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  Citation statistics : Table of Contents
   2017| September-December  | Volume 11 | Issue 3  
    Online since August 1, 2018

 
 
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ORIGINAL ARTICLES
Awareness and uptake of human papillomavirus vaccines among female undergraduate students: Implications for cervical cancer prevention in South-South, Nigeria
Chibianotu Ojimah, Omosivie Maduka
September-December 2017, 11(3):134-140
DOI:10.4103/phmj.phmj_14_17  
Background: Human papillomavirus (HPV) is a sexually transmitted infection found most commonly among sexually active adolescents and young women. HPV vaccine is available in Nigeria. However, very few persons have been vaccinated. This study, therefore, aimed to assess the level of awareness of HPV infection and its vaccine uptake among female university students in Rivers State. Methods: This was a descriptive cross-sectional study carried out between July and October 2015 in three Universities in Rivers State, Nigeria. Multistage sampling was used to identify the study participants. Results: A total of 780 eligible females were recruited into the study. About 262 (33.6%) had heard of HPV infection and 203 (26%) had heard of HPV vaccines. Among those who had heard of HPV vaccines, 148 (72.9%) were aware that the vaccine could protect against HPV infection while 97 (47.8%) were aware that the vaccine could protect against cervical cancer. Only 40 (5.1%) of study participants had been vaccinated with HPV vaccine. HPV vaccine uptake was significantly predicted by respondent's marital status (adjusted OR [AdjOR] = 0.061; 0.015–0.246), parity (AdjOR = 5.855; 1.433–23.923) and knowledge about HPV (AdjOR = 7.918; 3.062–20.475). Conclusion: Awareness of HPV infection and HPV vaccine among female undergraduates in Rivers State is poor. There is, therefore, need for health promotion interventions that address this gap as part of cervical cancer control activities.
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Waiting time and patient satisfaction: Survey of patients seeking care at the general outpatient clinic of the University of Port Harcourt Teaching Hospital
Daprim Samuel Ogaji, Margaret M Mezie-Okoye
September-December 2017, 11(3):148-155
DOI:10.4103/phmj.phmj_41_17  
Background: Improving efficiency in patient flow and the satisfaction of patients attending outpatient clinics may require paying close attention to the actual time spent by patients at the various service points during their visit to the hospital. This study assessed the time clients spent at various service stations, the level of their satisfaction with the time spent and the relationship between waiting time and satisfaction for patients seeking care at the General Outpatient Clinic of the University of Port Harcourt Teaching Hospital. Methods: A total of 422 adult patients seeking care at the clinic were selected by time-limited systematic random sampling and followed through all their engagements within the hospital. Details of the time spent at each service station and clients' satisfaction with the time spent were collected using record sheet and a patient satisfaction questionnaire. Data were analysed with the Statistical Package for the Social Sciences, version 20. The statistical effect sizes and confidence intervals of measured outcomes were reported. The P < 0.05 was considered statistically significant. Results: More of the patients were female (58.6%), married (65.3%) and regular visitors to the clinic (72.6%). The mean time of 83 min was spent on the movement to the hospital and further 274 min to conclude all relevant activities in the course of seeking general practice service in the hospital. The average time of consultation with the doctors was 19 min, whereas the longest mean waiting times of 77 and 50 min were spent while waiting to access radiological and laboratory services, respectively. More patients were satisfied with the time they spent consulting the doctors (93%) or waiting to have their vital signs checked by the nurses (83%) than they were with the time taken to access radiological (30%) and laboratory services (47%). There was a significant inverse relationship between the level of patient satisfaction and the duration of time spent at the service stations. Conclusion: The waiting time for patient accessing general outpatient care in the teaching hospital is long and could be a major contributor to negative patient experiences. There is a need for system redesign, establishment of patients' appointment scheduling and other interventions by service providers that will ensure efficient and effective management of patient flow, timely access to health services and an overall improvement of patient experience with the general outpatient encounter.
  5 12,873 1,015
Knowledge and perception of healthcare providers towards palliative care in Rivers State, Nigeria
Gracia Ker Eke, Geraldine U Ndukwu, Nkem S Chukwuma, Bassey B Diepiri
September-December 2017, 11(3):156-160
DOI:10.4103/phmj.phmj_26_16  
Background: Palliative care, a multidisciplinary approach to specialised medical care, focuses on improving the quality of life for both the patient and the family. It increases their satisfaction and improves clinical outcome. Its concept, however, is relatively new in Nigeria, with services mainly limited to patients who attend the tertiary hospitals. Aim: The aim of this study is to evaluate the knowledge and perception towards palliative care among health-care providers in Rivers State. Methods: This cross-sectional study was conducted in November 2012 at the University of Port Harcourt Teaching Hospital, among participants of a workshop on Hospice and Palliative care. Participants were healthcare providers from within and outside the hospital, including doctors, nurses, pharmacists, social workers, medical and nursing students. A structured, anonymous and self-administered questionnaire was used to obtain data on knowledge of palliative care and awareness information. Data were analysed using SPSS version 20.0. Results: There were 114 respondents and this comprised of 29 (25.4%) males and 85 (74.6%) females, giving a male-to-female ratio of 1:3. They were mainly doctors (44.7%) and nurses (44.7%). Majority (88%) had previously heard of palliative care. Sixty-four (56.1%) of them heard of it in a hospital setting from doctors/nurses, 37 (32.5%) from friends/family and 10 (8.8%) in school. Forty-six (40%) respondents believed that nurses should be the ones to provide palliative care services, while 32 (28%) believed the doctors should. Less than half (47.4%) were aware of the interdisciplinary facet of palliative care. Ninety-five (83.3%) respondents believed that terminally ill patients should benefit from palliative care services, while 17.5% believed that patients with diabetes should. More doctors (80%) than nurses (47%) rightly identified the components of palliative care. Conclusion: Healthcare providers had insufficient knowledge concerning the interdisciplinary nature of the palliative care team, potentials beneficiaries and components of palliative care.
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The effect of the application of different rates of herbicides on the residual level of the herbicides and their metabolites in harvested maize cobs
Joyce Chinyere Best-Ordinioha, EA Ataga, Best Ordinioha
September-December 2017, 11(3):122-126
DOI:10.4103/0795-3038.237884  
Background: The use of herbicide in weed control has grown significantly in Nigeria in recent years. Most of the applications are indiscriminately carried out by illiterate farmers, and therefore pose a significant threat to the environment, crop yield and human health. This study assessed the effects of different application rates of the herbicides on the residual levels of the herbicides and their metabolites in harvested maize cobs. Methods: The study was carried out in a plot of land at the University of Port Harcourt in 2013 and 2014, using a randomised complete block design with three replicates, and plot size of 2 m × 2 m. N-(phosphonomethyl) glycine was used to prepare the experimental plots, while different application doses of Primextra dual gold (2-chloro-4-(ethylamino)-6-isopropylamino-1,3-5-triazine and 2-chloro-N-(ethy-6-methy(phenyl)-N-(2-methoxyl-1-methylethyl acetamide) were applied to the plots, after planting the maize. The control plot was not treated with the herbicides. The residual levels of the herbicides and their metabolites in the cobs harvested from the plots were tested using gas chromatography, with Pulsed Flame Photometric Detector. Results: The residue of the herbicides and their metabolites were barely detectable in the harvested maize cobs when the herbicides were applied at or below their recommended dose, but noted at up to 0.09 ppm, when applied at twice the recommended dose. The residues were also noted in some of the cobs harvested from the control plot, at a mean concentration of 0.0033 ppm, which is significantly <0.012 ppm recorded in the treated plot. Conclusion: The residual concentrations of herbicides and their metabolites in harvested crops increased with increasing application dose of the herbicides. Proper education of farmers is, therefore, needed to safeguard the environment and public health.
  4 7,526 538
Scalp and hair disorders at the dermatology outpatient clinic of a tertiary hospital
Olusola Olabisi Ayanlowo
September-December 2017, 11(3):127-133
DOI:10.4103/phmj.phmj_32_16  
Background: Scalp and hair disorders are common and of immense health and cosmetic significance. Alopecia, the most common presentation of scalp disorders, has been found to impact negatively on the quality of life of patients. Aim: This study aimed to document the spectrum of scalp and hair disorders, with the age and sex distribution, at the dermatology outpatient clinic of the Lagos University Teaching Hospital (LUTH) between 2004 and 2012. Methods: This is a retrospective study of patients who presented primarily with hair and scalp disorders. Data was obtained from clinic records and patients clinic notes; and included biodata, diagnoses, age and sex distribution. Results: During the study period, 860 patients (5.3%) of the 16,160 patients presented primarily with scalp and hair disorders. Both children and adult patients are seen at the clinic. Patients seen ranged from 3 months to 80 years of age. More males (67.2%) than females (32.8%) were seen; with ratio 2.05:1. Tinea capitis, dermatophyte infection of the scalp, was the most common disorder (30.5%), with male preponderance in the first decade of life. Chronic inflammatory scalp disorders such as acne keloidalis, dissecting folliculiis and folliculitis decalvans were found predominantly in adult males; while alopecia areata, scalp psoriasis and pityriasis amiantacea were noted to be more common in adult females. Conclusion: This study noted high frequency of chronic inflammatory scalp disorders found predominantly in males. However, disorders of hair care practices such as traction alopecia found commonly in community surveys were not frequent presentations in our practice. Further to determine the epidemiologic factors, aetiology and clinical characteristics of the common scalp and hair disorders will be necessary.
  3 8,962 513
Aetiology and outcome of childhood heart failure in an emergency paediatric unit in North Central Nigeria
Mohammed Baba Abdulkadir, Surajudeen Oyeleke Bello, Dimeji Patrick Oladele, Bilkis Owolabi, Habeeba Dirisu Suberu, Peter Oladapo Adeoye
September-December 2017, 11(3):161-165
DOI:10.4103/phmj.phmj_16_17  
Background: Heart failure is a common consequence of both cardiac and non-cardiac disease contributing significantly to mortality amongst children. Objective: The study aims to describe the burden of heart failure in an emergency paediatric unit (EPU), its causes and the outcome. Methods: This is a retrospective review of admissions into the EPU over a 24-month period from May 2013 to April 2015. Children aged 1 month to 14 years who met the case definition for heart failure were recruited. Unit registers and hospital folders were reviewed, and data on age, sex, aetiology of heart failure, and outcome were extracted and recorded. Results: Two hundred and ninety-one (12.5%, 95% confidence interval: 11.3–14.0) of the 2321 medical admissions over the study period had heart failure. Majority (75.6%) of the children were aged < 5 years and 164 (56.4%) were male. The common causes of heart failure were severe anaemia (66.7%), acute lower respiratory infections (21.3%), congenital disease (8.3%) and acquired heart disease (3.8%). The case fatality rate for heart failure was 5.8% (17 deaths) with majority (64.7%) of the deaths resulting from severe anaemia. Conclusion: Heart failure is a common contributor to morbidity and mortality in this environment, and the causes are largely preventable. Aggressive management of these cases may result in an improved outcome.
  1 4,478 375
Aetiology and demographics of unilateral proptosis in Benin City
Dumebi H Kayoma, Odarosa M Uhumwangho, Vivian Osaguona
September-December 2017, 11(3):166-169
DOI:10.4103/phmj.phmj_19_17  
Background: Proptosis is a common presentation with a broad differential diagnosis in an ophthalmic clinic. Although the aetiology of unilateral proptosis is diverse, the impact may be sight-threatening and/or life-threatening if left unaddressed. Objective: To determine the aetiology and demographic pattern of proptosis seen in adult patients at University of Benin Teaching Hospital (UBTH) with a view to providing baseline information for improved practice. Study Design: A retrospective chart review. Methods: This was a retrospective chart review of all patients with proptosis at the UBTH eye clinic from January 2008 to December 2014. Information obtained included age at presentation, sex, duration of symptoms before presentation, predisposing factors and ocular and systemic examination investigations. Results: A total of 50 patients who had proptosis were identified during the period under review with a mean age of 37.60 ± 14.25 years. The age range was 17–66 years. There were 27 (54.0%) males and 23 females (46.0%), with a female-to-male ratio of 1:1.2. The common causes of proptosis were infection (orbital cellulitis) 36.0%, neoplasm (28.0%), idiopathic (18.0%), inflammation (12%) and traumatic (6.0%). Conclusion: Orbital cellulitis is the single most common cause of proptosis in this study.
  1 4,427 293
REVIEW ARTICLE
The unending threat of Lassa fever in Nigeria, what can be done; what should be done
Ballah Akawu Denue, Mary Stephen, Isabelle Dauvoux
September-December 2017, 11(3):113-121
DOI:10.4103/phmj.phmj_20_17  
Background: Lassa fever is known to be endemic in West African region, and Nigeria bears the most burden of the disease and case fatalities. It is worrisome and disheartening for an emerging infectious disease such as Lassa fever, to linger for 49 years but surge in incidence in a country such as Nigeria, endowed with both human and natural resources. Methods: The sources of the information presented was obtained through detailed review of literatures using Medline, Ovid and PubMed (search terms Lassa fever, Arenaviridae and viral haemorrhagic fever), case analysis, and surveys undertaking from the field, and relevant websites (such as Nigeria Center for Disease Control, Nigerian Federal Ministry of Health, Centers for Disease Control and Prevention). Results: The possibility of a large outbreak in Nigeria and other sub-Saharan Countries characterised by dearth of laboratory facilities for prompt diagnosis and personal protective equipment (PPE) and its potential use as a biological weapon has also raised the profile of this disease. Health education of the communities, improved funding through budgetary allocation for surveillance, prompt case management including laboratory facilities, training of health personnel, isolation of cases, barrier nursing, contact tracing, provision of antiviral drugs and vaccines that is effective against this disease and supply of PPE is not only necessary but also expedient in the light of the threat due to Lassa fever. Conclusion: The weak health-care delivery system in Nigeria, would continue to impede effective control of emerging and re-emerging infectious diseases including Lassa fever. There is an urgent need to provide resources to effectively control and prevent Lassa fever.
  1 11,101 1,719
CASE REPORT
Deliberate self-harm with multiple lacerations in a 23-year-old depressed Nigerian male
Charles I.K Iwunze, Chukwuma U Okeafor, Benjamin M Kejeh
September-December 2017, 11(3):170-174
DOI:10.4103/phmj.phmj_43_17  
Deliberate self-harm is an extreme reaction to psychological stress. It remains the strongest known risk factor for imminent suicide. There is a dearth of information on the extent of risk, especially in this environment. Psychiatric treatment should commence as soon as the patient is clinically stable. This is to report a case of deliberate self-harm with multiple lacerations in a depressed 23-year-old male with a history of cannabis abuse. The case is a 23-year-old male student with a history of cannabis abuse and depression following psychological stressors who sustained multiple self-inflicted deep lacerations to his neck and phallus. He had multidisciplinary management by the surgical and psychiatric teams. Reducing the risk of suicide by psychotherapy and treatment of underlying psychiatric conditions should be the mainstay of management in cases of deliberate self-harm beyond treatment of injuries sustained, irrespective of their severity.
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ORIGINAL ARTICLES
Knowledge and management of allergic rhinitis by general practitioners in Benin City
Wilson Osaretin Osarogiagbon, Dominic Osaghae
September-December 2017, 11(3):141-147
DOI:10.4103/phmj.phmj_25_17  
Background: Allergic rhinitis is a common manifestation of atopy among children, affecting up to 10%–20% of the world's population. Usually presents with rhinorae and sneezing and may co-exist with other allergic conditions like asthma. Aims: The aim of this study is to evaluate the knowledge and appropriateness of management of allergic rhinitis by general practitioners in Benin City, Nigeria. To determine physician-related factors that are related to the management of allergic rhinitis by general practitioners in Benin City, Nigeria. Settings and Design: This was descriptive cross-sectional study. Methods: General practitioners that gave consent and were non-experts were interviewed with the help of a researcher-administered questionnaire. Data generated were analysed using SPSS software version 19.0. Statistical Analysis Used: Descriptive statistics performed and group Chi-square was used to check for the relationship between variables. Results: Sixty-three (63) general practitioners had complete data, of which 45 were male, 11 were consultants. A total of 50 (79.4%) worked in medical centre, whereas 7 (11.1%) worked in private hospitals. Twenty-nine (46%) of the respondents had practiced for 1–10 years, 19 (30.2%) of the respondents were aged 20–30 years. Twenty-nine (46%) of the respondents had good knowledge of symptoms of allergic rhinitis while 6 (9.5%) had poor knowledge. In terms of differentials, 19 (30.2%) each had very good knowledge and good knowledge, respectively. However, only 2 (3.2%) had very good knowledge of treatment and 9 (14.3%) has good knowledge of treatment. Thirty-six (57.1%) had poor knowledge of treatment. Conclusions: Despite good knowledge of symptoms and differential diagnosis, the respondents had poor knowledge of standard treatment protocol in the management of allergic rhinitis.
  - 4,928 365