Open Access Review Article

Reproductive Health: Need of the Hour

. Diksha, C. K. Singh, . Priyanka

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/ajmah/2021/v19i930361

Reproductive health of women remains a major development task in any country. Reproductive health is a state of complete physical, mental and social well-being and not simply the absence of any disease, in all matters relating to the reproductive system and to its functions and processes. The Review Article outlines the current literature on women's reproductive health which consist abortion, sexually transmitted disease, child and forced marriage, contraceptive methods etc. current statistics related to women reproductive health also discussed in this paper. Reproductive health of women is maintained by reducing fertility rate and spacing among births. The use of various contraceptives is best known alternative. Health status of women has ramification and impact on the human well-being, economic growth and on their families also. Woman with poor health are likely to give birth to low weight infants and less care to their children.  Moreover, Indian women have high mortality rates, particularly during childhood and in their reproductive years. Other problems in women in India are low level of education, son preference, pressure of dowry, lack of independence and decision making. All these factors also have impact on the health of women (Reproductive Health Strategy, 2010). In this review paper, the efforts are made to discuss reproductive health and related issues of Indian women. Review article concluded that reproductive system of females comprises of the ovaries, fallopian tubes, vagina uterus, mammary glands, breasts, and vulva. All of these female genital organs play significant roles in the production and transportation of gametes and also production of sex hormones. There are different life stages accompanying with sexual subsists and reproductive health issues that include fertility, contraception, menstruation, menopause, sexually transmissible infections and chronic health problems like PCOS or PCOD etc. Taking care of reproductive systems in the female body requires attention to one’s health and regular check-ups.

Open Access Review Article

Impact of COVID-19 Variants on the Second Wave in India and Subsequent Discretion of Possibilities of the Third Wave

Sudarshan Ramaswamy, Meera Dhuria, Sumedha M. Joshi, Deepa H Velankar

Asian Journal of Medicine and Health, Page 115-126
DOI: 10.9734/ajmah/2021/v19i930373

Introduction: Epidemiological comprehension of the COVID-19 situation in India can be of great help in early prediction of any such indications in other countries and possibilities of the third wave in India as well. It is essential to understand the impact of variant strains in the perspective of the rise in daily cases during the second wave – Whether the rise in cases witnessed is due to the reinfections or the surge is dominated by emergence of mutants/variants and reasons for the same. Overall objective of this study is to predict early epidemiological indicators which can potentially lead to COVID-19 third wave in India.

Methodology: We analyzed both the first and second waves of COVID-19 in India and using the data of India’s SARS-CoV-2 genomic sequencing, we segregated the impact of the Older Variant (OV) and the other major variants (VOI / VOC).  Applying Kermack–McKendrick SIR model to the segregated data progression of the epidemic in India was plotted in the form of proportion of people infected. An equation to explain herd immunity thresholds was generated and further analyzed to predict the possibilities of the third wave.

Results: Considerable difference in ate of progression of the first and second wave was seen. The study also ascertains that the rate of infection spread is higher in Delta variant and is expected to have a higher threshold (>2 times) for herd immunity as compared to the OV.

Conclusion: Likelihood of the occurrence of the third wave seems unlikely based on the current analysis of the situation, however the possibilities cannot be ruled out. Understanding the epidemiological details of the first and second wave helped in understanding the focal points responsible for the surge in cases during the second wave and has given further insight into the future.

Open Access Original Research Article

First-aid Resources Availability and Attitudes of Senior High School Students in Tamale Metropolis, Ghana

Mohammed Mustapha Ibrahim, Amina Jibril, Atinga Adam Abdul Razak, Ruth Nimota Nukpezah

Asian Journal of Medicine and Health, Page 9-16
DOI: 10.9734/ajmah/2021/v19i930362

Aims: This study aims to explore the availability of first-aid resources in Senior High Schools and the attitudes of students towards giving first-aid in Tamale Metropolis, Ghana.

Methods: A cross-sectional study design was performed. This study was conducted in three different senior high schools, namely, Ghana Senior High School, Business Senior High School and Vitting Senior High School during April - July 2020.

The study recruited 381 students across the three schools. Students were categorized per their course of study and randomly sampled to attain the sample size. The median was used to determine the likeliest response of the ‘average’ respondent and Inter-Quartile Range (IQR) was used to measure dispersion in Likert scale questions.

Results: About 57.2% of participants stated that equipped first-aid kits were not provided in dormitories. All three schools lacked fire extinguishers in the dormitories. The schools also lacked equipped sick bays. A significant relationship was found between students’ perception of school safety and their attitude towards giving first aid (p-value = 0.005).

Conclusion: All schools had implemented the Ministry of Education safety standards and guidelines to a lesser extent. It is recommended that the Ministry of Education must play its supervisory role by ensuring the implementation of safety standards and guidelines on health and safety in the schools.

Open Access Original Research Article

Effects of Changing Anticoagulation with Unfractionated Heparin into Enoxaparin in Hemodialysis Patients:Prospective Non Randomized Unicentre Study

Abir Farouk Megahed, Mona Tawfik, Ghassoub Mustafa Hles, Hiba Ibrahim Ali Alsheikh, Nagy Sayed-Ahmed

Asian Journal of Medicine and Health, Page 17-29
DOI: 10.9734/ajmah/2021/v19i930363

Background: Maintaining the patency of the extracorporeal circuit (ECC) is required. The cost and long-term effect of anticoagulants on hemodialysis (HD) patients' parameters are still matters of concern. We aimed to study the effect of shifting to enoxaparin instead of unfractionated heparin (UFH) during HD and evaluate its efficacy, safety, and benefits.

Design and methodology: This study was conducted at Arar hospital, Kingdom of Saudi Arabia (KSA), and included 86 end-stage renal disease (ESRD) patients on HD for six months starting from October 2017. All patients had been on UFH as an anticoagulant during hemodialysis sessions before they were shifted to equivalent doses of enoxaparin sodium (Clexan®) as a therapeutic upgrade to start with. The patients’ files were examined retrospectively for the period of UFH therapy and then all patients were observed prospectively for at least 6 months while on Clexane. The occurrence of clotting in the dialysis sets were recorded and the need for urgent HD for each patient and the reasons. 

Results: There was a reduction of filter clots even with the reduction of enoxaparin dose. There was a significant reduction of mean cholesterol, calcium, phosphorus, sodium, chloride, and serum osmolality. We found a significant reduction of pre-dialysis potassium among those who presented with a pre-dialysis potassium of higher than 5.5 mg/dl during the enoxaparin phase. Patients, who had thrombocytopenia while on UFH; showed improvement in platelet count after the shift to enoxaparin. However, patients who had platelet count lowered than 150000/mm3 6 months after having been shifted to enoxaparin; many of them received HD through a permanent catheter. No patients had a three-fold increase of normal values (3ULN) of liver function tests whether being on heparin or enoxaparin.

Conclusion: Low molecular weight heparin (LMWH) could be more efficacious and safe than UFH with the improvement of some variables in HD patients.

Open Access Original Research Article

Assessment of the Adherence to Standard Operating Procedures of Covid-19 among Market Vendors in Sironko District

Ali Kudamba, Abdul Walusansa, Jamil E. Ssenku, Shaban A. Okurut, Habib Namagembe, Sumayah Nakitende, Muhamad Shaban Mubajje, Hussein Mukasa Kafero

Asian Journal of Medicine and Health, Page 30-43
DOI: 10.9734/ajmah/2021/v19i930364

Introduction: Coronavirus disease is one of leading causes of deaths in recent times that has surpassed cardiovascular and other respiratory diseases. The World Health Organization (WHO) setup Standard Operating Procedures (SOPs) that have been adopted by the different governments to curtail its spread. Nonetheless, information on the adherence to the SOPs amongst market vendors is not well elucidated. Moreover, markets are centers of convergence of many people which increases the risks of community transmission. Therefore, our study, investigated the extent of the adherence to the SOPs amongst market vendors in Sironko district.

Methodology:  A quantitative study with cross-sectional design was adopted with a sample size of 221 randomly selected participants. Pretested structured questionnaires were used in the data collection. Categorical data was presented in tables and graphs with frequency (%). Pearson’s Chi-square (X2) was used to examine the statistical significance of our results.  The analysis was done by using the statistical software MedCalc version 20.0008. All the analyses were done at 95% level of significance and a p<0.05 was considered statistically significant.

Results: A total of 221 participants were involved: 126, 57 % female, 80, 36% aged between 31-40 years and 158, 72% married.  Fever, dry cough, chest pain, arches & pain loss of speech & movements were the most reported signs and symptoms of COVID-19 (p<0.0001). Most of the respondents were aware of the SOPs, hand washing soap and adequate water were readily available (p<0.0001). The commonly implemented SOP was wearing face masks (p<0.0001). The radio talk shows & broadcasting were the main sources of information(p<0.0001). The inadequate facemasks and limited finances constrained the Implementation of SOPs (p<0.0001). 

Conclusion:  Most market vendors were aware of the COVID-19 SOPs and claimed they adhered. However, there is need to carry out a qualitative study to confirm the above claims.  

Open Access Original Research Article

An Appraisal of Malnutrition in Gynaecologic Cancer Patients Attending the Gynaecology Clinic in the University of Port Harcourt Teaching Hospital, Nigeria

Bassey Goddy, Igberase-Eromosele Temitope

Asian Journal of Medicine and Health, Page 44-51
DOI: 10.9734/ajmah/2021/v19i930365

Background: Malnutrition in cancer patients is associated with increased risk of adverse effects including mortality and thus requires special attention.

Objective: The aim of this study was to determine the prevalence and factors affecting malnutrition amongst gynaecological cancer patients at the University of Port Harcourt teaching hospital (UPTH).

Methodology: This was a prospective cross-sectional study involving 74 patients with histologically confirmed genital tract malignancies at the UPTH. A structured proforma was used to obtain nutritional history from the participants while the serum albumin level was used to determine the nutritional status. Data entry and analysis was conducted using SPSS version 25 software package. Results were presented in simple frequency tables and percentages. Chi square test was used to compare categorical variables and p value less than 0.05 was considered significant.

Results: The prevalence of malnutrition was 39.19%. The age range of participants was 26-92 years with most (25.7%) in the 4th decade. Patients with cervical and ovarian malignancies were more at risk of malnutrition. Low socioeconomic status, advanced stage disease, and reduced food intake were significantly associated with malnutrition. Poor appetite and early satiety were associated with poor food intake.

Conclusion: Malnutrition is highly prevalent amongst the study population. Cervical and ovarian cancer patients were more likely to suffer from malnutrition. Improvement in socioeconomic status and early detection of malignancy will improve the nutritional status of the study population.

Open Access Original Research Article

Psychological Impact of Diabetic Care on Satisfaction and Quality of Life of Diabetes Patients Attending Endocrinology Clinic, LAUTECH Teaching Hospital, Osun State, Southwest, Nigeria

Afolalu, Olamide Olajumoke, Akinwale, Oladayo Damilola, Makinde, Scholastica Omobolaji, Olawale, Stephen Gbadebo, Folami, Roseline Olufunmilola, Orunmuyi, Idowu Janet

Asian Journal of Medicine and Health, Page 52-62
DOI: 10.9734/ajmah/2021/v19i930366

Aims: Diabetes mellitus (DM) is a complex, debilitating and chronic illness that presents substantial challenges to every individual living with the condition. The impact of DM reaches far beyond the physical symptoms of the disease, often the emotional distress and psychosocial impact on the quality of life (QoL) of these patients complicates the effective management of the disease. Therefore, the objective of this study was to evaluate the impact of psychological experience and satisfaction with diabetic care on quality of life of diabetes patients.

Study Design: This was a descriptive research survey design carried out among diabetes patients attending endocrinology clinic of LAUTECH Teaching Hospital, Osogbo, Osun State, Southwest, Nigeria between August to December 2020. 

Methodology:  Sample size determination was obtained using Taro Yamane’s formula and sample consisted of one hundred and ten (110) diabetic patients attending endocrinology clinic of  LAUTECH Teaching Hospital, Osogbo. Samples were selected using convenience sampling method. Data were collected using modified Kessler psychological distress scale and Diabetes Quality of life Instrument and analyzed using descriptive statistics of frequencies, percentages and table. Inferential statistics of chi-square was used to test hypotheses at 0.05 level of significance. Results: The results showed that more than half of the patients had poor psychological experience 61(55.5%) with diabetic care, though majority were satisfied 66(60.0%) with diabetic care but demonstrated poor quality of life 65(59.1%). The result also showed a significant relationship between psychological experience and quality of life (x2=5.564; df=1; p-value=0.018), level of satisfaction with diabetic care and quality of life (x2=25.280; df=2; p-value=0.000), level of satisfaction with diabetic care and psychological experience of diabetes patients (x2=25.185; df=1; p-value=0.000).

Conclusion: Promotion of psychological wellbeing of diabetes patients and quality outcome of diabetic care as well as patient-centered psychological care are essential by providing care that is respectful and responsive to individual patient preferences, needs and values.

Open Access Original Research Article

Effects of Age and Sex on the Healing of Acetic-Acid Induced Ulcerative Colitis in Adult Wistar Rats

Serah F. Ige, Waliyat O. Aremu, Bolade S. Olateju, Victor A. Oladipupo, Adedayo T. Adekola

Asian Journal of Medicine and Health, Page 63-73
DOI: 10.9734/ajmah/2021/v19i930367

Aims: Ulcerative colitis is a disease of the bowel that occurs in all ages and affects both males and females. This research study was designed to investigate the effect of age and sex on the healing of colitis in rats.

Methodology: Twenty - eight rats were randomly distributed into four groups of seven animals per group; adult male rats, mid age male rats, adult female rats and mid age female rats. Mid age and adult Wistar rats were 7- 8weeks and 14 weeks old respectively. Colitis was induced through a single intra-colonic instillation of 7% acetic acid (1mL/100g body weight) and allowed to heal for 14 days. Blood samples were obtained for analysis. Colon samples were also obtained for histomorphological study and biochemical assays (Myeloperoxidase activities, Superoxide dismutase, Glutathione, Catalase and Malondialdehyde) levels.

Results: There was no significant difference in Malondialdehyde concentration, catalase, Superoxide dismutase, Myeloperoxidase, Platelet Distribution Width, Platelet Count, Basophil cell numbers, Eosinophil cell numbers, platelet cells, Mean Platelet Volume , Mean Cell Volume and white blood cells across the groups. The Glutathione concentration in mid age male rats was significantly increased when compared with adult male rats. The haemoglobin , Lymphocytes and Mean Cell Haemoglobin levels were increased while neutrophils and monocyte levels were decreased in the younger female rats. The histomorphological study revealed poorly preserved surface epithelia layer of the colon in adult male rats while mid age male and female rats showed moderately preserved surface epithelia layer, adult female rats showed normal surface epithelia layer.

Conclusion: Mid age rats heal faster than adult rats while in terms of sex, female rats tends to heal faster than male rats.

Open Access Original Research Article

Umbilical Cord Prolapse and Perinatal Outcomes in a Tertiary Hospital in Yenagoa, South-South Nigeria: A 5-Year Review

P. C. Oriji, D. O. Allagoa, D. C. Briggs, M. N. Chika, A. E. Ubom, C. E. Unachukwu, G. Atemie

Asian Journal of Medicine and Health, Page 74-83
DOI: 10.9734/ajmah/2021/v19i930368

Background: Umbilical cord prolapse is an obstetric emergency when the foetus is still alive, and it is associated with high foetal morbidity and mortality. If umbilical cord prolapse occurs outside the hospital, mortality rate can be as high as 44% – 70%, and as low as 3% when it occurs in the hospital.

Objective: To determine the incidence of umbilical cord prolapse and the perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over 5 years.

Materials and Methods: This retrospective survey was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables.

Results: Forty-one women had umbilical cord prolapse out of 4,571 deliveries, giving a case incidence rate of 8.9 per 1,000 deliveries. About three-quarters (75.6%) of the women were multiparous. A fifth (21.9%) of the foetuses died in-utero, while 27 (65.9%) babies survived. Five (15.6%) babies had severe birth asphyxia, and died (early neonatal death) in the special care baby unit. Decision-to-delivery interval was ≤ 30 minutes in only 12.5% of patients.

Conclusion: Umbilical cord prolapse is associated with significant perinatal morbidity and mortality. Prompt diagnosis and intervention are very key in preventing adverse perinatal outcomes.

Open Access Original Research Article

Phacoemulsification: Awareness among Postoperative Cataract Patients in South East Nigeria

Arinze Anthony Onwuegbuna, Akunne Ijeoma Apakama, Ejike Ekene Igboegwu, Emeka Akujuobi Chianakwalam, Miriam-Benigna Chika Amobi, Chuka Michael Okosa, George Uchenna Eleje

Asian Journal of Medicine and Health, Page 84-89
DOI: 10.9734/ajmah/2021/v19i930369

Objective: To determine the awareness of phacoemulsification among post operative cataract patients.

Methods: This was a prospective descriptive cross-sectional study to assess the knowledge of phacoemulsification among postoperative cataract patients that presented in community eye care outreaches in 3 local government areas of Anambra State Nigeria between June 21st 2021 to June 25th 2021.

Results: The total number of people that attended the outreaches during the study period were 975. Out of these, 167 participants had cataract surgery but only 155 (n=155/167) consented to the study, giving a response rate of 92.8%. The mean age was 67±13 years with an age range of 18 to 93 years. The male: female ratio was 1: 1.2. There were more females (n=84/155, 54.2%) than males (n=71/155, 45.8%).Majority obtained only primary education (n=74/155, 47.7%), while 20.6% (n=32/155) obtained secondary education, 14.2% (n=22/155) obtained tertiary education while 17.4% (n=27/155) had no formal education

Conclusion: Most cataract blind people in Nigeria are not aware of phacoemulsification cataract surgery and therefore may limit options for modern treatment of cataract blindness, even though this modern method of cataract treatment has been in place for decades in other countries.

Open Access Original Research Article

Blood Culture and Widal Test as Diagnostic Tools for Enteric Fever with Antibiogram in a Tertiary Care Centre at Dhaka in Bangladesh

Sushmita Roy, Iftikhar Ahmed, Provash Chandra Saha, Bhuiyan Mohammad Mahtab Uddin, Mejbah Uddin Ahmed, Md. Abdullah Yusuf

Asian Journal of Medicine and Health, Page 97-106
DOI: 10.9734/ajmah/2021/v19i930371

Background: Enteric fever still exists as one of the major public health issue occurring in our country. Antimicrobials are the mainstays of treatment of typhoid fever. Due to rapidly growing antibiotic resistance, Salmonella spp. is required to be periodically tested for susceptibility patterns. This will also enable planning of rational use of antibiotics.

Objective: To observe the diagnostic accuracy of enteric fever by blood culture and Widal test in a tertiary care center, at Savar, Dhaka; Bangladesh. Antimicrobial sensitivity pattern of this study will guide to modify recent changes in the trends of antimicrobial use at the local level.

Methodology: Blood samples were collected from 2194 febrile patients with clinically suspected enteric fever cases at a Tertiary Care Outdoor Centre from January 2017 to March 2020. Blood culture was performed to isolate S. typhi and S. paratyphi. Widal tests were done for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and anti TH were taken as a cut off value to indicate recent infection of typhoid fever. Antibiotic susceptibility testing was carried out using modified disk diffusion (Kirby–Bauer) technique.

Results: Out of 111 Salmonella isolates, 74 (5%) were S. typhi and 37 (25%) were S. paratyphi A.  Total 697 samples were positive for Widal test. A large number of isolates showed resistance to commonly used antibiotics such as nalidixic acid (94.6%), chloramphenicol (87.3%), amoxicillin (76.6%), cephradine (53.1%), azithromycin (46.8) etc. Resistance to cefixime and cefipime, ceftriaxone tended to increase than past. Imipenem, moxifloxacin and cefuroxime are escalating resistance which is alarming.

Conclusion: Blood culture is the most reliable among the diagnostic methods but it needs 5 to 7 days for delivery of final report. This delay leads to late diagnosis as well as provision of irrational usage of antibiotics. It is concluded that widal test would remain relevant as a diagnostic tool for enteric fever, which is more convenient, cheaper and faster than the other molecular tests. Our study revealed the antibiotic susceptibility of Salmonella isolates will be recommended for addressing the drug resistance.

Open Access Original Research Article

A Comparative Study on Oxygen Saturation, Breath Rate, Lung Parameters, Anxiety and Depression Level in Geriatric Population

P. Chaitra Bhat, K. U. Dhanesh Kumar, Subhashchandra Rai, K. B. Riyas Basheer

Asian Journal of Medicine and Health, Page 107-114
DOI: 10.9734/ajmah/2021/v19i930372

Background: Ageing has been associated with multiple medical conditions mainly due to impaired immune mechanisms and deteriorating physiological reserves such as declining physical health, increased risk for mental and emotional problems, economic constraints, changing roles and changing lifestyles. Chronic psychological and physical illnesses among geriatrics were studied univocally. Hence present study aimed to compare the effect of yoga techniques and conventional exercises.

Methods: 40 subjects participated in the form of group therapy based on the selection criteria. Yoga group received yogic Relaxation and pranayama (10 min each) and exercise group received supine rest and diaphragmatic breathing (10 min each) for four days per weeks continued for three months. Outcome measures were evaluated before the intervention and after three months of participation.

Results: The Oxygen saturation in yoga group were 96.4±1.39 and 97.05±1.19, and in exercise group 96.7±1.45 and 97.7± 0.73 in pre and post assessment. The breath rates in yoga group were reduced to an average of 19.1 and 19.65 in exercise group after 3 months. The mean vital capacity (L/min), FEV1 (mL/sec), FVC (L/min) in yoga group after 3 months were 1.72 ± 0.2, 1.53 ± 0.17 and 1.47 ± 0.1 and in exercise group were 0.72 ± 0.13, 0.70 ± 0.13 and 0.69 ± 0.13 after the intervention. The mean anxiety and depression measured with HADS were 8.9 ± 0.8 & 7.45 ± 0.75 and 9.0 ± 0.72 & 7.9 ± 0.8 pre and post respectively in Yoga Group & Exercise Group.

Conclusion: Yogic relaxation and pranayama is equally effective in supine rest and diaphragmatic breathing in improving oxygen saturation, breath rate, lung parameters and anxiety and depression in geriatrics.

Open Access Original Research Article

Comparative Evaluation of the Levels of CD4+ and CD8+ T-Cells, Viral Load, and Some Immunomodulatory Trace Elements in ART and ART-naïve HIV Patients in Port-Harcourt, Nigeria

Ugochukwu Chioma, Helen Anthony Waribo, Donatus O. Onwuli

Asian Journal of Medicine and Health, Page 127-133
DOI: 10.9734/ajmah/2021/v19i930374

Aim: To evaluate the levels of CD4+ and CD8+ T-cells, viral load, and some immunomodulatory trace elements in ART and ART-naïve HIV patients in Port-Harcourt, Nigeria.

Methodology: A total of 150 subjects (males and females) between the ages of 20 and 79 were recruited for the study, out of which 50 subjects were apparently healthy (those who tested negative for HIV), and were used as the control group, while the remaining 100 subjects were those who tested positive for HIV, and were used as the test group; out of this 100 subjects, 70 subjects were on anti-retroviral therapy (ART), while the remaining 30 subjects were not on anti-retroviral therapy (ART naïve). About 13 mls of venous blood was collected from the antecubital fossa of each subject. 3mls was dispensed into an EDTA-anticoagulant bottle, and used for the estimation of CD4+ and CD8+ counts using a BD fluorescent activated cell sorter count (FACSC count) automation. Also, 5mls of the venous blood was dispensed into another EDTA-anticoagulated bottle; it was spun to obtain the plasma which was used to analyze the viral load using real time polymerase chain reaction (RT-PCR) COBAS TaqMan 48 Analyzer. Then, another 5 mls of the venous blood was dispensed into lithium heparin bottle; it was spun to obtain the plasma, which was used for the analysis of copper, iron, zinc and magnesium by colorimetric method using semi auto-analyzer WP 21E, and selenium using atomic absorption spectrophotometer with graphite furnace technique SN-SG 710690.

Results: The results showed that there was no significant difference (p>0.05) in the mean levels of CD8+ T-cell, iron and magnesium between the HIV-positive subjects (ART HIV-positive and ART-naïve HIV-positive) and the control. However, the mean levels of CD4+ T-cell and plasma copper were significantly lower (p<0.05) in the HIV-positive subjects compared to the control; also, the mean levels of the CD4+ T-cell in the ART-naïve subjects were significantly lower compared to the ART subjects. The viral load in ART-naïve subjects were significantly higher compared to the ART subjects and control. However, the mean levels of zinc and selenium were significantly lower in the HIV-positive subjects compared to the control.

Conclusion: Based on these results, it may be stated that some immunomodulatory trace elements such as zinc and selenium were deficient in HIV-positive subjects, and as such, addition of zinc and/or selenium supplements in the treatment regimen for HIV-positive subjects may be helpful in boosting their immunity and effective management.

Open Access Original Research Article

Risk Asessment and Thromboprophylaxis for Venous Thromboembolism (VTE) in the Antenatal Population in a Tertiary Health Facility in Nigeria

Mkpe Abbey, Green Kinikanwo

Asian Journal of Medicine and Health, Page 134-142
DOI: 10.9734/ajmah/2021/v19i930375

Aim: To review the venous thromboembolism (VTE) risk assessment and thromboprophylaxis in the antenatal population in a tertiary health facility in Nigeria and to perform a retrospective VTE risk assessment of the patients with a view of determining those patients that would have needed VTE prophylaxis.

Design: It was a retrospective cross-sectional study.

Place and Duration of Study: The study was carried out at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria from the 1st of February to the 30th of April, 2020.

Materials and Methods: The following data were extracted from the hospital notes of 347 consecutive antenatal patients: history/demographic characteristics, risk factors for VTE, thromboprophylaxis, diagnosis and treatment of VTE, using the RCOG guideline 37a of 2015 as a benchmark for comparison. Data was analysed with the aid of a Statistical Package for Social Science (SPSS) software, version 18.

Results: VTE risk assessment and thromboprophylaxis  was not a routine practice at the UPTH. Apart from antenatal admission, the most frequent VTE risk factors in pregnancy were  BMI ≥30, Parity ≥ 3, Age > 5 years and current pre-eclampsia at 48.48%, 41.04%, 36.04% and 15.56% of the study population respectively. 131 (37.75%) of the 347 antenatal population fulfilled the criteria for venous thromboprophylaxis with low molecular weight heparin (LMWH) but they were not assessed and the drug was not given. 63 (18.16%) of the study population was to receive LMWH from 28 weeks of pregnancy while 68 (19.60%) of them were to be given from the first trimester. The prevalence of VTE was however very low at 0.02% (1 patient out of the 347 maternities), irrespective of the fact that 41 (11.82%) of the patients had symptoms and signs of VTE.

Conclusion: 131 (37.75%) out of the total 347 antenatal patients fulfilled the criteria to be given thromboprophylaxis but the prevalence of VTE was low at 0.02%. It was therefore recommended that a unified Nigerian national guideline should be written.

Open Access Case Report

Torsion of the Ovary in Infancy, a Rare Emergency; A Case Report

Abdelilah Radi, Karima Larbi Ouassou, Amal Hassani, Rachid Abilkassem, Aomar Agadr, Hicham Zerhouni

Asian Journal of Medicine and Health, Page 90-96
DOI: 10.9734/ajmah/2021/v19i930370

Torsion of the ovary is a rare condition whose diagnosis remains difficult given the non-specificity of the clinical picture as well as the difficulty of clinical evaluation, especially in young girls. It is a surgical emergency because it involves the vital prognosis by the hemorrhagic risk, and functional prognosis by the risk of infertility. The clinical picture is dominated by acute abdominal pain. Our work reports the case of a 2-year-old girl in whom the diagnosis of ovarian torsion was made in front of an atypical clinical picture. Laparoscopy is the method of choice for making a positive diagnosis and performing a conservative procedure as described in this work.