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   Table of Contents - Current issue
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January-June 2018
Volume 3 | Issue 1
Page Nos. 1-42

Online since Wednesday, October 10, 2018

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ORIGINAL ARTICLES  

Knowledge and practice of Ebola virus disease preventive measures among health workers in a tertiary hospital in Northern Nigeria p. 1
Ahmad Ayuba Umar, Michael Audu Sheshi, Mu'awiyyah Babale Sufiyan, Aisha Ahmed Abubakar
DOI:10.4103/archms.archms_45_17  
Background: Healthcare workers treating cases of Ebola virus disease (EVD) are at greatest risk of getting infected themselves. The risk increases when these workers do not have appropriate protective clothing or do not wear them properly or handle contaminated clothing incorrectly. This risk is particularly common in parts of Africa where health systems function poorly and where the disease mostly occurs. The study was carried out to assess the knowledge and practice of EVD preventive measures among health workers in a tertiary hospital in Northern Nigeria. Methodology: A cross-sectional survey was carried out using a self-administered, structured questionnaire, with a sample size of 80 health workers selected through multistage sampling technique. The data obtained were entered, cleaned, coded, and analyzed using IBM Statistical Package for the Social Sciences statistics 20. Results: All the respondents had heard of EVD, with 73% of them having good knowledge of the disease. Majority (62.2%) of the respondents had excellent knowledge of preventive measures of the disease. Positive attitude toward EVD preventive measures was demonstrated by 84% of the respondents. Only 41% of the respondents practiced hand washing all the time when attending to patients, 69% always used hand gloves for procedures which may involve contact with blood and body fluids, while 27% always used facemasks and goggles for procedures that may involve splashes of blood and body fluids, and 34% of the respondents, however, still practiced recapping of used needles. Conclusion: A third of the health workers still practiced recapping of needles, and very few health workers always use facemasks and goggles for procedures that may involve splashes of blood and body fluids. Management of tertiary hospitals should improve staff training on EVD preventive measures.
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Depression among students of a Nigerian University: Prevalence and academic correlates p. 6
Aisha Dabana, Abdulrazaq A Gobir
DOI:10.4103/archms.archms_5_18  
Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. It is extremely prevalent among university students and is a widespread problem globally. This study was conducted to determine the prevalence of depression and the academic factors that are associated with it among students of Ahmadu Bello University (ABU), Zaria, Nigeria. Methodology: This was a cross-sectional study conducted among 127 undergraduate students of ABU. Data were collected using a structured, self-administered Patient Health Questionnaire-9 (PHQ-9) and were analyzed using IBM-Statistical Software for Social Sciences, version 20.0. Results: Majority of the respondents (58.2%) had depression, with 37.0%, 15.7%, 3.9%, and 1.6% having mild, moderate, moderately-severe, and severe depression, respectively, according to the PHQ-9 scoring system, using a cutoff score of 5. There was no statistically significant association between depression and academic performance of respondents (P = 0.360) nor with interest (or lack thereof) in the course of study (P = 0.266). Conclusion: Depression, at different levels of severity, was noted among respondents. More screening and counseling services should be made easily accessible to students in the study area. Further research on nonacademic factors that could predispose to depression is recommended. This will aid in formulating policies for prevention and control of depression in the study area.
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Cardiovascular risk factors among geriatric Nigerians in a primary care clinic of a tertiary hospital in Southeastern Nigeria p. 11
Gabriel Uche Pascal Iloh, Okechukwu Kalu Iro, Peace Ifeoma Collins
DOI:10.4103/archms.archms_14_17  
Background: Cardiovascular (CV) risk factors tend to aggregate in geriatric population with variable distribution. These risk factors may act as alert signals for proactive geriatric CV health programs. This study was aimed at determining the frequencies of CV risk factors among geriatric Nigerians in a primary care clinic of a tertiary hospital in Southeastern Nigeria. Patients and Methods: This was a cross-sectional study carried out on 280 geriatric Nigerians at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Geriatric Nigerians aged 60 years and above were screened for risk factors of CV disease. The data collected included sociodemographic variables and metabolic, dietary, and behavioral risk factors using a structured, pretested, and researcher-administered questionnaire. Results: The top five most common CV risk factors were physical inactivity (67.1%), inadequate fruit consumption (65.7%), hypertension (48.2%), abdominal obesity (47.9%), and dyslipidemia (36.8%). Others were general obesity (31.1%), inadequate vegetable consumption (22.5%), diabetes mellitus (15.7%), habitual use of alcoholic beverages (9.0%), habitual use of snuff (3.9%), and nonhabitual smoking of cigarettes (2.8%). Conclusion: This study has demonstrated that the risk factors of CV disease exist among geriatric Nigerians in primary care, with five most frequent being physical inactivity, inadequate fruit consumption, hypertension, abdominal obesity, and dyslipidemia. Screening geriatric Nigerians for modifiable CV risk factors should be integrated into geriatric primary care in the study area.
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Analgesic and anti-inflammatory effects of resveratrol in rat models of pain: Any role in clinical pain management? p. 19
Elizabeth O Ogboli Nwasor, Ahmed-Sherif Isa, Emeka John Dingwoke, Abdullahi Hussein Umar
DOI:10.4103/archms.archms_54_17  
Background: Resveratrol (RSV) is a biomolecule that has been demonstrated in numerous studies to possess therapeutic potentials with multiple targets. Despite the reported low bioavailability, it could exhibit novel role in clinical pain management. Objective: To investigate the systemic analgesic and anti-inflammatory effects of RSV in comparison to diclofenac and etoricoxib. Materials and Methods: Following institutional ethics approval, the study was conducted in the physiology research laboratory. The animals (42 male Wistar rats) used were divided into seven groups (n = 6) in separate cages. Chemical pain was evaluated using formalin-induced nociception test. Statistical analysis was done using analysis of variance and Kruskal–Wallis statistical tests. Results: There is a significant change in nociceptive score in the early phase; however, no significant changes in the late phase in the formalin test. Anti-inflammatory studies showed that RSV 50 mg/kg has a significantly potent anti-inflammatory effect when compared to control, but similar in activity to etoricoxib. Tumor necrosis factor alpha and interleukin-2 concentration did not significantly differ between the groups. Conclusion: RSV may elicit its analgesic actions by inhibiting the direct activation of nociceptors. It may be suggested that systemic RSV at a dose of 50 mg/kg in Wistar rats significantly reduces inflammation comparable to etoricoxib, but possibly less potent than diclofenac. Thus, RSV may be useful in the management of acute and chronic pain with significant inflammatory components. Further broad based human clinical studies on the analgesic and anti-inflammatory properties of resveratrol are required to confirm its potential role in clinical pain management.
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Nasopharyngeal carcinoma at the Ahmadu Bello University Teaching Hospital, Zaria: A 22-year histopathological review (1992–2013) p. 24
Sannom Mildred Yates, Yawale Iliyasu, Saad Aliyu Ahmed, Almustapha Aliyu Liman
DOI:10.4103/archms.archms_10_18  
Background: Nasopharyngeal carcinoma (NPC) is uncommon cancer with unique geographical variations and strong association with Epstein–Barr Virus. The increasing incidence of NPC in Nigeria in recent years has reinforced the need for more studies to be done. This study aims to determine the frequency, age, and sex distribution as well as the histopathological patterns of NPC seen over a period of 22 years, from 1992 to 2013. Materials and Method: It was a retrospective study of all NPCs diagnosed in the Department of Pathology, Ahmadu Bello University Teaching Hospital from January 1st 1992 to December 31st, 2013. The request forms, histopathology reports, slides, and paraffin-embedded tissue blocks of all histologically diagnosed NPCs within the study period were retrieved and examined. The age, sex and site/nature of the biopsy were extracted. Histopathological diagnosis was in accordance to the 2005 World Health Organization classification. Results: NPC showed a frequency of 0.3% (112 cases) with a significant rise in incidence in the last decade. There was a male preponderance with M: F of 3.5:1. The age range was 6–91 years, mode 40 years, mean age 42.4 years, and peak age of incidence 40–49 years (18.8%). Histologically, nonkeratinizing carcinoma (NKC) was the most common (94.6%) followed by keratinizing squamous cell carcinoma (KSCC, 4.5%) and a single case of basaloid squamous cell carcinomas (bscc, 0.9%). Undifferentiated subtypes made up 79.4% of NKC, 12.7% differentiated and 7.9% mixed. In addition, 44.4% were of Regaud type growth pattern, 34.9% Schmincke type, and 20.6% were mixed. The nasopharynx was the most common site of surgical biopsy (57.1%) followed by the nasal cavity (17.9%) and cervical lymph node (11.6%). Conclusions: NPC showed a recent increase in frequency, a male preponderance and a unimodal age pattern that peaked in the 5th decade with an overall mean age of 42.4 years. NKC over KSCC and a solitary case of BSCC was seen. A significant number of biopsies were from sites outside the nasopharynx, suggestive of advanced disease with poor prognosis.
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Awareness of stroke and knowledge of its risk factors among respondents in Shika community, Kaduna State, Nigeria p. 30
Abdulhakeem Abayomi Olorukooba, Yahaya Mohammed, Shamsudeen Suleiman Yahaya, Lawal Amadu, Jimoh Mohammed Ibrahim, Mary Ojonema Onoja-Alexander
DOI:10.4103/archms.archms_1_18  
Context: Reduction in risk of stroke is possible through prevention, modification, or treatment of the emerging or established modifiable risk factors. Aims: The aim of this study is to assess the knowledge regarding stroke risk factors and factors affecting this knowledge among residents of Shika, Zaria. Settings and Design: A community-based cross-sectional descriptive study was conducted among 133 respondents in Shika community. Subjects and Methods: A pretested, semi-structured, interviewer-administered questionnaire was used to obtain data from the respondents. Statistical Analysis Used: Data were analyzed using IBM-SPSS version 21. Descriptive summary statistics such as mean and standard deviation (SD) were used to present numeric data such as age while frequencies and proportions were used for categorical data such as knowledge level. Chi-square test and Fischer's exact test were used to determine the association between categorical variables at a significant level of P< 0.05. Results: Majority of the respondents were males (64.7%), with a mean (± SD) age of 33 ± 14 years, and had tertiary education (46.6%). About 82.0% of them had ever heard of stroke. Only 21.8% of respondents had good knowledge (any respondent able to identify ≥2 established factors) of stroke risk factors. There was a statistically significant relationship between knowledge of stroke risk factors and gender of respondents (P = 0.04, χ2 = 6.25) as well as with the educational status of respondents (P < 0.001). Conclusion: Knowledge of stroke risk factors was found to be poor among the respondents, and educational status and gender of respondents were found to be associated factors. To increase public knowledge of stroke, community-based educational strategies based on the results of this study should focus on people with poor educational background.
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Depression among students of a Nigerian University: Prevalence and sociodemographic correlates p. 35
A Dabana, AA Gobir
DOI:10.4103/archms.archms_6_18  
Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases and several sociodemographic factors were found to be associated with it. It is prevalent among university students worldwide. This study assessed its prevalence and the sociodemographic factors associated with it among students of Ahmadu Bello University (ABU), Zaria, Nigeria. Methodology: A cross-sectional study conducted among 127 undergraduate students of ABU. Data were collected using a structured, self-administered Patient Health Questionnaire-9 and were analyzed using IBM-Statistical Software for Social Sciences, version 20.0. Results: Results indicated that 58.2% had depression, with 37.0%, 15.7%, 3.9%, and 1.6% having mild, moderate, moderately severe, and severe depression, respectively. Sociodemographic factors (such as gender and age) were not found to be associated with depression among respondents (P = 0.964 and 0.246, respectively). Conclusion: Depression, at different levels of severity, was observed among respondents. Counseling and screening services for depression should be conducted on all new students entering the university. The treatment of depression should be made easily accessible to affected students. Further research on non-sociodemographic factors that could predispose to depression is recommended.
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CASE REPORT Top

Radical orchidectomy for isolated tuberculosis of the testis: Call for restrain on surgeon's knife p. 40
Ballah Akawu Denue, Bukar Abba Zarami, Mohammed Bashir Alkali
DOI:10.4103/archms.archms_7_18  
Isolated testicular tuberculosis (TB) poses a diagnostic challenge even in regions that are known to be endemic for TB. It seldom presents with constitutional symptoms or genitourinary symptoms and can mimic testicular cancer at the initial stages. The dilemma is further compounded by a dearth of facility and expertise for cytohistological diagnosis of cases. The case presented in this report involved a 40-year-old patient that presented with a 7-month history of asymptomatic right testicular swelling with a working diagnosis of testicular cancer for which he had radical orchidectomy. Histology result was consistent with testicular TB. Isolated TB of the testis is a rare form of genitourinary TB, and it can present similar to testicular malignancy. It should be considered as a close differential diagnosis of testicular cancer especially among those residing in TB endemic regions such as Nigeria. Detailed evaluation of testicular lesion is, therefore, necessary to establish a diagnosis and definitive treatment. This could lead to a reduction in the cases of inadvertent orchidectomy as in this case here presented.
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