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   2015| January-June  | Volume 9 | Issue 1  
    Online since August 21, 2015

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The role of National Health Insurance Scheme on structural development of health facilities in Zaria, Kaduna State, North Western Nigeria
Muhammad Bello Garba, Clara Ladi Ejembi
January-June 2015, 9(1):9-14
Background: The National Health Insurance Scheme (NHIS) in Nigeria was introduced in 2005 to ensure universal access to good health care services, by protecting families from financial barriers to health care, and ensuring availability of funds to the health sector for improved services. Since introduction of the scheme, however, there has been no documented study carried out to assess whether there has been any improvement in human resource available for provision of health services and for other basic infrastructure in the participating facilities. Aim: This study was undertaken to assess and compare the funding patterns, and infrastructural and manpower development in health facilities in Zaria, Kaduna State, following the introduction of the NHIS. Materials and Methods: This study was comparative cross-sectional in design. Using stratified sampling technique one public and two private health facilities were selected from 16 secondary health facilities (5 public, 11 private) accredited by the NHIS. Retrospective analysis of data collected from their records on the pattern of funding, the levels of hospital infrastructure, and manpower in the facilities was carried out before and after the introduction of the NHIS. Results: The study demonstrated an almost three-fold increase in financial resources availability to the health facilities following enrolment into the NHIS, with the private facilities having a higher increase (300%) than the publicly owned facility (261%). Funds from the scheme, now constituting up to 36% of the total revenue, accounted for almost half (47%) of the increase. The facilities also witnessed improvement in physical infrastructure, staff strength, and diagnostic capability with variable statistical significance. Conclusion: The study demonstrates that the relationship between financial resource availability and facilities' staffing, laboratory diagnostic capability, and physical infrastructure is not always linear.
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Spontaneous subcutaneous emphysema and pneumomediastinum in a child with bronchial asthma
Bindu T Nair, Sajith Surendran, Tarikjot Singh Brar
January-June 2015, 9(1):30-32
Massive spontaneous subcutaneous emphysema is rare in the absence of trauma. An 11-year-old male child, a known case of poorly controlled bronchial asthma presented with sudden onset of respiratory distress after a sudden bout of cough. He also had painful swelling of the neck, chest, abdomen, and upper limbs. On clinical and radiological examination, he was found to have massive subcutaneous emphysema. A gastrografin study was done which showed no esophageal perforation. Computed tomography of his neck and thorax demonstrated pneumomediastinum with no lung or pleural pathology. Management was conservative with supplemental oxygen, nebulized bronchodilators, corticosteroids, and intravenous antibiotics. Child improved symptomatically without any surgical intervention and was discharged after 7 days.
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A Study of Knowledge and Practice among Nurses Regarding Care of human immunodeficiency virus Positive Patients in Medical College and Hospitals of Kolkata, India
Panchali Som, Sharmistha Bhattacherjee, Rituparna Guha, Madhumita Basu, Sumit Datta
January-June 2015, 9(1):15-19
Background and Objectives: Nurses are the frontline health workers whose work compels them to come in contact with different blood-borne pathogens, including human immunodeficiency virus (HIV). Therefore, their awareness regarding HIV is critical to successful implementation of the programmes. Objectives: To find out the knowledge and practice regarding HIV among nurses in medical colleges of Kolkata. Materials and Methods: A cross-sectional observational study was carried out among 250 nurses employed in five medical colleges of Kolkata over a period of 2 months (January-February 2015). Their knowledge in the areas of virology, modes of transmission, prevention, and nursing practices regarding HIV/Acquired Immune Deficiency Syndrome (AIDS) patients' care was assessed using a pretested questionnaire. The collected data were analyzed using SPSS software. Results: While the basic information about the disease such as causative agent, modes of transmission, etc., were known to most of the participants, deficiencies in their knowledge and awareness in many critical areas of the disease such as voluntary counseling and infant feeding practices were noticed. The practice was also found to be unsatisfactory. Training in HIV was found to be an important factor influencing the knowledge of participants. Conclusion: The knowledge and practice regarding HIV was found to be less than satisfactory which necessitates the need to impart focused training on prevention counseling regarding HIV, keeping in mind the rising incidence of HIV infection in India.
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Knowledge, attitude, and practice of basic hospital management principles among medical doctors in Lokoja, Nigeria
Ohireimen Ohioze, Bawo Onesirosan James
January-June 2015, 9(1):4-8
Background: Good management skills are required by medical doctors to offer optimal service to clients (patients). Though doctors are often managers, basic hospital management principles are lacking in the training curriculum, and may affect how they organize multi-disciplinary teams or units in synergizing healthcare delivery. Aims: This study sought to determine the level of knowledge, attitude, and practice of management principles among private and public medical doctors in Lokoja. Materials and Methods: A cross-sectional study of 160 medical doctors using a pretested 23-item closed-ended questionnaire. Descriptive and bivariate analyses (using the Chi-squared, Pearson's correlations and Students' t-tests) were performed to compare categorical and continuous outcomes respectively. Results: A total of 70.9% of respondents were found to have a high knowledge of basic management principles, 80.6% had a positive attitude toward management principles while only 35.6% of respondents actually used formal management principles in their administrative work. Public sector doctors had significantly better knowledge (P < 0.001), positive attitudes (P < 0.003), and higher level of practice (P < 0.004) compared to private sector doctors. There was a positive linear relationship among knowledge and attitude (R = 0.47), knowledge and practice (R = 0.33), and attitude and practice (R = 0.38). Conclusion: Public sector doctors had higher knowledge and better attitudes toward management principles compared to private sector colleagues. Low levels of practice of basic management principles were seen in both groups. This study sets the groundwork for future research.
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Relationship between anthropometric variables and lung function parameters among primary school children
Jibril Mohammed, Sa'adatu Abubakar Maiwada, Farida Garba Sumaila
January-June 2015, 9(1):20-25
Background: Anthropometric measurements in children are known to change with increasing age and other factors. This study investigated the relationship between anthropometric variables and lung functions (LF) of children. Materials and Methods: Two hundred and fifty apparently healthy school children aged between 6 and 12 years (male: 9.3 ± 2; female: 9.4 ± 1.9) participated in this study. They were recruited using multi-stage sampling technique from five purposively selected primary schools in Kano, Nigeria. Their LF such as forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC) and peak expiratory flow rate (PEF) were assessed using a micro computerized spirometer. Additionally, anthropometric variables, including height, weight, chest circumference (CC), waist circumference (WC) and hip circumference (HC) were measured. Data were analyzed using descriptive and inferential statistics on SPSS. Alpha probability level of 0.05 indicated point of significance. Results: The results showed gender similarities for age (P = 0.502; 95% confidence-interval [CI] = 0.07-0.15), height (P = 0.142; 95% CI = 0.003-0.04), weight (P = 0.511; 95% CI = −2.34-6.68), WC (P = 0.556; 95% CI = −2.23-6.53), HC (P = 0.084; 95% CI = −1.67-8.13), CC (P = 0.133; 95% CI = −0.11-0.02), FEV 1 (P = 0.452; 95% CI = −0.81-0.69), FVC (P = 0.158; 95% CI = −0.15-0.8) and PEF (P = 0.181; 95% CI = −0.009-0.07). All anthropometric variables showed significant relationship with LF parameters (0.289> r <0.581). In the male children, underweight and normal weight body mass index (BMI) groups had lower values for FEV 1 (P = 0.003) and FVC (P = 0.001) compared the higher BMI groups. In the female children, only the underweight BMI group showed lower values for FEV 1 (P = 0.042) and FVC (0.05) compared to other groups (P < 0.05). Conversely, the PEF was similar across all the BMI groups among both males (P = 0.104) and female (P = 0.296) children. Conclusion: Anthropometric variables are strong determinants of LF among the children. Besides higher BMI had a positive influence on FEV 1 and FVC values.
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Pathologist-clinician collaboration: A marriage of necessity toward improving the quality of patient care
Dauda Eneyamire Suleiman
January-June 2015, 9(1):1-3
  3,695 462 2
A 17-year-old of Nigerian girl with Sydenham chorea: A case report and review of literature
Emmanuel Okechukwu Ezunu, Chibueze Haggai Njoku
January-June 2015, 9(1):26-29
This is a 17-year-old Nigerian girl who had a history of a sore throat for 8 weeks and persistent fever, associated with central chest pain, abnormal fidgety movement of the body and fleeting joint pain. The diagnosis of Sydenham chorea was made due to the additional finding of positive anti-streptolysin O titer. Sydenham chorea is a neuropsychiatric disorder that is characterized by abnormal body movement, associated with mood and behavioral changes. It is an autoimmune disease that occurs following an infection with M serotype of Group A beta-hemolytic streptococcal infection that is prevalent in our environment. However, Sydenham chorea which is one of its manifestations is still rare in our environment, hence the need for literature review.
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Familial renal tubular acidosis: Report of two cases from a single family
Alina Naeem, Mahmoud Ahmed Kiblawi, Subhranshu Sekhar Kar, Elham Ahmed, Sheriff Mossad, BK Manjunatha Goud
January-June 2015, 9(1):33-37
Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, as a result of which the person's blood remains very acidic. Without proper treatment, chronic acidity of the blood leads to chronic kidney disease, kidney stones, metabolic bone disease, and growth failure. These are relatively rare inherited renal tubular disorders. We report two cases from a single family with distal RTA (dRTA) or Type 1 RTA presenting with varied clinical manifestations. Sensorineural deafness, which is rarely associated with dRTA, was present in the elder sibling.
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