Orient Journal of Medicine https://www.ajol.info/index.php/ojm <p>The <em>Orient Journal of Medicine</em> is a Nigerian journal publishing articles in clinical or laboratory medical sciences.</p> <p>Other websites related to this journal: <a href="https://orientjom.org.ng/index.php/ojm/index" target="_blank" rel="noopener">https://orientjom.org.ng/index.php/ojm/index</a></p> en-US <p>All Rights Reserved 2022@Orient Journal of Medicine(OJM).<br>Licensed under Creative Commons Attribution 4.0 International License</p> editorojm@gmail.com (Jude-Kennedy C Emejulu) Ifenna@skannet.com (Editor) Tue, 24 Oct 2023 12:32:30 +0000 OJS 3.3.0.11 http://blogs.law.harvard.edu/tech/rss 60 Synopsis of holmium: Yttrium-aluminum-garnet laser used with flexible ureteroscopy in the treatment renal stones https://www.ajol.info/index.php/ojm/article/view/257753 <p>Laser lithotripter is by far the most commonly used intracorporeal lithotriper. Despite the recent exciting in-roads made by the thulium fibre laser (TFL), currently, the holmium: yttrium-aluminium-garnet (Ho:YAG) laser is the lithotripter of choice for the treatment of urinary stones. This article aims to provide a concise review of the Ho:YAG laser used with flexible ureteroscopy for the treatment of renal stones. The review examines the technical aspects, the laser fibre, the setting and efficiency of Ho:YAG laser. This is a narrative review of the Ho:YAG laser used with flexible ureteroscopy in the treatment of renal stones. The relevant databases and journals in urology were searched for contemporary existing literature on the subject. The literature on the physics, the anatomy of the Ho:YAG fibre, the setting and efficiency of the Ho: YAG laser were reviewed. The safety of the Ho:YAG laser in the treatment of renal stones was also reviewed. Understanding the physics of Ho:YAG laser, proper choice of laser fibres and appropriate setting of the laser machine are essential for its optimal use in flexible ureteroscopy for renal stone</p> Idorenyin C. Akpayak Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257753 Tue, 24 Oct 2023 00:00:00 +0000 Bronchial foreign body mimicking chronic cough and recurrent bronchopneumonia: Diagnostic dilemma in a resource poor setting https://www.ajol.info/index.php/ojm/article/view/257781 <p>Foreign body (FB) in the lower airway could pose a life-threatening emergency. Occasionally, small objects in the airway may present insidiously. High index of suspicion is required to avoid delayed or missed diagnosis of foreign body with its attendant complications. A Six-year-old male admitted through the Children Emergency Room (CHER) with 6 months history of recurrent cough and fever associated with choking spells and noisy breathing, and a day history of shortness of breath. Child was said to have “swallowed” a plastic object in the course of the illness, which the care givers and attending physicians assumed had been passed out in faeces. He was managed as a case of recurrent bronchopneumonia with oral and parenteral medications with temporary relief of symptoms. Chest x-ray done at presentation showed evidence of left lung collapse with ipsilateral mediastinal shift. He had a diagnostic rigid bronchoscopy and a plastic object was discovered within the left main bronchus and subsequently retrieved. Broad spectrum antibiotics, anti-inflammatory and antipyretics were administered and by the second day post-op, all chest symptoms had resolved, and repeat chest x-ray showed normal findings. We recommend that any child with a history of recurrent cough and shortness of breath that is unresponsive to medical treatment qualifies for otolaryngological review to rule out bronchial FB via diagnostic bronchoscopy; Chest Radiograph may help support diagnosis but should not be used alone to exclude it.</p> Evaristus E. Afiadigwe, Chizaram I. Ndukwe, Ugochukwu S. Umeh, Afam B Obidike Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257781 Tue, 24 Oct 2023 00:00:00 +0000 Clinicians' contribution to medication non adherence: The role of clinicians' communication skill https://www.ajol.info/index.php/ojm/article/view/257755 <p><strong>Background</strong>: Medication nonadherence is a common problem, and the training of Clinicians to communicate better enhances patients' adherence to medications. <strong>Objectives: </strong>This study aims to assess Clinicians' communication skills during the process of rational prescribing in the clinics. <strong>Methodology</strong>: This was a cross-sectional questionnaire-based descriptive study conducted among Clinicians in a Nigerian tertiary hospital. The questions were adapted from the section on communication skills outlined in “Guide to Good Prescribing”. Responses were rated on a 5-point Likert scale from “all of the time” to “none of the time” and data analysed using SPSS version 22. <strong>Results</strong>: There were 100 Clinicians, 71 (71%) males and 29 (29%) females with mean years of practice of 8.2±5.8 years. Only 47% of the Clinicians informed their patients “all of the time” when medicine is prescribed in clinic on why the medicine is needed, 23% on which symptoms will disappear and which will not disappear with treatment. About 20% informed their patients “all of the time” on which side effects may occur and what action to take, while 18% and 11% respectively do same on how serious the expected side effects are and their expected duration. <strong>Conclusion</strong>: This study revealed poor communication of vital information, instructions and warning to patient during encounters in the clinics and this is a harbinger to medication nonadherence. Good training on therapeutic skills (how to select, prescribe and monitor treatment, and how to communicate effectively with their patients) if incorporated into medical training in developing nations will improve medication adherence.</p> Paul O. Nwani, Chinwe C. Ndukwe, Obiora D. Anaje, Cosmas M. Nwosu Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257755 Tue, 24 Oct 2023 00:00:00 +0000 Review of early anaesthetic complications in a tertiary health care centre in South Eastern Nigeria https://www.ajol.info/index.php/ojm/article/view/257757 <p><strong>Background: </strong>Over the years, anaesthetic practice has evolved, with attention paid to safety guidelines and quality assurance. This has resulted in reductions in anaesthesia-related complications. <strong>Objectives: </strong>This retrospective study examines surgical procedures and anaesthetic complications recorded in a tertiary hospital. <strong>Methodology: </strong>Anaesthetic records of all patients who had surgery during the study period were retrieved. The number of cases done by each surgical specialty, the anaesthetic techniques, and the anaesthetic complications encountered during anaesthesia and before discharge from the recovery room were recorded. Preoperatively, all patients were categorised according to the American Society of Anaesthesiologists (ASA) physical status classification. Cases were grouped according to surgical specialties. Data was analyzed with Statistical Package for the Social Sciences (SPSS) version 25. <strong>Results: </strong>Over a 2-year period, 1784 surgeries were conducted, General and Cardiothoracic surgeries accounted for the highest 354 (19.80%) and lowest 6 (0.30%) cases, respectively. The most common anaesthetic techniques employed were general anaesthesia with endotracheal intubation 731 (43.00%), subarachnoid block 559 (32.90%), and general anaesthesia with facemask 190 (11.20%). Seventy five (4.20%) cases had complications, 19 (1.07%) had hypotension, 15 (0.84%) had delayed recovery from anaesthesia, 9 (0.50%) cases had cardiac arrests and 5(0.28%) had laryngeal. Death on the table occurred in 5 cases (0.28%), bronchospasm, local anaesthetic (LA) toxicity and also nausea and vomiting occurred in 3 cases (0.17%) respectively. Coughing and vomiting, hypoxia and post spinal shivering occurred in 2 cases (0.11%), while total spinal, apnoea, failed intubation, bradycardia, pulmonary oedema, extrapyramidal side effects of metoclopamide and shock occurred in 1 patient (0.06%) each. <strong>Conclusion: </strong>Hypotension, delayed recovery and cardiac arrest were the most common complications in our environment. There was no association between the ASA physical status and the occurrence of anaesthetic complications.</p> Ifeatu O. Oranusi, Nkechi L. Ajani, Evaristus C. Ezema, Cyril E. Nwachukwu, Precious O. Okafor Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257757 Tue, 24 Oct 2023 00:00:00 +0000 Correlation between body mass index and tibiofemoral angle in adult Nigerian patients with primary knee osteoarthritis. A pilot study https://www.ajol.info/index.php/ojm/article/view/257759 <p><strong>Background</strong>: Chronic knee osteoarthritis, which represents the clinical manifestation of cartilage disintegration under various factors, including abnormal joint loading, is a common pathology globally. Factors such as obesity and malalignment are thought to play a role in its aetiopathogenesis and progression. There have been studies evaluating the relationship between the severity of symptoms in these patients, but the relationship between the tibiofemoral angle (TFA) and body mass index (BMI) in patients with primary knee osteoarthritis has not been extensively studied. <strong>Methodology: </strong>we prospectively evaluated 51 patients aged 50 years or older with clinical and radiological features of chronic osteoarthritis of the knee and who had not had any form of intervention before assessment. Clinical and radiological tibiofemoral angle (cTFA and rTFA) measurements, and BMI calculations from weight and height measurements, were obtained. We then determined the presence of a correlation between these variables. <strong>Results: </strong>The average ages for male and female subjects were 66.7 years and 67.5 years, respectively. Both males and females were obese, with similar BMIs of 32.8 and 32.6, respectively. Males had a varus angulation of 5 degrees on cTFA and rTFA measurements, while females had 2.5 degrees and 3.1 degrees of valgus angulation for the cTFA and rTFA, respectively. We found no correlation between cTFA or rTFA and BMI in either sex. <strong>Conclusion: </strong>We determined that the BMI in obese patients with primary knee osteoarthritis did not influence the magnitude of the clinical or radiological tibiofemoral angles.</p> Anirejuoritse Bafor, Peter E. Ogbemudia, Chukwuemeka N. Chibuzom Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257759 Tue, 24 Oct 2023 00:00:00 +0000 Reproductive health challenges of rural female adolescents in rural area of South Eastern Nigeria https://www.ajol.info/index.php/ojm/article/view/257770 <p><strong>Background: </strong>A rural young girl continues to be vulnerable in many societies of the world, including Nigeria because sexual and reproductive health needs are often underserved. Adolescent sexual and reproductive health (SRH) refers to the physical, mental and emotional well-being of adolescents which includes freedom from sexual violence, STIs, unwanted pregnancy, unsafe abortion, maternal death, and disability. These young individuals experience new mental, physical and hormonal changes that predispose them to issues associated with discovering their sexuality. <strong>Objectives: </strong>The study sought to determine the reproductive health knowledge as well as the reproductive health challenges of female rural adolescents in a rural area of South Eastern Nigeria. <strong>Subjects and Methods: </strong>A cross-sectional study was conducted of 250 secondary school students in Anaocha local government area in South Eastern Nigeria. The classes of the students varied from both junior and senior secondary classes. Multistage sampling technique was used in the selection of participants. Simple random sampling of towns and schools were done. Stratified sampling of the various classes in the schools was done and finally simple random sampling of respondents was done. Self administered questionnaire was used to obtain data from selected respondents. <strong>Results: </strong>Two hundred and fifty female adolescents were studied with a mean age of 14 ± 2.01 years. Majority of the students (82.8%) had attained menarche while 99.6% of students had a good understanding of puberty. Thirty-two had engaged in sexual activity with mean age of coitarche being 11 ± 3.3 years and modal age group being 12-14 years. Thirteen (5.2%) of the respondents had sex for economic reasons. Four (1.2%) had been raped while 22 (8.8%) of the respondents had been sexually harassed. Of those who had engaged in sex, only 7 (21.8%) used contraceptive while only one case of unwanted pregnancy was reported. <strong>Conclusion: </strong>Many of the respondents had good knowledge about puberty with cycle length and fertile period but poor knowledge on prevention of sexually transmitted diseases. There was also early coitarche with poor contraceptive use. Reproductive health challenges such as STIs, vaginal infections, unprotected intercourse, substance abuse, and same-sex relationship were still present among adolescents in the rural south Eastern Nigeria. There is still need for sexuality education to prepare young adolescents for a healthy sexual and reproductive life.</p> A. Lovelyn Obi-Nwosu, C. Florence Ubajaka, E. Emmanuella Onwuegbusi, B. Obi Nwosu, S. Isioma Ezemenahi, E. Emmanuel Okoh, S. Chukwudi Ojiakor, C. Skye Nwosu, C. Maryann Ulochukwu, B. Chinedu Azudialu Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257770 Tue, 24 Oct 2023 00:00:00 +0000 Exercise decisional balance among persons living with hypertension in a south-eastern state of Nigeria https://www.ajol.info/index.php/ojm/article/view/257772 <p><strong>Background: </strong>Exercise is key in the primary prevention and control of hypertension. The exercise decisional balance (EDB) reflects the perceived benefits (pros) and perceived barriers (cons) of exercise behaviour change and predicts one's readiness to engage in exercise behaviour change. <strong>Objectives: </strong>To assess EDB among persons living with hypertension in Nnewi, Anambra State, and the inter-relationships among participants' anthropometrics and socio-demographics and their EDB. <strong>Methodology: </strong>This cross-sectional study surveyed 150 adults (109 females and 41 males) living with hypertension in the study population. Participants were conveniently recruited from teaching and specialist hospitals, markets and offices in the study area. Data was summarised using descriptive statistics. Spearman rank order correlation and Mann-Whitney U tests were used to test for relationships and influences among variables. Alpha was set at 0.05. <strong>Results: </strong>The participants demonstrated good EDB (2.80 ± 0.97). The mean BMI (28.78 <strong>± </strong>5.88), waist (93.77cm ± 12.29) and hip circumferences (108cm.10 <strong>±</strong>13.25) of participants fell within overweight and unhealthy. Adiposity indices were significantly greater in females than in males, and showed significant negative correlations with EDB. Only 1.3% of the participants recorded negative decisional balance scores. The study observed no significant influence of gender, marital status and occupation on EDB. Age showed a significant positive correlation with Pros (r= 0.199, p=0.015) and EDB (r= 0.219, p=0.007). <strong>Conclusion: </strong>The majority of the participants had good EDB, though not as much reported as good enough exercise participation. Most participants were overweight, and adiposity indices showed significant negative correlation with EDB, while age showed significant positive correlation with EDB.</p> Ifeoma A. Amaechi, Chinecherem M. Ozodi, Augustine O. Akadieze, Adaeze Chukwudebelu, Paul O. Nwani Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257772 Tue, 24 Oct 2023 00:00:00 +0000 Prevalence and pattern of risk factors for chronic kidney disease among health workers in a tertiary institution in South East Nigeria https://www.ajol.info/index.php/ojm/article/view/257776 <p><strong>Background: </strong>Chronic kidney disease (CKD) is one of the leading causes of mortality globally. The prevalence of risk factors associated with CKD is on the increase in Nigeria. Early recognition and treatment of risk factors can prevent onset or slow down disease progression. <strong>Objectives: </strong>This study aimed to determine the prevalence of chronic kidney disease and some of its risk factors among health workers at Alex-Ekweueme Federal University Teaching Hospital, Abakaliki. <strong>Methodology: </strong>This was a cross-sectional study conducted as part of the activities to commensurate world kidney day. Consecutive volunteers were screened. Their bio-data, anthropometric data and blood pressures were obtained. Blood glucose was determined by glucometer, urine sample was collected for urinalysis and blood sample was taken for serum creatinine. Estimation of glomerular filtration rate (eGFR) was calculated using the modification of diet in renal disease ( MDRD) formula. <strong>Results: </strong>390 members of staff were screened. There were 152 (39%) males and 238 (61%) females. Mean age was 38.19 ± 10.24years. CKD risk factors were obesity (32.8%), hypertension (26.4%), proteinuria (11.0%) and diabetes mellitus (6.2%). 31.0% had CKD (eGFR&lt;60 ml/min) and CKD was significantly associated with age, hypertension, obesity and proteinuria. <strong>Conclusion: </strong>Chronic kidney disease and its risk factors were prevalent among the participants. Healthy lifestyle and regular screening among health workers should be encouraged to curb CKD and its risk factors.</p> O.F Afolabi, M.U Nwobodo, N Ifebunandu, I.I Ulasi, C.O Eze, C.N Ugwu, O.J Nwikwu, C.O Udeze, A.C Agbo, C.C Ologwu Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/ojm/article/view/257776 Tue, 24 Oct 2023 00:00:00 +0000