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  Citation statistics : Table of Contents
   2016| July-December  | Volume 19 | Issue 2  
    Online since July 5, 2016

 
 
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ORIGINAL ARTICLES
Clinical significance of microbial flora in middle ear infections and its implications
Pratibha M Mane, Anuradha Basawraju
July-December 2016, 19(2):128-130
DOI:10.4103/1119-0388.185437  
Introduction: Chronic suppurative otitis media (CSOM) has a multifactorial etiology, which follows acute ear infection and leads to deafness. The present study was conducted to know the etiology and antibiotic susceptibility pattern of the isolates. Methods: Ear swabs were collected and processed as per standard procedures. Results: The organisms isolated were Pseudomonas aeruginosa, Staphylococcus aureus, coagulase negative Staphylococci, Klebsiella spp., Proteus spp., and Serratia and they showed variable susceptibility patterns. The fungi isolated were Candida spp. and Aspergillus niger. Conclusion: Proper diagnosis and selection of antibiotics reduce the damage and toxicity of the drugs.
  2 2,899 164
Prevalence and pattern of burnout syndrome among healthcare professionals in a university teaching hospital
Peter O Ibikunle, Emmanuel Amah, U Useh
July-December 2016, 19(2):144-148
DOI:10.4103/1119-0388.185443  
Background: Burnout syndrome in health care workers is a state of physical, emotional and mental exhaustion caused by long-term involvement in high-stress situations. Burnout is regarded as the result of chronic stress that has not been successfully addressed. The purpose of this study was to determine the prevalence, patterns and comparison of the different stages of burnout syndrome amongst various health care professionals. Materials and Methods: Total of 280 health care professionals comprising 55 doctors, 165 nurses, three physiotherapists, five radiographers and 52 medical laboratory scientists participated in the survey. Participants were chosen using a proportionate stratified random sampling technique. The instrument used for data collection was the Maslach Burnout Inventory (MBI) .The data were analysed using descriptive statistics such as means and standard deviations, and inferential statistics (ANOVA). Significance was set at 95%. Results: The results reveals that burnout (EE-emotional exhaustion, DP-depersonalisation, PA-personal accomplishment) occurred in the following order, medical lab scientist (EE 33.85, DP:14.83, PA:21.77), nurses (EE:30.81, DP:12.80,PA:27.81), doctors (EE:25.47, DP:9.87, PA:31.64), radiographers (EE:16.8, DP:7.6, PA:36.2), physiotherapist (EE:8.67, DP:4.33, PA:37.68). There was significant difference in all the stages of burnout (P<0.05). Conclusion: Health care organisations need to acknowledge that those who work in the health care profession may need help to cope with the stress and burnout that are often associated with such practice. Efforts to alleviate burnout among health care professionals will have positive effect on health care service delivery.
  1 2,305 360
Impact of Vitamins C and E supplement on anti-oxidant enzymes (catalase, superoxide dismutase, and glutathione peroxidase) and lipid peroxidation product (malondialdehyde levels) in sickle subjects
Okot-Asi Thomas Nku-Ekpang, Ofem Effiong Ofem, Victor Otu Oka, Smith I Jaja
July-December 2016, 19(2):100-105
DOI:10.4103/1119-0388.185427  
Aim: This study sought to investigate the effect of combined supplements of Vitamins C and E glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) malondialdehyde (MDA) levels in sickle cell and non-sickle cell patients. Materials and Methods: A total of 27 subjects (16 controls and 11 test subjects) were used for this study. The sickle cell subjects (test) were obtained among the sickle cell patients who visited the out-patient clinic of the Lagos University Teaching Hospital (LUTH) for check-up, their ages ranged from 18 to 27 years. Venous blood samples of the subjects were carefully withdrawn using disposable syringes and needles at the sickle cell anemia (SCA) clinic, LUTH, Nigeria. Vitamins C and E supplementation commenced on the 1 st day of blood collection and lasted for 6 weeks. All the subjects received Vitamin E (1000 IU) in soft gelatinous capsule once daily and 200 mg of Vitamin C orally per day for 42 days. Blood was collected from each subject under aseptic procedure and MDA was determined to assess lipid peroxidation enzyme activity while GPx, SOD, and CAT were estimated for antioxidant enzymes' activity. Results: Results revealed significantly (P < 0.01) lower basal levels of SOD, GPx, and MDA in sickle (SCA) compared with non-sickle anemia (NSCA). After 42 days of Vitamins C and E supplementation, SOD, GPx, and MDA increased significantly in both groups, but the increase was more in SCA compared with NSCA subjects (P < 0.01). Conclusion: Hence, it was found that Vitamins C and E supplementation did not reduce lipid peroxidation enzymes (MDA) activity in SCA subjects despite the increase in scavenging enzymes' (SOD and GPx) activities in SCA.
  1 3,368 275
Association of comorbidities with breast cancer: An observational study
Neeti Sharma, Satya Narayan, Rajani Sharma, Akhil Kapoor, Narender Kumar, Rajkumar Nirban
July-December 2016, 19(2):168-171
DOI:10.4103/1119-0388.185449  
Background: The aim of this study was to describe the prevalence of comorbidity in newly diagnosed female breast cancer patients in north-west India. The second end point of the study was compliance for multimodality treatment. Comorbidity assessed by counting the number of coexisting diseases diagnosed in a cancer patient or by using a comorbidity index that combines the number and severity of the diseases. The most widely used index is the Charlson Comorbidity Index (CCI). Materials and Methods: The data of female patients with breast cancer were recorded, having comorbidities during the cancer registration or comorbidities diagnosed during the treatment at the host institute between January and December 2012. The patients were distributed on the basis of physical parameters such as age, stage, tumor grade, hormone receptor status, ECOG status at diagnosis and CCI. Scores of CCI are summed to provide a total score to predict mortality. Results: During the period of January to December 2012, 156 biopsy-proven breast cancer patients were included in the study. During this period, female breast cancer patients enrolled were 13.94% out of total patient enrollment. The most prevalent comorbidities associated with breast cancer are hypertension (21.8%), chronic obstructive pulmonary disease (COPD) (19.9%), rheumatologic disease (18.6%), and diabetes mellitus (16.7%), all four conditions have been reported in around 75% of the cases. The planning of multimodality management in comorbidity arm was significantly lower (P > 0.01) as compared to patients without comorbidity. Conclusions: The planning of multimodality management in comorbidity arm was significantly lower as compared to patients without comorbidity. Because of the comorbid condition, the definitive treatment of breast cancer was not given so this will also affect the treatment of breast cancer. When the CCI score increases with an increase in the number of comorbidities will decrease survival.
  1 2,761 261
Dietary habits and physical activity among medical students of a teaching hospital in South India: A descriptive analysis
SV Saranya, Chythra R Rao, Sravan C Kumar, Veena Kamath, Asha Kamath
July-December 2016, 19(2):172-177
DOI:10.4103/1119-0388.185450  
Context: Among the college population, it is assumed that medical students have better knowledge about healthy lifestyle and dietary practices when compared to other students. However, there is no evidence to indicate that this knowledge translates into practice in terms of maintaining good health. Also, medical students have been known to exhibit early risk factors for chronic diseases. Aim: To assess dietary practices and physical activity among medical students. Materials and Methods: A cross-sectional study was done among 438 medical students from a teaching hospital in South India. A predesigned questionnaire was used to assess diet and current physical activity levels [using the International Physical Activity Questionnaire (IPAQ) short version] among consenting medical students. Statistical Analysis Used: Data were analyzed using statistical package for social sciences (SPSS) version 15.0 from SPSS South Asia Bangalore, India. Chi-square test was used for univariate analysis. Results: Among 438 medical students, 97% were aware of balanced diet, but only 42.9% were following it. Nearly, 9.4% of students consumed junk foods everyday. Compared to the previous year, junk food intake had increased in 40.4% and fruit intake had decreased in 50% of students. Significant association was noted between overweight and obesity and daily consumption of junk foods. Over 95% of students were physically active. In comparison to the previous year, nearly 67% of students had increased their physical activity by walking. Conclusions: Although unhealthy eating habits were prevalent among medical students, practice of physical activity was good. It is, therefore, essential to identify and take corrective actions to promote healthy lifestyle practices.
  1 3,863 476
Work-related musculoskeletal pain and health-seeking behavior among Nigerian sewing machine operators
Aderonke O Akinpelu, Olufemi Oyeleye Oyewole, Adesola C Odole, Funmilayo D Ogunbamowo
July-December 2016, 19(2):152-158
DOI:10.4103/1119-0388.185446  
Background: Musculoskeletal pain (MSP) is the most common occupational health risk among sewing machine operators and their health-seeking behavior is not well understood. This study assessed the prevalence, pattern, and predictors of work-related MSP and health-seeking behavior among Nigeria sewing machine operators. Materials and Methods: Three hundred and twenty-five purposively selected registered sewing machine operators who have worked for at least a year without musculoskeletal trauma participated in this cross-sectional descriptive survey. Information on MSP and health-seeking behavior were collected through questionnaire interview. Results: Almost 69% (223/325) and 98% (318/325) of the participants reported the experience of MSP in the last 7-day and 12-month, respectively. Among those who reported the experience of pain, the most common pain site was low back, followed by the neck, while the elbow was the least common pain site. When the report of experience of pain was adjusted for sex, the same pattern of body regional distribution of pain was observed. Almost 36% (116/325) reported that MSP was due to a combination of work activities and position while 21% (69/325) reported that either work activities or position resulted in MSP. Majority (88%) of participants experienced limitation in daily activities as a result of MSP. The most sought after health-seeking behavior was self-medication (31.4%) followed by herbal preparations (17.8%). Only 3.7% (12/325) sought hospital treatment only and 2.5% sought hospital treatment in addition to other treatments. Only the factor "does pain limit activities" predicted MSP. Conclusion: Work-related MSP is prevalent among Nigerian sewing machine operators, and low back is the most common pain site. Only the factor "does pain limit activities" predicted MSP. Many of them engage in self-medication to alleviate their pain.
  1 2,506 243
FNAC a diagnostic modality in cysticercosis: Study of 148 cases with a brief review
Pooja Srivastava, Sachin Kolte, Kusum Gupta
July-December 2016, 19(2):159-161
DOI:10.4103/1119-0388.185447  
Aim: This study was done to analyze clinicopathological and fine-needle aspiration (FNA) findings of cysticercosis in a tertiary care center. Settings and Design: Retrospective data collected from April 2013 to December 2014 were analyzed. Materials and Methods: One hundred and forty-eight cases of suspected parasitic infection, who presented with soft tissue swelling, were analyzed. Results: Out of 148 cases 100 cases showed presence of parasitic fragments on FNA cytology (FNAC), while the rest 48 cases were reported as suggestive of parasitic infection. Conclusion: FNAC in cysticercosis is a low-cost, minimally invasive outpatient procedure. The cytological diagnosis is clear-cut in cases where the parasite structure is identified in the smears. In other cases, features suggestive of parasitic infection can help in indicating the possibility of the disease.
  1 1,504 114
Bacteriological profile and antibiogram of blood culture isolates from a tertiary care hospital of North India
Shilpi Gupta, Bineeta Kashyap
July-December 2016, 19(2):94-99
DOI:10.4103/1119-0388.185426  
Introduction: Blood stream infections cause a significant morbidity and mortality worldwide. Rapid and reliable detection of bacterial pathogens and rational use of antimicrobials are required for proper management. The present work was undertaken to study the bacteriological profile along with the antibiogram of the blood culture isolates from clinically diagnosed cases of sepsis. Materials and Methods: During the 1-year study period, 3472 blood samples from patients with a clinical diagnosis of sepsis were received at the Emergency Microbiology Laboratory of a 2500-bedded tertiary care hospital of North India. Bacteriological identification and antimicrobial susceptibility testing were performed for all bacterial isolates by following the standard protocol. Results: Culture positivity was seen in 16.5% of the septicemic cases. The most common bacteria isolated were Escherichia coli (22.4%) followed by Klebsiella species (19.7%), Staphylococcus aureus (18.3%), and coagulase-negative staphylococci (17.4%). About 26.5% of S. aureus were methicillin-resistant. Vancomycin (100%), gentamicin (87.9%), and ciprofloxacin (73%) showed the highest activity among the Gram-positive isolates. Most of the Gram-negative bacteria were multi-drug resistant (67.1%). Imipenem (98.8%), amikacin (90.8%), and cefoperazone/sulbactam combination (81.1%) showed the highest activity among Enterobacteriaceae. Nonfermenters in majority were susceptible to imipenem (88.2%), amikacin (81.6%), and piperacillin/tazobactam combination (72.4%). Gram-negative isolates showed 100% sensitivity toward colistin. Conclusion: The present study highlights the bacteriological etiology of sepsis along with the antibiogram of septicemic isolates that may provide necessary information for the formulation of antibiotic policy in effective management of such cases.
  1 3,098 559
Rheumatoid arthritis among autoimmune diagnosed patients: A pilot study at Africa's third largest hospital
Richmond Owusu Ampofo, Collins Osei-Sarpong, Benard Ohene Botwe
July-December 2016, 19(2):88-93
DOI:10.4103/1119-0388.185425  
Context: Rheumatoid arthritis (RA) is one of the leading causes of disability worldwide. Its etiology remains a generational challenge that keeps evolving with time. Epidemiological studies on this disease have been conducted in several countries around the globe. Unfortunately, little research has been done on RA in Africa. Due to this, RA is given low priority in medical research and often neglected in Africa. Aims: This pilot study aimed at estimating RA prevalence in a representative proportion of autoimmune diagnosed patients within Ghanaian population attending the rheumatology clinic of Korle Bu Teaching Hospital (KBTH). Setting and Design: This is a pilot and cross-sectional study conducted at the KBTH. Methods: Patients attending the rheumatology clinic of the KBTH were the subjects for this cross-sectional study. Data acquisition involved questionnaire usage and review of medical records. Statistical Analysis Used: Chi-square cross tabulation on SPSS 16 and frequency charts in Microsoft Excel were used to analyze outcomes. Results: Most patients (n = 153 out of 225) were diagnosed RA. These RA diagnosed patients (n = 133/87%) were often seropositive for RF. The female gender (n = 131/85.62%) was diagnosed mostly. The disease peaked among 51-60 years age group and economically active patients (n = 118/77%). Among all the ethnic groups, the Akans were the most RA diagnosed tribe (n = 78/153). Conclusion: RA is indeed a chronic disease that has its signs and symptoms not well known among patients. It exists at a high prevalence among the Ghanaian population attending the rheumatology clinic.
  - 2,662 1,481
Self-medication among North Indian first-year undergraduate healthcare students: A questionnaire-based study
Sharat Gupta, Manjinder Singh
July-December 2016, 19(2):162-167
DOI:10.4103/1119-0388.185448  
Background: Self-medication is the treatment of common health problems by a patient's own initiatives, without professional supervision. Throughout the world, healthcare students have been found to be more prone to indulge in this unhealthy practice. Aim: This study was conducted to assess the prevalence, practices, and perceptions regarding self-medication among healthcare students from northern India. Materials and Methods: The present survey-based study was conducted on 360 subjects (142 males and 218 females), aged 18-20 years. It included both medical and dental first-year undergraduate students, who were selected using convenience sampling. The data were collected using a validated, semistructured, and self-administered questionnaire. The results were presented as counts and percentages. Statistical Package for the Social Sciences version 13.0 (IBM corporation, Chicago, US) software was used for statistical analysis. Results: The prevalence rate of self-medication was 92.7%. The most common reasons cited were "quick relief" (90.4%) and "illness too trivial for consultation" (88.6%). "Advice from pharmacist" emerged as the main source of self-medication practices (95.8%). Analgesics (92.8%) and antibiotics (90.7%) were the most commonly used drugs, while the most common ailments for which self-medication was used were headaches/body aches (92.8%) and sore throat (85.6%). More than half of the participants had a positive attitude toward self-medication. Conclusion: A vast majority of the healthcare students are oblivious to the potential adverse side effects of self-medication. Therefore, there is an urgent need to appraise them regarding the dangers of indiscriminate drug use along with the implementation of stringent statutory regulations regarding the sale and availability of drugs.
  - 2,417 233
Pattern and frequency of endometrial changes and pathologies among pregnant and nonpregnant women presented with abnormal uterine bleeding in rural inhabitants of north India: A retrospective secondary data analysis
Seema Dayal, Ashish K Maurya
July-December 2016, 19(2):178-182
DOI:10.4103/1119-0388.185459  
Background: Abnormal uterine bleeding i.e., dysfunctional uterine bleed is one of the most frequent problems that occur in women of all ages. It occurs due to various disorders. Endometrial biopsy remains a preferred sampling procedure for the diagnosis of endometrial pathology. This study was conducted to determine the type, frequency of endometrial pathologies in women presenting with AUB, and their association with different age groups. Materials and Methods: This was retrospective study conducted in Histopathology Section of the Pathology Department of the Rural Institute of Medical Science and Research, Saifai, Etawah. Five hundred and forty seven (547) patients who have undergone endometrial biopsies and who clinically presented with AUB were included in this study. The pattern of endometrial pathologies was diagnosed, classified, and it was compared in terms of age. Result: Out of the 563 patients who have undergone endometrial biopsies and who presented with AUB, 547 were included in study and others were discarded because of scanty tissue. The patients were aged between 15 years and 72 years, and most of the patients were aged between 41 years and 50 years (36.56%). The common clinical presentation was menorrhagia (42.96%). The most common pattern on histopathology was secretory endometrium (28.33%). Pregnancy related pathology was also forming a bulk (17.36%), whereas incidence rate of malignancy was low (1.09%). Conclusion: AUB is the common clinical complaint interfering with the quality of life in healthy women. Endometrial sampling therefore, biopsy or curettage, is an important diagnostic procedure for the evaluation of AUB with special preference above 35 years of age to rule out malignancy.
  - 1,476 126
Nontraumatic myelopathy at the University of Port Harcourt Teaching Hospital: Magnetic resonance imaging evaluation
Regina Chinwe Onwuchekwa, Arthur Chukwubike Onwuchekwa, Emeka Ifedi Emedike
July-December 2016, 19(2):106-109
DOI:10.4103/1119-0388.185428  
Objective: The aim of the study is to evaluate the etiology of nontraumatic myelopathy on magnetic resonance imaging (MRI) with a view to highlight the most common causes. Materials and Methods: We retrospectively examined the images and reports of patients with nontraumatic spinal cord lesion who presented to the Radiology Department of University of Port Harcourt Teaching Hospital for MRI scan between 2007 and 2012. The following data were collected: age, gender, types of lesions, and location of lesions. Cases with incomplete information were eliminated and cases with conflicting image findings and reports were reviewed. Institutional ethics approval was not necessary for this retrospective study. The data were analyzed statistically using Statistical Package for the Social Sciences (SPSS) 14.0 window evaluation version. Results: Seventy-three patients satisfied the criteria for inclusion in the study. Of these patients, there were 21 females and 52 males giving a female-to-male ratio of 1:2.5. The mean age was 37 years (age range of 15-78 years). The age range of 51-60 years had the highest frequency of lesions, accounting for 29. 17%. Disc degenerative disease was found to rank the highest among the lesions seen on MRI, accounting for 46. 6%. Conclusion: MRI is useful in detecting and localizing the spinal cord lesion responsible for myelopathy. The finding in this study that the commonest cause of myelopathy is spondylosis has contributed to bringing into limelight the burden of degenerative spinal lesion in the environment and the need to provide adequate facilities for management of the condition.
  - 1,421 155
Sociodemography of musculoskeletal injuries due to roadside accidents: A register-based study from North-West India
Sunil Kumar Raina, Lokesh Thakur, Bhanu Awasthi, Naveen Kumar, Vipin Sharma, Sandeep Kalia
July-December 2016, 19(2):110-113
DOI:10.4103/1119-0388.185429  
Introduction: Majority of musculoskeletal injuries are attributed to roadside accidents (RSAs) due to vehicular traffic. In India, over 1.2 million are seriously injured and about 300,000 disabled permanently in road traffic crashes annually. Materials and Methods: The study was planned with a view to identifying the sociodemographic factors influencing roadside accidents and thereby leading to musculoskeletal injuries. It was a prospective, descriptive hospital-based study, conducted over a period of 1 year at a tertiary care center in a rural area of Himachal Pradesh, a sub-Himalayan state of India. Results: Musculoskeletal injuries due to RSAs were common in age group 16-30 years (n = 93, 49%), although no statistically significant association could be identified between age and RSA. Of all the vehicles involved in RSA, two-wheelers were the most common. Males and individuals engaged in government employment were more commonly involved in RSA. Importantly, no statically significant association could be found between RSA and education or income. Discussion: Majority of RSAs could be attributed to two-wheelers. Therefore, a policy framework on the prevention of musculoskeletal injuries due to RSA should focus on two-wheelers as an important factor. Conclusion: A policy framework on the prevention of musculoskeletal injuries due to RSA should focus on two-wheelers.
  - 1,441 122
Extended spectrum beta-lactamase and AmpC producing Klebsiella pneumoniae: A therapeutic challenge
Sheevani Sheemar, Shashi Chopra, Gomty Mahajan, Jaspal Kaur, Yadwinder Singh Chouhan
July-December 2016, 19(2):114-117
DOI:10.4103/1119-0388.185431  
Klebsiella pneumoniae accounts for substantial proportion of nosocomial infections. Increasing multidrug resistance of these bacteria is posing a great threat to hospitalized patients as it results into limitation of therapeutic options. Therefore, the present study was undertaken with the following Aim and Objective :To know the burden of extended spectrum beta lactamase (ESBL) producing K. pneumoniae and coexistence of AmpC in these isolates using phenotypic methods in a newly established teaching hospital in Punjab, India. Materials and Methods: ESBL and AmpC screening and confirmation was done using phenotypic methods as per the Clinical and Laboratory Standards Institute (CLSI) guidelines in 200 clinical isolates of K. pneumoniae. Results: Out of 200 isolates of K. pneumoniae, 116 (58%) were ESBL producer and 84 (42%) were ESBL nonproducer. Of these 116 ESBL-positive isolates, 29 (25%) were coproducer of AmpC beta-lactamase. ESBL producing isolates were significantly more resistant to other group of antibiotics as compared to ESBL nonproducers. Discussion: High prevalence rate of ESBL producing K. pneumoniae was observed in our institute. MDR in these isolates was frequent, indicating the extensive injudicious use of antibiotics. Conclusion: Increasing prevalence of ESBL producing K. pneumoniae need to be checked to reduce the mortality and morbidity due to the infections caused by these strains.
  - 1,912 251
Evaluation of retention of knowledge and skills imparted to third semester MBBS students through basic prehospital care of fracture
Dharmvir Ranjan Bharati, Partha Nandi, Ranabir Pal, Thiruvanthipuram Venkadesan Yamuna, Andharaj Lokeshmaran, Gautam Sarker
July-December 2016, 19(2):118-123
DOI:10.4103/1119-0388.185434  
Background: The basics of prehospital care of fracture is essential to the practice of medicine. Objectives: The study was intended to increases the knowledge in the applied aspects of basic prehospital care of fracture and evaluate the posttraining effectiveness of medical students. Materials and Methods: The World Health Organization (WHO) promoted "Injury Prevention and Control--A Handbook for Undergraduate Medical Curriculum" that was used to develop two teaching-learning modules. With the help of "Learning Resources Evaluation Guidelines," resource contents were designed and arranged to develop a teaching-learning module for two groups of third semester Bachelor of Medicine, Bachelor of Surgery (MBBS) students that was focused, compact, and completed within the stipulated time frame. The structured questions were used for evaluation of the cognitive domain while evaluation of the psychomotor and affective domains was done by "do it yourself" simulation exercises on mannequins. Results: For basic knowledge, the differences between pretest and posttest in both groups were statistically significant: the correlation between pretest and posttest was not significant in group 1 but was significant in group 2. For skill, the differences between pretest and posttest in both groups were statistically significant; the correlation between pretest and posttest was not significant in group 1, whereas it was significant in group 2. The second group learnt more at all levels. Conclusions: The study findings evidently pointed out that for optimum learning of all domains in order to bring about a change in the desired direction, there is need for training with a well-structured program to understand practical procedures in near-real life exposure.
  - 1,312 96
Study of haematological parameters of lubricating engine oil factory workers and controls in Nnewi, South-East Nigeria
Nancy C Ibeh, John C Aneke, Chide E Okocha, Samuel I Ogenyi
July-December 2016, 19(2):124-127
DOI:10.4103/1119-0388.185435  
Background: Products of crude oil, including benzene and its derivatives, exert adverse cytotoxic and suppressive effects on blood cells, particularly the hematopoietic precursors in the bone marrow. Objective: To determine the effect of exposure to lubricating oil on hematological parameters and how these are influenced by alcohol consumption in factory workers in Nnewi, South-East Nigeria. Subjects and Methods: A total of 50 nonsmoking lubricating oil factory workers and 50 apparently healthy nonoil factory workers were recruited for this study. A volume of 3 ml of venous blood was collected from each participant for full blood count, using automated hematology analyzer (PE-6800, Prokan; ). Data were analyzed using the Statistical Package for Social Sciences version 16.0 (SPSS Inc., Chicago IL, USA). The level of statistical significance was P < 0.05. Results: The mean ages of study subjects and controls were 29.00 ± 6.06 and 30.55 ± 5.47 years, respectively (P = 0.37). The means of red blood cell count, hemoglobin concentration, hematocrit, red cell indices and white cell and differential counts were significantly lower in the study subjects than controls (P values all < 0.05). There were no significant differences in parameters at different durations of exposure and between test subjects who consumed alcohol and those who did not. Conclusion: Occupational exposure to lubricating oils appears to suppress hematopoiesis, in a manner that may be independent of the duration of exposure.
  - 1,486 113
Can axillary temperature reliably screen for fever in under - five children?
Kelechi Kenneth Odinaka, Emeka Charles Nwolisa, Iheakaram Chinekwu Alfreda, Ifeyinwa Okafor Amamilo
July-December 2016, 19(2):149-151
DOI:10.4103/1119-0388.185444  
Background: In most developing countries, the body temperature of children is routinely measured through the axilla because it is convenient. However, concerns have been raised concerning the reliability of axillary temperature in screening for fever especially in under five children. Objective: This study was carried out to determine the reliability of axillary temperature in screening for fever in under five children. Materials and Methods: This cross-sectional study was carried out at the Paediatric Department of Federal Medical Centre, Owerri, Imo State. Eligible children were consecutively recruited. Rectal and axillary temperatures were taken simultaneously in each eligible child with a mercury-in-glass thermometer. Statistical analysis was done using SPSS version 20. Results: A total of 156 children were recruited and the children were aged 1 day to 59 months. There were 81 males and 75 females. There was a positive correlation between rectal and axillary temperature. Using the rectal temperature as gold standard, the sensitivity and specificity of axillary temperature was 88.6% and 89.6% respectively. Conclusion: The high sensitivity and strong positive correlation between axillary and rectal temperatures show that the axillary temperature can reliably screen for fever.
  - 1,924 107
Prevalence and infection intensity of geohelminthiases among school children as an environmental health indicator to guide preventive activities in Nandi County, Kenya
Chrispinus Siteti Mulambalah, Jimmy Ruto
July-December 2016, 19(2):131-137
DOI:10.4103/1119-0388.185439  
Background: Intestinal helminth infections acquired from contaminated environment cause morbidity and mortality worldwide. These infections have persisted in some communities prompting the need to evaluate epidemiological determinants and plan for intervention programs. Design and Setting: A 6 months cross-sectional school-based study was undertaken in Nandi County, Kenya to assess the prevalence and intensity of intestinal geohelminthiases in school children. Materials and Methods: Fecal samples were analyzed by modified formal-ether concentration technique. Whole sediment formed after centrifugation was transferred onto a slide and examined microscopically. All helminth ova and larvae were isolated and identified based on morphological features and enumerated. Chi-square statistic test was used to analyze and make comparisons of variables. Results: Of a total of 2000 stool samples collected, 73.9% (n = 1478) were analyzed while 26.1% (n = 524) were discarded due to contamination. Ascariasis was most prevalent accounting for 42-74% compared to trichuriasis 16-38% and hookworm disease 6-41%. There was no significance difference in prevalence among study sites and between sexes (P > 0.05). However, a significant difference in age group-specific prevalence (P < 0.05) was established. Analysis of sex-specific prevalence indicated that males had a higher prevalence than females (P < 0.05). Infection intensities were light in all sites and sexes. Conclusions: Intestinal geohelminthiases prevalence was high and was evidence of a major public health problem. The findings present a basis and good reference demonstrating the distribution pattern of geohelminths in school children. Relevant and appropriate treatment should be undertaken for those infected and plans for community-wide preventive measures should be initiated.
  - 1,887 153
Intrauterine contraceptive device use in Abakaliki, southeast Nigeria: A 5-year review
Nwali Matthew Igwe
July-December 2016, 19(2):138-143
DOI:10.4103/1119-0388.185441  
Objective: To evaluate intrauterine contraceptive device (IUCD) use in Abakaliki for acceptance rate, efficacy, and complications. Materials and Methods: A descriptive retrospective study was done in the family planning unit of the Federal Teaching Hospital, Abakaliki, between 1 January 2009 and 31 December 2013. The records of the clients from the family planning and their case files from the medical records units were studied. Data on sociodemographic characteristics, side effects, discontinuation, and reasons for discontinuation were extracted and fed into the computer using Epi Info program (2008) of Centers for Disease Control and Prevention (CDC) (Atlanta, GA) version 3.5.1 and were analyzed. Results: Out of 1,737 contraceptive acceptors, 230 clients accepted IUCD giving a rate of 13.2%. The mean age and parity were 33.6 ± 6.5 years and 4.6 ± 2.4, respectively. Only 3 (1.3%) out of the 230 acceptors were nulliparous, the rest were parous. Sixty eight clients discontinued the method giving a discontinuation rate of 29.6%. Young, married clients with low parity discontinued the method commonly desiring further conception hence used the method as spacer. The commonest reason for discontinuation was pregnancy desire (54.4%) followed by presence of side effect (19.1%). Eighteen clients (7.8%) had side effects or complications resulted from the use of this device. The commonest side effect was abdominal pain 8/18 (44.4%). Others were menorrhagia 4/18 (22.2%), missing IUCD 3/18 (16.7%), and pelvic inflammatory disease (PID) 3/18 (16.7%). The presence of side effect (P = 0.0156) and occupation (P = 0.0218) are the variables with significant correlation with the duration of usage of the method while young age (P = 0.0009), low parity (P = 0.0001), and marital status (P = 0.0001) had statistically significant relationship with the discontinuation of the method. Conclusion: IUCD is very effective but with the acceptance rate of 13.2% among the methods offered and discontinuation rate of 29.6% in Abakaliki.
  - 3,224 209
REVIEW ARTICLE
Factors determining sanitation information-seeking behavior: A literature review
Oluwaseun O Fagbemiro, Iyabo Yewande Ademuyiwa, Opeyemi D Soyemi, Adedamola O Ojo
July-December 2016, 19(2):81-87
DOI:10.4103/1119-0388.185424  
This paper reviewed various assessments by different authors on sanitation information-seeking behavior of people in various areas and setting. Databases were used in the search for relevant academic published articles including Google Scholar and Google search engine. Articles for the review were drawn from peer-reviewed journals. Moreover, conference papers and research by recognized independent institutions. This review showed that factors determining sanitation-seeking behavior could be seen in various contexts: Economical, environmental, technological, and psychosocial. Therefore, the effective utilization of sanitation information will depend on social structures, level of education, cultural beliefs and practices, economic, government, and environmental conditions. Sanitation is the hygienic means of promoting health through prevention of human contact with hazards of waste as well as the treatment and proper disposal of sewage and wastewater. Strategic policy formation in the society should be based on information relating to sanitation, cleanliness, health promoting, and information-seeking behavior.
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