Self Ear Cleaning: Prevalence and Profile among School Children in Ekiti, Nigeria

Background: Self-cleaning of ears with different objects is a common practice among school children with scanty report in literature. Aim: The aim of this study was to determine the prevalence and profile of self-ear cleaning among school children. Methods: It was a cross-sectional institutional-based study which was carried out among school children in Ekiti, south western Nigeria from January 2017, to March 2017. Results: A total of 174 students participated in this study. Their age ranged between 13 and 17 years. The highest number of participant was found at the age of 15 years. One hundred and eighteen (67.8%) of them had carried out self ear cleaning. Personal hygiene was the commonest reason for self ear cleaning in 28.8% of the students. Cotton buds were mostly used by the respondents in 51.7% of them. Injury to the external auditory canal (EAC) was the most recorded complications. Conclusion: The outcome of this study shows that self-ear cleaning practices were common among school children with a prevalence of 67.8%. Cotton buds were the commonest objects used. Avoidable complications were reported among respondents. There is a need to intensify efforts on public enlightenment programme and the establishment of school health programme in our various schools.

Awareness and Practice of Proper Health Seeking Behaviour and Determinant of Self-Medication among Physicians and Nurses in a Tertiary Hospital in Southwest Nigeria

Background: There is generally a lack of good health-seeking practices among health professionals due to a variety of factors, including the intensity of the medical practice itself. Doctors and nurses are perceived to have a good knowledge of ideal health-seeking behaviors and as such, it is important to determine the level of their awareness and estimate whether this knowledge is put into practice. This study, therefore, aimed to determine the level of awareness and practices of proper health-seeking behavior and to identify the factors responsible for self-medication among doctors and nurses in a tertiary hospital in Nigeria. Methodology: A cross-sectional descriptive study was conducted between April and may 2018 among 106 doctors and 164 nurses in a tertiary health facility in Ido-Ekiti, Ekiti State, Southwestern Nigeria. A simple random sampling technique by balloting was performed from the list of doctors and nurses in the hospital to select doctors and nurses that participated in the study. A pretested semi-structured self-administered questionnaire was designed and used to collect data. The data were entered into the computer software and analyzed using SPSS version 20. P ≤ 0.05 was taken as significant. Result: Out of 106 doctors and 164 nurses recruited, only 102 doctors and 143 nurses filled the questionnaire completely and returned for analysis. One hundred and four respondents (42.4%) fall within the ages of 31 - 40 years with a male to female ratio of 1:1.23. Awareness of proper health seeking behavior among both doctors and nurses was high among the two groups with no statistically significant difference between them. Twenty-nine (28.0%) doctors compared with thirty-four (23.8%) nurses go for a regular medical check-up with no statistically significant difference between the two groups (p = 0.411). Out of these, 5 (17.2%) doctors and 7 (23.8%) nurses visit at an interval of less than 6 month (p = 0.736). There is a statistically significant difference in the number of doctors (60.8%) compared with nurses (41.3%) that have consulted a doctor in the last one year (p = 0.003). More than half (51.6%) of this consultation among doctors was over the phone whereas 64.4% of such among nurses were via clinic appointment (p = 0.008). More doctors (90.2%) comply with their treatment prescription from physicians compared with nurses (77.6%) (p = 0.010). More nurses compared with doctors self-medicate when ill [Doctor 61.8% (63), Nurses 78.3% (112)] (p = 0.005) and had also self-medicated in the last one year [Doctor 34.3% (35), Nurses 42.7% (61)] (p = 0.187). Decreasing age, decreasing years of experience, increasing working hours, lack of health insurance, fear of confidentiality and lack of satisfaction with health services are factors that significantly increased the likelihood of self-medication among doctors and nurses within the last one year. Conclusion: Awareness of proper health seeking behavior was high but this did not translate into proper health-seeking practices among doctors and nurses. There is apathy for regular medical check-up and self-medication was also high among this group of health workers. Decreasing age and years of experience, increasing working hours, lack of health insurance, fear of confidentiality and lack of satisfaction with health services were factors were identified to significantly increase the likelihood of self-medication.

Impacts of Recent Infection Testing Integration into HIV Surveillance in Ekiti State, South West Nigeria: A Retrospective Cross Sectional Study

Background: Timely detection of recent HIV infections is critical in achieving the HIV epidemic. The aim of this study was to evaluate the effects of integrating the Recent Infection Testing Algorithm in HIV surveillance in Ekiti State, South West Nigeria. Method: Data from the Nigeria Medical Records System (NMRS)/National Data Repository (NDR) and Index Testing (IT) Services data capturing tools were abstracted for a retrospective cross-sectional study of 719 newly diagnosed HIV-positive cases who were screened for HIV incident infection using Asante rapid recency test kits between August 2020 and June 2022 at 5 selected recency testing health facilities. The venous blood (10 ml) of all the rapid Asante tested recent patients were collected into an EDTA tube and processed for viral load testing. The plasma level of HIV-1 RNA was quantified using the CAP/CTM and cobas 4800 platform at Obafemi Awolowo University Teaching Hospital PCR Laboratory Ife. Chi-square was used to characterize the recency status of the patients. A measure of the association was done using Chi-square, while the p-value of 0.05 was considered statistically significant. Results: The median age of the participants was 39 years. The result from the study showed that of the total number of 719 new cases of diagnosed HIV-positive, 626 of them were screened for rapid Test for Recency infection (RTRI) (87%). Overall, we found that 1.8% (11/626) of clients were classified as recent. The investigation also showed that from the index cases of the 11 confirmed recent infections, a total number of 125 additional positive cases were found. Conclusion: This result indicated a rise in the number of cases discovered in the State. Therefore, incorporating recency testing within regular HIV testing programs becomes essential in order to prioritize clients for index testing and provide useful information on transmission clusters.

Clinico-Epidemiological Pattern and Treatment of Epistaxis in a Tertiary Hospital in South Western Nigeria

Background/Objectives: Epistaxis is a common presentation and may constitute a major challenge to the parents and the health care givers. This study aimed at determining the clinico-epidemiological pattern, presentation and etiology of epistaxis. Materials and Methods: This prospective study of all patients that presented with epistaxis via the Ear, Nose and Throat department of a tertiary institution in Nigeria. The study was carried out between June 2012 and July 2017. Data were obtained from patients who gave consent by using pre-tested interviewer assisted questionnaire. All the data obtained were analyzed using SPSS version 16.0. Results: The prevalence of epistaxis in this study was 12.2%. The peak age group was 1-10 years with epistaxis prevalence of 36.4%. The male to female ratio was 1.5:1. Anterior epistaxis was more common than posterior epistaxis accounted for 80.1% and 7.4% respectively. Single episode of epistaxis was seen in 78.4% of the patients while recurrent epistaxis occurred in 21.6%. Unilateral epistaxis was 62.5%, bilateral epistaxis was 37.5% while right nasal bleeding accounted for 35.8%. The main local causes of epistaxis were trauma 29.5%, infective rhinosinusitis 18.8% and sinonasal tumours 12.5%. Severe epistaxis requiring blood transfusion was seen in 2.8% of the patients and death was recorded in 2.3%. Majority 110 (62.5%) were managed by observation alone, 20 (11.4%) by conservative therapy and 22 (12.5%) had surgical excision. Blood transfusion was given in 5. The outcome of treatment was good recovery in 79.0% while patients’ satisfaction with treatment was noted in 84.1%. Conclusion: Epistaxis is a common sinonasal presentation with effect on quality of life. In our center commonest site of nose bleeds was local mainly from traumatic, inflammatory and neoplastic aetiology.

<i>In-Vitro</i>Metabolite Colonic Production from Otili (<i>Sphenostylis stenocarpa</i>) as Influenced by Selected Gastrointestinal Microbes

In human nutrition, dietary fibers are un-degradable by mammalian enzymes, and are therefore potentially available for fermentation by micro-organisms living in the gastrointestinal tract. It is thought that these fermentable carbohydrates affect fermentation by stimulating the growth or metabolism of specific bacterial species, which are potentially beneficial for health. Hence in this study three gut associated microbes—Escherichia coli, Bacillus subtilis, and Lactobacillus acidophilus were made to ferment the non-digestible fraction of Otili—Sphenostylis stenocarpa, a well-established underutilized wild bean with high economic importance. After 18 hours’ fermentation period short chain fatty acids (SCFAs) and medium chain fatty acids (MCFAs) were detected and evaluated by GC-MS analysis. Metabolic products were relatively dependent on the fermenter. This present study affirmed butyric acid as the main SCFAs after 18 hours’ fermentation. The clinical significance of thirteen other MCFAs detected and quantified was also explored thus conferring a valuable prebiotic on Otili.

<i>In-Vitro</i>Measurement of pH and Antioxidant Capacity during Colonic Fermentation of Selected Underutilized Wild and Edible Beans

Human gut flora-mediated non-digestible fraction of wild edible and common edible was observed for pH at every 6 hours regime. The antioxidant ability was measured up to 18 hours of fermentation with different associated gut microbes. Changes in pH provide an overview of the fermentation process. In the in-vitro study of antioxidant activity by DPPH test, anti-oxidants values showed differences, depending on the substrate and microbial fermenters used for fermentation. At first 6 hours interval, it was observed that the wild bean-Feregede fermented by Enterococcus feacalis exerts the highest antioxidant capacity of 0.0043 Cathechin equivalents. It also exerts lowest antioxidant capacity of 0.0034 Cathechin equivalents after 18 hours fermentation. These data provided preliminary evidence that consumption of beans diet such as the wild bean—Otili, Feregede, pakala and edible bean—oloyin is limiting factor to liberation of antioxidant components during the gastrointestinal digestion. Thus, disruption of normal cellular homeostasis by redox signaling may result in the development of various gastrointestinal pathological conditions, including inflammatory bowel diseases.

Profile of Turbidity and Glucose Formation from Underutilised Wild, Edible Bean during <i>In-Vitro</i>Gastro Intestinal Digestion and Fermentation

Fermentation takes place throughout the gastrointestinal tract of all animals, but the intensity and products of fermentation depend on number and types microbes, which are generally highest in the large bowel. Large intestinal epithelial cells do not produce digestive enzymes, but contain huge numbers of bacteria which have the enzymes to digest and utilize many substrates. The seeds of beans (Otili, Feregede, Pakala and Oloyin) analyzed in this present study contain indigestible fraction called dietary fiber which helps to maintain functioning of the digestive system. Fermentation of indigestible fraction (IF) of these beans was mimicked through in-vitro method which leads to biochemical changes in the samples. During this experiment, increase in acidity and turbidity was observed. The glucose concentration decreases with some exceptions, such as Pakala fermented by Lactobacillus acidophilus which had the value of 6.260 mmol/L at 6 hr and increased to 6.616 mmol/L after 18 hours fermentation, Otili fermented by various microorganisms which had its turbidity increased by 50%. Lactobacillus acidophilus fermenting Pakala had the highest glucose concentration during the fermentation period. The increase in turbidity could be as a result of increase in microbial flora or production of metabolites, such as glucose. The approach followed here may be used as a predictive model to assess the metabolic implications of food substrates present in the traditional Nigerian orphan beans.

Outcome of Teenage Pregnancy in a Low Resource Setting: A Comparative Study

Background: Teenage pregnancy constitutes a high-risk pregnancy due to possible physical, psychological, socio-economic and increased obstetric risks associated with it. These risks though equally present in the older pregnant women are probably less when compared with teenagers. Thus perinatal outcome of pregnancies in these groups of patients varies. Objective: To compare the socio-demographic characteristics, pattern of pregnancy complications and perinatal outcome of pregnancy among primigravid teenagers and older primigravid women. Method: A comparative study was carried out among 58 primigravid teenagers and equal numbers of adult primigravidae at Federal Teaching Hospital, Ido Ekiti, Nigeria over five year period between January 2008 and December, 2012. Their socio-demographic characteristics, booking status, pregnancy complications, estimated gestational age at delivery, mode of delivery, post-partum morbidities, neonatal birth weight and perinatal mortalities were obtained from their case notes. Results: Deliveries by teenagers accounted for 2.48% of all deliveries during the period under review. Teenage age was significantly associated with unmarried status (P < 0.001). Two-third (67.2%) of the teenagers were unbooked for antenatal care whereas less than one-quarter of the adult were unbooked. Pregnancy related complications such as, hypertensive disorders of pregnancy, cephalopelvic disproportion/obstructed labour and anaemia were more among the teenagers compared with the older women. There were also more preterm deliveries among the teenagers compared with the older women (17.2% VS 5.2%). Perinatal mortality rate was 155/1000 birth among the teenagers. The incidence of Low birth weight and perinatal mortality were significantly higher among the teenage mothers (P < 0.05). However, there was no statistical difference in the occurrence of morbidity and maternal mortality in both groups (P > 0.05). Conclusion: Pregnancy and deliveries in teenagers are high risk. Therefore, sex education as well as access to reproductive health information and care will help reduce the occurrence of unwanted pregnancies and their lasting impact on teenagers, their families, and the society.

Knowledge, Attitude and Awareness of Hazards Associated with Use of Cotton Bud in a Nigerian Community

Background: Self-cleaning of ears with a cotton bud is a common practice, and the hazards asso-ciated with such action are well documented. The aim of this study is to find out the knowledge, attitude and awareness on the use of cotton buds among the people of Bida community. Design and Methodology: It is a community based cross sectional descriptive study carried out among people of Bida community. Subjects were selected by multistage sampling technique. Pre-tested semistructured questionnaires were used to collect data from 278 young adults and adults’ respondents. Results: There were a total number of 278 responses out of 290 respondents interviewed (M:F = 1:1.03). Age range was from 18 to 65 years with a mean of 29.64 ± 10.06 SD. The highest response was in the age group of 20 - 29 years. About 72.3% of the respondents had tertiary education, and 40.3% were civil servants. Majority (92.8%) of the respondents had indulged in the use of cotton buds to clean their ears. Most (57.8%) of those that had used cotton buds did so because of itching in the ears. Only 44.9% of respondents agreed that cotton buds could cause damage to the ears. Many (61.2%) believed that there was benefit of using cotton buds in cleaning the ears. Majority of the respondents (74.1%) had not got information on the danger of using cotton bud in cleaning their ears. Conclusion: From our data in this study, majority of the subjects had indulged in the use of cotton bud in cleaning their ears. And the commonest reason for using cotton buds is due to itching in the ears. Their Knowledge, attitude and awareness to the use of cotton buds are very poor with erroneous believe that there is benefit to its use. There is a need to increase awareness by public enlightenment and health education and to establish school health programme in our various schools.