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2022| January | Volume 25 | Issue 1
Online since
January 19, 2022
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ORIGINAL ARTICLES
Effectiveness of Kinesio Taping and Exercises for Pronated Feet in Children with Neurodevelopmental Disorders: A Cross Over Study
ST Parmar, HR Dhanuka, DR Shetty
January 2022, 25(1):21-26
DOI
:10.4103/njcp.njcp_62_21
PMID
:35046190
Background:
Taping is widely used intervention in various conditions treated by physiotherapist. Neurodevelopmental disorders in children leading to foot abnormality is one of the major concen. As taping is one of the intervention in same the study is focusing taping on pronated feet in the selected age group.
Aim:
The aim of this study was to investigate whether the kinesiotaping and exercise improve pronated feet in neurodevelopmental disordered (NDD) children.
Patients and Methods:
This was a cross over study, within subjects study evaluating two treatments, kinesio tape, and exercise. Thirty subjects with age group 6–12 years diagnosed with NDD having pronated feet. Subjects were allocated in the two groups. Group 1 included subjects for taping and Group 2 included subjects for exercise. Taping was applied for two consecutive weeks for 5 days per week and then 2 weeks of the window period, which was followed by two consecutive weeks of exercise sessions for 5 days per week. The navicular drop test and Foot Posture Index were measured pre and post treatment. Foot posture index used to examine the posture of foot and navicular drop test.
Results and Conclusion:
Group 1 (taping) and Group 2 (exercises) showed no significant results as a single entity, whereas there was a small effect seen of the intervention.
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Evaluation of Intermaxillary Fixation (IMF) Screw Therapy with Craniomandibular Index Analysis for Chronic Recurrent Dislocation in the Temporomandibular Joint
U Ertas, YE Ascl, E Yalcin, G Urvasizoglu
January 2022, 25(1):12-20
DOI
:10.4103/njcp.njcp_107_21
PMID
:35046189
Background:
Temporomandibular joint (TMJ) hypermobility is classified as a subluxation, complete (luxation), unilateral, or bilateral, acute, chronic protracted, or chronic recurrent dislocation.
Aims:
This controlled randomized clinical study aims to evaluate the effectiveness of intermaxillary fixation (IMF) screw application and autologous blood injections in the treatment of chronic recurrent dislocation of TMJ in comparison with the placebo group.
Patients and Methods:
The patients who were admitted to the Faculty of Dentistry of the Atatürk University between October 2018 and January 2020 were evaluated. Three hundred patients diagnosed with bilateral chronic recurrent dislocation of TMJ based on clinical findings and radiographs were included in the study. The patients were randomly divided into three groups according to the evaluation criteria. Group 1 received IMF, group 2 received autologous blood injection, and group 3 (placebo group) received an intraarticular saline injection.
Results:
The results of the patients who received IMF, autologous blood injection, and saline injection were evaluated by the craniomandibular index. The IMF group showed significant improvement after 1 month and 6 months (
P
< 0.001), while the patients who received autologous blood injection and saline injection showed no significant improvement (
P
> 0.05). The data were analyzed with IBM SPSS V23. The significance level was
P
< 0.05.
Conclusion:
In our study, the IMF gave the best results among all the study groups. The IMF technique can be used in patients with protracted chronic recurrent dislocation in whom autologous blood injection has failed.
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Factors Affecting Breastfeeding within the First Hour After Birth
FT Dudukcu, H Aygor, H Karakoc
January 2022, 25(1):62-68
DOI
:10.4103/njcp.njcp_703_20
PMID
:35046197
Background:
Every baby should start life with breastfeeding. However, some obstacles prevent babies from enjoying this right.
Aim:
This study aimed to determine the factors affecting breastfeeding within the first hour after birth.
Patients and Methods:
This study employed a comparison design. This was a comparative study of women who breastfeed their babies within 1 h of birth and those who did not. The research population consisted of 368 mothers who had babies aged 6–24 months. A semi-structured questionnaire, which consisted of 32 open- and closed-ended questions, was used to collect data. The number and proportions were used for the descriptive statistics, and Chi-square tests were used to compare data between groups. The level of statistical significance was accepted as
P
< 0.05.
Results:
Of the 368 participants, 50.8% breastfed their babies within the first hour after birth, 49.2% did not breastfeed within the first hour, 51.6% exclusively breastfed in the first 6 months, 48.4% did not breastfeed exclusively in the first 6 months. Moreover, results revealed that a high-risk pregnancy status, mode of delivery, prelacteal food, and the mother's role in making decisions about baby feeding affects breastfeeding practices within the first hour after birth.
Conclusions:
Initiatives should be increased to start breastfeeding within the first hour after birth in women who have high-risk pregnancy and those giving birth by cesarean section. Breast milk should be the baby's first food, and mothers should be the primary decision-makers in baby's nutrition.
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REVIEW ARTICLE
Chordoid Meningioma. Case Report and Review of the Literature
M Prokopienko, T Wierzba-Bobrowicz, W Grajkowska, T Stępień, M Sobstyl
January 2022, 25(1):1-4
DOI
:10.4103/njcp.njcp_667_20
PMID
:35046187
Chordoid meningioma is an uncommon histopathological type of meningioma, frequently associated with Castleman's syndrome. Histologically, chordoid meningiomas are similar to chordomas. Because of their high proliferative index, they present aggressive biological behavior and high risk of postoperative recurrence. We report a case of chordoid meningioma in an adult patient without Castleman's syndrome manifestation. As its chordoid feature is related with a rapid recurrence after incomplete removal, meticulous histopathological examination is crucial for the adequate postoperative treatment plan.
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ORIGINAL ARTICLES
Postcesarean Difficulties and their Association with Breastfeeding Success in Postpartum Women
C Cirpanli, B Demirtas Hicyilmaz
January 2022, 25(1):69-77
DOI
:10.4103/njcp.njcp_546_20
PMID
:35046198
Background:
The rate of cesarean section (CS) has been gradually increasing throughout the world. The impact of CS on the issue of breastfeeding success therefore merits attention.
Aim:
This study investigates postcesarean difficulties and their association with breastfeeding success.
Patients and Methods:
This study is a cross-sectional study involving the participation of 220 mothers who were receiving care at the Women's Health Training and Research Hospital in Ankara, Turkey between the dates of February 10 and August 10 of 2016. Data were collected using the Socio-demographic and Obstetric Characteristics Form and the LATCH Breastfeeding Assessment Tool (LBAT).
Results:
Women who had breastfeeding problems both previously (OR = 0.59; 95% CI: 0.18–1.76;
P
= 0.004) and currently (OR = 0.29; 95% CI: 0.14–1.30;
P
< 0.001) were more likely to have low breastfeeding success scores. There was no statistically significant relationship found between LBAT mean scores and other post-CS difficulties. Women aged 35 and older were more likely to have breastfeeding success compared to that of women of ≤19 years of age (OR = 4.33; 95% CI: 3.50–4.45;
P
= 0.051). Furthermore, women who had breastfeeding experience were more likely (OR = 1.86; 95% CI: 1.40–2.67;
P
= 0.010) to have a high breastfeeding success score.
Conclusions:
This study has revealed that breastfeeding success was associated more with breastfeeding problems than with other difficulties experienced after a CS. To prevent breastfeeding problems before they occur, newborns who are without complications should be kept in skin-to-skin contact (SSC) with their mothers immediately after the CS, breastfed within the first 1 hour after birth, and remain in SSC until the end of the first breastfeeding. Most importantly, to increase breastfeeding success after CS, creative staffing solutions need to be employed.
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Factors Affecting the Level of Perceived Competence in Disaster Preparedness among Nurses Based on their Personal and Work-related Characteristics: An Explanatory Study
OG Baker
January 2022, 25(1):27-32
DOI
:10.4103/njcp.njcp_468_20
PMID
:35046191
Background:
The disaster situations call upon the effective and speedy response from the nurses. The link to self-perceived competence in disaster preparedness remains unclear, although there is strong support for competence in nursing practice to ensure safe patient care.
Aims:
The study aims to evaluate the self-perceived competence and familiarity of nurses at personal and professional levels concerning disaster preparedness. Cross-sectional exploratory design was employed. A sample of 350 nurses from five government hospitals in Medina was surveyed using an emergency preparedness information questionnaire.
Patients and Methods:
IBM SPSS (Statistical Package for Social Sciences) for Windows, Version 21.0, was used for analyzing the data.
Results:
Nurses perceived inadequate preparation for emergencies. The unit area had no impact on their self-perceived competence and familiarity.
Conclusions:
Female nurses, non-Saudi staff, and years of work experience were perceived to increase nurse competence in disaster preparedness. The managers can create activities to enable nurses to learn and view their disaster preparedness concerns.
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Comparison of I-gel and LMA Protector in Laparoscopic Cholecystectomy: A Randomized Controlled Trial
DE Ari, S Abitagaoglu, C Koksal, A YildirimAr, D Emrem, M Ustun
January 2022, 25(1):90-96
DOI
:10.4103/njcp.njcp_693_20
PMID
:35046201
Aims:
Comparison of the use of I-gel and Laringeal Mask Airway (LMA) Protector in laparoscopic cholecystectomy regarding the time and ease of insertion for supraglottic airway devices (SAD) and gastric tube (GT), airway sealing capacity, and postoperative complications.
Patients and Methods:
Sixty-four American Society of Anaesthesiologists (ASA) I–III patients undergoing laparoscopic cholecystectomy were randomly allocated into two groups. After anesthesia induction, LMA Protector was inserted in Group LPRO (LMA Protector) (
n
= 33) and I-gel was inserted in Group IGEL (I-gel) (
n
= 31) patients. Time of SAD insertion, number of attempts, time, and ease of GT insertion were recorded. The peak inspiratory pressure (PIP) and oropharyngeal leak pressure (OLP) were measured at the time of SAD insertion, 10 min after insertion, 10 min after pneumoperitoneum, and just before the termination of pneumoperitoneum. The presence of bloodstains on SAD, sore throat, hoarseness, nausea, and pain in swallowing was assessed postoperatively. A
P
value of < 0.05 was accepted as statistically significant.
Result:
Two patients in Group LPRO needed endotracheal intubation and were excluded from the study. The SAD insertion time was shorter in Group IGEL than in Group LPRO (13 ± 7.4 s vs. 18.8 ± 9.8 s). The number of attempts and success rate on the first attempt were similar in both groups. GT insertion time was shorter in Group IGEL than Group LPRO (11 ± 7.7 s vs. 21 ± 11 s). The insertion of GT was easier in Group IGEL. The OLP levels decreased during the pneumoperitoneum in Group LPRO while they remained constant in Group IGEL.
Conclusion:
We observed that I-gel offers more stable airway sealing and easier GT insertion advantages when compared with LMA Protector in laparoscopic cholecystectomy.
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Triple-negative Breast Cancer (TNBC) and Its Luminal Androgen Receptor (LAR) Subtype: A Clinicopathologic Review of Cases in a University Hospital in Northwestern Nigeria
AA Liman, B Kabir, M Abubakar, S Abdullahi, SA Ahmed, SM Shehu
January 2022, 25(1):97-104
DOI
:10.4103/njcp.njcp_437_20
PMID
:35046202
Background:
Breast cancer (BC) is a common malignancy; the most frequent in Nigeria. BC characteristically exhibits great biologic diversity. Amongst its variants, the triple-negative subtype is also characterized by heterogeneity (thus making it a study in diversity within diversity) and also by some unique clinicopathologic features including clinical aggressiveness, lack of response to current targeted therapies, and tendency to cluster amongst young premenopausal women especially in populations of women of African ancestry.
Aims:
The objective of this study was to conduct a retrospective clinicopathologic survey of all breast carcinomas to profile the triple-negative breast cancers (TNBCs) amongst them and illustrate their immunohistochemical pattern of luminal androgen receptors (LARs) expression.
Patients and Methods:
All the cases entered into the departmental records as breast carcinomas over the study period were extracted including patients' request cards, hematoxylin and eosin-stained slides, and paraffin-embedded tissue blocks of those diagnosed as triple-negative cancers. These were immunohistochemically stained using a monoclonal antibody for androgen receptor (AR). The whole data were analyzed and presented in tabular formats.
Results:
A total of 660 breast carcinomas of which 89 (13.48%) cases were identified as TNBCs with a mean age of occurrence of 42.89 ± 11.88 years. Most TNBCs (95.5%) were carcinoma no special type and 61.8% had low or intermediate histologic grading. LAR expression was noted in 11.24% of the TNBCs.
Conclusion:
Triple-negative cancer in this study shares some of the known characteristics but also portrays some divergence from the commonly described features.
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Risk Factors Affecting Complications of Access Site in Vascular Intervention through Common Femoral Artery
MO Lee, KU Jeong, KM Kim, YG Song
January 2022, 25(1):85-89
DOI
:10.4103/njcp.njcp_37_21
PMID
:35046200
Backgrounds:
Traditionally, vascular interventions have been performed through the femoral artery.
Aims:
The purpose of this study was to evaluate risk factors affecting access-site complications in patients with hepatocellular carcinoma or peripheral arterial disease in lower extremity who underwent vascular intervention by accessing the common femoral artery (CFA).
Patients and Methods:
From December 2015 to November 2018, 287 patients underwent transarterial chemoembolization (TACE) or peripheral vascular intervention with ultrasound (US)-guided CFA access. Standard 18-gauge (G) access was used in 127 patients and Micropuncture® 21-G needles in 160 patients. Most access sites were managed with vascular closure devices and several were managed with manual compression. Within 24 hours after the procedure, all patients underwent US to evaluate the puncture site.
Results:
Access-site complications occurred in 55 of 287 patients: 34 hematomas (11.9%), 20 pseudoaneurysms (7.0%), and 1 dissection (0.4%). In the crude model, risk factors related to access-site complications were the usage of 18-G needles (OR, 2.18; 95% CI, 1.17-4.07;
P
= 0.014), smoking (OR, 2.23; 95% CI, 1.16-4.27;
P
= 0.016), and approach route (OR, 3.23; 95% CI, 1.33-7.82;
P
= 0.009). Needle size (OR, 2.13; 95% CI, 1.10-4.12;
P
= 0.025) was the only factor associated with access-site complications in the adjusted model.
Conclusion:
Needle profile was the only factor associated with access-site complications in this study. Therefore, a needle with a smaller profile than an 18-G needle will reduce the incidence of complications at the access site.
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Comparative Analysis of the Impact of Visual Impairment on Quality of Life of Patients Attending a Tertiary Hospital in South East, Nigeria
IL Ejiakor, EO Achigbu, OE Onyia, O Edema, FU Nkwogu, AJ Okeke, PE Ohanele
January 2022, 25(1):5-11
DOI
:10.4103/njcp.njcp_24_21
PMID
:35046188
Background:
Quality of life (QoL) is defined as an “individual's perception of their position in life in the context of the culture and value system in which they live and in relation to goals, expectations, standards, and concerns.” Visual Impairment affects QoL because of the restrictions it imposes on everyday life activities.
Aims:
This study aims to compare the QoL of visually impaired patients attending the Eye Clinic of Federal Medical Centre, Owerri with that of normally sighted persons. The findings will aid the formulation of policies guiding the management of visually impaired patients.
Patients and Methods:
This was a hospital-based case-control study which recruited all consenting new patients with visual impairment, and age, and sex-matched controls who presented at the Eye Clinic, Federal Medical Centre, Imo State, Nigeria during the period of the study. Data was collected using a semi-structured closed-ended questionnaire, and the World Health Organization QoL-BREF and analyzed with the Statistical Package for Social Science version 22.
Results:
Four hundred and two participants were recruited. Lower scores were recorded in all the quality of life (QoL) domains for the visually impaired compared with controls. The overall QoL and health status mean score for the visually impaired (61.10 ± 19.75) was significantly lower than that for the controls (70.90 ± 21.19) at
P
< 0.001. Severity of visual impairment at
P
< 0.001 significantly affected all the QoL domains for the visually impaired with the lowest score noted among the blind (58.21 ± 11.63) compared to controls (79.33 ± 11.74). Occupation and educational level significantly affected the QoL of the study group but not the controls.
Conclusion:
Visual impairment significantly reduces the QOL of patients. Policies targeted at enhancing the QoL of the visually impaired through rehabilitation and societal integration is recommended.
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CASE REPORTS
Use of Diode Laser for Lip Repositioning, Evolution of the Conventional Technique. A Case Report
A Martinez-Martinez, C Molinares-Villa, A Diaz-Caballero
January 2022, 25(1):110-113
DOI
:10.4103/njcp.njcp_77_21
PMID
:35046204
Introduction:
LipStaT® lip repositioning surgery using a diode laser for the management of gummy smiles offers promising and consistent long-term results.
Objective:
To describe the technique through a clinical case, including its indications, preoperative evaluation, surgical approach, and recommendations after the intervention.
Case Report:
A 29-year-old woman with excessive gingival display (EGD) of 4 mm when smiling; the LipStaT® technique was performed with a 940 nm diode laser to remove a strip of mucosa by ablating the epithelial tissue, and thus, achieve aesthetic, harmonic and functional results. The inflammation and postoperative pain were treated with the diode laser assisted lymphatic drainage technique. After follow-up, a satisfactory tissue response was observed, and no pain or inflammation was reported.
Conclusion:
The use of a 940 nm diode laser proved to be an effective treatment option for patients with a gummy smile, allowing control of intraoperative bleeding and improvement of the healing process obtaining predictable long-term results.
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ORIGINAL ARTICLES
The Effect of Different Surface Roughening Systems on the Micro-Shear Bond Strength of Aged Resin Composites
OI Karadaglioglu, L Gulec Alagoz, A Caliskan, G Aksoy Vaizoglu
January 2022, 25(1):37-43
DOI
:10.4103/njcp.njcp_95_21
PMID
:35046193
Background:
There are controversies regarding the most effective surface treatment method to be applied for the effective repair of resin composites.
Aims:
This study aimed to compare the effects of surface roughening processes on repair bond strength of different types of aged composites. Water aging was applied to 60 nanohybrid and 60 micro-hybrid resin composite samples for 1 year. Samples were randomly divided into five groups and four types of roughening processes. Bur, OPTIDISC, SUPERSNAP, and BISCO were applied to the water-aged resin composite samples. Micro-shear test method was used to measure the repair bond strength.
Materials and Methods:
Data were analyzed with IBM SPSS V23. Compliance with normal distribution was examined by Kolmogorov–Smirnov test. Two-way analysis of variance (ANOVA) and Tukey HSD test for multiple comparisons were used.
Results:
The main effect of the type of resin composites and surface roughening methods were found to be significantly different. The MPa values of surface roughening groups were similar while the lowest mean value was obtained for the untreated group of the nanohybrid resin composite (
P
< 0.001). The bond strength for both resin composites was generally considered within acceptable limits except for no treatment group of nanohybrid resin composite.
Conclusions:
This study showed that surface roughening method is mandatory for effective bond strength and the type of fillers in resin composite affects the micro-shear bond strength.
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Radıologıcal Evaluatıon of the Recesses on the Posterıor Wall of the Nasopharynx wıth Cone-beam Computed Tomography
FA Kaplan, H Saglam, E Bilgir, IS Bayrakdar, K Orhan
January 2022, 25(1):55-61
DOI
:10.4103/njcp.njcp_559_20
PMID
:35046196
Background:
The posterior wall of the nasopharynx is composed of loose connective tissue that includes many important anatomical structures. Various structures, such as the opening of the Eustachian tube (ET), the Rosenmüller fossa (RF), and the pharyngeal bursa (PB) are found here.
Aim:
To evaluate the nasopharynx posterior wall anatomic structures, including the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa with cone-beam computed tomography.
Materials and Methods:
The depth, width, and length of the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa were measured in 150 patients using axial-sagittal cone-beam computed tomography. The Eustachian tube and Rosenmüller fossa distance to the midsagittal plane, the coronal region passing through the posterior end of the nasal septum, the superior-inferior extremity of the recesses, and the nasal floor plane distance were measured. The relationship between Rosenmüller fossa types and other parameters were evaluated.
Results:
The incidence of right Rosenmüller fossa types 1, 2, and 3 were 16%, 18%, and 66%, respectively, and that of the left Rosenmüller fossa types 1, 2, and 3 were 16%, 19.3%, and 64.7%, respectively. The mean pharyngeal bursa width, length, and depth were 10.8, 5.7, and 4.0 mm, respectively; those of the Eustachian tube were 5.6, 7.1, and 7.3 m, respectively; those of the right Rosenmüller fossa were 4.0, 12.4, and 10.5 mm, respectively; and those of the left Rosenmüller fossa were 3.8, 12.5, and 10.9 mm, respectively.
Conclusions:
The posterior wall of the nasopharynx contains several important anatomical structures. Evaluation of these using cone-beam computed tomography has many clinical and radiological advantages. To understand and interpret the coincidental findings in CBCT, dental radiologists should have access to more detailed information concerning the anatomy of the nasopharynx.
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Clinical and Psychosocial Determinants of Patients with Tuberculosis/Human Immunodeficiency Virus Co-Infection: A Structural Equation Model Approach
MA Alao, OR Ibrahim, YH Chan
January 2022, 25(1):105-109
DOI
:10.4103/njcp.njcp_466_20
PMID
:35046203
Background:
Tuberculosis (TB)/human immunodeficiency virus (HIV) co-infection is a complex mesh of physical and psychosocial disorders that require a multimodal and multifaceted approach for improved outcomes.
Aims:
This study determined the treatment outcomes of patients with TB/HIV co-infection and the clinico-psychosocial predictors of the disease over a 10-year period in resource-limited settings.
Patients and Methods:
This study reviewed the 10-year retrospective treatment outcomes of patients with TB/HIV co-infection in a tertiary centre. The data were retrieved from the TB treatment registers and analyzed with STATA 16.0. The effects of latent constructs of high clinical severity, stigmatization, and family stress/burden on treatment outcomes were evaluated using a structural equation model.
Results:
Of the 1,321 who met the inclusion criteria, 1,193 had sufficient data. The mean age of the patients was 38.2 ± 16.7 years. The treatment adherence rate over the 10 years was 93.8% (±6.8%) but successful treatment outcome was 75.5% (±8.1%). Stigmatism of TB/HIV infections was experienced by adults and males (β = 0.972;
P
< 0.001 β = 0.674;
P
< 0.001, β = -0.770;
P
< 0.001, respectively), non-adherent to treatment (β = -0.460;
P
< 0.001) clinical severity of illness (β = 0.940;
P
< 0.001), and being HIV negative (β = -0.770;
P
< 0.001). Family Stress/Burden was strongly affected by both Death (β = 1.000;
P
< 0.001) and higher Stigmatism (β = 0.602;
P
< 0.001). Clinical severity of illness significantly influenced both Death and Unsatisfactory outcomes (β = 0.207;
P
< 0.001, β = 0.203;
P
< 0.05, respectively). Non-Adherence led to potentially unsatisfactory outcome.
Conclusion:
TB/HIV co-infection is a complex psychosocial disorder that is significantly and negatively impacted by social determinants of the disease. A holistic approach to treatment intervention that addresses the latent factors of stigmatization, family stress/burden, and high clinical severity is key to achieving a successful treatment outcome.
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Cancer in Five Countries of the Eastern Mediterranean Region: Epidemiological Trends and Risk Implications
SA Shurrab, AF Al-Badarneh, HI Nassar, AH Almshnanah
January 2022, 25(1):78-84
DOI
:10.4103/njcp.njcp_611_20
PMID
:35046199
Background:
Cancer is a major public health problem and is the second leading cause of death around the world. The incidence rates of some cancer types rise dramatically with certain risk factors, a fact that is exemplified by the high susceptibility to lung cancer as a result of tobacco smoking. The frame of cancer as a preventable disease and the challenges of its treatment emphasize the need for specific risk preventive measures. Therefore, attempts are continuously carried out to provide a better understanding of the cancer incidence patterns and how the most common risk factors are implicated.
Aims:
This study aimed to compare the cancer incidence rates in Jordan, Lebanon, Palestine, Syria, and Iraq over 18 years (2000-2017) and relate the high estimates to certain risk factors to help decision-makers better prevent this disease.
Materials and Methods:
Graphical and numerical descriptive illustrations of the total incidence rates, age-specific incidence rates, and incidence by cancer type were generated using data obtained from the Global Health Data exchange database. Risk factors prevalence and their pathogenic role were sought using PubMed and science direct databases as well as the world bank data.
Results:
Lebanon had the highest overall age-adjusted incidence rates with a gradual increase from 231 to 353 and the highest life expectancy mean of 77.5 years. Breast, lung, and colorectal cancers were the most common cancer types in both genders and all ages in the five countries with varied ratios that were consistent with the risk factors prevalent.
Conclusions:
The association between the spread of the studied risk factors and the high trends of the corresponding cancer types highlights the importance of targeted preventive measures and serve as a guide for evidence-based prevention strategies.
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Comparison of Inguinal Herniotomies with and Without Opening the External Oblique Aponeurosis in Children Above the Age of Two
Y Kart, C Ozturk
January 2022, 25(1):33-36
DOI
:10.4103/njcp.njcp_82_21
PMID
:35046192
Background:
Mitchell-Banks technique (MBT), in which inguinal canal is not opened, usually used in inguinal hernia repair in children under 2 years of age. The majority of pediatric surgeons tend to open the inguinal canal while performing inguinal hernia surgery in children over 2 years of age, called as modified Ferguson herniotomy (FH).
Aims:
This study aimed to compare early and late complications of the MBT and FH in over 2 years of age patients who underwent inguinal hernia surgery.
Patients and Methods:
We retrospectively reviewed the medical records of all children between 2 and 16 years old who underwent inguinal herniotomy procedure using the MBT and FH between January 2013 and December 2019. Patients were evaluated in terms of demographic data, early and late complications.
Results:
This study included 834 children. Of these, 379 (44.8%) were operated on by an FH with opening the inguinal canal (Group 1), and 455 (55.2%) by MBT superficially to the external ring (Group 2). There were 68 (17.9%) females and 311 (82.1%) males in group 1, while there were 151 (33.2%) females and 304 (66.8%) males in group 2. Early complications were wound infection (1.1% in the group 1 vs. 1.3% in the group 2,
P
= 1.00) and scrotal hematoma (1.3% vs. 1.8%,
P
= 0.89). Late complications included recurrence (1.6% in the group 1 vs. 1.8% in the group 2,
P
= 0.12), undescended testis (2.1% vs. 0.7%,
P
= 0.71), testicular atrophy (1.5% vs. 0.4%,
P
= 0.79), and hydrocele (1.9% vs. 1.8%,
P
= 0.87). There was no statistically significant difference in terms of early and late complications ratio between two groups.
Conclusion:
This study showed that inguinal hernia repair performed without opening the inguinal canal in children older than 2 years do not lead to an increase in complications. In this respect, MBT can be used as a simple and safe procedure in older children.
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Challenges of Accessing Care in Art Clinic during COVID-19 Lockdown in Lagos
AO Salako, OO Odubela, HO Ohwodo, B Opaneye, SO Ojuko, NL Nwankwo, QE Ejiga, AN David, OC Ezechi, BL Salako
January 2022, 25(1):49-54
DOI
:10.4103/njcp.njcp_391_20
PMID
:35046195
Background:
As the SARS-CoV-2 pandemic continues to ravage the world, its impact on the health systems and survival of people with chronic diseases especially People living with HIV [PLWH] could be undermined. It becomes relevant to assess the challenges PLWH face during this period to institute measures towards combating the negative effects of the pandemic.
Aims:
This study aims to investigate the challenges faced by PLWH in accessing care during the lockdown period in Lagos, Nigeria. The study was a cross-sectional one involving PLWH aged 18 years and above who presented for care. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, their knowledge about COVID-19 disease, and challenges experienced in accessing care during the COVID-19-induced lockdown. Ethical approval was obtained from the Institution Research Ethics Board (IRB) of NIMR.
Patients and Methods:
Data generated from the survey was exported to Excel and analyzed using SPSS version 23.0.
Results:
The mean age of PLWH who participated in the study was 42.2 (±12.2) years. The majority were female (74.3%), married (66.3%), employed (58.9%), and on less than $100 monthly income (80.5%). The commonest challenges experienced were psychological (78.5%), financial (68%) and food (40.7%). There were significant association among the income status, lack of food (OR: 2.5, CI: 1.4-4.5,
P
= 0.002), financial challenges (OR: 1.7, CI: 1.0-3.0,
P
= 0.048) and psychological challenges (OR; 1.8, CI: 1.0-3.5,
P
= 0.05). Ninety-five percent of participants believed SARS-COV-2 infection is a viral infection.
Conclusions:
PLWH faces a myriad of challenges that would have a significant impact on their overall well-being and the gains of HIV care.
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1
Development of Valid and Reliable Tools for Pediatricians' Knowledge and Self-Perceived Competency Towards Oral Health of Children in Turkey
G Ozkaya, CE Cubukcu, ZG E Ozdel
January 2022, 25(1):44-48
DOI
:10.4103/njcp.njcp_81_21
PMID
:35046194
Background:
This study aimed to develop a valid and reliable questionnaire of knowledge about oral health in childhood and a scale of self-perceived competency for pediatricians. In this way, the contributions of Turkish pediatricians on oral health in childhood and their effects on children's oral health and caregivers will be evaluated.
Subjects and Methods:
Items were generated from published scientific literature, other questionnaires, and interviewing notes with the pedodontists. The study group examined publications on the preventive oral health of children, and they included items related to children in the item pool. The initial knowledge questionnaire consisted of 23 items and 10 items for the self-perceived competency scale. The content validity of the questionnaire and scale were determined by the assessments of the expert team. The internal consistency of the knowledge questionnaire and test-retest reliability of the self-perceived competency scale was examined.
Results:
Thirty pediatricians took part in the study. The pediatricians were: 63.3% (
n
= 19) female and 36.7% (
n
= 11) male; their mean age was 37.97 ± 3.86 years. Most of the pediatricians were specialists with 83.4% (
n
= 25). The medical specialization of all pediatricians was university and the working year mean was 10.93 ± 4.28. The knowledge questionnaire had 10 items after content validity and internal consistency reliability investigations. The initial number of items for the self-perception level scale was 10. We excluded five items due to the content validity index. ICC value for 5-item self-perception level scale was calculated as 0.816 (95% CI: 0.606–0.914). Therefore, the scale has a good reliability level.
Conclusion:
Our knowledge questionnaire and self-perceived competency scale provide a validated and reliable tool in the assessment of pediatricians' knowledge and competency regarding oral health. Pediatricians can test themselves using this knowledge questionnaire and self-perceived competency scale.
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CASE REPORTS
A Case Report of Liver and Pancreatic Echinococcal Cysts
H Uzunoglu, MO Gul
January 2022, 25(1):114-117
DOI
:10.4103/njcp.njcp_500_20
PMID
:35046205
A 54-year-old female patient with complaints of abdominal pain for 2 months was admitted to the General Surgery clinic of our tertiary care hospital. Abdominal ultrasound (US) and computed tomography revealed cholelithiasis, liver hydatid cyst, and hypodense multicystic mass lesion in the pancreatic body. In the endoscopic US performed, pancreatic hydatid cysts were considered as the pre-diagnosis. Cystotomy and external drainage were performed on the 8-cm cystic lesion in the pancreas head-class junction. Pancreatic hydatid cyst can be rarely seen isolated or can develop synchronously to liver hydatid cyst, and should be kept in mind in a differential diagnosis. If the perioperative diagnosis is confirmed and in case of the absence of a pancreatic ductal fistula, surgical morbidity and mortality can be reduced by applying cystotomy and external drainage procedures.
[ABSTRACT]
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1,078
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Spontaneous Partial Percutaneous Extrusion of Swallowed Metallic long Spoon: A Case Report
CN Ekwunife, UN Ogbue, CO Kaduru
January 2022, 25(1):118-120
DOI
:10.4103/njcp.njcp_512_20
PMID
:35046206
Foreign body ingestion is a commonly encountered clinical challenge. Most of these objects pass spontaneously, but long objects could be retained leading to uncommon complications. There seem to be no record of percutaneous extrusion of ingested spoon in literature. We report a case of 20 year old lady who swallowed a long metallic spoon. It got retained in the stomach for a month without obstructive symptoms, until the tail end of it eroded onto the skin. It was retrieved through an open gastrotomy. Patient had an uneventful postoperative recovery. Clinicians should be mindful that ingested large foreign bodies may be delayed in presentation. Whereas our index patient had open surgery, minimally invasive retrieval approaches could be considered when comparable cases are encountered.
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REVIEWERS, 2021
Reviewers, 2021
January 2022, 25(1):121-122
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Online since 10
th
November, 2010