The association between medication adherence and blood pressure control among hypertensive patients attending a tertiary hospital in south-south Nigeria

Background: Hypertension is a common disease among adults. It is a global health condition that requires drugs and lifestyle changes for its management and control. Despite this, the rate of hypertension related deaths has been increasing in prevalence across the world. The purpose of this paper is to determine the association between medication adherence and blood pressure control among hypertensive patients in Family Medicine Clinic, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.Methods: A hospital based cross-sectional study was conducted in Family Medicine Clinic, University of Port Harcourt Teaching Hospital. Systematic sampling method was used to select 400 participants. A structured questionnaire namely Morisky Medication Adherence Scale-4 was adapted and used for data collection in this study. Bivariate analysis was done using Chi square test and odd ratio.Results: A total of 400 (118 males and 282 females) adult hypertensive patients participated in this study. Majority of the participants had poor adherence to medication treatment 71.2% (n=285), whereas the remaining ones 28.8% (n=115) had good adherence. Similarly, most of the participants, 77.2% (n=309) had poor blood pressure control while the remainder 22.8% (n=91) experienced the opposite. The bivariate analysis showed that good medication adherence was significantly associated with good blood pressure control.Conclusions: Medication adherence was low especially among those with poor blood pressure control. This link was statistically significant therefore doctor-patient interaction with emphasis on medication adherence is advocated.

Model exploration and analysis for quantitative safety refinement in probabilistic B

The role played by counterexamples in standard system analysis is well known; but less common is a notion of counterexample in probabilistic systems refinement. In this paper we extend previous work using counterexamples to inductive invariant properties of probabilistic systems, demonstrating how they can be used to extend the technique of bounded model checking-style analysis for the refinement of quantitative safety specifications in the probabilistic B language. In particular, we show how the method can be adapted to cope with refinements incorporating probabilistic loops. Finally, we demonstrate the technique on pB models summarising a one-step refinement of a randomised algorithm for finding the minimum cut of undirected graphs, and that for the dependability analysis of a controller design.Comment: In Proceedings Refine 2011, arXiv:1106.348

Prevalence and socio-demographic factors associated with anaemia in pregnancy in a primary health centre in Rivers State, Nigeria

Background: Anaemia, though a common problem in Nigeria, has not been adequately studied amongst pregnant women in primary health care facilities. Objective: This study is aimed at determining the prevalence of anaemia and sociodemographic factors associated with anaemia in pregnancy in a primary health centre in Rivers State, Nigeria. Methodology: This is a cross-sectional study carried out in a primary health centre. Association between variables was analysed using the Chi-square test. Results: Two hundred and twenty-seven pregnant women whose ages ranged from 16 to 40 years with a mean age of 26.8 ± 4.3 years were recruited for the study. The haemoglobin concentration ranged from 6 g/dL – 15 g/dL with a mean of 10.10 ± 1.27g/dL. A total of 142 (62.6%) participants were anaemic. Anaemia was observed to be least prevalent in women within the extremes of reproductive age (≤ 20 years and 36–40 years). There was no statistically significant association between age, educational level and marital status (p > 0.05). The association of anaemia with social class was statistically significant (p = 0.000). Severe anaemia was not a common finding amongst the patients but it was significantly associated with educational status (p = 0.02) and socio-economic status (p = 0.03). Conclusion: The prevalence of anaemia amongst the pregnant participants in the primary health centre was high. Out of all the socio-demographic characteristics, only socio-economic status was significantly associated with anaemia. It is recommended that the socio-economic status of women should be enhanced in line with the Millennium Development Goals to prevent anaemia and to enhance pregnancy outcomes

Partial Recovery of Traumatic Spinal Cord Injury Following Posterior Decompression/ Free Hand Pedicle Screw Instrumentation: A Case Report

Spinal cord injuries can be highly disabling. Although effective treatment for spinal cord injuries remains limited, operative stabilization and decompression of the neural canal may give rise to a better outcome and a faster rehabilitation. We report the operational management and rehabilitation of a 30-year-old woman who sustained L1 traumatic spinal cord injury with paraplegia (ASIA B) after being hit on the back by a pack of falling bricks. She sustained multiple vertebral fractures and a traumatic spondylolisthesis of L2/ L3, with canal stenosis were noted at the same level on MRI. Pedicle screw fixation of L1 to L4 (free-hand technique) was done with decompression of L2/L3 segments. Immediate recovery of power to the hip flexors was noted on the second post-operative day, with corresponding reduction in low back pain and  subsequent mobilization on wheel chair at the end of the second post-operative week. At the end of the eight post-operative week, patient began full weight bearing on a Zimmer’s frame without support. Key words: Spondylolisthesis, Neural canal, ASIA, Spinal recover

Tibio-fibular synostosis - a viable option in the management of segmental tibial loss: case report

Segmental tibia loss resulting in gap non-union presents a major challenge to the orthopaedic surgeon, especially when associated with infection, old or active osteomyelitis, and multiple previous surgeries. This is made rather worse in the presence of extensive skin and soft tissue scarring. Several options of treatment have been proposed with the most recent advance being the Ilizarov technique. However, in the face of extensive skin and soft tissue scarring especially in the anterior and antero-medial portions of the leg, bone transport becomes almost impossible and resort to other methods of treatment become handy.We report a case of segmental tibial loss in a26-year-old man who presented to the outpatient clinic with a two-year history of gap non-union of the right tibia (8cm) following a road traffic accident. This was complicated by a chronic ulcer seating on scar tissue with extensive skin and soft tissue scarification and muscle atrophy. He was successfully managed by proximal tibio-fibular synostosis with radiological evidence of distal tibio-fibular synostosis. Limb length and alignment were fully restored.Keywords: Antibiotics, bone graft, gap non-union, Kirschner wire, segmenta

Use of External Fixator in Achieving Early Osseous Fusion in Boyd’s Amputation of the Ankle – A Review of Two Cases

Boyd amputation refers to amputation at the level of the ankle with preservation of the calcaneus and heel pad with consequent fixation of the calcaneus to the tibia. This allows for complete weight bearing and provides stabilization of the heel pad. It is a technically more difficult procedure to perform than the Syme amputation which is a more popular procedure done in ankle disarticulations. The aim of this report is to document our experience with the use of external fixators to achieve osseous union in the management of diabetic foot gangrene. Two cases of diabetic foot gangrene were managed successfully by Boyd’s amputation using external fixators to achieve compression, osseous integration and union. This procedure will be quite useful in developing countries where prosthesis utilization is poor and expensive as obtains in higher level amputations.Key words: Calcaneus, Disarticulation, Diabetic foot, Gangren

Characterization of wetland soils of Zarama, Bayelsa state, Nigeria, in relation to iron and manganese distribution

This study investigated the soil properties of Zarama, Bayelsa state, Nigeria in relation to iron (Fe) and manganese (Mn) distribution, between October and December, 2005. Four soil profile pits representing varying creek water influences were studied. The soils have acquic moisture and isohyperthermic temperature regimes. Results showed that silt and clay dominated in all profiles with total sand being least, ranging from 20-310 g kg- 1 in profile 1. Soil pH was slightly acidic in the site (pH CaCl2 = 5.0-6.9). Organic carbon was highest in profile 3 (22-150 g kg- 1). There were higher values of Fe in wetter profile pits unlike Mn. Crystalline Fe (Fe d) was more abundant than amorphous Fe (Fe o). Total iron was significantly correlated with fine earth (r=0.80; p = 0.01; n = 26), total sand (r = - 0.76) silt (r = 0.63) and clay (r= - 0.88). Total manganese correlated significantly with fine earth (r=0.64), total sand (r = 0.52), silt (r = 0.46) and clay (r = 0.67). Keywords: Wetland, farming gleysation, marshland, iron, manganese, tropical soilsIJOTAFS Vol. 1 (1) 2007: pp. 80-8

Challenges of Christian Missionary Education in Igboland, Nigeria: Focus on the Impediments Affecting the Catholic Primary School Projects (1885-1970)

This paper discusses the key problems which militated against the Catholic missionary education in Igboland, Southeast Nigeria. It analyses the key problems which clogged against the mission’s educational enterprise in Igboland which is predominantly Christian, while the Catholic Mission remained the dominant force in its educational landscape. Because of its affinity with a greater majority of the Igbo population, and acceptance by local most communities, Catholicism became synonymous with the Igbo, with the effect that the mission’s educational space became so wide and could be found in most local towns and villages. As it were, this development fertilized the stage for the emergence of numerous thorns along the track with the effect that the quality of its primary school education was impacted, while its ability to spread to all towns and villages suffered setbacks. Meanwhile, the undue competitions and struggle for space and population between the mission and other Christian missions in towns and villages involved in the Igbo educational project became an added factor. It is the conclusion of this paper that faced with the weight of the militating factors, the mission’s educational project suffered setbacks in a number of areas. Keywords: Catholic; Christian Missionary; Education; IgboLand; Primary School. DOI: 10.7176/JEP/12-29-10 Publication date:October 31st 202

Knowledge and Compliance with Standard Precaution Among Healthcare Workers in A South-East Nigerian Tertiary Hospital

Background: Adherence to standard precautions (SP) is critical to reducing the burden of nosocomial infections. Objective: We assessed the knowledge and practice of SP among healthcare workers (HCWs). Methodology: A cross-sectional study was conducted among HCWs in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Anambra State, Nigeria using self-administered questionnaire and key informant interview. Results: Mean age and employment duration of subjects were 33.4±11.9 and 6.0 ± 6.7 years, respectively. Majority of the 341 HCWs had heard about SP (82.1%) and agreed that it should be applied to all patient care (78.0%). Only 45.7% of them correctly cited ≥2 components of SP. Two-third of participants reported that SP was poorly practiced in their unit mainly due to inadequate supply of materials (63.1%), inadequate staff training/retraining (62.2%), inadequate support by management (51.4%) and unavailable standard operating procedures (SOPs) on SP (37.8%). Compliance with SP and specifically, personal protective equipment (PPE) use were 65.1% and 76.2%, respectively. Profession (p=0.023), awareness about SP (p<0.001), SOP display in prominent places (p<0.001) and regular supply of running water (p<0.001) were significantly associated with SP compliance. Key informant interview revealed lack of written SP policies or its communication to HCWs, lack of training/retraining of HCWs and lack of materials required for SP practice. Conclusion: Knowledge of basic concept and practice of SP was not satisfactory among HCWs. Major barriers to SP were lack of materials, training and active support by hospital management. Awareness, SOP display in prominent places and regular supply of running water positively influenced SP compliance. Having written policies and communicating such to all HCWs, consistent supply of necessary materials, intensified training, and regular supervision are recommended Keywords: Universal precautions, Nosocomial infections, Tertiary hospitals, Health Personnel, Nigeri