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   Table of Contents - Current issue
Coverpage
January-June 2022
Volume 20 | Issue 1
Page Nos. 1-39

Online since Saturday, November 12, 2022

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ORIGINAL ARTICLES  

Knowledge and perception of mothers toward donor milk and human milk banking: Experience from two centers in Southwest, Nigeria p. 1
Tolulope Ogundele, Olorunfemi Akinbode Ogundele, Emmanuel Olaseinde Bello
DOI:10.4103/njgp.njgp_18_21  
Background: Breast milk is essential for the optimal growth and development of every child. When the mothers' milk is unavailable, the World Health Organization recommends donated human milk as the best alternative. However, the use of donated human milk has not been introduced in any part of this country. Therefore, this study aimed to assess the knowledge and perception of mothers on breast milk donation and human milk banking in Nigeria. Methodology: A structured, pretested self-administered questionnaire was used for data collection. Mothers attending child welfare clinics and the mothers in the newborn unit of two hospitals in Southwest Nigeria were recruited into the study. Data were analyzed using the SPSS version 22.0. Result: A total of 402 mothers were included in the study. The mean age was 29.8 ± 5.6 years. Forty-ix percent of the women were aware of human milk banking, and the majority (56.8%) heard about this from a health professional. 39.8% were willing to feed their babies with milk from human milk bank (HMB), and 62.1% were ready to donate their milk. Most of the mothers who were unwilling to feed their babies with milk from HMB reported personal reasons as responsible (40.3%). Factors associated with willingness to feed babies with milk from HMB include occupation (P < 0.001), education (P < 0.001), marital status (P < 0.001), and religion of the mothers (P < 0.005). Conclusion: The knowledge of women in Southwest Nigeria on breast milk donation and HMB is suboptimal. There is a need to educate the populace for effective implementation
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Hypercoagulable state in COVID-19 and diabetes: Cerebral vasospasm, intracardiac clot, and pulmonary embolism p. 6
Philip Chidi Njemanze, Chinenye U Mgbenu, Chinwendu C Darlington, Clara C Ofoegbu, Nneoma E Ukeje, Ijeoma A Ohaegbulem, Esther C Nneke, Joy E Onuchukwu, Chidimma O Ukaegbu, Marvis Amuchie, Clinton O Mezu, Juliet Chizoma Anaele, Ogechi Uzoma, Chinonso Mbara, Anthonia Amadi, Benedicta Iwuagwu
DOI:10.4103/njgp.njgp_3_22  
Background: Hypercoagulable state in the form of venous and arterial thromboembolism, associated with poor prognosis, could be a severe sequel of COVID-19 infections. We present representative cases that show hypercoagulable state in COVID-19 and the negative effects of diabetes and age on outcomes of anticoagulation therapy. Our aim is to understand the role of predisposing factors for the successful use of anticoagulants. Methods: We applied clinical history, examination, laboratory tests, noninvasive ultrasound imaging, and computer-assisted tomography to characterize hypercoagulable state in patients with COVID-19. Results: One patient (83 years) was diabetic of the elderly group (>64 years), who developed sepsis-induced coagulopathy (SIC), cerebral arterial vasospasm, intracardiac clots, coronary ischemia, and pulmonary embolism with fatal outcome despite the use of anticoagulation. The second patient (60 years) was diabetic of the middle-age group (48–63 years), who developed SIC, cerebral arterial vasospasm, intracardiac clots, and coronary ischemia and had good outcome with the use of anticoagulation. The third case was a patient (22 years) without diabetes of the youth group (15–47 years) who developed cardiomyopathy, heart valve vegetations, and cerebral arterial vasospasm, received anticoagulation, and had good outcome. The difference in outcome with the application of anticoagulation with lower molecular weight heparin could be related to the greater burden of disease including diabetes, age, and chronic obstructive pulmonary disease. Conclusion: Noninvasive ultrasound imaging modalities in combinations with computed axial tomography scans provided insightful characterization of the hypercoagulable state of COVID-19 infection, which helped guide therapeutic intervention.
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Knowledge and practice of COVID-19 preventive measures and its associated factors among attendees of a primary care clinic in Kano, Nigeria; A cross-sectional study p. 14
Zainab Abdulazeez Umar, Godpower C Michael, Bukar A Grema, Abdullahi K Suleiman, Abdulgafar L Olawumi, Fatima M Damagum, Zainab Abdulkadir
DOI:10.4103/njgp.njgp_1_22  
Background: In recent times, an increasing number of mysterious deaths related to Coronavirus disease 2019 (COVID-19) have engulfed one of the largest cities in Africa. Hence, there is a need to promote the prevention of morbidity and mortality from this currently poorly understood disease. Objectives: To assess the level of knowledge and practice of preventive measures against COVID-19 and to identify its predictors. Materials and Methods: A cross-sectional questionnaire-based study among 420 adults systematically selected from attendees of a Nigerian general outpatient clinic over a 4-week study period. Data collected included participants' sociodemographic characteristics and knowledge and practice of COVID-19 preventive measures. Data were analyzed using descriptive and inferential statistics. Binary logistic regression was used to identify predictors of knowledge and practice of the preventive measures. Variables with P < 0.05 were considered predictors. Results: A majority were females (57.5%), they had a mean age of 33.1 ± 11.7 years, with tertiary education (60.2%). Overall, more than two-third of 294 (71.4%) of the participants had good knowledge. However, only 59 (14.3%) of the participants had correct (good) practice. Only educational level (adjusted odds ratio [AOR] = 2.079, 95% confidence interval [CI] = 1.039–4.161) and overall knowledge (AOR = 0.342, 95% CI = 0.155–0.754) were predictors of knowledge and practice, respectively. Conclusion: COVID-19 preventive practice is still inadequate among this primary care population in Kano, Nigeria. Ensuring access to quality education and enlightenment campaigns will go a long way in improving the knowledge on COVID-19 preventive measures, which may improve practice.
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Pattern of cancers, co-existing non communicable diseases, and quality of life among elderly in a tertiary oncology health-care facility in Southwestern Nigeria p. 23
Babatunde Akodu, Ogheneochucko Layefa, Temitope Ladi-Akinyemi, Abdulrazzaq Lawal, Atinge Sonnen, Anthonia Sowunmi, Muhammad Habeebu, Olufunmilayo Olokodana-Adesalu
DOI:10.4103/njgp.njgp_7_22  
Background: Cancer burden is worldwide in distribution, but there is an increasing proportion of the burden in low- and middle-income countries. Cancer has been shown to be responsible for poor health-related quality of life (QoL) in the elderly who are usually more affected. The aim of the study was to determine the pattern of cancers and QoL amongst elderly patients attending the Oncology Clinic in Lagos University Teaching Hospital (LUTH), Idi – Araba, Lagos, Nigeria. Methods: This cross-sectional study was carried out among 160 elderly patients in Oncology Clinic in LUTH using consecutive sampling method. Data were collected using a validated questionnaire that was interviewer administered. Data entry and analysis were done using Epi-info 7.1 software. Chi-squared test was used to determine the association between patterns of cancer and QoL. The level of significance was set at P < 0.05. Results: The mean age of the respondents was 67.90 ± 19.3 years. About two-thirds (65.6%) were females, married (78.8%), and above one-half (52.5%) were employed. Majority of the respondents (92.5%) had caregivers who were their family members. The most common cancers seen were breast (44.4%), prostate (16.9%), cervical (9.4%), colorectal cancer (3.8%), and nasal carcinoma (3.8%) Two-third of the respondents (66.9%) had poor QoL scores. The mental component of QoL summary, (47.65 ± 17.1) was slightly higher than the physical component summary, (46.4 ± 14.6). No association was found between pattern of cancer and QoL (P > 0.05). Conclusion: Most participants in this study had poor QoL. Improving the socioeconomic status of these patients as well as affordable access to health-care may impact positively on their QoL.
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Intestinal parasitic infection-induced intestinal wall cytoskeleton dysfunction in diabetes mellitus p. 29
Philip Chidi Njemanze, Chinwendu C Darlington, Joy E Onuchukwu, Nneoma E Ukeje, Anthonia Amadi, Chinenye U Mgbenu, Clinton O Mezu, Juliet C Anaele, Mercy O Okoro, Esther Nneke, Clara C Ofoegbu, Lilian C Mbara, Ijeoma A Onweni, Benedicta C Iwuagwu, Marvis Amuchie, Linda O Uzoma, Faustina N Ojilere, Chidimma O Ukaegbu
DOI:10.4103/njgp.njgp_9_22  
Background: The gastrointestinal tract (GIT) could harbor intestinal parasitic infections (IPIs) alongside a dense and diverse microbial community, termed GIT microbiome. We examined the role of IPI-related changes in intestinal echoanatomy in the pathophysiology of type 2 diabetes mellitus (T2DM). Methods: The study included 95 subjects (44 males and 51 females). The diagnosis was based on clinical presentation and laboratory tests, including serial stool microscopy for IPIs, and for diabetes, measurement of hemoglobin A1C, fasting or random blood glucose level, or oral glucose tolerance testing. The B-mode ultrasound grayscale and color images using a high-frequency phased array transducer of 7.5 MHz of the duodenum and colon were obtained with and without water contrast. The duodenal wall thickness was used as measurement endpoint. Results: Eighty consecutive patients had at least one type of IPIs in serial stool microscopy, and 15 were healthy persons. Among the 80 IPI patients, 52 (65%) were diabetic, and 28 (35%) patients were nondiabetic. We demonstrated normal duodenum and colon echoanatomy in healthy persons. In patients with IPIs, the duodenal wall thickness (6.87 ± 2.09 mm) was greater than that in healthy persons (3.5 ± 1.07 mm) (P < 0.001). In diabetic patients, the duodenal wall thickness (7.23 ± 2.1 mm) was greater than that in nondiabetic patients (5.26 ± 2.07 mm) (P < 0.001). There were main effects of age and obesity but not sex. Antiparasitic treatment of IPIs alongside antidiabetic drugs improved control of fasting blood sugar. Conclusion: Ultrasound duodenography and colonography demonstrated IPI-induced intestinal wall thickening with rearrangement of the cytoskeleton, causing malfunction of the glucose transporter system which resulted in T2DM.
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CASE REPORT Top

Bladder stones secondary to migratory gauze strand postcesarean delivery: A case report and literature review p. 36
Neba Francis Fuh, Osagie Edwin Lawani, Tijani Idris Ahmad Oseni
DOI:10.4103/njgp.njgp_6_22  
Gauze is commonly used in surgery. Sometimes strands of gauze are left in situ during surgery. These gauze strands could cause problems later. We report a case of bladder stones secondary to migratory gauze strand postcesarean section. We present a 62-year-old widow who presented with lower urinary tract symptoms of 13-year duration following a cesarean section 15 years before presentation. She had a radiologic diagnosis of multiple bladder stones which on surgical removal, a gauze strand was found to be the nidus for stone formation. A migratory gauze strand from surgery done 15 years before presentation served as a nidus for bladder stone formation in a 62-year-old patient. Surgeons should be careful during pelvic surgeries/procedures not to leave behind foreign bodies like gauze strands that could migrate and cause bladder stones and its attendant sequelae.
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LETTER TO EDITOR Top

The need for a national dental institute in Nigeria p. 39
Oluwafemi Abolade, Kehinde Kazeem Kanmodi, Lawrence Achilles Nnyanzi
DOI:10.4103/njgp.njgp_2_22  
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