Prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department after the second wave of the coronavirus disease 2019 pandemic

Objectives:The present study aims to assess the prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department(OPD)after the second wave of the coronavirus disease 2019(COVID-19)pandemic.Materials and Methods:A descriptive,cross-sectional study was carried out among 117 OPD nurses between October and December 2021 using a purposive sampling technique.Two self-reported standardized scales,the Smartphone Addiction Scale-ShortVersion and Insomnia Severity Index were used.Kolmogorov–Smirnov test,Mann–Whitney U,and Kruskal–Wallis Htest were used.Pearson’s correlation and Scatter plot were used to determine the relationship between the study variables.A stepwise multiple linear regression analysis was also performed.Results:The majority of participants had slight smartphone addiction(78.6%)and suffered from sub-threshold to severe forms of insomnia(73.5%).A significant mild positive correlation was found between smartphone addiction and insomnia(r=0.195,P<0.05).Stepwise multivariate logistic regression analysis predicted factors such as female gender and exposure to smartphones for more than 5 years influencing smartphone addiction.A strong influence of exposure to the smartphone for more than 5 years was found on insomnia severity.Conclusion:Smartphone addiction and insomnia were identified problems among nurses working in the OPD after the second wave of the COVID-19 pandemic,requiring an urgent need to identify and manage various factors responsible for smartphone addiction and insomnia such as female gender and years of exposure to smartphones.

Knowledge, Attitude and Practice of Physicians in the Treatment of Hypertension in North-Central Nigeria

Background and Objectives: Hypertension is a global health hazard and most cases are first attended to by the physicians. Achieving a control will depend on the knowledge, attitude and practice of the physicians. We therefore determined the knowledge, attitude and practices of physicians on the detection and treatment of arterial hypertension in north-central Nigeria. Design and Methods: A cross-sectional study of 100 of the 250 physicians attending a continuing medical education lecture series in Bida was conducted using a pre-validated self administered questionnaire. Results: The mean age of the physicians was 41.05 ± 8.71 years and 59 (73.8%) were males. Forty-one (51.2%) of them have practiced for more than 10 years. Arterial hypertension was considered an important health problem by 93.8% of the physicians, 30% of them believed that it should not be referred to a specialist. Majority of the physicians request for urinalysis (96.2%), electrocardiogram (95.0%), fasting blood glucose (88.8%), blood urea nitrogen (98.8%) and fasting lipid profile (97.5%) to either assess target organ damage or associated co-morbid conditions. Fifty-seven (71.2%) of the physicians prescribe diuretics as the initial drug. However, the knowledge of the other drugs on initiation of therapy of mild uncomplicated hypertension was poor. The sources of information on arterial hypertension by physicians were scientific programs (73.8%), drug companies (38.8%) and journals in 11.3%. Conclusion: The knowledge, attitude and practice of physicians in the detection and management of hypertension were modest. Educative programs like continuing medical education, seminars, and conferences on cardiovascular disorders are advised to be organized regularly to strengthen these and update the physicians.

Patient Satisfaction with Psychiatric Services: A Survey at a Nigerian Federal Teaching Hospital

Background: Patient satisfaction, a measure of the extent to which a patient is content with the health care which he or she receives from his or her health care provider, is an effective means of evaluating the performance of a hospital leading to service improvement and attraction of more patients. In a country whose leadership currently calls for change of attitude of the citizenry, it is pertinent to assess how this change has been accepted in health institutions, especially among the most stigmatized group of patients, by assessing the latter’s level of satisfaction with the quality of services provided. Objectives: The study, carried out over a period of six months (1st May to 30th October, 2016), assessed the satisfaction of patients with the quality of care provided at the psychiatric outpatient department of the Federal Teaching Hospital, Abakaliki, Nigeria. Methods: Data were extracted from eligible participants using a sociodemographic/clinical profile questionnaire and the Charleston Psychiatric Outpatient Satisfaction Questionnaire. Results: 422 patients (53.6% males, 46.4% females) participated. Their mean age was 32.20 ± 11.35 years. Schizophrenia was the commonest diagnosis. The respondents appeared quite satisfied with the quality of services. Satisfaction with the helpfulness of the record officers was topmost in the administrative scale (92.9%) with satisfaction with the amount of time waited to be seen by doctor, the least (76.3%) while on the environmental scale, appearance of the doctor’s consulting room was most satisfying (93.4%) and cost of service the least (73.5%). 90.5% were satisfied with the overall quality of service provided and 94.8% indicated willingness to recommend the facility to others. Satisfaction was most affected by self-perceived mental and physical health. Conclusion: Patient satisfaction is a simple way to evaluate hospital services. Continual assessment of patient satisfaction is recommended to enable authorities improve on areas considered less satisfactory while sustaining service areas deemed highly satisfactory.

Critical reflection on the role of senior staff nurse

Objective: By critical emancipatory reflection, to be free the author from take-for- grant assumptions andoppressive forces in daily practice, the purpose is to make changes from the discovered constraints. Methods:Smyth’s reflective framework will be used to guide this reflection. Results: By engaging in critical emancipatoryreflection, author’s personal values, beliefs and assumptions are discovered through this process. There are somediscrepancies between author’s espoused values and my take for grant assumptions. Through critically analyzingthe historical, social culture, policy and personal constraints in detail, it helps author transform the practice issueinto a new way. Conclusion: Critical emancipatory reflection provides nurses with tool to uncover daily practiceissue, helps strengthen nursing values and improving care standards, and it should be encouraged.

Addressing constraints to informal providers’involvement in tuberculosis control:a qualitative study of patent medicine dealers and tuberculosis programme managers

Background:A major constraint to tuberculosis control is low case finding with under-reporting to national authorities.Evidence shows that Patent Medicine Dealers are first port of call for most people with symptoms of tuberculosis,yet there is poor referral of such clients to tuberculosis treatment facilities for further evaluation.This study investigated constraints to involvement of Patent Medicine Dealers in tuberculosis control.Methods:This was a cross-sectional qualitative study among Patent Medicine Dealers and Tuberculosis Control Programme Managers in Ebonyi State Nigeria.Sixty-four Patent Medicine Dealers and five Tuberculosis Control Programme Managers were interviewed using Focus Group Discussion and In-Depth Interview respectively.Data was collected with electronic audio-recording device and analyzed using thematic approach.Results:There are some knowledge gaps about tuberculosis signs,symptoms,free-treatment policy and mode of operation of care service among Patent Medicine Dealers.Patent Medicine Dealers and Tuberculosis Control Programme Managers are willing to collaborate in tuberculosis control effort but constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to keep up with such demands are obvious constraints.Conclusions:Knowledge gaps in tuberculosis,its control,constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to satisfy such demands are constraints to involvement of Patent Medicine Dealers in tuberculosis control.More robust engagement of Patent Medicine Dealers in tuberculosis control with clear job description through tuberculosis education and provision of incentives to support them are recommended policy approaches to improve linkage of clients to tuberculosis treatment facilities.

Fascioliasis presenting as colon cancer liver metastasis on 18Ffluorodeoxyglucose positron emission tomography/computed tomography: A case report

BACKGROUND Fascioliasis is caused by watercress and similar freshwater plants or drinking water or beverages contaminated with metacercariae. Fascioliasis can radiologically mimic many primary or metastatic liver tumors. Herein, we aimed to present the treatment process of a patient with fascioliasis mimicking colon cancer liver metastasis. CASE SUMMARY A 35-year-old woman who underwent right hemicolectomy due to cecum cancer was referred to our clinic for management of colon cancer liver metastasis. Both computed tomography and 18F-fluorodeoxyglucose positron emission tomography revealed several tumoral lesions localized in the right lobe of the liver. After a 6-course FOLFOX (folinic acid, fluorouracil, oxaliplatin) and bevacizumab regimen, the hypermetabolic state on both liver and abdominal lymph nodes continued, and chemotherapy was extended to a 12-course regimen. The patient was referred to our institute when the liver lesions were detected to be larger on dynamic liver magnetic resonance imaging 6 weeks after completion of chemotherapy. Right hepatectomy was performed, and histopathological examination was compatible with fascioliasis. Fasciola hepatica IgG enzyme-linked immunosorbent assay was positive. The patient was administered two doses of triclabendazole (10 mg/kg/dose) 24 h apart. During the follow-up period, dilatation was detected in the common bile duct, and Fasciola parasites were extracted from the common bile duct by endoscopic retrograde cholangiopancreatography (ERCP). Triclabendazole was administered to the patient after ERCP. CONCLUSION Parasitic diseases, such as those caused by Fasciola hepatica, should be kept in mind in the differential diagnosis of primary or metastatic liver tumors, such as colorectal cancer liver metastasis, in patients living in endemic areas.

Hypertrophic Osteoathropathy without Pachyderma in a Nigerian: A Case Report

Hypertrophic osteoathropathy is characterized by triad of digital clubbing, periostosis, and pachyderma. We report the case of a young male Nigerian with asymptomatic idiopathic digital clubbing with neither skin changes nor periosteal reaction. He presented to our hospital with swelling of fingers and toes of about six years’ duration. All his fingers and toes were clubbed with drumstick appearance, no swelling or tenderness of the wrists, elbows, ankles or knees and no skin changes. The laboratory findings were normal. Primary hypertrophic osteoathropathy without pachydermia was entertained when neither skin changes nor periostosis were found. Although primary hypertrophic osteoathropathy without skin involvement is rare, effort should be made to search for secondary causes.