Determinants of Low Back Pain among Health‑care Providers in a Federal Tertiary Hospital in Ekiti State, SouthWestern Nigeria

Introduction: Low back pain (LBP) is a usual musculoskeletal system disorder among the working population, especially among health‑care providers (HCPs). It is a significant contributor to work disability, work absenteeism, and lost hours globally. The study objectives are to find the prevalence and determinants of LBP among HCPs in a Federal Tertiary Hospital in Ido‑Ekiti, Ekiti State, Nigeria. Subjects and Methods: A cross‑sectional study was done among HCPs in a Federal Tertiary Hospital, Ido‑Ekiti, Ekiti State, Nigeria. The study included 336 participants working in the hospital. The respondents were selected using stratified sampling. Data were collected through an adapted questionnaire, which was pretested, semi‑structured, and self‑administered. The data were analyzed using STATA  version 12. Univariate, bivariate, and binary logistic analysis was used to find the prevalence and determinants of LBP. The significance level was set at 95% confidence interval and P ≤ 0.05. Results: The point prevalence, period prevalence, and lifetime prevalence were 39.9%, 44.6%, and 67.6%, respectively. The findings showed that the prevalence of LBP was higher among respondents who turn patient on the bed regularly (>3 times weekly) (odds ratio [OR] =18.46, 95% CL [6.84–49.81], P < 0.0001); and pulls and pushes object or people (more than 10 kg thrice a week) (OR = 8.22, 95% CL  [3.46–19.56], P < 0.0001) were statistically significant. Conclusion: The study revealed that HCPs suffered from a high prevalence of LBP, and the identified risk factors (turning of the patient and pulling and pushing of an object or  people) can be modified using an informed health intervention program (health education and ergonomics)

POVERTY-EDUCATION NEXUS: IMPLICATIONS FOR PROMOTION OF WOMEN EMPOWERMENT IN NIGERIA

The achievement of women empowerment is measured by the extent to which women and girls are able to act freely, exercise their rights, and fulfill their potential as full and equal members of society (USAID, 2012). Out of all the indices of human capital development, education is crucial and seems capable of propelling other indices such as training, employment, health and services. However the impact of poverty in accessing and utilizing education cannot be overemphasized. Poverty-education nexus impacts promotion of women development both at the family and societal levels. Education is a process of imparting knowledge, skills and information and represents an integral of personal upbringing. It is force of acquiring understanding and redesigning human environment with the view of achieving and sustaining a better quality of life. It is therefore an infrastructure provided for citizenry in order to enable them to acquire, sharpens their skills and earn better living conditions. However, as important as this ingredient is, women are still backward in education in virtually all developing countries. In Nigeria, majority of women lack access to education and are often restricted in terms of other rights including resources control (CBN, 2012; NBS, 2010; Uzoma, 2013). The study therefore attempted to confirm (or otherwise) the roles of education in women empowerment in Nigeria and proffer plausible measures to spur women education as well as national development as a whole. The study examined impact of poverty-education nexus in the promotion of women development in Nigeria. It specifically highlighted the issues and challenges in women empowerment and brought into fore the benefits inherent in educating women. The study adopted qualitative research approach and made extensive use of empirical but secondary information and statistics to justify most of the claims in the work. Information obtained were analysed following thematic content analysis intermediated by author’s reasoning and experience. Plagiarism test conducted revealed up to 9.7% level of plagiarism confirming the work as original. Information obtained through secondary data search were analyzed by interpretations of social meaning of observation through mapping and aggregation into logical segments. In addition, other basic tools of descriptive statistics and pictorial information such as graph/charts and frequencies distribution where applicable. The study shows that the sub-Saharan Africa adult literacy rate for women is the lowest (45.7%) compared with higher rates (of 98.9%) for other regions of the world. The study revealed that women are disadvantageously placed in terms of access to education and that disparity in male-female literacy may continue beyond 2015. The study posits that it is exigent to continuing raising awareness that women education and women’s empowerment is not only important for social development but is indispensable for economic development. The authors therefore believed that the barriers that impede women development would require government’s commitments such that acquired education can be transformed to meaningful economic activities through job opportunities

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Traditional birth attendants’ knowledge, preventive and management practices for postpartum haemorrhage in Osun State, Southwestern Nigeria

Abstract Traditional birth attendants (TBAs) have become an integral part of the workforce providing delivery services in Nigeria due to the limited number of skilled birth attendants and cultural preferences. This study assessed the knowledge, management and preventive practices regarding postpartum haemorrhage (PPH) among TBAs in selected communities in Osun State, Southwest Nigeria. The study employed a descriptive cross-sectional study design and recruited 260 TBAs in four communities in Osun State. Data were collected by means of an adapted semi-structured questionnaire. Data were analysed using SPSS version 23 and summarized using descriptive and inferential statistics (chi-square and logistic regression) with the level of significance set at p < 0.05. The findings indicated that most (71.4%) of the TBAs were cleric, while others were herbalist (28.6%). Although the majority (76.4%) of the TBAs had good knowledge of the causes and warning signs of PPH, a high percentage (69.3%) of TBAs had poor management practices, while 114 (64.1%) TBAs had inadequate preventive practices. Notably, almost none of the participants practised active management of the third stage of labour; the majority of TBAs did not administer any uterotonic drugs to the mother, nor did they deliver the placenta by controlled cord traction. Gender (P = 0.029), educational level (P = 0.035) and average number of births per month (P = 0.001) significantly influenced TBAs’ management practices. Similarly, the TBA type (P < 0.001), average number of births per month (P = 0.003) and experience with formal training (P = 0.005) showed significant associations with TBAs’ preventive practices. Furthermore, TBAs’ preventive practices towards PPH were influenced by the TBA type (OR: 4.23; 95% CI 1.64–10.90). TBA management practices were also influenced by the TBA type (OR: 4.42; 95% CI 2.03–9.61). Traditional birth attendants in this study had poor management and poor preventive practices for postpartum haemorrhage

Self-medication among health workers in a tertiary institution in South-West Nigeria

Introduction: inappropriate self-medication results in wastage of resources, resistance to pathogen and generally entails serious health hazard. This study was undertaken to determine the knowledge, practice and reasons for practice of self-medication among health workers in a Nigerian tertiary institution. Methods: this was a cross-sectional descriptive study conducted among staff of Federal Medical Center Ido-Ekiti, Nigeria. Simple random sampling technique was used to select 305 respondents that were interviewed via a pretested semi-structured questionnaire. Analysis was done using SPSS version 15 and while chi-square test was used to test significance between variables, significant (p value set&lt;0.05). Results: among the 305 respondents interviewed, the age range was 18-52yrs with greater proportion being males (51.8%). Majority of respondents were aware of self-medication (94.8%), but only 47.2% had good knowledge of it. Reasons for practicing self-medication were financial problem (10.8%), mild sickness (10.8%), lack of time (13.4%), knowledge of diagnosis (5.6%), convenience (2.3%) and non-availability of doctors (3.0%). The drugs used by respondents without prescription included analgesics (38.2%), antibiotics (19.0%) anti-malaria drugs (13.3%), and others (29.4%). Conditions for which respondents self-medicated were body pains (14.9%), catarrh (14.9%), headache (14.3%), sore throat (11.5%), diarrhea (11.2%), fever (9.0%) and toothache (5.6%). Conclusion: the study demonstrates that the prevalence of self-medication is relatively high. There is need for health education on the implication and danger of self-medication. There is also need for government to pass and enforce law to restrict free access to drugs.The Pan African Medical Journal 2016;2

Short-term COVID-19 vaccine adverse effects among adults in Ekiti State, Nigeria

Background: The safety of the COVID-19 vaccines has been a topic of concern globally. This issue of safety is associated with vaccine hesitancy due to concerns about the adverse effects of the vaccines. Consequently, this study determined the short-term safety profile of the Oxford/AstraZeneca COVID-19 vaccine in Ekiti State, Nigeria. Methods: Descriptive cross-sectional study conducted between May and July 2021 among individuals who had received the first dose of the first batch of the Oxford/AstraZeneca COVID-19 vaccine at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria. A Google form was used to collect data on the adverse effects of the vaccine. Results: Out of over 1,000 individuals who were approached, 758 respondents completed the study. A large percentage (57.4%) of those who received the vaccines were healthcare workers. Adverse effects were reported in 70.8% of the participants with most manifesting on the first day of the vaccination. The predominant adverse effects were injection site soreness (28.5%), followed by fatigue (18.7%) and muscle pain (8.6%). There was no report of severe adverse effects such as anaphylactic reactions, thrombosis, myocarditis, transient myelitis, or Guillen-Barre syndrome. Conclusion: This study found that self-reported adverse effects of the Oxford/AstraZeneca COVID-19 vaccine were mild and short in duration. This outcome has promising implications for improving COVID-19 vaccine uptake in the immediate environment and Nigeria

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

BackgroundTranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding.MethodsWe did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.FindingsBetween July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98).InterpretationWe found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial.</div