California's community-based tobacco control initiatives: a collaborative approach in the United States

California's Community-Based Tobacco Control Initiatives target smoking incidence through collaboration. Smoking has serious health and economic consequences, stressing the need for concerted action. The California Tobacco Control Program's smoking reduction success is discussed, focusing on socioeconomic differences. A comprehensive tobacco control strategy should involve multi-sector cooperation, according to the author. The planned collaboration comprises government, private corporations, public and civil society groups, health and social service providers, practitioners, and researchers. The strategy entails building a coalition including the California Department of Health, Community Counselors, Bill and Melinda Gates Foundation, and California Medical Association. The essay discusses coalition issues but also highlights their benefits, such as program capability and awareness

The burden of diabetes in America: a data-driven analysis using power BI

Background: High blood glucose levels in diabetes lead to devastating damage to the heart, blood vessels, eyes, kidneys, and nerves. It affects millions of Americans and costs the healthcare system billions of dollars. The disease’s causes, risk factors, and effective prevention and treatment methods are still unknown despite its prevalence. Methods: This descriptive study used US census and CDC data to describe diabetes in America. The US census and CDC provided this study’s population and diabetes data. This study used two datasets. The first dataset contains 73054 2020 US population records. This dataset’s second type was strings and decimals, including state, county, and 2020 affected population percentage. Diabetics are represented by 3154 data points. Power BI was used to visualize decision support data. Results: According to our analysis, millions of Americans suffer from diabetes, which costs billions in healthcare costs annually. Diabetes is most prevalent in California, with 28.9 million people affected. Most cases are 45-64 years old, and the number has increased over the past decade. These findings suggest that America’s growing diabetes epidemic requires more resources and facilities. Conclusions: Finally, our study covers diabetes’s prevalence, incidence, and trends in America. Our findings show that America’s growing diabetes epidemic need more money, manpower, and infrastructure. We advise the government to monitor diabetes and plan for future healthcare needs

Prevalence, patterns of clinical presentation, and the outcome of treatment of diabetes mellitus among paediatric patients in a tertiary care facility

Background: Diabetes mellitus is a multi-systemic disease condition characterized by elevated blood glucose level which can be due to relative or absolute deficiency of insulin secretion or action or a combination of both in humans including paediatric patients which disproves the thought that it is a disease of adults alone. Methods: The study was a retrospective descriptive cross-sectional full population study that involved getting the total population of 7880 paediatric patients that presented to the hospital facility within 3-years (from January 2019-December 2021) and from the total population getting the patients diagnosed with diabetes mellitus. A well-structured proforma was used to collect the relevant data needed from the case files of the patients. Statistical data analysis was done with SPSS version 25. Results: The study showed that out of 7880 paediatric patients that presented to the facility, 20 of them were diagnosed and treated for diabetes mellitus giving a prevalence of 0.25 per 100 patients. The paediatric patients diagnosed with diabetes mellitus were aged 8-18years; 11 females and 9 males. This study showed that about 75.0% of the paediatric patients with DM fully recovered following treatment and was subsequently discharged; however about 95% of these patients were lost to follow-up. Conclusions: Adequate measures needs to be put in place to ensure that the management of these patients are highly optimal and does not constitute much financial burden to the caregivers, in order to improve compliance to treatment and hence reducing morbidity and mortality associated with the condition

Addressing substance abuse among healthcare professionals in a tertiary healthcare facility in Nigeria: a case study of Nnamdi Azikiwe university teaching hospital

Background: The use of psychoactive substances is prevalent worldwide, including among healthcare workers whose well-being, productivity, and effectiveness in addressing substance addiction in patients and the wider community can be significantly impacted. However, the extent of substance misuse among healthcare professionals in Nigeria, with its substantial social and public health implications, remains poorly understood. This research focused on the prevalence, attitudes, substances used, and influencing factors regarding substance misuse among staff at Nnamdi Azikiwe university teaching hospital (NAUTH) in Nnewi. Methods: A descriptive cross-sectional study was conducted involving 194 healthcare workers, using a multi-stage sampling method. Data were collected via a semi-structured self-administered questionnaire and analyzed with SPSS version 20. Results were presented in tables, considering p values less than 0.05 as significant. Results: Of the 197 respondents, 63.5% were female and 36.5% male, spanning various professions including doctors, nurses, and other healthcare specialists. Notably, 66% of participants had used substances in their lifetime. Alcohol was the most commonly abused substance, with significant percentages of moderate and high-risk users. Socialization and peer pressure were identified as the predominant factors influencing substance use, with significant statistical associations found between substance use and variables such as profession, sex, and duration of practice. Conclusions: The study highlighted a considerable prevalence of alcohol use among healthcare workers, who generally held a moderate view towards substance misuse and identified socialization and peer pressure as key factors. These findings underscore the pressing need for targeted training and intervention strategies for substance addiction among healthcare workers in Nigeria

Knowledge, attitude and practices about hypertension amongst adult residents in South-Eastern Nigeria

Background: Hypertension (HTN) is a global public health concern and has been identified as the leading risk factor for cardiovascular morbidity and mortality. The objective of this study is to assess the prevalence, knowledge, attitude and practices regarding HTN amongst adult residents in South-Eastern Nigeria. Aims: The objective of this study is to assess the prevalence, knowledge, attitude and practices regarding HTN amongst adult residents in South Eastern Nigeria. Materials and Methods: This cross-sectional survey was conducted amongst male and female adult residents of Anaocha local government area, Anambra State, South-Eastern Nigeria, 18 years and above. Data was collected using a pretested interviewer-administered questionnaire amongst 296 adults. Blood pressures and the body mass index of those found to be hypertensive were obtained. Results were analyzed using SPSS version 25.0. Results: The mean age was 41.7 years, with 55.1% being females and 44.9% males. The prevalence of HTN was 30%. Overall, 53.28% of the respondents had good knowledge of HTN, although knowledge of the risk factors was lower (43.41%), while 80.24% had good attitude and 62.16% had good practices regarding HTN. Gender showed a significant association with level of knowledge of HTN. Only tribe and occupation were associated with attitude of the respondents towards HTN. Practice regarding HTN showed no association with any of the socio-demographic factors. Conclusion: The study found an acceptable level of knowledge, attitude and practices regarding HTN amongst the respondents. The prevalence of HTN amongst the study group was high and more work needs to be done to improve awareness and reduce HTN risk factors amongst the people

Assessment of Immunity against Hepatitis B Virus among Children Aged 2-17 Years in Nnewi, Anambra State, South-East Nigeria: A Pilot Study

Background: Nigeria is one of the hyper-endemic countries for hepatitis B with national prevalence rate of 11%. No study has been done in Nigeria to the best of authors’ knowledge to assess the level of immunity among children vaccinated against HBV. Objective: To assess prevalence of Hepatitis B surface antigen, determine the presence of antibodies to hepatitis B surface antigen (anti-HBs) and determine the titre levels of anti-HBs among those who have anti-HBs. Design: This was a pilot and a cross-sectional study. Methods: Consecutive children aged between 2 and 17 years seen at the outpatient clinic of NAUTH, Nnewi, Nigeria were recruited. Questionnaire was interviewer-administered. Venous blood was collected from each participant, analyzed for HBV serological markers and anti-HBs titre. Results: A total of sixty children were recruited. There was equal male and female distribution. 36.7% were aged 10-14 years. One child did not receive HBV vaccine. There was no incidental finding of HbsAg positivity. 15% of respondents had their immunity assessed after completing vaccination. There was presence of antibodies to HBsAg in19 children, and the anti-HBs titre was protective in 78.9% of those who had antibodies. Conclusion: After 18 years of introduction of the HBV vaccine into the NPI and routine infant immunization against hepatitis B virus in Nigeria, this pilot study has shown immunity against hepatitis B is not usually assessed after immunization and a significant proportion of children who were adequately immunized are not adequately protected against HBV. A large-scale study would be desirable for confirmation

Intra-operative Diagnosis of Lower Segment Scar Dehiscence in a Second Gravida After One Previous Lower Segment Cesarean Section: Should We Advocate for Routine Antenatal Uterine Scar Thickness Testing?

Background: Uterine dehiscence is a separation of uterine musculature with intact uterine serosa. It can be encountered at the time of cesarean delivery, suspected on obstetric ultrasound or diagnosed in-between pregnancies. The antenatal diagnosis may occasionally elude the Obstetricians. This particular case demonstrates an intra-operative diagnosis of uterine dehiscence with missed antenatal ultrasound diagnosis in an asymptomatic woman. Case presentation: She was a 32-year-old Nigerian second gravida who booked for antenatal care at 32 weeks of gestation following a referral from her attending Obstetrician from a neighboring state due to relocation. She had 3 antenatal visits and 2 antenatal ultrasound investigations without uterine scar thickness report. She subsequently had elective Cesarean section (CS) at a gestational age of 38 weeks plus 2 days due to persistent breech presentation on a background of a previous lower segment CS scar. There was no previous uterine curettage prior to or after the previous lower segment CS scar and there was no labor pains prior to the elective CS. The surgery was successful with intra-operative findings of moderate intra parietal peritoneal adhesions with rectus sheath and obvious uterine dehiscence along the line of the previous CS scar. The fetal outcomes were normal. Immediate post-operative condition was satisfactory and the woman was discharged on a third-day post operation. Conclusion: Obstetricians are charged to maintain a high index of suspicion when managing pregnant women with history of emergency CS in order to avert the adverse consequences of uterine rupture from asymptomatic uterine dehiscence. Based on this report, it may be useful to routinely assess the lower uterine segment scar of women with previous emergency CS using the available ultrasound facilities. However, more studies are needed before advocating for routine antenatal uterine scar thickness testing following emergency lower segment CS in low and middle-income settings