Western Nigeria Journal of Medical Sciences

Knowledge, perception and satisfaction with bed bath practices among confined patients in UNIOSUN Teaching Hospital, Osogbo

Moridiyat Omolara Adeyinka Adeyemo, Ifeoluwa Adeniyi, Rahmat Oyekale — Wed, 14 Dec 2022 00:00:00 +0100

Introduction: Bed bath is an important procedure done by the nurses to promote patients’ hygiene and prevent infection. Observations revealed that the materials for bed bath were usually improvised in majority of the hospitals in Osun state thus leading to variations from the standardized practice, as specified by guiding principles, hence the need to assess patients’ perception and satisfaction with the practices.

Objective: This study examined the knowledge, perception and level of satisfaction of bed bath among confined patients in UNIOSUN Teaching Hospital, Osogbo, Nigeria.

Method: A descriptive design was used. The target population was the confined but conscious patients in the hospital. Structured questionnaire was used to collect data from eligible and available 54 respondents. The data obtained were analyzed and discussed.

Results: The major findings revealed that 41(75.9%) of the respondents had high knowledge of bed bath, 28(51.9%) had good perception of it while 36(66.7%) were satisfied with the care. Patients’ inability to determine choice of water temperature and non-verbal communication by nurses were factors affecting the satisfaction derived from bed bath by the respondents. There was a significant association between respondents’ knowledge of bed bath (r = .796, p< .05) and satisfaction with it, however, there was no significant association between perception (r = 0.451, p> .05) and satisfaction.

Conclusion: Majority of the confined patients at UNIOSUN Teaching Hospital, Osogbo had high knowledge of bed bath, good perception of it and most were satisfied with it. Nurses should take cognizance of the identified factors associated with patients’ satisfaction with the procedure with a view to improving the practice.

Knowledge and Attitude of Nursing Mothers on Exclusive Breastfeeding in Southwest Nigeria

Wed, 14 Dec 2022 00:00:00 +0100

Introduction: The study aimed to assess the knowledge and attitude of nursing mothers regarding the practice of exclusive breastfeeding in the Ogbomoso community.

Methods: The study involved two hundred and twenty-eight consented breastfeeding mothers who fulfilled the inclusion criteria. A cross-sectional descriptive design was adopted using a validated interviewer-based questionnaire. Multistage sampling technique was used in selecting LGAs and health facilities. Knowledge and attitude questions were assigned 1 and 0 marks for appropriate and inappropriate responses respectively while level of knowledge and attitude were assessed using modified Bloom’s cut-off points. Quantitative analysis was conducted using SPSS version 25. A Chi-square test was conducted to assess the correlation between categorical variables (sociodemographic data, knowledge and attitude). All analyses were done at a 95% confidence interval and a p-value <0.05 was considered significant.

Results: The majority of the participants, 113(54.1%), were between 20 and 29 years. 138(66%) had good knowledge of exclusive breastfeeding (EBF), 65(31%) had fair knowledge and only 6(3%) had poor knowledge. Also, 153(73.2%) had a positive attitude towards EBF while 56(26.8%) had negative attitude. Varying knowledge levels and attitude shown by mothers towards EBF affected the practice, especially among those having more stressful work schedules amidst other sociodemographic factors thus having limited time and space for breastfeeding.

Conclusion: The study participants had good knowledge about EBF and majority showed positive attitude towards exclusive breastfeeding. Working in government employment or in companies where there is limited time and space for breastfeeding might affect their attitude towards the practice thereby opting for other feeding options. Efforts should therefore be put in place to ensure all nursing mothers embrace EBF.

Plasmodium falciparum Parasitemia with Anemia in Children under Five Years at a Tertiary Health Center in South-West, Nigeria

Wed, 14 Dec 2022 00:00:00 +0100

Objectives: Malaria is a major public health disease and a major cause of morbidity and mortality among the population in sub-Saharan Africa. Severe malaria could be life threatening, especially among children less than five years old.

Methods: The study was conducted at the Children Emergency and Pediatrics wards of the Federal Medical Centre, Owo, Ondo State in Nigeria, over a three-month period. Ethical approval was obtained and an informed consent was taken from the caregivers. One hundred children below the age of five years were involved in the study. Blood was obtained from the children for thick and thin smears for malaria parasite identification and estimation. Packed red blood cell volume was also estimated using microhematocrit method.

Results: About 90.3% of the children were found to have malaria while 59.1% were anemic. Using multivalent analysis, malaria parasitemia was found to be associated with anemia (P = 0.036) in this study, there was no significant association between age, gender and malaria with anemia.

Conclusions: Malaria in children is closely associated with anemia. Efforts should be geared towards prevention of malaria in children and pregnant mothers, also early detection and prompt treatment of malaria before complications such as anemia arises.

Keywords: Malaria, Plasmodium falciparum, Anaemia, Children, Nigeria

Prevalence and Clinical Correlates of Antiphospholipid Syndrome among pregnant women in Southwestern Nigeria

Wed, 14 Dec 2022 00:00:00 +0100

Introduction: This study aimed to utilize triple auto-antibodies to determine the prevalence of antiphospholipid syndrome (APS) among pregnant women in Ogbomoso, Oyo State, Nigeria.

Methods: The longitudinal descriptive study involved a hundred and sixty pregnant women with pregnancy complications and control. Participants were tested for APS by assaying Antiβ2, ACA and LAC at first contact and for persistent positivity after twelve weeks using the ELISA method with blood specimens. Data were analyzed using SPSS version 21.

Results: The prevalence of persistent positivity to anti-phospholipid antibodies in this study is 28.8% and 2.5% among the subjects and control respectively. Persistent positivity to ACA was observed in 26.3%, β2-GP1 in 21.1% and LAC in 16.8% of participants in the study group and 2.5%, 1.3% and 2.5% in the control group. Persistent positivity to anti-phospholipid antibodies was associated with hypertension and recurrent miscarriage (≥3).

Conclusion: Hypertension and recurrent miscarriage are associated with APS among pregnant women in this study area. Triple auto-antibodies are suggested as routine pregnancy tests among pregnant women with previous history of these complications.

Assessment of knowledge, attitude and patronage of traditional bone setting among residents of Ogbomosho, South Western Nigeria

Wed, 14 Dec 2022 00:00:00 +0100

Introduction

The aim of this study was to determine the utilization of traditional bone setters among residents of Ogbomosho, South Western Nigeria.

Methods

It was a cross-sectional study where 350 respondents were selected using multistage sampling technique. Data were collected using pre-tested self-administered semi-structured questionnaire; analyzed using Statistical Package for Social Sciences version 23 and presented using appropriate tables and charts. Level of significance was set at 0.05.

Results

The mean age of the respondents was 32.6 +1years with majority being young adults (56.6%), males (51.1%), married (56.6%), those with primary education (43.7%), residents in urban area (52.9%) and self-employed (48.3%). In terms of knowledge, awareness is high but the comprehensive knowledge of the inherent dangers of using such settings such as having tetanus infection and mismanagement is low. Overall, more than half of the respondents (56%) had poor knowledge of the dangers of patronizing traditional bone setters. However, regarding attitude, more than half (65%) had unfavorable attitude using the mean score. In terms of practices, less than one quarter of respondents (23.7%) had patronized traditional bone setters in the past due to reasons such as cost of hospital treatment, bone infection, attitude of health care staff, fear of operation, and delay in hospital treatment among others.

Conclusion

There is low comprehensive knowledge to inherent dangers, coupled with high patronage of traditional bone setters among respondents. Therefore, there should be an aggressive health promotion intervention and integration of such practices into modern settings.

Comparative effect of Nifedipine and Garlic (Allium sativum) on Renal toxicity induced by Hypertension in Wistar rats

Wed, 14 Dec 2022 00:00:00 +0100

Introduction

Research has shown that hypertension has lingering effect on several organs and the body in general. One of the most affected organs is a vital organ, the kidney. The aim of this study is to observe the effect of hypertension on the kidney and compare the therapeutic potential of Garlic and Nifedipine on the cyto-architecture and clearance rate of the kidney.

Methods

Twenty (20) male wistar rats weighing between 150-180 g were assigned into four groups (A,B,C,D) with each group comprising of five rats. Group A was designed as a control group which received 0.2 ml of normal saline. Group B received 3 mg/kg body weight of NaCl only, Group C received 3 mg/kg of NaCl and 3mg/kg of Nifedipine while Group D received 3 mg/kg of NaCl and 50mg/kg of Garlic for 28 days.

Results

Administration of Sodium Chloride (NaCl) only in group B treated rats showed significant increase in Concentration of Troponin-T and degeneration of cardiac cells. These effects were lessened in groups C and D treated with NaCl co-administered with Nifedipine and NaCl co-administered with Garlic respectively. Renal-toxicity was observed in group B with significant increase in the concentration of Urea and Creatinine when compared with control and Group D rats. Histologically, Control and Group D rats showed normal glomeruli with normal mesangial cells, the renal tubules appeared normal with no signs of dilatations and the interstitial spaces appeared normal and cleared.

Conclusion

This study revealed that hypertension induced by NaCl caused reduced efficiency in kidney function (renal dysfunction) in Wistar rats and Garlic was effective in attenuating the effect of the hypertension on the kidney better than the administration of antihypertensive drug (Nipedipine).

Spectrum of Neurosurgical Operations at the UNIOSUN Teaching Hospital, Osogbo, Nigeria

Taopheeq Bamidele Rabiu, Edward Oluwole Komolafe — Wed, 14 Dec 2022 00:00:00 +0100

INTRODUCTION: The field of neurosurgery is growing in Nigeria and in many parts of Africa. Nonetheless, there is little information on the types of neurosurgical operations being performed in the country especially outside of the early-generation neurosurgery centres. This study details the spectrum of neurosurgical operations in a new generation neurosurgery centre.

METHODS: A retrospective review of neurosurgical operations performed at the UNIOSUN Teaching Hospital, Osogbo, Nigeria from October 2011 to June 2022 was done. The neurosurgery operation register was reviewed for data on patients’ demographics, clinical diagnoses, types of operations performed and kinds of anaesthesia used. Simple descriptive statistical analysis was done.

RESULTS: 269 operations were performed in 257 patients. Males were 175(68.1%). Their ages ranged from 10days to 96years with a mean of 38.5years. 62(24.1%) were children. The most common diagnoses were acute traumatic brain injury (57, 22.2%), chronic subdural haematomas (38, 14.8%), brain tumours (30, 11.7%), hydrocephalus (25, 9.7%) and lumbar spondylosis (22, 8.6%). The most common procedures were burr holes (61, 22.7%), laminectomy (61, 22.7%), ventriculo-peritoneal shunt (27, 10.0%), craniotomy for tumour excision (25, 9.3%) and trauma craniotomy (24, 8.9%). Adjunct procedures included spinal stabilisation using Adeolu’s technique (20, 7.4%), spinal wiring (5, 1.9%), lumbar discectomy (7, 2.6%) and skull-base repair (2, 0.7%). 148(55.0%) of the procedures were done as emergency. General anaesthesia with endotracheal intubation was the most common type of anaesthesia (200, 74.3%).

CONCLUSION: A wide spectrum of neurosurgical operations was performed. These were mostly carried out in male adults and as emergency procedures.

Pattern and Predictors of Intradialytic Mortality in an urban dialysis centre in South-West Nigeria: A 3-year Audit

Titilope Adetoun Bamikefa, Babaniji Omosule , Samuel Dada, Ayodeji Lamidi — Wed, 14 Dec 2022 00:00:00 +0100

INTRODUCTION

Kidney (renal) replacement therapy is an integral component of the holistic care of patients with renal impairment. It may have adverse outcomes including intradialytic mortality. This study evaluates the prevalence as well as the factors contributing to intra-dialytic mortality in the studied population.

METHOD

A retrospective evaluation of the clinical and dialysis records of 188 adult patients who had haemodialysis in our facility over a 3-year period was performed. A comparison of clinico-demographic parameters was carried out between patients who experienced intra-dialytic mortality and those who had uneventful dialysis sessions. Data were analysed using SPSS version 24.

RESULTS

During the years under review, 14(7.4%) of the 188 patients dialysed experienced intradialytic mortality with a mean age of 40.6±16.0 years for those that died. More females died intra-dialysis compared to their male counterparts (M:F ratio = 1:3.6). The source of admission for dialysis (P=0.046), female gender (P=0.05), occurrence of intradialytic hypotension (P= 0.001), high predialytic systolic blood pressure (P= 0.039), underlying type of kidney disease (P=0.023), intra-dialytic level of consciousness (P=0.001) as well as dialysis reaction time (P=0.009) were associated with increased likelihood of intra-dialytic death. On multi-variate analysis source of admission (OD=0.000, P-value=0.998), in-patient status at last dialysis (OD=0,000, P-value=0.992), intradialytic hypotension (OD=0.000, P-value=0.980), predialytic systolic blood pressure (OD=25.431, P-value=0.981) and dialysis reaction time (OD=1696, P-value=0.981) were not predictive of mortality.

CONCLUSION

The occurrence of intradialytic mortality is dependent on predialytic as well as intradialytic factors although none of these factors exhibited predictive ability on multivariate analysis.

Depression and Personality Traits among Undergraduates in a Southwest Nigerian Institution

Wed, 14 Dec 2022 00:00:00 +0100

Introduction

Individual differences associated with diverse emotional reactions may be significantly traced to genetic makeup which can influence the experience of mental health disorders such as depression. Previous studies on depression and personality traits have focused largely on individuals who have been diagnosed and are being managed for depression, however, little attention is being paid to undergraduates who are yet to be diagnosed especially in a developing country like Nigeria. Therefore, this study aimed to identify the relationship between depression and personality traits among university students in Oyo State, Nigeria.

Methods

The study design employed a cross-sectional survey which consisted of four hundred and thirty-six full-time undergraduates using Fisher’s sample size formula. The Big Five Inventory-10 (α=0.63) and Patient Health Questionnaire-9 (α=0.85) were self-report questionnaires used as instruments for the study. The study questionnaires were administered to the consented respondents during lecture-free periods. Data analysis was done using SPSS version 21 and the statistical significance level set at P <0.05.

Results

The personality trait with the highest mean in the study population was Agreeableness (8.05 ± 1.76) which was higher among female respondents; followed by Conscientiousness (7.40 ± 2.01) which was significantly higher in respondents without depressive symptoms compared to respondents who screened positive for depression (P = <0.005). However, Neuroticism was significantly lower in respondents without depressive symptoms compared to their counterparts who screened positive for depression.

Conclusion

Neuroticism, although not the prevailing personality trait among respondents in this study area, has a positive association with depression which was statistically significant. However, further study is required to corroborate this finding.

Prevalence of Hepatitis B Among Pregnant Women At LAUTECH Teaching Hospital, Osogbo: A 5-Year Study

Wed, 14 Dec 2022 00:00:00 +0100

INTRODUCTION

Hepatitis B virus is most commonly transmitted from mother to child during birth and delivery. The prevalence of hepatitis B in pregnant women worldwide is 0.25-2.5% This study was designed to determine the prevalence of Hepatitis B among pregnant women at LAUTECH Teaching Hospital, Osogbo with a view to producing a data base for effective treatment and control plan of the disease.

METHODS

It was a retrospective study over a 5-year period (2015-2019) that determined the prevalence of Hepatitis B in pregnancy and feto-maternal outcomes. Data on socio-demographic characteristics of patients were retrieved from the case files. Data analysis was done with SPSS version 23 using appropriate statistical tools.

RESULTS

110 cases were identified among 4300 pregnant women. The prevalence of Hepatitis B was 2.56%. The prevalence increased over the 5-year period. There was association between the prevalence of Hepatitis B infection, age, marital status, location, and parity. There was also association between hepatitis and the birth weight of babies as well as their APGAR (Appearance, Pulse rate, Grimace, Activity, Respiration) scores.

CONCLUSION

The prevalence of Hepatitis B infection among pregnant women is slightly higher than the global prevalence with an increasing rate over the five-year period. Feto-maternal outcomes were associated with chronic hepatitis B infection. The importance of prevention of the infection needs to be further emphasized.

Sociodemographic characteristics and outcomes following closed thoracostomy tube drainage in a tertiary hospital in Osogbo

Oladapo Kolawole, Olufemi Ojewuyi, Gbenga Aderibigbe — Wed, 14 Dec 2022 00:00:00 +0100

Introduction

Closed thoracostomy tube with underwater seal drainage (CTTD) is a common life-saving procedure performed in the hospital setting. This study evaluates the socio-demographic characteristics of our patients who had CTTD, the indication for the procedure and outcome.

Methods

A well-structured proforma was used to collect information on patients that had CTTD for various reasons during the period under study. The age, gender, urgency of CTTD intervention, duration of admission, the side of the chest involved, indication, number of days patient was on CTTD, characteristics of the effluent, and outcomes were the variables analysed.

Results

A total number of 34 patients were recruited. The mean age was 43.15±16.9 years. Majority of the patients 21 (61.8%) were females. The CTTD was left sided in 44.1%, right sided in 47.1% and bilateral in 8.8%. In 19(55.9%) patients, the procedure was as an urgent intervention. Majority, 14(41.2%), had pulmonary tuberculosis, 10(29.4%) had metastatic breast cancer, 5(14.7%) had pneumonia and 2(5.9%) had trauma. One patient (2.9%) each had decompensated chronic liver disease, subphrenic abcesss and end stage renal disease. Patients were on CTTD for an average of 7 days. Majority, 20(58.8%), had serous effluent. Mortality occurred in 3 (8.8%) patients; all had malignant and bloody effusion.

Conclusion

CTTD is a very common and important life-saving procedure performed more commonly as an emergency. Majority had infective causes as the etiology. The odds of mortality were higher amongst those with malignant pleural effusion and bloody effluent.

Factors associated with differentials in modern contraceptive use among currently married women in Nigeria: Muslim North Versus Muslim South

Wed, 14 Dec 2022 00:00:00 +0100

Introduction

Despite the federal government’s modern contraceptive prevalence (mCPR) target of 27% by 2020, mCPR remained abysmally low. Recent data from the most recent Multiple Indicator Cluster Survey revealed mCPR of 18.3%, although with significant differentials along region and religious affiliations. This study examined factors associated with modern contraceptive use among currently married Muslim women in Northern and Southern regions of Nigeria

Methods

The study analysed secondary data pooled from the three most recent successive Nigeria Demographic and Health Survey data sets (2008, 2013, and 2018). Analysis was restricted to currently married Muslim women aged 20–40 years, who have given birth to at least a child and have at least two living children as at the time of the survey and were not currently pregnant. The weighted sample size for the study was 22,653 women: (2018=8,605; 2013=7,830 and 2008=6,217). The outcome variable was modern contraceptive use, defined as whether a woman is using any modern contraceptives coded as 1, or not, coded 0. Binary logistic regression was performed.

Results

Significant regional differentials in mCPR persist. At the multivariate level, education, wealth index, occupation, autonomy, joint decision on contraceptive use and knowledge of methods were significant predictors of mCPR among northern Muslim women. Among southern Muslim women, age, autonomy, joint decision on contraceptive use and knowledge of methods were factors that significantly predicted mCPR.

Conclusion

Within homogenous religion, regional differentials accounts for differences in modern contraceptive use in Nigeria, thereby providing useful information for programmes and policy.

Dry Eye Diseases – a review of current and emerging treatment modalities

Mustapha Hassan, Olufisayo Aribaba, Charles Bekibele — Wed, 14 Dec 2022 00:00:00 +0100

Introduction

Dry eye disease (DED), also known as dry eye syndrome (DES), and kerato-conjunctivitis sicca (KCS), is a common multifactorial disease of the ocular surface and its associated tear film production. The condition may cause ocular discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. This often results in discomfort to the patient. This article reviews DED with respect to aetiology, presentations and current management as well as new trends in the diagnosis and management of this common disorder.

Methods

This review used extensive literature search of existing body of knowledge and current research findings as presented at conferences and workshops. We have explored the current thinking and trends in this common ocular disorder outlining its causes, presentation and management. What the future portends in the area of research and innovative management strategies is also discussed.

Results

The review showed that early detection of this disorder can be achieved by a high index of suspicion, appropriate history taking and correct investigations. It is most often managed using benzalkonium chloride (BAK-rich) tear substitutes even though preservative-free eye medications are preferred where available and affordable.

Conclusion

Like other health challenges in our clime, late presentation is not uncommon. Penetrating keratoplasty for non-regressing superficial and deep corneal vascularization may be necessary.

COVID-19 Pandemic: Management in the State of Osun

Peter Babatunde Olaitan — Wed, 14 Dec 2022 00:00:00 +0100

The COVID-19 Pandemic which started in China and became a global threat with high morbidity and mortality was a shock to the world, especially the developing countries with poor health facilities. Nigeria was not exempted as the pandemic ravaged the world. Osun state had its own share but with adequate preparation and effective management of the pandemic by a team of health workers across the various specialties and support from other stakeholders like the security agencies, the press and various donors at different levels, the pandemic was well managed in the State of Osun. Facilities were put in place and mortality among confirmed cases was about 2.2%. In spite of the initial global reluctance to take the COVID-19 vaccines, Osun State is the third most COVID-19 vaccinated in Nigeria.

Case Report: Bilateral Massive Gigantomastia unrelated to Pregnancy and Puberty

Wed, 14 Dec 2022 00:00:00 +0100

Introduction

Gigantomastia refers to benign progressive breast enlargement to a degree that requires breast reduction surgery to remove more than 1.5kg weight of tissue on each breast. Several factors have been postulated as origin of gigantomastia which was the basis of its classification. These include hormonal, drugs and autoimmune factors among others.

Case

A 32-year old P₂+0 (2 alive) woman with history of progressive bilateral breast enlargement of 5 years with associated mastalgia and back pain. It started two and half years after her last confinement. She was not on any drugs which could cause gigantomastia. The patient had bilateral reduction mammoplasty done under general anaesthesia.

Conclusion

This idiopathic gigantomastia is a rare type of gigantomastia as pregnancy, puberty and/or drug were not implicated in this patient.