Faculty of Clinical Sciences

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    CONTRACEPTIVE UPTAKE AMONG WOMEN OF REPRODUCTIVE AGE IN A SEMI URBAN AREA IN JOS SOUTH LOCAL GOVERNMENT AREA OF PLATEAU STATE, NORTH CENTRAL NIGERIA.
    (THE NIGERIAN HEALTH JOURNAL, 2013-06) Moses Chingle, Mathilda Banwat, Luret Lar, Ayuba Zoakah
    BACKGROUND Family planning reduces the number of unintended and unwanted pregnancies and thereby saving women from high risk pregnancies and unsafe abortions. Despite the persistent advocacy urging the use of modern contraceptive methods for family planning, the fertility rates in most sub-Saharan African countries still remain unacceptably high mostly due to poor uptake of contraception because of cultural, economic and political barriers. Evidence from the recent Nigeria Demographic and Health Survey indicates that only about 15 percent of sexually active women currently practice effective contraception. The objective of the study was to assess the knowledge of contraceptive and its uptake among women of reproductive age in Gering community in Jos South Local Government Area of Plateau State. METHODS A cross sectional study design was used to assess knowledge and uptake of contraceptive among 400 respondents selected by multi stage sampling technique in Gering community using a semi structured interviewer administered questioner. Information about their knowledge, uptake, methods and factors that determine uptake of contraceptives was obtained. Data was analyzed using Epi Info statistical software and results were presented as tables. Chi square was used to test association between qualitative variables. RESULTS Majority, 362 (90.5%) of the respondents were aware of contraceptives, 200 (55.2%) had used one form of contraceptive or the other. Two common methods of contraceptives used were pills, 184 (34.2%) and injectable 176 (32.8%). Determinants of uptake included: prevention of unintended pregnancies in 136 (53.1%) and to space timing of child birth in 78 (30.5%). Factors found to be associated with contraceptives uptake among women included age, (p=0.000), education (p=0.000) and marital status (p=0.000). CONCLUSION This study showed that despite high awareness about contraceptives, the uptake is relatively low compared to the rates in developed countries. Factors like age, marital and educational status have statistically significant relationship with contraceptive uptake. There is a strong need to encourage continuing female education to enhance awareness on contraceptives and their benefits in reproductive health.
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    CLEFT LIP, ALVEOLUS AND PALATE IN AFRICAN NATIVES: AN UPDATE ON DEMOGRAPHICS AND MANAGEMENT OUTCOME
    (HHS Public Access, 2015-12) Drs O.B. Akintububo1, E.O. Ojo2, DD Kokong3, S.A. Adamu4, U.U Nnadozie5, Z Yunusa Kaltungo5, I Jalo6, and A.M Dauda7
    Background—Development of craniofacial structures is a complex process and disruption of any of the numerous steps can lead to development of oro-facial clefts. This is a surgically amenable anomaly as from early life that has had conflicting pattern of demographics reported by various researchers globally. There are several factors that are critical to the surgical outcome. Objective—Study the demographics and the management outcome of cleft lip, alveolus and palate and highlight factors responsible for improved care in recent time. Design—Descriptive cohort study. Setting—Tertiary health institution Method—All consecutive patients managed for cleft lip, alveolus and palate (CLAP) over 7years and 10months were studied. Outcome—Cleft lip, alveolus and palate repair was performed on 149 patients, January 1, 2001– December 31, 2008 with an incidence of 2.1/1000 live births. From this, 27 patients, averaging 4.5 patients per year were operated for the first 6 1/3 years while the remaining 122(81.9%) the next 1 1/2 years, averaging 81.6 patients yearly. Their ages ranged from 3 months – 60 years with 77 (51.7%) males and 72 (48.3.0%) females. Cleft lip was the main presentation in 108(72.5%) of which 72(66.7%) were left sided. Bilateral cleft lip were14 (9.4%). Five (3.4%) patients had associated anomalies out of which 3(60.0%) had CLAP while 2(40.0%) isolated cleft lip or palate. The technique for cleft lip repair was Millard’s and Noordhoof’s while palatal cleft was the twoflap palatoplasty with intravelar veloplasty. Success was recorded in 142(95.3%) with complication observed in 7(4.7%) patients. Conclusion—The rarity of cleft lip, alveolus and/or palate in the African native documented previously may no longer be tenable as observe in this study. Management outcome has improved owing to the collaboration with SmileTrain, USA, along with multidisciplinary approach.
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    Profile of Benign Breast Diseases in an African Population
    (Journal of Surgery, 2016-05) Ale Alexander Femi, Ozoilo Kenneth Nnaetio, Misauno Michael Ayedima
    Benign Breast Diseases (BBD) refer to all non-malignant conditions of the breast and it received little attention in the past because most of the focus was on breast cancer, despite the fact that it constitutes majority of the presentation in breast clinics. The objective of this study was to evaluate comprehensively the profile of BBD in our environment, highlight the age group distribution of these BBDs and its different modes of presentation. This was a prospective cross-sectional study conducted between May 2009 and April 2010 at the Taimako Breast and Cervical Screening Centre on women who presented for breast screening. There were two thousand and sixty five study subjects, out of which one hundred and fifty women were diagnosed with BBD (7.3%), while one thousand nine hundred and fifteen (92.7%) had normal screening results. The mean age of those with BBD was 27.9 ± 9.6 with an age range of 15 to 60 years. Breast lumps constituted 44.7% of the presentation of BBD and was the most common mode of presentation, while 17.3% of those diagnosed with BBD had no symptoms and were discovered following triple assessment. More than half (56.8%) of the women who complained of breast lumps did not actually have lumps following triple assessment. BBD comprised a spectrum of disorders, with Fibroadenoma being the commonest and occurred most frequently in the younger 2nd and 3rd decades as opposed to older decades.
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    Experience with rubber band ligation of hemorrhoids in northern Nigeria
    (Nigerian Medical Journal, 2013) Misauno, M. A.; Usman B. D.; Nnadozie U. U.; Obiano S. K.
    Background: Treatment of hemorrhoids in Nigeria is usually done by the traditional open method that requires hospital admission; anesthesia and is associated with high morbidity. Rubber band ligation is a suitable alternative to open hemorrhoidectomy and has the potential to reduce the need for hospital admission. Patients and Methods: This was a prospective analysis of consecutive patients presenting with hemorrhoids that were suitable for surgical treatment to the Jos University Teaching Hospital and the Federal Medical Centre Gombe from January 2008 to December 2010 (24 months). Results: A total of 232 rubber band ligations were performed on 40 patients whose ages ranged from 20 to 54 years with a mean age of 37.1 ± 12.2 years. There were 24 males and 16 females (M:F::2:3). Thirty‑nine patients (97.5%) were cured of their symptoms following the procedure, and 1 patient (2.5%) had severe pain as complication of the treatment. Another patient had recurrence that was treated by repeat rubber band ligation. Conclusion: We conclude that rubber band ligation is a safe and reliable way for outpatient treatment of hemorrhoids in Nigeria.
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    Body Size and Metabolic Health: A Phenotypic Characterisation of an Indigenous African Working Population
    (Annals of Medical and Health Sciences Research, 2017-08) Agaba, Patricia A.; Akanbi, Maxwell O.; Ocheke, Amaka N.; Gimba, Zumnan M.; Fannap, Binfa J.; Iliya, Friday G.; Agaba, Emmanuel I.
    Background: An obesity subgroup has been described that do not have the typical metabolic abnormalities associated with obesity. Aims: We characterized body size and metabolic phenotypes among public employees. Materials and methods: 879 participants were evaluated using WHO-STEP wise approach to non-communicable diseases screening. Body size was classed according to WHO guidelines. Metabolically healthy obesity (MHO) was defined as obesity without elevated blood pressure, diabetes mellitus and reduced HDL-C (< 40mg/ dl for men and<50 mg/dl for women respectively). Determinants of MHO were assessed in a logistic regression model adjusting for socio-demographic, clinical and biochemical variables. Results: 38.1% (335/879) had normal BMI, 35.5% (312/879) were overweight and 26.4% (232/879) were obese. The prevalence of metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOWT) and metabolically healthy obese (MHO) was 47.7% (160/335), 32.6% (102/312) and 18.5% (43/232) respectively (p<0.001). Tertiary education (adjusted odds ratio (AOR)=1.59; 95% CI: 1.03-2.47), hypertension (AOR=2.30; 95% CI: 1.58-3.35), hypercholesterolaemia (AOR=1.52; 95% CI: 1.06-2.17) and reduced HDL-C (AOR=2.40; 95% CI: 1.20-4.78) independently predicted generalized obesity, while male sex (AOR=0.10, 95% CI:0.07- 0.16) reduced the risk of generalized obesity by 90%. Age 45 years and older (AOR=0.29; 95% CI: 0.20-0.40, p<0.001), alcohol intake (AOR=0.50; 95% CI: 0.34-0.74, p<0.001), and generalized obesity (AOR=0.31; 95% CI: 0.20-0.47, p<0.001) were protective against MHO. Conclusion: A significant proportion of the participants had the MHO phenotype. Body size had an inverse relationship with metabolic health.
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    Sexual risk behavior and HIV infection among adolescents in secondary schools in Jos, Nigeria
    (Nigerian Journal of Paediatrics, 2014) John C; Okolo SN; Isichei C
    Abstract Background: In adolescents sexual risk behaviours are believed to enhance the transmission of HIV infection. This study, therefore aims to examine prevalent sexual risk behaviours of adolescents in secondary schools in a town in northern Nigeria and its relation to HIV infection. Method: A total of 883 subjects drawn from 10 schools out of 37, were recruited for the study. Structured self administered questionnaire was given to each subject. Consenting subjects received group pretest counseling and had HIV screening using Determine HIV test kits. HIV positive subjects had confirmatory test using Unigold test kit. Result: Males accounted for 42.5% (374) out of the 883 students studied. Of this, 169 (19.2%) were sexually active. Mean age at sexual debut was 13.8±2.9 years; 13.3±2.7 years for males and 14.6±3.2 years for females, p=0.006. Males 101 (27%) were more sexually experienced as against 13.4% of the females, p<0.0001. Among the sexually active37.6% had two or more sex partners, and 63.9% of them never used condoms. In the sexually active, 54 (42.5%) had nonconsensual sex (NCS), with more of NCS occurring in younger subjects p<0.0001, more females p<0.0001, associated with less condom use (p=0.02). Nine (eight females and one male) of the 883 subjects tested HIV positive. among the sexually active subjects, only four tested HIV positive. Condom use among the sexually active, HIV positive subjects was 25%. Conclusion: Prevalent sexual risk behaviors noted were early sexual debut, nonconsensual sex, unprotected sex and multiple sex partners.
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    Sociocultural factors influencing the control of malaria in an endemic city in North Central Nigeria
    (International Journal of Biological & Medical Researc, 2010) Godwin T. Jombo; Emmanuel M. Mbaawuaga; Priscilla Denen Akaa; Olusayo O. Alao; Etete J. Peters; Simon J. Utsalo; Edward E. Okwori; Tyavyar J. Akosu; Etiobong A. Etukumana
    The continued persistence of malaria in Africa appears to be largely due to socio-cultural factors which very often, are at variance with the standard control methods. The study was therefore designed to ascertain the socio-cultural factors affecting the control of malaria in an endemic city- Makurdi, north central Nigeria. The study was cross-sectional in nature using systematic sampling methods to identify households; both quantitative and qualitative data were generated from adult women using structured and semi-structured questionnaires, and focused group discussions (FGDs) to obtain information on malaria. Questionnaires were administered requesting such as age, educational level, marital status, and awareness or otherwise of the existence of malaria, and methods of prevention. Focused group discussions were used to obtain qualitative information on malaria not captured in the questionnaires. Data obtained was analysed using Epi Info 6 statistical software. Of the 2,075 adult women studied, 97.0% (n=2,013) were aware of the existence of malaria. Out of these, 83.0% (n=1,671) did not consider malaria to be a serious health problem that would need urgent attention. Educational level and marriage had a positive impact on knowledge about the disease (P< 0.05). Accessibility to information on malaria and general knowledge of the modes of transmission and control was generally low, and to a large extent influenced by their cultural beliefs, values and low economic strengths. There is a need to intensify adult health education and provision should be made for home health educators to raise peoples' knowledge about the disease. Policies meant to reduce the poverty level of the people should be put in place to raise their economic status.
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    PREVALENCE OF UNDIAGNOSED POST TRAUMATIC STRESS DISORDER AMONG IN-PATIENTS IN A SUBSTANCE USE DISORDER TREATMENT CENTRE IN NIGERIA
    (JOURNAL OF BIOMEDICAL RESEARCH & CLINICAL PRACTICE, 2018-04-23) Makput, D.M.; Dami, N.; Piwuna, C.G.; Haa, T.N.; Maton, C.
    Post traumatic stress disorder is a clinical disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. It occurs commonly as a co-morbid diagnosis with substance related disorders, as well as other psychiatric disorders. We postulated that post traumatic stress disorder may be under- diagnosed in therapeutic wards where substance use disorders are treated. This study thus sought to determine the prevalence of undiagnosed post-traumatic stress disorder in a substance use disorder in-patient population. The posttraumatic stress disorder check list, Civilian version was administered to patients on admission at the Center for addiction treatment and research, Vom, Plateau state, Nigeria in June 2017. Sociodemographic data and information regarding substance use were also obtained from the patients. A total of 38 inpatients were analyzed and 8 (21%) met the Diagnostic and statistical manual of mental disorders (fourth edition) criteria for current post traumatic stress disorder. None of the patients had a diagnosis of post-traumatic stress disorder in their case notes prior to the post-traumatic stress disorder check list administration in this study. Post traumatic stress disorder which is frequently co-morbid with substance abuse remains undiagnosed in many patients admitted to our therapeutic center.
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    The Pattern and Trend of Non-communicable Diseases in Children in Jos, North Central Nigeria: A Four-year Review
    (International Journal of TROPICAL DISEASE & Health, 2017) Esther S. Yiltok1*, Helen O. Akhiwu1 , Ibrahim I. Abok1 , Olukemi O. Ige1 and Emeka U. Ejeliogu
    Aims: Non-communicable diseases (NCDs) are becoming significant causes of morbidity and mortality. However very little information is available in our setting on the trend of NCDs in children. The aim is to determine the pattern and trend of NCDs in children in Jos, Nigeria. Study Design: This is a retrospective study of patients that were admitted and managed for NCDs. The relevant clinical information was extracted from the hospital records. Place and Duration of Study: The Emergency Paediatrics Unit (EPU) of the Jos University Teaching Hospital (JUTH), Jos Nigeria, between January 2012 and December 2015. Methodology: The study was a retrospective descriptive study where all records of children admitted into the EPU of JUTH within the period under review were retrieved. The bio-data of all patients and diagnoses made during the course of admission were documented. Those with inconclusive diagnoses and neonates were excluded. Data collected were entered into Epi Info version 7.2. The data was presented in frequencies and percentages and categorical variables were analyzed with the chi-square test. P value < 0.05 was regarded as statistically significant. Results: A total of 2273 children’s records were reviewed of which 36.7% had NCDs with the NCDs prevalence ranging from 29.5% - 40.5%. The three commonest NCDs were sickle cell disease (SCD), seizure disorder and severe protein energy malnutrition (PEM). There was a steady increase in the prevalence of seizures and PEM over the period. The prevalence of the diseases fluctuated over the years under review. Conclusion: The burden of diseases in children appears to be shifting towards non-communicable diseases as shown in the rising trend of NCD in our study. Therefore, there is an urgent need for relevant stakeholders to develop and ensure implementation of policies to curtail this menace which is also increasing the morbidity and mortality of children especially those less than five years of age.
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    Medical Emergencies in Primary Schools and School Ownership of First Aid Boxes
    (Medical Journal of Zambia, 2015) Agbo HA; Envuladu EA; Hassan Z; Enokela E; Zoakah IA
    Introduction: The school system aims at developing pupils academically and socially. In the process of achieving this, pupils are prone to accidents and medical emergencies due to their vulnerabilities. The ability of the school system to respond to these challenges may depend on the availability of well equipped First Aid Boxes (FABs) and the promptness of initiation of first Aid treatment. Objectives: The study determined the prevalence and types of medical emergencies in primary schools and the level of ownership of FABs. Methods: Using a multi-stage sampling technique, twenty-two primary schools were studied and a cross sectional study design was employed. Interviewer administered questionnaire and check-list were the instruments of data collection. SPSS statistical software version 16.0 was used for the analysis. Results: The 22 primary schools had a total population of 6,933 pupils; (4.9%) of the 139,494 population of the district. Twenty seven percent of the respondents experienced bruises, falls, and cuts; (22.7%) fever, cuts and episodes of convulsion; (13.6%) fever, bruises, stomach pains, falls and fractures. About (59.1%) of the primary schools had FABs with only (45.5%) of these schools with FABs containing the basic items. Conclusion: This study has brought to light the level of ownership of FABs in primary schools as well as prevalence and types of medical emergencies in primary schools. In view of this, actions need to be taken to address the identified gaps.