Open Access Original Research Article

Prevalence of Gestational Diabetes Mellitus and Maternal and Fetal Outcomes at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria

D. H. John, P. A. Awoyesuku, D. A. MacPepple, N. J. Kwosah

Journal of Advances in Medicine and Medical Research, Page 1-16
DOI: 10.9734/jammr/2019/v31i930319

Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment.

Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM.

Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05.

Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67).

Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.

Open Access Original Research Article

Trend Analysis of Vesico-vaginal Fistula among Attendee’s in Fistula Centres in Kano State, Nigeria

Onyeugo Glory Ugochi, Chimezie Iwuala, C. R. Nwufo, Sally Ibe, Obinna Godwin Udujih, Helen Ifeoma Udujih

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v31i930322

A study on the trend analysis of VVF among attendee’s in fistula centers, Kano State, Nigeria was carried out using ten (10) years hospital records. Results showed three peaks in prevalence in year 2010 (73.8%), 2015 (77.2%) and 2017 (59.3%). The highest peak was in the year 2015 while the lowest prevalence occurred in 2014 (46.0%). Overall, there is a decline in prevalence for the ten years studied. It was observed in this study that most of the patients reside in the rural area of the state, where lack of access to appropriate emergency obstetric care and strong hold to traditional practice is obtained. Therefore, there is need to expand the current strategies employed in the fight against VVF to include initiating a men-targeted programme to enlighten and educate men, especially those living in rural areas on the need to allow their women access to medical care during pregnancy to avoid complications that could result to Vesico-vaginal fistula.

Open Access Original Research Article

Creative Arts Therapy in Patient Care: The Perspectives of Clinicians in a Nigerian Tertiary Institution

O. O. Olonite, E. O. Oyetola, F. O. Oginni, A. A. Adewale, A. M. Oluwadaisi

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v31i930323

Aim: To assess the level of awareness and perceptions of Creative Arts Therapy (CAT) among practicing Nigerian clinicians in Obafemi Awolowo University, Teaching Hospital Complex (OAUTHC) Ile-Ife with a view to determining their willingness to incorporate CAT as an adjunctive tool in their routine patient care.

Methodology: A Cross-sectional study carried out at the general outpatient department, medical outpatient department, Surgical outpatient department and Dental Hospital units of OAUTHC between April 2018 and September 2019. One hundred participants were selected using simple random method from the pool of clinicians. Data were collected from the participants using self-administered structured questionnaire. Data were analyzed using STATA 14 statistical software.

Results: A total of 100 clinicians participated, 46% male 54% female. Their average age was 23.9 2.1years. Seventy-one (71%) were medical practitioner while 29(29%) were dentist. Resident doctors made up 70% of respondents while 30% were consultants. As a necessary adjunctive tool, about one-third 31(31%) strongly agreed, 42(42%) agreed while only 1(1%) participant disagreed. Dance was chosen as the most relevant art to clinical practice by 36(36%) of respondents. Significant improvements by CAT on patients’ prognosis was strongly agreed with by 36(36%), 50(50%) agreed, 18(18%) were indifferent. The majority of respondents attributed lack of available institutions offering Creative Art Therapy courses a major hindrance to its clinical application. The majority 90(90%) of clinicians agreed to the possible incorporation of Creative Art Therapy into the Nigerian healthcare system. Nine participants (9%) strongly agree to prescribe art therapy if such services are readily available in Nigerian healthcare system, 62(62%) agree, 25(25%) were indifferent while 4(4%) disagreed.

Conclusion: This study showed that a larger percentage of clinicians, claimed awareness of Art therapy being used as an adjunctive tool in patient care, and believes in its therapeutic benefits. Lack of facilities was identified as an obstacle to the use of art therapy in patient care.

Open Access Original Research Article

The Effective Way to Prevent Occupational Hazards on Tuberculosis Treatment

Franklyn Chukwudi N. Mbaneme, Emmanuel C. Obiano, Ebelechukwudi Obianuju Mbaneme

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v31i930324

Aim: The study aimed to monitor the effective ways to prevent the occupational hazards on tuberculosis (TB) treatment.

Methods: Multi-stage sampling procedure was used for this study.

Results: The findings of this study revealed that knowledge of occupational hazards of treatment and management of TB is not a new idea in Anambra state, however, majority of the respondents have low level knowledge of occupational hazards protection and prevention services available, particularly when it requires an improvement on the existing means of services.

Conclusion: Preventive and control measures to reduce the risk of TB infection and protection of health care workers should be given highest priority in health care planning and development.

Open Access Review Article

Membrane Interactivity of Non-steroidal Anti-inflammatory Drugs: A Literature Review

Hironori Tsuchiya, Maki Mizogami

Journal of Advances in Medicine and Medical Research, Page 1-30
DOI: 10.9734/jammr/2019/v31i930320

Background: Although the mode of action of non-steroidal anti-inflammatory drugs (NSAIDs) has been exclusively referred to as inhibition of cyclooxygenase, their broad pharmacological and toxicological spectra are not necessarily interpreted by the direct interaction with such enzyme proteins.

Aims: Since NSAIDs have the common amphiphilic structure, they have the possibility of acting on membrane-constituting lipids. In order to gain insights into the additional mechanism of NSAIDs, we reviewed their membrane interactivity to modify the physicochemical properties of membranes.

Methodology: We retrieved scientific articles from PubMed/MEDLINE, Google Scholar and ACS Publications by searching databases from 1990 to 2019. Research papers published in English in the internationally recognized journals and on-line journals were cited with preference to more recent publications. Collected articles were reviewed by title, abstract and text for relevance.

Results: Results of the literature search indicated that NSAIDs structure-specifically cause the in vitro and in vivo interactions with artificial and biological membranes to change membrane fluidity, lipid phase transition and permeability. The features and potencies of their membrane interactivity vary depending on drug concentration, medium pH and membrane lipid composition. In addition to membrane proteins, NSAIDs act on membrane lipids to exhibit the anti-inflammatory and anti-tumor activity by interacting with lipid bilayer membranes at relatively low concentrations to decrease membrane fluidity and thereby affect the enzymatic activity of membrane-associated proteins and to exhibit the gastrointestinal and cardiovascular toxicity by interacting with membranous phospholipids at relatively high concentrations to increase membrane fluidity and thereby impair the membrane-relevant biofunctions. Other diverse effects of NSAIDs may also be related to their membrane interactions.

Conclusion: NSAIDs share the membrane interactivity common to them as one of possible pharmacological and toxicological mechanisms.