bluuebunny/crossref_metadata_2025 huggingface dataset:
Domestic electricity usage estimation model using socio-economic factors
Authors: Ariyarathne Y. S. S. , Jayatissa N.  W. K. , Silva D. S. M. De
Published: June 2021

In this empirical study, socioeconomic factors that can easily be extracted from families have been used to build a "home electricity usage prediction" model based on two variables, family monthly income and family size. Each of these factors was evaluated individually. Two machine learning models were built using those factors as features. Models are based on “Linear regression” and “Random Forest” algorithms. This study revealed that the socioeconomic factors such as family size and family income are very effective in domestic electricity usage prediction model building, where the end usages are not known. Furthermore, the random forest algorithm was found to be more effective for unseen data than the linear regression algorithm. The accuracy of the models can be further improved by adding more data into the both models.
Measuring Customer Intrinsic Value, Brand Trust and Consumer-Brand Relationship in the Life Insurance Industry: Scale Development and Validation
Authors: Pushpakumara B. M. A. , Shamil Mohamed M. , Yatigammana M. R. K. N.
Published: June 2021

This is the first study to comprehensively explore, develop and validate a scale for customer intrinsic value, brand trust and consumer-brand relationship behavior for the life insurance industry in Sri Lanka. This task was realized through an extensive literature review and discussions with academic experts and practitioners in the insurance field. A factor analysis was performed using the principal component analysis with Varimax rotation. The refined scales exhibit reliability, convergent validity, discriminant validity and will be useful for future researchers and managers.
Tourism Amid Covid-19 Pandemic in Sri Lanka Way-Forwarding Strategies Through the Porters’ Diamond Model
Authors: Fernando Imali N.
Published: June 2021

Tourism has been emphasized as one of the main sources of foreign exchange for different economies in the world, whereas most of the developing countries recognized hospitality, Travel, and Tourism as an inspiring element for socio-economic prosperity. Within previous decades, tourism satisfaction or “choice for destinations” were gradually transformed towards different segments as a paradigm shift. The nature of tourism provides a pathway on socio-economic development, whereby entrepreneurship and venture creations, renewal of forgotten natural resources with new value addition, and diminishing the poverty line. Within this notion, COVID-19 Pandemic identified as a peripheral economic shock whereas distressing remarkably to the global economies contrarily by restricting human mobilization, entertainments, and events while negatively affecting the global economy. This paper adopts the Diamond model proposed by Porter by linking the vulnerability of the tourism industry in Sri Lanka during 1st-2nd waves of the pandemic. Research objectives were developed to identify the way-forwarding strategies on recovering the Tourism amid the COVID-19 pandemic, study sample had been derived by prioritizing the locked-down of the country by targeting key stakeholders, and data were qualitatively gathered. Within the light of the literature, each of the six facets has been identified as “Themes” and qualitatively discussed. As main findings, “situational forces” were emphasized as the most vibrant economic facet within the model, whereas the following main recommendations were proposed as way-forwarding strategies; (a) Safety, security, and political harmony of the country (b) Subsidies for tourism MSMEs and conducive environment for entrepreneurship. (c) Destination promotions / e-promotion platforms (d) Attracting foreign joint-ventures/ investments, (e) Healthy rivalry among the local firms and collective bargaining, (f) Prioritizing Spiritual, Health and wellness, Rural and Ayurveda tourism, (g) Popularizing Tea related Tourism through brand image of “Ceylon Tea”
Decision Making Styles of Sri Lankan Millennial: Are They Different?
Authors: Lakshika V. G. P. , Ahzan M. J. M. F.
Published: June 2021

At present consumer decision making is more complex and difficult but far more vitally in it is important than the past as the consumers today are thorough consumers. Therefore, consumer decision-making styles have become one of the most popular and interesting areas of research in the marketing and behavioral sciences of academia. Besides, in the modern marketing era, Millennial has become one of the major interesting research subject due to their unique characteristics. Therefore, the aim of this study is to develop a more rigorous understanding of the Sri Lankan millennial decision-making styles. The research philosophy of the current study is a positivist research paradigm and follows a deductive approach and survey strategy. Convenience sampling technique was used to draw the sample and the sample size was 385. The study extracted seven factors from the original Consumer Styles Inventory (CSI) scale through an exploratory factor analysis and found that Sri Lankan millennial has seven decision making styles namely Perfectionist Conscious, Habitual & Brand Loyal Conscious, Novelty Fashion Conscious, Brand Conscious, Hedonistic & Recreational Conscious, Confused by over choice and Impulsive Consumer. Further it revealed Price - conscious decision - making style did not appear among the Sri Lankan Millennial where Sri Lankan millennial are highly perfectionist conscious consumers. Based on the findings, study proposes several theoretical and practical implications along with direction for the future research.
Customers’ Role in Co-Creating Value at Self-Service Technologies: From Role Theory Perspective
Authors: Galdolage B. S.
Published: June 2021

Technological maturity brings both the organizations and customers into a digital era where organizations provide its service fully or partly through technological platforms, letting customers to perform by themselves without having direct interaction with the organization’s employees. This transforms customers’ role into more ‘active’ to be a collaborative value creator than be a passive recipient of the value produced by the organization. Organizations’ role also converts from ‘provider’ of the value to the ‘value facilitator’, who offer value prepositions for customers’ co-creation process. Though both the customers’ and business organizations’ roles have been changed in the current business context, the scholarly attention given to understand this transformation is very rare. In such a backdrop, this study aims at understanding customers’ role in co-creating value at SSTs using the foundations of the Role Theory. Centered on the positivistic approach, this research carried out a quantitative survey distributing self-administered questionnaires among 600 customers chosen based on non-probabilistic convenience sampling method. The study found significant positive impacts of ‘role script’, ‘role performance’ and ‘role set’, and insignificant effect of ‘role congruence’ on customer value co-creation in SSTs. The study theoretically contributes to enhancing the knowledge on customer value co-creation in self-service technologies from role theory perspective, while practically helps business organizations to understand customers’ role well and design SSTs which match with the customers’ expectations.
The Impact of Negative Brand Experience on Brand Avoidance with the Mediating Effect of Negative Emotions: Evidence from the Sri Lankan Mobile Telecommunication Sector
Authors: Amarasinghe D. P. , Jayasinghe J. A. S. C.
Published: June 2021

A knowledge gap existed in the light of available literature due to a lack of comprehensive understanding and conflicting viewpoints regarding negative brand experience and brand avoidance. This research aims to investigate the impact of negative brand experience on brand avoidance in the Sri Lankan mobile telecommunication industry. Further, it investigates the impact of negative brand experience on negative emotions, negative emotions on brand avoidance and examines the mediating effect of negative emotions in the relationship. This research is a positivistic study done using a questionnaire in selected urban areas based on a convenience sample of 120. A SEM model was used to analyze the data based on SPSS and Amos 23. The research bridges the theoretical gap that existed due to unawareness of simultaneous effects of negative brand experience and negative emotions on brand avoidance in the Sri Lankan context. Findings indicate that negative brand experience positively affects brand avoidance, while negative emotions also positively affect brand avoidance. Further, it realizes that negative brand experience has no significant effect on negative emotions. Finally, the research found that negative emotions have no mediating effect on the relationship between negative brand experience and brand avoidance.
Chronic diseases of lifestyle risk factor profiles of a South African rural community
Authors: Akindele Mukadas O, , Useh Ushotanefe
Published: June 2021

Globally, chronic diseases of lifestyle account for millions of dollars spent annually on health. These diseases share similar risk factors including: physical inactivity, obesity, cigarette smoking, and hypertension among others. This study sought to assess risk factors for chronic diseases of lifestyle of a rural community in South Africa. This study used a survey design with data randomly collected using the WHO STEPS Instrument for Chronic Disease Risk Factor Surveillance from participants who attended routine checks from February to October 2018 from a trained healthcare practitioner. Informed consent was sought from all participants before the administration of the instrument. The research setting was the community Primary Health Center. About 54.0% of participants presented with no family history of hypertension but 19.7% had a family history of type II diabetes mellitus. More women were found to be hypertensive, with the majority (93.4%) monitoring their blood pressure. The study revealed that more men were current smokers. A large number of participants were engaged in a sedentary lifestyle with about one-third of the participants reported being obese. Physical inactivity, sedentary lifestyle, and hypertension were among the lifestyle-related risk factors for chronic diseases among residents of this rural community.
Profiles of microorganisms isolated from neonates’ blood cultures, incubators, cradles, ventilators, washbasins, and health-workers of Libreville University Hospital Neonatal Service: focus on infection prevention and control measures
Authors: Kamgaing Eliane K. , Ndong Jean-Charles , Rerambiah Léonard K. , Siawaya Joel F.D.
Published: June 2021

Background: Nosocomial infection outbreaks in neonatal services are a serious healthcare concern in both developed and developing countries, but few studies have been conducted in sub-Saharan Africa.Objective: This study explored the etiology of septicemia in neonates and associated patterns of antimicrobial susceptibility in Gabon.Methods: We analyzed cultures from neonates’ blood and swabs from medical personnel and equipment located in the neonatology service.Results: Sixty-eight microorganisms were isolated from the medical personnel and equipment; 46 microorganisms were isolated from neonates’ blood culture. Klebsiella pneumoniae spp pneumoniae was the most common bacteria found in both (30.6% and 26.9%, respectively). All Klebsiella pneumoniae spp pneumonia isolates were resistant to amoxicillin with clavulanic acid, gentamycin resistance ranged from 93% to 100%, and cephalosporin resistance ranged from 33.3% to 47%.Conclusions: Awareness of the etiology, prevalence, and outcome of nosocomial infection is the first and most important step to appropriate interventions
Effectiveness of rotavirus vaccine in the prevention of diarrhoeal diseases among children under age five years in Kavango East and West Regions, Namibia
Authors: Magesa Emmanuel , Sankombo Marian , Nakakuwa Fillipine
Published: June 2021

Background: Diarrheal diseases due to rotavirus infection contribute greatly to morbidity and mortality rates of babies and young children in many developing countries. This public health concern can effectively be reduced by the use of the rotavirus vaccine, though there is an anecdotal evidence indicating that despite introduction of the vaccine the number of cases of diarrhoea diseases are still high in Namibia, particularly in Kavango east and west regions.Objective: This study evaluated the effectiveness of the rotavirus vaccine in preventing diarrhoea cases among children under age five years in Kavango regions.Methods: The study employed a quasiexperimental design comparing diarrhoea cases before (2010-2013) and after (2014- 2017) introduction of the rotavirus vaccine among children under age five years. Data were extracted from District Health Information System version 2 and analysed by using one way analysis of covariance.Results: Before introduction of the rotavirus vaccine, there were 14 500 diarrhoea cases, which is 1.6% rate of infection. After introduction of the rotavirus vaccine, there were 14 400 diarrhoea cases, which is 1.58% rate of infection. This is supported by the effect size (partial eta2) of 0.01%, which is very small. The trend of diarrhoea cases after rotavirus vaccine introduction fluctuated with no major decline of diarrhoea cases. Conclusions: The study concluded that rotavirus vaccine is less effective in preventing diarrhoea diseases among children under age five years in the Kavango regions. Further research is needed to substantiate these findings as other factors can contribute to fluctuation of diarrhoea cases.
Readiness of Nigerian Health-Care Workers to Work During COVID-19 Pandemic
Authors: Ogunkeyede Segun A. , Adeyemo Adebolajo A. , Ogundoyin Omowonuola A. , Oyelakin Oyeleye A. , Fawole Olumakinde B.
Published: June 2021

Introduction:

Health-care professionals of all cadres are the utmost valuable resource during pandemics and maintaining an adequate workforce of health professionals during an emergency is critical to ensure uninterrupted provision of services that are essential for patient care.

Aim:

Examine readiness of health-care workers (HCWs) to provide service in the course of the COVID-19 pandemic and the factors influencing their decision.

Methodology:

This was a cross-sectional study of Nigerian health sector workers HCWs in the course of the COVID-19 pandemic. The respondents were recruited using HCWs focus groups on WhatsApp and Telegram social medial platforms.

Results:

A total of 481 HCWs were recruited, consisting of 288 females and 193 males (M: F, 1:1.5), mean age = 30.71 ± 5.9 years. Most HCWs (97.3%) showed a willingness to provide service during the pandemic; 73.3% of the HCWs were willing to work if supplied with adequate personal protective equipment (PPE) although 5.8% were less willing to work without proper PPE. Factors supporting unwillingness to work during the pandemic were: concerns about the lack of adequate testing for COVID-19 (48.9%), lack of disability insurance plan (40.1%), fear of being infected (47.2%), and the risk of infection in family members (24.5%). The readiness to work was related to the job cadres of the HCWs (P = 0.001), while the provision of additional incentives and a change in the working conditions would influence the readiness of the HCWs to work.

Conclusion:

HCWs were ready to provide service in the course of the COVID-19 pandemic if there was a safe work environment, although the availability of PPE and other personal factors would influence their willingness to work, while improvement in working conditions would motivate HCWs to work.
Heavy Metal Content of Rice Meals Sold in a Nigerian Market Population with a High Prevalence of Hypertension
Authors: Anakwue Ralph C. , Nnakenyi Ifeyinwa Dorothy , Maduforo Aloysius N. , Young Ekenechukwu E. , Okoli Chijioke I. , Ndiokwelu Chika I. , Ezenduka Charles C.
Published: June 2021

Context:

Some market populations in Nigeria have been shown to have high prevalence of hypertension. Current evidence includes environmental pollutants such as heavy metals as risk factors for hypertension.

Aim:

To study the heavy metal content of rice meals sold in a market population with a high prevalence of hypertension.

Settings and Design:

This was a descriptive, cross-sectional study conducted in Ogbete market in Enugu, Southeast Nigeria.

Subjects and Methods:

Five different cooked rice meals were obtained from 25 locations of the market. The rice meals included jollof rice, white rice and tomato stew, fried rice, white rice and vegetable sauce, and white rice and palm oil stew (ofeakwu). Accompanying protein (meat, fish, and egg) and vegetable salad were excluded. Similar rice meals were homogenized and analyzed in triplicates using spectrophotometric methods for mercury, copper, cadmium, lead, and arsenic determination.

Statistical Analysis Used:

The mean concentrations of the heavy metals were compared using analysis of variance, and P < 0.05 was considered statistically significant.

Results:

Twenty-five rice dishes were evaluated, five of each kind. Arsenic content ranged from 503 to 550 mg/kg and was comparable across the five rice dishes (P = 0.148). Copper was significantly highest (16767 mg/kg) in the white rice and tomato stew dish (P < 0.001), while mercury was significantly highest (33 mg/kg) in white rice and ofeakwu (P < 0.001). Jollof rice had the highest cadmium content (23 mg/kg), which was statistically significant (P = 0.021). Lead was not found in any of the rice dishes.

Conclusions:

Risk factors such as heavy metals may play a role in the high prevalence of hypertension observed in market populations, and rice meals may be a major source of these heavy metals.
Magnesium Status in Patients with Type 2 Diabetes (about 170 cases)
Authors: Salhi Houda , El Ouahabi Hanan
Published: June 2021

Magnesium (Mg) is an extremely important mineral. It plays major roles in physiological activities of the body. Lower intake of Mg and low-serum Mg concentrations are associated with metabolic syndrome, insulin resistance, and Type-2 diabetes. Aim: The aim of the study is to evaluate the association between concentration levels of serum Mg and common complications and co morbidities of diabetes mellitus and other biochemical indices. It is a case control study conducted in our department of endocrinology in Hassan II University Hospital of Fez from January 2015 to 2018. Our patients were classified into two groups. Low Mg (Group 1, n = 85) and normal Mg group (Group 2, n = 85). We evaluated demographics characteristics of our patients; the association between Mg status and clinical, biological parameters; and association between Mg status and degenerative complications. Our study included 170 patients. The research results showed that serum Mg level was strongly related to age, sex, diabetes duration, body mass index, hypertension, and glycosylated hemoglobin. Concerning common complication; we only found a negative correlation between Mg level and the existence of nephropathy. We did not find significant correlation with retinopathy; neuropathy; and macroangiopathy. The study has demonstrated that a low Mg level is correlated with a poor control glycemic; high blood pressure and nephropathy in patients with Type 2 diabetes. However, more research is needed to confirm these effects.
Awareness and Practice of Cord Blood Donation by Pregnant Women in Lagos Nigeria
Authors: John-Olabode Sarah Oluwatayo , Okunade Kehinde S. , Ajie Iwuchukwu O. , Olorunfemi Gbenga , Oyedeji Olufemi A.
Published: June 2021

Background:

Poor awareness remains a substantial limitation to harnessing the benefits of umbilical cord blood (UCB) in sub-Saharan Africa. The aim of this study was to determine the level of awareness and factors influencing intention to donate cord blood to blood bank among antenatal clinic attendees at a tertiary hospital in Nigeria.

Methods:

We conducted a questionnaire-based cross-sectional study of 400 women attending the antenatal clinic of a tertiary hospital in Lagos, Nigeria, between February and June 2018. The data were analyzed using Stata version 13; comparisons were conducted with Chi-square, Student's t-test, and Mann–Whitney U-test. Univariable and multivariable binary logistic regression was conducted with “willingness to donate” as the outcome variable.

Results:

Majority (n = 287/331 [86.2%, 95% confidence interval [CI]: 76.4–84.9]) of the participants had some knowledge of UCB, almost half intended future donation of UCB (n = 161/333, [48.3%, 95% CI: 42.9–53.6]). Based on our findings, factors such as religion (P = 0.001), education (P = 0.03), information from health-care provider (P < 0.001) appear to influence awareness, and the decision to donate UCB.

Conclusion:

Although the awareness of the clinical uses of UCB is very limited in Nigeria, the intent to participate in UCB donation is high. Factors such as religion, education, and prior information about UCB donation by health-care providers have been identified in this study to have an influence on the decision to donate UCB.
Medical Students’ Contribution as a Refining Tool for the Conventional Educational System
Authors: Atia Omar Ahmed
Published: June 2021

One of the most important things that accentuate an institution's greater advancement is its pursuit of change. Student contribution has been advocated for by many well-standing universities and has proven a better approach and a more refined way of an exuberant advancement both academically and personally. This article highlights how such contribution can be administered using novel approaches while preserving the main guidelines for graduating not only health-care providers but also researchers and life-long learners. The new prospect of students as beneficial assets provides an educational institution with valuable creative ideas, eye sights that can detect points of possible reform in the educational system, and another significant voice to the making of future decisions. The faculty has successfully been able to apply certain characteristics-self-independence, new rational scope, practical and tutoring skills-to undergraduates through peer-to-peer learning technique, medical poster presentation skills, and case-based learning manner.
A Re-Evaluation of Ectopic Pregnancies in a Resource-Limited Setting
Authors: Duru Victor Chinazo , Izuka Emmanuel Obiora , Enebe Joseph Tochukwu , Iloghalu Emeka Ifeanyi , Ifezuoke Tochukwu Dickson , Nwagha Uchenna Ifeanyi
Published: June 2021

Context:

Ectopic pregnancy (EP) is a severe challenge in contemporary gynaecology, particularly in developing economies. Late presentation and diagnosis increase the associated morbidity and mortality. With the worldwide surge in incidence and varied presentation patterns, re-evaluation has become necessary. This study, therefore, aims at re-evaluating the risk factors and clinical patterns of EP cases in a tertiary health facility in a resource-limited setting.

Settings/Methods/Statistical Analysis:

All EP cases managed at the Teaching Hospital of the University of Nigeria (UNTH), Enugu, Nigeria, from January 1, 2008, to December 31, 2017, were retrospectively evaluated. The collected data was analyzed with the 23.0 edition of Statistical Package for the Social Sciences. Descriptive statistics was done for the qualitative variables. Cross-tabulation was done; the association levels were determined by Chi-square/Fisher's exact test and Student's t-test for the qualitative and quantitative variables. P = 0.05 was considered as the statistical significance level.

Results:

There were 6448 deliveries and 4129 gynaecological admissions. The mean age of the patients was 29 ± 3 years. Most (76.3%) of the participants (61) were multiparous, whereas only (2) 2.5% of the participants were grand-multiparous. The EP prevalence rate was 1.2% (80 out of 6448), and it constituted 1.9% (80 out of 4129) of all gynaecological admissions. All the patients presented with ruptured EP. The main presentation of EP among the participants was abdominal pain (69, [86.3%]), while the most presenting risk factor was a history of induced abortion (52, [65%]).

Conclusion:

We concluded that ectopic gestation remains a major gynaecological emergency in our environment. Most of our patients had ruptured EP, which could negatively impact our society, which places a high premium on childbearing.
Knowledge, Perception, and Consumption of Food Additives among Female Lecturers in Zaria, Nigeria
Authors: Ibrahim Muhammed Sani , Lawal Aminu , Umar Ahmed Ayuba , Asuke Sunday
Published: June 2021

Background:

Food additives are being utilized for both small- and large-scale food production but often find more applicability in mass food production. Food additive consumption over a long period could pose adverse health outcomes. The study determined knowledge, perception, and consumption of food additives among female lecturers in Zaria.

Methodology:

It was a cross-sectional study conducted among 180 full-time female lecturers of the three tertiary institutions, selected through a multistage sampling technique. Data were collected using a pretested self-administered questionnaire. The data were entered into IBM SPSS Statistics 20 and analyzed. Univariate analysis for categorical variables was done using simple proportions.

Results:

A total of 167 female lecturers responded giving a response rate of 92.8%. Their mean age was 42.7 ± 8.2 years. Majority (109, 65.3%) had good knowledge of food additives, less than half (77, 46.3%) had a good perception of them, and the overall consumption rate for food additives was 97.1%. Majority (77.8%) felt that the risks associated with food additives must never be ignored, about half (47.3%) felt that foods consumed by Nigerians were now generally more harmful. However, only about one-fifth felt that most fast foods do contain food additives (28.1%). Consumption rates were high for both natural and synthetic food additives (61.7%–92.2%), except for Ajinomoto and Vedan which were consumed by only 38 (22.8%).

Conclusion:

Knowledge of food additives was good, but their perception was poor and consumption was high. Stakeholders must begin to organize and sustain periodic sensitization campaigns on risks associated with the consumption of food additives. Futures studies should identify the reasons for poor perception and high level of consumption despite good knowledge among the study population.
Seroprevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Syphilis Infections among Pregnant Women Booked for Antenatal Care at Kogi State Specialist Hospital, Lokoja, Nigeria
Authors: Onuminya Dorcas Salime , Isabu Peter A. , Eifediyi Reuben , Eigbeifoh Joseph O. , Okogbo Felix O. , Sule-Odu Adewole O.
Published: June 2021

Background:

Sexually transmitted infections (STIs) among pregnant women are an important health issue in Nigeria, but its prevalence in Lokoja is not known.

Objective:

The objective of this study is to establish the seroprevalence of the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis infections among pregnant women booked for the antenatal clinic in Kogi State Specialist Hospital, Lokoja, Nigeria, and determine risk factors associated with the infections.

Methods:

We prospectively screened three hundred pregnant women booked for antenatal care between January 1, 2016, and December 31, 2016, for HIV, HBV, and syphilis. Their demographic data, risk factors, and results of the screening tests were analyzed using the SPSS version 20 and presented in simple charts, tables, and percentages.

Results:

Thirty nine (13%) out of the 300 pregnant women tested seropositive for either HIV (28, 9.3%), HBV (10, 3.3%), or syphilis (one, 0.3%). The most common identifiable risk factor for these infections was multiple sexual partners which accounted for 38.4%.

Conclusions:

The seroprevalence of STIs in this study was 13% and the most common risk factor for the infections was multiple sexual partners. Therefore, effective preventive strategies for HIV, HBV, and syphilis are advocated.
Pattern of Cancer in Bauchi
Authors: Adogu Ibrahim O. , Suleiman Dauda E , Malami Sani Abubakar , Aminu Muhammad Baffah , Muhammed Aminu Zakari
Published: June 2021

Context:

Cancer ranks second among the major causes of death globally. A projection by 2020 indicated that developing countries would account for about 70% of total cancer-related death worldwide. Despite the great threat posed by cancer to this region of the world, reliable statistics on the trends and patterns of cancer are rare.

Aims:

The aim of the study is to review the cases of cancer recorded in Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, from January 1, 2011 to December 31, 2019

Materials and Methods:

This is a retrospective, descriptive study. Nine years records of all pathologically diagnosed cancer cases in the ATBUTH, Bauchi were retrieved, reviewed, and grouped in accordance with the International Classification of Diseases for Oncology. The results were presented as simple frequency tables and charts.

Results:

A total of 1284 cancer cases were diagnosed during the period, an average of 142.7 cases per annum. There was a female predominance of cancer cases (male: female ratio - 1:1.53. The age range was from seven months to 95 years, with mean and median ages of 49.6 and 50 years, respectively. More than half of the cases were reported in the fifth to seventh decades of life. Prostate (14.6%) and non melanoma skin cancer (11.2%) were the most common cancers seen in males. In females, cancers of the cervix (37.9%) and the breast (22.9%) were the most common.

Conclusions:

Breast cancer and cancer of the uterine cervix were the most common cancers in women in this review while prostate cancer was the most common cancer in men. The need to establish a hospital-based and/or population-based cancer registry that will generate reliable cancer data in our environment cannot be overemphasized.
Clinical Characteristics of COVID-19 in a Tertiary Health Facility in Northeast Nigeria
Authors: Denue Ballah Akawu , Ngamariju Sepu , Abdul Habu , Musa Abubakar Mohammad
Published: June 2021

Aim:

The coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (severe acute respiratory syndrome coronavirus-2), has a varied clinical manifestation. We evaluated the clinical features of COVID-19 in symptomatic patients that presented for care at a Federal Medical Centre Nguru, Northeast Nigeria.

Methodology:

In this retrospective cohort study, we reviewed and analyzed relevant information abstracted from the medical records of symptomatic COVID-19 patients that were managed from March 14 to October 14, 2020, in the facility.

Results:

Clinical records of 55 symptomatic COVID-19 patients were evaluated in this study. Their mean age was 49.1 ± 16.3 (females 51.4 ± 15.6, males 48.5 ± 17.2, P = 0.601) with females constituting 47.2% of the studied patients. Fever (87.3%), cough (67.3%), sore throat (49.1%) and rhinorrhea (41.8%) were the most common clinical feature. Other features included difficulty in breathing (25.5%) and ageusia (14.6%). Gastrointestinal symptoms such as diarrhea, vomiting and abdominal pain were seen in 10.9%, 18.2%, and 9.1%, respectively. Twenty-one (38.2%) patients had a preexisting health condition. Chronic kidney disease was the most common; it was seen in 34% of patients, other common conditions included hypertensive heart disease (24%), and diabetes mellitus (16%).

Conclusion:

Respiratory symptoms are the most common presentation of COVID-19 in our setting. However, some patients also presented with additional extrapulmonary symptoms. A significant proportion, 38.2% of symptomatic COVID-19 patients, had preexisting health conditions.
Assessing Performance of Resident Doctors in Training in Northwestern Nigeria
Authors: Umar Shehu Salihu , Babandi Zaharadeen Shuaibu , Suleiman Auwal Garba , Umar Umar Muhammad , Olorukooba Abdulhakeem Abayomi , Ahmad Aisha Jamila , Muhammad Bilqis Olajumoke , Umar Abubakar Ibrahim , Ahmad Adam , Obazenu Lawson O.
Published: June 2021

Background:

Residency training is a postgraduate medical education where graduate doctors are mentored toward becoming independent specialists. In Nigeria currently, the Medical Residency Training Act (MRTA) 2017 guides residency training under the regulation of three postgraduate medical colleges: the National Postgraduate Medical College of Nigeria (NPMCN), West African College of Surgeons (WACS), and West African College of Physicians (WACP). For the respective colleges, resident doctors are expected to attempt Part One and Part Two fellowship examinations after completing their junior and senior residency training, respectively, within stipulated durations.

Objectives:

The aim of this study is to assess resident doctors' performance in training and predictive factors.

Methodology:

Electronic questionnaires was distributed to respondents through their contacts or emails. Data was collected within a period of one month, from July 10 to August 6, 2020. Data was analyzed using mean, standard deviation, simple tables as well as t-test and Chi-square test. The level of significance was set at 0.05 for decision purposes.

Results:

A total of 120 participants were involved in the study. The mean age of respondents was 38.0 ± 3.8 years, with a majority of 88 (83.3%) males and 107 (89.2%) married. On the first attempt, 48 (65.8%), 37 (60.6%), and 15 (57.7%) respondents were successful in NPMCN, WACS, and WACP Part One fellowship examinations, respectively. There was no significant difference in the success in Part One between the three postgraduate medical colleges. There was significant difference in the duration between the first attempt and success in Part One examinations for the three colleges, respectively (NPMCN – P = 0.001, WACS – P < 0.001, WACP – P = 0.036).

Conclusion:

There was a comparable success in Part One fellowship examination between the three postgraduate medical colleges, with over half of respondents recording success in their first attempt. However, there were significant delays between the first attempt and success in Part One examination for the three postgraduate medical colleges.
Antiretroviral Therapy-Related Problems among Human Immunodeficiency Virus-Infected Patients
Authors: Busari Abdulwasiu Adeniyi , Oshikoya Kazeem A. , Akinwumi Adeyinka F. , Usman Sikiru O. , Badru Wasiu A. , Olusanya Adedunni W. , Oreagba Ibrahim A. , Olayemi Sunday O.
Published: June 2021

Background:

There are problems associated with antiretroviral therapy despite its achievement. Poor medication adherence and inability to tolerate large pill burden are major problems facing patients with chronic illnesses. These drug therapy problems are under-studied among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Nigeria. We evaluated adherence and pill burden among this set of patients in a tertiary hospital in Lagos.

Methods:

Data for eligible HIV-infected adults were documented from case notes and through interviews using a well-structured questionnaire. Important details extracted were sociodemographics, pills information, and CD4 counts. The main outcome measures were drug adherence, as assessed by the four-item Morisky Medication Adherence Scale and pill burden, as measured by daily pill >5.

Results:

Of the 296 patients, 219 (74%) were females. Median age (interquartile range) was 40 (35.0–47.7) years. Majority (262; 88.5%) were married, had at least a secondary education (142:48.0%), and CD4 count >500 cells/ml (215; 72.6%). Pill burden >5 pills/day was observed in 12.2% of the patients, while adherence was documented for 83.4% of the patients. Majority (259; 87.5%) were receiving fixed-dose combination of antiretroviral drugs. Forgetfulness (16.5%) and being too busy to take pills (10.5%) were the most common reasons for nonadherence. Pill burden in those who were not receiving fixed-dose combination was significantly associated with medication nonadherence. However, only pill burden was found to be an independent prognosticator of non-adherance. (Odd ratio = 0.67, confidence interval = 0.03–1.66, P < 0.00).

Conclusion:

Medication nonadherence and pill burden were observed in more than one-tenth of patients. These were the two major antiretroviral therapy-related problems reported in this study.
The Use of Unripe Pawpaw for Wound Bed Preparation Following Radiation-Induced Sacral Ulcer
Authors: Nwankwo Ezekiel Uchechukwu , Maduba Charles Chidiebele , Modekwe Victor Ifeanyichukwu , Nnadozie Ugochukwu Uzodimma
Published: June 2021

Radiation wounds are very difficult to manage due to poor vascular status, excessive matrix metalloproteinases, and abnormal myofibroblast function. Such wound beds do not adequately support conventional resurfacing as do nonradiate beds. We present a 46-year-old female with a sacral radiation ulcer, which had earlier failed to support flap cover on two instances after bed preparation with conventional honey dressing and negative pressure dressing, but was subsequently successfully managed with unripe pawpaw wound bed preparation. A re-elevation of the right gluteal myocutaneous flap proved successful and satisfactory. The finding may have resulted from both enzymatic properties of unripe pawpaw and its ability to break the biofilms and to locally supply the ascorbic acid necessary for collagen synthesis and granulation tissue formation.
Self-monitoring of Blood Glucose can be Misleading Without Periodic Re-Calibration of Glucose Meters
Authors: Inaku Kenneth Ogar , Eyam Eyam Sunday , Emin Emin Johnson , Onuche Onuche Lawrence
Published: June 2021

Introduction

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Background:

Diabetes mellitus is highly prevalent in both developed and developing countries today affecting about 429 million adults globally and is expected to rise by 147% to 629 million in 2045. Effective management of diabetes mellitus requires the periodic measurement of fasting plasma glucose. Self-monitoring blood glucose has been used to achieve this for over three decades now. This study, therefore, assesses the performance of three blood glucose meters used by patients with diabetes in our environment.

Materials and Methods:

This study adopted a comparative analytical prospective design that involved three of the frequently used glucose meters in our environment namely RUBY®, ONCALL®, and FINETEST®. Glucose calibrators of increasing concentrations from 40 mg/dL to 200 mg/dL were prepared from a freshly constituted 1800 mg/dl stock solution of glucose. Sera obtained from five patients were assayed along with control sera using a routine laboratory method (glucose oxidase [GOX]) for standardization and the three glucose meters simultaneously and the results were compared for statistical differences on Microsoft Excel using means and standard deviation. P ≤ 0.05 was set as a level of significance.

Results:

The mean glucose values of calibrators (120 ± 63.3) were statistically significantly different from the mean glucose values of the RUBY (139.6 ± 80.9), (P = 0.0118) and the ONCALL (188.8 ± 82.1), (P ≤ 0.0001) glucose meters, respectively. The percentage increase in blood glucose estimation by the RUBY and ONCALL devices was 115.8% and 157.3% respectively. The FINETEST glucose meter overestimated glucose by 232.0% higher than the laboratory GOX method even though there was no statistical significance (P = 0.062) between the two means. The percentage imprecision for the different glucose meters was: RUBY 9.5%, FINETEST 14.8%, and ONCALL 18.2%.

Conclusion:

Quality control should be used routinely in the use of point of care testing glucose measurements and devices should be sent to the central laboratory periodically for recalibration to avoid mismanagement of diabetic patients on hypoglycaemic drugs.
Primary Empty Sella Syndrome Presenting with Profound Bilateral Visual Loss
Authors: Ezeh Ernest Ikechukwu , Akotanchi Besong-Ngem , Ezeh Roseline Nkeiruka
Published: June 2021

Primary empty sella syndrome (PESS) on background idiopathic intracranial hypertension (IIH) presenting with profound bilateral visual loss is a rare clinical occurrence. We report the case of PESS on background IIH in a 37-year-old obese Nigerian female. At presentation, she had a history of an insidious onset of loss of vision in both eyes with an associated history of headaches and tinnitus. Clinical examination and imaging studies revealed papilloedema and empty sella with a completely flattened pituitary gland. This report highlights that PESS could initially present to an ophthalmologist as a case of profound bilateral visual loss.
Obesity as a Risk Factor for Age-Related Cataract in a Nigerian Population
Authors: Muhammad Rilwan Chiroma , Kalambe Aisha Sheriff , Imam Abubakar
Published: June 2021

Purpose:

The purpose of the study was to investigate the relationship between obesity and age-related cataract in a Nigerian Population.

Materials and Methods:

Ninety adult patients aged between 45 and 65 years with age-related cataract were matched with ninety adult patients aged between 45and 65 years without cataract based on age and gender. Pretested interviewer-administered questionnaires were used to obtain information on demographics, educational levels, and occupation. Cataract was evaluated using a modified World Health Organization grading system. Body mass index (BMI) was categorized into four groups (underweight: BMI 15–19.9; normal weight: BMI 20–24.9; overweight: BMI 25–29.9; and obese: BMI >30). The association between degree and type of cataract and obesity was evaluated. Data was analyzed using IBM SPSS version 21. Confidence intervals of 95% and P < 0.005 were considered statistically significant.

Results:

Female participants had significantly higher mean BMI than males (27.56 ± 6.33 vs. 24.95 ± 4.35 P = 0.002). There was however no statistically significant difference noted in mean BMI based on the age groups or the levels of education. There was no statistically significant difference in BMI between participants with and without cataract (26.16 ± 5.87 vs. 27.56 ± 6.33, P = 0.824) regardless of the type and grade of cataract.

Conclusion:

The study showed a lack of association between obesity and cataract, further studies are required to explore causality.
Containing COVID-19 in Nigeria
Authors: Azuogu Benedict Ndubueze , Onah Cosmas Kenan , Ogah Emeka Onwe , Utulor Chinweoke Alfred , Iyare Osarhiemen , Adeke Azuka Stephen , Ebere Nkechi Elizabeth , Ewah Richard , Nnadozie Ugochukwu Uzodimma , Ogbonnaya Lawrence Ulu
Published: June 2021

Introduction:

The outbreak of coronavirus disease 2019 (COVID-19) in Nigeria prompted decision-making at the various levels of governance. Ebonyi State Government in South-east Nigeria closed her borders with neighboring states as a preventive measure for the spread of the pandemic. This study was an assessment of the effectiveness and challenges of border closure and surveillance activities in controlling the dispersion of the disease across states.

Materials and Methods:

The five major borders of Ebonyi State with her neighboring States of Enugu, Cross River, and Abia were visited. Information was collected about movement restrictions and surveillance at the borders using an observation checklist and key informant interviews. Data collected were analyzed using IBM-SPSS and thematic interpretation.

Results:

Commuters on essential duty were enforced to wear face masks, perform hand hygiene, and undergo screening for the symptoms of COVID-19 before entering the State. All the first 13 COVID-19 confirmed persons in the State were from those picked up as suspected cases by surveillance at the State borders. People who travelled hundreds of kilometers across several States were stopped from entering Ebonyi State. However, movement restriction at the borders was undermined by some security personnel who were bribed by commuters to allow them crossover during night hours.

Conclusion:

The lockdown and surveillance activities at the borders were effective in controlling the spread of COVID-19, but alternative routes of entry and corrupt act during odd hours constituted serious risks. Uniformity of movement restriction across all the states borders with vigilante groups manning inter-community boundaries may control the disease spread across regions.
Coverage of Cancer News in Pakistani Print Media
Authors: Mahesar Rameez Ali , Pasha Yasira Naeem , Pathan Mubina , Khan Mariam Israr
Published: June 2021

Background:

Newspaper coverage is a key source of cancer information. Although it was of profound significance to understand how the local newspapers of Pakistan cover the cancer news.

Aims and Objectives:

To counter this, the present study was aimed to examine the cancer news coverage of the last year 2020.

Materials and Methods:

Using content analysis technique, the whole year coverage in daily Pehnji Akhbar was investigated to determine which topic and the type of cancer were most frequently mentioned in the news, and what was the locality the cancer news was most frequently reported from. Results: In total, 90 cancer-related news were generated, out of which 7.5% of news were found as an average in each month during the whole year of 2020. Death was the topic of the majority (90%) of the news (contributing to 74% male deaths and 15% female deaths). However, blood, liver, throat, and mouth cancers were the most frequently mentioned-types in the news related to male victims. In terms of localities, the rural areas were the highest contributors of the 57 cancer news (contributing to 48% male victims and 14% female victims).

Conclusion:

It was found that cancer is increasing at an alarming rate in the rural areas of Sindh.

Recommendations:

Keeping in view the significance of the newspapers, it would help proffer the public with adequate information on cancer by increasing the mentions of particular types of common cancer. Also, it would be beneficial if the newspapers consider relating the news to the profiles of the victims.
Difficult lung separation. An insight into the challenges faced during COVID-19 pandemic
Authors: Khidr Alaa M. , El Tahan Mohamed R.
Published: June 2021

Difficult lung isolation or separation in patients undergoing thoracic surgery using one-lung ventilation might be attributed to upper airway difficulty or abnormal anatomy of the lower airway. Additionally, adequate deflation of the surgical lung can impair surgical exposure. The coronavirus disease 2019 (COVID-19) has a harmful consequence for both patients and anesthesiologists. Management of patients with difficult lung isolation can be challenging during the COVID-19 pandemic. Careful planning and preparation, preoperative routine testing, protective personal equipment, standard safety measures, proper preoxygenation, and individualize the patients care are required for successful lung separation. A systematic approach for management of difficult lung separation is centered around securing the airway and providing adequate ventilation using either a blocker or double-lumen tube. Several measures are described to expedite lung collapse.