Ibom Medical Journal

A call for action: Experiences of Intimate Partner Violence among Pregnant Women attending Antenatal Clinics in Primary Health Centres in Kotangora, North-Central Nigeria

Ajayi AO — 2026-10-01

Context: Intimate Partner Violence (IPV) particularly during pregnancy is a significant global public health challenge that negatively impacts maternal and child health outcomes. Therefore, this study aimed to assess the prevalence, patterns, and determinants of IPV among pregnant women in Kotangora, North-Central Nigeria.

Materials and Methods: A descriptive cross-sectional study conducted among 441 pregnant women attending antenatal clinics in Primary Health Centres. Multistage sampling technique was used to select respondents and data were collected using a pretested semi-structured questionnaire. Data analysis was done at univariate, bivariate, and multivariate levels. Level of significance was set at p < 0.05.

Results: Prevalence of physical violence among the pregnant women was 84.1%. Patterns of physical abuse experienced by majority of the respondents 347, (78.7%) included hair pulling, being kicked 323, (73.2%) and 346, (78.5%) said their partners had tried to choke them. A significant proportion of the study participants 408, (92.5%) also reported experiencing sexual abuse by their husbands. The predictors of IPV among the pregnant women were age at marriage (p=0.006; OR: 4.293; 95% CI: 1.524 to 12.099), family setting (p=0.021; OR: 0.277; 95% CI: 0.094 to 0.1823), level of education (p=0.06; OR: 6.017; 95% CI: 0.927 to 39.052) and living with husband’s relatives. (p=0.001; OR: 7.299; 95% CI: 2.353 to 22.648).

Conclusion: The high prevalence of IPV among pregnant women in Kotangora underscores the need for targeted interventions addressing socio-cultural factors. Incorporating routine IPV screening into antenatal care and implementing policy reforms focused on women's empowerment are crucial for improving maternal and child health outcomes.

A point prevalence of healthcare-associated infections in a university teaching hospital in Lagos, Nigeria

Oduyebo OO — 2026-10-01

Healthcare-associated infections (HAIs) are of significant public health concern. They are associated with antimicrobial resistance and they increase the cost of healthcare, morbidity and mortality.
This study is a point prevalence survey of healthcare associated infection among admitted patients in the Lagos University Teaching Hospital (LUTH). It was done using the protocol of the optional healthcare- associated (HAI) module of Global Point Prevalence Survey (G-PPS) to determine the prevalence of healthcare-associated infections and the associated risk factors.

The prevalence of HAIs in Lagos University Teaching Hospital (LUTH) was 7.4 for unit-specific HAI prevalence; the intensive care unit had the highest prevalence of 50%, followed by the surgical wards (11.8%), while the Child and Neonatal wards had the lowest HAI prevalence of 3.3%. The associated risk factors included invasive procedures such as insertion of central venous catheter, urinary catheters, ventilators and surgery. Ventilator-associated pneumonia (25.0%) was the leading HAI in the adult ICU ward.

Assessment of Knowledge of Community-Based Approaches to Substance Use Interventions: Best Practices and Innovative Programs Among Medical Doctors in Akwa Ibom State

Eziagu EO — 2026-10-01

Context: Community-Based Approaches (CBAs) are employed in substance use disorder treatment, but the familiarity and attitudes of medical doctors in Akwa Ibom State to these practices are not known. The purpose of this study was to assess how familiar Akwa Ibom State's medical doctors are with community-based approaches to drug use interventions, with a focus on best practices and cutting-edge initiatives.

Materials and Methods: A descriptive cross-sectional survey was conducted among medical doctors residing in Akwa Ibom State, Nigeria. Participants were recruited through convenience sampling using an electronic questionnaire distributed through professional medical groups. Data were collected using a structured questionnaire comprising both closed-ended and open-ended questions, thereby incorporating quantitative and qualitative components. Quantitative data were analysed using descriptive and inferential statistics, while responses to open-ended questions were analysed thematically.

Results: A total of 65 responses were received from medical doctors. The mean age of the respondents was 37.9 ± 4.9 years, with a slight preponderance of male respondents (58.5%). The concept of community-based approaches in substance use care, particularly the specific approaches/interventions, was mostly unfamiliar (69.2%) to the respondents. Despite their limited familiarity, the respondents correctly perceived (68.2%) CBAs. Inferential analysis showed no significant difference in familiarity scores by gender (p = 0.564), but significant differences were observed across years-of-experience categories (p = 0.046) and between psychiatry and other specialties (p = 0.016).

Conclusions: Generally, familiarity with community-based approaches to substance use treatment was poor among the respondents. However, they had good perceptions about them. Community-Based Education needs to be integrated into postgraduate training as it already is with undergraduate training.

Awareness and utilization of the who surgical safety checklist among surgical staff in a Nigerian tertiary hospital

Ilo IS — 2026-10-01

Context: The WHO Surgical Safety Checklist (SSC) is a standardized tool to improve patient safety and reduce surgical errors. Despite global adoption, consistent use remains limited in many healthcare systems.

Objective: To assess awareness, knowledge, and utilization of the SSC among surgical staff in a Nigerian tertiary hospital, and to describe perceived barriers to its use.

Methods: A descriptive cross-sectional electronic survey used total enumeration of all 93 members of a departmental theatre-users WhatsApp group at Federal Medical Centre Umuahia; 78 responded (83.9%). A structured questionnaire assessed awareness, training, knowledge of checklist phases, and self-reported use. Frequencies and percentages were calculated; associations with professional cadre were assessed using Fisher–Freeman–Halton exact tests with Monte Carlo estimation.

Results: Awareness was reported by 77 (98.7%), while 33(42.3%) had received formal training and 60 (76.9%) stated that they knew the three checklist phases. Routine use was reported by 42(53.8%), but only 13 (16.7%) reported always using the checklist. Sign-in was most often identified as the consistently applied phase (61; 78.2%), while sign-out was most often identified as skipped (49; 62.8%). Professional cadre was associated with reported knowledge of the phases (exact p < 0.001), but not with routine use (exact p = 0.167); the study was not powered for these comparisons.

Conclusion: Awareness was almost universal, but formal training and consistent checklist use remained limited. The sign-out phase was particularly vulnerable to omission. Multidisciplinary training and periodic assessment of actual checklist completion may improve implementation; these self-reported findings do not establish observed adherence.

Characteristics, Outcomes, and Predictors of Mortality of Acute Kidney Injury in a Rural Tertiary Hospital in Southern Nigeria

Rafiu MO — 2026-10-01

Context: Acute kidney injury (AKI) is a major contributor to global morbidity and mortality in critically ill patients. In Nigeria, AKI is commonly associated with preventable conditions, particularly infections; however, data on its characteristics, outcomes, and predictors of mortality are limited.

Objective: This study assessed the characteristics, outcomes, and predictors of mortality among patients with AKI at the Irrua Specialist Teaching Hospital (ISTH), Edo State.

Materials and Methods: A hospital-based retrospective study was conducted on 200 patients diagnosed with AKI at ISTH. Associations between variables and mortality were assessed using the chi-square test and Fisher’s exact test. Binary logistic regression was used to determine the predictors of mortality at a level of significance of p < 0.05.

Results: The mean participant age was 45.11 ± 23.18 years, with a male predominance (69%). Most cases of AKI were community-acquired (182, 91%), and sepsis/infection was the leading cause of AKI (115, 57.5%). Overall, 162 participants (81%) presented with stage 3 disease, 157 participants (78.5%) required dialysis, 19 participants (9.5%) achieved complete renal recovery, and the mortality rate was 27.5%. Mortality was significantly associated with higher Kidney Disease: Improving Global Outcomes (KDIGO) stage (p = 0.024), elevated blood urea nitrogen (p = 0.022), presence of complications (p = 0.001), dialysis requirement (p = 0.025), and intensive care unit (ICU) admission (p = 0.001). ICU admission (AOR = 0.035, 95% CI = 0.008 – 0.146, p <0.001), dialysis requirement (AOR = 0.313, 95% CI = 0.100 – 0.983, p = 0.047), and place of residence (AOR = 0.430, 95% CI = 0.187 – 0.989) were identified as independent predictors of mortality.

Conclusion: AKI in this setting is predominantly community-acquired and infection-related. Mortality is primarily driven by clinical severity and complications rather than by the underlying cause. Strengthening early detection, infection control, and access to renal and critical care services are essential to improve outcomes in resource-limited settings such as ours.

Contraceptive prevalence and factors associated with its use among women of child bearing age in Amai Community of Ukwani Local Government Area, Delta State, Nigeria

Etim JJ — 2026-10-01

Context: The use of contraceptives is essential for family planning in terms of child spacing. Its use is a cost‑effective public health measure for reducing maternal deaths due to unintended and high‑risk pregnancies. In other words, it improves reproductive health, and gender equity among women in developing countries as well improves maternal health by lowering cases of unwanted pregnancies. This study objective was to determine the prevalence of contraceptive use, types and factors associated with its use among women of child-bearing age.

Materials and Methods: This study adopted a descriptive cross-sectional study design. Questionnaires were used to collect data from 299 respondents using multi-stage sampling techniques. Data were analyzed using Statistical Package for Social Sciences version 26. Inferential statistic (Chi-square) was done at 0.05 significant level. Results were presented in tables.

Results: The prevalence of contraceptive practice was 49.8%. Condoms (10.4%), injectables (16.7%), implants (16.4%), pills (29.8%) and withdrawal method (26.8%) were the identified contraceptive methods used by respondents. Of all these methods, pills were the most used. This study indicates that there is an association between socio-demographic variables and the practice of contraceptives (p < 0.05).

Conclusion: Approximately half of the women in the study (49.8%) were contraceptive users. Contraceptive use education targeting adolescents and younger women (15-19 years) should be intensified and health authorities should ensure consistent availability of a broad range of contraceptive methods, particularly pills, condoms, implants, and injectables, which were prominent methods in this study.

Drivers of Condom use among undergraduate students in Rivers State, South-South Nigeria

Osaro BO — 2026-10-01

Context: There is increasing involvement of young people in unprotected risky sexual practices. This results in unwanted pregnancies and sexually transmitted infections. Condom use is poor among young people. This study assessed drivers of use of condom among undergraduates in South-South Nigeria.

Method: This is a descriptive cross-sectional study conducted among 440 undergraduate students in Rivers State, Nigeria who were selected through multistage sampling. Respondents provided information on their socio-demography, perceptions on condom use, use and reasons for use. Chi square test and logistic regression analysis was done using SPSS version 29. P value was set at P < 0.05 and results were presented on tables.

Results: Majority of the respondents were aged 20 – 29 years (n = 283; 64.1%), and single (n = 422, 95.9%). The prevalence of ever users of condom was 91.6%, current users were 30.2% and consistent users were 8.3%. Drivers of condom use were the belief that ‘condom is effective in preventing pregnancy/STI’ (aOR = 3.013, 95% CI = 1.107 - 8.198); knowing how to effectively use condom competence (aOR = 4.287; 95% CI = 1.578 – 11.644) and level of study (aOR = 0.371; 95% CI = 0.191 - 0.718).

Conclusion: Ever use condom rate was high while current use and consistent use was low. Knowledge of how to effectively use condom, perception of its effectiveness in preventing pregnancy and STIs and level of study were drivers of use. Training programs to encourage consistent condom use and to increase the self-efficacy of adolescents on condom use are recommended

Dyslipidaemia and Blood Pressure Patterns Among Patients with Type 2 Diabetes Mellitus in Calabar, Nigeria: A Comparative Cross-Sectional Study

Ajen MU — 2026-10-01

Context: Type 2 diabetes mellitus (T2DM) is frequently accompanied by dyslipidaemia and hypertension. Although these cardiometabolic abnormalities are well documented, there is limited local evidence describing their pattern among patients with T2DM in Calabar, Nigeria. This study compared lipid profile parameters and blood pressure patterns between adults with T2DM and healthy non-diabetic controls.

Materials and Methods: A hospital-based comparative cross-sectional study was conducted among 80 adults comprising 40 T2DM patients and 40 apparently healthy non-diabetic controls recruited from the University of Calabar Teaching Hospital, Nigeria. Fasting venous blood samples were collected for the determination of serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) and very low-density lipoprotein (VLDL-C). Blood pressure and anthropometric measurements were obtained using standardized procedures.

Results: Diabetic participants exhibited significantly higher LDL-C (4.64±2.40 vs. 3.27±1.78 mmol/L; p = 0.005) and TC (6.79±2.45 vs. 5.56±1.88 mmol/L; p = 0.004) than non-diabetic controls. No significant differences were observed in HDL-C, TG, or VLDL-C (p >0.05). Anthropometric parameters were comparable between groups. However, blood pressure patterns differed significantly (p = 0.008), with elevated blood pressure occurring more frequently among diabetic participants. HbA1C also differed significantly as 70.0% of diabetic participants had HbA1c values within the diabetic range compared with none of the controls (p<0.001).

Conclusion: T2DM was associated with significantly elevated atherogenic lipid fractions, abnormal blood pressure patterns, and poor long-term glycaemic control, highlighting an increased cardiovascular risk among affected individuals.

Education and demographic patterns of foreign trained medical graduates sitting the Medical and Dental Council of Nigeria Licensing Examination

Ugwu IC — 2026-10-01

Context: Foreign medical graduates (FMGs) represent a growing proportion but constant group of candidates sitting the Medical and Dental Council of Nigeria (MDCN) licensing examination. An understanding of their demographic distribution and medical training background is essential for designing targeted preparatory course and policy interventions for FMGs.

Materials and Methods: A descriptive cross-sectional study was conducted in 2024 among FMGs preparing for the MDCN licensing examination. Data on sociodemographic characteristics and undergraduate medical education were analysed using descriptive statistics.

Results: One hundred and twenty-five respondents were recruited. The mean age was 27.6 ± 3.5 years, with majority of the respondents being females (60.8%). Respondents trained mainly in China (36; 28.8%), Sudan (26; 20.8%), and Ukraine (23; 18.4%) with a significant association between the regional origin of the graduates and the choice of country of medical training (P= <.001). Most of them spent six years in medical school (76; 60.8%). Although 119 respondents (94.4%) reported clinical rotations, only 60 (48.0%) had exposure to tropical medicine and 43 (34.4%) had research exposure during their undergraduate training with a significant association between research exposure and their country of training (P< .001).

Conclusion: FMGs preparing for the MDCN licensing examination have heterogeneous educational backgrounds with important gaps in tropical medicine and research exposure. Structured bridging and preparatory programmes may enhance readiness for medical practice in Nigeria.

Effect of Persea americana unripe pulp methanol extract on pregnancy in laboratory animals

Johnson EI — 2026-10-01

Context: Persea americana unripe pulp may induce various hormonal changes in female rats.

Objective: To investigate the effect of Persea americana unripe pulp methanol extract on conception in female Wistar rats

Materials and Method: Forty (40) mature female Wistar rats, divided into 2 groups of 20 rats each were used for preimplantation and post-implantation experiments with mating done before and after administration, respectively. Doses were percentages of LD-50, given intraperitoneally for 12 days and mating was done at late proestrus in the female: male ratio of 2: 1. Control received 1 ml/kg body weight; experimental groups received 380 mg/kg, 760 mg/kg, and 1140 mg/kg body weight of Persea americana unripe pulp methanol extract. Animals were sacrificed on day 5 of pregnancy, day 15, day 20, and day 21 of pregnancy, while the rest were allowed to experience pregnancy outcome before sacrifice under general anesthesia.

Result: Pregnancy was unsuccessful; weight decreased with increasing doses; FSH and progesterone increased, while estrogen and LH decreased. Histological findings showed apparent endometrial thickening in all doses of extract.

Conclusion: The study showed that Persea americana unripe-pulp methanol extract inhibits conception, promotes contraception, and thus should be used with caution in women intending to conceive.

Effects of ethanolic extract of lawsonia inermis on pregnancy outcomes, fetal growth and the developing cerebral cortex of wistar rats

Fischer CE — 2026-10-01

Background: Henna is predominantly consumed in the northern part of Nigeria by males to enhance fertility whereas the female counterparts ingest it to terminate pregnancies.

Objective: The aim of the study was to investigate the teratogenic potential of the ethanol leaf extract of Lawsonia inermis (Henna) on the fetal cerebral cortex and somatic indices like fetal weight with and without placenta, crown-rump length, placental weight, umbilical cord length and tail length of albino rats.

Materials and methods: Twenty adult female albino Wistar rats (150-200g) and eight adult male rats (190-220g) were purchased for this study. The female rats were divided into four groups labelled A-D. The experimental groups, B-D had maternal administration of the extract at 200, 400, and 600mg/kg body weight respectively. One-way ANOVA and Scheffes post-hoc test were used for data analysis and p<0.05 was considered statistically significant.

Results: The mean number of fetuses across the treatment groups showed a significant difference from the low, medium to high dose groups respectively thus: 6.00±0.45, 3.60±0.87 and 3.00±0.32 when compared to the control group (6.40±0.75) at p<0.05. Thus, the number of fetuses decreased in a dose-dependent manner with the presence of resorption sites in the medium and high dose groups.

Conclusion: When the extract consumed is for abortifacient purposes and the dosage is not high enough for termination of the pregnancy, possible alterations may occur in the fetus, especially during the critical period of brain development. Therefore, henna has the potential to cause malformations in fetal cerebral cortex.

Evaluation of the pre- and post-treatment levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF- α) in patients with temporomandibular disorders

Ukpebor IV — 2026-10-01

Context: Diagnosis of Temporomandibular disorders (TMDs) have been traditionally based on history, physical examination and imaging with their attendant limitations. Recent advocacy supports using inflammatory markers in blood and saliva as an objective means for early diagnosis, treatment monitoring, and targeted therapy development.

Materials and Methods: This study used a quasi-experimental design to recruit 25 participants using consecutive sampling. Pain scores were obtained from the participants using the Visual Analogue scale after which 5mls of venous blood was collected from antecubital veins. Also, 5mls of unstimulated whole saliva was collected. They were thereafter placed on appropriate treatment and reviewed after 2 weeks. Post-treatment VAS score was obtained, along with blood and saliva samples for the evaluation of the biomarkers. Data obtained were analyzed using the median and inter-quartile ranges, and Spearman’s correlation. The Wilcoxon signed-rank test was used to compare the median pre and post-treatment levels of the biomarkers in both saliva and serum. The p-value was set at < 0.05.

Results: The salivary and the serum IL-1β median (Q3-Q1) level reduced from 963.5 (265.6)pg/ml to 514.6 (515.0)pg/ml (p= 0.011), and from 59.7 (125.1)pg/ml to 53.7 (102.7)pg/ml (p = 0.657) respectively. Also, the salivary and the serum TNF- α median level reduced from 616.9 (194.7)pg/ml to 571.6 (198.4)pg/ml (p = 0.122), and from 83.6 (79.9)pg/ml to 73.2 (80.9)pg/ml (p = 0.638) respectively.

Conclusion: The significant reduction in salivary IL-1β following treatment suggest that it may be a potential biomarker for assessing the effectiveness of therapeutic intervention in TMDs.

Exploratory classification of breast cancer status using anthropometric and physiological parameters: A logistic regression pilot study

Akpolile AF — 2026-10-01

Context: Breast cancer is a major global health problem, and early identification of individuals requiring further clinical assessment remains important. Anthropometric and physiological measurements are inexpensive and readily obtainable, but their ability to distinguish malignant from benign breast conditions is uncertain.

Objective: This pilot study evaluated the exploratory classification performance of anthropometric and physiological variables in distinguishing breast-cancer status using logistic regression.

Materials and Methods: A hospital-based observational pilot study was conducted at the University of Benin Teaching Hospital. Data from 20 participants were analysed. The recorded variables were age, weight, height, systolic blood pressure, diastolic blood pressure, and body-surface temperature. Missing values were replaced using column means, and the predictors were standardized before model fitting. The dataset was divided into training and testing subsets using an 80:20 split. Classification performance was assessed using accuracy, precision, recall, F1 score, confusion-matrix analysis, and the area under the receiver-operating-characteristic curve.

Results: The test set contained four participants. The logistic-regression model achieved an accuracy of 75.0%. For the benign class, precision was 1.00, recall was 0.50, and the F1 score was 0.67. For the malignant class, precision was 0.67, recall was 1.00, and the F1 score was 0.80. The ROC-AUC was 0.50, indicating no demonstrated discrimination beyond chance in this test set. Because the model was evaluated on only four participants, these performance estimates are highly unstable and should not be interpreted as definitive.

Conclusion: In this small pilot dataset, age, weight, height, blood pressure, and body-surface temperature alone did not demonstrate adequate discriminatory performance for breast-cancer classification. Larger, independently validated datasets incorporating clinical, imaging, pathological, and possibly molecular variables are required before such a model can be considered for clinical risk stratification.

Glaucoma Patients’ Perceptions and Factors Influencing Encouragement of Relatives for Glaucoma Screening at a Specialist Eye Clinic in Anambra State, Nigeria

Onwuegbuna AA — 2026-10-01

Context: Targeted screening of high-risk relatives of glaucoma patients is a key strategy of mitigating the menace of late presentation and glaucoma-related blindness in resource-limited and middle-income countries.

Aim: To assess glaucoma patients’ perceptions of familial glaucoma and identify factors associated with encouraging relatives to undergo glaucoma screening.

Materials and Methods: This was an analytical cross-sectional study conducted (January-June 2025) among 181 adult patients in a specialist eye clinic in southeastern Nigeria. A pretested interviewer-administered questionnaire was used to obtain data on demographic and clinical characteristics of respondents, knowledge and perceptions of familial glaucoma, and familial screening practices. The variables were summarised descriptively, and bivariate and multivariate analyses were used to examine associations between dependent and independent variables; p-values < 0.05 were considered statistically significant.

Results: The mean age of respondents was 63.79 ± 13.32 years, 51.4% were females. The majority (n=81.8%) believed relatives should be screened for glaucoma; however, only (43.6%) did so. There were significant associations between encouragement by relatives for screening, family history of glaucoma, perception of glaucoma as a familial disease, and perception that screening is necessary for relatives (<0.001). Perception that screening is necessary was the strongest independent predictor of encouragement (aOR = 16.44; 95% CI: 3.54–76.34; p < 0.001). Middle-aged (aOR = 8.64; 95% CI: 1.11–67.18; p = 0.039) and older patients (aOR = 13.41; 95% CI: 1.75–102.72; p = 0.012) had higher odds of encouraging relatives than younger patients.

Conclusion: Fewer than half of respondents encouraged their relatives to undergo screening, despite high awareness of its importance. This reiterates the need for improved family-centred glaucoma education through counselling to enhance screening uptake among high-risk relatives for earlier detection of glaucoma.

Health Workers’ Perspectives on Missed Childhood Immunisation Appointments and SMS Reminder Implementation in Primary Healthcare Centres in, Abuja, Nigeria

Ikeonu OC — 2026-10-01

Context: Childhood immunisation remains an effective public health intervention for preventing vaccine-preventable diseases. Missed appointments undermine vaccine uptake. Short Message Service (SMS) reminders have demonstrated effectiveness in improving childhood immunisation uptake and timeliness. Evidence on implementation barriers from frontline health workers remains limited. This study explored health workers' perspectives on factors associated with missed childhood immunisation appointments, the feasibility and implementation of SMS-based reminder in Abuja, Nigeria.

Materials and Methods: This qualitative design used key informant interviews. Twenty-eight different categories of health workers were purposively recruited from 14 primary healthcare facilities until thematic saturation was achieved. The interview guide explored immunisation attendance patterns, reasons for missed appointments, health system barriers, existing defaulter-tracking practices, and perceptions of SMS-based immunisation reminders. Interview transcripts were analysed using Braun and Clarke's six-step thematic analysis framework (2006) to identify recurring themes and patterns.

Results: Seven themes emerged: household constraints; mobility and continuity of care; clinic-organisation barriers; defaulter-tracking; acceptability of mobile reminders; operational barriers and community engagement and service responsiveness. Health workers viewed SMS reminders favourably but highlighted literacy, network coverage, electricity access and mobile phone ownership as implementation challenges. Participants with previous exposure to automated reminder systems expressed greater confidence in digital reminder interventions.

Conclusion: Missed childhood immunisation appointments arise from a complex interplay of caregiver, health system, and programme-level factors rather than a single cause. While health workers view SMS reminders as feasible and acceptable, long-term sustainability remains a key challenge for successful implementation. These findings support implementing a locally sustainable, funded, multi-channel follow-up system.

Inter-observer reproducibility of blood pressure measurements in the clinic in a tertiary hospital in Nigeria by nurses and physicians: A cross-sectional study

Ugwu CN — 2026-10-01

Accuracy of blood pressure measurement is critical to management of hypertension and stratification of patients. We observed marked variations in blood pressure readings obtained by the nurses and those obtained by the physicians at the time of the consultation.

Objective: To assess inter-observer reproducibility of blood pressure measurements in the clinics by nurses and physicians.

Method: This was a cross-sectional study. Blood pressure recordings of patients attending the cardiology clinics were obtained using validated electronic devices by the nurses and again by the attending physicians during consultation. The results obtained were analysed and coefficient of variation (COV) in percentage, inter-class correlation coefficient with 95% confidence interval (ICC), Bland-Altman limits of agreement of 95% and prevalence-adjusted and bias-adjusted kappa (PABAK) were used to determine inter-observer variability of the blood pressure measurements.

Results: Majority of the participants were aged between 51-70 years (44.2%) and females (53.8%). The mean systolic BP obtained by the nurses was 131.86±23.20 and 126.70±21.94 for those by the physicians while diastolic were 78.40±14.48 and 75.97±12.67 for the nurses and physicians respectively with overall significant p values. When subjected to test of COV (SBP 16.40, DBP 15.83), Bland Altman analysis (SBP 5.16, DBP 2.43) and PABAK (SBP 0.031, DBP 0.040), there was poor reproducibility of BP measurements by nurses and physicians.

Conclusion: There was poor reproducibility of blood pressure measurements taken by nurses and physicians in this study. Adherence to standardized guidelines for blood pressure measurement may improve blood pressure reproducibility among health care workers.

Knowledge and uptake of tetanus toxoid vaccine among mothers in a semi-urban community in South-South Nigeria

Alenoghena IO — 2026-10-01

Background: Tetanus is a vaccine-preventable acute disease that is caused by Clostridium tetani, and it has remained a major cause of morbidity and mortality in children under the age of 5 years in developing countries. This study aimed to evaluate the level of knowledge and uptake of tetanus toxoid (TT) vaccine among mothers in Esan Central L.G.A.

Materials and Methods: This community-based cross-sectional study was conducted in the Esan Central Local Government Area of Edo State. Data were collected from 226 pregnant women attending antenatal clinics, using an interviewer-administered questionnaire. Ethical approval was obtained from the Research and Ethics Committee of Irrua Specialist Teaching Hospital, Irrua. Analysis was conducted in IBM SPSS version 21, and results were presented as frequencies and proportions in tables and charts.

Results: All the respondents were aware of tetanus, and 203 (90%) were aware of tetanus toxoid vaccines. 88 (38.9%) of the respondents had good knowledge of tetanus toxoid immunization, 95 (42.0%) had fair knowledge, and 43 (19.0%) had poor knowledge. Knowledge of tetanus toxoid was significantly associated with maternal age (p=0.0001), educational status (p=0.001), and occupation (p=0.001), with older and more educated women having better knowledge. One hundred and ninety-nine (88.1%) respondents had a positive perception towards TT immunization. Respondents’ perceptions were significantly associated with educational status (p=0.027) and occupation (p=0.001). One hundred and twenty-five (55.3%) had taken TT vaccine. Vaccine uptake was significantly associated with educational status (p=0.001) and occupation (p=0.001).

Conclusion: Respondents’ educational status and occupation were significantly associated with knowledge of TT, perceptions of the vaccine, and vaccine uptake. Common hindrances to vaccine uptake included negative attitudes among some health workers, poor service quality, cancellations of scheduled services, and perceived vaccine side effects. Health workers should receive training and retraining, and health education should continue at all levels of health care. This should also be carried out in schools at all levels in the State.

Knowledge, attitude and perception of women attending antenatal clinic towards caesarean section at a tertiary facility in south-south Nigeria

Ilikannu SO — 2026-10-01

Context: Caesarean section (CS) is a life-saving obstetric procedure, yet its utilisation remains disproportionately low in sub-Saharan Africa, including Nigeria, where rates fall below the WHO-recommended minimum. Demand-side barriers rooted in inadequate knowledge, negative attitudes, and cultural misconceptions continue to drive this gap.

Objective: This study assessed the knowledge, attitudes, and perceptions of pregnant women attending antenatal care at a tertiary facility in South-South Nigeria towards caesarean sections.

Materials and Methods: A descriptive cross-sectional study was conducted among 290 consenting pregnant women attending the antenatal clinic of the Federal Medical Centre (FMC), Asaba, Delta State, between 1st March and 31st May 2024. Data were documented and analysed using SPSS version 26, and the level of significance was set at 5%.

Results: The mean age of respondents was 31.58±5.69 years. Good knowledge of CS was demonstrated by 150 (51.7%) of respondents, a positive attitude was reported by 275 (94.8%) of respondents, and good perception was held by 281 (96.9%) of study participants. Occupation (p = 0.004), parity (p < 0.001), and previous mode of delivery (p < 0.001) were significantly associated with a positive attitude towards CS.

Conclusion: Women attending antenatal care at FMC Asaba demonstrated predominantly good knowledge, positive attitude, and good perception towards caesarean section. Specific knowledge gaps and persistent cost perceptions remain addressable barriers. Occupation, parity and previous mode of delivery of the respondents were associated with a positive attitude towards caesarean section. Sustained evidence-based antenatal counselling on CS indications, safety, complications, and cost-mitigation pathways is recommended.

Knowledge, attitude, and willingness to undergo cervical cancer screening among female undergraduates in a southwestern tertiary institution

Adefala NO — 2026-10-01

Context: Cervical cancer screening identifies alterations in cervical cells that may develop into cancer. Different literatures have explored the knowledge and attitude of female undergraduates to cervical cancer screening; only a few of these have been carried out in private tertiary institutions. This study aimed to assess the knowledge, attitudes and willingness to undergo cervical cancer screening among female undergraduates in a tertiary institution.

Materials and Methods: Using a multistage sampling technique, this cross-sectional study was conducted among 399 female undergraduates at Babcock University. A structured self-administered questionnaire was used. Data were analyzed using IBM SPSS version 27.0. The level of significance was set at p<0.05. Relevant descriptive and inferential statistics were calculated. Results were presented in tables.

Result: The majority of respondents were 15-20 years (n=276, 69.2%) with a mean age of 19.1±22.3years. Most respondents were in the 4th academic year (n=95, 23.8%). Overall, 220 (55.1%) respondents had good knowledge, and 211 (52.9%) had poor attitude. While 47% (11.8%) and 217(54.4%) strongly agreed and agreed respectively, to undergo screening, 135 (33.8%) remained neutral. Presence of symptoms/risks was associated with willingness to undergo screening (p<0.01).

Conclusion: Respondents showed good knowledge of cervical cancer screening. The majority had a poor attitude despite generally favourable willingness to undergo screening. Public health policy and practice should focus on improving attitudes by integrating symptom-independent screening education into routine school health services.

Knowledge, Attitudes, and Barriers Toward Exercise Among Women with Pregnancy-Related Pelvic Girdle Pain: A Cross-Sectional Study

Mathew N — 2026-10-01

Context: Pelvic Girdle Pain (PGP) is a common musculoskeletal problem in pregnancy, often leading to functional disability, impaired mobility, and reduced quality of life. Despite the well-established role of exercise in alleviating symptoms, there is limited understanding of how pregnant women perceive exercise for PGP in low resource settings.

Objective: This study aimed to identify the knowledge, attitudes, and barriers related to exercise among pregnant women with PGP.

Materials And Methods: A descriptive cross-sectional study was conducted among 84 pregnant women aged 20–35 years, between the 18th–27th weeks of gestation, recruited from antenatal clinics in hospital in North Bangalore using a convenience sampling technique. A structured questionnaire was used to assess demographic details, knowledge, perceptions, and barriers toward exercise from June 2024 to November 2024. Data were analysed using IBM SPSS Version 25.0. Descriptive statistics were used to summarise the data, and inferential statistical tests were performed to determine associations between categorical variables. A p-value of <0.05 was considered statistically significant.

Results: Of 84 pregnant women assessed (mean age 27.4 ± 3.1 years), only 4(4.8%) demonstrated awareness of pelvic girdle pain (PGP) as a distinct condition. Despite this knowledge gap, 95.2% expressed a favourable attitude toward physiotherapist-guided exercise. Fatigue, lack of time, limited guidance, and absence of healthcare-provider advice were key barriers.

Conclusion: Knowledge gaps regarding about awareness in PGP and the role of physiotherapy were identified, despite generally positive attitudes and willingness to exercise.

Patterns of Medication Prescription and Barriers to Medication Adherence Among Outpatients at a Rural Tertiary Hospital in South-South Nigeria

Rafiu MO — 2026-10-01

Context: Medication adherence is vital for optimal therapeutic outcomes; however, nonadherence remains a major public health concern, resulting in suboptimal health outcomes and higher medical expenses.

Objective: This study evaluated medication prescription patterns, adherence levels, and associated barriers among patients attending outpatient clinics at the Irrua Specialist Teaching Hospital (ISTH), Edo State, Nigeria.

Materials and Methods: A descriptive cross-sectional study was conducted among 164 patients using a two-stage sampling technique (purposive sampling technique for clinic selection, and systematic random sampling technique for participant selection) at the Irrua Specialist Teaching Hospital (ISTH) outpatient clinics, using a structured questionnaire to assess socio-demographics, prescription patterns, adherence behaviors, and barriers. Adherence was evaluated using an adapted Morisky Medication Adherence Scale (MMAS-8). Data were analysed using descriptive statistics and inferential (chi-square) tests.The level of significance was p<0.05.

Results: The mean age of participants was 45.33 ± 3.79 years. More than half were females (62.8%). Most patients n (81.1%) received three or more medications, predominantly via the oral route. Analgesics (30%), antihypertensives (22%), and antidiabetics (20%) were the most frequently prescribed medications. Adherence was low (42%) to moderate (30%), driven by stopping medication upon symptom improvement (63.4%), skipping doses due to cost (56.1%), and forgetfulness (53.0%). Socio-demographic factors showed no significant association with adherence (p>0.05). However, medication type (p=0.022), number of prescribed drugs (p=0.016), primary prescriber (p = 0.043), and frequency of prescription review (p=0.003) were significantly associated with adherence. High drug costs (38.4%) and long waiting times (18.9%) were the most commonly reported barriers.

Conclusion: Polypharmacy and oral administration were the predominant patterns of medication prescription to outpatients in ISTH. Medication adherence was suboptimal and was primarily influenced by regimen and health system factors rather than by sociodemographic factors. Simplifying regimens, reducing drug costs, improving education, and conducting regular reviews are recommended strategies to improve adherence.

Predictors of mortality and survival patterns among patients with obstructive jaundice in a Nigerian tertiary hospital

Tagar E — 2026-10-01

Context: Obstructive jaundice particularly when caused by malignancy, remains a significant contributor to morbidity and mortality. This study aimed to assess survival rates and predictors of mortality in patients with obstructive jaundice.

Materials and Methods: The medical records of patients managed with obstructive jaundice at Irrua Specialist Teaching Hospital were retrospectively reviewed from January 2019 to December 2023. Data were collected using a predesigned proforma and analysed with Kaplan-Meier statistics and Cox regression models.

Results: The median age of patients was 55 years (IQR: 47-68), with a majority being female (40, 58.0%). Patients with malignant obstructive jaundice had significantly lower survival rates (log-rank p = 0.03). Among those with pancreatic head cancers, 75% of deaths (n=12) occurred within 48 days of hospital admission. Multivariate Cox regression showed that duration of postoperative hospital stay was significantly associated with mortality (p=0.008).

Conclusion: Prolonged postoperative hospitalisation is associated with increased mortality in patients with malignant obstructive jaundice. Addressing factors that contribute to longer hospital stays could potentially improve the survival outcomes.

Prevalence and Determinants of Severe Acute Malnutrition among Children Aged Under Five Years in Rural Communities of Kwali Area Council, Abuja, Nigeria

Ngwu JC — 2026-10-01

Context: Severe Acute Malnutrition (SAM) is a key public health problem in Nigeria, contributing to children's mortality. Understanding its local determinants is crucial for effective intervention.

Objective: This study aimed to determine the prevalence of SAM and to assess the effect of socio-economic, cultural/religious, and maternal/child-health-practice factors on SAM among children aged 6-59 months in the rural communities of Kwali Area Council, Abuja.

Materials and Methods: The study employed a community-based cross-sectional design involving 220 mother/caregiver-child pairs selected via a multi-stage sampling technique. Data were collected using structured questionnaires and anthropometric measurements. Nutritional status was determined using Mid-Upper Arm Circumference (MUAC), with SAM defined as MUAC < 11.5cm among children aged 6-59 months. Data were analysed in IBM SPSS Statistics version 29 using descriptive statistics, the Chi-square/Fisher's exact test for associations, and binary logistic regression done to identify independent determinants of SAM at a 5% significance level.

Results: The prevalence of SAM was 15.5% (34/220). At bivariate level, caregiver occupation (p=0.034), household drinking water source (p<0.001), food taboo (p=0.011), and immunization status (p=0.001) were significantly associated with SAM. Multivariable logistic regression (n=214) identified three significant independent determinants: food taboo (AOR=7.62, 95% CI: 1.86-31.17, p=0.005), incomplete immunization (AOR=4.92, 95% CI: 1.92-12.60, p=0.001), and an unimproved household drinking water source (AOR=4.06, 95% CI: 1.65-10.01, p=0.002).

Conclusion: The prevalence of SAM in Kwali (15.5%) remains above the national average of 7% and represents a serious public health concern. Food taboo practice, incomplete immunization, and an unimproved household drinking water source emerged as the three strongest, statistically significant, and modifiable determinants in this population, warranting targeted nutrition education, improved immunization coverage, and expansion of safe water access as priority interventions.

Prevalence and factors associated with bullying among secondary school students in Bayelsa State

Oguche OI — 2026-10-01

Context: Bullying probably represents the most obvious juvenile violence, manifested irrespective of location and type of school. Is a widespread public health concern among adolscents and has been reported in Nigerian secondary schools, with prevalence rates ranging from 40% to 85%. As an emergent issue affecting many students globally, it is a threat that should not be ignored

Objective: To determine the prevalence of bullying and identify risk factors for being bullied and being a bully among in-school adolescents in Bayelsa State.

Materials and Methods: A descriptive cross-sectional study was conducted involving 404 secondary school adolescents, using multistage random sampling. Data were collected using a questionnaire adapted from the bullying section of the Nigerian version of the Global School-based Student Health Survey (GSHS) and the LMS retrospective bullying questionnaire. Associations were assessed using the chi-squared test, with significance set at p ≤ 0.05.

Results: The prevalence of bullying was 85.6%. Reported types included physical (77.7%), verbal (76.2%), psychological (66.8%), and sexual (38.6%) bullying. Additionally, 14.4% of participants identified themselves as bullies. Victims were significantly targeted for perceived vulnerabilities, including being considered "weird" (p < 0.001), "weak" (p < 0.001), or from "poor families" (p = 0.003). Teacher-led victimization was significantly associated with physical (p = 0.001), psychological (p = 0.009), and sexual (p = 0.037) bullying. Predictors of perpetration included having friends who are bullies (aOR = 4.232, p < 0.001), desire for control (aOR = 2.302, p = 0.011), school gender structure (aOR = 2.753, p = 0.008), and previous victimization (aOR = 268.714, p < 0.001).

Conclusion: Prevalence of bullying is high among the respondents. Schools should implement policies to protect vulnerable students and provide early psychosocial intervention for victims to reduce progression to perpetration.

Prevalence and Factors Associated with Depression Among the Older Adults in Calabar Municipality, Cross River State, Nigeria

Ogban MA — 2026-10-01

Context: Depression among older adults is an important public health concern, particularly in low- and middle-income countries where ageing populations are increasing and access to geriatric mental health services remains limited. In Nigeria, socio-economic conditions, chronic illnesses, functional limitations, and social circumstances may increase the vulnerability of older adults to depression.

Objective: To determine the prevalence and identify factors associated with depression among older adults resident in Calabar Municipality, Cross River State, Nigeria.

Materials and Methods: A descriptive cross-sectional study was conducted among older persons aged 60 years and above who reside in Calabar Municipality. Using multistage sampling, 369 participants were recruited. Data were collected using a semi-structured, interviewer-administered questionnaire incorporating the Hamilton Depression Rating Scale (HAM-D) and analyzed using IBM SPSS version 25.0. Statistical significance was set at p < 0.05.

Results: The mean age of respondents was 66.47 ± 5.71 years. The prevalence of depression among the respondents was 51.2%, with mild depression being the most common (32.8%), followed by moderate (16.8%) and severe depression (1.6%). Significant factors associated with depression included advanced age (65 years and above), no formal education, unemployment, low income, unmarried (single, divorced, separated and widowed), presence of chronic illness and difficulty with daily activities (p < 0.05). Commonly reported coping mechanisms included praying (31.2%), resting (29.8%), and family or social connections (20.9%). Suggested interventions included provision of free healthcare services (36.3%) and government financial support (33.1%).

Conclusion: Depression was highly prevalent among older adults resident in Calabar Municipality and was associated with socio-economic, health-related, and lifestyle factors. Routine and accessible screening for depression, integration of geriatric mental health services into primary healthcare and community-based interventions are recommended to improve the early identification and management of depression among older adults in Nigeria.

Prevalence of Cardio-metabolic disorders among Dental Clinic attendees in a Tertiary Hospital, South East, Nigeria

Igbinedion HU — 2026-10-01

Background: Cardio-metabolic disorders are associated with dental diseases and they may affect the quality of life of patients with dental disorders.

Objective: The aim of the study was to determine the prevalence of diabetes mellitus, obesity and hypertension among patients attending dental clinic at Alex-Ekwueme Federal University Teaching Hospital, Abakaliki.

Materials and Methods: The study was a cross-sectional descriptive design carried out among 239 participants. The anthropometric, blood pressure, fasting/random blood sugar ((FBS/RBS) measurements were carried out on the participants. The data were analysed using Statistical Package for Social Sciences version 23.

Results: The study subjects were 111 males and 128 females. The average age of participants was 38.3±13.9 years. The mean weight, height and body mass index (BMI) of participants were 70.7±13.9kg, 1.6±0.1m and 26.8±5.4kg/m2 respectively. The mean waist circumference, hip circumference and waist: hip ratio were 59.3±25.4cm, 55.5±22.1cm and 1.07±0.3 respectively. The prevalence of obesity using BMI and waist circumference were 25.1% and 21.8% respectively. The prevalence of hypertension was 19.2%. The mean systolic and diastolic blood pressures were 113.4±14.7 mmHg and 70.2±9.7 mmHg with ranges of 101 mmHg and 51 mmHg respectively. Impaired fasting blood glucose was noted in 21.2% of participants. The prevalence of diabetes using FBS and RBS were 14.4% and 4.3% respectively. The mean FBS and RBS were 101.6±41.3 mg/dl and 112.9±52.7 mg/dl with ranges of 286 mg/dl and 440 mg/dl respectively.

Conclusion: With the established prevalence of these non-communicable diseases among dental clinic attendees, it has become imperative to advocate for the use of dental clinic in hospital settings as screening centres for such non- communicable diseases.

Self-Reported Health Effects of Cashless Economic Policy Among Undergraduate Students of the University of Calabar, Cross River State, Nigeria

Akpet OE — 2026-10-01

Context: Economic policy transitions can produce unintended public-health consequences when implementation outpaces social, financial and technological readiness. Undergraduates, just like others citizens of the country had their share of “shock” and challenges. They adopted several coping mechanisms just not to allow the new cashless policy disrupt their learning processes.

Objective: This study assessed the self-reported health effects of cashless economic policy among undergraduate students of the University of Calabar, Cross River State, Nigeria.

Methods and materials: A descriptive cross-sectional study design was adopted. Multistage sampling was used to select 427 consenting participants for the study. Semi-structured self-administered pretested questionnaire were used for data collection.

Results: The respondents had a mean age of 22.46 ± 3.88 years; Most, (73.5%) of the respondents were aged 20–29 years, and 57.8% were males. Although knowledge of cashless economic policy was generally high, with 68.4% of the respondents reporting good knowledge, self-reported health effects were common. Psychological stress was the most frequently reported effect (69.7%), followed by headache (63.0%), anxiety (43.3%), sleeplessness (36.1%) and depression-related symptoms (35.3%). Among the 236 students who reported health effects, 46.1% described them as mild, 39.9% as moderate and 14.0% as severe. Most students did nothing to manage these effects (67.8%), while 22.4% used drugs obtained from pharmacists or chemists.

Conclusion: The findings show that cashless policy transitions may create measurable stress-related and somatic burdens among students when payment infrastructure, liquidity access and support services are inadequate. There should be health-sensitive implementation of financial digitization policies by the Federal Government of Nigeria.

Prevalence and Patterns of Bullying Among In-School Adolescents in Calabar, Cross River State

Ekpenyong NO — 2026-10-01

Background: Bullying is a pervasive form of school violence with significant physical, psychological, and social consequences for adolescents. Despite extensive research in developed countries, limited data exist on the prevalence and patterns of bullying in Nigerian schools, particularly in Calabar, Cross River State. This study aimed to determine the prevalence and patterns of bullying among secondary school students in Calabar, Nigeria, and to provide evidence for policy and intervention strategies.

Methods: A cross-sectional descriptive study was conducted among 293 students selected through multistage sampling from 15 secondary schools in Calabar. Data were collected using a semi-structured questionnaire adapted from the Olweus Bullying Questionnaire and analyzed with SPSS version 25.

Results: The prevalence of bullying experience was 91.8%, while 93.9% of students reported perpetrating bullying. Verbal bullying was the most common form experienced (86.0%) and perpetrated (83.3%), followed by physical (78.5% vs. 64.5%), relational (76.5% vs. 54.9%), and cyberbullying (33.1% vs. 31.7%).

Conclusion: Bullying among adolescents in Calabar is alarmingly prevalent, with most students reporting both victimization and perpetration. The findings underscore the urgent need for comprehensive school-based violence prevention programs, mental health support services, and community engagement to address peer dynamics and power imbalances that sustain bullying. Aligning interventions with the Sustainable Development Goals (SDG 16.2 and SDG 4) will be critical in safeguarding adolescents’ rights to education, health, and well-being.

Protective Activity of Citicoline Against Neurobehavioral and Cerebellar Histo-biochemical Derangement Induced by Nickel Chloride: Role of Caspase-3 and NRF2

Idemudia OU — 2026-10-01

Context: Nickel chloride (NiCl2) is a widely used industrial compound that poses significant neurotoxic risks through mechanisms involving oxidative stress, apoptosis, and neuronal degeneration. The cerebellum is particularly susceptible to such insults due to its role in motor coordination and locomotor control.

Objective: The study investigated the neuroprotective potential of citicoline against NiCl2-induced cerebellar toxicity in adult Wistar rats.

Materials and Methods: Forty-two adult Wistar rats were randomly assigned to six groups and treated for 28 days as follows: I (Control), II (5mg/kg NiCl2), III (250 mg/kg citicoline + 5mg/kg NiCl2), IV (500 mg/kg citicoline + 5mg/kg NiCl2), V (250 mg/kg citicoline) and VI (250 mg/kg citicoline). Neurobehavioural assessments were performed using the Open Field Test, String Test, and Movement Initiation Test. Oxidative stress markers, including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and reduced glutathione (GSH), were evaluated in cerebellar homogenates. Histological examination of the cerebellum was conducted, while molecular docking studies were performed to investigate the interaction of citicoline with Caspase-3 and nuclear factor erythroid 2-related factor 2 (NRF2).

Results: Compared to control, NiCl2 significantly (p < 0.05) impaired locomotor and motor performance and induced oxidative stress (decreased SOD, CAT, GPx, and GSH; increased MDA), alongside histological evidence of Purkinje cell degeneration, nuclear pyknosis, and cerebellar layer vacuolations. Citicoline significantly (p < 0.05) reversed these behavioural, biochemical, and histological alterations when compared to rats treated with NiCl2 only, and showed favourable docking affinities towards Caspase-3 and NRF2.

Conclusion: Citicoline protects against NiCl₂-induced cerebellar toxicity by attenuating oxidative stress and possibly modulating apoptotic pathways, thus preserving neuronal integrity and highlighting its therapeutic potential for heavy metal-induced neurodegeneration and motor dysfunction.

The use of pentazocine, promethazine, and midazolam in colonoscopy in adults at the University of Benin Teaching Hospital

Irowa OO — 2026-10-01

Context: Colonoscopy is a valuable armamentarium for the diagnosis of lesions in the colon. Sedation/anaesthesia makes the procedure easier and tolerable in patients with good bowel preparation. Poor tolerability is one of the reasons for incomplete colonoscopy.

Objectives: To share our experience with the use of Pentazocine, Promethazine, and Midazolam during colonoscopy, highlighting, the indication for colonoscopy, the tolerability of the procedure, success rate (Caecal intubation rate), and lesional findings.

Materials and Methods: This is a 2-year descriptive cross-sectional study of patients referred for colonoscopy in the University of Benin Teaching Hospital. All patients received intravenous single-dose Pentazocine, Promethazine, and Midazolam. They were monitored during the procedure. Patients who required additional doses of Midazolam were adjudged to have poorly tolerated the procedure. The patient's demographics, indication for colonoscopy, colonoscopy findings, histology of specimens, and the tolerability of the procedure were entered into a proforma and analyzed.

Results: Over the study period, 129 colonoscopy were performed. The male-to-female ratio was 2:3 The peak age was 65, and the cluster age group was 5th – 8th decade of life. The caecal intubation rate was 97.7%. Bleeding per rectum was the main indication for colonoscopy in 48 patients (37.2%). Colon cancer was found in 20patients (15.5%) at colonoscopy, while haemorrhoids was found in 32 patients (24.8%). In 16 patient (12.4%) there was more than one lesional finding. A hundred and twenty-five patients (97%) tolerated the procedure, while four (3%) poorly tolerated the procedure. Colonoscopy was poorly tolerated in males (3) compared to females (1).

Conclusion: Bleeding per rectum was the main indication in our study with colonoscopy well-tolerated in 97% of study participants with the use of Pentazocine, Promethazine, and Midazolam.

The authors' advocate the use of single-dose Promethazine, Pentazocine, and Midazolam for elective colonoscopy.

Knowledge and acceptance of caesarean section among pregnant women attending antenatal clinic in federal teaching hospital, Ido-Ekiti, Ekiti State, Nigeria

Elegbede OE — 2026-10-01

Context: Caesarean section (CS) is a vital obstetric intervention for preventing maternal and neonatal morbidity and mortality when medically indicated. However, acceptance of CS in Nigeria remains suboptimal despite increasing awareness. This study assessed the level of knowledge and acceptance of CS among pregnant women attending antenatal clinic (ANC) at the Federal Teaching Hospital, Ido-Ekiti (FETHI).

Materials and Methods: A descriptive cross-sectional study was conducted among 152 pregnant women selected through systematic random sampling. Data were collected using a structured, pre-tested questionnaire. Knowledge of CS was assessed using a scoring system and categorized as good or poor. Acceptance was measured as willingness to undergo CS if medically indicated. Data were analyzed using SPSS version 27. Associations were tested using Chi-square statistics, with p < 0.05 considered statistically significant.

Results: Awareness of CS was universal. Overall, 61.8% of respondents had good knowledge of CS, while 38.2% had poor knowledge. Acceptance of CS if medically indicated was reported by 74.3% of respondents. Acceptance was significantly higher among women with good knowledge of CS compared to those with poor knowledge (p < 0.001).

Conclusion: Knowledge and acceptance of CS among pregnant women attending ANC at FETHI were relatively high. Good knowledge was a significant predictor of acceptance. Strengthening antenatal education on CS may further improve timely acceptance and reduce preventable obstetric complications.

Understanding the drivers of brain drain: A study of migration intention among medical students in Nigeria

Ededa EM — 2026-10-01

Context: Health workforce migration from low- and middle-income countries remains a major global health challenge. Nigeria, one of the largest contributors to the global medical workforce, faces increasing loss of physicians.

Objective: This study examined the prevalence and determinants of migration intention among Nigerian medical students.

Materials and Methods: A descriptive cross-sectional study was conducted among 1,299 medical students in Kano State, Nigeria, using a semi-structured, self-administered online questionnaire. Statistical analysis was done using IBM SPSS v27. Binary logistic regression identified independent predictors of migration at p < 0.05.

Results: Eight hundred and thirty respondents (63.9%) intended to practice medicine abroad. The most preferred destinations were the United States (375;45.2%), Canada (369;44.5%), and the United Kingdom (363;43.7%). Interest in international practice was high (mean 3.98 ± 0.74), while awareness of licensure pathways was relatively low (mean 2.35 ± 0.96). Major drivers included better remuneration and improved medical infrastructure. Financial constraints (807;62.1%) was the leading barrier. Migration intention was significantly associated with motivation for studying medicine (p = 0.004), participation in international programs (p < 0.001), and prior exploration of certification processes (p < 0.001). Independent predictors of migration intention included higher interest in international practice (AOR = 2.59; 95% CI: 2.1–3.1) and greater awareness of licensure pathways (AOR = 2.34; 95% CI: 2.0–2.8).

Conclusion: A substantial proportion of Nigerian medical students intend to migrate, reflecting systemic push factors and pull dynamics. Early, targeted retention strategies within medical training and health system reforms are urgently needed to mitigate future workforce losses.

Anatomical Perspective on Kidney Transplantation: A Narrative Review

Mchonde GJ — 2026-10-01

Context: Chronic Kidney Disease (CKD) is a progressive disorder characterized by irreversible renal damage and gradual loss of function, frequently diagnosed at advanced stages leading to end‑stage renal disease (ESRD). Kidney transplantation remains the definitive treatment for ESRD, yet surgical complexity is strongly influenced by recipient anatomy.

Aim and Objectives: To review the impact of anatomical variations on kidney transplantation, highlighting their role in operative planning, technical execution, and long‑term graft outcomes.

Methodology: This narrative review synthesizes evidence on anatomical considerations in kidney transplantation, focusing on pelvic vasculature, pelvic structures, and donor‑recipient mismatches that affect surgical feasibility, complication risks, and graft survival. Perspectives from retrieval and implanting surgeons highlight the importance of preoperative anatomical assessment. A systematic search of Medline, Web of Science, PubMed, and Google Scholar was conducted using controlled vocabulary and keywords related to Anatomy of the kidney (variations on kidney blood supply, renal blood supply, kidney anomalies, pelvic anatomy) and kidney transplantation (renal transplantation, kidney transplantation, kidney allograft recipients, kidney transplant recipients). Boolean operators, complemented by manual searches were employed to fine-tune the search terms. A total of 164 articles published from 1999 to January 31, 2026, were identified and evaluated for relevance, with 46 ultimately selected for inclusion in narrative analysis.

Results: Anatomical variations in pelvic vessels and structures complicate vascular anastomosis and increase intraoperative risks. Donor‑recipient anatomical mismatches affect technical feasibility and long‑term graft survival. Anticipation of aberrant vessels by retrieval surgeons reduces implantation emergencies. Careful anatomical planning by implanting surgeons enhances safety and effectiveness of transplantation.

Conclusion: Anatomical perspectives are critical for successful kidney transplantation. Thorough preoperative assessment and anticipation of anatomical variations optimize surgical strategies, reduce complications, and improve both graft and patient survival.

Cancer Treatment Abandonment in Africa: A Narrative Review of Socioeconomic Determinants, Clinical Consequences and Strategies for Improving Treatment Completion

Oderinde C — 2026-10-01

Context: Across Africa, patients with potentially curable cancers may fail to initiate or complete recommended curative treatment. This preventable phenomenon, known as treatment abandonment, occurs amid limited diagnostic capacity, workforce shortages, and substantial financial and geographical barriers to care, highlighting the need for an integrated synthesis of its magnitude, determinants, consequences and potential remedies. This narrative review therefore examined the magnitude and patterns of cancer treatment abandonment in Africa, identified its socioeconomic and related determinants, evaluated its clinical consequences, and critically examined strategies for improving treatment completion.

Materials and Methods: Peer-reviewed literature was identified through searches of PubMed/MEDLINE, Scopus and CINAHL, supplemented by reference-list screening, with 53 publications meeting the eligibility criteria and included in the narrative synthesis. Narrative synthesis accommodated the substantial heterogeneity in populations, cancer types, study designs and outcome definitions across the included evidence.

Results: Reported abandonment varied substantially across settings and observation periods, reaching 54% in paediatric cohorts and approximately one-fifth among adults initiating chemotherapy. Financial hardship, compounded by transport costs, distance from treatment centres and inadequate health-insurance coverage, was the most consistently reported determinant, alongside health-system, sociocultural and psychosocial barriers. These patterns carried real clinical weight: abandonment was strongly associated with reduced event-free survival and premature mortality, and it complicated the interpretation of survival statistics whenever patients lost to follow-up were censored rather than treated as an adverse outcome. Encouragingly, multicomponent interventions combining financial assistance, transport reimbursement, residential accommodation, patient navigation and active follow-up substantially reduced abandonment where they were evaluated, although navigation alone could not overcome unaffordable treatment.

Conclusion: Cancer treatment abandonment in Africa is therefore best understood as a structural and largely preventable outcome rather than being attributed primarily to a failure of patient motivation. Reversing it will require financial protection integrated into routine cancer services, expanded health-insurance coverage, decentralised care, standardised definitions and reporting, and reliable patient-tracking systems, supported by further prospective research, particularly among adult populations.

Ethical and legal issues in organ donation and transplantation in Nigeria

Agi AU — 2026-10-01

Context: Organ donation and transplantation are life saving interventions for end stage organ failure. In Nigeria, increasing cases of kidney, liver, and cardiac diseases have intensified demand, yet legal uncertainty, ethical dilemmas, organ trafficking, commercialization, cultural hesitation, and weak regulation undermine public trust and equitable access.

Objective: The study critically examined the legal and ethical issues surrounding organ donation and transplantation in Nigeria, and recommended reforms that close the existing regulatory gaps.

Study Design, Setting, Materials and Methods: This study adopted a doctrinal and comparative legal research design. It analyzed Nigerian statutes, particularly the National Health Act, the Criminal Code, and the Trafficking in Persons (Prohibition) Enforcement and Administration Act 2015, alongside international instruments of the World Health Organization and the World Medical Association. Legislation and practice in the United Kingdom, India, Spain, South Africa and Iran were reviewed for comparison, supported by media reports, government guidelines and academic literature on organ trafficking and transplant inequity in Nigeria.

Results: Findings revealed that Nigeria has no standalone organ transplantation law. The National Health Act 2014 bans the sale of organs but does not create a donor registry, a licensing authority, brain-death criteria or an enforcement body. This gap has allowed inconsistent consent practices, inequitable access to the few functioning transplant centres, and a documented pattern of organ trafficking that preys on poor and vulnerable Nigerians. Generally Nigeria’s regulatory framework is legally fragmented and ethically inconsistent. New 2025 federal guidelines on transplant services are a step forward but remain administrative, not legislative, and are not yet enforced.

Conclusion: The article concluded by pointing out that Nigeria needs a comprehensive, rights-based Organ Donation and Transplantation Act that sets clear rules on informed consent, creates a donor registry and a licensing authority, and imposes real penalties for trafficking and commercial dealing in organs. Enacting and enforcing such a law is essential to protect donors and patients and to restore public trust in transplantation.

National Policy Support for Integrating Primary Eye Care into Primary Health Care in Nigeria: Identifying Gaps and Advocating for Inclusivity

Ezeh EI — 2026-10-01

Background: Nigeria still grapples with a high prevalence of avoidable blindness. A major culpable factor is the inequitable access to comprehensive eye health services, particularly at the primary health care (PHC) level. To effectively and sustainably implement eye care services at the PHC level, there need to be a defined and/or supporting policy framework(s) for the integration of primary eye care (PEC) into primary health care in Nigeria. This article is aimed at highlighting available enabling policies for the integration of PEC into PHC in Nigeria.

Materials and Methods: A review of relevant policy documents was conducted to summarise the different policy documents and their corresponding integration support elements. Eleven (11) policy documents containing relevant elements for the integration of PEC into PHC in Nigeria were identified and the supportive policies were extracted and presented in a tabular fashion.

Findings/Conclusion: Our review highlights that, whereas Nigeria has an enabling policy environment for integrating PEC into PHC, but the current framework is fragmented and lacks policy coherence. There is an urgent need to consolidate existing policy provisions into a unified national framework for PEC integration and to revise the Minimum Standards for Primary Health Care to explicitly include PEC as a core service component. Such policy action would strengthen implementation, promote equity in access to eye care and support progress towards universal health coverage.

Navigating the Complexity of Elderly Self-care: A Narrative Review of Barriers and Facilitators in Chronic Disease Management

Ebereghwa EM — 2026-10-01

Context: Global life expectancy is rising, shifting the burden of chronic disease management largely to patient self-care. For the elderly population, independent care is complex and highly susceptible to age-related changes, yet a comprehensive understanding of what hinders or promotes this process remains fragmented.

Objective: This review aims to identify, categorize and analyze the multi-dimensional barriers and facilitators influencing chronic disease self-care among adults aged 60 and older.

Methods: A comprehensive search of databases including PubMed, PsycINFO and Google Scholar was conducted for English language peer-reviewed articles published between 2016 and 2026. A narrative synthesis framework was applied to extract, cross-reference and map critical structural, social, and personal themes.

Results: An initial 974 records were retrieved; 586 duplicates were removed and 466 were excluded during title and abstract screening. The remaining 122 full-text manuscripts underwent evaluation, yielding a final cohort of 42 high-quality, mixed-design studies for thematic synthesis after 74 were excluded for methodological variations.

Discussion: The intersection of physical decline, cognitive limitations and multimorbidity forms a “vulnerability triad”, complicating self-care as medical needs outpace patient capacity. While cognitive ageing and low health literacy hinder adherence, robust social networks and self-efficacy facilitate it. Digital interfaces provide essential external cognitive support but require age-inclusive design and human-led onboarding.

Conclusion: Elderly self-care is dictated by a delicate balance between personal limitations and external support systems. Improving elderly self-care and health outcomes requires a shift to holistic, person-centered models. Healthcare providers must actively mitigate physical barriers while leveraging family-centered support frameworks.

Pathopia: A novel nomenclature for induced refractive errors

Megbelayin EO — 2026-10-01

Refractive error or ametropia is a distinct eye condition that relates to ocular optics. Refractive error is not a pathologic state, but rather a condition inherent in ocular physiology as a result of operating as a biological camera. Subsequently, any refractive error resulting from an ocular pathologic state could be termed induced refractive error. This article sets out to enrich existing lexicon on ocular optics by coining pathopia as the appropriate word to qualify induced refractive error. Literature on this subject was reviewed and observation made that there has not been a unique taxonomic grouping for ocular anomalies presenting as overt refractive errors. The result showed that ocular morbidity concealed by a refractive error poses a significant challenge to early intervention and is likely to lead to poor visual outcome. It is concluded that pathopia or induced refractive error is a secondary refractive error due to distortions or abnormalities in cornea, lens, or retino-choroidal-scleral (RCS) complex resulting in increment or decrement in axial length or eye’s cumulative dioptric power.

Sentinel events, a burden in the operating room: A literature review

Gbadamosi DR — 2026-10-01

Context: Despite the existence of diverse integrated surgical safety measures pre-, intra-, and post-operatively globally, preventable adverse medical errors still occur to the patients in the operating rooms and has been regarded as the major cause of temporary or permanent disability and death among the victims.

Aim: The purpose of this paper is to explore sentinel events in the operating rooms

Materials and Methods: A comprehensive literature search was conducted across the electronic databases PubMed/MEDLINE, Embase, Conchrane and Google Scholar to source numerous articles on the subject matter. The articles search was between 2005 and 2026. Terms were combined using Boolean operators such as “Sentinel” AND “events,” “operating room” AND “surgical team members”.

Results: Various forms of sentinel events occur in the operating room but the common ones are fall, wrong-site surgery, retained surgical items, and operating room fire. Factors responsible for these events in the operating rooms are organizational factors such as limited policies, lack of perioperative protocols, and staff shortage Effective communication between the patient and surgical team members are crucial preventive measures against sentinel events in the operating rooms.

Conclusion: It is pertinent for surgical-team to be knowledgeable about patient safety. Also, standard practice protocol should be entrenched to limit sentinel events in the operating rooms.

Barriers to Orthopaedic Oncology Care in a Resource-Constrained Setting: A Case Series of Four Patients

Ubaha AG — 2026-10-01

The successful management of bone and soft tissue sarcomas depends on patient, hospital, and societal factors. We present four cases that presented at a tertiary hospital in Nigeria, highlighting delayed presentation, financial constraints, inappropriate biopsy, and radiotherapy gaps: a female with fungating dermatofibrosarcoma protuberans lost to follow-up; a 17-year-old male with suspected osteosarcoma of the right thigh discharged against medical advice who died at home; a 30-year-old male with soft tissue sarcoma of the foot and a history of inappropriate incisional biopsy who subsequently underwent below-knee amputation; and a 60-year-old male with high-grade liposarcoma who developed local recurrence while awaiting radiotherapy and subsequently died. Poverty, poor infrastructure, and cultural beliefs intensify these barriers.

Giant recurrent pleomorphic adenoma of the parotid gland with facial nerve palsy: A case report

Amaechi U — 2026-10-01

Context: Pleomorphic adenoma is the most common benign salivary gland tumour, typically involving the parotid gland. Giant pleomorphic adenomas with prolonged progression and associated facial nerve palsy are rare and present management challenges.

Case presentation: We report the case of a 46-year-old male with a long-standing recurrent giant pleomorphic adenoma of the right parotid gland following previous excision, presenting with facial nerve palsy. The patient had undergone previous surgery approximately 12 years earlier, with recurrence reportedly occurring approximately four months later. Delayed presentation was attributed to financial constraints. The patient had total parotidectomy. Histopathologic examination showed pleomorphic adenoma without identified malignant transformation. Early postoperative recovery was satisfactory; however, longer-term assessment was limited because the patient was lost to follow-up after three months.

Conclusion: This case highlights the potential for neurological complications and extensive tumour growth in long-standing untreated pleomorphic adenoma. Early intervention and long-term follow-up improve overall outcome and quality of life.

Intracranial toxoplasmosis in retroviral disease: An important differential of many space-occupying lesions in resource-limited settings

Irek EO — 2026-10-01

Background: Intracranial toxoplasmosis (IT) in HIV could be misdiagnosed for other space-occupying lesions (SOLs).

Case presentation: We report of a case of a 52-year-old man who presented with progressive left-sided body weakness of a week and altered sensorium of nine hours. While CT suggested glioma, MRI characterized the lesion better which was suggestive of IT after HIV diagnosis.
The patient was placed on anti-toxoplasmosis and anti-retroviral drugs. Clinical recovery was significant within 12-hours of regimen commencement.

Conclusion: A high index of suspicion, MRI and initiating timely therapy are essential to forestall mortality due to this protozoan infection in PLWHA presenting with focal neurological deficits.

Minimal orbicularis oculi myectomy for treatment of severe benign essential blepharospasm: A case report

Okonkwo SN — 2026-10-01

Benign essential blepharospasm (BEB) is a type of focal dystonia characterized by excessive, involuntary, repetitive contractions of the orbicularis oculi muscle. In severe cases, the spasms can lead to functional blindness. The most effective and commonly employed treatment option for BEB is the use of botulinum neurotoxin A. However it is expensive and only provides temporary relief of symptoms. We report the case of a 60-year-old woman who presented to our center with complaint of inability to open her eyes of 6 weeks duration. This was preceded by 7 months history of excessive blinking and increasing difficulty opening her eyes voluntarily. On examination, the eyelids were tightly closed and the protractor muscles (orbicularis oculi, procerus and corrugator muscles) were spastic. She was diagnosed of severe bilateral benign essential blepharospasm. She had bilateral minimal orbicularis oculi muscle myectomy (involving excision of 8 mm wide strip of the muscle which included the orbital, septal and distal part of the pretarsal orbicularis muscle) of the upper and lower eyelids leading to resolution of the muscle spasm and opening of the eyelids. At 14 months follow up, she remained free of symptoms. Minimal orbicularis oculi myectomy was effective in providing long term relief of blepharospasm in our patient. This may be a viable option for treatment of BEB in low-income countries like Nigeria.

Missed diagnostic clues and intraoperative discovery of situs inversus totalis in an adult trauma patient: A case report

Odion CO — 2026-10-01

Situs inversus totalis is a rare congenital anomaly that may remain undetected until imaging or surgery. We report a previously healthy 50-year-old male twin who presented with polytrauma and haemodynamic instability after a road traffic collision. He had left pneumohaemothorax, blunt abdominal trauma with peritonitis, and a closed right femoral fracture The patient’s haemodynamic instability and the need for urgent resuscitation and surgical intervention limited the time available for a complete preoperative assessment, while incorrect left–right labelling of the chest radiograph obscured recognition of dextrocardia.

At laparotomy, mirror-image abdominal anatomy was discovered incidentally, with the spleen on the right and the liver, gallbladder, and appendix on the left. The spleen was shattered, and a jejunal perforation was also identified. Right-sided splenectomy, jejunal repair, and incidental appendicectomy were performed. Postoperative imaging confirmed dextrocardia, and recovery was uneventful. This case highlights the importance of correct radiographic labelling, focused examination, and intraoperative adaptability when unexpected anatomy is encountered.

Rare Chest Wall Cystic Echinococcosis in a 3-Year-Old Boy in Southwestern Nigeria: A Case Report

Olatunde OAO — 2026-10-01

Context: Cystic echinococcosis (CE) from Echinococcus granulosus larvae manifests rarely as isolated chest wall masses in children, mimicking benign cysts clinically. Diagnosis demands histopathology, as radiology and cytology often underperform amid subtle pediatric signs and atypical presentations.

Case Presentation: A 3-year-old boy from southwestern Nigeria without travel or canine exposure presented with a painless 4cm × 4 cm swelling along the right anterior chest wall (anterior axillary line) of 6 months' duration. The clinical impression was lipoma. Ultrasound showed a well-defined subcutaneous cystic lesion infiltrating pectoralis major. Fine-needle aspiration cytology indicates benign cyst contents. Complete surgical excision under general anesthesia revealed a fibrous mass with muscle involvement. Histopathology confirmed hydatid cyst featuring an acellular laminated membrane containing “scoleces” with hooklets and brood capsules.

Conclusion: Chest wall CE evades early detection due to its rarity and absence of classic risk factors, even in endemic urban settings. Routine histopathologic examination of excised cystic lesions is essential to avoid missing CE, thus enabling timely antiparasitic therapy and preventing recurrence.