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Feb 2026 DOI 10.14302/issn.2474-9273.jbtm-25-5885
Background Depression, increasingly recognized as a critical factor impacting mental health, notably affects various populations, including teachers. This study aimed to delineate the specific characteristics of depressive symptom networks among Chinese teachers, identify the core symptoms of depression within this demographic, and examine the variations in depressive symptom networks across different genders and teaching stages. Method The study encompassed 1,670 teachers. Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Central symptoms were identified through centrality indices. Network stability was examined via a case-dropping procedure. Directed Acyclic Graphs (DAG) was used to identify the activating symptoms. Results “Personal devaluation” exhibited the highest and most stable centrality values in the network. “Depressed Affect” and “Emptiness of Life” were identified as the activating symptoms in the network. No significant differences were observed in the network structure and global strength of depression between teachers of different genders. However, significant differences in the network’s global strength were found between junior and senior high school teachers. Conclusion “Personal devaluation” emerged as the core depressive symptoms among teachers in China. “Depressed Affect” and “Emptiness of Life” serve as the gateways that activate the entire teacher depression network. Paying close attention to these symptoms could potentially alleviate the experiences of depression in this demographic.
Sep 2024 DOI 10.14302/issn.2690-4721.ijcm-24-5126
The development of medical therapy and patients profile has led to a rise in the incidence of nosocomial fungal infection. The frequency of candidiasis has surged worldwide, and the prevalent of healthcare diseases are now Candida species. Candida species causes a range of human infections known as Candidiasis. The non-albicans Candida (NAC) species have recently superseded Candida albicans as significant opportunistic pathogens. The study was conducted to determine the prevalence and antifungal susceptibility of Candida species isolated from various Clinical samples in Rivers State University Teaching Hospital, Port Harcourt, Nigeria. A total of 206 clinical specimens from male and female patients of all ages were sampled in the Department of Microbiology, Rivers State University Teaching Hospital, Port Harcourt, to investigate suspected Candida infections. The isolation and identification of Candida species was done by culture on SDA, Gram stain, sugar fermentation and phylogenetic profiling. Antifungal susceptibility pattern was done by Disc Diffusion method using Fluconazole, Ketoconazole, Miconazole, Nystatin and Itraconazole. The results showed that out of 206 specimens, 44 isolates (21.4%) were identified, with the majority (56.82%) from high vaginal swabs (HVS), followed by urine (31.82%) and oral swabs (11.36%). The age of patients ranged from four months to 73 years giving a Mean Age 1.86+ 0.344, with females (85.4%) outnumbering males (13.6%). Prevalence of Candida spp revealed Candida albicans (50%), Candida krusei (18.2%), Candida parapsilosis(11.4%), Candida glabrata and Candida tropicalis (9.1%) respectively and Candida pelliculosa (2.2%), with C. albicans being the most prevalent. The antifungal susceptibility testing among the azoles showed that Fluconazole (79.5%) and Ketoconazole (77.3%) were most sensitive agents against isolates from HVS, urine and oral swabs respectively and Itraconazole (34.1%) was most resistant especially to those from oral swabs. This study highlights the increasing prevalence of NAC species over Candida albicans and the growing resistance of Candida isolates to commonly used antifungal drugs. Diagnosis of these species of Candida and sensitivity to antifungal agents are critical components to treatment, particularly for patients with severe underlying illnesses who are hospitalized.
Feb 2024 DOI 10.14302/issn.2329-9487.jhc-24-4910
Ebstein’s anomaly is a rare congenital heart disease. It is usually associated with other congenital defects, particularly atrial septal defect/patent foramen ovale (PFO). We report here the case of Ebstein's disease revealed in a 23-year-old adult admitted for palpitations and exertional dyspnoea. He was in heart failure. The EKG showed atrial flutter . Cardiomegaly was present with a cardiothoracic index of 0.7. On echocardiography, the apical displacement of the tricuspid septal leaflet was 15 mm/m2 , the Celermajer index was Grade 3. There was a large thrombus floating in the right atrium. While awaiting surgical management, the patient was being treated with diuretics, digitalis and anticoagulants.
Feb 2024 DOI 10.14302/issn.2766-8681.jcsr-24-4897
Introduction The arrangement of teaching content to relate to or unite concepts that are regularly taught in different academic courses or departments is referred to as integration of teaching. It simply refers to creating links between theoretical knowledge and actual application. Teaching the fundamental sciences in separate blocks prevents students from having the opportunity to connect and integrate their newly acquired knowledge. Objectives To evaluate the effectiveness of Integrated teaching method over traditional teaching and perception of students towards integrated method among first MBBS students Methodology The total of 62MBBS first year students are randomly divided into two groups, with 31 in each group. Group A is subjected for Conventional teaching and Group B for Integrated teaching method in the same topic. Among the 2 sessions one session is Horizontal and other is Vertical method of integrated teaching have been implemented. Finally, an evaluation test was conducted for both the groups and the mean marks obtained by the students were analyzed by using SPSS software version 17. Student’s perception towards this method was evaluated by pre-validated feedback questionnaire and analyzed. Results The mean marks (outof40) obtained by Group B (Conventional teaching) is 13.82 and by Group A (Integrated Teaching) is 31.18. So, the marks obtained by students after integrated method were found to be higher than the other group which underwent conventional teaching and this difference was found to be statistically significant (P <0.0001). Discussion and conclusion In comparison to the typical conventional method, integrated teaching has been found to be a more successful mode of instruction in terms of students' performance and assessment exams.
Dec 2023 DOI 10.14302/issn.3070-1937.ijbt-23-4714
Background and Objectives Duffy (FY) blood group system is implicated in transfusion incompatibilities and haemolytic disease of the foetus and newborn (HDFN). The primary objective was to determine the Duffy phenotype among indigenous pregnant women in Gombe, Gombe State, Nigeria. Materials and Methods This was a Cross sectional study where simple random sampling was employed on consented participants. Two hundred and fifty nine pregnant women attending antenatal clinic at Federal Teaching Hospital Gombe were randomly recruited into the study. About 3mls of blood was taken, and Duffy antigen typed by standard tube technique (LORNE LABORATORY UK). Results Among the Indigenous tribe, the percentage of Fy(a+b+) was seen in 2.2% of Fulani and 3.4% of Tangale, Fy(a+b-) phenotype was seen in 4.3% of Tangale, 6.8% of Fulani,9.5% of Tera, 10.3% of Hausa and 10.5% of Waja. Fy(a-b+) phenotype was seen in 5.3% of Waja, 7.6% of Fulani,8.7% of Tangale, 9.5% of Tera and 12.5% of Bolawa. Fy(a-b-) phenotype was seen in 2.4% of Tula,6.4% of Bolawa,7.3% of Waja, 7.8% of Tera, 17.8% of Tangale, 11.8% of Hausa and 46.5% of Fulani. About 84.6% of the study population had the null Duffy phenotype. Conclusion The research showed the phenotypic distribution of Duffy blood group among the study participants with relatively high percentage of null Duffy phenotype hence possible risk of alloimmunisation.
Nov 2022 DOI 10.14302/issn.2644-1101.jhp-22-4273
The purpose of this topic is to add to the body of good teaching and learning that helps create the conditions for more critical thinking and practice skills that enable, keep students interested, and consistently motivate them. Teachers now have a greater focus on implementing motivational learning and studying strategies that are more relevant to the processes of teaching and learning thanks to new methodologies, which have further enhanced instructional strategies for teaching and learning. Positive school cultures that are long-lasting will result from these new methods and strategies. According to the authors, educators have been impacted by evidence-based practice and data-based decision making within the educational system. As a result, there is a growing need for educators to learn more about these resources that are relevant to students and can lead to greater success. These applicable interventions have a positive effect on students, and the information that helps them make decisions increases their response.
Aug 2021 DOI 10.14302/issn.2643-6655.jcap-21-3888
The number of children with SEN is continuously growing, leading to pressure on the few special schools available in the USA. Furthermore, the adoption of a special school system has been criticized on the basis that it isolates and discriminates against children with special educational needs and disabilities. Even though inclusive education can address such limitations, the application of the most appropriate pedagogical approaches for SEN learners is still a challenge. The presented study focused on critically appraising the pedagogical approaches for SEN learners in the 21st century and beyond. In order to achieve this goal, a systematic review of the literature approach was adopted. The literature search process was conducted on three databases: Education Full Text, Linguistics and Language Behavior Abstracts, and PsycINFO. The selection of these databases was influenced by their reputation of hosting high quality and up-to-date literature about special education. The initial literature search process generated 6129 hits, but only ten studies were finally selected for review after the application of inclusion and exclusion criteria. A critical review of the evidence presented in the selected studies generated eight themes describing various pedagogical approaches for special education, within both blended and mainstream learning environment. Knowledge generated in this systematic review can be used by the special education sector of the U.S to develop pedagogical approaches for SEN students, leading to improved performance and social skill development.
Jan 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3716
After entering the new century, people are facing a new external environment. Recently human society is coming into knowledge economy era, and the industrial structure has deeply been adjusted. Today, the past teaching method of imparting knowledge and getting people to accept education, or exam-oriented teaching ideas have been unable to keep up with the needs of the development of the Times. In the future, the key point of education is to promote people to understand the knowledge, and grasp rules between things. Based on this, it is particularly necessary for the talents cultivation to adopt a new idea of training. The paper takes the major in mathematics as an example, designs two classes of new teaching methods CT&CL and BOOF with the diversified assessment to cultivate students’ innovative thinking, providing a reference for the other students. The two classes of new teaching methods and the diversified assessment are worthy of further spreading and exercising during the coronavirus disease 2019 epidemic.
Jan 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3718
Currently, many educational practitioners do not agree on how flipped classroom affects students’ learning effect. In order to further explore the impact of flipped classroom on students’ learning effect, this paper conducts a quantitative analysis of some flipped classroom experimental and quasi-experimental studies systematically by means of meta-analysis method. The study finds that the random effect model shows that the combined effect is 0.373, reaching the statistical significance level, which indicates that flipped classroom has moderate positive effect on improving students' learning effect. There is no significant difference in the effect of flipped classroom on the learning effect of different subjects and stages, but the effect on primary school students is weaker. Significant differences in the effect on learning outcomes among different knowledge types have been found, and specifically, the flipped instruction is good for the study of practical knowledge, but has less influence on theoretical knowledge learning. Therefore, in the application of flipped classroom, it is necessary to pay attention to the characteristics of different learning objects and types of knowledge, and flipped classroom teaching cannot be used too much in primary school and the teaching of theoretical knowledge during the coronavirus disease 2019 epidemic.
Dec 2020 DOI 10.14302/issn.2474-3585.jpmc-20-3672
Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.
Mar 2020 DOI 10.14302/issn.2641-4538.jphi-19-2610
Background The relationship between predictors and the variable of interest was estimated using a structural equation model which is used to predict latent variables. The main advantage of the SEM is the ability to estimate the direct and indirect pathways of the effect of the primary independent variable on the outcome, given sufficient sample sizes. Despite not directly modeling the mediated pathways, GLMMs excluding mediating variables performed well with respect to power, bias and coverage probability in modeling the total effect of the primary independent variables on the outcome. In longitudinal studies, data are collected from subjects at several time points. The main purpose of longitudinal analysis is to detecting the trends or trajectories of the variables of interest. Methods A longitudinal study was conducted on 792 adults living with HIV/AIDS who commenced HAART. Structural equation modeling was used to construct a model to detecting predictors of CD4 cell count change. The procedure was illustrated by applying it to longitudinal health-related quality-of-life data on HIV/AIDS patients, collected from September 2008 to August 2012 monthly for the first six months and quarterly for remaining study period. Results The result of current investigation indicates that CD4 cell count change was highly influenced by certain socio-demographic and clinical variables. Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. Conclusions The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.
Mar 2020 DOI 10.14302/issn.2372-6601.jhor-20-3235
Introduction Acute leukaemia are the clonal and malignant proliferation of immature hematopoietic cells (blast), blocked in their differentiation process. There is an interaction between cancer cells and the clotting process. This could be the expression of Tissue Factor (TF) on the surface of tumor cells; or a lesion of the vascular endothelium and platelet activation. The result is an activation of clotting that can lead to disseminated Intravascular Coagulation (DIC). The objective of this study was to assess the risk of DIC occurring in patients with acute leukaemia. Methods This was a cross-sectional study for analytical purposes that took place on 40 frozen samples from the biobank of the haematology laboratory of Teaching Hospital Yopougon for which the diagnosis of acute leukaemia had been taken from myelogram. The myelogram results were accompanied by hemogram data. PTTa, QT, fibrinogen and D-Dimers were performed on these samples. The risk assessment of DIC occurred was determined on the recommendations of the International Society of Thrombosis and Hemostasis (ISTH). Results We noted a female predominance with a Sex Ratio (M / F) of 0.90. The average age of the patients was 38 years (± 23 years) with extremes ranging from 2 to 84 years. ALL represented 20 % of cases against 80 % for AMLs. Hemogram parameters were characterized by severe anaemia (Tx Hb < 6 g / dL) in 52.5 % of cases; hyperleukocytosis > 100.103 / mm3 in 35 % of cases; thrombocytopenia < 25.103 / mm3 in 40 % of case; and significant blood and spinal cord blastosis (> 80 %). The lengthening of the PTTa was observed in 50 % of cases, compared to 40% for the QT. Similarly, hyperfibrinemia was present in 65% of cases. D-Dimers were high in almost all subject (95 % of cases). According to the ISTH criteria, 17.5 % of subjects were at risk of developing a DIC. Conclusion The risk of occurrence of DIC is indeed present during acute leukaemia. The parameters of haemostasis are thus found to be crucial data in the follow-up assessment during the diagnosis of acute leukaemia.
Sep 2019 DOI 10.14302/issn.2474-3585.jpmc-19-3018
Radial Club Hand (RCH) is a rare and complex congenital disorder of the pre-axial border of the upper extremity. It is a congenital longitudinal radial ray deficiency which presents as radial deviation of the hand and distal forearm in the shape of a golf club 12. Radial ray deficiency (the most common type of longitudinal failure of formation) is a spectrum of malformations affecting the structures of the radial side of the forearm, including hypoplasia of the bones, joints, muscles, tendons, ligaments, nerves and blood vessels. The thumb dysfunction, wrist instability and short upper extremity that accompany this condition can cause significant functional impairment particularly in patients with bilateral involvement. Thus, the performance of activities of daily living such as accomplishing personal hygiene, fastening buttons and zippers becomes challenging 3.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750
Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.
Aug 2017 DOI 10.14302/issn.2578-2371.jslr-17-1669
Aims: To describe the clinical, biological and evolutionary features of mono infected patients treated with tenofovir in Togo. Method: It is a descriptive, prospective study. Patients were treated with Tenofovir Disoproxil Fumarate (TDF). The inclusion criteria were: active chronic HBV (HBs Ag-positive for more than 6 months, high aminotransferases, the HBV –DNA ≥ 2000 IU / ml for HBeAg negative or ≥ 20 000 IU / ml for HBeAg positive and significant fibrosis) and absence of HCV, HDV, or co-infection HIV. Results: Among patients with HBV in our department, only 10.68% were treated with TDF. The mean age of patients was 33.01±9.81years. There was male predominance (68%). The circumstances of discovery were mainly during blood donation (65.3%) and a routine checkup (14.7%). Clinical examination was normal in most of cases (86.7%) apart from hepatomegaly (9.3%) and icterus (4%).) The HBeAg was negative in 89.3%; the average DNA was 7.56 ±8.01 log10 IU/ml. Abdominal ultrasonography was performed in all patients and we found hepatomegaly (18.67%), splenomegaly (10.67%), and ascites (5.3%). The assessment of fibrosis and activity had enabled to find a fibrosis higher or equal to 2 in 12 cases (48%) and an activity higher or equal to 2 in 9 cases (36%). The clinical and virologic outcome was marked by an undetectable viral load (HBV-DNA˂10 IU/l) in 89.3% of the patients after 1 year of treatment. Conclusion: TDF had helped to find out an undetectable viral load in in 89.3% of the patients after one year of treatment.
Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5886
Objective Diabetes poses significant public health challenges, with many individuals remaining undiagnosed and at risk of complications. This study aimed to evaluate the performance of decision tree ensemble methods for predicting diabetes onset using the Framingham Heart Study Teaching Dataset and to explore sex-specific risk patterns relevant to AI-driven interventions. Methods We analyzed data from 11,627 participants, incorporating demographics, vital signs, smoking status, medication use, and laboratory measures. Random Forest classifiers were developed to predict diabetes incidence at approximately 6-year (Period 2) and 12-year (Period 3) follow-ups. Class imbalance was addressed using undersampling, oversampling, and the Synthetic Minority Over-sampling Technique (SMOTE). Results The models demonstrated robust performance, achieving an Area Under the Curve (AUC) of 0.856 in Period 2, and moderate predictive ability in Period 3 (AUC = 0.732 in males, 0.786 in females). Key predictors included glucose level, BMI, systolic blood pressure, age, and heart rate. Notably, differences emerged in predictive accuracy between men and women, suggesting potential sex-specific vulnerabilities that merit further study. Conclusion Machine learning approaches, particularly Random Forests, show promise for medium- and long-term diabetes risk prediction, supporting early identification and intervention efforts. Future work should focus on hyperparameter tuning and explainability techniques, such as SHapley Additive exPlanations (SHAP) values, to improve model precision, interpretability, and fairness. Equity-focused strategies remain critical to ensure AI-driven tools benefit diverse populations and do not exacerbate existing disparities in diabetes care.
Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.
Sep 2024 DOI 10.14302/issn.2694-2275.jzr-24-5256
Stimulating precocious metamorphosis in anuran larvae is an important pedagogical tool for understanding vertebrate development. However, historically, artificially provoking metamorphosis by immersing tadpoles in exogenous inducing agents (e.g., thyroxine, and iodine) compromises the longevity of the experimental animals, resulting in up to 100% mortality within a week. In our undergraduate teaching lab, we house our experimental tadpoles in circular glass dishes having a surface area of 182 cm2. Over the past four academic years this lab was performed, we observed 100% mortality of experimental animals within 10, 12, or 15 days when treated with 10-5 M, 10-6 M, or 10-7 M thyroxine, respectively. Here, we investigated whether increasing the surface area to 413 cm2 using square glass dishes would reduce the mortality of the treated animals. Omnibus Kaplan-Meier survival analysis demonstrates a statistically significant decrease in mortality in tadpoles reared in the larger square dishes compared to those housed in the smaller round dishes (P < 0.05). However, increasing the surface area of our reaction vessels could not rescue survivability of those tadpoles immersed in thyroxine, but did increase survivability of control tadpoles maintained in pond water (P < 0.01), tadpoles subjected to iodine (P < 0.05) or treated with actinomycin D (P < 0.05). These data demonstrate that increasing available reaction vessel surface area reduces overall tadpole mortality during chemically modified metamorphosis in an undergraduate teaching lab setting.
May 2024 DOI 10.14302/issn.2998-4122.jlr-24-4985
Despite a large number of studies examining syntactic features that are predictive of second language (L2) writing quality, assessed by human raters at the university level, few have systematically investigated this link using a large set of indices in the foreign language learning (EFL) classroom context. The current study sought to determine the extent to which a variety of syntactic complexity and sophistication indices are associated with and may predict writing quality by analyzing 30 argumentative essays written by undergraduate EFL students in an Ethiopian university classroom setting. To represent syntactic complexity as a multidimensional construct, we used conventional absolute measures, fine-grained clausal and phrasal indices, and newly proposed sophistication indices related to the use of verb argument constructions (VACs) indexed by TAASSC (Tool for the Automatic Analysis of Syntactic Sophistication and Complexity; 17. Essays were graded, and five separate predicted models of writing quality were created utilizing each complex feature index and all of the measures. Robust predictors of writing quality were identified at both syntactic complexity and sophistication dimensions. Regression analyses showed that the combined model including both fine-grained clausal complexity and VAC-based indices could account for 53.6% of the variance (the largest amount of variance in the study) in writing scores. The finding indicates that the inclusion of diversified adverbial modifiers and nonfinite clauses such as modal auxiliaries controlled by less frequent verbs were predictive of higher-quality writing. These findings shed light on some characteristics of L2 learners' writing growth and enable us to draw pedagogical implications for teaching and assessing writing in the Ethiopian EFL context.
Apr 2024 DOI 10.14302/issn.2329-9487.jhc-24-5040
Objective Hypertensive crisis is an increasingly frequent medical condition in our context. Its management in medical emergencies is a real challenge for physicians. Few data on hypertensive crisis are available in Chad. The aim of this study was to investigate the epidemiological, clinical and prognostic characteristics of hypertensive crisis in the medical emergency department of Reference National Teaching Hospital in N'Djamena. Patient and methods This was a prospective cohort study running from 1er March 2020 to October 31 2020. Patients presenting with a sudden and severe rise in blood pressure (systolic ≥ 180 mmHg and/or diastolic ≥ 110 mmHg) with or without acute target-organs damage, had been consecutively included and followed up over a period of one (01) month. Epidemic and clinical characteristics on admission, and morbidity and mortality parameters during the course of the disease were collected. The Kaplan-Meier method and the Cox model were used to analyze survival and factors associated with death, with a significance level of p<0.05. Results Of the 3978 hypertensive patients admitted to medical emergencies, 252 had a hypertensive crisis, i.e. a prevalence of 6.3%. Two hundred and seventeen (217) patients were included in the study, divided into 149 cases (69%) of hypertensive emergency and 67 cases (31%) of hypertensive hypertensive urgencies. The mean age of the patients was 55.2 ± 14 years (20 and 80 years) and 67% were male. Hypertension was known in 138 patients (64%). At least one complication was present on admission in 69% of patients. Complications were classified as cardiac (50.7%), neurological (38.2%), kidney impairment (46.5%) and ocular (46.1%). The average number of antihypertensive drugs used was 2 ± 0.83 14. Calcium antagonists (86.5%), diuretics (35.5%), converting enzyme inhibitors or angiotensin II receptor antagonists (33.3%) and betablockers (18%) were the pharmacological classes prescribed. Good compliance during follow-up was observed in 124 patients. One-month survival was 84% for all patients, with a 16% mortality rate. Factors associated with death were the duration of hypertension, and the occurrence of cardiovascular, renal dysfunction and ocular disease (p < 0.05). Conclusion Hypertensive crisis is a frequent pathology in sub-Saharan Africa, with high morbidity and mortality. Prevention requires early detection and effective management of hypertension.
Mar 2024 DOI 10.14302/issn.2691-5014.jphn-24-4984
Introduction Children with complicated Severe Acute Malnutrtion (SAM) admitted to Therapeutic Feeding Center (TFC), and ‘uncomplicated’ SAM managed in Outpatient Therapeutic Program (OTP). Objective This study aims to examine the anthropometric differences between SAM admitted to TFC and OTP. Methods A hospital based case control study conducted in the Therapeutic Feeding Program (TFP) of Al-Sadaka General Teaching hospital, Aden, included complicated (cases) and uncomplicated (control) severely wasted 6-60 month old children admitted between July 2022 to June 2023. The WHO anthropometric calculator was used to assess every child’s weight-for-length/height SD and length/height for age SD. Results A total of 313 cases and 122 controls were admitted, mean age, weight, length/height, and MUAC among the cases were (13.04±7.34 mo., 5.41±1.33 kg, 68.32±7.10 cm, and 10.57±1.36 cm) respectively; while among the controls were (20.05±12.93 mo., 7.05±1.74 kg, 76.89±10.46 cm, and 11.28±1.11 cm) respectively. Severe wasting by WFL/H < - 3SD z- score seen more among the controls; cases vs controls were (37.0% vs 68.9%). Howevere, the other groups of severity of WFL/H z-score were seen with nearly douple frequencies among the case vs the controls (35.8% vs 18.8% < - 4SD), (14.7 vs 7.4% < - 5SD). Less than – 6SD was seen much more among the cases vs the controls (8.6% vs 1.6%). Less than – 7 SD among the cases was 1.3% and no children belong to this group in the controls.. The majority of the cases belonged to the age group 6-24 months. Conclusion Children a dmitted to TFC had severe wasting reaching up to < - 6 and < - 7 SD below the WHO cut-off, WFL/H < - 3SD z-score, and at an early age, with simultaneous presence of severe stunting and low MUAC which denotes high mortality risk.
Dec 2023 DOI 10.14302/issn.2329-9487.jhc-23-4848
Introduction Rheumatic heart disease is mostly common in low-income or developing parts of the world, such as Sub-Saharan Africa, with a high morbidity and mortality rate. There are few data that are available in Chad on rheumatic heart disease. Our objective was to study the clinical, echocardiographic, therapeutic, and progressive aspects of rheumatic heart disease at the Renaissance University Hospital Center and the National Reference Teaching Hospital in N’Djamena, Chad. Patient and methods This was a prospective, multicenter and observational cohort study, covering a consecutive series of patients consulted and/or hospitalized for rheumatic heart disease, documented by an echocardiogram from January 2015 to January 2021. Results Among the 4456 patients consulted and/or hospitalized, 398 cases of rheumatic heart disease (8.9%) were collected, and 364 patients had met the inclusion criteria. The mean age was 31.2 ± 14.4 years, and 193 patients (53%) were female. On admission, heart failure was present in 214 patients (58.8%), ischemic stroke in 10 patients (2.7%) and supraventricular arrhythmias such as atrial fibrillation in 94 patients (25.8%) and atrial flutter in 6 patients (1.6%). Mitral regurgitation was observed in 49.7% (n=181) of cases, aortic regurgitation in 33.2% (n=121), mitral stenosis in 31.3% (n=114), and aortic stenosis in 7.7% (n=28). At least two valvular disorders were combined in 48.4% of cases. A surgical intervention such as a heart valve replacement and/or valvuloplasty was performed in 80 patients (22.2%). At least one rehospitalization was noted in 56.9% of patients. Forty-two of the 150 patients free of heart failure at inclusion (28%) had experienced the first episode of decompensated heart failure during follow-up. On the other hand, in 119 patients (55.6%), it was the second episode of decompensated heart failure. Other progressive complications included atrial fibrillation (13.8%), thromboembolic complications (6.3%), infective endocarditis (6.0%) and prosthetic valve dysfunction (1.4%). Altogether, the mortality rate was 10.4%. It was 9.9% in non-operated patients compared to 12.5% in operated patients (p=0.49). Conclusion The present study shows that morbidity and mortality of rheumatic heart disease remain high in our context and often affect children, young adults, and women. Treatment is essentially based on cardiac surgery which is not available in Chad.
Sep 2023 DOI 10.14302/issn.2693-1176.ijgh-22-4255
Nutrition during pregnancy is of utmost important to ensure positive pregnancy outcomes after delivery. This study examined the utilization of nutrition services provided at health facilities to pregnant women. A cross sectional study design, involving 105 pregnant women and 5 RCH providers from 2 health facilities was used. Structured questionnaires, and structured observations were used in data collection. SPSS software version 25 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and on job trainings/seminars. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. In adequate staff and lack of teaching materials contributed to the poor delivery of quality nutrition education to all pregnant women as it was observed that there is variations in nutrition information given to women. More than a half of all pregnant women (63%) started their ANC clinic during their first trimester where they received all nutrition services including education on importance of nutrition during pregnancy which helped them to be aware of the relationship between diet maternal nutrition and birth outcomes (63.8%). Most common food group that has been consumed more by pregnant women was grains, roots and tubers and plantains, while also there was high consumption of fruits and vegetables by all women as they are being more emphasized during routine clinics to prevent anemia. Also, there are some barriers that were identified by the service providers which makes their work difficult such as inadequate teaching materials like brochures, posters and jobs aids, also shortage of staff was found to be the core cause of services being provided occasionally as it is the RCH nurse who provide the education and counselling as there is no any nutritionist hired by government at the facility. Regional and district nutrition officers should coordinate and conduct on job training to health providers on issues related to nutrition in order to update their nutrition knowledge and facilitate clear, accurate and more evidence based nutrition information delivered.
Nov 2021 DOI 10.14302/issn.2577-2279.ijha-21-3925
Introduction The nose is one of the important component of the face which is considered as the major clue for the ethnic origin. The proportion of the nose is determined on the same principal as that of the skull.The external nose extends the nasal cavities onto the front of the face and positions the nares so that they point downwards. The shape of the nose is pyramidal with its apex anterior in position. The upper angle of the nose between the openings of the orbits is continuous with the forehead. Materials and Methods This study was carried out among residents of Ramnagar Gaupalika-7, Sarlahi,Nepal, one of the core region of Madhesh Nepal dated Jan 2021 to April 2021.The cohort consists of independent adults of age group 17-45 and consenting adults from the metropolis. Ethical approval was sought prior to conducting the study from the supervising ethical committee of the Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Written consents were taken from the subjects for the recruitment in the study. Results The present study involved 100 subjects of equal males and females subjects of age groups 17-45 years from Madheshis community of Nepal. The table 1, table 2, table 3 below shows the values obtained for different parameters for males and females. The mean value of nasal height for male and female is 52.59±1.89 and 50.27±2.16 mm and the nasal width for male and female is 37.64±1.72mm and 35.42±2.04mm and the value of mean nasal index for both the sexes are 71.59±2.31and 70.58±3.04 respectively. The dominant type of the nasal morphology in both the sexes are the mesorrhine type and the leptorrhine type as well. Conclusion The human nose is a dominant feature in facial region which differs in anatomy and morphology among racial groups and of the most characteristic differences during the analysis of ethnic and racial differences. The dominant type of the nasal index is the mesorrhine type in both the male and female of the Madheshis community. Hence the data obtained here will be useful for the differentiation of different ethnic groups of Nepal as well as in the field of forensic science and rhinoplastic surgery.
Aug 2021 DOI 10.14302/issn.2379-8572.joa-21-3913
This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.
Mar 2021 DOI 10.14302/issn.2577-2279.ijha-21-3746
Background The neonatal morbidity and mortality is very high in the Sudan, the umbilical cord association and contribution to this is planned to be answered. Therefore the present study was designed to provide some information on the morphological variations of human umbilical cord via gross anatomical assessment and their correlation with foetal factors such as foetal weight and length. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018 Results The mean diameter of the 371 umbilical cords was 2.1±0.24cm. Length was 53.8±3.8 cm length ranging from 48 – 62 cm and 10 (2.7%) of 371 umbilical cords were uncoiled. of which, 1 (0.3%) cords were with absent Wharton’s Jelly. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. There was just significant strong positive correlation between umbilical cord length and length of neonates. Also Umbilical cord diameter had a positive correlation with length of neonates and negative correlation with weight of neonates and APGAR Score. Conclusion The present study suggests that ‘normal’ cord length should be between 40 cm and 70 cm in length. Umbilical cord diameter had a positive correlation with fetal length and negative correlation with fetal weight and APGAR score. The diameter range of 1-2 cm suggests that a normal cord must not exceed 2 cm in diameter. However the umbilical cord index had negative correlation with length of neonates.
Feb 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3226
Charcot Marie Tooth disease is a is a very chronic progressive hereditarymotor and sensory neuropathy characterized by progressive weakness andloss of touch sensation across various parts of the body. There are no curative or effective medical therapies that can ameliorate the disability associated with Charcot Marie Tooth disease. The aim of this paper is to describe the safe novel use of cerebrolysin in an Iraqi patient with Charcot Marie Tooth disease. Patients and Methods A boy who was born on the seventh of November, 2009, and was first seen on 29th of January, 2018 at the Children Teaching Hospital of Baghdad Medical City and had Charcot Marie Tooth disease was observed. He had difficulty in walking and abnormal gait that made him left first grade primary school. The nerve conduction study and electromyography study supported the clinical diagnosis of chronic symmetric sensori-motor polyneuropathy of moderated severity. The boy was treated with a safe novel therapy for one month. He receivedten doses of 3 ml intra-muscular cerebrolysin every three days. Results The short term effect of the therapy was dramatic with noticeable improvement that has never been reported before with this condition. Conclusion Further studies enrolling more patients are highly recommended.
Feb 2020 DOI 10.14302/issn.2577-2279.ijha-20-3178
Background In recent years great attention has been focused on the structural and histological structures of the placenta and the umbilical cord due to their vital roles in fetal development and neonatal survival. While extensive studies have been documented in this area in the developed world, there is very little published information about the morphological variations that occur in human placenta in Sudan. Therefore, this study was designed to evaluate the structural variations in placental indices and its relation to neonatal outcome. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018. Results Mean placental indices for weight, diameter and thickness were 515.51 g, 18.80 cm and 2.43 cm respectively. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. Neonatal weight correlated significantly with placental weight, neonatal length and neonatal head circumference (P < 0.000). On the contrary, neonatal weight had no significant correlation with placental thickness and diameter Conclusion In this study, there was a strong relationship between the placenta and the fetus suggesting that the well-being of the fetus is highly dependent on the placenta since it serves as a link between the mother and the fetus.
Aug 2019 DOI 10.14302/issn.2639-3166.jar-19-2967
A field experiment was carried out at the Teaching and Research Farms of The Federal University of Technology Akure to evaluate the responses of cassava varieties to time of planting in plantain-based intercropping system in the rainforest zone of Nigeria. The objectives were to identify the more compatible cassava variety for intercrop with plantain examine e the appropriate time to introduce cassava varieties into plantain/cassava intercrop and to identify the more compatible cassava variety for intercrop with plantain. The experiment involved the use of two varieties of cassava (TME 419 non branching and TMS 98/0581 moderately branched) planted at spacing of 1 x 1 m into the alleys of false horn plantain variety space at 3 x 2 m. The treatments were sole plantain, sole cassava varieties (TME 419 poorly branched variety and TMS 0581 branching variety), plantain + he respective cassava varieties (TME 419 and TMS 98/0581) at the same time, and plantain + the respective cassava varieties (TME 419 and TMS 98/0581) at 4 weeks after planting>the treatment plot size was 9 m x 6 m. The plantains and the two cassava varieties were planted sole as the control treatments. The introduction of cassava into plantain as intercrop was carried out at different times which were; at the same time with plantain, and at four (4) weeks after planting plantain. Data on growth parameters such as; plant height, pseudo-stem girth, number of leaves were taken for plantains, while plant height, stem girth, number of leaves, number of branches, height at branching were taken for cassava at 4, 8, 12, 16, 20 and 24 weeks after planting (WAP). Yield parameters such as; bunch weight, number of fingers, number of hands, length of fingers, girth of fingers, weight of hands, weight of fingers were taken for plantains while number of tubers, weight of tubers, girth of tubers, length of tubers, fresh root yield, shoot biomass, were taken for cassava at harvest. The data collected were subjected to statistical analysis. The results showed a higher growth and yield performance for TME419 (49.2 t/ha) and TMS98/0581 (45.7 t/ha) planted sole, and TME 419 (39.5 t/ha) intercropped at planting compared to TMS 98/0581 (24.4 t/ha) intercropped at planting, TME 419 (21.7 t/ha) and TMS 98/0581 (15.7 t/ha) intercropped at 4 week after planting (WAP), respectively. But there was no significant difference (P<0.05) recorded for the growth of plantain, whereas the yield of sole plantain was higher and differed significantly (P<0.05) from the yields of intercropped plantain. All the treatment combinations had land equivalent ratio (LER) and area time equivalent ratio (ATER) greater than 1. Plantain + TME 419 intercropped at the same time recording the highest LER and ATER (1.48 and 1.5) while plantain + TMS 98/0581 had the least 1.11 and 1.14 respectively. The cost benefit analysis for the treatment combinations showed that TME 419 planted sole had the highest return of ₦3.567 per ₦1 invested, TME 419 intercropped at the same time gave a return of ₦3.416 per ₦1 invested, which was greater than other intercropped treatments. Intercropping cassava with plantain at the same time, as well as the use of TME 419 variety gave the best performance in terms of growth, yield, land equivalent ratio, area time equivalent ratio and returns on investment. This combination are recommended for plantain-based intercropping system involving cassava in the study area.
Jul 2019 DOI 10.14302/issn.2379-7835.ijn-19-2721
Introduction In the past several decades, Zambia has suffered high levels of under nutrition particularly stunting among children below 5 years of age. Although appropriate complementary feeding practices are reported to reduce child deaths by 6%, they have not received the adequate attention from programme officers and caregivers in terms of implementation. Objectives The objective was to investigate issues surrounding the common complementary feeding practices practised by caregivers of children below five years in health facilities and areas where high rates of malnutrition admission come from. Design A cross sectional research using both qualitative and quantitative methods. The study used mostly proportions based mostly on global indicators on complementary feeding. Qualitative data was also analysed according to themes of global complementary feeding indicators Setting The study was conducted in five hospitals, namely Arthur Davison, Solwezi Central, Kabwe and Livingstone General, and University Teaching Hospital. Subjects The target populations were mothers whose children were admitted for malnutrition and those with children 0-59 months living in communities with the highest number of malnourished cases admitted to selected hospitals Results About45.2% (190) of caregivers introduced liquids before six months of age and 7.6% (32) after 6 months attributing child thirst, medication and advice from health worker as the main reasons. Slightly above half (54.2% of 224) of mothers/caregivers used cups to feed their babies. The use of feeding bottles was still common (8.2% of 34). Responsibility to feed the child is mostly left to the mother (86.4%, 362). In addition, children were being feed about 2.67 (SD 0-72) per day. Conclusions Child feeding practices were still poor. This contributes to poor child growth and health. More interventions should be planned to improve child care behaviour.
Apr 2019 DOI 10.14302/issn.2639-3166.jar-19-2732
The objectives of this study were to assess the Quality of Agricultural Graduates, employers’ perceptions of the employability and skills. A descriptive, analytical statistics, multistage random sampling method was adopted. Where two types of questionnaires were distributed to the Graduates and institutions associated with Sustainable agriculture (SA). The collected data was analyzed by Statistical Packages for Social Sciences (SPSS). The results revealed some respondents began higher education in Arabic (66.7%), while others in English (33.3%). The respondents faced with difficulties in understanding the courses due to teaching methods (36.7%), language (33.3%), and curriculum (30%). The result indicated some respondents (56.7%) do not have back ground about (SA). The respondents in the Ministries of Agriculture assessed the Graduates in regard to agricultural skills, and confidence to perform duties as fair (10%), and good (23.3%), but, for reliability, managerial skills, tactic and ability to participate in forums as fair (6.7%). Good (27.7%), fair (3.3%), and good (30%) respectively. Assessment of the Graduates at Research Centers, were assessed in relation to Research methodology, statistical analysis, and writing scientific papers as good (40 %,).While for Software skills as excellent (100%), and for Agricultural Technology Transfer as very good (80%). While; the respondents from Faculties of Agriculture, assessed the Graduated for practical skills, teaching ability, skills of writing scientific papers, participation in workshops and seminars as good (93.3%), very good (6.7%), fair (6.7) and very good (33.3%), respectively. The Graduates’ quality is below the expectations. Based on the above findings, the study recommends the review of the whole educational system, Faculties of Agriculture to include the concepts of sustainable agriculture in their curriculum and give high consideration to practical part. In the same context, further study is recommended including the whole Country.
Oct 2018 DOI 10.14302/issn.2644-1101.jhp-18-2261
In the third world school dropout rates are the highest, which is largely attributable to a dearth of efficacious teachers. The present research is an analysis of the teacher efficacy based on the teaching milieu. The Ohio State Teacher Efficacy Scale was used for data collection. Probability sampling design was used to select 171 secondary school teachers. As per the results, subject specialization affects teacher efficacy the most whereas, institution type influences teacher efficacy the least. The less experienced teachers have a greater self-efficacy than the experienced teachers, teachers teaching uncrowded classes are more efficacious than those teaching crowded classes.
Sep 2018 DOI 10.14302/issn.2470-5020.jnrt-18-2321
Background: Person with Alzheimer Disease may present cognitive, social, communication, physical, and orientation impairments. Furthermore, individuals with Alzheimer Disease may exhibit challenging behavior, isolation, and passivity. Objectives: To emphasize the role of Assistive Technology-based interventions and Cognitive-Behavioral Programs to improve the independence, and the quality of life of patients with Alzheimer Disease. To assess the effects on teaching adaptive responding, and decreasing challenging behaviors. Method: A selective literature review was carried out considering Alzheimer, Assistive Technology, Cognitive-Behavioral Programs, Adaptive Responding, Challenging Behaviors, and Quality of life as keywords. Twenty-six studies were reviewed. Results: Empirical data demonstrated the effectiveness, and the suitability of the selected interventions, although few failures occurred. The participants involved significantly increased their adaptive responding during the intervention phases, and maintained their performance over the time. Conclusion: Assistive Technology-based rehabilitative programs and Cognitive-Behavioral Interventions may be helpful for promoting the independence and the quality of life of individuals with Alzheimer Disease.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
Aug 2017
Objectives: To describe the frequency, clinico-laboratory characteristics and treatment outcomes of patients with juvenile idiopathic arthritis (JIA) in Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria. Methods: This is a retrospective review of patients with JIA seen over a five-year period at the rheumatology clinic and children ward of LASUTH. We reviewed the folders of 28 patients from our unit records. The demographics, baseline clinical and laboratory characteristics, treatment given and patient outcomes were extracted and analyzed. Results: A total of 28 patients with JIA were managed over the study period. Twenty one (75%) patients among our JIA cases were female and the mean age at presentation was 9.8±3.9 years. The mean duration of symptoms before diagnosis was 21.8±5.7 months. Polyarticular JIA (PJIA) constituted 14 (50%) cases, while oligoarticular and systemic-onset JIA (SoJIA) constituted 9 (39.3%) and 5 (17.9%) of the JIA cases respectively. Anaemia was present in 20 (71.4%) patients, leucocytosis in 16 (57.1%) and thrombocytosis in 11 (39.2%). Twenty five (89.2%) patients had elevated erythrocyte sedimentation rates (ESRs), 21 (75%) had elevated C-reactive protein levels and 23 (82.1%) patients had hyperferritinaemia. Positive antinuclear antibody (ANA) was found in 5 (17.8%) patients. Mortality was documented in 2 (7.1%) patients both of whom were SoJIA cases. Eleven (39.3%) patients were lost to follow up. Conclusion: Unlike the common report of oligoarticular JIA (OJIA) being the most frequent subtype of JIA in various series from North America and Europe, PJIA was the most frequent subtype seen among our patients and this variant accounted for half of all JIA cases seen. There were no cases of psoriatic, enthesitis-related or undifferentiated JIA and most patients had haematological abnormalities and high levels of inflammatory markers at presentation.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-16-1348
Background and Objective: Cognitive stimulation training was effective in reducing risk of cognitive decline and dementia in patients with mild cognitive impairment. The present study aimed to explore factors that contribute to regular participation and practice cognitive stimulation training for elderly patients with mild cognitive impairment. Materials and Methods: Data were collected through individual face-to-face interviews with 25 elderly subjects with mild cognitive impairment, and analyzed using interpretive description method. Results: Five core themes emerged from the analysis of data: (i) program with four subthemes of “interesting session, ” “effective teaching materials,” “suitable duration and frequency” and “small group activities;” (ii) group facilitators with three subthemes of “good explanation,” “always facilitate” and “friendly personality;” (iii) homework assignments with two subthemes of “suitable content” and “can adapt in daily living;” (iv) family members with two subthemes of “supporting” and “sharing;” (v) before and after class notification. Conclusion: Increasing awareness of holistic factors including in clinic and at home should be emphasized in planning cognitive stimulation training. Having an effective program and facilitators and collaboration from family member were the keys of successful training.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-17-1420
Dehydration in acute care is associated with increased morbidity and mortality. However, no standard approach to hydration assessment exists in clinical settings. The pilot study aimed to explore total body water content as means for immediately assessing hydration status in clinical settings. People aged 60 years or more, voluntarily admitted to a tertiary teaching hospital’s Geriatric and Rehabilitation Unit were eligible for participation. Total body water assessment by tracer dilution was compared with standard clinical assessment of hydration status. The study participants (78.6±8.5 years, 6/14, 43% male) clinically assessed with poor hydration (3/14) had a higher percentage of body weight as water (59.0±2.3 vs 50.6±6.4%), and lower mean weight (54.1±12.9 vs 77.5±24.1 kg) and lower body mass index (20.0±3.7 vs 30.2±6.5 kg/m2) than the well-hydrated (11/14). Weight (n=14) and body mass index (n=11) explained a substantial proportion of variation in total litres of body weight as water (r=0.92, R2=0.85; r=0.80, R2= 0.64) and percentage of body weight at water (r=0.6, R2= 0.36; r=0.72, R2= 0.52) respectively. This pilot study revealed higher percentages of body weight as water amongst those clinically assessed with poorer hydration. Future regression analysis of total body water and hydration needs to adjust for the potential confounding effect of weight and body mass index. Implications for practice from this preliminary study indicate that findings did not support single point measurements of either total body water or percentage of body weight as water as potentially simple methods for clinically assessing hydration status amongst older hospitalised people.
Oct 2016 DOI 10.14302/issn.2572-3030.jcgb-16-1190
Background: Gastric cancer (GC) ranks as the fourth most common cancer and the second leading cause of cancer deaths worldwide. Epstein-Barr virus is a well-known oncogenic virus, it is responsible for 10% of gastric carcinomas across the world. The aim of study was to determine the prevalence of EBV associated with GC in Sudanese patients. Method: Fifty Paraffin embedded blocks of gastric biopsy specimens diagnosed as gastric carcinoma were collected from Soba university hospital and Ribat teaching hospital, Khartoum, Sudan. DNA was extracted from the paraffin-embedded tissue, and then Epstein-Barr virus gene was detected by polymerase chain reaction (PCR). Result: Among the gastric biopsy specimens 27 (54.0%) were of male and 23(46.0%) were of female. Eleven EBV positive samples were found in gastric carcinomas (22.0%), 8 (72.7%) were of male and 3(27.2%) were of female. The mean age of the patients was 56 years, the most positive cases were between 50-59 years old, and (10%) of them are alive in Khartoum. Conclusions: There exists an association between EBV and gastric carcinoma in some Sudanese patients.
Oct 2015 DOI 10.14302/issn.2470-5020.jnrt-15-726
Background: A higher incidence of symptomatic lacunar infarction (LI) was confirmed in metropolitan areas. The aim of this study was to determinethe prevalence characteristics and early predictors of LI in a population of elderly outpatients in northern China. Methods: From February 2011 to March 2012, a retrospective cohort of new patients was selected for study, all registered neurologic outpatients of the tertiary teaching hospital in northern China. A total of 453 outpatients, clinically only having had an initial visit and a magnetic resonance imaging study of the brain, were enrolled. The prevalence characteristics and vascular risk factors of LI were assessed. Results: Of 453 symptomatic outpatients, 258(57.0%) patients had symptomatic LI. We found that the main types of symptomatic LI were nonfocal symptoms, such as dizziness and headache, dizziness/vertigo, and migraine/headache. Age, BMI, smoking, history of hypertension, duration of hypertension, existing hypertension, headache and dizziness, pure motor hemiparesis, blood glucose, hypercholesterolemia, systolic blood pressure, and ABCD2 score, were significantly higher in patients with LI than in those without LI (P<0.05). Multivariate logistic regression confirmed that hypertension ≥3years in duration (odds ratio=1.092; 95% CI, 1.019 -1.170) and a median mABCD2 score ≥4 (odds ratio=3.912; 95% CI, 2.955- 5.180) were independent, early predictors of symptomatic LI. Conclusions: The incidence of LI in Northern China was located at the higher end of range in northern China, and common type of symptomatic LI was nonfocal symptoms. Hypertension of long duration and high-risk ABCD2 scores are early predictors of symptomatic LI.
May 2015 DOI 10.14302/issn.2381-862X.jwrh-14-625
Objectives: To identify the lowest hemoglobin concentration (Hb) associated with increased risk of materno-fetal complications. Material and methods: This cohort study was conducted in the Yaoundé University Teaching Hospital, Cameroon, from March 1st, 2011 to February 28th, 2013. Maternal and fetal outcomes among anemic women (AW) and non-anemic women (NW) were compared. Two hundred and twelve AW (booking Hb <10g/dl) without any chronic diseases, carrying singletons and 212 similar NW (Hb ≥11g/dl) were followed up. Main variables were booking and 36 weeks Hb, complications observed and birth weight (BW). Data were analyzed using SPSS 18.0. Fisher exact test and t-test were used for comparison. Level of significance was P<0.05. Results: Mean booking Hb was 8.9 ± 1.1 g/dl among AW against 11.7 ± 0.6 g/dl among NW (P<0.001). Complications of anemia in pregnancy in our series (low BW (RR 7, 95%CI 1.6-30.4), pre-eclampsia (RR 3.3, 95%CI 0.9-11.9) and premature delivery (RR 3, 95%CI 0.6-14.6)) occurred frequently when mean 36 weeks Hb was <9g/dl. Conclusion: Complications were significantly observed when mean Hb was persistently <9g/dl.
Feb 2015 DOI 10.14302/issn.2381-862X.jwrh-14-532
Objective: To identify risk factors for ≥4500 g macrosomic babies given that maternal and neonatal complications of macrosomia increase with birth weight. Design: Cross sectional analytical study. Setting: The Yaoundé University Teaching Hospital and Central Maternity, Cameroon from October 1st, 2012 to June 30th, 2013. Population: 42 women who delivered ≥4500 g babies and 126 women who delivered babies of 4000 to <4500 g were recruited. Methods: Data were analysed using SPSS 18.0. Analyses included the student t-test and the Fisher exact test. The level of significance was P<0.05. Main outcome measures: Fetal sex and birth weight, gestational age at delivery, maternal age at delivery, parity, mother's pre-gestational body mass index (BMI), weight gain during pregnancy, father's BMI and past history of ≥4000 g macrosomia. Results: Main risk factors for ≥4500 g macrosomic babies were maternal weight gain of ≥16 kg (OR 4.2, 95%CI 2.0-8.9), maternal age ≥30 (OR 3.8, 95%CI 1.8-8.2), post term (OR 2.3, 95%CI 0.9-5.6), past history of ≥4000 g macrosomia (OR 1.9, 95%CI 0.9-4.1) and male sex (OR 1.3, 95%CI 0.6-2.8). Conclusion: To reduce the risk of ≥4500 g macrosomic babies, women at risk should make efforts to gain less than 16 kg bodyweight during pregnancies. Moreover, post term pregnancies should be avoided.
Jul 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-321
Background: The use of condoms in marriages is a complex decision. It however plays a role in prevention of HIV and other sexually transmitted infections (STIs). The problem is, what factors and conditions determine consistent condom use among HIV positive women? This study aimed at identifying determinants of consistent condom use among HIV positive women cohabiting with their partners and attending ‘Heart to Heart’ treatment centre in Abia State University Teaching Hospital. Materials and Method: This longitudinal descriptive study was conducted among 248 married HIV positive women who attended ‘Heart to Heart’ treatment centre in the Abia State University Teaching Hospital from December 2012 to February 2013 and are cohabiting with their partners. Interviewer administered semi-structured questionnaire was used to obtain data from the respondents. Data were analysed using SPSS version 17 software. Results: A total of 73(29.4%) of the respondents used condom consistently. Age, level of education, and desire for more children influenced condom use (OR 7.023., CI 2.050 – 24.047, P<0.001). The older the respondents, the more condom they used (OR 164.474, CI 21.477 – 1260.2, P<0.001). Also the more educated the respondents were, (tertiary, secondary) the more likely they used condom. Women who did not desire more children used condom more than those who desired more children (OR 13.612, CI 0.043-26.311, P<0.001). Women who had disclosed their HIV status to their spouses, used condom more than those who had not (OR 13.072, CI 5.836 – 29.253, P<0.001). Conclusion The fact thatonly 29.4% of the respondents used condom consistently with their spouses shows lack of awareness of the benefits of condom use. Health education which will stress the importance of using condom in preventing HIV transmission and other sexually transmitted infections (STIs) is recommended for HIV positive women and their spouses.
Dec 2012 DOI 10.14302/issn.2324-7339.jcrhap-12-71
In India, interruptions to highly active antiretroviral therapy (HAART) are due to adverse drug reactions (ADRs) and no reports on the direct cost incurred in the management of ADRs to HAART are available. There is a need to study direct cost incurred with ADRs to HAART to explore the high economic cost burden imposed by ADRs to HAART in HIV/AIDS patients. This study was aimed to evaluate the direct cost incurred in the management of ADRs to HAART in Indian HIV positive patients. This prospective study was conducted at a Medicine department in a South Indian tertiary care teaching hospitals were ADRs reporting system exist. HIV-positive hospitalized in-patients were identified and intensively monitored for ADRs to HAART. The World Health Organization (WHO) probability scale was used for causality assessment of ADRs. Modified Hart wig and Siegel scale was used for severity assessment of ADRs.Pearson chi-square test identified association of mean direct cost between ADRs and without ADRs by investigating total mean direct cost. The overall direct cost per ADRs to HAART was found to be higher in the context of expenditure on health care cost in India.