Open Access Original Research Article

Knowledge, Attitudes and Practices of Primary Health Care Physicians Regarding Diabetes Management: A Cross Sectional Study in Gharbia Governorate, Egypt

Mai Mohamed Mahmoud Abu Kahf, Khalil Mohamed Abbas Ayad, Mamdoh Ahmed Gabr, Walaa Mohamed El Sayed Shehata

Asian Journal of Medicine and Health, Page 1-15
DOI: 10.9734/ajmah/2019/v17i430169

Background: With increasing prevalence of diabetes mellitus worldwide, primary health care physicians are the main providers of diabetes care and their knowledge, attitudes and practices are important to achieve goals in diabetes management.

Objectives: Assessment of the knowledge, attitude and practices (KAP) of primary health care physicians regarding management of diabetes. To find-out gaps between the practices of primary health care physicians and the already established national and international guidelines.

Methods: This cross- sectional study was conducted on 144 primary health care physicians working in a randomly chosen primary health care centers in Al Garbia Governorate. Data collected concerning knowledge, attitudes and practices of primary care physicians regarding diabetes management.

Results: The study included 144 primary health care physicians working in 38 primary health care centers in Gharbia governorate. About two thirds (95) of the studied physicians were working in rural areas and the rest (49) in urban ones. As regards years since graduation, fifty three of the studied physicians were graduated <5 years and the rest (91) were graduated ≥5 years. Concerning relevant certifications or training courses, about three fourths (106) had relevant past experiences while one fourth (38) had no such experiences. Urban primary care physicians had higher percentage of correct knowledge than the rural ones as regards diagnosis, complications and managements of DM (p value <0.05). Primary care physicians with increased years of practice and who attended relevant training courses had favorable attitude and practices as regards counseling and regular examination of diabetic patients (p value <0.05).

Conclusion: The current study revealed a shortage of knowledge, attitude and practices of primary health care physicians as regards management of diabetes. The defect in knowledge and unfavourability of attitude and inappropriateness of practices are obvious in family physicians working in the rural health care facilities, those without relevant experience and those graduated less 5 years.

Open Access Original Research Article

Effect of Infant and Young Child Feeding Practices on the Nutritional Status of Children 0-24 Months of Age in Port Harcourt, Nigeria

N. S. Tobi, B. A. Alex-Hart, I. O. George

Asian Journal of Medicine and Health, Page 1-21
DOI: 10.9734/ajmah/2019/v17i430170

Background: Childhood under-nutrition is prevalent in many developing countries including Nigeria, and is an underlying cause for more than half of all childhood deaths. Based on the recent Nigeria Demographic and Health Survey (NDHS), the prevalence of under-nutrition between 2008 and 2013 has risen, despite an increase in exclusive breastfeeding (EBF) rate over the same period.

This study was carried out to assess the effect of infant and young child feeding practices on , nutritional status of children  0 – 24 months in Port Harcourt, Nigeria.

Subjects and Methods:  Data were collected between November and December 2016 from 307 mother-child (aged 0 – 24 months) pairs attending six health centres in Port Harcourt using a pretested self-administered questionnaire. Data collected included maternal and child socio-demographics, mother’s infant feeding practices, 24-hour dietary recall and anthropometric measurements. Data were analysed using SPSS version 20.0.

Results: The mean age of the children was 5.6±6.1 months, 207 (67.4%) were under 6 months of age and 100 (32.6%) between the ages of 6 to 24 months. Three hundred and three (98.7%) children were breastfed. The rate of exclusive breastfeeding was 51.7% among the children aged 0 – 5.9 months. The mean age at which breastfeeding was stopped was 9.3±5.5 months. The average age at which complementary foods were started was 4.4±1.8 months. All the children on complementary feeding met the minimum feeding frequency, but only 43 (33.6%) met the minimum dietary diversity of 4 or more food groups. Overall, 111 (36.2%) children were fed according to WHO recommendation. 10.1% of the children were overweight/obese, 5.5% were wasted, 6.2% were underweight and 8.8% were stunted. Lack of EBF was positively associated with stunting (p = 0.024).

Conclusion: Infant and Young Child Feeding practices among mothers in Port Harcourt fall short of the WHO recommendations, resulting in various types of malnutrition among the children. Therefore, more emphasis should be laid on growth monitoring and promotion services and age-specific nutritional counseling to parents and care-givers.

Open Access Original Research Article

Tetanus Toxoid Status and Determinants of Uptake among Women in Etche Local Government Area, Rivers State, Nigeria: A Community Based Study

N. Gabriel-Job, L. E. Yaguo Ide

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/ajmah/2019/v17i430171

Introduction: Nigeria is one of the countries where maternal and neonatal tetanus is still prevalent and as such a public health issue. In spite of campaign on maternal tetanus immunization, its safety and protection against tetanus, uptake has remained poor.

Aim: This study is aimed to determine the level of Tetanus Toxoid (TT) vaccine uptake among women of child bearing age in Rivers State Nigeria.

Methods: Using a cluster sampling method, a descriptive cross-sectional community based study was carried out. The study was carried out in Opiro community in Igbo Agwuru-Asa Clan in Etche Local Government Area of Rivers State.

Results: Of the 555 women studied 108(19.5%) of them had received 5 doses of TT while 206 (37.1%) had received at least two doses of TT, giving an overall prevalence of TT utilization among women of childbearing age of 31.7%. Eighty four (31.2%) of women who were ≤ 30 years compared to the 122(42.7%) of the older women had received at least 2 doses of TT vaccine. This was statistically significant (P=0.005, OR 1.67, 95% CI 1.16-2.32), educational level, marital status and occupation also significantly affected Tetanus Toxoid vaccine uptake among the women.

Conclusion: This study concludes that utilization of TT immunization among women is low, that younger age, marital status, level of education and occupation of the women can significantly affect the level of TT uptake among women. There is need to strengthen immunization in this community and to create awareness on the need to get optimal Tetanus Toxoid immunization.

Open Access Original Research Article

Profile of Biochemical and Oxidative Stress Markers in Male Athletes Following Strenuous Exercise Session

K. U. Nwoke, F. S. Amah-Tariah, A. N. Chuemere

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/ajmah/2019/v17i430172

With the increasing number of people who participate in one form of exercise or the other, believing that it improves health and enhances professional sporting career, the question of its health benefit can only be answered with the knowledge of the metabolic changes that occur during exercise. This study therefore, was aimed at investigating the implications of physical exercise on some metabolic biomarkers, and to identify the changes that occur in subjects who undergo strenuous regular physical exercise in the tropics. Blood samples were collected from 86 male athletes and 100 male non-athletes aged between 22 and 30 years following established protocols. The athletes were at the peak of their training in preparation for a major sporting event and the blood samples were collected at rest and immediately after strenuous exercise sessions; while blood samples from the non-athletes were collected only at rest and served as control. The samples were prepared and used for the evaluation of some metabolic and oxidative stress markers. All experimental evaluations were done following well established methods. Result showed that serum concentrations of creatinine, urea, bilirubin, testosterone and cortisol all significantly increased in athletes after strenuous exercise. However, there was no statistical significant change in these biomarkers between athletes at rest and non-athletes. Also except glutathione reductase which significantly decreased in athletes after exercise, other oxidative stress markers assayed significantly increased in athletes after exercise; there was also no significant change between athletes at rest and non-athletes. From the result, this study concludes that strenuous exercise may increase oxidative stress in the cells, cause hemolysis or muscle damage and subsequent myoglobin degradation.

Open Access Original Research Article

Knowledge, Attitude and Practice of First Aid and Emergency Care among the Classes Educated in Aurangabad, Maharashtra

Rohit Jacob, Manjiri Naik

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/ajmah/2019/v17i430173

Aims: To find an association between educational qualification of the participant and knowledge of first aid and emergency care. To understand the common misconceptions of First Aid practices among the educated class of Aurangabad. To conduct a seminar cum workshop session for the educated class of Aurangabad.

Study Design: Cross sectional study with a sample size of 700 participants. The candidates were provided with a questionnaire and a seminar demonstrating First aid and Emergency care was conducted post-questionnaire.

Place and Duration of Study: The study was conducted among the educated class in the city of Aurangabad between October 2018 to February 2019.

Methodology: The candidates were selected from different schools, colleges, small firms, church gatherings and hotel staff. Data was collected using a self-administered pre – tested questionnaire. Based on the scores obtained in each condition, the overall knowledge was graded as good, moderate and poor. A seminar was conducted post questionnaire and the improvement in their knowledge was tested.

Results: Out of 700 candidates included in the study, 110(15.7%) were school going children, 60 (8.6%) were high school students, 50(7.1%) were college students, 280(40%) were graduates and 200(28.6%) were post graduates. 410(58.7%) had poor knowledge about First Aid and Emergency Care and only a mere 39(5.6%) had good knowledge about First Aid and Emergency Care. 105 candidates (15%) of the candidates believed that applying hot compresses relieves an ankle sprain. 77 candidates (11%) of the candidates believed that inducing vomiting is initial modality of management in a patient who accidentally ingested acid.

Conclusion: Initiation of First aid and Emergency care training programs among all age groups still remains an enigma. Conducting such workshops on First aid and Emergency Care among communities can make the citizens competitive enough to provide first aid independently and spontaneously in real life situations.