Current Trends in Disease and Health Vol. 2

Modelling and Prediction of Atherogenic Index of Plasma Against Cardiometabolic Risk

Charles C. Onoh — 2019-11-08

Background and aim: Cardiometabolic risk is a constellation of cardiovascular risk factors which include diabetes, hypertension, obesity and dyslipidaemia. Atherogenic Index of Plasma (AIP) is gaining prominence as a screening tool for dyslipidaemia however, these tools are expensive, time consuming, cumbersome and beyond the reach of an average Nigerian. The purpose of this study was to determine the predictors and modelling of AIP against some cardiometabolic parameters among workers in Owerri, Nigeria. Prediction and modelling of AIP will give cost effective options in the assessment of cardiometabolic risk.

Methods: This was designed as a work-site based cross sectional study carried out on three hundred and sixty one (361) transport workers. The respondents were anthropometrically examined. Blood glucose estimation was determined using glucose oxidase/peroxidase method of Trinder. Lipid indices were determined using Freidewald’s method. Data were facilitated using XLSTAT 2016. Principal component analysis and Logistic probit regression models were employed to determine the degree of relationship and superiority.

Results: AIP was shown to be statistically significant and positively correlated with waist circumference (WC), body mass index (BMI) and systolic blood pressure (SBP) based on the Logistic regression analysis with a Goodness of fit of 69.97%. WC is the most powerful anthropometric tool in predicting cardiometabolic syndrome. AIP was shown to be a principal and dominant predictor of cardiometabolic syndrome.

Conclusions: This study has established that AIP correlates statistically and significantly with WC, BMI and SBP. A set of predictive regression models for AIP was developed for WC, BMI and SBP. AIP as a calculated factor can be used in the clinical setting as a cost-effective diagnostic tool in assessing cardiometabolic risk beyond the routinely done lipid profile especially where others have failed and most importantly in resource-poor setting like Nigeria.

Quality of Life of Palestine Children Exposed to Wars in Gaza

Abdelaziz Mousa Thabet — 2019-11-08

Aim: This study aimed to investigate the impact of trauma due to wars on quality of life of Palestine children living in Gaza with special reference to 2009 war.

It is analytic study; the study sample consisted of 195 children and adolescents who were selected purposely from three areas in the Gaza Strip. Those children exposed to variety of traumatic events besides losing their homes during ground incursion of the border and shelling and bombardment of the area. They were 101 boys (51.8%) and 94 girls (48.2%). The age ranged from 7 to 18 years with mean age of 12.84 (SD = 2.9). Children were assessed by socio-demographic questionnaire, Gaza Traumatic Events Checklist, and Health Related Quality of Life.

Results: The highest frequencies of reported traumatic events by Palestinians children were 97.9% hear shelling of the area by artillery, 93.3% hear the sonic sounds of the jetfighters, 90.8% watched mutilated bodies in TV, and 85.6% were forced to move from home to a safer place during the war. The study showed that mean total quality of life was 62.80, physical functioning was 69.87, emotional functioning was 51.96, mean of social functioning was 77.62, and school functioning mean was 47.53. Total traumatic events reported by children were negatively strongly correlated with total Health Related Quality of Lief (HRQoL), physical, emotional, and social functioning. However, traumatic experiences by children were not correlated with school function.

Conclusion: In summary, this study not only supports the findings of the body of research as it relates to traumatic experiences in children and adolescents and impact of their health quality of life, but also has important implications for establishing and implementation of different psychosocial intervention programs for the school-aged population in Gaza Strip. There are need to be considered in the planning of educational and mental health support services by different governmental United Nations organizations, and non-governmental organization in Gaza. Also, successful treatment of the mental health symptoms associated with traumatic events first requires an acknowledgment of the trauma and then a process which allows for comprehensive assessment and accurate diagnosis.

Work-Related Musculoskeletal Disorders amongst Office-Based Civil Servants in Rivers State, Nigeria

Ify L. Nwaogazie — 2019-11-08

This study was carried out to investigate Work-Related Musculoskeletal Disorders (WRMDs) among office-based civil servants in selected ministries (Ministry of Education and Health) –Min-C and local government areas (Ikwerre and Obio/Akpor) LGA-C of Rivers State using 200 office-based civil servants as the study population. A lykert model response questionnaire was used as the instrument of primary data collection to investigate prevalence of WRMDs among the study population. The data obtained were analyzed using Kendall’s coefficient of concordance (w). The w-values for general office ergonomic awareness were 0.271 (27.1%) for LGA-C and 0.739 (73.9%) for Min-C while that of workstation ergonomics awareness were 0.297(29.7%) and 0.323(32.3%) for LGA-C and Min-C, respectively. When Workstation Ergonomic Practice was considered the w-values for LGA-C were 0.771 (77.1%) and 0.9896 (99%) for Min-C while that of Musculoskeletal Disorder/Pain complaints were 0.995 (99.5%) for LGA-C and 0.992 (99.2%) for Min-C. These values suggest that there is low level of ergonomics awareness and practice, and high prevalence of musculoskeletal disorders/pains among the study population. The study also indicates that the most affected body regions were waist, back, and neck.

Lifestyle and Its Relationship with Body Weight

Nicolás Padilla-Raygoza — 2019-11-08

A review of the self-perception of lifestyle and its relationship with body weight in adults is carried out, because the prevalence of overweight / obesity in the world continues to increase and Mexico is not exempt from it. The causes of obesity are reviewed and how different dimensions of lifestyle affect the increase in body mass index. It also includes a review of ways to prevent obesity through lifestyle interventions.

Water and Waterborne Diseases: A Review

Nwabor Ozioma Forstinus — 2019-11-08

Despite numerous efforts by government at various levels and other agencies interested in water and its safety, waterborne diseases are still a major public health and environmental concern. The huge investment towards water research, although worth the spending, has not yielded the much expected result as waterborne diseases continue to plague developing countries with Africa and Asia having the worse hit. The unavailability of pipe-borne water and the dependence of rural dwellers on surface waters which are often contaminated with faecal materials are undoubtedly the major causes of the rising prevalence of waterborne diseases. Water availability and poor hygienic practices amongst these rural dwellers are also of paramount concern as they play significant roles in the spread of water-washed diseases. Also, poor environmental practice which encourages the breeding of insects and other forms of vectors within residential areas contribute to the increasing prevalence of waterborne diseases. This review focuses on waterborne diseases, its classification and the various methods employed in the bacteriological analysis of water.

Relationship of Apolipoprotein B-100 and Lipid Profile Parameters among Diabetic Patients in a Tertiary Hospital in Nigeria

Tomisin Matthew Adaja — 2019-11-08

Diabetic dyslipidaemia is the bane of most complications seen in diabetes mellitus. The aim of our study is to determine the levels of apolipoprotein B-100 among diabetic adults and non-diabetic control; and its relationship with the traditional lipid profile parameters.

A total of 58 subjects including 30 diabetic patients and 28 non-diabetic controls selected from diabetic clinic and immunization centres respectively. Subjects were randomly selected, examined clinically and have their anthropometric parameters measured. Lipid profile was assayed using standard enzymatic spectrophotometric methods while serum apolipoprotein B-100 was measured using sandwich immunoassay technique. Data were expressed in means and standard deviations. Differences in means between the two groups were assessed using Student T-test and relationships tested using Pearson’s correlation study. Mean ages of diabetic and non-diabetic groups were 57.7±7.4 and 49.3± 17.9 years respectively (p>0.05). Statistical differences exist in the age, weight, BMI, and blood pressure between the two study groups. Serum apolipoprotein B-100 in the diabetic and non-diabetic controls were 84.9±58.8 and 67.6±44.3 mg/dl respectively (p<0.05). A weak positive correlation exists between serum apolipoprotein B-100 and haemoglobin A1c (r=0.420; p=0.021) while a strong positive correlation exists between apolipoprotein B-100 and LDL-cholesterol (r=0.702, p=0.001); apolipoprotein B-100 and non-HDL-cholesterol (r=0.690; p=0.001) and apolipoprotein B-100 and total cholesterol (r=0.688; p=0.001). Elevated apolipoprotein B-100 is a biochemical feature in poorly controlled diabetes mellitus. There is a positive relationship between apolipoprotein B-100 and total cholesterol, LDL-cholesterol and nonHDL-cholesterol. We advise the adoption of apolipoprotein B-100 as a routine test in the evaluation of diabetic dyslipidaemia among the diabetic patients.

Effect of a Cognitive-behavioral Program on Adherence to Antihypertensive Therapeutic Regimen in Older Adults: A Quasi-experimental Study

Celia Monserrat Bernal-Razon — 2019-11-08

Aims: To determine the effect of a cognitive-behavioral program on adherence to the antihypertensive therapeutic regimen of the elderly.

Study Design: Quasi-experimental study.

Place and Duration of Study: It was performed in the House of the Grandfather, nursing homes Juan de Celayeta and Beautiful Sunset San Juan Bosco rest house, all of Tepic, Nayarit, between April 2015 and May 2016.

Methodology: We included 49 elderly people with arterial hypertension, in two groups: interventional and comparison, with written informed consent. Data collection was done with the questionnaire of therapeutic adherence for hypertension; blood pressure was measured with a portable aneroid sphygmomanometer. The cognitive behavioral intervention was performed on the intervention group based on psychoeducation and cognitive restructuring to improve adherence to the therapeutic regimen.

Results: Both groups were similar in their sociodemographic characteristics. For therapeutic adherence, there were statistically significant differences between the intervention group and the comparison group (P <.05). Membership to the intervention group showed a strong effect on non-hypertension, post intervention (P <.05).

Conclusion: The cognitive-behavioral program had a positive effect on adherence to the antihypertensive therapeutic regimen, showing significant changes in the intervention group, and a reduction in the proportion of patients with hypertension.

Sickle Cell Disease and Severity of Malaria

Maman Daou — 2019-11-08

Background: The relationship between sickle cell disease and malaria remains controversial and the hypothesis that sickle cell disease protects against malaria is widespread.

Methodology: A descriptive and retrospective study over a two-year period (2014-2016) was conducted in pediatric departments A and B of the National Hospital of Niamey (HNN). The objective is to assess the relative risk between sickle cell disease and the severity of malaria.

Results: Nine hundred and seventy four (974) patients infected with Plasmodium falciparum were included in this study. Thirteen point twenty four percent (129/974) of patients had sickle cell disease, of which 93.8% (121/129) had SS form and 6.2% (8/129) SC form. Seventy-nine point eight percent (103/129) of sickle cell patients had severe malaria (RR = 0.9, p = 0.17). Ninety six point one percent (99/103) of patients with severe malaria have SS hemoglobin versus 3.8% (4/103) who have SC hemoglobin (RR = 0.6, p = 0.05). Eleven point forty three percent (4/35) of sickle cell patients died of malaria (RR = 0.1, p = 0.4). Seventy-five percent (3/4) of the deceased sickle cell have SS hemoglobin versus 25% (1/4) who have SC hemoglobin (RR = 5, p = 0.2).

Conclusion: Heterozygous sickle cell patients have less severe malaria than homozygotes. Malaria is more severe and more lethal in homozygous sickle cell patients. A strategy for the prevention of sickle cell malaria should be developed during periods of high transmission.

Knowledge and Awareness of Glaucoma among Population of Western Saudi Arabia, Taif City

Ashwaq Mohammed Almalki — 2019-11-08

Background: Glaucoma is a leading cause of irreversible visual loss worldwide. In Saudi Arabia, it accounts for blindness in 3% of the population above the age of 40 years. Moreover, Hospital-based observations and studies acknowledge the distribution of various subtypes of glaucoma in the kingdom. Nevertheless, there is a paucity of studies which designed to assess general population level of awareness regarding glaucoma in Saudi Arabia. This study aimed to assess general population knowledge and level of awareness in the western region of Saudi Arabia, Taif city.

Methods: A cross-sectional survey was carried out in a public place in Taif City, in the Kingdom of Saudi Arabia during the glaucoma awareness week in 2018. A total of 409 respondents participated and completed the study questionnaire. Statistical Package for Social Sciences (SPSS) was used for data analysis, where descriptive data was expressed as numbers and percentages, and the Chi-square (χ2) test was applied to test the relationship between variables. Quantitative data was expressed as mean and standard deviation (Mean ± SD), and Mann-Whitney (U) test was applied to compare medians for groups not normally distributed. A p-value of <0.05 was considered as statistically significant.

Results: Of the 409 interviewees participated, 62% were females with a mean age of (26 ±13) years, where the majority of males and females participants had a secondary school education (40% and 42% respectively). Most of the male and female respondents have heard of glaucoma before (63.1% and 61.1 respectively). Male participants defined glaucoma as a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness (41.1%), while the majority of females defined glaucoma as a slow drainage of fluid within the eye which causes fluid to build up leading to increased intraocular pressure within the eye (39%). Male participants ranked family members as the primary sources of information about glaucoma (41%) followed by medical campaigns (24.2%), while female respondent’s ranked medical campaigns as the primary source of information (34.1%), followed by family members (33%). Female respondents in this study showed a high level of awareness concerning glaucoma disease compared to male respondents.

Conclusion: While there is relatively good awareness level among the population in Taif city, further studies in different regions of the country on different population sectors are needed to assess knowledge and awareness level for a better understanding of the population’s age distribution, demographic differences regarding glaucoma awareness.

Promotion of Health in Self-efficacy, to Reduce Tobacco Consumption in Young Adults

Alicia Aboytes-Alvarez — 2019-11-08

Aim: The objective was determinate the effect of intervention on the self-efficacy and tobacco intake, to decrease smoking in young adults.

Study Design: Study interventional.

Place and Duration of the Study: Juventino Rosas, Mexican community, between September 2014 and May 2015.

Methodology: Sample of 101 smoking young adults between 20 and 30 years. The experimental group had 50 participants and control group 51, and all signed the inform consent. For data collection were used the “Scale for measuring the level of efficacy for smoking cessation” and “Questionnaire for the classification of consumers of cigarette for young”. The intervention was developed in 12 weekly sessions of 50 minutes each, for 3 months, aimed at increasing the self-efficacy through strategies of education, motivation and handling emotions.

Results: There was an association between interventional group and high self-efficacy (P=.01) and the OR = 2.96, IC95%=1.28 to 6.84. There was an association between consumed cigarettes and intervention group (P= .0001); OR=0.2, IC95% =0.08 to 0.46.

Conclusion: The interventional group improved significantly the level of self-efficacy and reduced consumption of cigarettes.

Indications for Gynaecological Consultation by Women at a Rural Outreach Centre in North-Central Nigeria

Jonathan Abina Karshima — 2019-11-08

Aims: To identify the reasons for consultations, the common clinical diagnosis and disease pattern at a rural gynaecologic outreach clinic.

Study Design: Descriptive Retrospective Study.

Place and Duration of Study: NKST Hospital Mkar-Gboko, Benue state, North-central Nigeria, in seven years (1^st April 2005 to 31^st July 2012).

Methodology: Information from the case notes of patients who attended the outreach clinic over the study period were retrieved and analysed. Majority of the patients came by self-referral.

Results: Of the 1,733 women that attended the clinic during the study period, 1,605 (92.6%) women made the inclusion criteria and formed the study population. The age range was 15 to 78 years; mean value of 33.6 +/- 9.5 year; 78% of the women were ages 21 – 40 years. The mean parity was 2.1 +/- 2.7and ranged between 0 to 13 children. 68% of the women were para 0 – 2 whilst 18% had parity of 5 and above. The women had 73 reasons and 2,390 presenting complaints, 49.6% of them had multiple presenting complaints (average 1.5 complaints per woman). Most common complaints were inability to conceive, lower abdominal pain and leaking of urine and /or faeces amongst 38%, 11% and 10% of the women respectively. There were 63 disease conditions with 1,793 clinical diagnoses. About 12% of the women had multiple clinical diagnoses. The three leading clinical diagnoses were infertility, genital fistulae and uterine myoma, in 46%, 12% and 10% of the women respectively; followed by sundry other gynaecological disorders (9%) and medical disease conditions (5%) in which hypertension, diabetes mellitus and retroviral diseases were more frequent in that order. Some women (n = 21; 1%) came for second opinion.

Conclusion: Gynaecological diseases are diverse and common among women in rural central Nigeria. Inability to conceive, lower abdominal pain and incontinence of urine and or faeces were the three main reasons women sought consultation with the gynaecologist at Mkar. Infertility, genital fistulae, uterine myoma, non-communicable medical disorders and retroviral diseases were leading clinical diagnoses. Extending the services of Gynaecologist to the rural areas in the region may reduce the access gap to women’s health and enhance national development.

Type 2 Myocardial Infarction- A Case Report

A. S. V. Prasad — 2019-11-08

Type 2 MI (T2MI) was defined as myocardial infarction other than due to coronary artery disease (CAD), produced by disparity between supply and demand of oxygen .Cases were reported in literature where T2 MI was diagnosed even in presence of 90% block in coronaries, where recent ischemic changes were shown to be not due to the CAD, but to disparity between supply and demand of oxygen. There was considerable overlap with the classical type 1 NSTE MI and T2 MI. Distinguishing between the two was considered challenging. Though T2 MI constituted about 25% of all cases of MI, the centres reporting Type 2 MI ranged between 0-13% only. Type 2 MI, the new heterogeneous group, was officially recognised by the task force on the universal definition of MI in 2007. The scope and criteria were changing since it was defined in 2007. Further, it appeared that -coronary cause of MI was more important than disparity between supply and demand of myocardial oxygen supply. For instance Sepsis, one of the important causes of T2 MI, could cause Type 2 MI by myocardial depression even in presence of normal oxygen perfusion.

A case diagnosed initially as NSTEMI, was retrospectively considered the possibility of T2MI. The reasons there of and the intricacies in the diagnosis of T2 MI are discussed in this article.

Ergonomics Workstation Assessment of Musculoskeletal Disorders in a Nigerian University

Ify L. Nwaogazie — 2019-11-08

This study examines the experiences of musculoskeletal discomfort among staff and students of the University of Port Harcourt as it relates to their workstations. Questionnaires were designed to extract information from respondents on their experience of musculoskeletal pains and other discomforts. A total of 320 questionnaires were distributed randomly to staff and students across the three campuses of the University of Port Harcourt. One hundred and forty (140) questionnaires were distributed to staff (academic, 60 and non-academic, 90) out of which 115 were retrieved. Similarly, 170 questionnaires were distributed to students out of which 163 were retrieved; altogether 278 out of 320 yielded a 86.9% response rate. The study revealed that there is a strong relationship between the workstation set up and development of musculoskeletal discomfort in classrooms and offices at the University of Port Harcourt. Most staff and students experienced low back and neck pains due to poor ergonomic practices. Furthermore, most of the students respondents spent their reasonable time sitting in class receiving lectures (47%) and studying/reading (18.3%), respectively. While a handful of students (9%) stood for most of the time receiving lectures; due to limited number of seats. A multiple regression analysis on workstation against MSDs (lower backaches, headaches, neck & upper backaches and neck & shoulder aches) yielded a coefficient of variance, R2 of 87%. The sensitivity analysis on the regression model gave the following results: R2 = 29.94, 1.23, 41.7, and 14.12% for workstation against i) lower backaches; ii) headaches; iii) neck & upper backaches; iv) neck & shoulder aches, respectively. The result of Kruskal-Walli’s test of significance on the questionnaire response to simple ergonomic workstation (the cause) and those of musculoskeletal disorder (the effect) showed not significant. This confirmed the consistency of responses (that is, the samples were from the same distribution). Kendall’s w-statistic for staff and students level of agreement < 50% in all cases.

Satisfaction with Waiting Time among Antenatal Women Attending the Antenatal Clinics of South East Nigeria

C. C. Ofoegbu — 2019-11-08

Background: Patient satisfaction is a useful measure to provide a direct indicator of quality in health care. Assessing patient perspectives gives them a voice, which can make public health services more responsive to people's needs and expectation.

Objective: To evaluate and compare the clients’ satisfaction with waiting time among pregnant women in public and private health facilities in south east Nigeria.

Study Design: A comparative cross sectional study was carried out.

Methodology: Using pretested interviewer administered questionnaire, information on clients’ satisfaction was obtained from 500 women attending antenatal care clinic in south east Nigeria.

Results: The mean ages of the public-teaching hospital respondents was 29.6 ± 4.0 and is slightly higher compared with that of private-mission hospitals respondents which was 29.5±4.6 Satisfaction was higher among the public-teaching hospital respondents (67.4%) than the private-mission hospital respondents (46.4%) and this is statistically significant. However, there is need to improve the waiting time in entirety considering only 59.8% of the whole study reported satisfaction.

Conclusion: There is low satisfaction with waiting time among antenatal mothers utilizing hospital services and dissatisfaction was more in private hospitals when compared to public hospital.