Open Access Opinion Article

Medical Education and the Loss of Productive Years: Part 1, Highlight of the Problem

Muhammad Shamim

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/40048

The core objective of the current article is to highlight some time related issues of medical education. In the last few decades, a significant high trend for studying medical education has been observed. In many countries, a significant surplus pool of doctors are waiting for residency, practice and beginning of their profession. Hence, there are more doctors than the requirements. Some professional studies are getting fewer students, leading to a mismatch of supply and demand; this require increasing government and private sectors’ spending. The students also suffer as they lose their precious time and they could not start a professional life as early as possible. After doing 20 to 30 years of study, there is not much time for doing other things.

Open Access Original Research Article

Behavioural Habits of Alcohol Abusing Students at a State University in Zimbabwe

Lynah Makuyana, Esther Mufunda, Mercy Machanja

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/34607

Background: Hazardous alcohol consumption among university students has an adverse impact on public health and economic development.

Aim: The study aimed to describe behavioural habits of alcohol abusing students at a State University in Zimbabwe.

Methods:  A cross-sectional study was done, and a sample of 100 students with a history of alcohol abuse was recruited using snowballing technique. The Alcohol Use Disorders Identification Test (AUDIT) was used to determine behavioural habits among the University students. Data were collected in April - May 2015. Data were analyzed using descriptive statistics.

Results: The results showed that the alcohol beverage commonly abused by the students were spirits (42%), followed by other alcohol-containing drinks (38%) with 32% reporting taking six or more drinks on one occasion, which according to the AUDIT, reflects a state of hazardous alcohol use. Forty-two percent had failed to stop once they had started drinking alcohol, while 36% had been unable to perform customarily expected behaviours. Fifty percent (50%) needed a drink in the morning after a heavy drinking session. This trend indicates alcohol dependence that can lead to negative consequences for the drinker. Most of the respondents (58%) never had feelings of remorse after drinking while 64% had failed to remember the previous night’s events because of drinking. This indicates harmful alcohol use among the students.

Conclusion: This study revealed that university students who hazardously drink alcohol have behaviours that are detrimental to health. These students perform poorly academically and have risky sexual behaviours that expose them to sexually transmitted illnesses including HIV. Their conduct poses a concern for public health professionals and economic development. 

Recommendations: It is recommended that instead of reacting to consequences of alcohol abuse among students, Universities need to develop strategies for early detection of students at risk of alcohol abuse as well as implement primary, secondary and tertiary interventions. Community mental health services, school health programmes and school psychological services that provide care and rehabilitation of students with alcohol use disorders must be strengthened.

Open Access Original Research Article

Prenatal Ultrasonographic Management of Pregnancy: Is Routine Screening Necessary?

R. C. Onwuchekwa, O. West

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/39920

Objectives: The routine use of prenatal ultrasonography in all pregnancies had been of concern, especially in resource-limited developing countries. The study aims to evaluate the prenatal use of ultrasonography in our tertiary health institution to determine the cost-effectiveness and justification of routine prenatal scan in a resource-restricted environment.

Patients and Methods: This was a prospective study of all cases of obstetric ultrasonography seen in the radiology department of our health institution over a one year period from January to December 2017.  The request forms and the duplicate copies of the obstetric scans were collected and stored on a safe shelf each day after work and were later analyzed to elicit information for the study. All cases of complete abortion and pseudo-cyesis were excluded. Also excluded were request forms without clear obstetric indication for example a request for pelvic or abdominopelvic scan where the patient was found to be pregnant on ultrasonography. 

The data was analyzed using the IBM SPSS Statistics for Windows, Version 20.

Results: A total of 550 cases were included in the study. The mean age was 32.08±4.96 years. More than 60% of the patients were within the age range of 26 years to 35 years. The most frequent indication for the prenatal scan was for routine assessment which is ultrasound scanning performed in the absence of any clinical condition. Routine scan constituted 392(71.3%) cases; this was followed by placenta localization 24 (4.4%) cases and gestational diabetes which constituted 18(3.3%) cases. Of the routine scans done 33(8.42%) were abnormal while 35 (22.15%) of the diagnostic scans were also abnormal. The commonest abnormality detected was oligohyramnios which constituted 20(29.41%) cases. Other abnormalities include uterine fibroid 14(20.59%), intrauterine fetal death 12(17.65%), abortion 10(14.71%) and placenta previa 6(8.82%). 290(52.73%) cases were done during the 3rd trimester, and of these, 38.62% were done during the 36th -38th weeks of gestation. During the first trimester, most of the scans 19(44.18%) were done at 9th and 10th weeks of gestation while second trimester scans 41(18.89%) were mainly during the 23rd and 24th weeks of gestation.

Conclusion: The study showed high rate of routine ultrasound scan without justifiable clinical indication. Majority of these scans were done during the second and third trimesters which lack the benefits associated with baseline prenatal ultrasonography usually carried out in the first trimester of gestation.

Open Access Original Research Article

Prevalence of Multi-antibiotic Resistant Bacteria in Birds Faeces and Soil Samples from Poultry Farms in Ogbomoso, Oyo State, Nigeria

A. A. Ayandele, L. O. Owolabi, A. A. Oladeinde, I. B. Aseweje, E. A. Oshodi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/39868

Aim: This study was designed to determine the prevalence of multi-antibiotic resistant bacteria in poultry faecal and soil samples from poultry farms in Ogbomoso, Oyo State, Nigeria.

Introduction: The indiscriminate use of antibiotics in the treatment of animals' infection and as growth promoters is increasing the incidence of multi-antibiotic resistant bacteria at an alarming rate. This poses a danger to human health because resistant bacteria can be transferred to human through the food chain. 

Methodology: Different isolating media were used to determine the microbial load of faecal and soil samples from two farms and bacterial identification was carried out by standard methods. A susceptibility profile of the bacterial isolates was determined by Kirby-Bauer disc diffusion method and multiple antibiotic resistant (MAR) index was also determined. 

Results: Soil samples showed high counts of the microbial load as compared with faecal samples, with count ranging from 0.2 to 10.5 ×105cfug-1. Majority of the isolates belonged to Gram-negative bacteria (90.9%) and five genera of bacterial isolates were identified in this study (Klebsiella, Citrobacter, Escherichia, Shigella, and Staphylococcus), while all the isolates showed 12.5 to 100% resistant to all the antibiotics used in this study. The prevalence of multi-antibiotic resistant was 100% and the MAR index ranged from 0.6 to 1.0.

Conclusion: The study revealed that samples from the poultry farms used were reservoirs of multi-antibiotic resistant bacteria and MAR index showed that the resistance observed was from the overuse of antibiotics in the environment. Therefore there should be strict regulations on the use of antibiotics in animals' farms and proper monitoring should be ensured by the government.

Open Access Original Research Article

Assessment of Knowledge, Perception and Prevalence of Bullying Practices among Medical Students of Quetta

Noman Ul Haq, Zara Arshad, Shabir Ahmed Lehri, Aqeel Nasim, Muhammad Saood, Muhammad Samsoor Zarak

Journal of Advances in Medicine and Medical Research, Page 1-20
DOI: 10.9734/JAMMR/2018/40585

Aim: The aim of the study was to determine the knowledge, perception, and prevalence of bullying among the medical students of Quetta.

Methods: This study was a questionnaire-based cross-sectional study which was conducted on medical students of 1st through the 5th year from Bolan Medical College and Quetta Institute of Medical Sciences, Quetta. Total 364 students took part in the study. The data was analyzed on SPSS version 20. The questionnaire included separate sections to assess knowledge, perception and prevalence of bullying among the students.

Results: Majority of students had adequate knowledge about bullying, however, 34.9% of medical students were found to be bullied which is a very high percentage. Most of the bullied students were male and most were from 5th year. Moreover, most of the participants who were bullied had felt depressed after being bullied and the majority of them did not make any complaint to their institute’s authorities. Considering perception, maximum students had a negative perception about bullying.

Conclusion: Such high rates of bullying among medical students indicate the need for the institutions to have a strong policy against bullying with proper monitoring. Moreover, there should be student psychiatric councilors inside the campus to provide counseling to students who are going through mental disturbances because of victimization. There is also a need for raising or spreading awareness among students, so they perceive and deal with bullying in a better way. Alongside, mental health issues related to bullying must be brought to discussions more frequently.

Open Access Original Research Article

Seroprevalence of Toxoplasma Antibody and Clinical Features of Toxoplasmosis in Posterior Uveitis in South-West Nigeria

Oluwatoni O. Onabolu, Olatunbosun Olawale, Olubunmi T. Bodunde, Adetunji H. Ajibode, Taibat O. Otulana, Olubukola A. Ayeni, Adeduntan S. Olagbenro, Philip Olatunji

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/40572

Background: Toxoplasmosis is the presumed cause of posterior uveitis in South West Nigeria, and patients are mostly treated empirically on the basis of clinical findings.

Aim: To determine the level of IgG and IgM toxoplasma antibodies consistent with diagnosis of toxoplasma associated posterior uveitis in immune-competent subjects and compare with normal controls.

Design: A cross-section analytic study.

Place and Duration: Department of Ophthalmology, Olabisi Onabanjo University Teaching Hospital Sagamu Ogun State from July 2016-March 2017

Methodology: Consecutive patients with clinical signs of posterior uveitis were recruited and had questionnaires administered to obtain socio-demographic data and risks of toxoplasma infection. Venous blood was collected for hemoglobin concentration, white blood cell count differentials, HIV seropositivity, and for ELISA immunoglobulin assay for Toxoplasma IgG and IgM antibodies.

Results: Thirty-four consecutive cases with a clinical diagnosis of posterior uveitis and nineteen age sex-matched healthy controls were recruited for the study. Twenty-five (73.53%) cases had significantly elevated levels of Toxoplasma IgG and 3 for IgM (8.82%); while amongst the controls, 31.6% had significantly raised IgG while 15.8% had for IgM. The difference between cases and controls for elevated serum levels of Toxoplasma antibodies was statistically significant (p=.003).

Conclusion: Elevated serum IgG toxoplasma antibodies are useful in the diagnosis of posterior uveitis caused by Toxoplasma gondii and fairly corresponded to the clinical fundus finding.

Open Access Review Article

Common Fallacies of Probability in Medical Context: A Simple Mathematical Exposition

Rufaidah Ali Rushdi, Ali Muhammad Rushdi

Journal of Advances in Medicine and Medical Research, Page 1-21
DOI: 10.9734/JAMMR/2018/40784

This paper presents and explores the most frequent and most significant fallacies about probability in the medical fields. We allude to simple mathematical representations and derivations as well as to demonstrative calculations to expose these fallacies, and to suggest possible remedies for them. We pay a special attention to the evaluation of the posterior probability of disease given a positive test. Besides exposing fallacies that jeopardize such an evaluation, we offer an approximate method to achieve it under justified typical assumptions, and we present an exact method for it via the normalized two-by-two contingency matrix. Our tutorial exposition herein might hopefully be helpful for our intended audience in the medical community to avoid the detrimental effects of probabilistic fallacies. As an offshoot, the pedagogical nature of the paper might allow probability educators to utilize it in helping their students to learn by unraveling their private misconceptions about probability.