European Journal of Medical and Health Sciences 2020-02-27T02:09:41-05:00 Editor-in-Chief Open Journal Systems European Journal of Medical and Health Sciences The progress towards achieving the UNAIDS ambitious viral suppression target among adults living with HIV in South-Western Nigeria 2020-02-26T13:59:53-05:00 Saheed Opeyemi Usman Adetosoye Adebanjo Anuri Emeh Ererosanaga Ogboghodo Babatunde Akinbinu Chisom Udechukwu Jennifer Ale Chiedozi Akueshi Emmanuel Fatunsi Abimbola Ariyo Adijat Suraju Ekene Anugha Patrick Akande Femi Owolagba Toyin Jolayemi Prosper Okonkwo <p><strong>Background</strong>: In sub-Saharan Africa where genotypic drug resistance testing is rarely performed and poor adherence is blamed for the inability to achieve viral suppression and treatment failure, programmatic approaches to preventing &amp; handling these are thus essential. Hypothesis tested was antiretroviral therapy adherence effect on viral load outcome. This study was aimed at determining and monitoring HIV/AIDS disease progression using viral load to provide prognostic information and evaluate patients for viral suppression using the World Health Organization (WHO) guideline strategies.</p> <p><strong>Methods</strong>: This study was an observational study of subjects living with HIV already initiated on antiretroviral therapy for at least six months, enrolled in health facilities across Ondo State, South-Western Nigeria, during a 12-month observation period starting October 2018 till September 2019. Quantitative viral load analysis was done using Polymerase Chain Reaction, Roche Cobas Taqman 96 Analyzer. All data were statistically analyzed, using Statistical Package for the Social Sciences (SPSS), with multiple comparisons done using Post Hoc Bonferonni test. <strong>Results</strong>: A total of 8124 (1947 males &amp; 6177 females) subjects eligible for the study were recruited. Most of them are in the age range of 35 – 39 years, with a mean age of 42.02 ± 10.88 years. 7162 (88.2%) &amp; 1771 (21.8%) of the subjects had viral suppression of &lt;1000 RNA copies per ml and &lt;20 RNA copies per ml respectively. The unsuppressed subjects went through enhanced adherence counselling (EAC) for three months and viral load test repeated thereafter. 192 patients who had completed the three sessions of EAC and repeated viral load increased the entire suppression numbers to 7339 (90.3%) &amp; 1824 (22.5%) &lt;1000 RNA copies per ml and &lt;20 RNA copies per ml respectively during the period of observation. ART adherence has significant effect on viral load outcome from the study hypothesis tested.</p> <p><strong>Conclusion</strong>: Current ART regimen &amp; HIV treatment enhanced adherence counseling are key to the achieving viral suppression, thus, routine viral load monitoring will ultimately help in HIV/AIDS disease progression follow up and reduce treatment failure tendencies. This will help more patients stay on first line regimen and prolong their life expectancy, indicating that the UNAIDS last 90 target is achievable.</p> 2020-01-12T14:38:15-05:00 Copyright (c) 2020 Saheed Opeyemi Usman, Adetosoye Adebanjo, Babatunde Ankinbinu, Chisom Udechukwu, Jennifer Ale, Ererosanaga Ogboghodo, Anuri Emeh, Chiedozi Akueshi, Emmanuel Fatunsi, Abimbola Ariyo, Adijat Suraju, Ekene Anugha, Femi Owolagba, Patrick Akande, Toyin Jolayemi, Prosper Okonkwo Air Quality Toxicity Index (AQTI): Quantifying Air Pollution Impact on Disease Onset 2020-02-26T13:59:53-05:00 Harold I Zeliger <p>Air pollution impacts 90% of the world's population and is the number one cause of premature deaths worldwide, etiamted at 8-10 million pre year. Breathing polluted air is associated with the accelerated onset of numerous illnesses, including respiratory diseases, cardiovascular diseases, several cancers and Alzheimer's disease. Fice major pollutants are typically monitored in cities around the world for air quality. These include ozone, particulate matter, dulfur dioxide, nitrogen dioxide and carbon monoxide. The Air Quality Toxicity Index (AQTI), that is first reported here, provides a quantitative indicator with which to monitor air quality, make air quality comparisons of different locations and compare air quality of the same locations as a function of time.</p> 2020-01-16T14:03:33-05:00 Copyright (c) 2020 Harold I Zeliger A Review of Prevalence and Pattern of Intestinal Parasites in Nigeria (2006-2015) 2020-02-26T13:59:52-05:00 Oluwatobiloba Ibukunoluwa Funso-Aina Henry Nnaemeka Chineke Prosper Obunikem Adogu <p>Intestinal worm infestation has become a global health problem and still highly prevalent in the tropical region. Soil-transmitted helminth (STH) infections form the most important group of intestinal worms affecting two billion people worldwide, causing considerable morbidity and suffering, though largely preventable.</p> <p>Spatial distribution of helminth infections across the six geopolitical zones of Nigeria identified the following helminthes; <em>Ascaris lumbricoides,</em> hookworm, <em>Trichuris trichiura, S. stercoralis,</em> <em>Taenia </em>sp,<em> S. mansoni</em>,<em> S. stercoralis, Enterobius vermicularis </em>and<em> Hymenolopis nana</em>. This study revealed that prevalence of intestinal helminth in the country has not declined since the 1970s. <em>Ascaris lumbricoides </em>was the most prevalent helminth in the Southwestern (21%) and South-southern (13%) parts of Nigeria. Hookworm was the most prevalent helminth infection in the Southeastern (19%) while multiple infections were highly prevalent in Northern Nigeria (25% in North-central and 19% in the Northeast and Northwest, respectively). Cases of <em>Taenia sp</em> and <em>Schistosoma mansoni </em>infections were high in the Northeast and Northwest of Nigeria (8% and 6%, respectively).</p> <p>Nigeria has benefited from the Water, Sanitation and Hygiene (WASH) programme for over thirty years in the aspects of enhanced capacity building for applying personal hygiene and sanitation, improved water sources and provision of sanitation facilities and the National Emergency Group for coordination of emergency preparedness and response for WASH-related diseases. WHO estimated that more than 9% of the disease burden and 6% of deaths could be prevented by improving the WASH intervention programme. Children suffer the most, as 25% of global mortality of children (1 month<em>–</em>14 years) was linked with unsafe water and inadequate sanitation or insufficient hygiene, which was polarized in developing countries. To overcome challenge of WASH-related diseases, improved hygiene practices are essential. It is therefore important to sensitize people on the importance of water and sanitation practices through hygiene education. For effectiveness, hygiene education should be incorporated into the curriculum of schools from primary to tertiary institutions.</p> 2020-01-16T14:17:47-05:00 Copyright (c) 2020 Funsho-Aina Oluwatobiloba Ibukunoluwa, Henry Nnaemeka Chineke, Prosper Obunikem Adogu Patient Waiting Time: Gaps And Determinants Of Patients Waiting Time In Hospitals In Our Communities To Receive Quality Services 2020-02-26T13:59:52-05:00 Saheed Opeyemi Usman E. Olowoyeye O. J. Adegbamigbe G. P. Olubayo A. A. Ibijola A. B. Tijani I. N. Usman O. J. Fatunmbi T. C. Omisakin T. Ipinmoye <p><strong>Background</strong>: Patient waiting time has been recognized as an important indicator for determining the quality of healthcare services offered by health facilities. Waiting time is strongly related to patients’ satisfaction with the care received at the hospital in general.</p> <p><strong>Methods: </strong>This is a descriptive cross-sectional study carried out in February 2018 among new patients attending general out-patient department (GOPD) of randomly selected hospitals in South-Western Nigeria. A structured pre-tested questionnaire was used to elicit information from 223 patients who were recruited into the study using a convenience sampling method.</p> <p><strong>Results: </strong>The average total clinic waiting time (TCWT) from entry to seeing a medical doctor was 137.02 ± 53.64 minutes. Only 6 (2.7%) met the Institute of Medicine (IOM) recommendation of having at least 90% of patients seen within 30 minutes of their scheduled appointment in contrast to 193 (86.5%) of respondents desiring to wait not more than 30 minutes for whatever reason before been attended to by the doctor. Although, the level of satisfaction was high (81.2%) in this study, patients who waited longer (&gt;180 min) are more likely to be dissatisfied with services rendered in the OPDs (χ² = 20.104, df = 1, P = 0.001). Factors such as few health personnel (81/120) and having an insurance cover contributed significantly to the waiting time (χ² = 19.54, df = 1, P = 0.001).</p> <p><strong>Conclusion: </strong>In a competitively managed health care environment, patient waiting time play an increasingly important role in a clinic’s ability to attract new business. Efforts therefore, should be made not only to reduce the patient waiting time, but health managers should invest in resources and activities that ensure a productive use of the time patients spend in the process of seeking healthcare services.</p> 2020-01-16T14:40:57-05:00 Copyright (c) 2020 Saheed Opeyemi Usman, E. Olowoyeye, O. J. Adegbamigbe, G. P. Olubayo, A. A. Ibijola, A. B. Tijani, I. N. Usman, O. J. Fatunmbi, T. C. Omisakin, T. Ipinmoye Single Renal Metastasis From Cervical Cancer 2020-02-26T13:59:51-05:00 Youssef Ghannam Oussama Elidrissi H. Moudlige M. Dakir A. Debbagh R. Aboutaieb <p>63-year-old patient, followed for cervical cancer classified 2b; declared cured after a treatment with chemo-radiotherapy and brachytherapy and who presents after 10 months of his last treatment session a fortuitous discovery of a right renal mass The patient subsequently benefited from a right enlarged total nephrectomy whose anatomo study pathology showed the appearance of a secondary epidermoid carcinoma of cervical neo.</p> <p>In our case, there is a single renal metastasis of cervical cancer with no local development and after 10 months from the end of treatment.</p> 2020-01-22T15:52:04-05:00 Copyright (c) 2020 Youssef Ghannam, Oussama Elidrissi, H. Moudlige, M. Dakir, A. Debbagh, R. Aboutaieb Emphysematous Cystitis Responsible for a Bladder Perforation 2020-02-26T13:59:51-05:00 Moussaab Rachid El Mahdi Graiouid Mohammed Dakir Adil Debbagh Rachid Aboutaieb <p>Emphysematous cystitis is a rare form of lower urinary tract infection characterized by the presence of gas in the lumen and / or bladder wall. We report a case of a 64 year old patient hospitalized for an acute abdominal table. The diagnosis of emphysematous cystitis complicated by bladder perforation was made after performing an abdominal scan. Medico-surgical treatment has been initiated.</p> 2020-01-24T11:42:56-05:00 Copyright (c) 2020 Moussaab Rachid, El Mahdi Graiouid, Mohammed Dakir, Adil Debbagh, Rachid Aboutaieb Robots Visit Homes For Elderly People Who Have Difficulty Going Out and Practice Brain Training 2020-02-26T13:59:51-05:00 Kazue Sawami Mitsuo Kimura Tetsuro Kitamura Masahiko Kawaguchi Mihoko Furusumi Chizuko Suishu Naoko Morisaki Sonomi Hattori <p class="Abstract"><em><u><span lang="EN-US">Introduction</span></u></em><span lang="EN-US">: When it becomes difficult for the elderly to go out due to a decrease in walking ability, the decline in their mental and physical function accelerates. Currently, elderly people who have difficulty going out have no effective measures in place. Therefore, we wanted to prevent their functional decline by visiting homes and intervening. For the intervention, a robot developed for brain training for the elderly people was used. The goal was not only brain training, but also to obtain psychological activation through interaction with robots and supporters.</span></p> <p class="Abstract"><em><u><span lang="EN-US">Method</span></u><span lang="EN-US">: </span></em><span lang="EN-US">The subjects were elderly people who had difficulty going out. Researchers, supporters, and robot visited their homes to conduct brain training by robots and recollection methods were performed with supporters. Cognitive tests (immediate and delayed reproduction of 10 words) and psychological surveys (interviews) were conducted before and after the intervention.</span></p> <p class="Abstract"><em><u><span lang="EN-US">Result</span></u><span lang="EN-US">: </span></em><span lang="EN-US">There were 29 subjects, 8 males, and 21 females, with an average age of 79.5 ± 4.95. The maximum score for the cognitive test is 10. Immediate playback was improved from 5.5 points to 8.1 points (p &lt;0.01), and delayed playback was improved from 4.7 points to 7.5 points (p &lt;0.01). In the analysis of psychological verbatim record, as a result of the pre-interview, “Once I stop going out, it becomes troublesome to get dressed up and go out”, “There are days when I don't talk about anything all day”, “If someone doesn't come or make a phone call, there are no chance of a conversation”. In the interview after the start, there were most categories as “I came to think that vitality is important”, “I became more motivated”, and “I'm looking forward to talking”. As for robots, there were many reactions such as cuteness, healing, and fun compared to interpersonal communication.</span></p> <p class="Abstract"><em><u><span lang="EN-US">Conclusion</span></u><span lang="EN-US">: </span></em><span lang="EN-US">Brain training during the visits showed that there is a significant improvement in cognitive score, and that it is effective as a countermeasure for the elderly who cannot go out. In addition, the robot has a high affinity for all subjects, the effect of softening the tension associated with receiving the visit was confirmed. Conversation with a robot that resolves the shortage of human resources is meaningful because in the situation where no one talks to anyone throughout the day the utilization of robot shows the improvement in energy and motivation due to increased conversation. By supplementing the interaction with regular supporters to this, it can be a more effective measure.<u></u></span></p> 2020-02-08T09:24:24-05:00 Copyright (c) 2020 Kazue Sawami, Mitsuo Kimura, Tetsuro Kitamura, Masahiko Kawaguchi, Mihoko Furusumi, Chizuko Suishu, Naoko Morisaki, Sonomi Hattori Child Schizophrenia: Theory and Practice 2020-02-26T13:59:50-05:00 Petro Petlovanyi Anatolii Tsarkov <p>Child schizophrenia is a mental disorder that affects brain structures, emotional and cognitive functions. The disorder is characterized by psychotic symptoms: disorder of thinking, inadequate emotional reactions, disorganized behavior, deterioration of social functioning and loss of will. Schizophrenia in children is one of the most common mental illnesses affecting up to 1% of all children. For a long time, the term "child schizophrenia" was used to refer to various disorders that had similarities with each other. Children were referred to schizophrenics if they had borderline symptoms. Child schizophrenia develops gradually; sudden onset it is not common. Schizophrenic child requires help from multidisciplinary team members including child and adolescent psychiatrist and all possible levels of psychotherapy and psychological interventions. This article discusses classification, clinical presentation, all possible treatment and rehabilitation of children with schizophrenia.</p> 2020-02-12T12:31:49-05:00 Copyright (c) 2020 Petro Petlovanyi, Anatolii Tsarkov Histological Evaluation Of Articular Cartilage Damage Following Radiofrequency Chondroplasty 2020-02-26T13:59:50-05:00 Vidhya Lakshmi S. Rufus V. Raj Santhosh Sahanand <p><u>Background</u>: Radiofrequency probes have been used extensively in various arthroscopic procedures. Measurable cartilage damage occurs after radiofrequency probe application. However, the histological changes of cartilage damage following radiofrequency chondroplasty have not been extensively studied.</p> <p><u>Materials &amp; Methods</u>: Articular cartilage specimens were obtained from patients undergoing total knee replacement surgeries. Radiofrequency probes were applied at 1, 3 and 5 seconds and samples were sent to histopathology laboratory. The histological changes of cartilage damage were analyzed using the International Cartilage Repair Society (ICRS) assessment scale. Safranin O staining was done to assess the proteoglycan content.</p> <p><u>Results</u>: Histologically measurable articular cartilage damage occurs after radiofrequency probes</p> <p><u>Conclusions</u>: The time of application of radiofrequency probes should be optimized so as to minimize cartilage damage.</p> 2020-02-13T15:13:21-05:00 Copyright (c) 2020 Vidhya Lakshmi S., Rufus V. Raj, Santhosh Sahanand Breast Reconstruction Surgery in the Netherlands, an Alternative Payment Method for Breast Reconstruction Surgery. Are Extra Fees Feasible in the Context of Reconstructive Surgery? 2020-02-16T14:46:21-05:00 Saeed Alqahtani Mohammed Ahmedhani Kilani Shahbaz Mansoor <p>Breast cancer is the most common cancer in women in the Netherlands, and breast reconstruction is becoming a common surgical procedure for women who have had a mastectomy. Reconstruction post breast cancer treatment is covered by conditional reimbursement until 01-04-2020 as long as it as an autologous fat transplant. Conditional reimbursements are special legal exceptions under constant consideration by the Ministry of Health and require evidence on treatment and cost effectiveness to be moved to basic healthcare package.</p> <p>Surgeons at Maastricht UMC+ have developed sophisticated techniques for women that undergo a reconstruction surgery to recover sensitivity of the breasts. Improved sensitization would lead to a better quality of life and protect the skin against thermal and mechanical injuries. However, current health insurance coverage of breast reconstruction does not permit these additions. Furthermore, the reimbursement system in The Netherlands does not allow people to pay an extra fee for these additions.</p> 2020-02-16T14:46:21-05:00 Copyright (c) 2020 Saeed Alqahtani, Mohammed Ahmedhani Kilani, Shahbaz Mansoor The Treatment Planining of Rectum Tumors and The Use of The Wedge Filter for Ensuring The Correct Isodoses 2020-02-22T12:13:24-05:00 Idajet Selmani Partizan Malkaj <p>One of the most important issues in the field of radiotherapy is the correct distribution of the dose around the volume of interest or planning target volume (PTV). For making this possible the exact isodose in a treatment plan has to cover the PTV, so it is used the wedge which is a part of the linear accelerator head. Wedge plays the role of a filter and usually it is called wedge filter. The wedge filter is in use almost in all treatment plans, for all the parts of the body. In this paper it is consider the use of the wedge filter for treatment of rectum tumors.</p> <p>The process starts with the scanning of the patient and the deliantion of the interest’s volums in the Monaco system. In the following the imagins have been sent in the treatment planning system for making the nesessary plans for treatment of the rectum. Two plans were done, one with the use of the wedge and the other without using it. The dose volume histogram helps for compering the results of the plans. The best conformity of the isodoses it was for the plan with the use of wedge through volume of interest, which is planning target volume (PTV).</p> 2020-02-22T12:13:24-05:00 Copyright (c) 2020 Idajet Selmani, Partizan Malkaj Oxidative Stess Index (OSI) Condensed Questionnaire 2020-02-24T15:26:05-05:00 Harold I Zeliger <p>The oxidative Stress Index (OSI) has been shown to predict the onset of non-communicative disease.&nbsp; A condensed form of the OSI questionnaire has now been developed to enable meaningful OSI data to be obtained from answers to only eight questions, rather than the 400+ items contained in the original detailed questionnaire.</p> 2020-02-24T15:26:05-05:00 Copyright (c) 2020 Harold I Zeliger Corneal Placido Topography And Its Correlation With The Best Fitting Curve For Non-Astigmatic Eyes 2020-02-27T02:09:41-05:00 Evangelos S. Pateras Karaabatsas Konstantinos <p>Placido topographer CSO Phoenix had been used to measure 30 peoples corneas with astigmatism &lt; 0.50 Dc (<em>University of West Attica</em>) and their refractive maps were taken. The refractive power map was used with measurements taken at the horizontal (180°), vertical (90°), and oblique axes (45° and 135°) for each of these 30 people. The keratometric measurements for &gt; 5mm were recorded. The investigation took place at University of West Attica. The results showed that the shape of the cornea varies in the various meridians (e.g. 180° or 90°) and even with oblique meridians (e.g. in the nasal relative to the temporal side) and its curvature correlates with a different equation for each meridian.</p> 2020-02-27T02:09:41-05:00 Copyright (c) 2020 Evangelos S. Pateras, Karaabatsas Konstantinos