搜索结果：Annals of Ibadan postgraduate medicine

Background: The choice of specialty by medical students and early career doctors affects health workforce distribution in any country. In addressing healthcare needs of the populace, appropriate distribution of manpower across board is essential. Several factors come into play in making these choices. This study assessed factors affecting the career choices of final year medical students and how curricular changes may have influenced these. Methods: This was a cross-sectional study conducted among 236 final year medical students of the University of Ibadan by convenience sampling using self-administered semi-structured questionnaires. Questions were on sociodemographic characteristics, career counselling, preferred future career, and factors affecting these choices. Data were analyzed using SPSS version 21 software. Results: A total of 236 medical students participated in the study. The mean age of participants was 23.6(±1.9) years. Only 112(47.5%) respondents had received any form of career counseling/guidance in the course of their medical training. The commonest first choice specialties were obstetrics and gynecology 54(22.9%), surgery 44(18.6%), and psychiatry 18(7.6%). Personal interest most often (185, 78.4%) influenced career choice overall, showing significance in obstetrics and gynecology (p=0.02), family medicine (p=0.02), and public health (p<0.001). Conclusion: The predominant choices of future specialty among final year medical students were obstetrics and gynecology, surgery and psychiatry. The change in curriculum for medical students may have affected the pattern of their choices with more interest shown in previously neglected areas.

BACKGROUND: Diabetic retinopathy is an increasing cause of blindness. The prevalence of retinopathy in hospital attending diabetics in Ibadan is reported to be 42 %. This study assessed the barriers identified by patients and service providers to delivering good services for diabetic retinopathy in Ibadan, Nigeria, Sub-Saharan Africa. METHODS: A qualitative survey using non-participatory observation, in-depth interviews (patients and healthcare providers), and focus group discussion for diabetic patients in the eye clinic in University College Hospital, Ibadan was done. Semistructured interview and topic guides were used to evaluate the barriers to effective service. The participants were selected using a non-probability, purposive sampling strategy. Twenty participants were involved in the pilot study. There were ten in-depth interviews of patients and two focus group discussions of patients (3 in each group). Four healthcare providers were interviewed (a retinal surgeon, a senior registrar, an endocrinologist and a public health nurse). RESULTS: Lack of awareness that diabetes causes irreversible blindness was identified as a major barrier by both patients and providers. Cost of treatment of diabetes and treatment of retinopathy was also an important barrier. The long waiting time before consultation, staff attitudes to patients and appointment scheduling problems deterred patients from using the service. CONCLUSIONS: More diabetic patients can be encouraged to use eye service by providing more detailed information/counselling and making clinic attendance less costly and more convenient.

Malaria is endemic in most countries within the African continent and accounts for high morbidity and mortality in those countries. The Nigerian Government launched the National Malaria Strategic Plan 2014-2020 to address the high burden of malaria in the country. However, like the previous plans, this plan focused more on the vulnerable groups to malaria (i. e. pregnant women, children under five years old and people living with HIV/AIDS) as the target population for the interventions. Men being the heads of the family in most African societies make all health decisions for the family. Many interventions that did not involve men do not succeed because of the decision roles men play in the family. An understanding of the knowledge and perception of men regarding malaria causes prevention, and management would assist in developing interventions aimed at reducing morbidity and mortality related to the disease in the community as well as achieving the Sustainable Development Goal 3.3, which focuses on Ending the Epidemic of Malaria. Therefore, this study was designed to investigate the knowledge and perception of malaria among Hausa married men in Mokola community, Ibadan.The study was a descriptive cross-sectional survey. A three-stage sampling technique was used to recruit 302 Hausa married men based in Mokola; stratified into the Hausa and Yoruba (Okesu) axis, systematic random sampling was used to select the houses and balloting was used when a house had more than one married man. A validated semi-structured interviewer-administered questionnaire was used for data collection. Knowledge, perception and preventive practices were measured on a 22-point, 26-point and 14-point scales, respectively. Knowledge scores of 1≤13 and scores >13 were categorized as poor and good, respectively. Perception scores of 0≤16 and scores >16 were categorized as poor and good, respectively. Preventive practice scores of 0≤8 and scores ˃8 were categorized as poor and good, respectively. Data was analyzed using descriptive and inferential statistics such as Chi-square test at p˂0.05 level of significance. Respondents’ mean age was 36.4 years, with trading accounting for 97.7% respondents’ occupation. Respondents whose monthly income range from N30,000-N75,000 accounted for 56.0%. Monogamy was practised by 75.5% with 73.2% having less than 5 children. Most respondents (76.2%) correctly defined malaria, with 22.2% obtaining information on malaria from the electronic media. Majority (99.3%) of respondents acknowledged to buying of drugs as one of the roles men should play in the treatment of malaria in their households. Most respondents, 89.1%, had good knowledge on definition of malaria and 97.0% had a good perception towards malaria management in their families with 51.6% of respondents reporting that a family member had malaria less than a month ago. Respondents who used ITN as prevention against malaria for their families accounted for 80.8%. Overall, 78.5% of respondents practised right preventive practice against malaria. The test of association between level of education and knowledge of malaria showed that only knowledge on symptoms of malaria was associated with the respondents’ level of education (p = 0.012). Test of association between level of education and perception of malaria revealed that perception of the respondents on causes of malaria was significantly associated with their level of education (p = 0.003). The test of association between respondents’ knowledge and perception on malaria revealed that knowledge and perception were significantly associated (p < 0.001), also the test of association between knowledge and the preventive practices of respondents revealed a statistically significant association exists between knowledge level and preventive practices against malaria (p= 0.028). Majority of respondents had good knowledge and perception on malaria and only few reported practicing malaria preventive measures involving spending money for their households. Interventions such awareness through the electronic media and community mobilization on malaria preventive measures focusing on men should be carried out in other communities.

BACKGROUND: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS: Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING: Bill & Melinda Gates Foundation.

BACKGROUND: Bronchiolitis is a common cause of hospitalization among infants. The limited effectiveness of conventional medication has prompted the use of complementary and alternative medicine (CAM) as alternative or adjunctive therapy for the management of bronchiolitis. AIMS: To determine the effectiveness and safety of CAM for the treatment of bronchiolitis in infants aged less than 2 years. METHODS: A systematic electronic search was performed in Medline, Embase, CINAHL, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL) from their respective inception to June 30, 2016 for studies evaluating CAM as an intervention to treat bronchiolitis in infants (1 month to 2 years of age). The CAM could be any form of treatment defined by the National Center for Complementary and Integrative Health (NCCIH) and was utilized either as a single agent or adjunctive therapy. The predefined primary outcome was length of hospital stay. Secondary outcomes were time to resolution of bronchiolitis symptoms, adverse events, and all other clinical outcomes reported by the included studies. RESULTS: The review identified 11 studies (8 randomized controlled trials and 3 cohort studies) examining four herbal preparations and four supplements used either as adjunctive or alternative therapy for bronchiolitis in 904 infants. Most studies were of moderate quality. Among six studies reporting on length of stay, a significant benefit was found for Chinese herbal medicine compared to ribavirin in one cohort study (n = 66) and vitamin D compared to placebo in one randomized controlled trial (n = 89). Studies of Chinese herbal medicine (4 studies, n = 365), vitamin D (1 study, n = 89), N-acetylcysteine (1 study, n = 100), and magnesium (2 studies, n = 176) showed some benefits with respect to clinical severity scores, oxygen saturation, and other symptoms, although data were sparse for any single intervention and the outcomes assessed and reported varied across studies. Only five studies reported on adverse events; no serious adverse events were reported. CONCLUSIONS: Among 11 studies examining the effect of CAM on inpatients with bronchiolitis, six reported on the review's primary outcome of length of hospital stay. In general, findings did not show a significant benefit associated with the primary outcome. Preliminary evidence indicated that Chinese herbal medicine mixtures, vitamin D, N-acetylcysteine, and magnesium might be useful in managing the symptoms of bronchiolitis. However, the evidence was not sufficient or rigorous enough to formulate recommendations for the use of any CAM. Among studies that reported adverse events, no serious harms were noted.

Developments in Information and Communication Technologies (ICT) have radically taken over every sphere of activity in university libraries. Academic libraries owe it a key duty to keep pace with technological advancement in order to cope with users’ continual sophisticated information requirements. The main purpose of this study was to examine the use of electronic resources by postgraduate students of the University of Cape Coast, and with a view of giving recommendations based on findings. The major objectives of the study are: (1) To determine postgraduate students’ awareness of electronic resources in the library. (2) To find out the frequency of usage of e-resources by students. (3) To determine the computer literacy level of postgraduate students. And (4) To identify the likely problems in the utilization of electronic resources by postgraduate students. The findings revealed that most of the postgraduate students were aware of the e-resources in the library. The findings of this study also revealed that most postgraduate students rather preferred to access information from Google scholar, and other web based databases more frequently than the databases in the library. The respondents identified poor internet connection as the most significant constrained for ineffective access e-resources.

Agrarian rural dwellers in Nigeria produce about 95% of locally grown food commodities. The low accessibility to and affordability of orthodox medicine by rural dwellers and their need to keep healthy to be economically productive, have led to their dependence on traditional medicine. This paper posits an increasing acceptance of traditional medicine country-wide and advanced reasons for this trend. The fact that traditional medicine practitioners' concept of disease is on a wider plane vis-à-vis orthodox medicine practitioners' has culminated in some socio-cultural and magico-religious practices observed in preparation and use of plant medicines for farmers' health management. Possible scientific reasons were advanced for some of these practices to show the nexus between traditional medicine and orthodox medicine. The paper concludes that the psychological aspect of traditional medicine are reflected in its socio-cultural and magico-religious practices and suggests that government should fund research into traditional medicine to identify components of it that can be integrated into the national health system.

Wound colonization by microorganisms is most frequently polymicrobial and incidences of high level resistance among bacterial isolates from wounds have been reported. Methicillin-resistant Staphylococcus aureus (MRSA) and extendedspectrum beta-lactamase (ESBL) producing Gram-negative bacteria both constitute serious challenge to physician in their choice of antibiotic treatment of infections caused by these bacteria. This study determined the antibiotic susceptibility profiles and prevalence of MRSA and ESBL producers among wound bacterial isolates from a tertiary hospital in Ibadan City.Forty (40) clinical bacterial isolates from five wound sources were collected from the Microbiology unit of the University College Hospital (UCH), Ibadan and were authenticated with standard bacteriological techniques. Antibiotic susceptibility test was done by disc-diffusion method using 19 antibiotics belonging to 12 classes. MRSA strains were detected by their resistance to cefoxitin and/or oxacillin antibiotics. Presumptive ESBL production was by double-disc synergy test using 30 μg cefotaxime and ceftazidime around 20/10 μg amoxicillin-clavulanic acid discs. ESBL confirmation was by minimum inhibitory concentration (MIC) using agar-dilution method.The authenticated isolates include Proteus spp (47.5%), Staphylococcus aureus (27.5%), Pseudomonas aeruginosa (12.5%), Klebsiella spp (7.5%), Acinetobacter baumanii (2.5%) and E. coli (2.5%). Distribution of the isolates collected according to wound sources includes: acute soft tissue wounds (35%), leg ulcer (32.5%), surgical wounds (17.5%), burn wounds (12.5%) and diabetic foot ulcer (2.5%). Distributions according to patients’ gender are: male (65%), female (35%), and according to age-groups are: 0 – 19 years (22.5%), 20 – 39 years (35%), 40 – 59 years (32.5%) and ≥ 60 years (10%). All (100%) the isolates were multidrug resistant (MDR) being resistant to ≥ 3 classes of antibiotics. Percentages of isolates resistance to each of the antibiotic include: piperacillin, piperacillin tozobactam and amoxicillin-clavulanic acid were 100%, ceftazidime, cefuroxime, cefixime, aztreonam, sulphamethoxazole-trimethoprim, erythromycin, chloramphenicol and doxycyclin were &gt; 70%, cefoxitin (62.5%), Nitrofurantion (52.5%), ciprofloxacin (45%), ofloxacin (35%), perfloxacin (37.5%), gentamicin (32.5%) and imipenem (2.5%). Of the 11 Staphylococcus aureus collected, 54.5% were detected to be MRSA strains while ESBL production was detected in 55.2% of the Gram negative isolates.This study revealed 100% MDR phenotype constituting high level of MRSA strains (54.5%) and ESBL producers (55.2%) among Gram-positive and Gram-negative bacterial wound isolates respectively. Hence, this calls for caution in the use of extended spectrum antibiotics in treating patients with infected wounds.

Objective . The present study was aimed at assessing the impact of teledentistry, its application, and trends in uplifting dental practice and clinical care around the world. Material and Methods . The present observational study comprised of an electronic survey distributed among dental professionals around the globe. The validated survey form consisted of a total 26 questions with 5‐point Likert scale response. The questionnaire used was divided into four domains: usefulness of teledentistry for patients, its usefulness in dental practice, its capacity to improve the existing practice, and the concerns attached to its use. The statistical analysis was performed using SPSS‐25. ANOVA test was used to assess the effect of independent variables on dependent variables. A p value of ≤0.05 was taken as statistically significant. Results . A total of 506 dental professionals participated in the study with the response rate of 89.39%. More than half of the participants (50‐75%) endorsed that teledentistry is a useful tool for improving clinical practice as well as patient care. Two‐thirds of the participants (69.96%) considered that teledentistry would reduce cost for the dental practices. On the other hand, about 50‐70% of dental professionals expressed their concerns regarding the security of the data and consent of patients. The most preferred communication tool for teledentistry was reported to be videoconference followed by phone. The majority of participants recommended the use of teledentistry in the specialty of oral medicine, operative dentistry, and periodontics. There was a significant difference between the age, experience of dentists, and their qualifications with domains of teledentistry. Conclusions . The overall impact of dental professionals towards teledentistry was positive with adequate willingness to incorporate this modality in their clinical practice. However, the perceived concerns pertaining to teledentistry are significant impediments towards its integration within the oral health system. An in‐depth study of its business model and cost‐benefit needs of time, especially in the context of developing countries, in order to avail the optimum benefits of teledentistry.

The study aims at investigating the awareness and usage of electronic information resources among postgraduate students of library and information science in Southern Nigeria. The descriptive survey design was adopted for the study. The census sampling technique was adopted for this study. Thus, the entire population of three hundred and seventy-five (375) postgraduate students of library and information science in Southern Nigeria were used as the sample for this study. The questionnaire tagged: Awareness and Usage of Electronic Information Resources by Postgraduate Students of Library and Information Science Questionnaire (AUEIRPSLISQ) was used as instrument for data collection. Four research questions were answered and two null hypotheses were tested at 0.05 level of significance. The simple percent statistical tool was used to answer the research questions and Pearson Product Moment Correlation Coefficient (PPMCC) for testing the hypotheses. The results obtained revealed that postgraduate students of library and information science are quite aware and highly use electronic information resources. The study also reported that postgraduate LIS students are skilled in the use of electronic information resources. Based on the findings the study concluded that electronic information resources are essential tools for empowering postgraduate students of library and information science in Southern Nigeria.

In sub-Saharan Africa, accessibility to affordable quality care is often poor and health expenditures are mostly paid out of pocket. Health insurance, protecting individuals from out-of-pocket health expenses, has been put forward as a means of enhancing universal health coverage. We explored the utilization of different types of healthcare providers and the factors associated with provider choice by insurance status in rural Nigeria. We analysed year-long weekly health diaries on illnesses and injuries (health episodes) for a sample of 920 individuals with access to a private subsidized health insurance programme. The weekly diaries capture not only catastrophic events but also less severe events that are likely underreported in surveys with longer recall periods. Individuals had insurance coverage during 34% of the 1761 reported health episodes, and they consulted a healthcare provider in 90% of the episodes. Multivariable multinomial logistic regression analyses showed that insurance coverage was associated with significantly higher utilization of formal health care: individuals consulted upgraded insurance programme facilities in 20% of insured episodes compared with 3% of uninsured episodes. Nonetheless, regardless of insurance status, most consultations involved an informal provider visit, with informal providers encompassing 73 and 78% of all consultations among insured and uninsured episodes, respectively, and individuals spending 54% of total annual out-of-pocket health expenditures at such providers. Given the high frequency at which individuals consult informal providers, their position within both the primary healthcare system and health insurance schemes should be reconsidered to reach universal health coverage.

Objectives: Postgraduate medical training is characteristically intensive and stressful. Given that anxiety disorders are often linked with stress-related scenarios; awareness of the burden of anxiety disorders among postgraduate medical trainees and their determinants is essential for informed intervention. This study was set to investigate the pattern of anxiety psychopathology, and to determine its correlates among doctors in a Nigerian postgraduate medical training facility.Methods: The participants, made up of 204 resident doctors were administered questionnaire to elicit their socio-demographic and work related variables. Subsequently, 12- item General Health Questionnaire (GHQ-12) was used to ascertain the presence of emotional distress, and the Structured Clinical Interview for Diagnostic &amp; Statistical Manual for Mental Disorders- fourth edition [DSM-IV] Axis-1 Disorders, Non-patient edition (SCID-1/NP) was administered to characterize anxiety related psychopathology in the participants.Results: The mean age of participants was 33.44 (±4.50). In all, 120 (58.8%) respondents reported various difficulties with their examinations, 14(8.3%) reported having physical disorder and 59(28.9%) respondents were emotionally distressed. The prevalence of anxiety psychopathology based on DSM-IV criteria was 13.2% and the pattern elicited based on recognised categories include generalized anxiety disorder (4.9%), obsessive-compulsive disorder (3.4%), specific phobia (2.4%), social phobia (1.5%) and substance induced anxiety disorders (1.0%). Having additional qualification to the medical degree seems protective against anxiety psychopathology (?2= 3.91; df=1; p&lt;0.05), while those with emotional distress (?2=17.54; df=1; p&lt;0.001) were more likely to experience anxiety.Conclusion: Comprehensive and need-based mental health services with psychosocial support for trainee doctors are implied. Future research focusing on modifiable predictors of mental health challenges among resident doctors and their linkage with specific aspects of training is indicated.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.25-32

BACKGROUND: Severe Retinopathy of Prematurity (ROP) is a serious vasoproliferative disorder that can affect extremely premature infants. It continues to be one of the most important preventable causes of blindness in children. Our study is aimed at finding the incidence of ROP and its association with some risk factors in Palestine. METHODS: From the 1st of January 2016 to 31st December 2016, a total number of 115 infants who met the criteria for ROP screening in three neonatal intensive care units were included in the study. The medical records of infants were reviewed retrospectively and multiple factors that may be associated with the development of ROP were collected manually. RESULTS: The incidence of ROP and severe type 1 ROP that require treatment was 23.5 and 11.3% respectively. After conducting univariate analysis of risk factors, statistically significant risk factors affecting the development of ROP in our study were: low gestational age, low birth weight, type of multiple gestation, the presence of affected sibling, low level of Hemoglobin at birth, respiratory distress syndrome, low Hemoglobin level, blood transfusion and days on oxygen supplements with either mechanical, non-mechanical methods or both combined. High bilirubin levels were found as a protective factor against the development of ROP. However, when a multivariate analysis was performed, only low gestational age, total days on oxygen supplement and high bilirubin levels were significant regarding the development of ROP. CONCLUSION: The incidence of ROP is considered a relatively low percentage compared to neighboring countries that have higher levels of human development index. Statistically significant risk factors need to be considered when clinicians deal with premature infants.

BACKGROUND: One of the essential components of antenatal care (ANC) is birth preparedness and complication readiness (BP/CR). Strengthening BP/CR measures is one of the principal strategies to reduce maternal mortality and morbidity. The current study aimed at determining the level of men's knowledge about obstetric danger signs, and their involvement in BP/CR among community of Northwest Ethiopia. METHOD: A cross-sectional community based survey was conducted in Northwest Ethiopia from May 2016 to July 2016. Data was analyzed by the Statistical Package for the Social Sciences software Version 21.0 for Windows. Participants' socio-demographic characteristics, knowledge of obstetric danger signs, and level of involvement in BP/CR were described using frequencies and percentages. Bivariate and multivariable logistic regressions were employed to explore the associated factors and P-value of 0.05 was used as a cut-off point to declare significant association. RESULT: From 856 men who were invited for the study, 824 men agreed for the interview giving a response rate of 96.2%. Half of the men stated one danger sign that may occur during pregnancy 407(49.4%); one third during delivery 271(32.9%); and 213(25.8%) during postpartum period. Among all participants, 256(31.1%) had not made any preparations; 363(44.1%) made one step; 116(14.1%) made two steps; 82(9.9%) made three steps; 5(0.6%) made four steps; 2(0.24%) made five steps; and no one made all the birth preparation steps during the birth of their last child. BP/CR was significantly association with knowledge of at least one danger sign during pregnancy (AOR = 3.3, 95% CI: 3.1, 3.9); during delivery (AOR = 2.2, 95% CI: 1.1, 2.8); and post partum period (AOR = 1.8, 95% CI: 1.1, 2.4). Furthermore, BP/CR was found to be positively associated with being married, completing college education, escorting wife to antenatal care, and urban residence. CONCLUSIONS: Men's level of knowledge about obstetric danger signs, and their involvement in BP/CR was found to be very poor. Considering the importance of male involvement in the maternal health care, it is recommended to advocate policies and strategies that can improve awareness of men and enhance their engagement in the maternal care.

In accordance with the recommendations of The International Council for Standardization in Haematology (ICSH, https://icsh.org/), this article describes the morphophysiological characteristics of the precursors and mature erythroid cells in the early period of postnatal development of birds (Gallus gallus L.) including calculation of the surface area of these cells (S, μm2 , X±SEM). Depending on cell shape, cytoplasm color, and chromatin organization in nucleus, the following types are distinguished: basophilic erythroblasts (69.60±4.01 μm2 , p≤0.05), polychromatophilic erythroblasts (65.42±2.49 μm2 , p≤0.05), and oxyphilic erythroblasts (71.10±4.43 μm2). Formation of cell pool is characteristic for erythropoiesis in birds due to mitotic proliferation of basophilic erythroblasts. There are often proerythroblasts and polychromatophilic erythroblasts. The nucleus of a polychromatophilic proerythroblast contains a large number of histone proteins; therefore, it has an intensely basophilic color with a pronounced oxyphilic hue (proteinrelated oxyphilia). The accumulation of hemoglobin in the protoplasm of these cells contributes to the gradual transition of the basophilic staining of cytoplasm to the oxyphilic one which is typical for mature red blood cells (73.95±2.10 μm2 , p≤0.05). Cell shape and the structure of erythroblast nucleus approaches to these of mature red blood cells.

BACKGROUND: There is an increasing recognition that non communicable diseases impose large economic costs on households, societies and nations. However, not much is known about the magnitude of diabetes expenditure in African countries and to the best of our knowledge no systematic assessment of the literature on diabetes costs in Africa has been conducted. The aim of this paper is to capture the evidence on the cost of diabetes in Africa, review the methods used to calculate costs and identify areas for future research. METHODS: A desk search was conducted in Pubmed, Medline, Embase, and Science direct as well as through other databases, namely Google Scholar. The following eligibility criteria were used: peer reviewed English articles published between 2006 and 2016, articles that reported original research findings on the cost of illness in diabetes, and studies that covered at least one African country. Information was extracted using two data extraction sheets and results organized in tables. Costs presented in the studies under review are converted to 2015 international dollars prices (I$). RESULTS: Twenty six articles are included in this review. Annual national direct costs of diabetes differed between countries and ranged from I$3.5 billion to I$4.5 billion per annum. Indirect costs per patient were generally higher than the direct costs per patient of diabetes. Outpatient costs varied by study design, data source, perspective and healthcare cost categories included in the total costs calculation. The most commonly included healthcare items were drug costs, followed by diagnostic costs, medical supply or disposable costs and consultation costs. In studies that reported both drug costs and total costs, drug costs took a significant portion of the total costs per patient. The highest burden due to the costs associated with diabetes was reported in individuals within the low income group. CONCLUSION: Estimation of the costs associated with diabetes is crucial to make progress towards meeting the targets laid out in Sustainable Development Goal 3 set for 2030. The studies included in this review show that the presence of diabetes leads to elevated costs of treatment which further increase in the presence of complications. The cost of drugs generally contributed the most to total direct costs of treatment. Various methods are used in the estimation of diabetes healthcare costs and the costs estimated between countries differ significantly. There is room to improve transparency and make the methodologies used standard in order to allow for cost comparisons across studies.

Background. Dental caries (decay or cavities) is a breakdown of teeth as a result of bacteria. Dental caries is one of the preventable oral health problems and the most common chronic diseases in childhood. Poor dental and oral health affect the quality of children’s life. Objectives. To estimate the prevalence of dental caries and its associated factors among primary school children in Alem Ketema, North Showa, Ethiopia. Methodology. An institution-based quantitative cross-sectional study was conducted on 422 primary school children, from February 9 to March 8, 2020. Pretested structured questionnaire and oral examinations were conducted by using the WHO criteria (DMFT) index to collect the data. The data were entered into Epi-Data 3.1 software, and analysis was carried out using SPSS version 23 and variables with <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> </a:math> value ≤0.05 in the multivariable binary logistic analysis were considered as a cut-point to declare statistical significance. Result. The prevalence of dental caries was 46.9% (95% CI: 42.1, 51.7). The mean Decayed, Missing, and Filled Teeth (DMFT) index was 1.28 (±1.21). Being male (AOR = 1.975, 95% CI = 1.067–3.66), lack of parents’ insistence (AOR = 2.052, 95% CI = 1.079–3.902), lack of oral health education program (AOR = 4.753, 95% CI = 1.69–13.38), history of dental aches (AOR = 2.88, 95% CI = 1.55–5.32), and poor habit of mouth wash (AOR = 4.74, 95% CI = 2.55–8.79) were found significantly associated with dental caries. Conclusion. The prevalence of dental caries was higher and a common public health problem among school children. Lack of parent’s insistence, sex, dental ache history, poor practices of mouth wash, and lack of oral health education were significant predictors of dental caries. Therefore, oral health education program and parents encouraging their children to practice oral hygiene are important to prevent dental caries.

Background: Patient satisfaction is related to the quality of services received and the extent to which specific needs are met. Satisfied patients are likely to come back for the health services and recommend it to others. Objective: To assess and compare patients’ satisfaction with the quality of prenatal/antenatal care (QPC) services received at a tertiary and secondary health facility in Ibadan, Nigeria. Methods: A comparative cross sectional study used an interviewer administered questionnaire to assess and compare the quality of antenatal care among women who had antenatal care and delivered live baby in two government health facilities—Adeoyo Maternity Hospital (secondary health facility) and University College Hospital (tertiary health facility). A total of 500 women were interviewed within 48 hours post delivery and data obtained was analyzed with SPSS version 20. Results: The mean age was 29.7 (SD = 4.95) years. About half of the respondents had more than four antenatal visits, almost two-thirds (61.4%) were primipara, and 55.6% delivered per vagina. Almost all (98.4%) the women were very satisfied with the QPC received while a little above half (54.0%) received high QPC. Health facility and mode of delivery were found to be significantly associated with the satisfaction of the QPC. Factors predicting high QPC comparing the tertiary and secondary health facility are “availability” (OR = 0.341, 95%CI = 0.173 - 0.672) and “support and respect” (OR = 5.599, 95%CI = 3.621 - 8.659) of health care workers. Conclusion: Though the women were very satisfied with the QPC rendered barely half of them reported high quality QPC and this should be the ultimate aim. Promoting and ensuring high quality of antenatal care in our hospitals will improve the antenatal attendance and hospital deliveries with subsequent reduction in maternal morbidity and mortality.