Physical Activity Profile of Medical Practitioners: A Preliminary Cross-sectional Study in Kano, Northwest Nigeria

Background: Insufficient physical activity (PA) is a recognized risk factor for noncommunicable diseases. Evaluating health‑care workers’PA is crucial because PA impacts their health, and they are important health promotion agents. Hence, this study assessed the PA profileof medical practitioners in Kano, Nigeria. Materials and Methods: This was a cross‑sectional study involving 178 medical practitioners selected from attendees of a 1‑day  continuing‑medical‑education lecture, using a modified physical activity assessment tool. It assessed the moderate‑ and vigorous‑intensity PAs performed, PAs’ sufficiency, their plan and confidence of increasing PA, and factors associated with performing sufficient PA. Chi‑square test and logistic regression analysis were employed in determining the association between variables and sufficient PA and predictors of sufficient PA, respectively. Results: Respondents’ mean age was 37.5 ± 9.5 years; they were predominantly males (133, 74.7%). They spent a median (interquartile range [IQR]) of 65.0 (22.5–165.0) minutes per week on moderate‑intensity activities and median metabolic equivalent‑minutes/week (IQR) of 400.0 (120.0–1140.0). Most respondents (119, 66.8%) had engaged in PA in the past 5–6 months or intended to become more physically active in the next six months. Most (155, 87.1%) had some level of confidence in increasing their PA levels. The association between respondents’ sociodemographic variables and sufficient PA was statistically insignificant.However, engagement in moderate‑intensity housework (odds ratio [OR] = 2.39, 95% confidence interval [CI] = 1.15–4.96, P = 0.02) andaerobic exercises (OR = 11.57, 95% CI = 1.29–103.63, P = 0.03) increased the odds of attaining sufficient PA. Conclusion: Sufficient PA prevalence among respondents was low. Engagement in moderate‑intensity housework and aerobic exercises were predictors of sufficient PA. Most respondents were motivated to become physically active in the future. Appropriate interventions are required to improve their PA levels. Keywords: Aerobics, housework, medical practitioners, physical activity, physical activity assessment too

Six Strategies for Optimizing Linear Growth through Improving Awareness of Breastfeeding, Dietary Diversity in Complementary Feeding, and Growth Monitoring during Early Life

Only one-fourth of the countries under the Sustainable Development Goal are ‘on track’ to reduce the burden of malnutrition as of 2020. A deficit in linear growth during the first 5 years of life is mainly due to growth faltering in the first 1000 days. This deficit has been consistently reported to be linked to suboptimal cognitive neurodevelopment, while its improvement in early childhood has been reported to offer an opportunity for rescuing neurocognitive potential. This paper describes the perspectives of multidisciplinary experts, representing a range of disciplines related to child growth and nutrition, from Nigeria, Indonesia, and Malaysia, who convened virtually to review and discuss measures aimed at preventing a further increase in growth faltering, including stunting, among children aged 0-3 years under the current prevailing circumstances. Based on the latest evidence of practices and knowledge, the expert panel proposed six strategies to support linear growth in early life which consists of 2 new initiatives: 1) increasing peer-to-peer knowledge transfer among HCP via digital engagement; 2) increasing knowledge transfer from HCPs to caregivers via social media; while maintaining the existing strategies: 1) stimulating initiatives to support breastfeeding during the first 6 months of life; 2) improving quality of complementary feeding; 3) strengthening growth monitoring to detect suboptimal growth in early childhood; 4) optimizing public-private engagement. The recommended solutions presented herein are the culmination of the collective insights of the expert panel. These recommendations offer invaluable approaches on addressing the critical public health issue of malnutrition, specifically growth faltering, and can benefit not only the three countries concerned but also other low and middle-income countries facing similar nutritional challenges

Antihypertensive medication non-adherence and its associated factors among adult patients with uncontrolled hypertension in a primary care setting

Introduction: Medication nonadherence is a significant challenge in the management of patients with hypertension. This study aimed to assess antihypertensive medication nonadherence and its associated factors in a cohort of patients with uncontrolled hypertension. Material and Methods: A cross-sectional study was conducted among 225 adult patients with uncontrolled hypertension systematically selected from attendees of the general outpatient clinic of an academic tertiary hospital in Kano, Nigeria. A structured questionnaire was used to collect data on their sociodemographic, clinical, and follow-up appointment characteristics. An 8-item medication adherence scale was used to assess medication adherence. Results: There were 155 (68.9%) females. The participants' median age (interquartile range [IQR]) was 55 (45–63) years. Their median adherence score (IQR) was 4 (1–6) of 8, while 87.1% were non-adherent to antihypertensive medication. The duration of treatment (p = 0.009), current blood pressure (p = 0.006), and adherence to follow-up clinic appointments (p = 0.0004) were significantly associated with their median medication nonadherence scores. Conclusion: The prevalence of medication non-adherence in this population is high; however, patients who have been treated for more than 5 years, those with high blood pressure readings (Stage 2 hypertension), and those who were adherent to follow-up appointments had worse medication adherence scores than the other counterparts. These findings justify the need to extensively explore (especially those with long duration of treatment and Stage 2 blood pressure readings) and address the reasons for non-adherence to antihypertensive medication (which should include the identified associated factors), given that medication adherence is crucial in controlling hypertension and its consequences

Menstrual hygiene practices among female adolescents seen in general outpatient clinic

Introduction: Menstruation is a normal physiologic phenomenon which is indicative that a woman is ready for her reproductive roles. Adolescents are often uninformed and inexperienced on most health-related issues including menstruation. This study therefore hopes to determine the common menstrual hygiene practices among adolescent females. Materials and Methods: This was a cross-sectional study involving women aged 14–18 years. A pretested questionnaire was administered by trained female clinical assistants to those who cannot read and write; however, literate respondents self-administered the questionnaires. Results: Three hundred and ninety-six (95.4%) of the respondents were aware of menstruation before their first period. Four hundred and two (96.9%) respondents believed menstruation was caused by the age of maturity, while 13 (3.1%) reported failure of fertilization of the ovum resulted in menstruation. Close relations were common source of information on menstruation; however, the age of menarche ranged from 9 to 18 years, with a mean age of 13.4 ± 1.5 years. Sixty-one (14.7%) respondents used clean cloth for menses, 271 (65.3%) used sanitary pad, while 83 (20.0%) used tampon. However, 55 (13.3%) reused their sanitary wares. Most respondents changed their sanitary wares twice in a day; they mostly bath twice in a day even during their periods. Conclusion: Most respondents were aware of menstruation before their menarche and their close relatives were their common source of information on menstruation, 13 years was the mean age of menarche; most respondents used sanitary pads; however, 20% of them still used tampons

Is this 4-year-old female child suffering from a forme fruste of hypomelanosis of Ito?

Hypomelanosis of ito (HI) is a multisystemic disorder characterized by cutaneous, neurologic disorder, and musculoskeletal disorder. However, there may be isolated cutaneous manifestation, resulting in diagnostic overlap with other hypopigmentary lesions such as nevus depigmentosus and hypopigmentation along the lines of Blaschko. Therefore, there is the need for generally acceptable diagnostic criteria avoiding these ambiguities. Hence, the case of a 4-year-old female child with isolated hypopigmentations characterized as whorls on the torso and as linear distribution along the lines of Blaschko is reported

Pap smear awareness, utilization, and pattern of cervical intraepithelial neoplasia among women attending a tertiary hospital in Northwestern Nigeria

Background: Globally, cervical cancer affects approximately 528,000 women each year, with about 80% of them occurring in developing countries. Developed countries have successfully reduced the incidence of cervical cancer by 70% through organized cervical screening programs. Objective: The aim of the study is to assess the level of Pap smear awareness and utilization among adult females attending the general outpatient clinic of Aminu Kano Teaching Hospital, Northwestern Nigeria, in order to encourage early detection of premalignant cervical cancer. Methods: This was a descriptive cross-sectional study that assessed Pap smear awareness, utilization, and pattern of cervical intraepithelial neoplasia among 422 adult females in Kano, Northwestern Nigeria, using an interviewer-administered questionnaire. SPSS version 20 was used to analyze the data. The sociodemographic characteristics of participants, risk factors of cervical cancer, and awareness and utilization of Pap smears by participants were expressed in means and proportions. The Chi-square test was used to explore associations between categorical variables. Logistic regression was performed to identify the predictors of Pap smear awareness and its utilization among the study participants. P < 0.05 was considered statistically significant. Results: Of the 422 women who participated in the study, the majority (292, 69.2%) had never heard of Pap smear screening while 130 (30.8%) were aware of Pap smear. Similarly, 342 (81.0%) women who participated in the study had never undergone a Pap smear. Three hundred and eight (74%) had normal cytology results, 107 (25%) had inflammatory changes, 4 (0.8%) had low-grade squamous intraepithelial lesion, and 1 (0.2%) had high-grade squamous intraepithelial lesion. Having higher education and being employed were associated with Pap smear awareness while increasing age and educational level were associated with Pap smear utilization. Conclusion: This study revealed a low awareness and utilization of Pap smear screening in Northwestern Nigeria

The Perception of Asthma and Views on Metered-dose Inhaler by Caregivers of Asthmatic Children in Aminu Kano Teaching Hospital, Kano

Introduction: Much have been achieved in improving the quality of life of asthmatic children such as providing efficient treatment and preventive measures; however, acceptability of these treatments such as metered-dose inhalers (MDI) by caregivers desires to be studied. Materials and Methods: This study was cross-sectional involving caregivers of asthmatic children aged 5–14 years. Results: One hundred and nineteen caregivers were recruited, consisting of 93 mothers (78.1%), 22 fathers (18.5%), and 4 relations (3.4%). However, 88 (73.9%) of the respondents believed asthma was inheritable. Sixty-five (54.6%) of the respondents had counseling on asthma but majority of the respondents will accept MDI if prescribed for their wards; however, among the 33 (27.7%) that will reject, majority believed MDI will make asthma chronic (51.5%). However, 69.7% of them agreed to accept MDI if properly counseled on the advantages and effectiveness of MDI. Although majority of those that had counseling on childhood asthma would accept MDI, this observation was not statistically significantly (χ2 = 2.741; df = 1; P = 0.11); however, most of those with a family history of asthma would accept MDI and this observation was statistically significant (χ2 = 14.312; df = 1; P = 0.00). Similarly, maternal education showed statistically significant association with willingness to accept MDI (Fisher's exact test = 15.444; P = 0.01). Oral medications were the preferred route by the respondents (66.4%) if given the choice to choose. Conclusion: Most respondents believed that asthma is heritable, and majority will accept MDI if prescribed by a physician but they will prefer oral medication as a matter of choice; however, maternal education had significant relationship with the willingness to accept MDI

Prehospital care practices for venomous snakebites in resource-limited settings: A narrative review

Venomous snakebite is a medical emergency encountered worldwide, especially in resource-limited communities. It usually leaves victims at the mercy of traditional care, whose effectiveness have come under scrutiny over time. Several of these traditional/ first aid practices have also been reported over time. Controversies over their efficacy often result in confusion among snakebite victims, their caregivers, and sometimes, among health-care providers. This narrative review describes reported prehospital interventions for venomous snakebites highlighting their usefulness, dangers, and/or limitations associated with their use and the currently widely recommended prehospital activities for venomous snakebite

Awareness of family medicine discipline among clinical medical students of Bayero University, Kano, Nigeria

Introduction: Undergraduate medical education requires the studying of a wide range of medical specialties to produce the future workforce of the healthcare system. Family medicine (FM), a relatively new specialty in Nigeria, aims at supplying doctors capable of providing comprehensive healthcare for the majority of the population. However, many Nigerian medical schools (Bayero University inclusive) are yet to include FM in their undergraduate curriculum. Methods: This was a descriptive cross-sectional study of 178 respondents randomly and proportionately selected from 400-, 500- and 600-level medical students of Bayero University Kano. Using a structured questionnaire, their awareness of FM discipline, specialty preferences, factors influencing specialty preferences and their views on the relevance of FM in improving health systems were assessed. Results: A majority of the respondents (60.7%) were males and most (93.8%) had heard of FM. However, only 19.7% of respondents were aware that FM was taught in the undergraduate programme of medical schools; 86% were aware of a postgraduate FM programme. FM (22.5%) was the second most preferred specialty following surgery (23.6%). Personal interest in the specialty was the main (76.5%) reason for preference. Only 2.9% believed the postgraduate training for FM had a longer duration. All respondents believed FM was relevant as a specialty. Conclusion: The knowledge and perception of the FM discipline among clinical medical students of Bayero University was good. They expressed that FM was relevant in the healthcare system as shown in their preference for the specialty, which ranked second among other specialties. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.131348

Anomalous origin of the left coronary artery from the main pulmonary artery

The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart anomaly; this occurs in 1/300,000 live births. ALCAPA syndrome was first described in 1933 by Bland and co-authors in autopsy specimens; however, further description of its clinical manifestations resulted in the naming of Bland–White–Garland syndrome. The case of a 2-year-old boy who was referred for echocardiographic investigation due to recurrent cough, catarrh, and occasional noisy breathing is reported in this communication; his chest X-ray was normal, while electrocardiogram showed Q-waves on limb leads I and aVL and the echocardiographic study showed ALCAPA