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 Crossref, 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> en-US <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> (Prof. Tinuade Ogunlesi) (Temitope Soretire) Fri, 28 May 2021 11:57:28 +0000 OJS 60 Pattern of Computerized Tomographic Findings in Suspected Gallbladder Cancer in Nigeria <p><strong>Background:</strong> Gallbladder (GB) cancer is a rare malignancy with a variable incidence worldwide. Imaging detection at an early stage is elusive. Preoperative imaging for tumour recognition and non-invasive staging is essential to triage patients to appropriate care.</p> <p><strong>Objectives:</strong> To describe the CT imaging findings of GB cancer among Nigerians.</p> <p><strong>Methods:</strong> A retrospective review of the CT images of 15 patients who had gall bladder carcinoma between January 2015 and June 2017 at a private diagnostic facility in Lagos was done.</p> <p><strong>Results:</strong> The age of the patients ranged from 39 to 73 years with a mean age of 60.9 years. The male to female ratio was 1:4.3. Clinical presentations included abdominal pain (61.5%) and jaundice (38.5%). Irregular GB wall thickening (61.5%) and focal mass lesions in the GB (38.5%) were the main features on imaging while 38.5% had associated gall stones. Infiltration of the adjacent liver was found in 76.9% and 60 % of those who had local infiltration of the liver also had intrahepatic metastasis.</p> <p><strong>Conclusion:</strong> A majority of gall bladder cancer cases are still diagnosed in their late stages. CT scan readily delineates regional spread into adjacent organs which may be obscured in other imaging modalities due to adjacent bowel gas.</p> MA Olusola-Bello, AA Olatunji, OI Ajayi, AO Adekoya Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 09:46:57 +0000 Anti-Mullerian Hormone Levels in Regularly Menstruating Nigerian Women <p><strong>Background:</strong> Studies have shown that serum levels of Anti-Mullerian Hormones (AMH) decrease with age as it is also an early and sensitive marker of ovarian reserve in women in the North American, European and Asian regions. Various research works have also generated data about AMH in the Caucasian, Americans and Asians There was a need to compare these known data with African data.</p> <p><strong>Objectives:</strong> To assess the serum levels of AMH in healthy women of reproductive age and determine the relationship between AMH, age, Body Mass Index, parity and menstrual cycle in healthy regularly menstruating women.</p> <p><strong>Methods:</strong> A cross-sectional study of 200 apparently healthy women aged 21-45 years was carried out between January and May 2014. Serum AMH and FSH levels were measured in the participants using Enzyme-Linked Immunosorbent Assay.</p> <p><strong>Results:</strong> The median AMH value was 4.07ng/mL, while the median FSH value was 9.65mIU/mL. The reference 90% CI of AMH was 0.60 -9.71 ng/ml. There was a significant negative correlation between serum level of AMH and age (r = - 0.718, p&lt;0.001).</p> <p><strong>Conclusion:</strong> The serum AMH levels gradually declined throughout the reproductive lifespan of a woman.</p> OO Olawale, VO Dada, FM Abbiyesuku, OO Eluyera, EW Olooto, KC Osuji Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital <p><strong>Background: </strong>Pulmonary embolism (PE) is a disease associated with high morbidity and mortality in the more technically advanced western world. However, in Africa and Nigeria in particular, the burden of PE is largely poorly defined as few data are available.</p> <p><strong>Objectives:</strong> To characterize the clinical profile, management and outcomes in PE patients confirmed with Computerized Tomography Pulmonary Angiography (CTPA).</p> <p><strong>Methods:</strong> A retrospective study was conducted at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. The medical records of PE patients confirmed by CTPA and admitted to the intensive care unit of the hospital spanning July 2016 to June 2020 were retrieved for analysis.</p> <p><strong>Results:</strong> Thirty-one patients with the age range of 26 to 93 years were included and the mean age was 55.5±18.5 years. Breathlessness was the most prevalent presenting symptom. In the majority of patients (48.4%), the risk factors were not known. However, the most common risk factor and co-morbidity was pregnancy (16.1%). The in-hospital mortality rate was 9.7%.</p> <p><strong>Conclusion:</strong> The clinical characteristics of PE in this cohort were similar to those described in the literature. The high mortality rate in this study also underscores the need for large population studies in black Africans.</p> JO Ogunkoya, AO Oluwole, BO Adefuye, AO Adebola-Yusuf, O Ehioghae Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 The Contribution of Dysphagia to Acute Stroke Morbidity and Mortality in Nigeria: A Prospective Study <p><strong>Background:</strong> The assessment of time-trend morbidity and mortality in acute stroke is critical to clinical policy decisions and resource allocation.</p> <p><strong>Objectives:</strong> To determine the prevalence of dysphagia in acute stroke and the impact of dysphagia on short term stroke outcome (30 days post-stroke).</p> <p><strong>Methods:</strong> This was a prospective longitudinal study. Bedside screening for dysphagia modified Rankin score (MRS) and Barthel Index (BI) were performed on acute stroke patients on day 1, day 7, day 14 and day 30 after stroke to determine the frequency of dysphagia. Patients with dysphagia were then compared with age- and gender-matched controls (stroke patients without dysphagia) in terms of stroke characteristics and 30-day outcome.</p> <p><strong>Results:</strong> Of the recruited 200 patients, 99 (49.5%) had dysphagia. Patients with intracerebral haemorrhagic stroke had a significantly higher prevalence of dysphagia (64% <em>vs</em> 36%; p&lt;0.001). At baseline, dysphagic patients had more severe (Mean NHISS score, 22.81 Vs 8.92; p=0.01) and subcortical strokes (57.1% <em>vs</em> 42.9%, p = 0.015). At 30 days after stroke, the mean MRS was significantly higher in the dysphagic stroke patients (3.8±1.02) compared to those without dysphagia (2.5±1.3), (p = 0.001)]. Case fatality was higher among the dysphagic (79.8% <em>vs</em> 15.84%; p = 0.001) and the mean survival time was lower (12.21 days) among the dysphagic group (p = 0.001)</p> <p><strong>Conclusion:</strong> Severe stroke, subcortical stroke and haemorrhagic stroke types were significantly associated with dysphagia at baseline. Dysphagia adversely influenced 30-days morbidity and case fatality in this cohort of acute stroke patients.</p> OO Olajide, PB Adebayo, FT Taiwo, MO Owolabi, A Ogunniyi Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 Perception of Preclinical Medical Students About Pathology Subject and the Teaching Methods in an Indian Medical College <p><strong>Background:</strong> Pathology is a key subject at the pre-clinical stage of medical training.</p> <p><strong>Objectives:</strong> To determine the perception of second-year MBBS (preclinical) students regarding Pathology as a subject and the effectiveness of various teaching, learning and assessment methods.</p> <p><strong>Methods:</strong> This cross-sectional study was carried out on 145 randomly selected, second-year MBBS students, appearing for their Phase II final university exams. A predesigned questionnaire with questions about students’ perception of pathology was administered to the students. The questionnaire also assessed the various teaching-learning methods currently used by the faculty. The students were also requested to make suggestions regarding the modifications needed in the teaching methods.</p> <p><strong>Results:</strong> A total of 145 out of 150 regular-batch students participated in the study. One hundred (68.9%) regarded pathology as an interesting subject; 131 (90.3%) felt pathology acts as a bridge between paraclinical and clinical branches while 107 (73.8%) found blackboard teaching more effective.</p> <p><strong>Conclusion:</strong> The study revealed that the preclinical medical students showed a favourable predisposition towards pathology as a subject while highlighting areas that need to be addressed for more effective teaching and improved learning towards producing better medical professionals.</p> S Sood, SP Gulia Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 10:58:33 +0000 Independent Predictors of Recurrence of Vertigo Among Nigerians <p><strong>Background:</strong> Recurrence of vertigo indicates a morbidity to the patient and a dilemma for the managing physician.</p> <p><strong>Objectives:</strong> To describe the characteristics of vertigo, document prevalence and explore the characteristics which could independently predict recurrence of vertigo.</p> <p><strong>Methods:</strong> A cross-sectional study of patients managed for vertigo in a tertiary facility was retrospectively done. Patients’ demographic and clinical characteristics, associations of vertigo, audiological symptoms, comorbid illnesses, and duration to achieve control of vertigo were recorded. Recurrence of vertigo was used to categorize the patients. The factors that were associated with recurrence on univariate analyses were evaluated as independent predictors of recurrence of vertigo.</p> <p><strong>Results:</strong> The 73 patients with a male-to-female ratio of 1:1.4 were aged 35 -78 (mean 56.6±9.9) years. The associated symptoms included body weakness (34.2%), audiological symptoms (38.4%), 27.4% had antecedent head and neck injury and vertigo was precipitated or aggravated by changes in the head and neck position in 63.0% Vertigo was controlled within 1 -7 (Median 2) days, 35.6% had a recurrence of vertigo. Age, the experience of nausea and vomiting, previous head and neck injury, presence of comorbidity, and long duration to achieve control of vertigo were significantly associated with recurrence of vertigo. All these factors except the presence of comorbidity could independently predict the recurrence of vertigo.</p> <p><strong>Conclusion:</strong> Vertigo is common in adult females, and mostly positional in type. About a third of patients may have a recurrence of vertigo. Age, especially above 57 years, nausea and vomiting, head and neck injury and prolonged period to control vertigo may independently predict recurrence of vertigo.</p> OA Sogebi, EA Oyewole Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 Health-seeking Behaviour and Self-rated Health of Adult Men in an Urban Local Government Area in Lagos, Nigeria <p><strong>Background: </strong>Evidence from the literature suggests that men are less likely to seek health services compared to women. It is important to understand the factors that influence the health-seeking behaviour of men and how it affects their self-rated health.</p> <p><strong>Objectives</strong>: To assess the health-seeking behaviour and self-rated health perception of adult men in an urban community in Lagos state.</p> <p><strong>Methods: </strong>A descriptive, cross-sectional study was conducted among 300 adult males aged 18 years and above in an urban community in Lagos State, Nigeria. An interviewer-administered questionnaire was used to obtain relevant data. Associations between categorical variables were subjected to statistical analysis.</p> <p><strong>Results: </strong>The health-seeking behaviour of the men in the study area was influenced by factors such as the severity of illness (66.1%), availability of funds (13.1%) and subscription to health insurance (18.2%). A majority (94.7%) self-rated their health as good, very good or excellent. Provision of expert care (45.6%) was considered the most important characteristic of health-seeking behaviour. Alcohol consumption (38.8%) was significantly associated with the health perception of the respondents. The respondents (50.2%) preferred using hospitals, compared to other sources during their last illness episode.</p> <p><strong>Conclusion:</strong> The respondents exhibited a preference for hospital visit during their last illness, confirming appropriate health-seeking behaviour in the absence of economic hindrances and other factors. Respondents with little or no alcohol intake had better self-rated health.</p> AO Ogunyemi, TO Egemba, OO Onigbogi Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 Electroencephalographic Correlates of Cognition among Nigerian Women with Epilepsy on Anti-epileptic Monotherapy <p><strong>Background:</strong> The prospect of EEG as a potential biomarker for detecting a cognitive decline in those living with epilepsy has not been extensively studied.</p> <p><strong>Objective: </strong>To determine the relationship between electroencephalographic (EEG) changes and cognitive functions in Women with Epilepsy (WWE).</p> <p><strong>Methods:</strong> The study involved 100 adult WWE aged between 16 and 40 years on Levetiracetam (LEV) or Carbamazepine (CAB) monotherapy. Zung Self-Reporting Depression Scale (ZSRDS) was used to assess the mood of participants while the Community Screening Interview for Dementia (CSID) was used to assess various cognition domains.</p> <p><strong>Results:</strong>&nbsp; The frequency of Periodic Epileptiform Discharges (PED) (p = 0.008), delta waves and theta waves (p = 0.004) were higher in WWE with Cognitive Impairment (CI) compared to those without CI. Lower cognitive scores were seen among those with delta wave across the domains of cognition with statistical significance for language fluency (p = 0.039), language comprehension (p = 0.000), and total CSID (p = 0.000). WWE with PED had a lower mean total CSID score compared to those without PED (p = 0.019). The absence of alpha wave (p = 0.027), presence of delta wave (p = 0.013), slow frequency (p = 0.015) and PED (p = 0.031) were EEG predictors of cognitive impairment. Medication type (p = 0.016) and depression (p = 0.001) were the clinical predictors of cognitive impairment in WWE.</p> <p><strong>Conclusion:</strong> The frequencies of PED and slow waves were higher in WWE with CI while the absence of alpha wave, presence of delta wave and PED were EEG predictors of CI.</p> <p>&nbsp;</p> L Ogunjimi, A Alabi, B Osalusi, A Muritala, A Aderinola, A Ogunniyi Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 Relationship between breastfeeding practices and nutritional status of children aged 6-24 months in South-west Nigeria <p><strong>Background:</strong> Breastfeeding is the ideal form of nutrition for the healthy growth of infants, and it reduces the risk of malnutrition and several childhood morbidities.</p> <p><strong>Objectives:</strong> To assess the breastfeeding practices of mothers and the relationship between these practices and the nutritional status of their children.</p> <p><strong>Methods:</strong> It was a descriptive, hospital-based, cross-sectional study that involved children aged six to 24 months in Ilesa, Osun State, Nigeria. Socio-demographic characteristics and breastfeeding practices were documented, anthropometric measurements were obtained, and nutritional status was determined for the children. Underweight, stunting and wasting were defined as z-score &lt; -2 for the weight-for-age, length-for-age and weight-for-length, respectively. A child was taken to be undernourished if any of underweight, stunting or wasting was present.</p> <p><strong>Results:</strong> Fifteen (3.6%) of the 420 children studied had mixed feeding from birth, while 273 (65.0%) were exclusively breastfed for six months. Two hundred and sixty-eight (63.8%) of them were still breastfeeding at the time of the study, while 152 (36.2%) had stopped breastfeeding. Nearly one-quarter (103/420; 24.5%) of the children were undernourished. A significantly lower proportion of children who had exclusive breastfeeding were undernourished, compared to those who were not exclusively breastfed (p = 0.033). Exclusive breastfeeding was independently associated with reduced odds of undernutrition (OR = 1.62, 95% CI = 1.02-2.57, p = 0.039).</p> <p><strong>Conclusion:</strong> Exclusive breastfeeding for six months significantly reduces the risk of undernutrition among young children.</p> OO Abolurin, OA Oyelami, SB Oseni, MA Akinlosotu, KJ Sodeinde, AO Adekoya Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000 Osteosarcoma with Orbital Metastasis in a Nigerian Child: A Case Report and Review of the Literature <p>Osteosarcoma is the most common primary bone tumour with a peak occurrence in adolescence. The occurrence of osteosarcoma in preadolescents is rare with a paucity of data in the developing world. Metastasis of osteosarcoma to the orbit is even a rarer presentation with few cases reported in the literature but to the best of the researchers’ knowledge, none of the previous cases had contralateral orbital metastasis to osteosarcoma. This is the first case report of orbital metastasis of osteosarcoma in Nigeria. The present case is presented for its rarity, to increase awareness and add to knowledge on the possibility of metastasis to contralateral orbit in osteosarcoma.</p> MO Adekunle, IN Diaku-Akinwumi, AO Akinola, G Akinyosoye Copyright (c) 2021 Annals of Health Research Fri, 28 May 2021 00:00:00 +0000