Open Access Review Article

Trends of HIV/AIDS in Southeast Asia

Jennings Hernandez, Anjali Kumar

Asian Journal of Medicine and Health, Page 1-13
DOI: 10.9734/AJMAH/2018/44090

It is very important to recognise trends in HIV/AIDS in specific areas such as Asia because it is vital to understanding the effectiveness of current approaches towards diagnosis and treatment. It is also very important to understand the risk factors that significantly predispose people in Asia to contract HIV/AIDS such as lifestyle, culture, and religion. This review extensively analyses the various current trends of HIV/AIDS in India, China, Thailand, Cambodia and Indonesia. Additionally, cultural diversity carries certain social and religious stigmas associated with the disease. These social stigmas also pose as a significant influence in government involvement with regards to the funding of HIV/AIDS awareness, education, prevention, and the protection of human rights. Lack of education about the methods of protection and transmission of the disease remains to be a significant hindrance in the prevention of a further rise in epidemiological statistics. Moreover, these factors are attributed towards the rising incidence or risk of HIV within several populations amongst these countries. This review also analyses the clinical presentation, epidemiological statistics, and the financial and socioeconomic impacts of HIV/AIDS in India, China, Thailand, Cambodia and Indonesia. Financial burdens and lack of government infrastructure in the healthcare systems are largely responsible for the rapidly rising prevalence of the disease among the populations along with the inaccessibility to prevention and treatment methods. Furthermore, the scarcity of available antiretroviral and preventative medications is discussed. Lastly, this review explores various methods of diagnosis, treatment and prevention plans that are implemented in modern medicine with respect to HIV/AIDS.

Open Access Original Research Article

Ear Diseases among Primary School Children in Ibadan Metropolis, Southwestern Nigeria

Waheed Atilade Adegbiji, Stanley Baba Amutta

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/42941

Background: Otologic diseases is a common cause of social dysfunction worldwide in otorhinolaryngology practice. This study aimed at determining the prevalence, pattern, sociodemographic features in primary school children in Ibadan.

Materials and Methods: This was a cross-sectional descriptive study of urban groups of private school children with otologic diseases.

The study was carried out between October 2017 and March 2018.

Data was taken using pretested interviewers assisted questionnaire.

Data obtained were collated and statistically analysed using SPSS version 18.0.

Results: Prevalence of otologic diseases was 50.7%. There were 56.9% males, and male to female ratio was 1.5:1.

Common otologic diseases were 25.8% earwax impaction, 13.7% chronic suppurative otitis media, 10.6% otitis media with effusion, 10.0% foreign body impaction and 8.4% otomycosis.

Bilateral otologic diseases in 54.4% were commoner with right otologic diseases accounted for 22.7% while left otologic diseases accounted for 21.9%.

Common clinical features were hearing impairment, ear discharge, itching, aural blockage, earwax and tympanic membrane perforation in 40.3%, 38.7%, 34.2%, 26.8%, 26.0% and 22.1% respectively.

The most frequent type of hearing impairment was the conductive hearing loss in 34%.

Type A tympanometry (standard) was the most characteristic findings in 49.5%. Pure tone audiometry revealed 17.0% mild, 4.3% moderate and 1.8% moderate-severe hearing impairment.

Conclusion: There is a high prevalence of otologic diseases and resultant hearing impairment in this study. The causes are preventable. Therefore, the need for sensitization of the community and policymaker towards early detection and treatment.

Open Access Original Research Article

Clinical Pattern of Acquired Thyroid Disorders in Childhood and Adolescents Attending Endocrine Unit, Tripoli Children Hospital

Faten BenRajab, Salha Gliwan, Gehan Bensreiti

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/AJMAH/2018/43515

Background and Aims: Thyroid disorders are one of the endocrine disorders commonly encountered in childhood and adolescence and they manifest with alternations in thyroid hormone secretions, goitre or both. Normal thyroid gland function is critical for early neurocognitive development, as well as for growth and development throughout childhood and adolescence.

This study was aimed to describe the clinical pattern of acquired thyroid disorders in children and adolescents.

Study Design: A descriptive cross-sectional hospital based study.

Place and Duration of Study: The study was conducted at the Tripoli Children hospital from January 2000 to December 2012.

Methodology: All Patients aged between 1- 18 with thyroid disorders, attending the pediatric endocrine clinic were included, the diagnosis of thyroid disorders was based on clinical features, thyroid function tests and anti-thyroid antibodies test. Data included age, gender, clinical features, duration of symptoms before diagnosis, results of investigations including blood tests, bone age x-ray and result of brain Magnetic Resonance Imaging (MRI), family history of autoimmune disease and any associated problem. Data were analysed using the SPSS program.

Results: During 12 years period under review, 148 patients (5.9%) had thyroid disorders, 135 (91.22%) patients had hypothyroidism, 11(7.43%) had hyperthyroidism, 2 (1.35%) had a goitre in euthyroid state. Mean age at presentation for primary hypothyroid was 9 + 3.8 years, for secondary hypothyroidism was 7 + 1.5 years, for hyperthyroid was 9.8+ 2.2 years and for euthyroid goitre was 9.2+ 2.1 years. Male to female ratio was 1:1.3. The family history of autoimmune disease was positive in 33 patients (22.3%), in 29 (41.43%) patients of primary hypothyroidism and 4 (100%)  patients with Graves' disease were had a positive family history. Mean duration of symptoms before presentation was 0.43+ 0.1 years for primary hypothyroidism and 1.4+0.21 years for secondary hypothyroidism while for patients with hyperthyroidism was 0.7+0.15 years, in two children with euthyroid goitre was 0.8 years. About 31% of patients with hypothyroidism were of short stature followed by fatigability and sleepiness (23.9%). About 64% of patients with hyperthyroidism had goitre and eye signs followed by palpitation and weight loss (54.5%). There were co morbidities in 75 children out of 148 patients as a result of growth hormone deficiency, diabetes mellitus and some other syndromes. Anti-thyroglobulin antibodies were positive in 21(14.2%) patients, Thyro- peroxidase antibodies were positive in 26 (17.6%) patients. Bone age estimation was delayed in 73(49.3%), advanced in 7(4.7%) patients. Brain MRI was done for 46 patients; which showed pituitary hypoplasia in 15.5%, 10.8% had normal brain MRI, in 4.7% of patients MRI showed other findings.

Conclusion: hypothyroidism constituted the greatest proportion of the thyroid disorders in children and short stature is the commonest presenting symptoms of a hypothyroid child, paediatricians should be aware of the need to screen children who present with a short stature for hypothyroidism.

Open Access Original Research Article

Metabolic Syndrome among Healthcare Workers in a Tertiary Hospital in South-South, Nigeria

Tomisin Matthew Adaja, Joseph Osagie Idemudia

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/AJMAH/2018/43851

Background: Healthcare providers occupy an important position in the health sector and the economy of a country.  Ensuring their sound health goes a long way in maintaining the health of the citizens at large. Metabolic syndrome is described as the constellation of interrelated physiological, clinical, biochemical and metabolic factors that directly increases cardiovascular disease (CVD) risks, type 2-diabetes and other causes of morbidity and mortality. The study determined the prevalence of metabolic syndrome among the healthcare workers in the University of Benin Teaching Hospital, Benin City, Edo State, South- South, Nigeria.

Materials and Methods: A total of three hundred and twenty- five subjects between the age ranges of 21-69 years were recruited for this cross-sectional study. One hundred and sixty (160) of the subjects were males, and one hundred and sixty- five were females. The anthropometric and blood pressure measurements were done using standard techniques. Fasting serum lipid profile and fasting plasma glucose were assayed using standard laboratory techniques. International Diabetes Federation (IDF) criteria were used for the diagnosis of metabolic syndrome.

Results: One hundred and three subjects (31.7%) were overweight, and eighty- three (25.5%) were obese, one hundred and twenty-five (38.5%) had a normal weight, and fourteen (4.3%) were underweight. The mean fasting plasma glucose (FPG), triglycerides (TG) and systolic blood pressure were normal (4.87±1.28 mmol/L, 0.91±0.54 mmol/L and 116.2±15.7 mmHg respectively). The prevalence of metabolic syndrome among the female subjects was about three times that of the male subjects. The overall prevalence of metabolic syndrome among the study population was 15.4%. Higher incidence of metabolic syndrome was seen among the female health workers.

Conclusion: The study demonstrated a high prevalence of metabolic syndrome among healthcare workers in UBTH, and recommends aggressive enlightenment programme on health consciousness among healthcare workers.

Open Access Original Research Article

Knowledge of Healthcare Providers in Secondary Health Care Facilities towards Exclusive Breastfeeding among HIV Positive Mothers in Akwa Ibom State, Nigeria

Grace C. Essien, Mary A. Mgbekem, Oladapo T. Okareh

Asian Journal of Medicine and Health, Page 1-12
DOI: 10.9734/AJMAH/2018/43556

Exclusive Breastfeeding for 6 months by HIV infected mothers has been recommended by the Nigeria National guidelines on Preventing Mother to Child Transmission (PMTCT) of HIV. This study was designed to assess the knowledge of Health Care Providers in secondary healthcare facilities towards exclusive breastfeeding among HIV positive mothers in Akwa Ibom State, Nigeria. A self-administered questionnaire was used to elicit data from the respondents. Approval to carry out the study at the health facilities was obtained from the Ethical Review Committee of the Akwa Ibom State Ministry of Health, Uyo. A purposive sampling technique was used to select three secondary health facilities (one per senatorial district), while proportionally stratified sampling technique was used to select 278 healthcare providers. Data were analysed using the Statistical Package for Social Science (SPSS) version 20.0 and presented using inferential and non-inferential statistical method. Statistical significance was established at p<0.05 level. The findings revealed that 191(68.7%) of the respondents had good knowledge of exclusive breastfeeding among HIV positive mothers. The odd ratio findings of nurses’ response (OR = 4.20, C.I = 1.781-9.889, p = 0.001, p<0.05) were significantly higher than the reference group (the CHEW/CHO cadre). There was also a significant association between years of experience and knowledge of exclusive breastfeeding among the respondents ( = 12.78, p = 0.005, p < 0.05). The findings reveal that nurses have higher knowledge and are in constant relationship with the women. However, there is still a gap in encouraging HIV positive mothers to practice exclusive breastfeeding.