ABSTRACT
Background: Type 2 diabetes mellitus is a multi-factoral medical condition that aggregates in the family and has implications for family health. Research analyses of determinants of type 2 diabetes mellitus have demonstrated the interactions and clustering of family biosocial factors in its epidemiology. Aim: To determine the prevalence of type 2 diabetes mellitus and describe the associated family biosocial factors in ambulatory adult type 2 diabetic Nigerians in a primary care clinic in Southeastern Nigeria. Study Design: This was a cross-sectional study. Seven hundred and fifty patients were screened for diabetes mellitus and thirty five of them who had diabetes mellitus were age and sex matched with thirty five non-diabetic, non-hypertensive patients for the determination of the association with family biosocial factors. Place and Duration of Study: The study was carried out at a primary care clinic in Umuahia, South-eastern Nigeria in May 2011. Methodology: Data on family biosocial factors were obtained using pretested, structured and interviewer-administered questionnaire. Diabetes mellitus was defined using American Diabetes Association criterion. Results: The prevalence of type 2 diabetes mellitus was 4.7%. Eleven (1.5%) of the diabetic patients were newly diagnosed in the hospital. There were fourteen (40.0%) males and twenty one (60.0%) females with sex ratio of 1:1.5. The age ranged from 28-82 years with mean age of 47±11.2 years. The middle aged adults were predominantly affected. Family biosocial factors significantly associated with type 2 diabetes were family history of hypertension (P=.006) and diabetes mellitus (P=.048). A significantly higher proportion of the diabetic patients had family history of hypertension compared to the non-diabetic and non-hypertensive subjects. The diabetic patients were one and half times more likely to have family history of hypertension compared to their non-diabetic and non-hypertensive counterparts. Conclusion: The study has shown the prevalence of type 2 diabetes mellitus with predilection for middle aged adult Nigerians. The associated family biosocial factors were family history of hypertension and diabetes mellitus. Screening adult Nigerians with family history of hypertension and diabetes mellitus for diabetes mellitus is recommended in primary care setting for familycentred preventive care.
ABSTRACT
Aims: The objectives were to determine the rural communities’ knowledge on cause, transmission, spread of malaria, breeding sites of mosquitoes, signs and symptoms, health seeking behaviour of respondents, preventive measures and patterns of home management of malaria in the rural communities in Imo State. Study Design: A descriptive survey design was used. Place and Duration of Study: Imo State, Nigeria, between February 2013 and April 2013. Methodology: The sample size was 2674 adults (1650 males, 1024 females, age range 20-70 years). A structured, validated and reliable questionnaire (r = 0.81) and focus group discussion were used as instruments for data collection. Results: The result showed that out of 2674 respondents, 1683(62.9%) reported that malaria is transmissible while 976(36.5%) reported that malaria is not transmissible. Majority 2262(84.6%) noted that malaria spreads through mosquito bite while insignificant number said malaria spreads through drinking dirty water and eating unhygienic food. 1501(56.1%) noted that stagnant dirty water is a common breeding site for mosquitoes. Most of the respondents had good knowledge of the signs and symptoms of malaria which was used in prompt diagnosis. Majority 41% first patronized medicine stores followed by 38.5% that visited the hospital and health centers. In terms of preventive measures practiced by respondents, the majority 1049 and 1028 used mosquito bed nets and insecticide spray respectively while 237 used firewood smoke to drive mosquitoes away. In the pattern of home management of malaria, 62.3% used anti-malaria drugs, 10.5% used a special herb, Azadirachta indica (dogonyaro/Akum shut up leaf), 6.9% used combination of seven leaves (Pawpaw, mango, guava, Nchuanwu (Occimum basilicum) and awolowo leaf (Chromolaena odorata), orange and lemon grass) While 6.0% used prayers to God. Conclusion: Based on the above results and to keep abreast with the conventional practice, the rural communities require health education on home management of malaria.
ABSTRACT
Aims: The objectives were to determine the impact of health seeking behaviour, educational attainment and financial Strength on home management of malaria in rural communities in Imo State, Nigeria. Study Design: A descriptive survey design was used. Place and Duration of Study: Imo State, Nigeria, between February 2013 and April 2013 Methodology: The sample size was 2674 adults (1650 males, 1024 females, age range 20-70 years). A structured, validated and reliable questionnaire (r=0.81) was used to collect data from 2674 consenting respondents. Results: The result showed that the health seeking behaviours of respondents when they suspect malaria was as follows; 25.7 percent patronized patent medicine stores/chemist, 22.3 percent visited health centers/ hospitals,18.6 percent consulted family members/friends/ neighbor for help. This statistically had a significant influence on the pattern adopted in managing malaria at home (Chi-square = 263.98, P -value < 0.001). Furthermore, 25.4 percent of those who visited the health centers/hospitals used more of Artemisinin-based Combination Therapy in managing malaria. Those who patronized patent medicine/chemist used more of chloroquine/quinine (25.7 percent), only 18.1 percent used a special herb, dogonyaro/Akum shut up leaf (Azadirachta Indica) in managing malaria at home. Those who visited herbalists (20.5%) also used chloroquine/quinine while those that visited prayer houses also used more of chloroquine/quinine (22.3%) and less of ACT (15.5%). The impact of educational attainment on pattern of home management of malaria was statistically significant (Chisquare= 155.47,P-value<0.001). Those who had no formal education used more of Chloroquine/Quinine in managing malaria at home while those who attained secondary and tertiary education adopted more of Artemisinin-based combination Therapy (ACT) in managing malaria. Herbal treatment (Dogonyaro/Akum shut up leaf (Azadirachta Indica), seven leaves and application of local ointment/lotion) were less used by respondents with higher educational attainment. Financial strength was also found to be statistically associated with the pattern of management adopted by the rural dwellers (Chisquare= 118.46, P-value<0.001). Those whose average monthly income was above 30,000 Naira used more of conventional medication and less of herbs. Conclusion: The findings showed that the rural communities need more enlightenment and education on home management of malaria.
ABSTRACT
Background: Cystic hygroma is a rare congenital malformation of the lymphatic system which may cause neonatal airway obstruction. Surgical excision of this tumour is associated with high morbidity and mortality. Aim: To report the anaesthetic management for a successful excision of a cystic hygroma in a neonate. Case Report: A two-day-old female presented with history of an anterior neck swelling; tachypnoea and dyspnoea ; noticed at birth. There was associated stridor and subcostal recession. A diagnosis of cystic hygroma with upper airway obstruction was made. Tumour excision was done under endotracheal general anaesthesia. An intraoperative tracheostomy was carried out. Cyanosis occurred frequently within first 24 hours postoperatively while in the special care baby unit (SCBU) and was relieved by intermittent suction of the tracheostomy tube. Patient was weaned off the tracheostomy tube on the 30th post-operative day and discharged home two days later. She was subsequently followed up at the paediatric surgery outpatient clinic. Conclusion: Anaesthetic management for excision of a cystic hygroma in a neonate is by no means easy. It can be successful if the airway remains patent; ventilation is adequate; normothermia and optimal replacement of body fluid losses are ensured