bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Pattern and Outcome of Management of Acquired Anorectal fistulas in Children at a semi-urban Teaching Hospital
Authors: Olori Samson , Osagie Olabisi O. 
Published: November 2022

Background: Acquired anorectal fistulas are a severe cause for parental concerns, and they pose considerable challenges in their management.
Aim: The aim of this study is to document the pattern of presentation and the management outcome for the cases of acquired anorectal fistula in children seen in our centre.
Method: A retrospective review of the thirteen (13) case notes of the patients with acquired anorectal fistulas managed from 2008-2011 was done. The information retrieved included; the age at presentation, sex, aetiology of the fistula, site of the fistula, the duration of the fistula to the presentation, weight loss, and other associated medical conditions, history of a developmental milestone, type of intervention, the outcome of management, HIV status of patients and parents.
Results: There were two males and eleven females; eight of whom were HIV positive. Five fistulas were due to each to faecal impaction, birth trauma, trauma from rectal enema procedure, iatrogenic following posterior sagittal ano-rectoplasty (PSARP) and sexual abuse respectively.
Conclusion: The fistula healing outcome for acquired anorectal fistula in HIV positive cases was weak compared to the trauma-related groups.
Prevalence of Tuberculosis among bedside contacts of Smear Positive Tuberculosis Patients at The University Teaching Hospital, Lusaka, Zambia
Authors: Lungu Patrick Saili , Chanda Duncan , Chongwe Gershom , Lakhi Shabir 
Published: November 2022

background
Screening of contacts of TB patients is not routinely done in resource-limited countries like Zambia despite WHO recommendations, leading to missed opportunities for prevention, early diagnosis and high mortality.
OBJECTIVES
Main objective was to establish the prevalence of latent and active tuberculosis in bedside contacts of smear-positive index patients and associated risk factors.
METHODS
We recruited bedside contacts of smear-positive TB patients in medical wards and contacts of surgical patients as a comparison group using a questionnaire to collect data on various variables. Active TB was diagnosed microbiologically and radiologically, while LTBI by TST.
RESULTS
We had 64 TB-unexposed and 70 TB-exposed, with a mean age of 41.2 [±13.5] years and 40.2 [±14.7] years respectively. Prevalence of active TB in the two groups was 10.0% and 0% respectively while that of LTBI was 83.1% and 38.3% respectively. TB exposure was significantly associated with active TB (p=0.014), LTBI (p<0.001) and type of contact (p<0.001)] but not duration of exposure (p=0.057).
CONCLUSION
Bedside contacts were at increased risk of contracting both latent and active TB. Given the significant burden of LTBI in the general population without documented TB exposure, there is an urgent to institute preventive measures to protect/treat contacts of TB patients.
Mental Health and Healthcare Provision in Zambian Correctional Facilities
Authors: Chinyama Jonathan , Menon Anitha J 
Published: November 2022

Objective: The aim was to determine the prevalence of Axis- I disorders, mental health problems and mental health care service provisions in Zambian correctional facilities
Study sample: 240 inmates were interviewed using the Mini International Neuro-psychiatric interview (MINI), the Warwick-Edinburgh Mental Well-being scale (WEMWBS) and demographic questionnaire
Research Design: This was a cross-section point prevalence
Control or comparison condition: Inmates were statistically compared to each other based on the correctional facility security levels.
Results: The prevalence for current Axis- I disorders was 46.2%. Combined (current and past) prevalence was 63.3%. Major depressive episode current was the most prevalent 47 (19.6%), Psychotic disorder current 38 (15.8%), Psychotic disorder lifetime 18 (7.5%), Major depressive episode past 17 (7%), substance dependency current and Posttraumatic disorder at 14 (5.8%), Manic episode current 5 (2.1%) and the rest below 2% respectively. Total number of inmates with suicide risks was 49 out of 240 (20.4%). Out of 49, 20 (40.8%) had high- risk suicidality levels, 8(16.3%) had moderate suicidality risk- levels and 21(42.9%) had low suicidality risk- levels. Medium had the highest prevalence rate of inmates at risk of suicide 31(63.3%). Out of 31, 17(54.8%) had low risk, 6(19.4%) moderate and 8(25.8%) high-risk levels respectively. The second highest was maximum 18(20%): out of 18, 4 (22.2%) had low risk, 2(11.1%) had moderate and 12(66.7%) high- risk levels. Maximum had the highest number of inmates who were found with high-risk 12(66.7%) of suicidal ideations and attempts followed by medium 8 (25.8%) and minimum did not register any inmates with suicide risks. There was a positive and significant relationship between suicidality risk levels and the type of correctional facility. Inmates in maximum correctional facility were more likely to have suicidal ideations and attempts than their counterparts in both.
There was high current substance dependency in medium correctional facility with 11% distribution compared to maximum correctional facility 3%. Current substance abuse was 2% for both maximum and medium respectively. Only 1% in medium had current alcohol abuse and dependency. The prevalence of substance abuse represents the count of substance abuse and not the number of inmates because some inmates abused one or more substances.
Mental Well-being
Minimum (50.7) ,Medium (63.2) and Maximum (37.4) respectively
Conclusion: Socio-epidemiological assessment found a high prevalence of Axis- I disorders and mental health problems compared to the general population. The low prevalence of substance abuse was largely due to the inmates’ limited access to substance in the correctional facilities. There was total absence of mental health care services in all the three correctional facilities.
Psychosocial Impact of Dental Aesthetics among Secondary School Students in Birnin Kebbi, Northern Nigeria:
Authors: Kanmodi Kehinde Kazeem , Nwafor Njideka Jacob , Iyadi Linda Ekele , Amoo Babatunde Abiodun , Eddah Kelechi Israel , Omoleke Semeeh Akinwale 
Published: November 2022

Introduction: Dental aesthetics is a major determinant of good psychosocial well-being. Individuals with good dental aesthetic appearance tend to enjoy better social interactions and quality of life than those with poor dental aesthetic appearance. This study aims to assess the psychosocial impact of dental aesthetics among secondary school students in Birnin Kebbi metropolis, Kebbi State, Northern Nigeria.
Material and Methods: This study was a questionnaire-based cross-sectional survey of 692 students attending Army Day Boys Secondary School (ADBSS) and Army Day Girls Secondary School (ADGSS), Birnin Kebbi. Data collected was analysed using SPSS version 20 software.
Results: The majority (75.4%) of the 692 respondents were within the age range of 15 – 19 years of age, 50.7% were in SS 1 class, and 53.7% were females. The majority (>82%) of the respondents were confident about the appearance of their dentition, roughly half of the respondents were negatively impacted, socially, by the appearance of their dentition. There exists a statistically significant relationship between respondents’ gender and: psychosocial self-perception of their dental aesthetics (p-values<0.05); and concerns about their dental aesthetics (p-values<0.05).
Conclusion: This study concluded that many of the surveyed northern Nigeria secondary school students were not convenient with their current dental aesthetic appearances. Appropriate counselling, public health, and clinical intervention programmes may go a very long way in minimizing the negative impact of dental aesthetics-associated psychosocial problems among this population group.
Incorporating “ICT” Training into Undergraduate Medical Curriculum:
Authors: Kanmodi Kehinde Kazeem , Evbuomwan Oghosa , Nwafor Njideka Jacob , Omoruyi Emma , Buowari Dabota Yvonne 
Published: November 2022

Background: The huge relevance of Information and Communications Technology (ICT) in healthcare cannot be overemphasized. Despite the huge benefits associated with the use of ICT in healthcare, many medical schools (especially in the developing countries) are yet to incorporate ICT education as an academic course in their school curricula. This study aims to assess the opinions of medical students on the incorporation of ICT as an academic course into undergraduate medical curriculum.

Material and Methods: This study was a cross-sectional online survey of 135 medical students. Study data was collected using an e-questionnaire which explored the participants’: level of academic exposure to ICT education, usage of digital health products, perception of the relevance of digital technologies in healthcare, and opinions on the incorporation of ICT into undergraduate medical curriculum. Collected data was analyzed using SPSS version 23 software.

Results: Majority of the respondents were from developing countries (95.6%), 71.1% were 21 – 25 years old, 63.7% were females, and 47.4% were final year students. Not up to one-third (28.1%) of them had ever taken a course (or obtained a degree) that is related to ICT, 5.9% did not consider digital health technologies to be of relevance to healthcare, 91.1% were of the opinion that the future of healthcare is digital, 87.4% were enthusiastic about using and/or promoting digital health strategies, and 94.8% were of the opinion that medical schools should have ICT courses in their curriculum. However, there exists no statistically significant difference between the opinions of the respondents on the incorporation of ICT into medical curriculum and their: gender, age, country of residence, location of school, and academic level (p-values>0.05).

Conclusion: This study showed that the surveyed medical students’ opinions favored the incorporation of ICT as an academic course into the medical school curriculum.
Interventional Treatment of Symptomatic Uterine Fibroid by Uterine Artery Embolisation at the University Teaching Hospital in Lusaka, Zambia
Authors: Yiqiang Liu , Sunkutu-Sichizya Veronica Kangwa , Huimin Fu , Nteeni Mutinta Siachami 
Published: November 2022

Abstract
Purpose: To investigate the clinical effect of interventional therapy for symptomatic uterine fibroid by transcatheter uterine artery embolization.
Methods: 16 patients of symptomatic uterine fibroids were treated with selective uterine artery embolization, and the relief of symptoms and reduction of fibroids were observed.
Results: Bilateral uterine artery embolization was done in 16 patients. Follow-up for 5 ~ 7 months showed that the clinical symptoms of 14 patients were obviously improved, and the reexamination of 1 patient of a super large myoma showed no obvious change after 6 months. B-Ultrasound showed that the size of the tumor was reduced by 43% ~ 92%. The major complication was being is postoperative lower abdominal pain.
Conclusion: Uterine artery embolization is a safe and effective method to treat uterine fibroid.
Feasibility and Safety of Prosthetic Implants for Inguinal Hernia Repair in a Nigerian Tertiary Hospital
Authors: Ogbuanya Aloysius Ugwu-Olisa , Olisa Dr Fabian Ugonna , Oguonu Dr Amobi , Ugwu Nonyelum Benedett 
Published: November 2022

Background: Worldwide, inguinal hernia repair is the commonest surgical procedure in general surgery, but the optimal repair technique for inguinal hernia has not been defined and accepted in most parts of Africa and other developing nations. The aim of this study was to determine the epidemiology of inguinal hernias and feasibility of mesh implants in our centre.
Methodology: This was a descriptive cross-sectional study of consecutive adult patients with uncomplicated inguinal hernias who received polypropylene mesh for repair of their inguinal hernias. Selection criteria included inguinoscrotal/inguinolabial hernia, recurrent or bilateral hernia or bubunoceles with wide defects. Descriptive statistics and tests of significance were done.
Results: Inguinal hernia represented 77.3% of all abdominal wall hernias encountered during the study. However, only 27.8% (100 patients) of the 360 patients that satisfied the inclusion criteria received mesh implants. Of the 100 patients studied, 31% had recurrent hernias, 48% harbored complete inguinoscrotal/inguinolabial hernia while 13% had incomplete inguinoscrotal hernia. Majority (86%) had unilateral hernia.The annual repair rates using mesh implants increased progressively from 4% in 2013 to 40% in 2017. A quarter (25%) had comorbidities. Majority (60%) of repairs were under general anesthesia. The overall postoperative complication rate was 14%. Wound infection rate was 3.5%. There was statistically significant difference in the rates of wound-related events between recurrent and primary inguinal hernias (p=0.000). There was no mortality or recurrence recorded in this study.
Conclusion: The uptake of mesh implants for inguinal hernia repair in our environment is low, though the trend is changing with higher proportions of patients accepting mesh implants in recent time. Elective inguinal hernia surgery with polypropylene mesh is feasible, safe, effective and reproducible in our setting.
Medical School Admissions: A Review of Global Practices, Predictive Validity, and Practice Points for Africa.
Authors: Ezeala Christian Chinyere , Ezeala Mercy Okwudili , Shaikh Vaseem , Akapelwa Tumelo M , Phiri Sam Beza , Kamvuma Kingsley , Mulemena John A , Mushabati Festus , Chanda Warren , Sijumbila Gibson 
Published: November 2022

Background: Processes for selection of candidates into medical schools vary globally. Knowledge of the predictive validity of a selection method is important for policy revision.
Aim: To survey the practices used by medical schools to select students and their predictive validity.
Methods: Search terms developed from the research problem were used to search Google Scholar, PubMed, and Educational Resources Information Centre (ERIC). These were “medical school,” “predictive validity,” “success,” “academic achievement” “admission criteria,” and “student selection.” Retrieved articles were screened for relevance and sorted according to countries of publication. Authors narratively reviewed the articles from each country and collated the findings. Best practices were recommended for African-based medical schools.
Results: Articles retrieved from 14 countries were included in the review. USA, Canada, UK, Australia, and New Zealand operate centralized medical school admission programs and administer nation-wide admission tests. These tests cover cognitive and non-cognitive domains. The validity of these tests in predicting medical school success were extensively studied and reported. Other countries do not operate centralized medical school admission programs. Most of these rely on cognitive excellence to select students. Few reports are available on the validity of selection practices in Africa. Most rely on cognitive excellence which highly predicted academic success during preclinical studies. Predictivity decreased during clinical phases and non-cognitive variables became better predictors of success.
Conclusion: Medical school admission processes should consider cognitive and non-cognitive factors. With non-cognitive factors, candidates with right attitudes are selected. African countries should align their practices to that of Western countries.
The practice of clinical social work in Namibia
Authors: Chipare Mwakanyadzeni Abigail , Mupazvihwo Tracy , Tapera Roy , January James 
Published: November 2022

Clinical social workers are essential in the provision of mental health services for the prevention, diagnosis, and treatment of mental disorders in the community. They have a crucial role in improving and maintaining the mental health functioning of individuals. The extent to which clinical social work services are used in Namibia is poorly understood. This paper examines the evolution and practice of clinical social work in Namibia based on review of documentary evidence. Results indicated that there is a great need for clinical social work services in Namibia as the field is relatively unknown with most social workers doing general social work duties. Challenges and solutions are discussed.
Tobacco smoking prevalent in Zambian males: Observations from the Zambia Demographic Health Survey 2013-2014.
Authors: Nalule Flavia Muyinza , Michelo Charles Cheembo , Olowski Pawel 
Published: November 2022

Introduction: Tobacco smoking is one of the biggest public health threats causing poverty, several illnesses and death. Previous studies found that the lower the education, the higher the risk of smoking. This study assessed the association between education attainment and smoking among participants of the Zambia Demographic Health Survey 2013-2014. Methodology: This was a population-based cross-sectional study. Secondary data was extracted from existing Zambia Demographic Health Survey 2013- 2014 data sets, from ten provinces in comparison with different variables to constitute a resultant data set which this study used. All successfully interviewed male and female participants who answered the question, “Do you currently smoke cigarettes?” or “Do you currently smoke or use any other type of tobacco?” were included. The data extraction form was used to extract values of dependent and independent variables and imported into statistical analysis tool Stata version 13. Descriptive statistics of individual characteristics, testing for associations using the Pearson’s Chi Square test and logistic regression were performed. Results: Overall there were 14773 men and 16411women with mean age of 15-19. Smoking prevalence was 9.9% overall and 20.4% in men, but 0.5% in women. The incidence of tobacco smoking is steadily increasing with increase in age among both men and women. There was a significant increase in the incidence of smoking between 20-24 and 25-29 particularly in male smokers. Higher socioeconomic status seems to have a protective effect, consequently smoking remains highest among poor individuals and lowest among the rich. Higher education groups had a decreased likelihood to smoke with an odds ratio of 0.5 overall, 0.2 in men and 0.1 in women. Conclusions: We report high and unchanging prevalence of smoking predominantly concentrated in rural adult populations with lower education attainment. This suggests past health promotion efforts that targeted whole population may not have been relevant to the most affected groups. This therefore calls for reshaping health promotion messages to target specific populations and settings with highest burden. Furthermore, this calls for additional explorative studies in order to examine reasons for smoking in lower educated groups including exploring how what has worked in reducing smoking in higher educated groups could be extrapolated to most affected low educated and rural populations.
Intussusception in Children treated on the basis of clinical features: A prospective observational study from Enugu State, Nigeria
Authors: Chukwubuike Kevin Emeka 
Published: November 2022

Objective: Intussusception causes intestinal obstruction more commonly in infants and the symptomatology of intussusception plays a significant role in the management of the patients. The objective of this study was to evaluate of the reliability of the patients’ clinical features for surgical decision making when ultrasound is not available. Materials and Methods: This was a prospective observational study of children aged 15 years and below who had laparotomy for intussusception without preoperative ultrasound confirmation of intussusception (group A) from June 2017 to May 2018. The second group of children (group B) was children who had laparotomy for intussusception with ultrasound confirmation in the preceding year. Group A and group B were compared to determine the reliability of the clinical features in surgical decision making. Consecutive children who presented during the study period were recruited after getting consent from the parents and the study was carried out at a pediatric surgery unit of tertiary hospital in Enugu, Nigeria. Results: There were 32 patients in group A and 30 patients in group B. There were no significant difference in the patients’ demographic profiles, presenting symptoms, operative procedures, post-operative complications and mortality of the 2 groups of patients. However, when compared with group A patients, there were more negative laparotomies in group B patients (3.1% versus 16.7%) which was statistically significant (p=.0.023), at 95% confidence interval. Conclusion: Clinical features of intussusception in children can be relied on for surgical decision making.
Evolution of spontaneous dissecting mycotic superior mesenteric aneurysm in a 12 year old child
Authors: Mulenga Mulewa , Bvulani Bruce , Maleya Adrian 
Published: November 2022

Visceral artery aneurysms are uncommon especially in children. One of the main complications before surgery is rupture.
This 12 year old child presented with a large, fast growing, mycotic superior mesenteric aneurysm that had all the favourable conditions for rupture. There was spontaneous dissection of the weakened media with partial erosion of the aneurysm into the wall of the third part of the duodenum. However, this aneurysm formed a thrombus that gradually occluded the lumen. This led to formation of collateral vessels for the continued vascular supply of the midgut.
The uniqueness of this case report has been highlighted from several points (the rarity of the condition in children, the favorability of the conditions to rupture, the gradual but complete luminal occlusion with the eventual formation of collaterals to supply the midgut, and the spontaneous medial dissection with partial duodenal wall erosion without causing rupture).
Although there is no standard surgical approach, early elective surgery is recommended. Non-operative approach is an option that should aim at reducing the risk for rupture. Control of blood pressure is key.
This child underwent surgery. Under total vascular exclusion, the aneurysm was opened. After total luminal occlusion and collateral blood supply to midgut was noted, infected thrombus was evacuated and the aneurysm walls debrided.
Keywords: Superior mesenteric artery, visceral artery aneurysm, aneurysm, midgut.
Investigation of Adjoint of Linear Transformation and Some Its Important Properties
Authors: Yousefi Najibullah , Popalzai Laila , Jalal Hadia 
Published: November 2022

Linear operator on inner product space is including adjoint operator, self adjoint operator, unitary operator, normal operator ,… (self adjoint operator and unitary operator is normal operator but convers is not true at all) in this paper I discussed about adjoint operator and self adjoint operator of linear transformation and some important properties.
In this paper first I defined the linear transformation, inner product space, adjoint linear transformation, self adjoint operator and very important relevant properties and theorem.