamins (C, E, carotenoids), B-complex vitamins, vitamin D, trace minerals (iron, copper, zinc, selenium), and electrolytes (sodium, potassium, magnesium, calcium) in cardiovascular health. This scoping review with narrative synthesis was informed by PRISMA principles. PubMed, Scopus, Cochrane Library, and Google Scholar were searched (1980-2024) for English-language human studies on micronutrients and cardiovascular outcomes. Study selection involved screening, full-text review, and snowballing. Quality was assessed through critical appraisal. Data were synthesised thematically. Approximately 70 key studies were included from over 200 identified references. Antioxidant vitamins show inconsistent benefits, with some cohorts demonstrating 27-47% risk reductions despite null RCT results. Vitamin D deficiency (30-50% prevalence) is consistently associated with CVD risk, though supplementation trials are mixed. B-vitamins improve endothelial function via homocysteine reduction. Trace minerals demonstrate biphasic relationships, where both deficiency and overload increase CVD risk. Electrolyte balance, particularly the sodium-potassium ratio, critically determines blood pressure and cardiovascular outcomes. Current evidence does not support universal supplementation. The complex relationships between micronutrient status and CVD outcomes underscore the need for personalized approaches.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1703-1719"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric Primary Intracranial Tumours: A 14-year Clinicopathologic Study in North-Central Nigeria.","authors":"Philip Ojile Akpa, Barka Vandi Kwaghe, Innocent Emmanuel, Christiana Nwanneka Ibeanu, James Eveshojaime Ben, Jacob Anzaku Emmanuel, Jeneral Dumura Alfin, Danaan Joseph Shilong","doi":"10.71480/nmj.v67i5.1498","DOIUrl":"10.71480/nmj.v67i5.1498","url":null,"abstract":"<p><strong>Background: </strong>Paediatric intracranial tumours are the commonest solid neoplasms affecting children with increasing incidence worldwide. They are second only to leukaemia in incidence and have the highest rate of mortality among childhood cancers. The aim of this study is to determine the age and sex distribution, histopathological subtypes, WHO tumour grades and neuroanatomical sites of occurrence of paediatric primary intracranial tumours diagnosed histologically in a tertiary health centre in north-central Nigeria.</p><p><strong>Methodology: </strong>This was a retrospective descriptive study of primary intracranial tumours histologically diagnosed in children (0-17 years) over a 14-year period at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria. Data on age, sex, tumour site, histological diagnosis, tumour grade and clinical presentation were retrieved and analysed using descriptive statistics.</p><p><strong>Results: </strong>Patient ages ranged from 6 weeks to 17 years with a mean age of 8.99 ± 5.26 years. Peak diagnosis occurred in children 0-4 years (30.8%) with overall female predominance (M: F=1:1.26). The most common tumour was pilocytic astrocytoma (23.1%), followed by medulloblastoma (15.4%). A predominance of low-grade (73.1%) over high-grade tumours (26.9%) was observed, and tumours were equally distributed between the supratentorial and infratentorial compartments. Headache (67.3%) was the most common presenting symptom, followed by impaired vision (30.8%) and gait disturbance (26.9%).</p><p><strong>Conclusion: </strong>The clinicopathologic pattern of primary intracranial tumours observed in our study is broadly consistent with regional and global reports. An improvement in diagnostic capacity and collaborative research in this field is necessary for improving outcomes.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1729-1741"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Versus Haematocrit Estimation of Intra-Operative Blood Loss in Open Posterior Spine Surgery: A Prospective Study.","authors":"Simon Adewale Balogun, Oluseun Abolade Olarewaju, Christopher Obinna Anele, Chizowa Okwuchukwu Ezeaku, Jeremiah Adelabu Abimbola, Edward Oluwole Komolafe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Bleeding during spine surgery can be significant enough to require intraoperative blood transfusion. Unnecessary blood transfusion is associated with significant risks. Therefore, the accurate determination of intraoperative blood loss is important. The visual estimation of blood loss is the commonly used method; however, its accuracy remains a subject of debate.</p><p><strong>Methodology: </strong>A total of 60 patients scheduled for posterior spine surgery were enrolled on the study. In the theatre, the patients' haematocrit level was determined before and after surgery using a hand-held hemoglobinometer, and a Bourke and Smith equation was used to calculate the blood loss. Blood loss was also visually estimated by the anaesthetist and documented. Statistical analysis was performed using SPSS 26 to compare both methods.</p><p><strong>Results: </strong>In all patients, the mean blood loss was 993.8ml by visual estimate and 754.6ml by haematocrit calculation (P = 0.006). When stratified, the mean blood loss for instrumented surgery was 1147.3ml for visual estimation, and 814.9ml for haematocrit calculation methods (P = 0.001). For lumbar spine surgeries, the mean blood loss was 1141ml for visual method and 773.9ml for the haematocrit method (P = 0.002).</p><p><strong>Conclusion: </strong>This study showed that the visual method of blood loss determination significantly overestimated the volume of intraoperative blood loss compared to the more objective haematocrit calculation method in patients undergoing posterior spine surgeries.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 4","pages":"1407-1415"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the Utilization of Basic Emergency Obstetric and Newborn Services among Health Care Workers in Southwest, Nigeria: A Qualitative Study.","authors":"Yetunde Omolola Oyedeji, Oluniyi Ebenezer Oyedeji, Adetunmise Oluseyi Olajide, Matthew Idowu Olatubi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Maternal and neonatal mortality remain major public health challenges, particularly in low- and middle-income countries such as Nigeria. Although Basic Emergency Obstetric and Newborn Care (BEmONC) services are designed to prevent most maternal and neonatal deaths, their utilization remains suboptimal due to several contextual barriers. This study explored barriers to the utilization of BEmONC services in selected primary healthcare centres in Oyo State, Nigeria.</p><p><strong>Methodology: </strong>An exploratory qualitative study using Key Informant Interviews (KIIs) was conducted among healthcare workers involved in maternal and newborn care services in selected primary healthcare centres in Oyo State. A total of 28 participants were recruited using purposive sampling. Data were collected using a semi-structured interview guide and were analyzed thematically with the aid of NVivo software. Ethical approval and informed consent were obtained before data collection.</p><p><strong>Results: </strong>Four major themes emerged from the analysis: health system constraints, patient-related barriers, healthcare worker-related barriers, and communication and coordination gaps. Key barriers identified included inadequate equipment and supplies, shortage of skilled personnel, lack of emergency transportation, financial constraints, cultural beliefs, preference for traditional birth attendants, low awareness of BEmONC services, staff stress and burnout, poor healthcare worker attitudes, and weak referral systems. These barriers contributed to delays in seeking, reaching, and receiving appropriate maternal and newborn care.</p><p><strong>Conclusion: </strong>Utilization of BEmONC services is influenced by interconnected health system, socio-cultural, and workforce-related barriers. Strengthening healthcare infrastructure, improving staffing and continuous training, enhancing community awareness, and establishing effective referral and communication systems are essential for improving maternal and neonatal health outcomes in Oyo State, Nigeria.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 4","pages":"1451-1462"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Management Outcomes of Women with Adenomyosis: A Prospective Review from a Fertility Centre in Nigeria.","authors":"Felix Adaoje Elachi, Clement Fateh Ayuba, Keneth Egwuda, Tochukwu Dickson Ifezoke, Innocent Ojogbane Ekele, Aboki Ali Dunah, Rukaiyah Miko Dawuud, David Azaki, Sakina Gazali, H Mukaddas, Chinonye Lawson Evule","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Adenomyosis is seen in women with infertility, with a significant impact on their lives. This study aims to evaluate the clinical characteristics, management strategies, and treatment outcomes of women diagnosed with adenomyosis.</p><p><strong>Methodology: </strong>This prospective study, conducted at Alps Hospitals and Diagnostics from June 2021 to December 2024, involved 44 women with adenomyosis. The clinical data were collected, reviewed, and analysed.</p><p><strong>Results: </strong>The mean age of participants was 39.5 ± 5.1 years. Most (77.3%) participants were nulliparous, with a mean duration of infertility of 7.4 ± 4.2 years. The most common (63.6%) presenting symptom was combined dysmenorrhoea and menorrhagia. Ultrasonography identified adenomyosis in 54.5% of cases.Diffuse adenomyosis was seen in 52.3% of women. Myomas were the most common (79.5%) co-existing pelvic pathology. Double-flap adenomyomectomy and wedge resection were done in 54.5% and 29.5% of participants, respectively. 13.6% of participants had medical treatment. Surgical site infection was the most frequent (6.8%) post-operative complication.Double flap adenomyomectomy and wedge resection resulted in reductions in Visual Analogue Scale (VAS) scores for dysmenorrhoea and menorrhagia. There was no significant difference (p-value> 0.05) when both surgical options were compared. GnRH analogues resulted in temporary symptom relief. Three women had positive pregnancy tests following In Vitro Fertilization (IVF), out of which 1 resulted in a live birth and 2 ended in miscarriages.</p><p><strong>Conclusion: </strong>Adenomyosis predominantly affects infertile nulliparous women in the late third decade of life with previous uterine surgeries. Combined menorrhagia and dysmenorrhoea are a common presentation, and conservative surgeries may provide sustained symptom relief with limited improvement in reproduction.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 4","pages":"1502-1512"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Ultrasonographic Varicocele Grading with Seminal Fluid Analysis in Male Infertility at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.","authors":"Mubarak Zubair Abdullahi, Isah Ismaila Mato, Isah Adah Suleiman, Ibrahim Aliyu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Infertility is a global health issue with profound social and psychological consequences, particularly in sub-Saharan Africa, where male factors are often underdiagnosed. Varicocele, a dilatation of the pampiniform plexus veins, is a leading correctable cause of male infertility. Seminal fluid analysis (SFA) remains the cornerstone for evaluating male fertility. Establishing correlations between ultrasound grading of varicocele and semen parameters may provide clinicians with predictive, non-invasive tools for managing infertility. The objective of the study is to correlate the ultrasound grading of varicocele with seminal fluid findings in infertile men.</p><p><strong>Methodology: </strong>This was a cross-sectional analytical study conducted on 225 infertile men aged 23-68 years with sonographically confirmed varicocele at Ahmadu Bello University Teaching Hospital, Zaria, between September 2023 and June 2024. Participants underwent scrotal ultrasonography using Sarteschi's criteria for varicocele grading, and semen analysis was performed in accordance with WHO 2010 guidelines. Data were analyzed with SPSS v23 using descriptive statistics, ANOVA, and Spearman correlation.</p><p><strong>Results: </strong>The modal age group was 31-35 years (28.4%). Left-sided varicocele was most common (44.4%), followed by right (35.5%) and bilateral (20%). Varicocele grade distribution was: I (20.4%), II (19.1%), III (24.4%), IV (14.2%), and V (21.7%). Higher varicocele grades correlated negatively with sperm count (r = -0.64, p = 0.001), motility (r = -0.40, p = 0.021), and morphology (r = -0.43, p = 0.013). Patients with grade IV-V varicocele showed significantly impaired semen quality compared to grades I-II.</p><p><strong>Conclusion: </strong>Increasing varicocele grade is associated with progressive deterioration in semen parameters. Ultrasound grading of varicocele may serve as a reliable predictor of seminal quality, assisting in clinical decision-making for the management of male infertility.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 4","pages":"1617-1622"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tourniquet with Intravenous Tranexamic Acid versus Tourniquet with Vaginal Misoprostol for Blood Loss Reduction during Open Myomectomy: A Double-Blind Randomised Trial.","authors":"Robinson Onyekachukwu Ogwu, Osamudia Okhionkpamwonyi, Samuel Okwuchukwu Ilikannu, Sunday Emmanuel Jombo, Ufuoma Eyeregba, Babatunde Oyefara, Ursula Nkiruka Kachi-Ogwu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Myomectomy has remained one of the main surgical techniques for managing uterine fibroids, especially in sub-Saharan Africa, where women desire to preserve their uterus for fertility and other cultural reasons. However, blood loss remains a major complication during myomectomy. The study's objective was to compare tourniquet with intravenous tranexamic acid and tourniquet with vaginal misoprostol in blood loss reduction during open myomectomy.</p><p><strong>Methodology: </strong>A double-blind randomised controlled trial with Pan-African Clinical Trials Registry approval number PACTR202406615201194 was conducted. A total of 78 eligible women for abdominal myomectomy were randomised into two groups. Participants in group I received 1g intravenous tranexamic acid intra-operatively after an incision was made on the uterus. They also had vaginal administration of folic acid into the posterior vaginal fornix one hour before the myomectomy for a placebo. Participants in group II received 400mcg vaginal misoprostol inserted into the posterior vaginal fornix one hour before the myomectomy. Both groups of women had tourniquets applied at the isthmic portion of the uterus to occlude the uterine arteries after delivery of the uterus before commencing the myomectomy procedure.</p><p><strong>Results: </strong>Patients randomised into the tourniquet with tranexamic acid group had lesser intraoperative blood loss, lesser need for blood transfusion, and higher postoperative haemoglobin concentration compared to the tourniquet with vaginal misoprostol group, and these findings were statistically significant (p < 0.001, p = 0.0321, p < 0.001, respectively). There were no untoward side effects noted in either group.</p><p><strong>Conclusion: </strong>The results of this study suggest that the use of a tourniquet with intravenous tranexamic acid has a better effect in reducing blood loss than a tourniquet with vaginal misoprostol during open myomectomy.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 4","pages":"1530-1540"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-Demographic and Occupational Correlates of Job Satisfaction among Healthcare Workers at Tertiary Hospitals in Kaduna State, Nigeria: A Cross-Sectional Study.","authors":"Hassan Bala Salihu, Idris Muhammad Yakubu, Bilyaminu Usman Sa'ad, Musa Alhaji Rufai, Titilope Rashidat Salami","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Job satisfaction among healthcare workers is a key determinant of workforce stability and service quality. However, limited research has examined socio-demographic and occupational factors associated with job satisfaction among healthcare workers in Northern Nigeria. This study examined socio-demographic and occupational correlates of job satisfaction among healthcare workers at tertiary hospitals in Kaduna State, Nigeria.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted among healthcare workers at Ahmadu Bello University Teaching Hospital and Barau Dikko Teaching Hospital in Kaduna State. Non-probability sampling was used to recruit 282 participants across professional categories. Data were collected using an adapted structured, self-administered questionnaire. Chi-square tests and binary logistic regression were used to examine associations between variables and job satisfaction at p < 0.05.</p><p><strong>Results: </strong>Overall, 54.3% of participants reported moderate-to-high job satisfaction, while 45.7% reported low satisfaction. In bivariate analysis, religion (χ² = 8.99, p = 0.01), number of dependents (χ² = 9.14, p = 0.027), multiple leave types (χ² = 6.32, p = 0.015), and income satisfaction (χ² = 8.93, p = 0.004) were significantly associated with low job satisfaction. However, in multivariate logistic regression, only two variables remained significant. Having more than one leave type was associated with increased odds of low satisfaction (AOR=1.95, 95% CI: 1.18-3.25, p = 0.010), while satisfaction with income was associated with reduced odds of low satisfaction (AOR=0.45, 95% CI: 0.28-0.75, p = 0.002).</p><p><strong>Conclusion: </strong>Moderate job satisfaction levels were observed among healthcare workers in tertiary hospitals in Kaduna State. Income satisfaction and leave entitlements were independently associated with job satisfaction. Interventions should prioritize equitable compensation and the practical implementation of leave policies to improve workforce satisfaction.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 4","pages":"1563-1572"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}