Open Access Review Article

Advancing Exclusive Breastfeeding among HIV-Positive Mothers in Low Resource Settings

Okereke Goodluck Chibuike

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/AJMAH/2018/32877

Exclusive breastfeeding (EBF) involves giving only breastmilk without addition of any complementary foods during the first 6 months of life. Diarrhoeal diseases is the second leading cause of death in under five children globally.  On the other hand, exclusively breastfed infants have a reduced risk of gastrointestinal infections. Within the context of mother to child transmission (MTCT) of Human Immuno-deficiency Virus (HIV) following birth, exclusive breastfeeding of the HIV exposed infant is the gold standard infant nutrition. New guidelines by the World Health Organisation (WHO) stipulated new approaches especially public health approach in applying the updated infant feeding. The new guidelines borders on amongst others, the duration of breastfeeding by mothers living with HIV (MLWH). It is now recommended that MLWH should breastfeed for at least 12 months and may continue breastfeeding for up to 24 months just as it is applicable in the general population or longer while being fully supported for anti-retroviral therapy (ART) adherence. Despite the benefits of exclusive breastfeeding, inadequate knowledge of breastfeeding has been identified as a constraint to exclusive breastfeeding especially among HIV positive mothers in low resource settings. Exclusive breastfeeding by HIV positive mothers is imperative especially in low resource settings where malnutrition and poor environmental conditions are endemic. This will reduce infant morbidity and mortality. Non-exclusive breastfeeding, more than doubles the risk of vertical transmission of HIV and confers lesser protection against serious childhood illnesses such as diarrhoea and pneumonia compared to exclusive breastfeeding.

Selection Criteria: Systematic reviews, randomised controlled trials, policy briefs, and cross-sectional studies that border on effects of exclusive and non-exclusive breastfeeding on HIV-free survival of HIV-exposed infants.

Open Access Original Research Article

Acute Kidney Injury in Hospitalised Medical Patients: Aetiology and Prognosis

José Antonio Díaz-Peromingo, María del Carmen Beceiro-Abad, María Aurora Freire-Romero, Lucía Martínez-Braña, Lara María Mateo-Mosquera, Alba Catalina Valcárcel-Rodríguez, María Jesús Domínguez-Santalla, Ignacio Novo-Veleiro, Arturo González-Quintela

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2018/43449

Background: Acute Kidney Injury (AKI) increases the length of hospitalisation and mortality. The study aims to assess the incidence, risk factors and outcome of AKI in hospitalised medical patients.

Methods: AKI was measured in adult patients by using the serum creatinine criteria. Baseline data included age, sex, diagnosis during admission, pathological records, analytical data, use of nephrotoxic drugs, length of hospital stay, mortality at the hospital and during the follow-up, and the cause of death.

Results: A total of 100 patients were included with a mean age of 75.6 years. Majority of male patients (n= 23; 56%) were showed AKI development. The most frequent associated diseases were hypertension, type 2 diabetes mellitus, and heart failure. Hospital stay was greater than 10 days in 52 patients. The patients who developed AKI were older, and had an increased prevalence of heart failure, hypertension, diarrhoea, anaemia, increased BUN, impaired GFR, and were most frequent under ARBs or diuretics. Mortality was higher in the AKI group during hospitalisation.

Conclusions: AKI is frequent in hospitalised medical patients. A previous history of hypertension, heart failure, presence of diarrhoea, anaemia, increased BUN, low eGFR, and the use of ARBs or diuretics are the risk factors for AKI. Patients who developed AKI had an increased likelihood of death during hospitalisation.

Open Access Original Research Article

Effects of Formalin Inhalation on Physical Characteristics and Renal Profile of Albino Wistar Rats

J. N. Egwurugwu, M. C. Ohamaeme, C. N. Ekweogu, E. E. Ngwu, P. C. Ugwuezumba, F. U. Ogunnaya, B. C. Azudialu, D. I. Izunwanne, P. Nwamkpa, M. U. Elendu, I. G. Eberendu

Asian Journal of Medicine and Health, Page 1-11
DOI: 10.9734/AJMAH/2018/44412

Background: Formalin exposure is common in our environment. This study assessed the effects of formalin inhalation on renal function and physical features of albino wistar rats.

Materials and Methods: Thirty apparently healthy male albino wistar rats, weighing between 100-160 g, divided into five groups of six rats each were used for this study that lasted for four weeks. Group  A, the control group, exposed to ambient air, received normal rat chow and portable water ad libitum, while the test groups B, C, D and E had 2, 4, 6, and 8 hourly daily exposure to formalin respectively via inhalation in the cadaver dissecting hall of the Anatomy laboratory for medical students, in addition to normal rat feed and water ad libitum when not exposed to formalinFortnightly, four rats were randomly selected from each group, anaesthetised with chloroform and blood samples collected through cardiac puncture for the analysis of serum electrolytes, urea and creatinine.

Results: Results showed yellow discoloration of the skin, drowsiness, reduced movements and feeding habits in groups C-E when compared with those in groups A and B. The results also showed  statistically significant duration of exposure dependent increase in serum concentrations of sodium, potassium, urea  and creatinine in test groups C to E after 2 & 4 weeks exposure  when compared with control (p<0.05). After 2 weeks exposure, only  group E had a significant increase in serum concentrations of chloride and bicarbonate while all test groups except group B had significant elevation after 4 weeks exposure.

Conclusion: Persistent inhalation of formalin may have deleterious effects on the kidney, skin, brain and appetite. We, therefore, recommend that medical students and lecturers, as well as those using Formalin, should have time-limited exposure, well-ventilated rooms, use of less toxic chemicals for embalming as well as a restriction to the utilisation of this chemical as a food preservative, and use of personal protective equipment during procedures.

Open Access Original Research Article

Periodontal Diseases and Associated Risk Factors among Residents in Orlu, Nigeria

M. C. Ohamaeme, J. N. Egwurugwu, I. G. Eberendu, U. F. Ogunnaya, C. N. Ekweogu, S. D. Ejikunle

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2018/44538

The global burden of periodontal diseases is enormous with attendant health challenges especially in developing countries like Nigeria.  This study assessed the risk factors associated with periodontal diseases in Orlu Local Government Area (LGA) of Imo State, Nigeria.  This cross-sectional descriptive study evaluated 500 respondents randomly selected from the LGA. An interviewer administered questionnaire was used to collect the data which was analysed with descriptive statistics, and chi-square used to determine the level of significance set at p≤0.05. The results showed that the younger population, as well as males, were more likely to have periodontal diseases and this was statistically significant (p<0.02). It was also found  that lower income earners were more at risk to developing periodontal diseases compared to higher income earners which was also significant (p<0.00). Those who used chewing stick or toothpaste with brush, and the respondents who brushed two or more times per day were less likely to have periodontal diseases compared to those who used water+ salt or alcohol and  the respondents who brushed only once or less per day and these were also significant (p<0.05 and p<0.01 respectively). We recommend that regular dental check-ups, regular brushing of teeth, the creation of awareness, increased oral health education and inter-sectoral collaboration be embarked upon to achieve a better oral health.

Open Access Original Research Article

Implementation of WHO, 2006 Child Growth Standards: Health Workers Knowledge, Attitudes and Practices in Kasarani, Kenya

Mola Caroline Nabukanda, Solomon Kemoi Cheboi, Judith Waudo, Irene Awuor Ogada

Asian Journal of Medicine and Health, Page 1-15
DOI: 10.9734/AJMAH/2018/44728

Introduction: In the populous Nairobi peri-urban setting, growth assessment of children, under five years of age is wanting (20%). Stunting, wasting and underweight were 17.2%, 2.5% and 3.8% respectively against the national statistics of 27%, 11% and 4%. A study was undertaken to assess health workers current levels of knowledge about WHO 2006 child growth standards, their attitudes, and practices.

Methodology: The study was undertaken in Kasarani using a facility based cross-sectional survey in 45 health facilities. Purposive sampling was used to recruit 129 participants. The data were collected using an interviewer-administered questionnaire adopted and modified from the previous studies. Data were entered and analysed using the Statistical Package for Social Science     version 25. 

Results: The study revealed that the calibration of the weighing instrument was more pronounced in private (66.7%) than in faith-based (28.6%) and public facilities (4.8%). Health workers with moderate knowledge were five times more likely (OR: 4.886, 95% CI 1.565-15.250) to implement WHO, 2006. Respondents who perceived growth assessment using the WHO growth standards as an effective method to detect malnutrition were thirteen times (OR=12.900; 95% CI 0.427 – 389.372) more likely to plot the child’s measurements.  Similarly, those who considered malnutrition as dangerous to child growth and development were three times (OR=2.671; 95% CI 1.042 – 6.573) more likely to be practitioners of the WHO growth standards. Significant positive correlations were found between knowledge with attitude (r=0.227), attitude with practice (r=0.226), as well as knowledge with practice (r=0.250).

Conclusion: The study revealed that informed health workers may eventually develop a positive attitude and good practice towards the WHO 2006 child growth standards. Training interventions on the importance of adherence of growth monitoring guidelines may improve growth assessment.