Review of COVID­19 vaccine

Coronavirus disease 2019 (COVID­19) accounts for over 92 million confirmed cases worldwide, with over 2.06 million deaths. In the past year, more than 290 candidate vaccines have been tested; COVID-19 vaccine development was sped up, with shortened timeline, due to the urgent global need in the face of the pandemic. In addition, people with the highest risk of contracting the disease, such as health workers with a high risk of exposure, elderlies, and people with underlying comorbidities, were prioritized with vaccination rollout. The article narratively reviewed original and review articles available on PubMed and Google Scholar related to the theme to provide up­to­date information. The different templates developed and studied for COVID-19 vaccines include the whole-virus vaccine, viral vector vaccine, nucleic acid (deoxyribonucleic acid and ribonucleic acid), and protein subunit vaccine. Myths impede vaccine uptake in this part of the globe. Adopting these myths leads to sharing and spreading, which negatively impacts the prevention of COVID-19 and vaccine uptake. Adverse event following immunizations (AEFIs) is classified based on severity, from minor to severe. The minor ones are common events that pose no potential health risks to the receiver of the vaccine. The type determines the safety profile, severity, and frequency of AEFIs observed with the vaccine administration. Overall, this pandemic has heightened the global level of threat awareness; it has also provided motivation to prepare for future pandemics by developing new vaccines.

Mothers' perception of COVID-19 infection in their under-five children presenting in a tertiary health institution in South-East Nigeria and associated factors

Background: Maternal attitude to health-seeking behavior of their under-five children in the COVID-19 pandemic is not well-known. Objectives: This study is aimed at determining mothers' perception of COVID-19 pandemic among their under-five children and associated factors. Methodology: This is a prospective and observational study carried out in two health institutions in South-East Nigeria. Results: Most subjects, 243 (65.3%) noted that someone without showing symptoms of COVID-19 could transmit the virus. Of the mothers of children under-five, 271 (72.8%) highlighted the possibility of COVID-19 infection in the under-five. A small number of participants 53 (14.2%) showed awareness that people should cough into their elbows as a way of preventing the transmission of COVID-19. A small number of participants, 160 (43.0%) had a good perception of COVID-19. Majority of mothers who were married, 148 (44.7%) showed a good perception of COVID-19 when compared with those who were single, 12 (29.3%); however, this is not significant, (χ2 = 3.550, P = 0.060). A large number of participants who have attained tertiary education, 92 (48.9%) had a good perception of COVID-19 which is higher than that seen in mothers with secondary education 68 (37.0%) (χ2 = 5.444, P = 0.020). Participants who were 30­34 years had 1.8 times higher odds of good perception of COVID 19 compared with mothers who were more than 35 years (adjusted odds ratio = 1.803, 95% confidence interval = 1.026­3.170). Conclusion: Although most mothers affirm that a child could be infected by COVID-19, a small number of them actually had a good perception of COVID-19 infection. Good perception of COVID-19 among the under-five is enhanced by the high level of education and age of 32­34 years.

Knowledge, attitude, practice and predictors of preventive practices toward COVID-19 among healthcare workers in Ogbomoso, Nigeria: A cross-sectional study

Background: COVID-19 quickly assumed a global epidemic with its attendant health, socio-political and economic impacts. Healthcare workers are particularly at increasing risk of being infected and transmitting the virus. This study assessed knowledge, attitude, practice and predictors of preventive practices toward COVD-19 among healthcare workers in Ogbomoso, Nigeria. Study Design: Cross-sectional study. Data were collected online among health workers across health facilities in Ogbomoso. Factors associated with good practices were analyzed using Chi-square. Predictors of good preventive practices were determined by multivariate binary logistic regression. The level of statistical significance was determined to be at P < 0.05. Results: There were 132 study participants; with an average age of 31 years. Fifty-eight percent were medical laboratory scientists. Levels of good knowledge, attitude, and practices were 59.1%, 58.3%, and 38.6%, respectively. Eight-seven percent of respondents sourced COVID-19 related information via the mass media. Ninety-four percent of respondents will not stay at home if sick because of work. Age, profession, and knowledge are significantly associated with COVID-19 preventive practices. The predictors (Model II) of good COVID-19 preventive practices include being a laboratory scientist (odds ratio [OR]: 2.44 [95% confidence interval (CI): 1.05, 6.71]; P = 0.039), working in primary health facility (OR: 4.72 [95%CI: 1.08, 20.67]; P = 0.039) and having good COVID-19 knowledge (OR: 3.71 [95%CI: 1.49­9.925]; P = 0.005). Conclusion: Our study has shown the predictors of good COVID-19 preventive practices among healthcare workers and the need for policy and practice change as it relates to COVID-19 infection prevention and mitigation among healthcare workers.

Coronavirus Disease 2019 Virus among ophthalmologists in Nigeria: Knowledge, attitude, and perceptions

Background: Globally, there is still much to learn about the evolving coronavirus disease 2019 (COVID-19) virus, its transmission, prevention, and treatment. Therefore, this study investigates the knowledge, perception, and screening practices of COVID-19 infection in the ophthalmology practice in Nigeria. Materials and Methods: This survey was a descriptive, cross-sectional survey conducted among practising ophthalmologists and ophthalmologists in training in Nigeria in an online survey. Data compiled were then analyzed using the IBM SPSS software version 22.0 with two-tailed P < 0.05 considered to indicate statistical significance. Results: A total of 206 ophthalmologists/ophthalmologists in training were recruited for this study. Most of the respondents, 97 (47.1%), practiced in centres in South-West Nigeria and were board-certified ophthalmologists 96 (46.6%). In general, the majority of the respondents, 182 (88.3%), had good knowledge regarding the COVID-19 virus, its transmission, prevention as it regards the ophthalmic practice, 134 (74.8%) either agreed or strongly agreed that the ophthalmologist is at a higher risk of contracting the virus from infected patients even if the patient is asymptomatic. COVID-19 infection was perceived as very serious by the majority of the respondents, 135 (65.5%), although 128 (62.1%) felt that all routine cases should be seen only following a low-risk assessment. Conclusion: As the world races toward complete vaccination of the population against this fatal infection, continued training is required to ensure the best practices among ophthalmologists to bridge the present knowledge gaps, corrects myths, misconceptions, and ensure the safety of both the patient and the ophthalmologist.

Knowledge of COVID-19 and practice of preventive measures among adult residents during the ease of lockdown in Nigeria

Background: The governments of many countries have taken steps to avert the spread of COVID 19. The gradual relaxation of the lockdown in Nigeria might be counter-productive if not properly managed. The best means to reduce and stop transmission is for the public to be adequately informed about the disease and its preventive measures. This research assessed the knowledge of COVID-19 and practice of preventive measures along with its predictors among Nigerian residents during the ease of the lockdown. Methodology: A cross-sectional study was conducted among 1421 adult residents of Nigeria. Data were collected between 6th and 20th September, 2020, using a semi-structured online questionnaire adapted from previous studies. IBM SPSS version 26 was used for data analysis. Pearson's Chi-square and logistic regression were used to determine the predictors of preventive practices. Results: The mean age of the respondents was 27.5 ± 9.1 years. A very large proportion (98.8%) of the respondents had a good knowledge of the disease (score of ≥4 out of 6 variables) and the internet (70.1%) was the major source of their information. However, only 57.6% of them had good practice of preventive measures of the disease (score of ≥3 out of 4). Predictor of good practice of preventive measure included female sex (adjusted odds ratio [AOR] = 2.626; 95% confidence interval [CI] = 2.078­3.319), being married (AOR = 2.177; 95% CI = 1.568­3.023), and possessing tertiary and postgraduate level of education (AOR = 1.813; 95% CI = 1.082­3.036 and AOR = 2.102; 95% CI = 1.206­3.664, respectively). However, residents in local government headquarters and other villages as well as towns (AOR = 0.541; 95% CI = 0.388­0.756 and AOR = 0.587; 95% CI = 0.350­0.983, respectively) have less likelihood of engaging in good practice of preventive measures. Conclusion: Majority of the research participants had good knowledge of the disease, while about half take part in good preventive practices measures. Predictors of the practice measures included sex, level of education, place of residence, as well as marital status. Therefore, targeted interventions should be directed to the males, those who reside outside the Federal Capital Territory and state capitals, and other high-risk groups as found by this study to reduce the risk of disease contraction during this period.

Preparedness of Nigerian Health Institutions toward managing Lassa Fever Epidemic and Covid­19 Pandemic

Objectives: The objective is to assess standard practice of healthcare workers and preparedness of their healthcare institutions toward controlling spread of infectious diseases. Background: With the on ­ going epidemic of Lassa fever and the rising incidence of Covid­19 pandemic in Nigeria, there has been efforts from government and stakeholders in health towards controlling the surge of these diseases. This study is a multi­center survey involving frontline health­care workers, from 102 health institutions.Methodology: Pretested self­administered questionnaires were sent through online Google form to health­care workers across various health institutions through their respective social media platforms. Their consent was sought and the questionnaires were filled through registered emails. Multiple entry from same individual was prevented. The number of respondents was 451. The information gathered include biodata of health­care workers, details of their cadre and years of practice, their level of standard precautions and preparedness of their health institutions. Data gathered were collated, summarized, and analyzed using simple tables with proportions.Results: The practice of standard precaution was inadequate with only 59.4% of respondents washing their hands regularly after touching patients or carrying out procedures, while only 34.4% of them used face masks while consulting patients with respiratory symptoms. As for preparedness of health institutions in control of Lassa fever and Covid­19, 63.1% and 77.6% of respondents affirmed that their health institutions had written protocol of managing infectious diseases and had organized workshop on Lassa fever and/or Covid­19, respectively, while only 45.5% and 20% of respondents had dedicated isolation wards and functional intensive care units in their health institutions.Conclusion: The standard safety precautions by health­care workers were suboptimal and preparedness of their health institutions was generally inadequate for the management and control of infectious diseases

Completeness and adequacy of clinical and demographic information in non- gynaecologic surgical pathology requisition forms: an analysis of 1046 cases

BACKGROUND: An important cornerstone in health care delivery is the field of surgical pathology and one of its major aims is to provide a complete, precise and comprehensive diagnosis within a short period of time. In achieving this, the clinician needs to properly fill a surgical pathology requisition form.METHOD: All the consecutive requisition forms from January 1, 2018 to April 30, 2018, totaling 1046 were evaluated for completeness of the information. The requesting clinicians were unaware and cytologic smears were excluded. Patient confidentiality was maintained as no names were recorded. All the Information on the forms was recorded as being present or absent. Analysis was done using the Statistical Package for Social Science version 20.RESULTS: Altogether 1046 forms were evaluated and (100%) of the sample population bore the surnames and first names. Ages were recorded in 93.7%. Similarly, 68.2% of the forms did not bear the hospital number. Clinical summary and date of request were absent in 42.9% and 35.4% of the forms respectively. Clinicians name/ signature and investigation required were absent in 25.1% and 21.1% of the forms respectively. Overall, 77.6% of information was provided while 22.4% not provided.CONCLUSION: The names were completely filled in all the requisition forms. Others were incompletely filled. These findings should be communicated to Clinicians and the recurring attitude of allowing House Officers to fill the requisition forms should be discouraged. Efforts should also be made to let Clinicians appreciate the importance of good clinical information since this determines to a large extent the output of laboratory results

Factors associated with substance use among secondary school adolescents in gwagwalada area council, Abuja, Nigeria

Adolescents use substances for various reasons such as for pleasure, stress and anger management. Many factors have been reported to influence adolescent substance use. However, there is paucity of reports from this part of Nigeria.AIM/OBJECTIVES: To identify the socio-demographic factors associated with substance use among secondary school adolescents in Gwagwalada Area Council.MATERIALS AND METHODS: A cross-sectional, descriptive, questionnaire-based, study was carried out in secondary schools among adolescents aged 10 years to 18 years who met the inclusion criteria and after appropriate ethical approval had been obtained.RESULTS: One thousand, one hundred and ninety-six student-filled questionnaires were analysed. The mean age of the students was 14.54 years ± SD 2.28. The students' religion, family structure, residence and type of school were associated with licit substance use while their religion, family structure and residence were associated with illicit substance use (P =<0.05). There was also statistically significant relationships between frequency in participation in religious activities and tobacco use (P = <0.01) and birth order and cocaine andhallucinogen use at P = 0.014 and P = 0.018, respectively.CONCLUSION AND RECOMMENDATION: Several factors were associated with adolescent substance use in this study. It is recommended that more in-depth studies be done to determine causality

Incidence and outcome of umbilical cord prolapse: experience in a tertiary health facility south eastern Nigeria

BACKGROUND: Umbilical cord prolapse is a rare obstetric emergency with adverse perinatal outcomes. The incidence has been on the decline, hence necessitating the need for periodic evaluation in order to document its contribution to perinatal indices. We sought to determine the incidence, predisposing factors and fetal outcome of umbilical cord prolapse.METHODS: This was a retrospective descriptive study carried out in Federal Medical Centre(FMC), Umuahia over a 5-year period from January 1, 2009 to December 31, 2013. Data was analyzed using WinPepi version 11.65. Statistical analysis was done using Chi-squared test with level of significance set at P < 0.05. RESULTS: The incidence of umbilical cord prolapse was 0.3%. The mean age was 31.8 ± 5.1 years. Multiparous women constituted 80% of those diagnosed with the condition while 84% of the women were unbooked. Although multiple risk factors were noted in the parturient, multiparity ranked highest (80%) while artificial rupture of membrane contributed the least (4%). Most (84%) of the women were delivered by emergency cesarean section. The perinatal mortality rate was 12%. CONCLUSION: Umbilical cord prolapse remains a high risk condition to the fetus. Therefore, early presentation to the health care facility in the event of membrane rupture may improve its outcome

The association between sperm quality and asymptomatic chlamydial infection in infertile men at a private fertility clinic in Nigeria

BACKGROUND: Association between chlamydia trachomatis infection and male infertility is debated in literature. There is little or no information from Nigeria. The study aimed to determine the prevalence of chlamydial infection and its association with sperm quality parameters among a symptomatic men that present for infertility treatment in a Nigeria facility. METHODS: A cross-sectional study conducted at a private assisted conception clinic in Lagos, Nigeria among 138 men seeking infertility care. Seminal fluid analysis and IgG Chlamydial serology were performed for each participant. Data obtained were analysed using SPSS; p was significant at <0.05. RESULTS: Of the 138 men screened, 13.9% were Chlamydia-positive. Twenty-one per cent of clients who tested positive to Chlamydia had predominantly immotile sperm, compared with 10.2% without the infection; 26.3% with non-progressive motility had Chlamydia, compared with 2.8% men who were not infected. These differences were statistically significant (p = 0.001). More of those (57.9%) with Chlamydia (compared to 33.1% without) had significant leukocyte counts (p = 0.037). There were no statistically significant differences in sperm count and percent motility between serologically positive and negative men. CONCLUSION: Positive Chlamydia serology is associated with non-progressive motility and leukocytospermia in infertile Nigerian men

Covert contraceptive use among women of reproductive age in Ibadan, Nigeria

BACKGROUND: This study assessed the prevalence and determinants of covert contraceptive use among women of reproductive age in Ibadan, Nigeria. METHODS: A cross sectional study among women attending a family planning clinic in a maternity teaching hospital in Ibadan, Nigeria was conducted. Data was collected on sociodemographic characteristics, contraceptive use and partner awareness of use. The socio-demographic predictors of covert contraceptive use were explored using logistic regressions. RESULTS: Twenty-five (6.8%) of the 365 respondents were practicing covert contraception. Their mean age was 34.7+6.67 years, 98.6% were married and with modal parity of 3 (29.6%). A logistic regression analysis showed that participants' age (p = 0.555), occupation (p = 0.679), education (p = 0.642), parity (p = 0.385) and husbands' education (p = 0.926) were not statistically associated with covert contraceptive use while husbands' financial supports (p = 0.000) and approval for family planning use (p = 0.000) were associated with reduction in the likelihood covert contraceptive use. CONCLUSION: Covert contraceptive use exist among our women. Poor financial support and disapproval by the husbands were the strongest predictors of the practice. Greater male involvement in contraceptive service provision will help address these negative factors promoting covert contraceptive practices

Medical students' perceptions regarding antibiotics use and antimicrobial resistance in ebonyi state, Nigeria'

BACKGROUND AND OBJECTIVES: Medical students as future doctors have important roles to play in the control of antimicrobial resistance. The aim of this study was to assess the perceptions of medical students regarding antibiotics use and antimicrobial resistance in Ebonyi State, Nigeria. METHODS: A cross-sectional survey was conducted among all the 184 fifth and sixth year medical students in Ebonyi State University, Nigeria using semi-structured, self-administered questionnaires. Proportions, chi square and logistic regression were estimated with Epi Info version 7.2 at 5% level of significance. RESULTS: Respondents were mostly males (62.5%), aged 20-29 years (68.9%) with 60.9% of them in final year. Majority (85.9%) had used antibiotics in the last one year. Most (78.3%) rated themselves to have adequate knowledge on antibiotic use and resistance but only 40.2% respondents had positive perception towards antibiotic use and resistance. Similarly, only 46.7% agreed that hand washing was important in controlling antimicrobial resistance. Majority (53.3%) believed that antibiotics were safe drugs and should be used commonly while only 50.5% disagreed with use of antibiotics as first line treatment for sore throat. Desire for more education on antimicrobial resistance and use was a significant predictor of positive perception (OR 0.36, 95% CI; 0.15-0.87; P=0.024) CONCLUSION: There was poor perception towards antibiotic use and resistance in spite of the high rates of antibiotic consumption and self-rated knowledge onantimicrobialuse. Thereisneedforreorientationofmedicalstudents' perceptions towards antibiotic usage and the role of infection control in curbing antimicrobial resistance

Prevalence of vaginal group-b-streptococcus, antibiotic and antigen sensitivity amongst parturients at the federal medical center owerri, Nigeria

BACKGROUND: Group B streptococcus (GBS) is one of the principal agents of early onset neonatal sepsis, pneumonia and meningitis with significant morbidity for newborns and parturients.AIM: This study was done to determine the prevalence of vaginal group B streptococcus amongst parturients in FMC Owerri. It also aimed to elucidate the antibiotic sensitivity of the strains of GBS isolated while comparing the sensitivity of antigen detection tests of GBS to culture.PATIENTS AND METHODS: This cross-sectional study was done at the labour ward and lying-in units of the Federal Medical Center, Owerri,from February 2015 to October, 2015. It involved one hundred and eighty (180)womenrecruitedsystematically. Two swab samples, high vaginal and rectal were collected from the parturients intrapartum and cultured. The babies were examined and weighed immediately after delivery, seen on the second and tenth days after delivery for features of fever or any other complaints. RESULTS: The overall prevalence of GBS amongst parturients was found to be 6.1%. Prevalence of vaginal colonization was 3.3% and that of the rectum was 2.8%, (2c=0.1282, df=1,p=0.502). Neonates with colonized mothers all had complaints of fever postpartum which was statistically significant (=55.86, df=1, p<0.001). All the microbes showed 100% sensitivity to penicillin G, erythromycin, gentamycin and ceftriaxone. Antibiotic resistance was discovered in augmentin (67%), Cloxacillin (55.6%) and ofloxacin (33.3%). Antigen detection tests gave Sensitivity=100%, specificity=96.4%, positive predictive value (PPV) = 64.7%, negative predictive value (NPV) =100%. Detection in both vaginal (=60.290, p=0.000) and rectal (=50.799, p=0.000) samples were statistically significant. CONCLUSION: The prevalence of GBS in parturients in the Centre is low. Strains of GBS isolated amongst the sampled population in FMC Owerri had a high sensitivity to penicillin G, erythromycin, gentamycin and 3 generation cephalosporins. Antigen detection method for screening of GBS though very sensitive is however not specific with a significant false positive detection rate due to antigen cross reaction. It is however recommended that antigen detection be employed as intrapartum measure in high risk cases to reduce turnover time whilst supported by culture results later. There was associated significant neonatal sequaelae and further research to establish causal relationship will be advised

Early outcome of open locked intramedullary nailing of femoral diaphyseal fractures in a resource ­ poor setting

BACKGROUND: Closed locked intramedullary nailing is largely considered the preferred treatment option for fractures of the femoral diaphysis, owing to its associated high union and low complication rates. In resource poor regions where intraoperative imaging is not readily available, most of these injuries are treated by open locked intramedullary nailing and plate osteosynthesis. This study was designed to assess the outcome of open locked intramedullary nailing of femoral diaphyseal fractures. METHODS: Medical records and radiographs of all adult patients who had open locked intramedullary nailing of fractures of the femoral diaphysis between January 1, 2013 and July 31, 2017 were retrieved. A total of 45 patients with 46 fractures of the femoral diaphysis were retrospectively studied. Each patient was followed up for at least 12 months. Early outcome of treatment was assessed using the Thorresen's criteria.RESULTS: A total of 45 patients (24 male; 21 female) with 46 femoral diaphyseal fractures were studied. The age range of the patients was 18 years to 80 years, with a mean age of 33.56 (SD=12.87) years. Forty two (91.3%) cases were closed fractures. Twenty four (53.3%) patients had right femoral diaphyseal fracture. The overall union rate was 95.7%. The range of time to fracture union was 12 weeks to 34 weeks, with an overall mean time to fracture union of 13.65 ± 3.57 weeks. Ipsilateral knee joint stiffness (n=4, 8.7%) and osteomyelitis (n=3,6.5%)werethecommonestcomplicationsrecorded.Overall infection rate was 10.8%. Using the Thoresen's criteria, the overall outcome of treatment in this study was excellent in 37 (80.4%) patients. CONCLUSION: There is no significant difference between the outcome of open nailing compared to closed nailing of femoral diaphyseal fractures

Patients' knowledge of health rights and satisfaction with outpatient services at the tertiary hospitals in Enugu state, Nigeria

BACKGROUND: Patient satisfaction is a key indicator for measuring the success of the health system goals, delivery quality care that is safe, equitable, patient-centered, evidence-based, timely and efficient, through interprofessional collaborative team work. Equally, patient's knowledge of their health rights will enhance better provider-patient's relationship, patient satisfaction, and effective care management. OBJECTIVES: The aim of this study was to compare patients' knowledge of health rights, satisfaction with the physicians' conducts and outpatient services across three tertiary hospitals in Enugu, Nigeria. METHODS: A descriptive cross-sectional study of 304 patients selected from the outpatient clinics of the University of Nigeria Teaching hospital (UNTH), National Orthopaedic Hospital (NOHE), and Enugu State University of Science and Technology Teaching Hospital (ESUTH), from October to December, 2015 was conducted. A four point Likert scale, dissatisfied (1), very dissatisfied (2), moderately satisfied (3), and very satisfied (4) was applied. Knowledge of health rights were scored as follows, 0-5 poor knowledge, 6-10 good knowledge, 11 and above very good knowledge. A minimum sample size of 91 patients was calculated for each of the study hospital, but increased to100 each, to enhance precision, reduce error margin, and to contend possible nonresponses and incompleteness. A multi-stage sampling technique was applied. The data were analyzed using SPSS version 16.0.RESULTS: Knowledge of health rights was poor in 5.9%, 20.8%, and 14.9% of patients (X2 =9.61, p=0.000), and very good in 70.6%, 2 46.5% and 59.4% patients (X2 =12.14, p=0.000) from UNTH, NOHE, and ESUTH respectively. The mean knowledge scores were 10.50 ±3.240 for UNTH; 8.72±2.953 for NOHE; and 9.93±3.151 for the ESUTH. The overall mean knowledge scores of the patients across the three hospitals was not statistically significant (F=0.000, P =1.000). Patients' overall mean satisfaction with physicians' conduct and services was 3.63±0.525 for UNTH, 3.45±0.741 for NOHE, and 3.47±0.609 for ESUTH, with no statistically significant difference (F=0.000, P =1.000). Overall mean satisfaction scores for the general outpatient services were 3.19±0.728, 3.15±0.713, and 3.00±0.721 for UNTH, NOHE, and ESUT respectively. The observed differences in the overall mean satisfaction for the general services provisions across the hospitals was not statistically significant (F=0.000, P=1.000). Patients' mean knowledge scores were statistically (p=0.000) associated with mean satisfaction with the physicians' conduct and services provision across hospitals. CONCLUSION: Patients knowledge of health rights and satisfaction with physicians' conducts and outpatient services across the hospitals were generally good and satisfactory, but differed statistically in-between hospitals

Assessment of patients knowledge and attitude towards diabetes and its relationship with glycemic control: a cross-sectional study in a Nigerian tertiary hospital

BACKGROUND: It is postulated that increased knowledge of patients about diabetes as well as a positive attitude will lead to improved glycaemic control and better outcome. The aim of this study was to determine the knowledge and attitude of diabetic patients in a tertiary hospital in Enugu and the relationship with their glycaemic control.METHODS: A cross-sectional study was done using a structured questionnaire to obtain socio-demographic data and assess knowledge and attitude to diabetes on consecutive patients attending the outpatient clinic in a tertiary hospital. Responses were scored with equal weighting. The fasting blood glucose of the patients was measured and recorded.RESULT: There were 51(60.7%) females and 33 (39.3%) males, with majority (63.1%) in the age range 41 -64 years and 32(38.1%) had only primary education. The mean knowledge score was 6.19 ± 2.08 and 33(39.3%) demonstrated good knowledge. Knowledge did not differ between males and females (p=0.34), but was highest in those with tertiary education (p = 0.02). Positive attitude to the condition was recorded in 63(75%) subjects. There was poor correlation between knowledge and attitude (r = -0.161, p= 0.14). Those with good knowledge scores were 2 times more likely to have good glycaemic control compared with those with poor knowledge; OR = 2.015, p = 0.02. Therewas no significant difference between the glycemic control of those with good attitude and those with poor attitude (p= 0.08).CONCLUSION: Although overall knowledge was poor, patients had a good attitude to their illness. Knowledge, but not attitude was significantly positively associated with glycemic control

Health effects of noise exposure levels among instrumentalists in pentecostal churches in port harcourt city, Nigeria

BACKGROUND: Noise is everywhere in our daily lives and becomes very important as it affects our health. Religion is anintegr al part of daily lives and the use of acoustic and electronic instruments in worship. With the increase in sophistry of these instruments come their attendant untoward effects on the auditory organs of the body. This study was to assess noise exposure levels amongst instrumentalists in Pentecostal churches in Port Harcourt City, Nigeria.MATERIALS & METHODS: Following ethical consideration, 216 consenting respondents from 30 churches in Port Harcourt were recruited by table of random numbers. Structured close ended interviewer administered questionnaire incorporating the Hearing Health Quick Test (HHQT) was used to access demographic data. Hearing assessments were also performed using tonal audiometry. The data were entered and analyzed using SPSS version 20.0 and presented using descriptive and inferential statistics.RESULTS: Most 90.28% and 37.96% of respondents were male and within the 39-45 year-old age range respectively. Also, 80.56% of respondents were aware that loud music can cause permanent hearing loss. The prevalence of NIHL andTinnitus was 39% and 38% respectively; and only 19% used Hearing Protection Devices (HPD). Statistically significant risk of NIHL was observed in musicians who had experienced tinnitus, played only amplified instruments and Music experience greater or equal to 10 years (p=0.001).CONCLUSION: Gospel instrumentalists are exposed to noise in the course of their duties which have significant effect on their hearing. Use of Hearing Protection Devices (HPD) as a personal protective equipment is encouraged just as health education of this group of workers is necessary

Audit of medical records keeping at a Nigerian geriatric clinic

BACKGROUND: A medical record also known as health chart is the written health information about a patient or clients and is always opened whenever a patient or client visits a health facility. There are different types of medical records and it may be problem based or patient based; paper based or electronic. It enhances continuity of care; source of communication between healthcare professionals, as aides de memoire and it is a legal document. OBJECTIVE: To compare the medical records keeping with reference standards. METHOD: This is a prospective clinical audit, was conducted in a Nigerian Nursing Home for the elderly. The medical record keeping was compared with the generic standards of medicalrecordkeepingofthehealthinformatics Unitof the Royal College of Physicians. Two clinical audit cycles were performed. results: At the first clinical audit cycle only the third standard was 50%, others were zero. At the second clinical audit cycle there was improvement and 100% increase in standard 1, 3, 4 and 5, with 10% increase in standard 2. Paper based medical records are kept at the nursing home. Most of the residents do not know their age as their birth dates was not recorded. There were 30 residents at the nursing home when the clinical audit was conducted. CONCLUSION: Initially, the medical record keeping was below standard but with the clinical audit there was improvement. Clinical audit is important in medical practice in comparing the practice with standards

Prevalence and comorbidities of childhood overweight and obesity among school aged children in an urban settlement in Benin City, Nigeria

Background: The prevalence of childhood overweight and obesity is rising worldwide and its impact spanning through adolescence to adulthood.Objectives: This study aimed to determine the prevalence of overweight and obesity and the occurrence of high blood pressure and elevated blood glucose among school aged children in an urban settlement in Benin City, Nigeria.Design: A cross-sectional, descriptive study was utilized.Subjects and setting: A total of 195 school aged children residing in households in the selected ward were recruited for the study carried out between 2014 and 2015.Outcome measures: Anthropometric measurements were recorded and used to determine the body mass indices (BMI) of the children. Also blood pressure measurements and random blood sugars of the respondents were determined to ascertain the blood pressure and glycaemic status of the children.Results: The proportion of overweight respondents was 7.7% and 3.1% for obesity giving a combined proportion of 10.8% while that for underweight was 11.8% amongst the study respondents. The females, 18 (16.6%) had a significantly higher proportion of overweight and obesity than the males, 3 (3.5%) [p = 0.003]. The prevalence of hypertension was 6 (3.1%) and elevated blood glucose was 4 (2.1%). Conclusion: The prevalence of overweight was 7.7% while that for obesity was 3.1%. Also, the prevalence of hypertension and elevated blood glucose was 3.1% and 2.1% respectively amongst the school aged children and females had a significantly higher proportion of overweight and obesity than males in the study. There is a need for public enlightenment towards promoting healthier lifestyle choices and screening of disease conditions early in childhood

Malaria Vaccine:The Pros and Cons

Background: Malaria is an important parasitic disease of humans caused by infection with a parasite of the genus Plasmodium and transmitted by female anopheles. Infection caused by P. falciparum is the most serious of all the other species (P. ovale; P. vivax and P. malariae) especially in terms of morbidity and mortality hence the reason why most of the research has been focussed on this species. The disease affects up to about 40 per cent of the world's population with around 300-500 million people currently infected and mainly in the tropics. It has a high morbidity and mortality especially in resource-poor tropical and subtropical regions with an economic fall of about US$ 12 billion annually in Africa alone. relevant literatures were reviewed from medical journals; library search and internet source. Other relevant websites like PATH; Malaria Vaccine Initiative and Global Fund were also visited to source for information. The key words employed were: malaria; vaccine; anopheles mosquito; insecticide treated bed-nets; pyrethroids and Plasmodium. several studies have underscored the need to develop an effective human malaria vaccine for the control and possible eradication of malaria across the globe with the view to reduce the morbidity and mortality associated with the disease; improve on the social and economic losses and also protect those at risk. It is very obvious that the need for effective human malaria vaccine is not only to serve those living in malaria endemic regions but also the non-immune travellers especially those travelling to malaria endemic areas; this would offer cost effective means of preventing the disease; reducing the morbidity and mortality associated with it in addition to closing the gap left by other control measures. It is very obvious that there is no single control measure known to be effective in the control of malaria; hence the need for combination of more than one method with the aim of achieving synergy in the total control and possible eradication of the disease. It suffices to say that despite the use of combination of more than one method (e.g. drugs treating patients; breaking the life cycle of the vector mosquito using larvicides; clearing swamps and other mosquito breeding sites); no much progress was made towards achieving this goal; hence the renewed interest especially with regards to vaccine development