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Clustering of Metabolic Syndrome and its Risk Factors among Adult Nigerians in a National Health Insurance Scheme Primary Care Clinic of a Tertiary Hospital in South-Eastern Nigeria
Gabriel Uche Pascal Iloh,
Orji Udo Nnorom,
Patrick Uchenna Njoku,
Godwin Oguejiofor Chukwuebuka Okafor,
Augustine Obiora Ikwudinma
Issue:
Volume 2, Issue 2, March 2014
Pages:
33-42
Received:
26 January 2014
Accepted:
Published:
10 March 2014
Abstract: Background: The increasing incidence of MetS in Nigeria is a national health problem. As the case detection of MetS increases in different Nigerian populations evaluating for its clusters among NHIS patients in primary care setting is an important health service challenge that is often overlooked. Aim: This study was designed to determine the prevalence of MetS and its risk factors among adult Nigerians in a NHIS primary care clinic of a tertiary hospital in South-eastern Nigeria.Materials and Methods: This was a primary care clinic-based cross sectional study carried out on 210 adult NHIS patients using International Diabetes Federation(IDF) criteria: An Individual was considered to have MetS in the presence of waist circumference(WC) ≥94 cm for men and ≥80 cm for women plus any two or more of the following: systolic and/or diastolic blood pressure ≥130/85 mmHg and/or hypertension on treatment; fasting blood glucose ≥ 100mg/dL and/or diabetes mellitus on treatment; triglyceride level ≥150 mg/dL and/or hypertriglyceridaemia on treatment and high density lipoprotein(HDL-C) cholesterol <40mg/dL for men or <50 mg/dL for women and/or HDL-C dyslipidaemia on treatment. Data was collected using pretested, structured and researcher administered questionnaire. Results: The prevalence of MetS was 38.6%. MetS was significantly associated with old age≥40 years(p=.002), female sex(p=.044), family history of hypertension(p=.036) and physical inactivity(p=.001). The most significant predictor of MetS was physical inactivity.[OR=3.09 , CI=(1.81-10.06), p=.001]. The patients with MetS were three times more likely to be physically inactive compared to their non-MetS counterparts. Conclusion: This study has shown that MetS exist among the study population and was significantly associated with old age ≥40 years, female sex, family history of hypertension and physical inactivity. The most significant predictor variable was physical inactivity. NHIS patients in the primary care clinic should be the focus of primary and secondary preventive interventions for MetS.
Abstract: Background: The increasing incidence of MetS in Nigeria is a national health problem. As the case detection of MetS increases in different Nigerian populations evaluating for its clusters among NHIS patients in primary care setting is an important health service challenge that is often overlooked. Aim: This study was designed to determine the preva...
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Traditional Medicine Information Management
Aghebati Azita,
Safdari Reza,
Dargahi Hosein,
Gushe Gire Seid Ashrafoldin
Issue:
Volume 2, Issue 2, March 2014
Pages:
43-48
Received:
17 January 2014
Accepted:
Published:
10 March 2014
Abstract: Objective: Given the increasing development of traditional medicine, the World Health Organization (WHO) has noted data management of traditional medicine and the need for acquiring the existing knowledge through the accurate exchange of information as well as preservation and protection of traditional knowledge resources. The use of traditional medicine in developing countries and developed countries is increasingly expanding. The purpose of this study is to developa traditional medicine information management processing. Methods: This is a review article which is carried out using books, articles, national and international journals as well as electronic resources and websites available on the Internet. Results: Despite the increasing development of traditional medicine, information has not been developed. Information development through web-based resources, proper communication with physicians and pharmaceutical packaging can lead to the development of information and quality of care. WHO has become a convenient and reliable source for information exchange. A global database of traditional medicine as well as a global database of medicinal herbs has been developed by WHO. The recommendations of WHO on documentation of traditional medicine include initial complaint recording, medical history, the findings of the physical examination, examination diagnosis and treatment plan, privacy and patient satisfaction, insurance and legal reports. Data elements should be standardized for comparison. The data can be transferred using electronic records. Furthermore, the record of data and assessment of patient’s status will be done better. WHO published the international standard terminology that is the underlying data to better understanding of actions, research and training and developing a database to retrieve articles. The chapter 23 of the book, ICD 11, is developed tomake evidence-based traditional medicine, terminology, diagnosis classification, and designed interventions. It is also widely used in the International Classification of Traditional Medicine (ICTM) project which employs a wide range of traditional medicine knowledge worldwide. Conclusion: Given the development of traditional medicine, therapeutic interventions and medicinal complications of traditional and conventional medicine cause risks to patients. Development of reliable information and proper communication of patients and physicians will be helpful. Standard documentation, the global database and international classification and naming resources will integrate information and develop global statistics. Information development and information management process have an important role in improvement of patient care.
Abstract: Objective: Given the increasing development of traditional medicine, the World Health Organization (WHO) has noted data management of traditional medicine and the need for acquiring the existing knowledge through the accurate exchange of information as well as preservation and protection of traditional knowledge resources. The use of traditional me...
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The Place of Traditional Medicine in the African Society: The Science, Acceptance and Support
Samuel S. Antwi-Baffour,
Ajediran I. Bello,
David N. Adjei,
Seidu A. Mahmood,
Patrick F. Ayeh-Kumi
Issue:
Volume 2, Issue 2, March 2014
Pages:
49-54
Received:
15 January 2014
Accepted:
Published:
10 March 2014
Abstract: Traditional medicine (TM) has been described by the World Health Organisation (WHO) as one of the surest alternative means to achieve total health care coverage of the world’s population. In most African societies, traditional medicine plays an important role in the lives of millions who cannot access western medicine. In some areas, TM is part of the first set of response mechanisms for medical emergencies whilst in others the whole health system of the community is hinged on medicines rooted in local practice and belief. Although the relevance and values of TM is begining to gain recognition, African traditional medicine (ATM) still faces some challenges which underscore its scrutiny. This paper thus analyses the issue of science, acceptance and support for successful implementation of ATM and present the contemporary measures that are being taken to raise its standard to the level of western medicine.
Abstract: Traditional medicine (TM) has been described by the World Health Organisation (WHO) as one of the surest alternative means to achieve total health care coverage of the world’s population. In most African societies, traditional medicine plays an important role in the lives of millions who cannot access western medicine. In some areas, TM is part of ...
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Characterization of Coronary Artery Diseases Using 256 Multi Detectors CT Scanners
Salma Mohamed Mirghany Abdelmageed,
Caroline Edward Ayad,
Hanaa Mohamed Alsaqaa,
Hythum Salah Mohamed,
Elsafi Ahmed Abdalla
Issue:
Volume 2, Issue 2, March 2014
Pages:
55-61
Received:
1 February 2014
Accepted:
Published:
20 March 2014
Abstract: Coronary heart disease is the most common cause of death in the general population. Multi detector Computed Tomography (MDCT) is noninvasive technique and can study the entire coronary-artery tree during a single imaging session. The aims of this study were to characterize coronary arteries in patients who were clinically diagnosed to have coronary artery disease (CAD) using (MDCT) 256 slices, and to compare the findings with other cardiac examinations outcome. The study was done at King Fahad Specialist Hospital-Alqaseem- KSA during the period from January to May 2013 .A total of 102 patients, 63(61.76%) males, and 39 (38.24 %) females were included. All patients with pre-test probability of CAD underwent coronary CT angiography with beta-blockers were administered prior to the scan, and other cardiac investigations were obtained. Patient’s age, gender, BMI, weight, Cholesterol level, Hypertension, Diabetes Mellitus, chest pain types, Calcium scoring, were evaluated and correlated with the CT findings and other cardiac investigation results. The evaluated arteries were Left Main Artery (LMA), Left Anterior Descending artery (LAD), Right Coronary Artery (RCA), and Left Circumference Artery (LCA) and were observed for plaques characterization, occlusion or stenosis. A significant association was detected between the CT plaques morphology and BMI, Hyper tension and calcium score at P-value < 0.05. Patients with normal findings in ECG 53 (57.6%) , Echocardiography 58.0(76.3%) and Myocardial Perfusion Imaging (MPI) 2(25.0%) were found to have positive cardiac disease in CTA. Echocardiography is able to characterize Atrial filibration, Heart failure, Ventricle diseases, Valve stenoses and has significant association with gender P-value 0.022 and BMI P-value 0.042.Myocardial Perfusion Imaging results showed the cardiac function and ejection fraction. No significant association was found between CT findings in coronary arteries and MPI results at P-value 0.789.Coronary CTA disclose diseases in arteries (98.5%), heart anomalies or valve disease 3(3%) ,plaques with significant stenosis 4(4%) , plaque without significant stenosis 11(10.9%) ,stenosis without plaques 14 (14%) and total occlusion 1(1%). In relation to other cardiac tests; cardiac ischemic changes can be detected in ECG, MPI and Echocardiography. Association between CT Plaque Characteristics and Invasive Coronary Arteries results were significant for LAD and RCA at P-value 0.05. Coronary CTA is a promising non-invasive technique and is highly recommended for characterization of Coronary Arteries and diagnosis the CAD; it could be of great value prior to invasive coronary angiography, although ECG, Echocardiography and MPI(SPECT) are better in studying function.
Abstract: Coronary heart disease is the most common cause of death in the general population. Multi detector Computed Tomography (MDCT) is noninvasive technique and can study the entire coronary-artery tree during a single imaging session. The aims of this study were to characterize coronary arteries in patients who were clinically diagnosed to have coronary...
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Characterization of Rectal Neoplasms Using Computerized Tomography
Caroline Edward Ayad,
Wael Abdelgafour Mohammed,
Elsafi Ahmed Abdalla,
Samih Awad Kajaok
Issue:
Volume 2, Issue 2, March 2014
Pages:
62-67
Received:
7 February 2014
Accepted:
Published:
20 March 2014
Abstract: The aims of this study were to characterize and localize the rectal neoplasms by the computerized tomography (CT) and sigmoidoscopy in patients who suspected to have colorectal neoplasms. It was conducted at Radiology and Endoscopy Departments - Soba Hospital-Khartoum-Sudan. This study was extended from October 2011 to December 2011, fifty patients were studied including 34 males and 16 females, and their mean age was 52.5 years ranged from 25–85 years. All patients underwent sigmoidoscopy, axial CT images for pelvis, enhanced with contrast medium, and biopsy as confirmation method. The location of rectal neoplasm was measured in (cm) and the lesions were characterized in CT as circumferential, eccentric rectal wall thickening, masses, tumors according to thier contrast enhancement, in Sigmodioscopy the lesions were classified as seen into polyploidy, obstructive, ulcerative, circumferential lesions and tumor. In the histopathology findings, the lesions were characterized as poor, moderate, well differentiated adenocarcinoma and Tubulovillous adenoma.The study showed that the males were more affected than females. Sigmoidoscopy and CT can predict the lesion type and characterize the changes in the rectum and rectosigmoid region according to its citation from the anal verge significantly at p- value 0.001and 0.038. No significant relation was found between the biopsy results and the presence of the lesions through distance from anus at P-value 0.161. When comparing the CT, sigmoidoscopy and biopsy results; CT has an accuracy of 72% and sensitivity of 69.9 %, sigmoidoscopy has an accuracy of 86.0%and sensitivity of 88.9% where the biopsy has accuracy of 90% and sensitivity 89.1% in differentiation of rectal neoplasms. It can be believed that CT and sigmoidiscopy should be performed together and used as essential methods in diagnosing of rectal neoplasms in addition to histopathological examination as an effective tool in determining the possibility of malignancy of this detected neoplasms.
Abstract: The aims of this study were to characterize and localize the rectal neoplasms by the computerized tomography (CT) and sigmoidoscopy in patients who suspected to have colorectal neoplasms. It was conducted at Radiology and Endoscopy Departments - Soba Hospital-Khartoum-Sudan. This study was extended from October 2011 to December 2011, fifty patients...
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Estimation of Fetal Age Sonographically Using Umbilical Cord Diameter in Second and Third Trimester
Elsafi Ahmed Abdalla,
Caroline Edward Ayad,
Farida Ahmed Eisa
Issue:
Volume 2, Issue 2, March 2014
Pages:
68-72
Received:
26 February 2014
Accepted:
8 April 2014
Published:
10 April 2014
Abstract: Assessment of gestational age is paramount in obstetric care. This study was to evaluate the gestational age (GA) by measuring the Umbilical Cord Diameter (UCD) in the second and third trimester of pregnancy, and to compare the findings with the Femur Length (FL), Bi- parietal Diameter (BPD) and Last Menstrual Period (LMP). Fifty Sudanese Pregnant women underwent routine sonographic examination using 3.5MHz curve liner transducer; the sonographic cross-sectional area of the umbilical cord was measured in a plane adjacent to the insertion of the cord into the fetal abdomen. Maternal age and number of parity have been evaluated. The relation was statistically significant between UCD depth, width and GA. Gestational age can be predicted and can be depicted by the following equations: GA= (1.380 × UCD length +8.160) and GA= (1.545× UCD width+5.943). There was unsubstantial relation between UCD and maternal age. A linear relationship was found between parity and the UCD depth and width. Using paired T-test indicates that the GAs calculated from FL was accurate, there was no significant difference detected between the LMP age and the estimated one and UCD depth, width, but BPD showed significant difference at p = 0.005 .Measuring UCD is useful for the assessment of gestational age. It has a role in obstetric care in the second and third trimester of pregnancy, and these equations can be used to estimate the gestational age instead of BPD and FL.
Abstract: Assessment of gestational age is paramount in obstetric care. This study was to evaluate the gestational age (GA) by measuring the Umbilical Cord Diameter (UCD) in the second and third trimester of pregnancy, and to compare the findings with the Femur Length (FL), Bi- parietal Diameter (BPD) and Last Menstrual Period (LMP). Fifty Sudanese Pregnant ...
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Characterization of Biliary Confluence Angle in Asian Population
Eman Abdul Rahman Mohammed Altai,
Caroline Edward Ayad,
Elsafi Ahmed Abdalla
Issue:
Volume 2, Issue 2, March 2014
Pages:
73-77
Received:
26 February 2014
Accepted:
8 April 2014
Published:
10 April 2014
Abstract: This study aimed to evaluate the morphological alterations in the biliary confluence angle of Asian population, describing the most frequent MR cholangiopancreatography (MRCP ) findings, evaluating the confluence angle in the cases of dilated and normal ducts, and to correlate the angle with the patients age, gender, nationality, height , weight and body mass index (BMI). The study was done in Suleiman Fakeh Hospital in Jeddah KSA, in the period from March 2011 up to May 2012. The sample was drawn from patients in both gender referred to MRCP imaging with different indications and was classified into two groups, the first group was patients with normal biliary ducts, the second group was patients with dilated biliary ducts . All examinations were done using MRI 1.5 Tesla, Siemens Avanto 2010, single shot fast spin echo (SSFSE). Protocol using coronal oblique images was applied where the angle was measured. Results showed that the most common MRCP findings were: distended gall bladder, gall stone, cholecystitis, cholecystectomy, liver cirrhosis, hepatomegaly, hepatic lesion, pancreatitis ,and pancreatic lesion. MRCP can evaluate the biliray confluence angle in dilated and normal ducts. No significant relation was found between the biliary confluence angle and the selected variables in both normal and dilated ducts, but a significant relation was detected with the age in patients with normal biliary ducts. Dependency upon the biliary confluence angle is not benifectual for diagnosis or prediction of diseases. A new equation for predicting the biliary confluence angle with the known Asian ages was established.
Abstract: This study aimed to evaluate the morphological alterations in the biliary confluence angle of Asian population, describing the most frequent MR cholangiopancreatography (MRCP ) findings, evaluating the confluence angle in the cases of dilated and normal ducts, and to correlate the angle with the patients age, gender, nationality, height , weight an...
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Assessment of Sexual Risk Behaviours of In-School Youth: Effect of Living Arrangement of Students; West Gojam Zone, Amhara Regional State, Ethiopia
Issue:
Volume 2, Issue 2, March 2014
Pages:
78-83
Received:
28 October 2013
Accepted:
8 April 2014
Published:
10 April 2014
Abstract: Background: Contemporary threats to adolescents' health are primarily the consequence of risk behaviors and their related adverse outcomes. Identifying factors associated with adolescents' risk behaviors is critical for developing effective prevention strategies. A number of risk factors have been identified, including familial environment; however, to the investigator's best knowledge, there have been only one previous study of possible differential vulnerabilities of in-school adolescents to risky sex in reference to parental influences and living arrangements in Ethiopia. Objective: To assess and compare sexual risk behaviours of preparatory students in West Gojam zone, in reference to their living arrangements Methodology: A comparative cross-sectional study was done in ten preparatory schools; West Gojam zone, Amhara National Regional State, Ethiopia. The study participants were selected based on probability proportional to size. A total of 314 students [104 living permanently in the corresponding towns and 210 not], were included in the study. Result: Seventy three (23.2%) respondents had ever had sexual intercourse with an individual of the opposite sex. Disaggregated by sex, 55 (25.0%) of males had had sex compared to 18 (19.4%) of females. Twenty two students (33.3%) reported having had two or more sexual partners in their lifetime (range 1-7, average1.56). In the logistic regression analyses, controlling for observed covariates, age more than 20 years [OR= 2.85; 95%CI= 1.07 to 7.59], having peer pressure to have sex [OR= 4.43; 95%CI= 2.02 to 9.69] and perceived family connectedness [OR= 0.96; 95%CI= 0.92 to 0.99] continued to be significantly and independently associated with sexual activity Conclusion: A greater sense of connectedness to parents decreases the likelihood of sexual activity regardless of living arrangement, Parental monitoring, gender, khat and alcohol consumption, and parental education. Students with peer pressure to have sex are more likely to initiate sexual intercourse.
Abstract: Background: Contemporary threats to adolescents' health are primarily the consequence of risk behaviors and their related adverse outcomes. Identifying factors associated with adolescents' risk behaviors is critical for developing effective prevention strategies. A number of risk factors have been identified, including familial environment; however...
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