Annals of Health Research http://annalsofhealthresearch.com/index.php/ahr <p>Peer-reviewed journal of medical and health-related sciences to&nbsp;disseminate research works and ideas in the fields of medicine and allied health and social sciences with the ultimate goals of enhancing knowledge, improving practice and encouraging practice-centred research.</p> Medical and Dental Consultants Association of Nigeria, OOU Teaching Hospital, Nigeria en-US Annals of Health Research 2476-8642 <p>The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.</p> Endometriosis: Unveiling the contemporary issues in diagnosis and treatment http://annalsofhealthresearch.com/index.php/ahr/article/view/111 <p>Endometriosis is characterized by the presence of ectopic endometrial-like tissue in extra-uterine sites which may induce chronic inflammatory reaction, scar tissue, and adhesions that may distort the pelvic anatomy. The true prevalence of the disease is not known. The disease usually affects women of the reproductive age group and is most typically diagnosed in women aged between 25-30years. Some of the factors which increase the risk of disease include early menarche, shorter menstrual cycles and nulliparity. The symptoms are often non-specific making diagnosis difficult with resultant delay in initiation of appropriate therapy. However, chronic cyclical or non-cyclical pelvic pain with or without menstrual abnormality is common. This review describes the various management options in endometriosis with emphasis on the effective medical and surgical interventions which are useful in the developing world.</p> Adetokunbo O Fabamwo Onyinyechi J Agbara ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 1 6 10.30442/ahr.0401-1-01 Estimating the weighted prevalence of anxiety disorders in breast cancer patients using a Two-stage approach http://annalsofhealthresearch.com/index.php/ahr/article/view/74 <p><strong><em>Background</em></strong><strong>:</strong> A two-stage survey is useful when the actual diagnostic interview is time-consuming and expensive to administer on the general population.</p> <p><strong><em>Objective:</em></strong> To compare Schedule for Clinical Assessment in Neuropsychiatry (SCAN) with Hospital Anxiety and Depression Scale (HADS) in the determination of the prevalence of anxiety disorder in patients with breast cancer.</p> <p><strong><em>Methods:</em></strong> A cross-sectional study of 200 female patients diagnosed with breast cancer attending the Oncology Out-Patients Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria was done. The instruments used for the survey included a socio-demographic questionnaire, the HADS and the SCAN.</p> <p><strong><em>Results:</em></strong> The mean age of the subjects was 49.6 ± 11.2 years. Majority of the subjects (76.5%) were married. Using HADS with a threshold score of ≥ 8, 53 (26.5%) met the criteria for probable anxiety disorders (herein called ‘cases’). Of the 68 patients (all 53 ‘cases’ plus 15 randomly selected 10% of the non-cases) interviewed with the SCAN instrument, only 38 met the criteria for diagnosis of anxiety disorder.</p> <p><strong><em>Conclusions: </em></strong>The prevalence of anxiety disorders can be determined with greater precision using the two-stage design approach. Diagnostic tools like SCAN should therefore be incorporated in the assessment protocols for patients with breast cancer and other illnesses.</p> Olamijulo A Fatiregun Oluseun Peter Ogunnubi Omolara A Fatiregun Bolutife O Oyatokun Osunwale Dahunsi Oni Adebayo R Erinfolami Joseph D Adeyemi ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 7 15 10.30442/ahr.0401-1-02 Prevalence of microalbuminuria among adults with Type 2 Diabetes mellitus at OOUTH, Sagamu http://annalsofhealthresearch.com/index.php/ahr/article/view/89 <p><strong><em>Background</em></strong><strong>: </strong>Diabetes mellitus is a serious global epidemic. The menace of this chronic disease is attributable to its chronic complications which threaten both the world economy and life expectancy, especially in Sub- Saharan Africa. Nephropathy is a complication of Diabetes mellitus and a leading cause of End Stage Renal Disease.</p> <p><strong><em>Objectives</em></strong><strong>: </strong>To determine the prevalence of microalbuminuria as well as the effects of co-morbidities on the pattern of microalbuminuria among adults with Type 2 Diabetes mellitus.</p> <p><strong>&nbsp;<em>M</em></strong><strong><em>ethods</em></strong><strong>: </strong>A total of 325 adults with Diabetes mellitus and 100 controls without Diabetes mellitus were studied. The subjects with diabetes were classified into four groups ([i] diabetes only, [ii] diabetes with hypertension, [iii] diabetes with obesity and [iv] diabetes with hypertension and obesity). Urinary protein, microalbuminuria, fasting plasma glucose and Glycated Haemoglobin (HbA1c) were measured using standard methods.</p> <p><strong><em>Results</em></strong><strong>: </strong>The overall prevalence of microalbuminuria was 35.1% in the diabetic population compared to 8.0% in the control group. The prevalence of microalbuminuria in the various diabetic subgroups were as follows: 30.3% (diabetes only), 43.1% (diabetes with hypertension), 37.0% (diabetes with obesity) and 44.6% (diabetes with hypertension and obesity). The fasting plasma glucose and HbA1c were statistically significantly higher in the diabetic population than the control group. This indicated that there is a poor glycaemic control in the diabetic population and hence a possible cause of diabetic nephropathy.</p> <p><strong><em>Conclusion</em></strong><strong>: </strong>The risk of diabetic nephropathy was significant in the study population. The presence of one or more co-morbidities and poor glycaemic control increased the occurrence of diabetic nephropathy.</p> Adebayo Adetola Amballi Olatunde Odusan Omobola Abioye Ogundahunsi Alfred Ademola Jaiyesimi Sunday Kolawole Oritogun Wasiu Eniola Olooto ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 15 21 10.30442/ahr.0401-1-03 Over-nutrition among primary school pupils in a semi-urban Local Government Area, South-western Nigeria http://annalsofhealthresearch.com/index.php/ahr/article/view/91 <p><strong>&nbsp;</strong></p> <p><strong>Background:</strong> Studies from the developing countries suggest that childhood obesity is more prevalent in the urban settings. The search for childhood overweight/obesity (over-nutrition) needs to go beyond the urban into the semi-urban and rural areas.</p> <p><strong>Objectives:</strong> To determine the prevalence of over-nutrition and the associated factor among primary school pupils in Ikenne Local Government Area of Ogun State, Nigeria.</p> <p><strong>Methods:</strong> This was a cross-sectional analytic study of pupils of 15 schools (10 public and 5 private) using the multistage random sampling and the proportionate sampling techniques. Data were collected using interviewer-administered questionnaire, data on physical activity, household possessions, dietary practices and relevant physical findings were obtained.</p> <p><strong>Results:</strong> A total of 422 pupils were studied; the age ranged between 18 and 192 months with a mean of 107.2 ± 36.4 months. The prevalence of Overweight/Obesity (Over-nutrition) was 6.4% with male predominance: 8.1% vs 4.4% without statistical significance (p = 0.19). Over-nutrition was significantly more prevalent among pupils aged &lt;5 years and in the pupils of private schools (p = 0.000 and p = 0.007 respectively) and significantly related to the Dietary Diversity Score (p = 0.0001). Over-nutrition was more frequent among children whose parents had university education and were middle level civil servants without statistical significance. (p = 0.66, 0.19 respectively). Group physical activity was low in 96.3% and Food Frequency Score was poor in 87.5% of the overweight/obese pupils. Female gender, long duration of breastfeeding and delay in weaning significantly correlated with childhood over-nutrition.</p> <p><strong>Conclusions</strong>: Over-nutrition is not uncommon in the semi-urban Nigerian setting. The early life feeding practices, quality of the child’s diet and physical activities appear to be important contributors to childhood over-nutrition in this setting.</p> Tamra Iyabo Runsewe-Abiodun Oluwafolahan Sholeye Abiodun Alaje Olatunbosun O Olawale Olatunde Odusan ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 22 33 10.30442/ahr.0401-1-04 Prevalence and correlates of subjective traumatic distress among Emergency Department Nurses in Lagos, Nigeria http://annalsofhealthresearch.com/index.php/ahr/article/view/92 <p><strong>Background:</strong> The manifestations of subjective traumatic distress among emergency nurses in Nigeria have not been extensively studied.</p> <p><strong>Objective:</strong> To determine the prevalence and correlates of subjective traumatic distress among emergency department nurses in Lagos, Nigeria.</p> <p><strong>Methods:</strong> One hundred nurses working at the Emergency Department of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria, were surveyed for the impact of subjective traumatic distress using the Revised Impact of Event Scale. The sociodemographic characteristics and some work-related factors were also determined.</p> <p><strong>Results:</strong> Of the 100 participants, 60 (60%) met the criteria for the impact of subjective traumatic distress. The overall mean score of the participants for the IESR was 27.9 ± 6.7 with a range of 0 to 66. The most frequent symptoms of subjective trauma distress sub-scale included avoidance symptoms, (mean: 12.2± 9.1; range 0-28) intrusion symptoms (mean: 7.3 ± 3.8; range 0-20) and hyperarousal symptoms (mean: 5.3 ± 1.6; range 0-17). Female participants had higher exposures in the sub-scales of the IESR scores. The associations between sociodemographic parameters such as age, gender and marital status and the subscales of the IESR were not significant.</p> <p><strong>Conclusion:</strong> The study showed that more than half of the participants experienced subjective psychological traumatic distress. There is a need for hospital managers to provide psychological interventions regularly for emergency department nurses to prevent occurrence of psychopathologies such as burnout and posttraumatic stress disorders.</p> Ayodele Olurotimi Coker Olayinka Olufunmilayo Coker Tariela Oladipupo Foluke Adesope Omotayo Adedotun Alonge ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 34 42 10.30442/ahr.0401-1-05 Assessment of ART knowledge and adherence to ARVs among PLWHA accessing care in two Nigerian Military HIV/AIDS Treatment sites http://annalsofhealthresearch.com/index.php/ahr/article/view/93 <p><strong>Background:</strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Adherence to Highly Active Antiretroviral Therapy (HAART) is critical in achieving treatment goals, avoiding antimicrobial resistance, preventing treatment failure and improving the patient’s quality of life.</p> <p><strong>Objectives:</strong> To assess the knowledge of antiretroviral therapy (ART) and adherence to antiretroviral (ARVs) medicines amongst People Living With HIV/AIDS (PLWHA) accessing care in two Nigerian Military HIV/AIDS Treatment sites.</p> <p><strong>Methods:</strong> Four hundred patients on HAART who visited the study sites during the study period were recruited for the study using systematic random sampling method. A semi-structured, pretested, interviewer-administered questionnaire was used to obtain demographic details. Patients’ knowledge of HIV was assessed using an 8-item questionnaire while adherence was measured using the Simplified Medication Adherence Questionnaire (SMAQ).</p> <p><strong>Results:</strong> The predominant age group was 31-40 years (46.4%). There were more females (69%) than males (31%). Only 45.5% answered knowledge questions correctly. The adherence level in this study was 64.0%. The major reasons cited for non-adherence included being away from home (23.6%), forgetfulness (17.1%), busy schedule (14%), need to conceal medication (12.7%) and feeling better (11.6%).</p> <p><strong>Conclusion:</strong> Patients’ knowledge of ART and adherence to ARVs medicines were sub-optimal. Appropriate strategies to improve patients’ knowledge of ART and adherence to ARVs are recommended.</p> David Ufuoma Adje Felicia Esemekiphorar Williams Chukwuka Nicholas Bezugbe Dauda Audi Dangiwa ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 43 52 10.30442/ahr.0401-1-06 Rifampicin resistance among patients with Tuberculosis at the Olabisi Onabanjo University Teaching Hospital, Sagamu http://annalsofhealthresearch.com/index.php/ahr/article/view/98 <p><strong><em>Background</em></strong>: Tuberculosis (TB) is a major public health problem in Nigeria. The emergence of multidrug-resistant Tuberculosis poses a threat to global Tuberculosis control and if not effectively addressed, may wipe out the achievements of previous efforts in controlling Tuberculosis.</p> <p>Objectives: To determine the prevalence and factors associated with rifampicin resistance amongpatients receiving care for TB at the OlabisiOnabanjo University Teaching Hospital, Sagamu.</p> <p><strong><em>Methods</em></strong>: A retrospective study of presumptive Tuberculosis cases managed between January 2013 and December 2016 at the Directly Observed Treatment clinic, OlabisiOnabanjoUniversity Teaching Hospital Sagamu, Ogun State, Nigeria,was done. One sputum sample was obtained from each patient for the Gene Xpert<sup>®</sup> test to diagnoseTB and to determine rifampicin resistance among patients with confirmed Mycobacterium tuberculosis infection. HIV screening &nbsp;was also &nbsp;carried out on all the patients using HIV Rapid Test kits. The sociodemographic data were retrieved from the presumptive Tuberculosis register.</p> <p><strong><em>Results</em></strong>: A total of 1572 presumptive TB patients were screened for TB, out of which 187 (11.8%) were confirmed to be infected with <em>Mycobacterium</em> <em>tuberculosis</em> (MTB). A total of 20 (10.7%) of the 187 MTB patients had rifampicin resistance using Gene Xpert<sup>® </sup>method. Rifampicin resistance rate was significantlyassociated with re-treatment TB category but not with age, sex or HIV status.</p> <p><strong><em>Conclusion: </em></strong>The study showed rifampicin drug resistance among confirmed TB patients. There is a need to decentralizethe use of &nbsp;Gene Xpert<sup>®</sup> test for TB to the peripheral facilities and make it a point of care test for presumptive TB patients.<strong> <em><br></em></strong></p> Olusoji J Daniel Janet Olufisayo Bamidele John Kolawole Sodeinde Adeola Adebayo Ekundayo Adekunle Albert Salako ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 53 59 10.30442/ahr.0401-1-07 Juvenile Idiopathic Arthritis in a Tertiary Rheumatology Clinic http://annalsofhealthresearch.com/index.php/ahr/article/view/115 <p><strong><em>Background:</em></strong> Juvenile Idiopathic Arthritis (JIA) is one of the common chronic diseases in childhood. The inflammatory process in the joint is triggered by pro-inflammatory cytokines. The treatment is directed at alleviation of pain, inhibition of disease activity and preservation of range of motion.</p> <p><strong><em>Objectives:</em></strong> To describe the spectrum of clinical presentations, laboratory parameters and drug therapy among patients with Juvenile Idiopathic Arthritis seen at a Tertiary Health Centre.</p> <p><strong><em>Methods:</em></strong> All the patients who fulfilled the classification criteria of the International League of Associations for Rheumatology for JIA between July 2012 and June 2016 were included in the study. The clinical features, results of laboratory investigations and the treatment received were recorded.</p> <p><strong><em>Results:</em></strong> A total of 1910 patients were seen at the Out-Patient Rheumatology Clinic over the 4-year period but only 18 case files of patients with JIA (0.95% of total) were retrieved. There were 13 females and 5 males with a female-to-male ratio of 2.6:1. The age range was 8-15 years with a mean of 10.3 ± 2.1 years. The duration of symptoms prior to presentation ranged between 2 years and 7 years with a mean of 4.2 ± 1.3 years. Polyarticular presentation was observed among 61.1% (11/18), pauciarticular in 27.8% (5/18) and systemic in 11.1% (2/18). Fever was uniformly seen among the patients with systemic onset, while fever and joint swelling were the common presentations in the other groups. Knee and ankle joints were most commonly affected. Erythrocyte Sedimentation Rate was elevated in 88.9% of the patients. Methotrexate was used in 61.1% and combination therapy was used as necessary.</p> <p><strong><em>Conclusion:</em></strong> JIA is relatively uncommon in the setting of study. Polyarthritis form of JIA was the commonest type and response to steroid was uniformly good. Early recognition of the subtypes of JIA will enhance effective management of cases.</p> Segun Akintayo Oguntona Olabanke Arike Olatunde Ayodeji Emmanuel Fawole ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 60 67 10.30442/ahr.0401-1-08 Socio-demographic and other risk factors associated with HBV potential infectivity among Hepatitis B Surface Antigen Negative blood donors http://annalsofhealthresearch.com/index.php/ahr/article/view/113 <p><strong><em>Background</em></strong><em>:</em> There have been cases of post-transfusion hepatitis in spite of transfusion of hepatitis B surface antigen negative blood unit.</p> <p><strong><em>Objective:</em></strong> To determine the socio-demographic and risk factors associated with positivity of anti-HBc among Hepatitis B surface antigen negative blood donors.</p> <p><strong><em>Methods</em></strong><em>:</em> A cross-sectional study was carried out among 490 HBsAg negative blood donors. The participants were tested for anti-HBc using ELISA kits. A structured questionnaire was used to obtain socio-demographic data and other possible risk factors.</p> <p><strong><em>Results</em></strong><em>:</em> The mean age of the participants was 32.5 ± 9.5 years with male predominance of 462 (94.3%) while 375 (76.5%) were first time donors. Of the 490 HBsAg negative blood donors, 89 (18.2%) were positive for anti-HBc.</p> <p>The highest prevalence of anti-HBc occurred in the 26-34 years age group. Independent risk factors associated with the presence of anti-HBc included age (p = 0.049), marital status (p = 0.003), dental and surgical procedure (p&lt;0.001), traditional practices such as tattoo, body piercing and scarification (p&lt;0.001) and previous blood transfusion (p = 0.016).</p> <p><strong><em>Conclusion</em></strong>: Age, marital status, traditional and cultural practices like scarifications, tattoo and body piercing and history of blood transfusion were risk factors associated with HBV infection despite HBsAg negativity.</p> Olusogo Ebenezer Busari Omotola Toyin Ojo Yetunde Adebisi Aken'Ova ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 68 74 10.30442/ahr.0401-1-09 Blood levels of some toxic metals in Human Immunodeficiency Virus (HIV) Type 1- infection http://annalsofhealthresearch.com/index.php/ahr/article/view/112 <p><strong><em>Background</em></strong><strong>:</strong> The introduction of antiretroviral therapy has reduced the mortality rate and increased the average life-expectancy of HIV-infected population. Infection probably due to the combination of the effects of environmental exposures and chronic inflammation and the role of mpact in infected individuals have been under-reported.</p> <p><strong><em>Objective</em></strong><strong><em>:</em></strong> To compare the plasma levels of cadmium (Cd), lead (Pb), mercury (Hg) and nickel (Ni) in HIV 1 –positive subjects receiving highly active anti-retroviral therapy treatment (HAART) and treatment-naïve subjects.</p> <p><strong><em>Methods</em></strong><strong><em>:</em></strong> The 300 study participants comprised 100 confirmed HIV-1 positive individuals on HAART, 100 HIV-1 positive HAART-naïve and 100 HIV-1 negative controls. Plasma levels of toxic metals were determined using inductively coupled plasma mass spectrometer (Agilent 7500, Norwalk, USA).</p> <p><strong><em>Results</em></strong><strong><em>:</em></strong> Plasma levels of toxic metals were significantly higher among HIV-infected subjects than controls (p &lt;0.001), with only Cadmium concentration being significantly higher (p = 0.05) among the HAART-treated subjects than HAART-naïve subjects.</p> <p><strong><em>Conclusion</em></strong><strong><em>:</em></strong> High toxic metal levels may lead to increased oxidative stress and adverse prognostic outcomes. Periodic evaluation of the blood levels of some toxic metals in HIV-1 infected individual is suggested and preventive strategies against environmental pollution should be adopted.</p> Mathias Abiodun Emokpae Ikenna Mbonu ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 75 81 10.30442/ahr.0401-1-10 Noonan Syndrome: A Case Report http://annalsofhealthresearch.com/index.php/ahr/article/view/96 <p>The clinical findings and treatment options of cardiovascular abnormalities in a 20-year old male patient with Noonan syndrome are described with literature review. The classical clinical features of Noonan syndrome which were identified included short stature, abnormalities of ear and eye, low posterior hair line, cubitus valgus and webbed neck. The major cardiovascular abnormalities included pulmonary valvular stenosis and hypertrophic cardiomyopathy. A comparison with Leopard syndrome is made and the overlapping features between the two rare genetic disorders are discussed.</p> Fahad Khan Sumaita Waqar Noor Ul Ain Jamal Asra Saleem ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-06-17 2018-06-17 4 1 82 87 10.30442/ahr.0401-1-11