Microalbuminuria is an independent risk factor for cardiovascular diseases (CVD), and it is now considered as an important emerging target for primary prevention strategies in CVD. Restriction of dietary acid intake has been suggested as one possible effective dietary strategy that might offer significant reductions of microalbuminuria. However, reports from previous studies are conflicting. We investigated whether higher dietary acid intake is associated with greater risk of microalbuminuria in apparently healthy adult Nigerians. We assessed dietary intake using a food frequency questionnaire and the Nigerian Food Composition Table. Acid forming potential of our local diets were estimated as Potential Renal Acid Load (PRAL) scores. Urine albumin and creatinine were measured. Microalbuminuria was defined as urinary albumin-creatinine ratio of 30 – 300mg/g. Across the quartiles of the PRAL scores, there was a statistically significant trend with higher intake of dietary acid associated with increased risk of incident microalbuminuria (p for trend < 0.05). We conclude that among the subjects in this study higher intake of dietary acid is associated with significantly increased risk of microalbuminuria. We recommend further longitudinal studies that will investigate whether lifestyle modification that include restriction of diet with high acid-forming potentials, in the general population or among individuals with cardiovascular risk profile, will be a useful approach in lowering the incidence of microalbuminuria and preventing (and/or delay) cardiovascular diseases in our setting.
Globally, internet addiction (IA) is now known as a disorder that arises from an overuse of available technology with a wide range of behaviours and impulse-control leading to poor psychological, mental and general well-being. This study aims to assess the prevalence and determinants of internet addiction among undergraduate medical students in Enugu State. This was a cross-sectional study conducted among 400 undergraduate medical students in two medical colleges in Enugu State, Nigeria. A pre-tested, semi-structured, questionnaire that adapted questions from Young's internet addiction test (YAT) was self-administered to the sampled students. Chi-squared tests of significance and binary logistic regression were used in the analysis. Results were reported as odds ratios at 95% confidence intervals. Findings reveal that the mean age of respondents was 21.9± 3.6 years and they were predominantly females (62.2%). Out of 400 respondents, 3 (0.8%) were found to have severe IA while 71 (17.7%) were found to be moderately addicted and 216(64%) had mild addiction. The remaining 110 (27.5%) students were found to have no addiction. Bivariate analysis revealed that mothers’ highest educational qualification and students’ educational sponsors were associated with IA. On multivariate analysis, sponsorship by siblings (AOR= 2.869, CI= 1.322-6.226) and relatives (AOR= 6.336, CI= 1.473-27.250) were predictors of IA. In conclusion, with increasing reliance on the use of internet especially among the young people, the risk of IA is inevitable. More comprehensive evaluations should be employed routinely among the students to prevent dependency on the internet given the current technological trends, proliferations of smart gadgets and globalization.
Patients with psychosis are often mistaken for cerebral malaria, and hence continue to be poorly treated. This work is aimed to highlight the features of cerebral malaria and psychosis so that distinctions and proper treatment are obtained. It was a case of 28 years old woman with 4th episode of mental illness characterized by strange voices gossiping about her, poor hygiene, belief of being monitored through her phone, accusing the mother-in-law of witchcraft, and refusing food cooked in the house because it was poisoned. Four days before presentation, she smashed their television because they were discussing her childlessness. She was not feverish, not a known epileptic, diabetic or hypertensive, and no psychoactive substance use. Previous episodes of this illness were treated in a peripheral hospital as typhoid fever and malaria without significant change in her condition until she presented to us where she received antipsychotics, and she became well and was discharged.
This review sought to highlight the 2017/2018 Measles Vaccination Campaign implementation process in Delta State, Nigeria. Data on different aspects of the campaign were reviewed and analyzed using simple descriptive statistics. A total of 1, 157 827 eligible children were vaccinated, 1368-member teams were trained to offer vaccination services, 26 (25 minor and I major) adverse events following immunization were recorded and subsequently managed by trained clinicians at designated secondary health facilities in the 9 affected local government areas, 17,948 safety boxes were generated, stored and incinerated at the Ibuzor industrial waste plant near the state capital. While 2.59% and 18.02 % of all vaccinated children between the ages of 9 and11 months had received a first measles dose and other doses, 2.08% and 77.32% of all children between the ages of 12-59 months had received the first dose and other doses respectively. The state vaccine wastage rate was 12.2%. At the end of the campaign, the state recorded administrative measles coverage of 106.5% while the National Bureau of Statistics in conjunction with partners reported a post campaign coverage of 93.8%. The measles vaccination campaign for controlling measles in Delta State which targeted children between the ages of 9 and 59 months was able to achieve the desired coverage required for herd immunity. Political support from the state government and from relevant line ministries, robust advocacy, communication with electronic and print media, training of teams and sustained social mobilization were veritable tools to the overall success of the measles campaign in Delta State
Myrmeleon sp. is an insect that lives in the soil that some people believe in a certain ethnicity in the treatment of diabetes disease. This research aims to find out the effectiveness of Myrmeleon sp in lowering blood sugar levels of diabetes mellitus patients in the working area of Puskesmas Batui, Banggai Regency. This type of research is a "Quasi experiment" using the design of One group Pretest-Posttest. The study sample was patients diagnosed with diabetes mellitus in the working area of Batui Health Center, Banggai Regency. Respondents were divided into a group of experiments that were previously sampled selected with purposive sampling techniques, then the data was analyzed to find out the effectiveness of Myrmeleon sp. The hypothesis of this study was tested using Wilcoxon Signed Rank Test with SPSS program. The results showed that there was a significant difference between GDS measurements before and after Myrmeleon sp consumption. It concluded that Myrmeleon sp is effective in lowering blood sugar levels in patients with diabetes mellitus
In Nigeria, almost half (45.4%) of all smokers had tried to quit smoking. Appropriate and widely accessible tobacco cessation programs for tobacco smokers are yet to be addressed in Nigeria. This study aimed to identify the cessation experiences of tobacco smokers in Ibadan, Oyo State Nigeria. This is a descriptive cross-sectional study of 280 tobacco smokers selected using convenience sampling methods and snowball technique to examine tobacco cessation experiences. Data were collected with a semi-structured interviewer-administered questionnaire. Data were analyzed with SPSS version 21.0. The mean age of smokers was 29.6 ± 5.1. In all, 208(74.3%) smoke daily. Only 40(14.3%) have thought of quitting tobacco smoking and 4(10%) were aware of any tobacco cessation programs in Nigeria. Also, 141(50.4%) wanted tobacco cessation programs in a neutral place out of the hospital. Comfort 65(57%) and accessibility 22(19.3%) were the reasons for choosing a neutral place. Only 18(6.4%) were willing to pay $1 for each tobacco cessation consultation cession. Encouraging smokers to participate in cessation programs will involve health education 92(32.95), mobilization 11(3.9%), provision of incentives 10(3.6%), and media advertisement 5(1.8%). Among female smokers, 5 (29.4%) were willing to quit compared to 23(8.7%) male smokers p=0.006. There is a need to publicize the existing cessation programs. Services should be made non-hospital based while the fee should be made affordable. The use of incentives should be considered. More research would be needed to also understand the perspectives of health workers on tobacco cessation.
The use of cyclophosphamide in the treatment of malignancies is associated with bone marrow suppression, with its attendant decrease in blood parameters leading to leucopenia, anaemia, thrombocytopenia and other abnormalities. These side effects limit the use of cyclophosphamide, as ferrous sulphate has not been able to solve this problem. Many clinicians result to blood transfusion in order to boost the blood parameters to a level that will withstand cyclophosphamide use. This study aims at exploring the prophylaxis potential of Mucuna flagellipes leaf extract against cyclophosphamide-induced bone marrow suppression. Twenty Wistar rats were used for this experiment. The rats were divided into 5 groups, each group had 4 rats. Group 1 was control; groups 2-5 were treated with 100mg/Kg of cyclophosphamide; groups 3 and 4 also received 250mg/Kg and 500mg/Kg of extract, respectively, while group 5 received 400mg/Kg of ferrous sulphate. There was a significant decrease (P<0.05) in the packed cell volume and white blood cell count in group 2 when compared with group 1. Groups 3 and 4 showed a statistically significant increase in the packed cell volume (P=0.003) and white blood cell count (P=0.015). There was also an increase in the number of proliferating cells in the bone marrow of groups 3 and 4. Mucuna flagellipes leaf extract increases packed cell volume and white blood cell count and the number of proliferating cells in the bone marrow in the presence of cyclophosphamide. Mucuna flagellipes leaf extract can be used in clinical practice to cushion the bone marrow suppression effect, leukopenia and anaemia, that follows the use of cyclophosphamide in the treatment of malignancies.
Calvarial fracture occurs when biomechanical stresses applied to the skull exceed its tolerance. The patterns of fracture produced will depend on the location, direction and kinetic properties of the impact and also on the intrinsic features of the bone. The aim of the study is to determine the pattern of fractures of the calvaria among head injury patients in Enugu. A prospective cross -sectional study involving 150 head injured patients with fracture of the calvaria, who presented to the Accident and Emergency Department of Enugu State University Teaching Hospital between January, 2016 and December, 2018. Information was obtained from the patients’ records and CT image findings. Data was analyzed using SPSS 20.0. Majority of the patients were aged 21-30years (29.6%). There is male preponderance (82.7%).Linear calvaria fracture accounted for the highest percentage of fracture patterns (47.3%), comminuted (18.7%), depressed (10.0%), multiple linear (8.7%) and others (15.3%). Comminuted fracture was the most associated with assault (7 out of 27 patients); linear fracture with fall from height, Basilar fracture with patients age between 31- 40years, and multiple comminuted between 41- 50 years. Frontal bone (41.9%) is the mostly affected. Road traffic accident (RTA) accounted for most head injuries with calvaria fractures (70.0%), followed by assault (18%). RTA is the most common cause of head injury in Enugu, with the frontal bone mostly affected and linear fracture being the commonest pattern of fractures of the calvaria in head injury patients.
In 2015, the National Agency for the Control of AIDS (NACA) in partnership with the Subsidy Reinvestment and Empowerment Program (SURE-P) conducted an integrated multi-disease HIV counseling and testing outreach campaign in Tudun Wada LGA of Kano State, Nigeria to assess the prevalence of HIV and other communicable and non-communicable diseases in that local council. Data on different aspects of the screening and treatment campaign were collated using a Federal Government of Nigeria outreach client data form and analyzed using Statistical Package for Social Sciences. A total of 3114 members of the community registered for the outreach but only 2869 accessed services. While 51.6% of all the clients were females, 29.9% were in full employment, 8.9% had a body mass index above 25kg/m2, 52.1% engaged in very active exercise and only 7.9% ate fruits daily. About 40.8%,12%, 8.6% and 0.7% tested positive for malaria, HBsAg, HCV and HIV/AIDS on screening with rapid diagnostic kits. Even though 25.4% and 25.1% had a family history of hypertension and diabetes only 4% and 6.5% had abnormal readings using standardized WHO recommended cut-off points. Malaria and peptic ulcer disease were the most prevalent diseases seen and managed by the medical teams with rates of 59.8% and 22.8% respectively. The integrated multi-diseases outreach carried out in this local council was well attended. Clients were screened for both communicable and non-communicable diseases and referred to the general hospital in the area for follow-up and further management. Political support from the National Agency for the Control of AIDs, the state government and from relevant line ministries, robust advocacy, communication with electronic and print media, training of teams and sustained social mobilization were veritable tools to the overall success of the campaign in Kano State.
Space available for the spinal cord (SAC) is a measure of cord functional reserves. Reduction in SAC value may predispose to cord injury. This study assessed the accuracy of MRI derived SAC in predicting the risk of spinal cord injury by comparing the subaxial cervical spine SAC values obtained in asymptomatic Nigerians and those with traumatic cervical spine cord injury (CSCI). Prospective, cross-sectional MRI-based study of selected 100 consenting asymptomatic adults and 88 CSCI patients done in Memfys Hospital, Enugu Nigeria from 2012 to 2017. SAC was calculated by subtracting disc level midsagittal cord dimension from corresponding level spinal canal dimension. Age range was between 21 to 50yrs. Data was analyzed using inferential and descriptive statistics. Mean SAC was used in calculating the sensitivity and NPV for SCI at each level. Average SAC value for each disc level for the asymptomatic and those with CSCI respectively were: C3/4 (4.9 + 1.2mm, 2.5 +/-1.7 mm), C4/5 (4.5+/-1.0mm, 2.2+/-1.4mm), C5/6 (4.7+/-1.0mm, 2.3+/-1.6mm), C6/7 (5.1+/-1.1mm, 2.7+/-1.9mm), C7/T1 (5.7 +/-1.2mm, 4.2+/-1.9mm). P-values were <0.05 especially at C4/5 and C5/6. Frequencies of cord injury level were: 43.2% (C5/6), 28.4% (C4/5), 17.1% (C6/7), 5.7% (C3/4), 3.4% (C7/T1), and 2.2% (C2/3). MRI derived SAC has a sensitivity of 93% and NPV of 90% in predicting an individual’s risk of SCI. SAC has a high sensitivity and NPV and will be a good screening tool in predicting the risk of subaxial CSCI. SAC is significantly lower in the CSCI group especially at C4/5 and C5/6 levels.
The Editor in Chief, Journal of Experimental Research Department of Anatomy, Enugu State University of Science and Technology, College Of Medicine (ESUCOM), GRA Enugu, Nigeria.
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Enugu State University of Science and Technology