Communal conflicts in Nigeria: Assessment of the impacts on internally displaced persons and settlements amidst COVID-19 pandemic.

Acknowledging that violent communal conflicts can lead to increased displacement and overcrowding in IDP camps, this study investigates the impact of such conflicts on internally displaced persons (IDPs) and their camps in Benue State, Nigeria, amid the COVID-19 pandemic. Employing a mixed-method approach, 386 IDPs and 20 stakeholders were purposively selected. Based on the research objectives, descriptive and inferential statistics were employed to analyze the research objectives. Employing logistics and multi-linear regressions, the data reveal that unregulated access to IDP camps resulted in overcrowding, straining resources like food and shelter. The study identifies economic losses and various challenges stemming from communal conflict and COVID-19, causing chaos, anxiety, and uncertainty in the IDP camps. These findings highlight the urgent need for ongoing humanitarian assistance to alleviate the precarious conditions faced by IDPs and their camps nationwide and recommend that the IDPs camps across the country need constant humanitarian aid to mitigate the various precarious conditions in the camps.

Impact of squatting on selected cardiovascular parameters among college students.

Squatting is an active posture test used in assessing baroreflex sensitivity, and the array of patients a physiotherapist handles may benefit from this test to avoid the adverse effects of exercise. Therefore, this study is designed to evaluate the effect of squatting on heart rate and blood pressure among undergraduate students. 35 males (mean age = 22.94 ± 1.846) and 40 females (mean age = 22.28 ± 2.075) participated in this experimental study. Demographic data and baseline cardiovascular parameters (blood pressure and heart rate) were taken before exercise. The exercise protocol, the squatting stress test, was done for 2 min, after which post-exercise blood pressure and heart rate were taken at one minute each. A repeated measure ANOVA and independent t-test were used to analyse the difference at the 0.05 alpha level. It was found that there was a significant difference between pre-exercise in lying and squatting post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01), pre-exercise in lying and standing post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01), pre-exercise in standing and standing post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01), and pre-exercise in standing and squatting post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01). Also, there was a significant difference in pre-exercise heart rate between lying and standing (p < 0.05) and not between the first minute and second minute post-squatting or standing exercise systolic blood pressure (p = 0.588) or diastolic blood pressure (p = 0.22-1). In conclusion, squatting trials among undergraduates revealed some statistically significant changes, especially between the cardiopulmonary parameters obtained in a standing position compared to lying and those measured after one minute. Therefore, caution should be observed when administering exercises that require changes in posture.

Self-Care Practices and the Associated Socio-Demographic Variables of Persons With Type 2 Diabetes Mellitus (T2dm) in Southeast, Nigeria.

Objective: The study was aimed at assessing the self-care practices and the associated socio-demographic variables of persons with T2DM in South East, Nigeria. Methodology: A cross-sectional study involving 382 persons with T2DM proportionately selected from 4 tertiary health institutions in South Eastern, Nigeria. Data was collected using the Summary of Diabetes Self-Care Activities (SDSCA) and a researcher-developed questionnaire. The questionnaire was administered to persons with T2DM who attended a diabetic outpatient clinic. Data collected was analyzed in frequency percentage. Responses on SDSCA were ranked and rated as poor, moderate, and good self-care behavior. The level of significance was placed at P < .05. Result: The majority of the participants were within the age groups of 40 to 59 (46.9%) and 60 and above (46.9%); the majority (74.6%) were married while a good proportion were traders (59.7%). Also, the majority of participants (81.2%) were on oral hypoglycemic agents. Findings further showed that a good proportion (51.3% and 89.8%) of study participants had good self-care behavior in diet and medication domains respectively. Whereas the proportion of participants with poor self-care behavior was very high in foot care (75.1%) and fairly high in both self-blood sugar testing (37.7%) and exercise (37.2%) domains. Only 7.9% practiced 3-monthly laboratory blood glucose testing while 16.5% went for eye checks every 6 months. Conclusion: Individuals with diabetes mellitus have poor self-management behavior in most domains of the self-management practice. Age, gender, marital status, educational level, and occupation significantly influenced self-management practices. Hence nurses and health educators should take diabetes self-management education very seriously to help diabetes sufferers improve their self-management behavior.

Generalized anxiety disorder screening using gad-7 among in-school adolescents of anambra state, nigeria: a comparative study between urban and rural areas.

BACKGROUND: Previous studies have reported that general anxiety disorder manifestations differ in diverse settings. OBJECTIVE: To determine and compare the prevalence of probable anxiety disorders among in-school adolescents in urban and rural areas of Anambra State. METHODS: A total of 1187 in-school adolescents were recruited using a multi-stage sampling technique. The study instrument was an interviewer-administered pretested questionnaire adopted from General Anxiety Disorder (GAD-7). Data were analyzed with the IBM Statistical Package for the Social Sciences (SPSS) version 22. RESULT: One hundred and twenty of the participants out of the 1187 (10.1%) were found to have probable generalized anxiety disorders using GAD-7 as screening tool. The prevalence of symptoms of anxiety disorder revealed that urban participants had a higher prevalence compared to their rural counterparts (11% vs. 8.8%), while females had a higher prevalence compared to the males in the ratio of 3:2 (or 12% vs. 8%). The prevalence of symptoms of anxiety disorders among females was higher than that of males even when compared based on a rural and urban settings. When all other variables are held constant, urban participants were found to have a 50% higher chance of being identified with anxiety disorders compared to their rural participants (OR = 1.500, C.I.:1.002-2.246, p = 0.049). CONCLUSION: The prevalence of probable anxiety disorders was found in 10% of the participants. The females have a higher propensity to exhibit symptoms of anxiety disorders than the males. Anxiety status affects how adolescents view their general health. The study started from the date of approval by the West African College of Physicians on the 21 February 2017, but Ethical Clearance from NAUTHEC was given on the 19th December 2016.

Effect of Educational Intervention Program on Self-Efficacy of Individuals with Type 2 Diabetes Mellitus in South-East, Nigeria.

Objectives: Diabetes Mellitus is a chronic disease, which requires a level of confidence among the sufferers in its management. This study investigated the effect of an educational intervention program on self-efficacy (SE) in diabetic individuals with type 2 diabetes mellitus in South-East, Nigeria. Methods: The study was a quasi-experimental controlled study, comprising 382 individuals with type 2 DM selected, and assigned to intervention (IG) and control groups (CG). The instrument for data collection was the Stanford Chronic Disease Self-Efficacy Scale (SCDS). Pretest data were collected, and thereafter education on diabetes management was given to the IG group. The IG was followed up for 6 months. At the end of 6 months, post-test data were collected using the same instrument. Data were analyzed using Pearson Chi-square test statistics. A P-value less than .05 alpha level was considered significant. Results: There was no statistically significant difference between the two groups before intervention. However, after 6 months of intervention, a significant proportion of participants' scores in IG moved from low to either moderate, or high SE in almost all the SE domains (P < .05. Conclusions: There was an improvement in most domains of self-efficacy in the intervention group after 6 months of educational intervention.

Neighborhood safety, fall indices, physical activity level and social participation restrictions from a population of community-dwelling older adults in Nsukka, Enugu State, Nigeria.

BACKGROUND: Restriction in physical activity (PA) and social participation restriction (PR) can be heightened in the presence of fear of fall (FOF), fall experience, and perceived unsafe neighborhood, particularly among older adults. Despite the enormous benefits of social participation and physical activity, many older adults remain vulnerable to participation restriction and this probably accounts for a significant proportion of health challenges for older adults. OBJECTIVE: This study investigated the relationship between neighborhood safety (NS), fall indices, physical activity, and social participation restriction among older adults from selected communities in Nsukka, Enugu state, Nigeria. METHODS: This was a cross-sectional survey of 170 recruited via consecutive non-probability sampling techniques. Socio-demographic variables, co-morbidities, and fall prevalence were obtained using a self-administered questionnaire. The study instruments include the PA neighborhood environment scale - Nigeria (PANES-N), PA scale for elderly (PASE), Participation scale (PS), Modified fall efficacy scale (MFES), and Fall risk assessment tool (FRAT) and fall indices. STATISTICAL ANALYSIS: Descriptive statistics of mean and standard deviations, frequency counts, and percentages were used to analyze the socio-demographic variables, and Inferential statistics of Spearman rank order correlation were used to determine the relationship among the neighborhood safety, fall indices, physical activity level, and participation restrictions. RESULTS: PR has a negative relationship with NS (r = -0.19, p- 0.01), and fall efficacy (r = -0.52, p- 0.001). However, PR has a positive relationship with fall risk (r = 0.36, p = 0.001). CONCLUSION: Participation restriction is negatively correlated with neighborhood safety, fall efficacy, and PA. The PR has a positive relationship with fall risk (FR).

Effect of educational intervention programme on the health-related quality of life (HRQOL) of individuals with type 2 diabetes mellitus in South-East, Nigeria.

BACKGROUND: Diabetes is one of the most important chronic diseases that have a great impact on health as people with diabetes are constantly being reminded of their disease daily; they have to eat carefully, exercise, and test their blood glucose. They often feel challenged by their disease because of its day-to-day management demands and these affect their quality of life. The study aimed at determining the effect of an educational intervention program on the quality of life of Individuals with type 2 Diabetes Mellitus in South East, Nigeria. METHODS: A quasi-experimental controlled study involving three hundred and eighty-two (382) type 2 DM persons recruited from the tertiary health institutions in South East, Nigeria, and randomly assigned to intervention and control groups respectively. Data was collected from the diabetic clinics of the health institutions using the SF - 36 questionnaires. Pretest data collection was done, and thereafter, education on self-care was given to the intervention group. After a 6months follow-up, post-test data were collected from both groups. Analysis was done using an Independent t-test, Analysis of Covariance (ANCOVA), Paired Samples Test, and Spearman rank order correlation at 0.05 alpha level. RESULTS: The control group indicated significantly higher mean HRQOL scores in most domains of the HRQOL before intervention (t = -1.927 to -6.072, p < 0.05). However, 6 months after the intervention, the mean HRQOL scores of the intervention group increased significantly in all the domains of HRQOL (p < 0.05) with an effect size of 0.14 (Eta squared). A comparison of the two groups shows a statistically significant difference (64.72 ± 10.96 vs. 58.85 ± 15.23; t = 4.349. p = 0.001) after the intervention. Age was inversely correlated with some domains of HRQOL; as age increases, HRQOL decreases in those domains. Gender had no significant influence on HRQOL. CONCLUSION: Educational intervention was effective in improving HRQOL in individuals with type 2 DM. Hence, it is recommended for inclusion in all diabetes care plans.

Work-related stress, quality of life, and coping mechanism among lecturers in a Tertiary Educational Institution in Anambra State, Nigeria.

INTRODUCTION: Work-related stress (WRS) is a highly prevalent and pervasive problem that can result in loss of productivity and deterioration of a lecturer's health. Lecturing work requires coping with some of the stressful situations found in any workplace to have a favourable quality of work life. The study determined the influence of sex, years of teaching experience, and academic rank on work-related stress, coping mechanisms, and quality of work life among lecturers at Nnamdi Azikiwe University (NAU). METHOD: This was a cross-sectional survey involving 283 lecturers consecutively recruited from NAU after proportionate randomization of the lecturers in 101 departments. The Health and Safety Executive Work Related stress (HSE-WRS), Work-Related Quality of life (WRQL), and Brief-cope Questionnaires (BCQ) were applied to assess the participant's work-related stress, quality of work life, and coping mechanism (CM) respectively. Data were analyzed using Kruskal Wallis and Mann-Whitney U tests at a 0.05 level of significance. RESULT: Sex, years of teaching experience, and academic rank had statistically significant influence on 14 subsets of coping mechanism with p-values

Validation of an iCare Health Monitor smartphone application in the assessment of vital signs among stroke survivors in a poor-resource country.

Background: Frequent and accurate monitoring of blood pressure (BP) is a vital part of stroke management. There is therefore the need for availability of simple, portable and accurate devices for monitoring BP at any point in time. Objective: To determine the validity and reliability of the iCare Health Monitor (iCHM) smartphone application in the measurement of BP, heart rate (HR) and respiratory rate (RR) amongst stroke survivors in Anambra State. Methods: This was a cross-sectional survey involving 86 stroke survivors (64.0% males; mean age = 65.23 ± 12.10 years) consecutively recruited from three conveniently selected centres in Anambra State. BP, PR and RR were assessed using both the standardised methods and iCHM. The parameters were reassessed with the iCHM after few minutes. Convergent validity and test-retest reliability of the iCHM were determined using Pearson product moment correlation and intra-class correlation coefficient respectively at an alpha level of 0.05. Results: The convergent validity of the iCHM was excellent in measuring systolic BP (SBP) (r = 0.96; p < 0.01), diastolic BP (DBP) (r = 0.93; p < 0.01), HR (r = 0.96; p < 0.01) but moderate in measuring RR (r = 0.74; p < 0.01). The test-retest reliability of the iCHM was excellent in assessing SBP (ICC = 0.95; p < 0.01), DBP (ICC = 0.94; p < 0.01) and HR (ICC = 0.92; p < 0.01) but poor in assessing RR (ICC = 0.35; p = 0.03). Also, the iCHM displayed clinically insignificant bias. Conclusion: The iCHM is a valid and reliable tool for assessing BP and HR (but not RR) among stroke survivors. Its use is therefore recommended especially in poor-resource countries where gadgets for assessing BP and PR might not easily be affordable and available.

The Burden and Quality of life of Caregivers of Stroke Survivors with Cognitive Impairment in Selected Healthcare Facilities in Anambra State, Nigeria.

Objective: To determine the burden and quality of life of caregivers of stroke survivors with cognitive impairment in selected healthcare facilities in Anambra State, Nigeria. Methods: This was a cross-sectional survey using the World Health Organization QOL-BREF and Caregiver Strain Index (CSI) as instruments. Descriptive statistics of frequency, percentage counts, mean and standard deviation were used to summarize the socio-demographics. Spearman's ranked order correlation; Mann-Whitney U test assessed the correlation and gender and age difference in QoL and caregiver's burden. Alpha level was set at 0.05. Results: Physical health domain of QOL was slightly moderate (53.29 ± 15.19), psychological health was low (46.33 ± 16.96), social relationship was slightly moderate (51.16 ± 0.31), environmental health was slightly moderate (51.22 ± 15.88), the burden of caregivers was high (6.35 ± 1.29). Conclusion: The quality of life of the caregivers of stroke survivors with cognitive impairment was moderate, and the caregivers' stress was high in the sample of the population studied.

Prevalence and risk factors of Hepatitis D virus antibody among asymptomatic carriers of Hepatitis B virus: a community survey.

Background: Hepatitis D virus (HDV) can cause a chronic infection in the presence of hepatitis B surface antigen and contribute to the burden of chronic liver disease especially in regions where chronic hepatitis B virus (HBV) infection is endemic. Aim: To determine the prevalence and risk factors of HDV among asymptomatic carriers of HBsAg in Cross River State, Nigeria. Methods: This was a cross-sectional study conducted among apparently healthy adults resident in Cross River State, Nigeria. A structured questionnaire was used to collect socio-demograhic data and risk factors for HBV/HDV infection. Participants blood samples were screened for HBsAg. Samples that were HBsAg positive were further screened for anti-HDVIgM. Statistical analysis was performed using statistical package for social sciences (SPSS) version 20. Results: A total of 90 HBsAg positive samples were assayed. The prevalence of anti-HDV IgM was 5.6% (95% CI 1.1-10.1). The HDV positive subjects were mostly females (80%), reported family size of >5 members (80%), had female circumcision (75%) and took injections from Non-certified health care practitioners (NCHCPs). None of the assessed risk factors were significantly associated with HDV infection (p >0.05). Conclusion: Hepatitis D virus is moderately prevalent amongst asymptomatic HBsAg carriers in Cross River State, Nigeria.

Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study.

BACKGROUND: Systematic reviews demonstrated that gait variables are the most reliable predictors of future falls, yet are rarely included in fall screening tools. Thus, most tools have higher specificity than sensitivity, hence may be misleading/detrimental to care. Therefore, this study aimed to determine the validity, and reliability of the velocity field diagram (VFD -a gait analytical tool), and the Timed-up-and-go test (TUG)-commonly used in Nigeria as fall screening tools, compared to a gold standard (known fallers) among community-dwelling older adults. METHOD: This is a cross-sectional observational study of 500 older adults (280 fallers and 220 non-fallers), recruited by convenience sampling technique at community health fora on fall prevention. Participants completed a 7-m distance with the number of steps and time it took determined and used to compute the stride length, stride frequency, and velocity, which regression lines formed the VFD. TUG test was simultaneously conducted to discriminate fallers from non-fallers. The cut-off points for falls were: TUG times ≥ 13.5 s; VFD's intersection point of the stride frequency, and velocity regression lines (E1) ≥ 3.5velots. The receiver operating characteristic (ROC) area under the curves (AUC) was used to explore the ability of the E1 ≥ 3.5velots to discriminate between fallers and non-fallers. The VFD's and TUG's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Alpha was set at p < 0.05. RESULTS: The VFD versus TUG sensitivity, specificity, PPV and NPV were 71%, 27%, 55%, and 42%, versus 39%, 59%, 55%, and 43%, respectively. The ROC's AUC were 0.74(95%CI:0.597,0.882, p = 0.001) for the VFD. The optimal categorizations for discrimination between fallers/non-fallers were ≥ 3.78 versus ≤ 3.78 for VFD (fallers versus non-fallers prevalence is 60.71% versus 95.45%, respectively), with a classification accuracy or prediction rate of 0.76 unlike TUG with AUC = 0.53 (95% CI:0.353,0.700, p = 0.762), and a classification accuracy of 0.68, and optimal characterization of ≥ 12.81 s versus ≤ 12.81 (fallers and non-fallers prevalence = 92.86% versus 36.36%, respectively). CONCLUSION: The VFD demonstrated a fair discriminatory power and greater reliability in identifying fallers than the TUG, and therefore, could replace the TUG as a primary tool in screening those at risk of falls.

Impact of exercise training on symptoms of depression, physical activity level and social participation in people living with HIV/AIDS: a systematic review and meta-analysis.

BACKGROUND: Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls? METHOD: Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2). RESULTS: Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18-86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2-3 times/week, at 40-60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = - 0.74, 95% confidence interval (CI) - 1.01, - 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI - 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI - 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants). CONCLUSION: Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies. TRAIL REGISTRATION NUMBER: INPLASY202040048.

Social Support, General Self-Efficacy, Fear of Falling, and Physical Activity Among Older Adults in a Middle-Income Country.

Objectives: To investigate the levels and interrelationships between fear of falling (FOF), physical activity (PA), social support (SS), and general self-efficacy (GSE) among older adults in a Nigerian community. Methods: This was a cross-sectional survey involving 100 older adults (65.0% females; mean age = 74.25 ± 8.01 years) consecutively recruited from Nnewi community. Participants' FOF, PA, GSE, and SS were assessed using standardized questionnaires. Data were analyzed using descriptive statistics, Spearman rank order correlation, and structural equation modeling at a 0.05 level of significance. Results: The participants' mean FOF, PA, GSE, and SS scores were 15.22 ± 7.43 (fearful), 114.76 ± 90.18 (low), 21.64 ± 8.25 (low) and 5.72 ± 1.19 (high) respectively. There were significant correlations between each pair of FOF, PA, GSE, and SS scores of the participants (p < .05). FOF and GSE were significant predictors of PA while GSE and SS were significant predictors of FOF. Conclusion: FOF and SS were high while PA and GSE were low in this sample of Nigerian older adults. Significant correlations existed between FOF, SS, GSE, and PA, with FOF and GSE being predictors of PA while GSE and SS significantly predicted FOF. Measures should be geared towards reducing FOF and improving PA, GSE, and SS in this group.

Cross-cultural adaptation and validation of the reintegration to normal living index into IGBO language among individuals with mobility disability.

BACKGROUND: Community reintegration is one of the most important elements of disability rehabilitation globally. Hence, there is need for availability of psychometrically-sound and culturally-specific instruments for its measurement. Most of the available community reintegration measures were developed and validated in developed countries and might therefore not be suitable for use in developing countries. This study was aimed at cross-culturally adapting and validating the original English visual analogue scale version of the Reintegration to Normal Living Index (RNLI) into Igbo Language and culture among people with mobility disability in Igbo land, Southeast Nigeria. The English version of the RNLI was cross-culturally adapted to Igbo following the American Association of Orthopaedic Surgeons' guideline. The RNLI was translated into Igbo Language, synthesized, back translated, and subsequently subjected to expert panel review, pretesting and cognitive debriefing interview. The final Igbo version of the RNLI was tested for internal consistency and construct validity in a sample of 102 consenting participants (61.8% males; 46.92 ± 20.91 years) recruited from conveniently sampled clinics and rehabilitation centres in Anambra and Enugu States of South-Eastern Nigeria. The construct (concurrent) validity was evaluated using Spearman rank correlation, scatter plot and Mann-Whitney U test while the internal consistency was evaluated using Cronbach's alpha at alpha level of 0.05. RESULTS: The RNLI was successfully cross-culturally adapted to Igbo with all the 11 items still retained. The mean total score of the participants on the RNLI was 58.62 ± 21.25. The internal consistency coefficient (α = 0.84) of Igbo version of the RNLI was excellent. The Spearman correlation coefficients between the participants' total, subscale and domain scores on the Igbo and the English versions of the RNLI (r = 0.81-0.95) were excellent. There was no significant difference between corresponding scores in the English and Igbo versions of the RNLI. CONCLUSION: The Igbo version of the RNLI is a valid and reliable outcome measure among Igbo people living with mobility disabilities in Southeast Nigeria. It is therefore recommended for use among this group.

Correction to: Effects of transcutaneous electrical nerve stimulation in the Management of PostInjection Sciatic Pain in a non-randomized controlled clinical trial in Nnewi, Nigeria.

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Effects of transcutaneous electrical nerve stimulation in the Management of Post-Injection Sciatic Pain in a non-randomized controlled clinical trial in Nnewi, Nigeria.

BACKGROUND: Many studies on transcutaneous electrical nerve stimulation (TENS) had been undertaken to explore its pain relieving efficiency on several medicals/surgical conditions but none, specifically, had been carried out to determine the effect it has on post-injection sciatic pain (PISP) which comes about from wrong administration of intramuscular pain. This study aims to assess the effects of TENS in the management of PISP. METHODS: A total of 72 PISP subjects comprising 40 test subjects and 32 control subjects participated in a non-randomized controlled clinical trial in the current study. Participants were recruited from Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi and Landmark Physiotherapy Services, Nnewi. The participants were however blinded to the intervention method they will receive before being allotted conveniently to test/experimental group (TG) or control group (CG). A written informed consent was obtained from participants before enrollments in the study. TENS and sham TENS (STENS) was applied to 40 test and 32 subjects respectively, 3 times a week, and 1 hour per session for the 10 weeks the study lasted. The Visual Analogue Scale was used to collect baseline data as well as those of 2nd, 4th, 6th, 8th and 10th weeks after TENS and STENS interventions. The data analysis was performed with the Descriptive statistic of Mean ± SD, mean comparison test, repeated analysis of variance and paired wise t-test. Statistical level of significance was set at P < 0.05. RESULT: Results of repeated measure ANOVA showed that the pain level among participants in the treatment group at the end (after 10 weeks) of the intervention was significantly lower than that of their counterparts in the control group (F = 16.26; p = 0.01); with the intervention accounting for the 19% of the variance. The effect size (partial eta squared) = 0.19. CONCLUSION: The outcome of this research has proved the effectiveness of TENS in the management of PISP and is being recommended in the management of PISP. TRIAL REGISTRATION: Pan Africa Clinical Trial Registry ( PACTR201805003408271 ). The study was registered retrospectively on the 29th May, 2018.

Effects of a 12-month task-specific balance training on the balance status of stroke survivors with and without cognitive impairments in Selected Hospitals in Nnewi, Anambra State, Nigeria.

BACKGROUND: Stroke results in varying levels of physical disabilities that may adversely impact balance with increased tendency to falls. This may intensify with cognitive impairments (CI), and impede functional recovery. Therefore, task-specific balance training (TSBT), which presents versatile task-specific training options that matches varied individual needs, was explored as a beneficial rehabilitation regime for stroke survivors with and without CI. It was hypothesized that there will be no significant difference in the balance control measures in stroke survivors with and without CI after a 12-month TSBT. OBJECTIVE: To determine if TSBT will have comparable beneficial effects on the balance control status of sub-acute ischemic stroke survivors with CI and without CI. METHODS: One hundred of 143 available sub-acute first ever ischemic stroke survivors were recruited using convenience sampling technique in a quasi-experimental study. They were later assigned into the cognitive impaired group (CIG) and non-cognitive impaired group (NCIG), respectively, based on the baseline presence or absence of CI, after screening with the mini-mental examination (MMSE) tool. With the help of four trained research assistants, TSBT was applied to each group, thrice times a week, 60 mins per session, for 12 months. Their balance was measured as Bergs Balance scores (BBS) at baseline, 4th, 8th, and 12th month intervals. Data were analyzed statistically using Kruskal Wallis test, and repeated measure ANOVA, at p < 0.05. RESULTS: There was significant improvement across time points in the balance control of CIG with large effect size of 0.69 after 12 months of TSBT. There was also significant improvement across time points in the balance control of NCIG with large effect size of 0.544 after 12 months of TSBT. There was no significant difference between the improvement in CIG and NCIG after 8th and 12th months of TSBT. CONCLUSIONS: Within the groups, a 12-month TSBT intervention significantly improved balance control, respectively, but with broader effects in the CIG than NCIG. Importantly, though between-group comparison at baseline revealed significantly impaired balance control in the CIG than NCIG, these differences were not significant at the 8th month and non-existent at the 12th month of TSBT intervention. These results underscore the robustness of TSBT to evenly address specific balance deficits of stroke survivors with and without CI within a long-term rehabilitation plan as was hypothesized.

HIV-related knowledge, attitude and practices of healthy adults in Cross River State Nigeria: a population based-survey.

INTRODUCTION: Human Immunodeficiency Virus (HIV) remains a global health problem disproportionately distributed across Nigeria. Cross river state (CRS), a tourist state, located in the Niger delta, has one of the highest prevalence rates. There is evidence that poor knowledge and stigmatization are obstacles to achieving universal access to HIV prevention programs. The objective of this study was to determine the Knowledge, Attitude and Practice (KAP) of HIV among adults resident in CRS, Nigeria. METHODS: A cross sectional descriptive survey design was employed. A total of 1,620 healthy adults were recruited. KAP towards HIV was assessed using a structured pre-tested questionnaire. Categorical variables were described as frequencies and continuous variables as median and interquartile range. Kruskal-Wallis test was used to determine relationship between variables and median KAP scores. P value < 0.05 was considered significant. All analyses were performed using Stata 12 statistical package. RESULTS: A total of 1,465 respondents completed the questionnaire correctly giving a response rate of 91%. The M: F ratio was 1:1.8. The median age was 38 years. Majority was married and had formal education. Knowledge of HIV and common routes of transmission was high (>80%). However, misconception that HIV can be transmitted through hugging, hand shake, mosquito bites and witch craft was also common (> 60%). The overall attitude and practice towards persons living with HIV infection was poor. CONCLUSION: This study showed misconceptions in the knowledge and consequences of HIV infection which is associated with negative attitude towards persons living with HIV.