Predictors of Shisha Use among Medical and Dental Students in Ibadan, Nigeria.

Background: Shisha is a form of smoked tobacco product. Medical trainees are potential stakeholders in providing accurate information about shisha and discouraging its use. However, few studies have targeted medical trainees to provide much-needed information for policymaking and planning of programs. Aim: To determine the prevalence and predictors of shisha use among medical and dental students in Ibadan, Nigeria. Subjects and Methods: A cross-sectional study was conducted among medical and dental students (n = 252) of the University of Ibadan, selected using the stratified random sampling technique. The Global Health Profession Students Survey (GHPSS) questionnaire was used to obtain information about socio-demographics, shisha and other tobacco use, and knowledge and attitude towards shisha use. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Continuous data were presented using mean and standard deviation, whereas categorical variables were reported as proportions. The association between the outcome variable (shisha use) and independent variables (sociodemographic characteristics, having friends who use shisha) was measured using Pearson's Chi-square test, and factors significant (P < 0.05) were entered into the multivariable logistic regression model. Result: The mean age (± SD) was 21.7 (± 3.1) years. Over half [136 (54%)] were males, and most [199 (79%)] were medical students. About 28 (11%) were not aware of shisha, whereas 22 (8.7%) reported they had ever used shisha. The mean knowledge score was 5.6 ± 4.7, and 76 (33.9%) supported shisha use. Positive predictors of shisha use included the male gender [OR: 6.4 (95% CI: 1.76-23.10)] and having a friend who uses shisha [OR: 28.2 (95% CI: 5.49-144.23)]. Conclusion: The prevalence of shisha use among medical and dental students in Ibadan is unacceptably high, although low compared to other countries in similar resource settings. Surprisingly, the students had poor knowledge about shisha, and over a third supported its use, especially males who were more prone to use it. There is a need to design targeted health promotion and education for the students, especially males.

PREVALENCE AND PREDICTORS OF CIGARETTE SMOKING AND ALCOHOL USE AMONG SECONDARY SCHOOL STUDENTS IN NIGERIA.

Background: Cigarette and alcohol use are the most common causes of noncommunicable diseases. Studies related to cigarette and alcohol use among Nigerian adolescents have shown increases in the habits and require urgent intervention. Nationally representative data is needed to develop effective national policies and interventions, but this is lacking. Hence, this study aimed to provide nationally representative empiric information about cigarette and alcohol use prevalence and predictors among Nigerian secondary school students. Methods: This study included 2,530 Nigerian students in Nigeria from five of the six geopolitical zones in Nigeria. A self-administered questionnaire was used to obtain information about the participants' sociodemographic and school-based characteristics, cigarette and alcohol use status, and harm perception of tobacco and alcohol use. Data were analysed with SPSS version 25 at p<0.05. Results: Participants' mean age (±SD) was 16.34 (±2.0) years. The prevalences (95%CI) for ever-cigarette and current-cigarette smoking were 11.1% (95%CI:9.9-12.4) and 8.4% (95%CI:7.3-9.5), respectively. While 21.0% (95%CI:19.4-22.7) and 15.6% (14.2-17.1) were the prevalences for lifetime and current alcohol use, respectively. The predictors of current cigarette smoking were studying in northern-Nigeria (aOR:1.94;95%CI:1.10-3.44), attending private-schools (aOR:1.56;95%CI:1.03-2.38), boarding-student (aOR:1.75;95% CI:1.15-2.69), male-gender (aOR:3.03; 95%CI:1.80-5.10), current alcohol use (aOR:12.50;95%CI:8.70-18.18), having no (aOR:2.59;95%CI:1.58-4.26) or low tobacco harm perception (aOR:2.04;95%CI:1.18-3.53). The predictors of current alcohol use were male (aOR:1.32; 95%CI:1.01-1.72) and current cigarette smoking (aOR:12.5;95%CI:8.77-17.86). Conclusion: The prevalences of cigarette and alcohol use were high among Nigerian secondary school students, and both habits were strongly associated. Their predictors were school-related factors, sociocultural characteristics, and tobacco harm perception.

MISSED DIAGNOSIS OF ISOLATED BILATERAL TRANSVERSE FACIAL CLEFT: A CASE REPORT.

INTRODUCTION: Bilateral transverse facial cleft is the most common of the rare facial clefts and early presentation is a key element for successful management and prevention of possible complications like poor esthetics, speech and eating difficulties. Though several studies have documented reasons for late presentation, none has highlighted non-referral due to missed diagnosis by healthcare workers as a reason. CASE REPORT: A nine-year-old girl was brought by her parents to the Primary Oral Health Clinic on account of "very wide mouth" noticed at birth. The mother noticed the anomaly few hours after she gave birth to her and immediately pointed the attention of the nurses and birth attendants to it but they dismissed her concern. Subsequently, the mother took the girl to the maternity centre for routine immunization appointments, but none of the healthcare workers she encountered recognized the birth defect. The parents further reported that the girl received jests and abuses from her peers. A diagnosis of Isolated Bilateral Tessier number 7 cleft was made based on clinical examination findings. She was referred to a cleft centre where the repair was successfully carried out at no cost to the patient through the Smile-Train® sponsorship program. Subsequent follow-up visits to the primary healthcare clinic in the sixth and ninth month post-surgery revealed remarkable improvement in both patient's and parents'self-reported psycho-social wellbeing. CONCLUSION: This case report presents a rare presentation of delayed isolated congenital bilateral macrostomia because of healthcare workers failure to diagnose.

REALITIES OF COVID-19 PANDEMIC IN NIGERIA: COPING WITH THE CHALLENGES AND CHARTING A WAY FORWARD.

The impacts of COVID-19 have cut across both developed and developing countries alike. This has prompted different coping mechanisms for survival through these trying times. The reality of stigmatization in this period has negatively affected health-seeking behavior and public response to the outbreak. Challenges exist at both the community and the healthcare providing facilities. We present a review of best practices in coping with COVID-19. Our focus is on how to cope with the challenges and strategies to improve the response to the pandemic in Nigeria. It is required that safety measures be fully adopted and practiced by individuals and groups. Collaborative efforts are required by all stakeholders, government, healthcare workers, and private organizations to mitigate the negative effects of the pandemic, avoid stigmatization, and ease the return journey to normalcy.

Burnout among Nigerian doctors: a systematic review

Burnout among physicians is a global phenomenon which has been under-reported in middle and low-income economies. The importance of burn-out on the physicians' well-being, patient care and overall health care system cannot be overemphasized. In Nigeria, few studies are specific to burnout, with most of the available studies exploring psychosocial issues at physicians' workplace stress and job dissatisfaction. This present review of literature is assessing burnout among Nigerian Physicians. This review is designed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The review identified observational, review, longitudinal and experimental studies on Nigerian physicians between 1970- 2017, which have the full text in the English language. The articles were searched from online databases such as PUBMED, Directory of Open Access Journals (DOAJ), African Journals Online (AJOL) and Google Scholar by researchers. The keywords used include "Physician", "Nigeria", "burn-out" syndrome. The prevalence of 23.6% to 51.7% burnout was reported among physicians in the selected studies, with young age being a strong predictor for burnout. High burden of emotional exhaustion, depersonalization and personal accomplishment were reported in the study carried out among resident doctors who are early career doctors. The prevalence of burnout reported from these studies in Nigeria is very high, although they are within the globally reported range of physician burnout. Nevertheless, there is a dearth of information on the subject matter among Nigerian Physicians. There is a need to carry out more studies on burnout among Nigerian Physicians