MOSP - Macao Scientific Publishers

文章

Meta-analysis of the prognostic role of p53: Playground for solution or source of confusion?

Georgia Levidou*, Paraskevi Fragkou, Efstratios Patsouris and Penelope Korkolopoulou

Abstract: Deregulation of the p53 gene is considered to be a prognostic marker in patients with tumours. In this review we are summarizing the results of meta- analyses dealing with the prognostic role of p53 status published in the literature. We found 7 studies examining 5 different tumours (osteosarcoma, ovarian carcinomas (OC), astrocytomas, urothelial bladder carcinomas and non-small lung cell carcinomas (NSCLC)). Significant results are reported in four of the studies (OC and NSLCC). However, most of the studies found significant heterogeneity, particularly those that reported significant results, whereas the majority used the results of univariate survival analysis for quantitative synthesis. Despite the significant information published the last decades regarding the role of p53 alterations in the clinical course of patients with malignant tumours, it could be argued that there is a huge amount of studies that cannot be combined in order to provide more valid and aggregated results.[...] Read More.

Keywords: Overexpression, tumours, p53 protein, immunohistochemistry.

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Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children

Abdulraheem I. S.*, Onajole A. T., Jimoh A. A. G. and Oladipo A. R.

Abstract: Mothers play an important role in immunization of their children. A target of 95% immunization coverage is necessary for the sustained control of vaccine preventable diseases. Partial immunization coverage against vaccine preventable diseases is a significant public health problem especially in rural areas in Nigeria. The reasons for partial immunization and factors responsible for missed opportunities are poorly understood and little data is available to explain the phenomenon that could support the decision making. This study aimed at finding out the reasons for partial immunization and factors responsible for missed opportunities for immunization in children less than one year of age. Mothers of children within one year of age were the study subjects using a cross-sectional study design. The immunization card was utilized to check for completeness and correctness of immunization schedule, and also for identifying the appropriate use of all available opportunities for immunization. About two-third (62.8%) of the children were not fully immunized by one year of age, 33.4% had experienced a missed opportunity for immunization and 36.4% were partially and incorrectly immunized. Parents objection, disagreement or concern about immunization safety (38.8%), long distance walking (17.5%) and long waiting time at the health facility (15.2%) are the most common reasons for partial immunization. Missed opportunities for immunization and partial immunization need to be avoided in order to enhance the fully immunized percentage for those children who reach the health facility, especially in rural areas where the immunization coverage is below the expected national coverage (minimum 80%).[...] Read More.

Keywords: Incomplete vaccination, reasons and factors, rural Nigerian children.

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The pattern of skin disorders in a Nigerian tertiary hospital

D. D. Atraide, M. R. Akpa and I. O. George*

Abstract: We analyzed the data of patients with skin disorders attending the Dermatology Clinic of the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria with the aim of identifying common skin disorders in our community. All patients attending the Dermatology Clinic of the UPTH, Nigeria from January 2005 to December 2008 were included in this retrospective analysis. The medical records of the patients (dermographics, history, physical examination and laboratory investigations) were analysed to ascertain the diagnosis. All patients were evaluated by qualified dermatologists. A total of 1,333 patients attended the Dermatology Clinic of UPTH. There were more females 812 (60.9%) than males 521 (39.1%). More than three quarter of the cases were aged above 16 years while less than a quarter were children below 16 years. Infectious diseases 317 (23.8%), mostly fungal 207 (15.5%) were the most common cause for attendance, followed by dermatitis 207 (15.5%) and pigmentary disorders 98 (7.4%). Preventable skin diseases are common in Port Harcourt, Nigeria. Health education is therefore necessary to curb their spread, reduce the associated morbidity, and improve the health status of the population. Effort should be made to train health workers in the diagnosis and treatment of the more common dermatologic conditions.[...] Read More.

Keywords: Pattern, skin disorders, infectious diseases, Port Harcourt, Nigeria.

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Concurrent sexual partnerships among Chinese men: Evidence from a national population-based survey

Full Length Research Paper

Abstract: We sought to determine the pattern of the concurrent sexual partnerships among Chinese men and its correlates with individual, partnership and community factors. Using data from the Chinese Health and Family Life Survey, we examined the prevalence and distribution of sexual concurrency of 1689 men. A two-level logistic regression was employed to assess variables associated with sexual concurrency. Nine percent of men had concurrent sexual partnerships in preceding year. Sexual concurrency was associated with higher income (OR, 1.21; 95% CI, 1.02 to 1.48), longer traveling time (OR, 2.03; 95% CI, 1.44 to 2.87), and more frequent socializing activities (OR, 1.15; 95% CI, 1.01 to 1.30). Men who perpetrated domestic violence (OR, 1.92; 95% CI, 1.20 to 3.08) and perceived partners having other concurrent partners (OR, 4.19; 95% CI, 1.95 to 9.02) were more likely to have concurrent sexual partnerships. Tolerant community attitude towards sexual behavior and community education level showed effects on men’s concurrency involvement. The results contribute to a better understanding of the potential role of concurrent sexual partnerships in the spread of HIV and other STIs in China.[...] Read More.

Keywords: Concurrent sexual partnerships, risk factors, human immunodeficiency virus prevention, Chinese men.

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Visceral fat with its risk factors amongst the Indonesian Javanese elderly

Fatmah, Yusran

Abstract: Direct and indirect risk factors are implied in increased elders’ visceral fat level, namely socio-economic, gender, age, workload, physical activities and eating pattern. The aim of study was to get the information on visceral fat level and its risk factors amongst The Indonesian Javanese elderly. A total of 812 elder’s (517 women and 295 men) participated in the cross sectional study. Results showed that 12.8% of respondents with high level of visceral fat and 26.7% almost reach high level. Rural and urban areas, educational background, workload when aged 25 and 55 years, and physical activities aged 25 and 55 years had significant correlation with the visceral fat. Body Mass Index (BMI), weight, and height had a significant association with the visceral fat whereas the highest on the BMI (r = 0.896). A decreased visceral fat pattern following reduced weight and height according to sex. Mild physical workload aged 55 years had the opportunity of 2.29 times greater than those who had the heavy workload level at the same age. Nutrition education for elderly should include advice to increase physical activity in order to reduce high level of visceral fat.[...] Read More.

Keywords: Visceral fat, risk factors, elderly, physical activity, workload.

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Physical violence among intimate partners in Nigeria: A multi level analysis

Yusuf O. B.*, Arulogun O. S., Oladepo O. and Olowokeere F.

Abstract: Gender based violence is gaining more and more recognition, the world over. The prevalence and factors associated with physical violence as it affects both men and women taking into account the hierarchical nature of the data was reported in this study. A descriptive cross sectional survey was carried out on adult women and men in three selected states of Nigeria. A random effect logistic model was fitted. More female respondents had experienced physical violence compared with males. Behavioural factors of partners were found to greatly influence domestic violence against females such as young age and partner’s smoking and drinking status. These results would provide more insights into the determinants of violence in developing country settings.[...] Read More.

Keywords: Physical violence, intimate partners, multilevel analysis, determinants.

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Technical competence of tutors in pre-service health training institutions on Expanded Programme on Immunization in North Western Nigeria

A. S. Umar*, A. O. Olatunji*, A. O. Abiola, A. Yakubu and M. Oche

Abstract: The study was conducted to assess the knowledge and skills of tutors on Expanded Program on Immunization (EPI) in some pre-service health training institutions in Nigeria to identify their training needs. The study was a cross sectional survey using a structured self-administered questionnaire and an observational checklist. A total of 62 tutors from 5 pre-service health training institutions were selected. The level of knowledge was assessed using a scoring system as adequate or in adequate. Overall, 25 (40.3%) of respondents’ had adequate knowledge on basic knowledge on immunization concepts, principles and components of Reaching Every Ward approach (REW). The overall mean score was 24.4 ± 2. In all the 5 schools studied, there were no teaching aids (vaccine carriers, ice packs, cold box, AD syringes, safety box, IEC materials and data tools) and no reference materials (REW field guide or immunization in practice) in the school library. In-service training is the only variable that have demonstrated significant statistical association on overall knowledge of respondents’ (df = 1; F = 8.62; P[...] Read More.

Keywords: Tutors, pre-service health training institutions, knowledge, teaching aids, Expanded Programme on Immunization (EPI), Nigeria.

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Antibiotic self-medication among university medical undergraduates in Northern Nigeria

Joseph O. Fadare* and Igbiks Tamuno

Abstract: Self-medication is becoming a common type of self-care behavior among the population of many countries. Many international studies have investigated the prevalence and nature of self-medication practices at the population level. In Nigeria, some workers have also looked at the population prevalence of self-medication in general; however the prevalence of antibiotic self-medication among medical undergraduates has not yet been studied. The interest in studying this practice among this select group is due to the fact that they are the future prescribers and health educators of the population of Nigeria. The study was a cross-sectional pre-tested questionnaire-based study carried out among medical students of the Bayero University, Kano, North-West Nigeria during a two-week period in August 2008. The information from the returned questionnaire were coded, entered and analyzed using SPSS Version 12 statistical software. A total of 183 students filled and returned the questionnaire giving a response rate of 83.2%. Out of these respondents, 120 (65.6%) were males and the mean age of respondents was 23.2 ± 2.5 years (Range 17 to 31). 71 (38.8%) of the medical students admitted to the practice and there was no statistically significant difference among the different levels of medical education (p >0.05). Antibiotics from the penicillin group (ampicillin/cloxacillin, amoxicillin and ampicillin) were the most frequently used. Self-medication with antibiotics is prevalent among medical undergraduates in Northern Nigeria. There is a need for an intervention to address this practice.[...] Read More.

Keywords: Antibiotics, self-medication, medical undergraduates, Nigeria.

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Comparison between all patients refined diagnosis related groups with the centre for medicare and medicaid services diagnosis related groups

Alberto Pilotto, Marilisa Franceschi, Mauro Di Bari, Franco Rengo, Roberto Bernabei, Luca Lorenzoni, Niccolò Marchionni and Antonio Greco

Abstract: Aim of the study was to compare the ability of the all patients refined diagnosis related groups (APR-DRG) with the centre for medicare and medicaid services diagnosis related groups (CMS-DRG) in predicting multidimensional impairment of elderly patients. Cases discharged from 20 geriatric units were grouped by the CMS-DRG and the APR-DRG. A comprehensive geriatric assessment (CGA) was performed using the activities of daily living (ADL), instrumental activities of daily living (IADL), short portable mental status questionnaire (SPMSQ), comorbidity index rating scale (CIRS), mini nutritional assessment (MNA), geriatric depression scale-short form (GDS-SF) and exton smith scale (ESS). Number of drugs at admission (DPA) and length of stay (LOS) were also recorded. CMS-DRG and APR-DRG relative weights (RW) were used for comparisons. 1273 patients were included. With increasing the APR-DRG-RW, a significant increase in the prevalence of impaired patients was found in ADL, IADL, SPMSQ, CIRS, GDS-SF and ESS. The CMS-DRG-RW subgroups showed a significant difference for MNA and GDS-SF. LOS was significantly different for both APR and CMS DRG. The number of CGA domains in which APR showed a more significant trend in disability when compared to CMS DRG demonstrates that the former was a better predictor of multidimensional impairment.[...] Read More.

Keywords: All patients refined diagnosis related groups (APR-DRG), centre for medicare and medicaid services diagnosis related groups (CMS-DRG), comprehensive geriatric assessment, elderly.

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Analysis of factors related to complaints in medical schemes

Michael Mncedisi Willie

Abstract: Medical schemes are insurance institutions that cover medical expenses in South Africa. These institutions reimburse their members for actual expenditure on health. The Medical Schemes Act (Act 131 of 1998) defines the business of a medical scheme as the business of undertaking liability in return for a contribution in order to make provision for obtaining any relevant health service. The Council for Medical Schemes (CMS) is an autonomous statutory body created by parliament to regulate the medical schemes industry in South Africa. The CMS handles complaints from members of medical schemes. The objective of the study was to assess factors that impact on the response time to complaints by members of medical schemes. Survival analysis techniques were employed to assess these factors. The regression models controlled for factors such as, medical scheme type, medical scheme size, severity of complaints and effects of the analysts. The model revealed the effect of analysts as a significant factor to response time to complaints. The findings of the study revealed useful results in terms of identifying analysts that take longer to resolve complaints. The study also revealed that the nature of complaints as an important factor to the response time. There is a need for the complaints department to be properly resourced and continuously train staff to ensure effective resolution of complaints in medical schemes.[...] Read More.

Keywords: Survival analysis, Kaplan-Meier, Tarone-Ware test, Cox proportional hazard model, log-rank test.

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