Annals of Health Research <p>Peer-reviewed open access journal of medical and health-related sciences to&nbsp;disseminate research works and ideas in the fields of clinical sciences, basic medical sciences and public health with the ultimate goals of enhancing knowledge, improving practice and encouraging practice-centred research. It is indexed by African Index Medicus and Index Copernicus. It is also registered with the Committee for Publication Ethics (COPE) and the Directory of Open Access Journals (DOAJ).</p> <p><em><strong>This journal is published under the Creative Commons License Attribution Non-Commercial CC-BY NC. This license lets others remix, tweak and build upon our works non-commercially and although, their new works must also acknowledge us and be non-commercial, they do not have to license their derivative works on the same terms.</strong></em></p> Medical and Dental Consultants Association of Nigeria, OOU Teaching Hospital, Nigeria en-US Annals of Health Research 2476-8642 <p>The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.</p> Editorial TA Ogunlesi Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 xii xii Health : A Critical Determinant of National Development <p>The Walter-Harkness Health Plan, 1946-1956 in Nigeria identified Malaria as one the leading causes of morbidity and mortality in Nigeria. Even though that plan was truncated by the achievement of Self-Government by some parts of Nigeria in 1951, it is worrisome that some 70 years after, Malaria remains a leading cause of morbidity and mortality in all parts of Nigeria.</p> <p>We have failed to consider the circumstances of our patients and those factors that make them repeat visits to health facilities for the same conditions over the years. If a mother brings the child to the health centre six times in a year for diarrhoeal disease, then we should reconsider our approach to the management of both mother and child or else we will soon lose that child to some complication of diarrhoeal disease.</p> <p>Poverty exposes people to agents of disease and ensures that once they contact disease, it becomes difficult for them to survive the disease or the complications of the disease. Once disease sets in, individuals, families and communities are further impoverished. Conversely, disease exposes individuals, families and communities to poverty and ensures that they remain poor. We owe it a duty to our generation and those coming behind to begin to seriously apply those strategies that can effectively liberate our nation from the bondage of disease and poverty.&nbsp;</p> A Osibogun Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 1 10 10.30442/ahr.0601-01-61 Comparative analysis of pregnancy and labour outcome among booked nullipara and primipara women in Sagamu, Nigeria <p><strong>Background:</strong> Pregnancy and childbirth are normal physiological processes. The best outcomes of most pregnancies are possible if adequate care is provided during pregnancy. Parity is one of the major determinants of pregnancy outcome.</p> <p><strong>Objectives:</strong> To compare the pregnancy, labour and foetal outcomes of booked nulliparous and primiparous women.</p> <p><strong>Methods:</strong> This is a retrospective, cross-sectional study conducted in the Department of Obstetrics and Gynaecology, Olabisi Onabanjo Teaching Hospital, Sagamu, Ogun State Nigeria from January 2014 to December 2016.</p> <p><strong>Results:</strong> There was a significant difference between the mean age at booking of the nulliparous (Para 0) (26.7±4.4 years) and primiparous (Para 1) women (29.1±4.1 years) (p &lt;0.001). The estimated gestational age (in weeks) at delivery was 38.1±4.8 in the Para 0 group and 38.2±3.9 in the Para 1 group. The mean duration of the first stage of labour was 11.3 ±5.7 hours in the Para 0 but 9.5 ± 5.3 hours in the Para 1 group and the difference was statistically significant (P&lt;0.001). The maternal outcome was favourable in both groups of women even though two unavoidable deaths were recorded in the Para 1 group. The foetal outcomes in the two groups were comparable and both the Crude Odd Ratio and the Adjusted Odd Ratio differences in the two groups did not reach a significant level.</p> <p><strong>Conclusion:</strong> Delivery outcomes in both groups were favourable and comparable. &nbsp;This can be attributed to the standard antenatal care received by both groups and well-supervised deliveries.</p> AO Sule-Odu EO Jaiyesimi PO Adefuye AO Adejumo AK Akiseku OM Elegbede Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 11 20 10.30442/ahr.0601-02-62 Age and gender demographics in social media use, Smartphone addiction and psychological morbidity among university undergraduates in Southwest Nigeria <p><strong>Background: </strong>Smartphone addiction has become a public health issue. The use of social media has led to unintended consequences, especially among young adults and college students. Unfortunately, the pattern of use, the prevalence of addiction and the relationship with actual psychological morbidity are not clear.&nbsp;&nbsp;&nbsp;</p> <p><strong>Objective: </strong>To evaluate the prevalence of Smartphone addiction and the relationship to the frequency of social media use and psychological morbidity among Nigerian university students.</p> <p><strong>Method: </strong>One hundred and fifty-nine students were recruited through social media invites and direct invitation from Lecture Halls. The socio-demographic forms, the Smartphone Addiction Scale (Short Version) and Self-reporting Questionnaire-20 were administered.</p> <p><strong>Results: </strong>WhatsApp was the most frequently accessed social media phone application (62.9%).Participants who used Instagram had the highest mean score on SAS-SV (31.4±9.4) and SRQ-20 (8.1±5.3). The prevalence of Smartphone addiction was 34.6% (55/159) while 48.4% (77/159) met the criteria for psychological morbidity. A higher proportion of males met the criteria for Smartphone addiction (29; 50.8%). Males had higher mean SAS scores (31.7±9.4) compared to the females (28.1±8.5) (p = 0.01). Smartphone addiction was more frequently associated with psychological morbidity among males (p = 0.01). No significant difference in Smartphone addiction and psychological morbidity was found across ages.</p> <p><strong>Conclusion: </strong>Smartphone addiction is prevalent and associated with psychological morbidity among male undergraduates. There is a need to direct interventions at curbing its prevalence among undergraduates.</p> TO Afe OO Ogunsemi BS Osalusi OO Adeleye AO Ale Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 22 35 10.30442/ahr.0601-03-63 Indications for blood and blood products transfusions among children in a semi-urban tertiary hospital in Nigeria <p><strong>Background: </strong>Anaemia is prevalent among children in our environment, often necessitating blood transfusions. The knowledge of the common indications for blood transfusion and the required preventive measures is likely to reduce the transfusion rates.</p> <p><strong>Objective: </strong>To determine the disease conditions requiring blood transfusion in post-neonatal age children at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.</p> <p><strong>Methods: T</strong>he hospital records of all children aged 1 month to 18 years admitted into the post-neonatal ward who received blood transfusions over 18 months (1<sup>st</sup> July 2015to­31<sup>st</sup> December 2016) were reviewed.</p> <p><strong>Results: T</strong>here were 710 paediatric admissions out of which 82 (11.6%) received blood transfusions. Ninety transfusions were carried out amongst 82 children, at a ratio of 1.1 transfusions per child. Severe malaria (28.1%), sickle cell anaemia (19.5%) and septicaemia (18.3) were the most common disease conditions requiring blood transfusions. The leading blood products transfused included packed red cells (64.5%) and whole blood (30.0%).</p> <p><strong>Conclusion: </strong>Blood transfusion is frequently indicated in the paediatric population in our setting, largely due to severe malaria and sickle cell anaemia problems. Intensifying efforts on the use of long-lasting insecticide-treated nets and environmental control may reduce the prevalence of severe malaria, while improved nutrition, adequate hydration, regular malaria prophylaxis, prompt treatment of infections and regular use of haematinics may minimize the need for blood transfusions among children with sickle cell anaemia.</p> SO Akodu AF Adekanmbi FA Gbadebo DM Olanrewaju Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 36 43 10.30442/ahr.0601-04-64 Effects of aqueous leaf extract of Telfairia occidentalis on haematological parameters and liver enzymes in male Wistar rats <p><strong>Background: </strong>The leaves of <em>Telfairia occidentalis</em> (locally known as Ugu) are widely consumed as part of a staple in the southern region of Nigeria. Its nutritional benefits include its rich mineral contents and antioxidant properties. It has been suggested that the leaf extracts may affect blood parameters.</p> <p><strong>Objectives: </strong>To investigate the effects of aqueous extracts of <em>T. occidentalis </em>leaves on haematological indices and liver enzymes in rats.</p> <p><strong>Methods:</strong> Twenty-four male Wistar rats weighing between 150g and 200<em>g</em> were used for the study. They were categorized into four groups of six rats each <em>viz</em>: high-dose, medium-dose, low-dose, and control groups. The leaf extract was administered in doses of 300mg/kg, 200mg/kg, and 100 mg/kg, respectively, while the control group received distilled water rather than leaf extracts.&nbsp;</p> <p><strong>Results:</strong> There was a dose-dependent decrease in the concentrations of liver enzymes and an increase in blood parameters. There was a significant difference (p = 0.000) in the mean red blood cells countof the control group (7.5±0.2×10<sup>12</sup>/L) compared to the low-dose group (9.1±0.1×10<sup>12</sup>/L), the medium-dose group (11.7±0.2×10<sup>12</sup>/L) and the high-dose group (13.3±0.2×10<sup>12</sup>/L).For the liver enzymes, there was a significant decrease in the mean AST levels in the high-dose group (42.8±3.5 IU/L)<strong>, the </strong>medium-dose group (53.7±5.7IU/L) and the low-dose group (68.5±3.5IU/L) were compared to the value for the control group (88.6 ±2.5× 10<sup>12</sup>/L).</p> <p><strong>Conclusions: </strong>Using an animal model, <em>Telfairia occidentalis </em>may have hepatoprotective and haemopoietic properties.</p> IO Osonuga AS Faponle EN Ezima TK Adenowo AA Adelegan Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 44 50 10.30442/ahr.0601-05-65 Accuracy of Lateral Invertogram in diagnosing and classifying anorectal malformations <p><strong>Background: </strong>The initial management of a new born baby with anorectal malformation could be made only after an accurate determination of the level of the anomaly.&nbsp;</p> <p><strong>Objective:</strong> To determine the accuracy of lateral invertogram in diagnosing and classifying anorectal anomalies.</p> <p><strong>Methods:</strong> This was a retrospective study carried out between January 2003 and December 2013. The accuracy, sensitivity, and specificity of lateral invertogram in diagnosing and classifying anorectal malformations in the cases studied were determined.</p> <p><strong>Results:</strong> A total of 62 children with anorectal malformations patients were seen during the study period. The age range was 4 hours to 6 years. A total of 50 (80.6%) had lateral invertogram while only 39 films of lateral invertogram were available for analysis. A total of 22 patients had high anomalies while 12 patients had low anomalies. The accuracy of lateral invertogram in identifying anorectal anomaly was 100% and its ability to differentiate between high and low anomalies was 76.5%. The Sensitivity in identifying high anomalies was 59% while the specificity was 31.8%. The sensitivity in identifying low lying lesions was 66.5% while the specificity was 50%.</p> <p><strong>Conclusion: </strong>The accuracy, sensitivity, and specificity of lateral invertogramin diagnosing and classifying anorectal malformations were found to be satisfactory in the present study.</p> CC Nwokoro BA Ayoade BA Salami OM Fatungase AA Olatunji EA Emmanuel Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 51 58 10.30442/ahr.0601-06-66 Bacterial colonization on Automated Teller Machines from selected Local Government Areas in Ibadan, Oyo State <p><strong>Background:</strong> Automated Teller Machines (ATM) are interactive physical platforms that respond to touch command of the user when an account holder inserts a coded bank card. They are operated with finger impressions of bank customers after insertion of the coded card.</p> <p><strong>Objective:</strong> To determine the prevalence of isolates, quantify and determine the susceptibility of the isolates to conventional antibiotics and to test the efficacy of disinfectants on the bacterial isolates from these selected ATMs.</p> <p><strong>Methods: </strong>Ten(10) ATMs were selected per Local Government Areas (LGA) in five LGA. Sterile swab impregnated with physiological saline was aseptically impressed and rolled over the keypad and screens of the ATMs. The swabs were inoculated in peptone broth and incubated for 24 to 48hours. The inoculums from the broth were streaked on five (5) different selective agar media and standard biochemical tests were used to confirm the bacterial isolates.</p> <p><strong>Results:</strong> The prevalence rates of the bacterial agents found on the ATMs were as follows: <em>Staphylococcus aureus </em>(30; 60%), Coagulase-Negative <em>Staphylococcus spp</em> (10; 20%), <em>Pseudomonas spp</em> (16; 32%), and <em>Streptococcus spp</em> (20; 40%) respectively. Antibiogram was carried on biochemically identified isolates, and most of the isolates showed varied susceptibility to the antibiotics and the disinfectants tested.</p> <p><strong>Conclusion:</strong> Multiple bacterial isolates found in this study have the potential to attain pathogenic status in compromised hosts and the possibility of transmission of these isolates from one user to another is a challenge of epidemiological magnitude.</p> OL Okunye BC Kotun T Kolade-Titilayo Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 59 66 10.30442/ahr.0601-07-67 Surgical management of gynaecomastia: Experience from a tertiary health facility in Southwest Nigeria <p><strong>Background: </strong>Gynaecomastia is the benign enlargement of the male breast as a result of glandular proliferation, usually resulting in feminine appearance. The treatment is usually surgical for cosmetic reasons.</p> <p><strong>Objective</strong>: To describe the local experience with the surgical treatment of gynaecomastia by conventional subcutaneous mastectomy.</p> <p><strong>Methods: </strong>This is a retrospective study of all cases of gynaecomastia seen at the surgical out-patient department of the Olabisi Onabanjo University Teaching Hospital, Sagamu, covering the period from January 2009 to October 2019.The data obtained included age, duration of symptoms, treatment, postoperative complications and type of anaesthesia.</p> <p><strong>Results: </strong>A total of twenty-three cases were seen. The mean age was 26.4±17.5 years with an age range of 15 to 84years. The mean duration of symptoms was 2.9±3.6 years. About 70% of the cases were aged less than 21years. Twenty-one patients (91.3%) had a subcutaneous mastectomy, and local anaesthesia was deployed for the procedure in 16 (76.2%) cases. Two patients (9.5%) developed postoperative haematoma while one patient developed severe keloid at the surgical site.</p> <p><strong>Conclusion: </strong>Subcutaneous mastectomy for gynaecomastia can be safely done under local anaesthesia and it gives a good cosmetic effect with minimal postoperative complications.</p> BA Salami BA Ayoade AO Adekoya O Odusan OM Fatungase Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 67 73 10.30442/ahr.0601-08-68 Qualitative phytochemical screening and antimicrobial evaluation of the total alkaloids of the hydroalcoholic extracts of the leaves and stem bark of Musanga cercropoides (Urticaceae) <p><strong>Background: </strong><em>Musanga cecropioides </em>R.Br. ex Tedlie (Urticaceae) is a plant that is widely used in Nigerian traditional medicine for the treatment of various infections such as cough, diarrhoea, and vaginal candidiasis.</p> <p><strong>Objective: </strong>To study the antimicrobial potency of the total alkaloids of the hydroalcoholic extracts (HAE) of the stem bark (ST) and leaves of <em>Musanga cecropioides.</em></p> <p><strong>Method: </strong>The antimicrobial activities of the total alkaloidal constituent of the HAE of the ST and leaves were screened using agar diffusion method using <em>Staphylococcus aureus, Bacillus subtils,Klebsiella pneumonia, Escherichia coli</em>, and <em>Candida albicans </em>as test organisms. The preliminary phytochemical screening of the ST and leaves were performed following the conventional standard procedures of Trease and Evans.</p> <p><strong>Results: </strong>Phytochemical screening revealed the presence of alkaloids, phenols, flavonoids, tannins, sterols, saponins and terpenoids. The HAE of both ST and leaves exhibited notable activities against the tested microorganisms at different concentrations (500, 250, 125, 62.5 mg/ml) with zones of inhibition ranging from 8.6±0.5mm to 20.0±1.0mm. The highest activity against bacteria had a zone of inhibition of 18.6±1.1mm and 20.0±1.0mm for fungus. The zone of inhibition for antibacterial control drug (Ciprofloxacin) was 42.3±2.0mm while that of antifungal control drug (Griseofulvin) was 32.0±0.8mm. The total alkaloid yield for the ST was 1.200%w/w and 1.332%w/w for the leaves.</p> <p><strong>Conclusion: </strong><em>Musanga cercropoides</em>may be a valuable source of a therapeutic agent for potent clinical antimicrobials.</p> SF Ibitoye G Ukpo AS Rabiu Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 74 84 10.30442/ahr.0601-09-69 Motor co-ordinative roles of Nigella sativa oil in mice models of phenol-induced essential tremor <p><strong>Background: </strong>Essential tremor, regarded as the world's most common movement disorder, is a neuronal disorder characterized by uncontrollable shaking (tremor) of different parts of the body. <em>Nigella sativa </em>is a medicinal herb with pharmacologically proven therapeutic potentials in various ailments including neurological disorders.</p> <p><strong>Objective: </strong>To evaluate the therapeutic roles of <em>Nigella sativa </em>on cerebellar phenotypes in phenol-induced mice models of essential tremor.</p> <p><strong>Methods: </strong>Tremor response, body weight, temperature, motor coordination (using the parallel bars and static rods tests), relative brain weights, cerebellar glutamate and Glutathione peroxidase (GPX) and histoarchitecture were assayed in 75 adult male BALB/cm ice weighing 21-30g. The animals, equally divided into five groups were respectively administered feed and water only (CTRL); 100mg/kg phenol and 1ml/kg <em>Nigella sativa</em> oil concurrently (PNSC); 100mg/kg phenol (P); 1ml/kg <em>Nigella sativa</em> oil followed by 100mg/kg phenol (NSP); and 1ml/kg <em>Nigella sativa</em> oil (NS).</p> <p><strong>Results: </strong>The PNSC, NSP and NS mice displayed significant weight reduction. Histoachitectural defects, stagnancy in weight, high Glutathione peroxidase (GPX) and high glutamate levels and poor motor coordination were exhibited by the P group. The CTRL and NS animals demonstrated good motor coordination while the PNSC and NSP groups showed better coordination than the untreated P group. The CTRL group showed no histoarchitectural defects while the NS and PNSC animals showed histoarchitectural regeneration.</p> <p><strong>Conclusion: </strong>This research affirmed the weight-reducing, neuroprotective, neuroregenerative and motor coordinating effects of <em>Nigella sativa </em>in the modelled tremor condition.</p> RO Folarin OB Surajudeen EO Omotosho AO Owoniyi DO Oyeleye P Shallie Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 85 99 10.30442/ahr.0601-10-70 Effect of aqueous extract of Allium sativum (Garlic) on fertility in male Wistar rats <p><strong>Background:</strong> <em>Allium sativum</em> (Garlic) is widely used as a food flavour and it has antimicrobial medicinal purposes. It has other beneficial effects such as improving the cardiovascular and immune systems. The likely effect of garlic on the testicular functions remains controversial.</p> <p><strong>Objective: </strong>To investigate the effects of fresh garlic on the fertility of male Wistar rats by quantitative determination of testosterone, follicle-stimulating hormone (FSH), and Luteinizing hormone (LH) levels, as well as the sperm properties.</p> <p><strong>Methods:</strong> The aqueous extracts of garlic were administered to the animals through the oral route. Thirty-five male rats were categorized into seven groups, with five rats each distributed as follows: high-dose, medium-dose, low-dose that were administered 750, 500, and 250 mg/kg body weight dosages of the aqueous extracts, respectively. Others were the control group, which received no extract, and the recovery groups received the same doses of the extract. The recovery groups were left for additional twenty-one days without receiving the extract.</p> <p><strong>Results:</strong> The results showed an increase in testosterone levels at medium to high-doses of the extract including sustained high levels in recovery groups. Also, there were increases in sperm motility and sperm viability.</p> <p><strong>Conclusions:</strong> These findings suggest garlic may play beneficial roles in the reproductive functions of male Wistar rats.&nbsp; The mechanisms for these effects may involve the interplay of many currently unknown factors.</p> AS Faponle IO Osonuga EN Ezima TK Adenowo AA Adelegan Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 100 107 10.30442/ahr.0601-11-71 Complications of mastectomy for breast cancer in a tertiary care centre in South-west Nigeria <p><strong>Background</strong>: An important aspect of the surgical management of breast cancer is loco-regional control which can be accomplished by either breast conservation surgery or mastectomy.</p> <p><strong>Objective:</strong> To examine the outcome of the operation of mastectomy with respect to the complications of the procedure.</p> <p><strong>Methods:</strong> This is a retrospective study of all the patients who had a mastectomy for breast cancer in a Nigerian tertiary care centre from 1<sup>st</sup> January 2012 to March 2019. The hospital records of the patients were retrieved. Demographic and relevant clinical characteristics of the patients were extracted.</p> <p><strong>Results:</strong> A total of 77 cases were eligible, 76 women and one man. The age range was 28-76 years. Right mastectomy was performed in 54.5% cases. Preoperative comorbiditiesincludedobesity(34%), hypertension (31.2%), anaemia (6.5%) and Diabetes mellitus (7.8%). Modified radical mastectomy was done in 51.9% cases, simple mastectomy in 36.4%, “Toilet Mastectomy”in 9.1%, and mastectomy after breast conservation treatment in 2%. Twenty-eight percent of the cases required a blood transfusion, 31.2% received neoadjuvant chemotherapy while 58.2% had adjuvant therapy. The complications observed included: haemorrhage (7.8%), seroma (9.1%), flap necrosis (9.1%) andtumourrecurrence (7.8%). As at the time of the report, 41.6 % were alive, 19.4% were dead and 39.0% were lost to follow-up.</p> <p><strong>Conclusion:</strong>The complications of mastectomy were mostly haemorrhage, seroma,and flap necrosis, similar to previous reports from other parts of the world.</p> Babatunde Ayoade Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 108 113 10.30442/ahr.0601-12-72 Protective effects of Nigella sativa on Pre-fronto-cortical functions in mice Attention Deficit and Hyperactivity Disorder (ADHD) model <p><strong>Background: </strong>Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder associated with pre-fronto-cortical (PFC) cognitive dysfunctions. Ethanol is a psychoactive agent and its foetal exposure is employed in the modelling of ADHD.</p> <p><strong>Objective</strong>: To determine the curative roles of <em>Nigella sativa </em>in the PFC functions of mice induced with ADHD-like symptoms.</p> <p><strong>Method: </strong>Twelve BALB/c mice pups each from four groups of dams were studied. Normal saline was administered to the control (CTRL) dams, ethanol to the ETH dams, <em>Nigella Sativa</em> to the NS dams, and <em>Nigella sativa </em>followed with ethanol to the NSE dams. Novel object recognition test was used to assess recognition memory in the pups 15 days after weaning. Histological illustration of PFC was conducted using haematoxylin and eosin (H&amp;E) stain.</p> <p><strong>Results</strong>: ETH mice exhibited the least recognition memory while <em>Nigella sativa</em> prevented this deficit in NSE mice by eliciting much higher recognition memory. This indicates the neuroprotective role of <em>Nigella sativa </em>despite prenatal exposure<em>.</em> NS pups also had the highest weight gain, as well as the glutamate and Glutathione, peroxidase (GPX) levels, while raising these levels in the ETH-exposed mice which had the lowest levels, indicating a neurochemical potentiation. The results of the histological analysis showed the protective roles of <em>Nigella sativa</em> on the PFC neuronal densities.</p> <p><strong>Conclusion: </strong>This study suggests the protective effects of <em>Nigella sativa</em> on the prefronto-cortical functions in mice ADHD model following maternal exposure to ethanol.</p> R Folarin S Adefoluke T Ogunwale O Osinowo A Ogunledun I Ibrahim Copyright (c) 2020 Annals of Health Research 2020-03-28 2020-03-28 6 1 114 124 10.30442/ahr.0601-13-73