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   Table of Contents - Current issue
Coverpage
January-March 2022
Volume 19 | Issue 1
Page Nos. 1-48

Online since Monday, March 7, 2022

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EDITORIAL  

Faculty of clinical sciences to hold its first international conference p. 1
Adesoji O Ademuyiwa
DOI:10.4103/jcls.jcls_17_22  
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ORIGINAL RESEARCH REPORTS Top

Knowledge, attitude, and anxiety of Nigerian nurses toward coronavirus: An online cross-sectional survey p. 2
Ogechi Helen Abazie, Oluwafunmilola Mary Mobolaji-Olajide, Linda Chihurunanya Odikpo, Emon Umeh Duke, Dooshima Dorothy Gbahabo, U Ayishetu Musa-Malikki
DOI:10.4103/jcls.jcls_10_21  
Background: Health care workers have been affected the most by coronavirus all over the world. Their knowledge and attitude toward caring for people with coronavirus have neither reduced their anxiety nor number of casualties from the pandemic. The aim of this study is on knowledge, attitude, and anxiety of Nigerian nurses toward coronavirus. Methods: A cross sectional, online quantitative survey of the six geopolitical zones in Nigeria was done using multistage sampling technique. Data were collected using Google Forms from 209 nurses, and the Statistical Package for the Social Science (SPSS) version 20 software was used for data analysis. Level of anxiety was determined using Generalized Anxiety Disorder Assessment. Descriptive data of participants were presented in tables, charts, percentages, means, and standard deviation, while the inferential data were tested with Chi square at a significance level of P = 0.05. Results: Mean age of the respondents was 41.01 ± 8.21 years, with 13.1 ± 8.44 years as mean for years of experience. Only 57% had good knowledge with mean of 10.67 ± 1.197, while 70.8% had positive attitude toward nursing care during coronavirus pandemic. Anxiety level increased from 1.88 ± 0.82 before to 2.33 ± 0.96 during the pandemic. Association of knowledge and anxiety before and during was P = 0.79 and P = 0.27, respectively. Gender and age were significant with anxiety during the pandemic with P = 0.01 and P = 0.02, respectively. Conclusion: Adequate knowledge with positive attitude may not be enough to reduce the anxiety level of nurses, hence the need for adequate psychosocial support and provision of personal protective equipment for the nurses in other to keep them safe for optimum health workforce.
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Perception of healthcare workers towards the government's Coronavirus disease 2019 pandemic response in Ekiti State, Nigeria: A cross sectional study p. 10
Adeyinka Adeniran, Esther O Oluwole, Florence C Chieme, Babatunde Olujobi, Marcus M Ilesanmi, Omobola Y Ojo, Modupe R Akinyinka
DOI:10.4103/jcls.jcls_14_21  
Background: Globally, coronavirus 2019 pandemic has led to severe illnesses, loss of lives, and social disruption in Nigeria. Ekiti State government introduced different strategies, protocols, and standard operating procedures in the control of the pandemic. This study assessed the perception of primary healthcare workers (HCWs) to the measures introduced to combat the coronavirus disease 2019 (COVID-19) pandemic in Ekiti State, Nigeria. Methods: This study was a descriptive cross-sectional study conducted between August and September 2020 among primary HCWs in Ekiti State. A Google survey tool was used to create an online questionnaire which was administered to respondents on social media platform. Analysis was done using STATA SE 12. Descriptive and bivariate analysis were conducted with a level of significance set at P < 0.05. Results: The mean ± standard deviation age of the respondents was 44.2 ± 6.7 years. Almost all (99.4%) of respondents had heard of COVID-19 pandemic while less than three-quarter (67.7%) had been trained on COVID-19. About half (54.6%) and (50.0%), respectively had good knowledge and perception of COVID-19, while three-quarter (75%) had good practice. About half (50.4%) had good perception about government's response toward COVID-19 prevention and protocols. Social and news media and family and friends were significantly associated with respondents' perception toward government' response (P = 0.000; 0.006 and 0.011) respectively. Similarly, the level of perception and practice of respondents were found to be statistically significant with respondent's perception of government response to COVID-19 (P = 0.001 and 0.040) respectively. Conclusion: Only about half of the respondents had good knowledge of COVID-19 and positive perception toward government's response to COVID-19 pandemic. Intensification of government's efforts toward the pandemic control in Nigeria is recommended.
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Folliculitis keloidalis in an urban market in Lagos, Nigeria: A community survey p. 17
Olusola Olabisi Ayanlowo, Ehiaghe Lonia Anaba, Ayesha Omolara Akinkugbe, Erere Otrofanowei, Olufolakemi Cole-Adeife, Moses Karami
DOI:10.4103/jcls.jcls_49_21  
Background: Folliculitis keloidalis (FK) also known as acne keloidalis nuchae is a follicular scalp disease found predominantly in males of African origin. Studies suggested that FK is associated with hair care practices and shaving. This study aimed to determine the prevalence of FK in a community in Lagos. Methods: This was a community-based, cross-sectional study at the Sandgrouse market in Lagos Island, Nigeria. Self-administered questionnaires were used to obtain demographic and clinical information. Diagnosis of FK was clinical and included follicular and keloidal papules, pustules, nodules, and tumors at the nape, sometimes spreading to other parts of the scalp, with intense itching. Results: A total of 100 males and 207 women were enlisted in the study and clinically evaluated for features of FK. None of the female participants presented with history and clinical features of FK. Seventy-five percent were between the age of 30 and 60 years. Fifteen male participants had a prior history of FK on the scalp and eight had previous treatment. Examination revealed the presence of FK in four respondents (4%): 3 had only on the scalp and one had on both the scalp and the beard area; and none had keloidal lesions. Conclusion: All respondents with FK presented at the early stage with keratotic/follicular papules. We posit that self-treatment with antibiotics and triple action creams (consisting of potent steroids, antifungal, and antibiotic) sold in the market and over the counter is responsible for the early and mild presentation.
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Knowledge, attitude, and prescribing practices of antimicrobials among doctors in the outpatient departments of Lagos university teaching hospital Idi-Araba: A cross sectional study p. 22
Babatunde Akodu, Raheem Bisola, Ladi-Akinyemi Temitope, Lawal Abdulrazzaq, Oshun Philip, Baiyeroju Ibukunoluwa, Orumbie Patrick, Olokodana-Adesalu Olufunmilayo, Oyeleke Ganiya, Osuagwu Chioma, Oduyebo Oyinlola
DOI:10.4103/jcls.jcls_32_21  
Background: Antimicrobial prescription becomes inappropriate when there is overprescribing, unsuitable dosage and when patients do not complete their treatments. In the outpatient settings, irrational prescription of antibiotics is more evident and has led to the development of resistance, adverse reactions, and increased health care costs. Understanding the knowledge, driving forces and practices of prescribing antibiotics is a step towards ensuring rational use of antibiotics. The study aimed to assess the knowledge, attitude, and practice of antimicrobial prescription among doctors in the outpatient departments of Lagos University Teaching Hospital Idi-Araba. Methods: This was a cross-sectional study conducted consecutively among 259 doctors in the outpatient departments of LUTH. Data entry and analysis were performed using Epi info software version 7. The level of statistical significance was at P < 0.05. Results: The mean age of the respondents was 33.5 ± 6.9 years. Majority of the respondents were males (58.7%). One-third (39%) had between 6 and 10 years of work experience. One-fifth (20.8%) of the respondents were from the department of surgery. Almost all (98.8%) had an overall good knowledge of antibiotics. Majority, (95.4%) had a good attitude towards prescribing. Two-third (63%) requested for a laboratory test before prescribing. However, less than half (44.4%) prescribed based on guidelines and more than half (56.8%) had received trainings on antibiotics prescriptions. Two-third (63.7%) of the respondents had good prescribing practices. There was a statistically significant association between the years of work experience and knowledge of prescribing antibiotics (P = 0.036). Conclusion: Majority had good knowledge and positive attitude toward prescribing. The severity of infection, availability of the drug, cost of the drug, and clinical response of the patients were the major predictors of antimicrobial prescription of the respondents. Antimicrobial stewardship programs should be enhanced and antibiotic surveillance should be improved.
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Colonic polyps in Nigerians, a change in trends: A retrospective single-center clinicopathological study p. 31
Omolade O Adegoke, Mustapha Akanji Ajani, Ifeanyichukwu D Nwanji
DOI:10.4103/jcls.jcls_31_21  
Background: Adenomatous polyps in the colon are recognized precursors of colorectal carcinoma; however, the low incidence of these polyps in sub-Saharan Africans has led many to believe that the pathway of colorectal cancer may differ in this region. The objective of this study was aimed to determine the change in trends of colonic polyps in Nigeria. Methods: This was a 10-year retrospective review of all colonic polyp specimens received at the Department of Pathology in our hospital utilizing the histopathology request cards and hematoxylin and eosin-stained slides. The data were analyzed using the IBM SPSS Statistics (version 23; IBM Corporation, Armonk, New York, USA). Results: A total of 131 cases were reviewed. The age of patients ranged from 5 to 86 years with a mean age of 55 years. The male-to-female ratio was 1.6:1. The mean age was 59.4 years. Of the 131 cases reviewed, 62 patients had adenomatous polyps, 49 had inflammatory polyps while 20 others included juvenile polyps, hyperplastic polyps, and hamartomatous polyps. Conclusion: Adenomatous polyps are increasingly being seen among Africans in the sub-Sahara region and perhaps they are not as rare as it was once thought provided the facilities for the diagnosis are available. They may yet play a more important role than has been ascribed to them in the pathogenesis of colorectal carcinomas in Africans.
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Postmastectomy breast reconstruction awareness and attitudes in Nigerian women with breast cancer: A descriptive, cross sectional survey p. 35
Afieharo I Michael, Olayinka A Olawoye, Samuel A Ademola, Ebere Osinachi Ugwu, Foluke O Sarimiye, Omobolaji O Ayandipo, Rotimi O Aderibigbe, Ayodele O Iyun, Odunayo M Oluwatosin
DOI:10.4103/jcls.jcls_28_21  
Introduction: Sub-Saharan Africa has a high burden of breast cancer and very low rates of breast reconstruction. This study aimed to determine the awareness of and attitude to breast reconstruction among women with breast cancer who had mastectomy. Methods: A cross-sectional study of women with breast cancer who underwent mastectomy was done. Participants were recruited from September 2020 to January 2021 from the surgical oncology and radio-oncology outpatient clinics of the University College Hospital, Ibadan. A multivariate logistic regression was used to determine predictors of awareness and attitudes to breast reconstruction. P ≤ 0.05 was considered statistically significant. Results: Fifty-one women participated in the study. The mean age was 54.76 (+9.94) years. Most, 30 (58.8%) of them had tertiary level of education, were working, 39 (76.5%) and were married, 41 (80%). Funding for the mastectomies was mainly out-of-pocket 34 (66.7%). Most 37 (72.5%) were not aware that the breast could be reconstructed before their surgery and only one (1.96%) of the women had breast reconstruction. The reason most proffered for declining breast reconstruction was not wanting another surgery 13 (33.3%). The age (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.001–0.33), P = 0.006 of the participants and the educational status (OR 12.50, 95% CI 1.86–84.26), P = 0.009 were significant predictors of awareness of breast reconstruction. None of the variables were significant predictors of positive attitudes to breast reconstruction. Conclusion: There is a very low level of awareness of breast reconstruction. Younger age and tertiary education were significant predictors of awareness of breast reconstruction.
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CASE REPORT Top

Dunbar (or median arcuate ligament) syndrome: A case series p. 45
Praveen K Sharma, Pavankumar Mathapati, M Meyyappan, Keerthi Vatsan
DOI:10.4103/jcls.jcls_50_21  
Dunbar syndrome (DS) (or median arcuate ligament [MAL] syndrome) is a rare entity of the vascular compression syndrome, where there is focal proximal coeliac axis compression by MAL. It results in an insufficient supply of blood to the respective organs of the gastrointestinal tract. Multidetector computed tomography is a very convenient, noninvasive modality in diagnosing this condition and helpful in distinguishing it from other conditions, such as atherosclerotic disease. DS can further be treated disorder surgically by relieving the compression and sometimes may need vascular reconstruction. We present five cases of the DS.
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