Safety perception and determinants of complementary and alternative medicine usage among surgery out-patients in LAUTECH Teaching hospital, ogbomoso, Nigeria.

Objectives: The use of complementary and alternative medicine (CAM) stemmed from the search of humans for other means of relieving pain and managing diseases which has plagued its existence. CAM use is on the increase among the general population in both the developed and developing nations and also among surgical patients. There is therefore a need to ascertain the perceived adverse effects, the safety perception and the determinants of its use so as to improve the advocacy for adequate regulation. Methods: It was a cross-sectional study carried out among surgical outpatients in a tertiary hospital. One hundred and fifty patients between the ages of 18 and 85 years were recruited. An interviewer-administered questionnaire was used to collect data from each participant. Data was analyzed using SPSS version 22. Results: The lifetime prevalence of CAM use among the respondents was 76 % while the point/current prevalence was 37.3 %. The percentage of current users using CAM for surgical complaints was 30.4 %. Biological based therapy accounted for 110 (72 %) of CAM used and unbranded herbal products was responsible for more than two-third of it. Almost a third of the patients (46, 30.7 %) perceived that CAM is safe while 62 (41.3 %) were not sure of its safety. Only 15 (13.2 %) and 6 (5.3 %) have ever recorded side effects and drug interactions respectively. Older age group, income less than 10,000 Naira, positive safety perception and belief about CAM were identified as determinants of CAM usage. Conclusions: The prevalence of CAM usage among surgical outpatients was quite high and the major determinants of its use are the patient's age, safety perception and their level of income.

An Accelerated Failure Time Model to Predict Cause-Specific Survival and Prognostic Factors of Lung and Bronchus Cancer Patients with at Least Bone or Brain Metastases: Development and Internal Validation Using a SEER-Based Study.

BACKGROUND: This study addresses the significant challenge of low survival rates in patients with cause-specific lung cancer accompanied by bone or brain metastases. Recognizing the critical need for an effective predictive model, the research aims to establish survival prediction models using both parametric and non-parametric approaches. METHODS: Clinical data from lung cancer patients with at least one bone or brain metastasis between 2000 and 2020 from the SEER database were utilized. Four models were constructed: Cox proportional hazard, Weibull accelerated failure time (AFT), log-normal AFT, and Zografos-Balakrishnan log-normal (ZBLN). Independent prognostic factors for cause-specific survival were identified, and model fit was evaluated using Akaike's and Bayesian information criteria. Internal validation assessed predictive accuracy and discriminability through the Harriel Concordance Index (C-index) and calibration plots. RESULTS: A total of 20,412 patients were included, with 14,290 (70%) as the training cohort and 6122 (30%) validation. Independent prognostic factors selected for the study were age, race, sex, primary tumor site, disease grade, total malignant tumor in situ, metastases, treatment modality, and histology. Among the accelerated failure time (AFT) models considered, the ZBLN distribution exhibited the most robust model fit for the 3- and 5-year survival, as evidenced by the lowest values of Akaike's information criterion of 6322 and 79,396, and the Bayesian information criterion of 63,495 and 79,396, respectively. This outperformed other AFT and Cox models (AIC = [156,891, 211,125]; BIC = [158,848, 211,287]). Regarding predictive accuracy, the ZBLN AFT model achieved the highest concordance C-index (0.682, 0.667), a better performance than the Cox model (0.669, 0.643). The calibration curves of the ZBLN AFT model demonstrated a high degree of concordance between actual and predicted values. All variables considered in this study demonstrated significance at the 0.05 level for the ZBLN AFT model. However, differences emerged in the significant variations in survival times between subgroups. The study revealed that patients with only bone metastases have a higher chance of survival compared to only brain and those with bone and brain metastases. CONCLUSIONS: The study highlights the underutilized but accurate nature of the accelerated failure time model in predicting lung cancer survival and identifying prognostic factors. These findings have implications for individualized clinical decisions, indicating the potential for screening and professional care of lung cancer patients with at least one bone or brain metastasis in the future.

Is Intimate Partner Violence More Common Among HIV-Positive Pregnant Women? A Comparative Study in Oyo State, Nigeria.

Introduction: Intimate partner violence (IPV) is the most common form of violence against women. Pregnant women are also not exempted from the menace of IPV which has dire consequences for both the mother and child. There is an established link between HIV and IPV and both have a synergistic effect. This study is aimed at comparing the prevalence, pattern, and determinants of IPV among pregnant women living with HIV and HIV-negative pregnant women attending antenatal clinics in Oyo state. Methodology: This is a descriptive cross-sectional study carried out among women attending antenatal clinics in Oyo state using a multistage sampling technique. The study spanned through March and September 2019. The data collection was conducted using a semi-structured questionnaire and the analysis was done using Statistical Package for Social Sciences version 22. The pattern and prevalence of IPV were measured using the Composite Abuse Scale, a 30-item validated interviewer-administered research instrument. It measured 4 dimensions of abuse: physical, emotional, severe, combined, and sexual harassment. A preliminary cut-off score of 7 was used to divide respondents into the presence or absence of IPV. A Chi-square test was used to test for an association between IPV and socio-demographic characteristics and a logistic regression was used at the multivariate level to identify the determinants of IPV. The P-value was set at <.05. Results: Out of the 240 booked pregnant women, 44.2% of HIV-negative respondents and 47.5% of women living with HIV reported being abused in the index pregnancy. Severe combined abuse was the most common type of abuse, 110 (75.1%), followed by emotional abuse, 70 (40.2%), physical abuse, 68 (39.3%), and sexual harassment, 67 (38.1%). Respondents living with HIV reported suffering more physical abuse than their HIV-negative counterparts. Occupation of respondents and duration of marriage determinants of IPV among HIV-positive participants are statistically significant while the duration of marriage was not statistically significant for IPV among HIV-negative respondents. Conclusion: This study recorded a high prevalence of IPV among pregnant women living with HIV and HIV-negative pregnant women with a slight increase in the group living with HIV. It is therefore recommended that IPV screening programs and intervention strategies should be developed for every pregnant woman, irrespective of their HIV status.

Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in oyo state, Nigeria.

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of #x003C;0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in Oyo State.

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of <0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

Pilot study of new statistical models for prognostic factors in short term survival of oral cancer.

Background: Survival times of oral cancer are poorly documented in Nigeria. This is partly due to poor documentation and limited investigations to elicit sufficient prognostic factors. In this study, we applied a new statistical model for survival times of oral cancer patients considering limited prognostic factors. Methods: A total of 29 cases of Oral cancer patients with stage I to IV invasive primary oral cancer treated at the University of Port Harcourt, Nigeria between 2008 and 2015 were used to generate prognostic models. Profiled prognostic factors include age, stage of tumor development, habitus, and treatment modalities. The baseline statistical distributions considered were Exponential, Weibull, Lognormal and Log-logistic distributions. The Chi-Square test was considered for the suitability of the model chosen. A comparison of the model performance was done using the Akaike Information Criterion (AIC). Results: Seventeen (58.6%) of the oral cancer patients were males and 12(41.4%) were females within the age range of 19 and 73 years. Sixteen (55.2%) of the patients were censored while 13(44.8%) were not censored. The estimated median survival time (MST) for the males was 29.50 months while that of the female was 7 months. Four parametric statistical models were tested and all identified tumor stage [cTNM stage (p= 0.000)] and treatment modality (p= 0.000) as more important predictors of survival. The models were then compared, using the Akaike Information Criterion (AIC) to determine the model best fit for the data. The model with the lowest AIC and so considered the best was the Weibull Statistical Model (WSM) with AIC= 100.76. Conclusions: This study suggests that the Weibull survival model is the best fit for estimating oral cancer survival times especially where only limited prognostic factors are available. Larger studies are required to validate the findings of this pilot.

The modified beta transmuted family of distributions with applications using the exponential distribution.

In this work, a new family of distributions, which extends the Beta transmuted family, was obtained, called the Modified Beta Transmuted Family of distribution. This derived family has the Beta Family of Distribution and the Transmuted family of distribution as subfamilies. The Modified beta transmuted frechet, modified beta transmuted exponential, modified beta transmuted gompertz and modified beta transmuted lindley were obtained as special cases. The analytical expressions were studied for some statistical properties of the derived family of distribution which includes the moments, moments generating function and order statistics. The estimates of the parameters of the family were obtained using the maximum likelihood estimation method. Using the exponential distribution as a baseline for the family distribution, the resulting distribution (modified beta transmuted exponential distribution) was studied and its properties. The modified beta transmuted exponential distribution was applied to a real life time data to assess its flexibility in which the results shows a better fit when compared to some competitive models.

Data on the survival times of breast cancer patients in a Teaching Hospital, Osogbo.

In a bid to assess the contribution of prognostic factors to survival times of breast cancer patients from day of presentation in Nigeria, a data was collected from Ladoke Akintola University of Technology Teaching Hospital Osogbo. This is a retrospective data culled from the case note files of the breast cancer patients. The survival time of the patients was recorded as the difference between the day of presentation and the day of last contact. The data is censored at 1 year. The prognostic factors considered are years of breastfeeding(In years), Age at menarche, stage at presentation, neoadjuvant treatment offered and use of contraceptives. Four survival models were applied to the data to assess the contribution of the prognostic factors to survival times.

Awareness and Utilization of Adolescent Reproductive Health Services among In-School Adolescents in Urban and Rural Communities in Oyo State.

INTRODUCTION: Adolescents require a range of scientifically accurate sexual and reproductive health information and services. Adolescent reproductive health services (ARHSs) are an integral part of adolescent health and it is pertinent that adolescents know about them to be able to benefit from them. This study was to assess the awareness and utilization of adolescents in Oyo State about ARHSs. MATERIALS AND METHODS: A descriptive cross-sectional study carried out among in-school adolescents where 225 respondents each were selected for the rural and urban groups using a multi-stage sampling technique. Data were collected using a semi-structured questionnaire, and analysis was performed with SPSS version 22. RESULTS: A total of 225 rural and 225 urban respondents participated in this study, with a mean age of 14.3 ± 1.93 and 13.9 ± 2.03 for rural and urban respondents, respectively. Few of the respondents (59, 13.1%) were aware of the existence of ARHS, of which, 34 (57.6%) were of the urban respondents and 25 (42.4%) were from the rural respondents. Only 36 (7.8%) of respondents had ever utilized ARHS with 22 (61.1%) from urban communities. The major reason why almost half of 207 (49.6%) of the adolescents had never been to a facility rendering ARHS before was that they did not know where to go, which was higher among the rural respondents. CONCLUSIONS: Awareness of ARHSs was lower among rural respondents, leading to poor utilization of such service. It is, therefore, recommended that more youth-friendly environments should be made available and accessible to adolescents, especially in rural areas (114, 53.3%).