275 research outputs found

    Pediatric maxillofacial injuries at a Nigerian teaching hospital: A three-year review

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    Aim: To determine the nature of pediatric maxillofacial injuries, according to etiology and characteristics of patients.Materials and Methods: The records of patients aged 15 years and below who presented with maxillofacial trauma to the Maxillofacial Clinic of Aminu Kano Teaching Hospital, Kano, Nigeria over a 3-year period were retrospectively examined. Patients’ demographic and etiologic factors were obtained and analyzed. A P value of <0.05 was considered significant.Results: A total of 160 patients comprising males, 102 (63.8%) and females 58 (36.2%), were seen over the period of study. The age of patients range from 4 months to 15 years, mean 7.07 Β± 4.52 years. There was no gender difference in terms of age (P < 0.05). Road traffic accident (RTA) was the most common etiologic factor accounting for 45.0% ofcases. This was followed by fall (40.6%). Animal related injury and violence accounted equally for 3.8%. Soft tissue injuries in the form of abrasion, laceration and avulsion accounted for 70.0% of cases. Other anatomical sites included the mandible (16.3%), dento-alveolar fractures(12.5%), and midface (1.3%).Conclusion: Road traffic accident and falls still remains the leading cause of maxillofacial injuries in children in this part of the globe. There is a need to reinforce existing traffic laws that aimed at minimizing the menace of RTA-related accidents.Key words: Maxillofacial injuries, Nigeria, pediatri

    Health related quality of life and psychological variables among a sample of asthmatics in Ile-Ife South-Western Nigeria

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    Background: Assessment of health related quality of life (HRQL) has become central to assessing the selfperceived impact of physical and mental impairment on patient’s health. Studies have reported a high rate of psychological disturbances among asthmatics; however, the impact of these psychological factors on HRQL remains unexplored. Objectives: To assess the health related quality of life among a sample of asthmatics and to identify the psychological and clinical variables that affect quality of life among asthmatics. Method: A total of 81 patients attending the clinic were assessed using the Mini-Asthma Quality of Life questionnaire (Mini-AQLQ), and the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinical variables were also obtained from the patients, the lung function was assessed using Peak Expiratory Flow Rate (PEFR). Results: Mean age of all the patients was 35.22 (SD±14.36) with a mean duration of asthma symptoms of 17.5 (SD±14.4) years. Mean peak expiratory flow was 336 l/min (SD±74.12). Anxiety was present in 44.4% of respondents, while 40% of respondents reported the presence of depressive symptoms, 48.1% of the respondents reported low scores on the asthma quality of life questionnaire. Poor quality of life was associated with the presence of psychological symptoms, female sex, and lower educational level. Conclusion: Psychosocial variables are just as important as clinical variables as determinants of health related quality of life among asthmatics.Keywords: quality of life; asthma; anxiety; depression; psychosocia

    Comparison of Statistical Models Used for Assessing Factors Associated with Infant Mortality in Nigeria

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    Background: Infant mortality is a public health concern especially in developing countries, particularly Nigeria. Different models had been used independently to identify factors associated with infant mortality. Some of the used models sometimes violate the underlying assumption for the models. This study was designed to compare the models that have been previously used and identify the appropriate model using standard model selection criteria to analyse risk factors for infant mortality in Nigeria. Methods: The study utilised 2008 Nigeria Demographic and Health Survey (NDHS) data with a sample size of 7107. The NDHS was a stratified two-stage cluster design where a questionnaire was used to collect data on the birth history of women aged 15-49 years. The models employed for this study were: Logit, Probit and Clog-log. The model selection criteria were Akaike Information Criterion (AIC), Residual Deviance and Vuong test. The model with the smallest criteria was considered to be the best fit. Results: The results showed that Infant Mortality in Nigeria can be appropriately modelled by Clog-log model. The models and corresponding AIC values were: Logit (6171.1), Probit (6212.6) and Clog-log (6126.6). The residual deviance included: Logit (6135.1), Probit (6176.6) and Clog-log (6090.6). Clog-log had the smallest AIC and residual deviance values; hence, it was of the best fit. Home delivery and delivery by professionals had negative significant associations with infant mortality while women's education (primary/no education) and birth order had positive significant association, (p < 0.05). Conclusion: The best model for infant mortality evaluation in Nigeria was Clog-log. Generally, improved women’s education would significantly reduce Infant Mortality in Nigeria

    A comparative assessment of public and private dots laboratories in the Lagos state TB control programme

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    Background: The purpose of the laboratory services within the framework of the NTP is to provide bacteriologic evidence for the diagnosis, follow-up of TB patients and to document cure at the end of treatment. However to be fully functional, laboratory commodities should be available as needed. This study compared the laboratory hygiene practices and availability of laboratory equipment and other consumables for making diagnosis of TB in public and private DOTS laboratories in Lagos State.Methods: A descriptive comparative cross sectional study comparing availability of commodities in public and private laboratories involved in TB services in Lagos State.Results: Seventeen DOTS laboratories and 34 laboratory scientist/technician were recruited for this study. About three quarter and two thirds of the public and private DOTS laboratories respectively had reagents for smear microscopy. A significantly higher proportion of the public DOTS laboratories had separate area for TB work and separate table for smear preparation (p &lt;0.05). A higher proportion (71.4%) of the laboratory scientist/ technicians at the public compared with 38.5% of those at the private DOTS laboratories had good knowledge of the laboratory diagnosis of TB.Conclusion: Laboratories involved in TB service are not functioning optimally and need to be strengthened.Key Words: Laboratory, DOTS, Consumables, Hygiene.French AbstractContexte : L’objet des services des laboratoires dans le cadre du NTP est de fournir les preuves bactΓ©riologiques pour le diagnostic, de suivre les patients tuberculeux et de documenter la guΓ©rison a la fin du traitement. Toutefois, pour Γͺtre pleinement fonctionnel, les produits de laboratoire devraient Γͺtre disponibles au besoin. Cette recherche comparait les pratiques hygiΓ¨nes de laboratoire et la disponibilitΓ© des Γ©quipements de laboratoire et autres consommables pour faire le diagnostic de la tuberculose aux laboratoires de DOTS publics et prives dans l’État de Lagos.MΓ©thodes : Une Γ©tude transversale comparative et transversale descriptive comparant la disponibilitΓ© des produits aux laboratoires publics et privesΒ  concernes a fournir aux services tuberculeux dans l’état de Lagos.RΓ©sultats : Dix – sept laboratoires de DOTS et 34 scientifiques/techniciens ont Γ©tΓ© recrutΓ©s pour cette recherche. Environ trois quarts et deux tiers des laboratoires de DOT publics et prives ont eu rΓ©actif respectivement pour la microscopie des frottis. Une proportion significativement plus Γ©levΓ©e des laboratoires de DOTS publics a eu un espace sΓ©parΓ© pour les travaux de la tuberculose et une table sΓ©parΓ©e pour la prΓ©paration des frottis (p&lt;0,05). Une proportion Γ©levΓ©e(71,4%) des scientifiques/techniciens des laboratoires publics comparativement a 38,5% de ceux des laboratoires de DOTS prives avaient une bonne connaissance de diagnostic laboratoire de la tuberculose.Conclusion : Les laboratoires qui ont concernΓ© a fournir les services tuberculeux ne fonctionnent pas de la faΓ§on optimale et doivent Γͺtre renforcΓ©s.Mots– clΓ©s : Laboratoire, DOTS, consommables, HygiΓ¨ne

    Arthropod Borne Disease: The Leading Cause of Fever in Pregnancy on the Thai-Burmese Border

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    Fever during pregnancy can be harmful for the mother and the infant. In resource poor settings health workers have very few field-based tests that help them identify the cause of infection. This study examined the causes of fever in pregnant women using laboratory support that is typically unavailable to most women living in the tropics. On the Thai-Burmese border there has been a great reduction in malaria in the last 20 years. However malaria remained the leading cause of fever in pregnancy in this study conducted between 2004 and 2006. Urinary tract infection was also a common cause of fever as it is in resource rich countries. Other diseases transmitted by mosquitoes (dengue), ticks (scrub and murine typhus), or rodents (leptospirosis) were common. Scrub and murine typhus were associated with stillbirth and low birth weight. Microscopy remains the most useful tool in the field for the diagnosis of fever in pregnant women. Leptospirosis, dengue and rickettsial infections require improved field-based diagnostic tools to ensure that women receive appropriate antibiotic therapy

    C5 deficiency and C5a or C5aR blockade protects against cerebral malaria

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    Experimental infection of mice with Plasmodium berghei ANKA (PbA) provides a powerful model to define genetic determinants that regulate the development of cerebral malaria (CM). Based on the hypothesis that excessive activation of the complement system may confer susceptibility to CM, we investigated the role of C5/C5a in the development of CM. We show a spectrum of susceptibility to PbA in a panel of inbred mice; all CM-susceptible mice examined were found to be C5 sufficient, whereas all C5-deficient strains were resistant to CM. Transfer of the C5-defective allele from an A/J (CM resistant) onto a C57BL/6 (CM-susceptible) genetic background in a congenic strain conferred increased resistance to CM; conversely, transfer of the C5-sufficient allele from the C57BL/6 onto the A/J background recapitulated the CM-susceptible phenotype. The role of C5 was further explored in B10.D2 mice, which are identical for all loci other than C5. C5-deficient B10.D2 mice were protected from CM, whereas C5-sufficient B10.D2 mice were susceptible. Antibody blockade of C5a or C5a receptor (C5aR) rescued susceptible mice from CM. In vitro studies showed that C5a-potentiated cytokine secretion induced by the malaria product P. falciparum glycosylphosphatidylinositol and C5aR blockade abrogated these amplified responses. These data provide evidence implicating C5/C5a in the pathogenesis of CM

    Drinking beer, wine or spirits – does it matter for inequalities in alcohol-related hospital admission? A record-linked longitudinal study in Wales

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    Background: Alcohol-related harm has been found to be higher in disadvantaged groups, despite similar alcohol consumption to advantaged groups. This is known as the alcohol harm paradox. Beverage type is reportedly socioeconomically patterned but has not been included in longitudinal studies investigating record-linked alcohol consumption and harm. We aimed to investigate whether and to what extent consumption by beverage type, BMI, smoking and other factors explain inequalities in alcohol-related harm. Methods: 11,038 respondents to the Welsh Health Survey answered questions on their health and lifestyle. Responses were record-linked to wholly attributable alcohol-related hospital admissions (ARHA) eight years before the survey month and until the end of 2016 within the Secure Anonymised Information Linkage (SAIL) Databank. We used survival analysis, specifically multi-level and multi-failure Cox mixed effects models, to calculate the hazard ratios of ARHA. In adjusted models we included the number of units consumed by beverage type and other factors, censoring for death or moving out of Wales. Results: People living in more deprived areas had a higher risk of admission (HR 1.75; 95% CI 1.23–2.48) compared to less deprived. Adjustment for the number of units by type of alcohol consumed only reduced the risk of ARHA for more deprived areas by 4% (HR 1.72; 95% CI 1.21–2.44), whilst adding smoking and BMI reduced these inequalities by 35.7% (HR 1.48; 95% CI 1.01–2.17). These social patterns were similar for individual-level social class, employment, housing tenure and highest qualification. Inequalities were further reduced by including either health status (16.6%) or mental health condition (5%). Unit increases of spirits drunk were positively associated with increasing risk of ARHA (HR 1.06; 95% CI 1.01–1.12), higher than for other drink types. Conclusions: Although consumption by beverage type was socioeconomically patterned, it did not help explain inequalities in alcohol-related harm. Smoking and BMI explained around a third of inequalities, but lower socioeconomic groups had a persistently higher risk of (multiple) ARHA. Comorbidities also explained a further proportion of inequalities and need further investigation, including the contribution of specific conditions. The increased harms from consumption of stronger alcoholic beverages may inform public health policy
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