Open Access Original Research Article

Prevalence of Drug and Alcohol Use among Undergraduate Medical Students in a Nigerian Private University

O. I. Oyeniran, T. Chia, A. O. Ajagbe

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/ajmah/2019/v16i130132

Aim: This study was carried out to determine the prevalence of drug and alcohol use among medical students in a private University based in Abuja, Nigeria.

Study Design: A descriptive cross-sectional survey.

Place and Duration of Study: College of Health Sciences (CHS), Nile University of Nigeria, Abuja, between June 2018 and September 2018.

Methodology: Using a semi-structured, self-administered questionnaire, information was obtained from 49  second year medical students (11 males, 38 females; age range 17-25 years), who were surveyed for the prevalence and reason of drug and alcohol use. Data retrieved was sorted, collated and subjected to statistical analysis using SPSS version 23.0 statistical package.

Results: The mean age of students was 18.9 years and a higher proportion of respondents were female students (n=38; 77.6%). Out of the 49 students examined in this study, only 2 students currently use drugs while 8 students consume alcohol, given a prevalence of 4% and 16.3% respectively. Reasons given by one male alcohol user include: to build self-confidence (12.5%), while one female drug user uses it to escape from worries or troubles (50%). The prevalence of alcohol use was highest among male students (n=5; 62.5%), while that of drug use was highest among female students (n=2; 100%). Results also showed that the majorities of students were occasional users; and so there was no evidence of physical dependence.

Conclusion: Findings established low prevalence of drug and alcohol use among study groups. However evaluation of full-scale university-level intervention is highly necessary.

Open Access Original Research Article

Knowledge of Hospital Staff on the Procedures and Obstacles to Public Procurement in Ghana

Ramatu Agambire, Charles Adusei

Asian Journal of Medicine and Health, Page 1-11
DOI: 10.9734/ajmah/2019/v16i130133

Healthcare is an essential part of human life and cannot be disregarded whether for an individual, a family or a state. A conscious and planned effort must be taken by the state to make sure that goods and services are made available and accessed through effective and efficient procurement systems. The purpose of the study was to examine hospital staff knowledge on application, procedures and obstacles to public procurement at Oda Government Hospital in Ghana. A mixed method approach using survey and interview guide was used to solicit information from the hospital staff and the Procurement Manager. Data was analysed using descriptive statistics and Kendall Coefficient of Concordance. The study revealed that the staff had knowledge on procurement procedures and tried to follow the recommended guidelines. The highest mean was scored for application and familiarity with the Public Procurement Act (PPA) whereas verification of documentation, opening tenders for bidding and publishing contract awards were the key procurement procedures.Major obstacles identified included bureaucracy, lack of skilled personnel and adhoc membership of the tender team. The Medical Superintendent and the hospital Administrator were the officers responsible for policy approval and supervision of the Public Procurement Act. There is a need to enforce adherence to the Public Procurement Act and ensure regular training of staff and stronger stakeholder participation in the procurement processes to equip the staff with knowledge and skills on the application of the Public Procurement Act.

Open Access Original Research Article

Resistance Pattern of Nitrofurantoin of Uropathogens in Different Age Groups at Dr. Lal Path Labs, National Reference Laboratory, Rohini, Delhi

Puneeta Singh, Shalabh Malik, Vandana Lal

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/ajmah/2019/v16i130134

Aims and Objectives: This study was undertaken to highlight the resistance pattern of Nitrofurantoin among 5162 UTIs causing isolates at Microbiology Department of Dr. Lal Path Labs between April to June 2019.

Materials and Methods: This retrospective study was performed in Department of Microbiology at Dr. Lal Path Labs, Delhi during period April to June 2019. Standard loopful midstream urine samples collected in a sterile container were inoculated on UTI Chromagar and incubated overnight at 37ºC and demonstrating significance colony count of ≥105 CFU/ml. Common Enterobacteriaceae group of isolates and Gram positive isolates identified by MALDI TOF-MS (Bruker, Daltonics) were included in this study. To determine Nitrofurantoin resistance by VITEK-AST (Biomerieux) system on 280/P628 antibiotic susceptibility testing cards respectively as per as CLSI M100-S-29. Proteus spp, Pseudomonas spp., Acinetobacter spp, of complicated UTI isolates were excluded from this study. 

Results: Of the 29485 urine samples tested during April to June 2019, 5162 (17.5%) were culture positive. Out of the 5162 positive isolates 2856 (55.3%) were isolated from female patients and 2306 (44.7%) from male patients. The most common bacterial isolates were members of  Enterobacteriaceae 4728 (91.5%) and Gram positive were 434 (8.5%). The most predominant age group infected with uropathogens were elderly adults ≥ 50 years of age constituted 58.1% of the UTIs culture positive cases. Klebsiella pneumoniae demonstrated highest resistance of 92.3% whereas Staphylococcus aureus demonstrated the least resistance of 8.3%.

Discussion and Conclusion: The alarming substantial resistance to Nitrofurantoin in decreasing order has been noticed in Enterobacteriaceae i.e., Klebsiella pneumonia (92.3%), Enterobacter spp.(58.2%), Citrobacter spp (42.6%) and Gram positive Enterococcus spp. (45.6%) which is across all age groups. Most susceptible to Nitrofurantoin were Escherichia coli (69.9%) in Gram negative and Staphylococcus aureus (91.7%) in Gram positive. This finding emphasis the need of robust restriction of Nitrofurantoin antibiotic policy and usage to uncomplicated UTIs caused by Escherichia coli and Staphylococcus aureus.

Open Access Original Research Article

A Prospective Observational Study on the Appraisal of Common Cause and Efficacy of Continuous Phototherapy in Patients with Neonatal Jaundice

V. Premsai, G. Ramya, Y. Kavya Chowdary, Syeda Zaineb Humaira Hussaini, C. Aparna

Asian Journal of Medicine and Health, Page 1-14
DOI: 10.9734/ajmah/2019/v16i130135

Background: Neonatal jaundice is generally harmless, but high concentrations of unconjugated bilirubin may rarely cause kernicterus. Hyperbilirubinemia is the most common cause of neonatal readmission to the hospital, in the majority of cases.

Aims: The study aims to determine incidence rate of neonatal jaundice as well as evaluate the commonest cause and determine the efficacy of continuous phototherapy.

Study Design: A Prospective observational study.

Place and Duration of Study: The study was conducted in Avis Ankura hospital for women and children. It is a well-recognized, authorized hospital where obstetrics and neonatal care is provided. The study was conducted between October 2018 to March 2019.

Methodology: The study was conducted in Avis Ankura hospital for women and children. It is a well-recognized, authorized hospital where obstetrics and neonatal care is provided. A total of 162 neonates were considered. Informed consent was obtained from all the subject’s care takers. Subjects enrolled in the study were admitted in NICUs’. This study appraises the conventional cause of NNJ, evaluates the efficacy of continuous phototherapy and detects the phototherapy induced adverse reactions by using Naranjo’s causality assessment scale.

Results: Among 162 patients, 94 patients (58%) were found to be males and 68 patients (42%) were found to be females. Low birth weight neonates (43.20%) were found to be more prone to neonatal jaundices. In this study, it was found that duration of phototherapy was longer in extremely low birth weight neonates (34 hours) in relation to birth weight and average duration of phototherapy. Based on the conventional cause, physiological cause (56.79%) was observed to be highest among other causes of neonatal jaundice. The short term adverse reactions due to phototherapy were identified using Naranjo’s Causality Assessment Scale. The TSB levels were increased before phototherapy (pre- treatment) and decreased after phototherapies (post-treatment) which were assessed by using American Academy of Pediatrics guidelines.

Conclusion: From this study, it was concluded that males were more prone to develop neonatal jaundice when compared with females. Physiological jaundice contributes majority of cases   among the total cases. The use of phototherapy was inversely related to gestational age and birth weight.

Open Access Original Research Article

An Epidemiological Study of Traumatic Head Injury in a Tertiary Care Center in Kancheepuram, Tamil Nadu, India

K. Myl Kumaran, Pragadeesh Raja, M. Jasmine

Asian Journal of Medicine and Health, Page 1-5
DOI: 10.9734/ajmah/2019/v16i130136

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury.

Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients.

Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21.

Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM.

Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.