Open Access Original Research Article

Unfavorable Attitude and Perceived Stigma towards Leprosy: A Concern for Status Perpetuation in a Community in Cross River State, Nigeria

G. I. Ogban, A. A. Iwuafor, U. E. Emanghe, S. N. Ushie, E. M. Ndueso, R. I. Ejemot- Nwadiaro, N. C. Osuchukwu

Asian Journal of Medicine and Health, Page 1-13
DOI: 10.9734/ajmah/2020/v18i830225

Background: Negative attitude and stigma against leprosy patients constrain them to resort to concealing their status thus resulting in delayed detection, treatment, complications and perpetuation of the condition in the locality. This study was aimed at finding out the prevailing attitude and stigma toward leprosy in the community with a view to addressing the fueling factors.

Materials and Methods: It was descriptive cross sectional study. Semi-structured interviewer administered questionnaires were used for data collection. Explanatory Model Interview Catalogue (EMIC), was used to grade stigma against leprosy amongst participants. Answers to questions in the questionnaire were assigned scores which were summed up into percentage breakpoints. A respondent was interpreted as having favorable or unfavorable attitude to leprosy depending on his or her percentage sum of score.

Stigma was categorized based on the sum of an individual’s EMIC score as high, moderate or low level of stigma. Data were analyzed using SPSS version 20.

Results: The study revealed that only 44(15%) of respondents had favorable attitude towards leprosy whereas 250(85%) had unfavorable attitude towards this group. Attitude to leprosy was observed to be significantly related to age and sex of respondent, religion and ethnicity, p-value< 0.05. EMIC profile of the study respondents revealed that 47(16%) demonstrated low stigma, 81(28%) demonstrated moderate stigma and 166(56%) demonstrated high stigma towards leprosy. There was no statistically significant relationship between stigma and socio-demographic variables.

Conclusion: Misunderstanding and misconceptions about leprosy and leprosy patients is still well rooted in the norms and culture of the people of Ikun, breeding negative attitude and stigma toward leprosy. Vigorous leprosy awareness programs structured along the lines of attitude-stigma influencing socio-demographic variables, with emphasis on the cause, transmission, diagnosis and treatment of leprosy will help to stem the tide of myths and misconceptions.

Open Access Original Research Article

Ocular Morbidity Pattern and Presentation among Residence of a Semi-Urban Community in Rivers State, Nigeria

N. E. Chinawa, V. K. Odogu, E. I. Ezeh, F. E. Anyiam

Asian Journal of Medicine and Health, Page 14-20
DOI: 10.9734/ajmah/2020/v18i830226

Background: Ocular diseases vary in different parts of the world and are influenced by racial, geographic, socioeconomic and cultural factors. The common ocular diseases worldwide are cataract, glaucoma, conjunctivitis, corneal ulcers, uveitis, refractive errors, pterygium.

Methods: This was a community-based cross-sectional descriptive study carried out in Rumuokwuta community in Rivers state. Socio-demographic and clinical presentation information was obtained from an interviewer-administered questionnaire. Distant visual acuity was assessed at 6 m with the Snellen’s chart while near vision assessment was at 33 cm with a Sussex vision R near vision chart. External eye examination was with pen touch while fundoscopy was with direct Ophthalmoscope. Data were analyzed with the Statistical Package for Social Sciences (SPSS) v20. Using descriptive statistics, categorical variables were presented in the form of frequencies and percentages (%) and summary statistics in means and standard deviations (SD). Using inferential statistics, the Chi-Square (X2) test of significance was used to associate categorical variables and a p-value ≤ 0.05 was considered statistically significant.

Results: A total of 114 subjects were examined.The mean age was 41.41± 15.49 years. The male to female ratio was 2:3. About 70.5% and 76.2% respectively in Right Eye and Left Eye had normal vision better than 6/18, while 27.1% and 21.9% respectively in Right Eye and Left Eye had a low vision (VA between 6/18 and 6/60). About 2.6% in either eye were blind. The three most common ocular conditions were Glaucoma (13.95%), Refractive error (13.02%) and Presbyopia (12.56%).

Conclusion: The commonest cause of Ocular morbidity in this study are glaucoma, refractive error and presbyopia. The age distribution of a study area was a significantly associated factor in the frequency of visual impairment and blindness.

Open Access Original Research Article

Pattern of Childhood and Adolescent Neuropsychiatry Disorders Associated with Obstetric Complications in University of Port Harcourt Teaching Hospital (UPTH)

A. K. Nkporbu, K.I. Green

Asian Journal of Medicine and Health, Page 21-31
DOI: 10.9734/ajmah/2020/v18i830227

Background: Obstetric complications tend to affect the immature brain which may cause or predispose to neurological or psychiatric disorder(s) in childhood or adolescence.

Aim: To determine the pattern and prevalence of childhood and adolescent neuropsychiatric disorders associated with obstetric complications in UPTH.

Methodology: This is a multi-design study, a descriptive cross sectional for assessing psychiatric illness in childhood and adolescence at the time of presentation in the outpatient clinic and this was followed by a retrospective design for mothers to recall cases associated with obstetric complications. Therefore, all cases of childhood psychiatric disorders with established and reliable history of obstetric complications as volunteered by either or both parents of affected children from January, 2013-December, 2019 were included in the study. Diagnoses were made by consultant neuropsychiatrists using the Diagnostic Statistical Manual version 5 (DSM IV) criteria. All cases with family history of mental illness were excluded from the study. A study questionnaire was also administered to the mothers of affected children. The results were analysed using GraphPad Prism statistical software.

Results: In all, 2182 cases of various childhood psychiatric disorders were seen within the period under study. Out of this figure, 408 (18.7%) were associated with history of obstetric complications. The most prevalent neuropsychiatric disorder was substance abuse with 17.3%, followed by depression 16.2% and then anxiety disorder 14.8%.

Conclusion: Obstetric complications have become important in childhood and adolescent neuropsychiatric disorders and is therefore important to pay more attention to steps that are necessary to prevent obstetric complications in pregnancy, labour, delivery as well as the immediate post partum.

Open Access Original Research Article

Vision-related Quality of Life among Adult Patients with Visual Impairment at a Tertiary Eye Centre, South-South Nigeria

Ernest I. Ezeh, Roseline N. Ezeh

Asian Journal of Medicine and Health, Page 37-48
DOI: 10.9734/ajmah/2020/v18i830229

Aim: To determine the vision-related quality of life (VRQOL) and associated factors among adult patients with visual impairment.

Study Design: It was a cross-sectional study.

Place and Duration of Study: Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria, between August 2015 and March 2016.

Methodology: We consecutively recruited 270 patients aged 18 to 90 years with visual impairment. Presenting visual acuity was assessed to determine the degree of visual impairment, anterior segment and posterior segment examinations as well as refraction were done to establish clinical diagnosis, and an interviewer National Eye Institute’s 25-itemVisual Functioning Questionnaire (NEI-VFQ-25) was administered to estimate the vision-related quality of life (VRQOL). Data was entered into and analyzed with SPSS for Windows version 20. Descriptive statistics such as frequency, mean, standard deviation, and range with 95% confidence interval were calculated and the Chi square (χ2) test for categorical variables and the Student’s t-test for continuous variables were used for test of significance, p value <0.05. ANOVA test, including Post-hoc analysis were used to determine associations between categorical and numerical variables at p value <0.05.

Results: A total of 270 study subjects participated in the study. The study participants included 152(56.3%) males and 118(43.7%) females, with Mean age ± SD was 51.07±16.91 years.  Based on the intra study categorization of VRQOL among the study participants, most (85.6%) had good VRQOL. However, the overall mean VRQOL score was remarkably low 41.23±22.87. The proportion of poor VRQOL was 39 (14.4%). The poor VRQOL was significantly associated with blindness 11.60±19.10 (p < 0.001). Age ≥80 years [44.0(95% CI: 27.4-60.7)], rural residents [64.9(95% CI: 58.7-71.1)], no formal education [48.5(95% CI: 33.5-63.5)] and widowhood [48.0(95% CI: 32.4-60.7)] had statistically significant association with low mean VRQOL scores.

Conclusion: Above three-fourth of the participants had good VRQOL, with reference to the categorization of in this study. However, the overall mean VRQOL score was remarkably low. Blindness, older age, rural residency, illiteracy, widowhood, agricultural workers and Ibo ethnicity had a statistically significant association with low vision-related quality of life.

Open Access Original Research Article

Pyogenic Anaerobes of Wound Infection and the Associated Risk Factors among Patients in Uyo, Southern Nigeria

I. A. Onwuezobe, P. C. Matthew

Asian Journal of Medicine and Health, Page 49-57
DOI: 10.9734/ajmah/2020/v18i830230

Aims: Anaerobic causes of pyogenic wound infection are not usually investigated due to difficulties in cultural techniques, lack of equipment and technical man-power. Therefore, this study aimed to investigate the anaerobic bacteria agents of pyogenic infection and the associated risk factors among patients in a tertiary hospital.

Study Design: This was a descriptive cross-sectional study conducted at the University of Uyo Teaching Hospital, Uyo and carried out on 136 wound samples from patients. These samples were collected from all consented patients with pyogenic wound infection that met the inclusion criteria.

Place and Duration of Study: The study was conducted at Uyo, the capital city of Akwa Ibom State, Nigeria between April and October, 2018.

Methodology: Deep wound swabs or aspirated pus samples were collected and inoculated into fresh 25% Sheep Blood Agar plate and incubated in an anaerobic jar containing anaerobic indicator and Gas-pak at 37oC for 48 – 72 hours Identification of isolates was performed following standard procedures. Data were obtained through a well- structured questionnaire and analyzed using SPSS software.

Results: Of the 136 samples collected, 127 yielded microbial growth with a total of 202 isolates which included 50 and 2 pure growths of aerobes and anaerobes respectively and 75 combined growths of aerobes and anaerobes. Overall, more aerobes (125) were isolated when compared to the anaerobes (77). Nevertheless, the predominant anaerobe was B. fragilis 26(33.8%). There was a statistical significant relationship between the age of the patient and infection by gram- positive anaerobes (p = 0.002).

Conclusion: Bacteriodes fragilis is mainly involved in anaerobic pyogenic wound infections in Uyo, however, only the age of the patient was found to be a factor in the prevalence of infection by gram-positive anaerobes.

Open Access Original Research Article

Study of Estimation of Urinary Delta Aminolevulinic Acid Levels as an Indicator of Lead Exposure in Pottery Workers

Neelam J. Patil, Sayali R. Kalokhe, Sachin A. Patharkar, Alka V. Nerurkar, Pradeep N. Surve, Umesh R. Shinde

Asian Journal of Medicine and Health, Page 58-63
DOI: 10.9734/ajmah/2020/v18i830234

Background: Lead toxicity is a significant environmental hazard and has widespread ill effects on human body. In this study we detected the lead exposure by measuring urinary delta aminolevulinic acid levels. The activity of delta aminolevulinic acid dehydratase enzyme is inhibited significantly by lead, which leads to an increase in urinary δ- ALA excretion. Hence we can use estimation of urinary δ-ALA levels as a surrogate marker of lead exposure in pottery workers.

Aim: To estimate the urinary delta aminolevulinic acid levels in pottery workers as an index of lead exposure.

Materials and Methods: The study was done on 85 pottery workers of age group between 18 to 50 years with their brief history related to lead exposure. Their urine samples were analysed for δ-ALA by Ehrlich method.

Results: According to our observation, it was found that out of 85 urine samples; 58 samples showed increased urinary δ-ALA levels (68.23%).

Conclusion: We conclude that the prevalence of lead exposure in pottery workers in Mumbai is very high. Good hygienic practices and necessary precautions should be followed to avoid its ill effects on human body.

Open Access Case Report

Successful Treatment of Pulmonary Embolus Secondary to Diabetic Ketoacidosis with Tissue Plasminogen Activator

Arun Agarwal, Mamta Agarwal, Hiren Bhanderi, Vishal Singh Charan

Asian Journal of Medicine and Health, Page 32-36
DOI: 10.9734/ajmah/2020/v18i830228

A 75-year-old woman with a history of Type 2 Diabetes mellitus attended triage with complaints of nausea, occasional vomit, pain in epigastrium and some vague heaviness in breathing of 4-5 days duration. On her physical examination she had mild tachypnea, peripheral capillary oxygen saturation (SpO2) 92% on room air, and high blood glucose and ketones respectively. She was evaluated and diagnosed to have bilateral submassive pulmonary Thromboemboli.

She was managed with fibrinolytic treatment, Heparin, and supportive treatment along with management of Diabetic Ketoacidosis (DKA). Etiological examinations did not reveal any underlying cause. The contribution of diabetes and its acute complication, DKA, to the development of pulmonary thromboembolism is controversial and is discussed. This case with the presentation of sub-massive pulmonary embolism in a patient of DKA with no underlying cause identified is being reported owing to its rareness.