Background: The failure to monitor and link patients from HIV testing to HIV care and retain them in care until they are eligible for ART is a major barrier to early ART initiation. This study evaluated the retention ...Background: The failure to monitor and link patients from HIV testing to HIV care and retain them in care until they are eligible for ART is a major barrier to early ART initiation. This study evaluated the retention in pre-ART care of HIV-positive patients who are ineligible to start ART in Nigeria. Methods: Out of 1766 ART-ineligible HIV-positive patients enrolled into pre-ART care (during 1st March to 31st December 2007), 1,098 patients were randomly selected for a five-year (ending 30th April 2012) retrospective cohort assessment using routine data in two health facilities. Retention was defined as remaining connected to pre-ART care once entered until ART initiation or transfer-out to continue care elsewhere. Probability of retention was estimated using Kaplan-Meier survival method and log-rank test. Cox proportional hazards model was used for attrition and P P P P = 0.000]. Socio-demographic characteristics, CD4 cells count and WHO clinical stage at pre-ART enrolment were not associated with attrition (P > 0.05). Conclusion: Retention in pre-ART care was somewhat poor. Uptake of CPT significantly improved retention. Majority of attrition occurred in first year of pre-ART care. Close monitoring and tracking of patients during this period is recommended.展开更多
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 t...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.展开更多
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 chan...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.展开更多
文摘Background: The failure to monitor and link patients from HIV testing to HIV care and retain them in care until they are eligible for ART is a major barrier to early ART initiation. This study evaluated the retention in pre-ART care of HIV-positive patients who are ineligible to start ART in Nigeria. Methods: Out of 1766 ART-ineligible HIV-positive patients enrolled into pre-ART care (during 1st March to 31st December 2007), 1,098 patients were randomly selected for a five-year (ending 30th April 2012) retrospective cohort assessment using routine data in two health facilities. Retention was defined as remaining connected to pre-ART care once entered until ART initiation or transfer-out to continue care elsewhere. Probability of retention was estimated using Kaplan-Meier survival method and log-rank test. Cox proportional hazards model was used for attrition and P P P P = 0.000]. Socio-demographic characteristics, CD4 cells count and WHO clinical stage at pre-ART enrolment were not associated with attrition (P > 0.05). Conclusion: Retention in pre-ART care was somewhat poor. Uptake of CPT significantly improved retention. Majority of attrition occurred in first year of pre-ART care. Close monitoring and tracking of patients during this period is recommended.
文摘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.
文摘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.
