Featured Papers

done_all Clinical Sciences

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    IMPACT OF SCHOOL ABSENCE ON ACADEMIC PERFORMANCE OF SCHOOL CHILDREN WITH ASTHMA IN ENUGU, NIGERIA

  • person_outlineAuthor(s): Nduagubam OC, Oguonu TA, Ojinnaka N, Ibekwe RC
  • subjectCategory: Clinical Sciences
  • access_time20 December, 2017
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    A number of factors are thought to influence the academic performance of children with asthma and absence from school is one. Reports on the impact of school absences on the academic performance of children with asthma are limited and the findings are inconsistent. The impact of school absences on the academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with Asthma (Subjects) aged 5–11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- , sex- and socio-economic class - matched non- asthmatic classmates (Controls) were recruited from the school. The total number of days of school absence for 2012/2013 academic session was obtained for each pair of pupils from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of same session. The median number (range) of days of absence from school for the entire study population was 6 (1 - 41) days. The median number (range) of days absent from school was 9 (1 - 29) days for the subjects and 3 (1 - 41) days for the controls. The difference was highly statistically significant (U= 5103, p < 0.001). The number of controls who had average and good academic performance was higher than that of subjects. However there was no significant association between academic performance and school absence in both subjects (2   = 3.92, d.f = 2, p = 0.141) and controls (2 = 0.59, d.f = 1, p = 0.444). We concluded that although children with asthma miss more school days than their non –asthmatic classmates, this does not significantly affect their academic performance.

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    CHILDHOOD DREADLOCKS (DADA HAIR): PERCEPTION AND HEALTHCARE SEEKING BEHAVIOR OF CARE-GIVERS IN A DEVELOPING COUNTRY.

  • person_outlineAuthor(s): Ndu IK, Ayuk AC , Osuorah DIC , Ubesie A, Ekwochi U, Chinawa JM, Asinobi IN, Amadi OF , Okeke I, Obu HA
  • subjectCategory: Clinical Sciences
  • access_time20 December, 2017
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    The word "dada" is used to describe dreadlocks. Several cultural beliefs and practices are associated with concept of the “dada” child and this influence the health care seeking behaviour of caregivers. To determine the perception of caregivers about childhood dreadlocks (Dada hair) and its effect on the health care seeking behavior of care givers in Enugu South-East Nigeria. A cross sectional study involving care-givers seen at the two tertiary health institutions in Enugu State, South Eastern Nigeria.  Interviewer administered questionnaires were used to obtain data from the study participants. There were 273 respondents, 90.1% of whom were females and 40% were of low socioeconomic status (SES). One hundred and twenty three (45%) participants believed in the concept of childhood dreadlock but only 27 (9.9%) reported previously or currently having a child with dreadlocks. Thirteen percent were of the view that under no circumstances should dreadlocked hair be washed or combed while 20% opined that a special ritual should be performed by a religious representative before cutting or shaving the dreadlocked hair. Fourteen percent of the caregivers believed that illness in a child with dreadlocks was of supernatural origin and would not respond to treatment with conventional medicine. For respondents that accept the use of conventional healthcare medicine during ill health of a dada child, twenty nine (11%) would refuse any medical interventions that would involve shaving the hair for venous access or neurosurgical procedures until the necessary ceremony had been performed. Only mother’s level of education was significantly associated with belief in the concept of the “dada” child. There is need for appropriate enlightenment of parents and care givers especially in the lower educational group about the importance of seeking healthcare and other necessary preventive strategies for the dada child while still respecting their cultural belief in the concept of childhood dreadlocks.

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    AWARENESS OF HIV PREVENTION METHODS AMONG INHABITANTS OF A RURAL COMMUNITY IN ENUGU STATE, NIGERIA

  • person_outlineAuthor(s): NDIBUAGU EO
  • subjectCategory: Clinical Sciences
  • access_time20 December, 2017
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    Human Immunodeficiency Virus is an infective organism that attacks the immune system of victims, frequently leading to disease known as Acquired Immune Deficiency Syndrome.  This virus is present in some body fluids of infected persons. Prevention can be done through; correct and consistent use of male and female condom, safe blood transfusion practices, elimination of mother-to-child-transmission, not using already used injection needles and sharps, testing and counseling for HIV and sexually transmitted infections, voluntary medical male circumcision, and antiretroviral drug use for prevention. This research was conducted in Egede, Udi Local Government Area, Enugu state, Nigeria. Interviewer administered questionnaire was used to collect information from respondents who presented for a medical outreach activity in January 2015. Socio-demographic data revealed that 76.9% were over fifty years, 69.9% females, 82.8% married, 52.7% had no formal education, and 69.9% farmers. On awareness of HIV prevention methods; abstinence from sexual intercourse scored 36.1%, being faithful to one uninfected partner 30.1%, correct and consistent use of condom 28.4%, organizing HIV/AIDS awareness campaign 26.4%, transfusing only screened blood 26.7%, preventing infection from mother to child 26.4%, HIV counseling and testing (HCT) 27.4%, male circumcision 16.9%, treatment of sexually transmitted infections 23.6%, giving antiretroviral drug to an exposed person 24.0%, giving antiretroviral drug to the partner of an infected person 21.3%, and by avoiding skin scarification and tattooing 18.9%. Total awareness on HIV prevention methods was 25.5%. It is important that HIV/AIDS awareness activities be stepped up in rural areas of Enugu state and Nigeria generally.

  • library_books

    Academic Performance of Primary School Children with Asthma

  • person_outlineAuthor(s): Nduagubam OC, Oguonu TA, Ojinnaka N, Ibekwe RC
  • subjectCategory: Clinical Sciences
  • access_time19 June, 2017
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    The academic performance of children with asthma may differ from that of their non-asthmatic colleagues. Reports on the academic performance of children with asthma are limited and the findings are inconsistent. The academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with asthma aged 5–11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age-, sex- and socio-economic- matched non- asthmatic classmates were recruited as controls. Academic performance was assessed overall using the average of the overall scores in the three term examinations of same session as well as specifically using the performance in four key subjects (English, mathematics, Social Studies and Sciences). Socio-economic status was determined using the occupational status and educational attainment of each parent. The median (range) overall academic scores for the children with asthma 79.04% (36.08% - 99.57%) was not significantly different from those of controls 80.01% (50.65% - 97.47%) (U = 6804, p = 0.461). We concluded that the academic performance of children with asthma compares favorably with that of children without asthma. 

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    Haematological Changes in Patients with Human Tuberculosis.

  • person_outlineAuthor(s): Okafor AI
  • subjectCategory: Clinical Sciences
  • access_time19 June, 2017
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    Some haematological alterations due to active cases of tuberculosis caused by Mycobacterium tuberculosis were investigated in Enugu Urban of South East, Nigeria. The results revealed thrombocythaemia, leucocytosis and elevated Erythrocyte sedimentation rates (p<0.05). There was oligocythaemia, as well as reduced haematocrit and haemoglobin concentrations (p<0.05). The significant oligocythaemia, anaemia, reduced packed cell volume found in active TB positive persons are all attributed to invasion of haematopoietic organs by any of the Mycobacteria tuberculosis complex (MTBC) namely: M tuberculosis, M. bovis, M africanum, M. canetti, M. microti, and M. leprae, which reduced substantially the rate of erythropoiesis. The invasion of lymphoid organs such as lymph nodes, thymus and tonsils by MTBC stimulated the synthesis of leucocytes leading to leucocytosis (p<0.05). This could be an inflammatory response which prepared the victim to defend itself  against any of the MTBC that invaded the lungs and might even invade other extrapulmonary organs. Thrombocythaemia in active TB is attributed to haemoptysis, since the latter occurs whenever there is a wound or a threat to tissue injury or damage. When these changes in haematological parameters are used in combination with other tests, microscopic and clinical methods, TB diagnosis and treatment could be well improved.

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    Determinants of Survival in Low Birth Weight Infants at a Tertiary Healthcare Facility in the South Eastern Nigeria

  • person_outlineAuthor(s): Ekwochi U, Ifediora C, Osuorah CDI, Ndu IK, Asinobi IN, Amadi OF, Agwu S, Okeke IB
  • subjectCategory: Clinical Sciences
  • access_time19 June, 2017
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    Low birth weight (LBW) babies account for a large number of neonatal deaths globally, with over 90% of these occurring in developing countries with low resources. Identifying factors that determine survival in these sub-groups of babies in such a low-resource setting will help clinicians prioritize care and improve outcomes. This study aims to bridge some knowledge gaps in this regard. This was a 45-month prospective study carried out at the Enugu State University Teaching Hospital (ESUTH), Enugu, Nigeria. All eligible newborns weighing between 500g and <2500g that were seen in this period were enrolled and monitored. Data collected were analysed with SPSS Version 24, and significant associations identified using logistic regression models. A total of 166 LBW neonates were enrolled, and 68.2% of them survived. Asphyxia and episodes recurrent apnoea were recorded at least once in 78.8% and 68.4% of the babies respectively, with about two-thirds requiring respiratory support at one time or the other. Survival in these LBW newborns was negatively associated with gestational age at birth of less than 32 weeks (OR 0.17; CI 0.03-0.50; P<0.01) as well as with episodes of recurrent apnoea (OR 0.07; CI 0.02-0.34; P<0.01). However, intra-uterine exposure to malaria was associated with a 15 times higher likelihood of survival (OR 15.41; CI 2.22-106.91; P=0.01). No significant associations was found between survival and attendances to antenatal care, mode of delivery, birth weight and a number of neonatal morbidities like necrotizing enterocolitis, hypothermia, hypoglycaemia, septicaemia, anaemia and neonatal jaundice. Survival rate among low birth weight neonates in a low resource setting is decreased with delivery at less than 32 weeks completed gestation as well as recurrent episodes of apnoea, but is increased with in-utero exposure to malaria. 

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    CO-EXISTENCE AND SEROPREVALENCE OF BRUCELLOSIS IN A MALARIA-ENDEMIC METROPOLIS OF SOUTH-EASTERN NIGERIA

  • subjectCategory: Clinical Sciences
  • access_time4 January, 2017
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    Malaria and typhoid are known major causes of febrile conditions in the South-Eastern Nigeria, hence healthcare providers usually co-administer antibiotics and anti-malaria on febrile patients without or before proper laboratory diagnosis. Despite this, fever and other symptoms of malaria sometimes persist after repeated treatment regimens. We investigated possible co-existence and prevalence of another fever-causing condition – brucellosis, with malaria and typhoid. The systematic study done between January 2015 and June 2016 involved 682 febrile patients referred to a private medical laboratory in Enugu metropolis in South-Eastern Nigeria for investigation for malaria and typhoid only. The number was made up of 295(43.3%) males and 387(56.7%) females, aged between 10 and 50 years. Identification of malaria parasites was done using thick films stained with Giemsa stain while typhoid and brucellosis were investigated serologically using Chromatest® febrile antigen kits. Our results showed prevalence of 39.1%, 66.0% and 28.6% for malaria, typhoid and brucellosis respectively in the studied population. Prevalence among male and female patients was 46.1% and 33.9% for malaria, 80.3% and 55.0% for typhoid, and 34.2% and 24.3% for brucellosis respectively. The results also showed that prevalence of malaria decreased with age while typhoid and brucellosis increased with age. We opine that 28.6% prevalence of brucellosis in a city with rare pastoral activities is high, and may be the cause of persistent fever after repeated combined treatment for malaria and typhoid. We advocate that these disease conditions should be simultaneously investigated for in all cases of febrile conditions to ensure wider investigation and treatment options, improvement on patients\' recovery time and reduction in man-hour loss.

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    ASCORBIC ACID STATUS IN PREGNANCY AND POSTPARTUM WOMEN IN ENUGU, SOUTH-EAST, NIGERIA: ARE VITAMIN SUPPLEMENTS SUFFICIENT?

  • subjectCategory: Clinical Sciences
  • access_time2 January, 2017
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    Pregnancy has been shown to be a period of stress, during which the nutritional needs of the foetus is dependent on that of the mother. It is also a condition exhibiting increased susceptibility to oxidative stress, leading to potential damage. Ascorbic acid is a strong antioxidant as well as a reducing agent and is increasingly utilized to normalize the pro-oxidant - antioxidant balance during pregnancy. Since ascorbic acid cannot be synthesized by the body, leading to total dependence on exogenous supply in diets, there is need to evaluate the level of the vitamin in pregnant women and determine their predisposition or otherwise to avitaminosis C. Ascorbic acid levels of 60 apparently healthy pregnant women, aged between 20-40 years old and attending the antenatal clinic at the UNTH, Enugu, 60 age-matched women in their postpartum and 60 age-matched non-pregnant women (controls) were assayed using the 2,4-dinitrophenyl hydrazine method. The serum ascorbic acid levels were significantly lower (P<0.05) in pregnant women, showing a steady decline with gestational age increase. There were statistically significant decreases (P<0.05) in the second and third trimesters whereas a significant increase (P<0.05) was observed in the postpartum period, when compared to the controls. The serum levels of ascorbic acid were decreased significantly as pregnancy progresses; in spite of the supplements given Significant increases in the postpartum period may be attributed to the absence of oxidative stress and recovery from stress. Additional supplementation and increased dietary intake should be encouraged in pregnant women.

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    ASSAULT-RELATED LIMB INJURIES SEEN IN A TERTIARY INSTITUTION IN NIGERIA

  • subjectCategory: Clinical Sciences
  • access_time26 November, 2016
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    Interpersonal violence seems to be on the increase worldwide. This is known to cause significant morbidity and mortality. The aim of this study is to evaluate limb injuries that are related to assault seen in ESUT Teaching Hospital Park lane, Enugu, Nigeria. The limbs are very important in economic survival and its loss or dysfunction could create serious disability and jeopardize survival. This was a prospective study carried out between March 2012 and February 2013 in the Forensic Clinic of ESUT Teaching Hospital Park lane, Enugu. Interviewer administered structured questionnaire was used to collect data from the victims off assault visiting the Forensic Clinic of the Hospital. Data was analyzed using simple statistical methods. A total of 1928 individuals visited the Forensic Clinic during the study period. 233 of them sustained one form of injury or the other. Limb injuries occurred in 88 (37.7%) of injured victims. Upper limb and lower limb injuries occurred in 71.6% (n = 63) and 18.2% (n = 16) respectively and 10.2% (n = 9) had injuries involving both upper and lower limbs. Male to female ration is 1.6:1. The commonest weapon of assault was knife 22.7% followed by wood 18.1% and teeth 16.0%. Workman\'s tools and bottle accounted for 13.6% and 11.4% respectively. The youngest victim was 15 years and the oldest 65 years. The modal age range of victims was 21 – 30 years 43.1% (n – 38) and mean age is 34.1 years. Laceration 44.3% (n – 39) was the commonest soft tissue injury seen and bone fracture was seen in 3.4% (n – 3) of cases. Most of the injuries occurred in business or work place 37.5% (N – 33), closely followed by attacks in the living quarters 36.4% (n – 32). The upper limb is a common site of injury during assault probably because most individuals would attempt to protect themselves using their hands. Weapons used in assault are those commonly found at the point of assault and active young people are easily involved.

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    BACTERIAL AIR MICROFLORA ISOLATES IN TWO OBSTETRICS AND GYNAECOLOGY UNITS OF A HOSPITAL IN NIGERIA ARE POTENTIAL THREATS OF NOSOCOMIAL INFECTIONS.

  • subjectCategory: Clinical Sciences
  • access_time26 November, 2016
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    Ever since the history of infirmaries, nosocomial infections have been of grave threats to hospital set-ups, the deadliest being nosocomial respiratory tract infection (RTI). Nosocomial RTI was consequently investigated in two units of Obstetrics and Gynaecology department of a hospital in Nigeria using the “Settling Plate” technique and various culture media for bacteria isolation. Identification of the isolates was done on the basis of each isolate\'s cultural, morphological and biochemical characteristics.  Six potentially pathogenic bacteria genera/species (Staphylococcus aureus, Streptococcus sp, Escherichia coli, Pseudomonas aeruginosa, Klebsiella sp and Bacillus sp) were isolated in the two units.  Staphylococcus was isolated in all (100%) of the exposed plates; Streptococcus sp and Bacillus sp. in 75% (6/8), Pseudomonas aeruginosa and Escherichia coli in 50% (4/8), and Klebsiella sp in only 25% (2/8). This work therefore indicated high degree of poor atmospheric sanitation in those units as well as strong indication of imminent threat of nosocomial respiratory tract infections. Routine sanitary surveillance and fumigation of the wards are advocated

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