Objective To elicit the explanatory models (EM) of hypertension among patients in a hospital-based primary care practice in Nigeria. Design Semi-structured in-depth individual interviews and focus groups were conducted with 62 hypertensive patients. Interviews and focus groups were audio-taped and transcribed verbatim. Data analysis was guided by phenomenology and content analysis using qualitative research software ATLAS.ti 5.0. Results Patients expressed four categories of EM of hypertension: 1) perceptions of hypertension, 2) consequences, 3) effect on daily life, and 4) perception of treatment. Focus group discussions and key informant interviews yielded a wide range of insights into the social and cultural factors influencing patients’ beliefs and health behavior. Participants were aware of the risks of hypertension. There was disagreement between participants’ own understanding of the serious nature of hypertension, the need for long-term treatment, and the desire to take medication long-term. Participants acknowledged the use of traditional medicine (e.g. teas and herbs) and healers. Different themes emerged for men versus women such that women often focused on family issues while men tended to discuss external stressors stemming from work as a cause of hypertension. Men were concerned with frequent urination, decreased libido and erectile dysfunction. Conclusion Knowledge gained will inform development of patient-centered treatment plans and targeted behavioral and educational interventions.
BackgroundThere has presumably been an increase in cases of sexual assault in Nigeria; however, accurate data on the characteristics of the survivors and perpetrators are not readily available in most cases.AimTo report the pattern and characteristics of sexual assault perpetrators and survivors managed at the Mirabel Centre, Lagos State University Teaching Hospital (LASUTH), Ikeja – a three-year review.MethodsA retrospective audit carried out in the sexual assault referral centre (SARC) – Mirabel Centre, LASUTH, Lagos State, Nigeria. A total of 2160 case files from July 2013 to January 2017 were assessed for age group of survivors and gender, among others.ResultsA total of 2160 cases were analysed. The mean age of survivors was 13.9 (± 4.4) years with the 11–20 years age group having the highest number of survivors (48.4%) and the 0–10 years age group having 35.9% of survivors. Majority of the survivors (97.7%) were female. The majority of the perpetrators were known to the survivors with 10.3% being family members. Defilement (71.6%) was the most reported type of assault at the centre with rape (20.3%) being the second most common. The majority of the referrals to the centre were from the police (76.7%), while self-referrals made up 8% of referrals.ConclusionMinors and adolescents formed the majority of the survivors. Defilement was the most reported form of sexual violence. There needs to be special intervention for better monitoring and protection of minors and youths against sexual assault. The establishment of more sexual assault referral centres in Nigeria will increase reportage and treatment of survivors.
Purpose:Oxidative stress has been implicated in the pathophysiology of glaucoma, cataract, and many degenerative diseases. The purpose of this study is to evaluate the systemic oxidative stress in black-African patients diagnosed with primary glaucoma or age-related cataract (ARC) and compare these indices to normal control patients and between the two conditions.Methods:This was a descriptive cross-sectional study of consecutive recruited subjects attending a tertiary care facility. One hundred adults were enrolled and sub-grouped into: Normal controls (n = 20), patients with primary glaucoma (n = 40), and patients with cataract (n = 40). The data were collected on patient demographics and clinical information. Ten milliliters of the venous blood was taken from each subject for the evaluation of serum biochemical indices of oxidative stress. Laboratory measurements of enzymatic and nonenzymic anti-oxidants, as well as lipid peroxidation, were conducted using established and validated spectrophotometric methods. The systemic oxidative stress was measured by the serum levels of anti-oxidant enzymes and lipid peroxidation, and compared between the groups and to a control group of patients.Results:Statistically, significantly reduced serum levels of glutathione, glutathione-S-transferase, superoxide dismutase, catalase, and ascorbic acid were found in the patients with glaucoma or cataract when compared with controls (P < 0.05 for all). Differences in serum lipid peroxidation levels across or between the groups were nonsignificant. Serum protein levels were significantly higher among the subjects with cataract or glaucoma than in controls.Conclusion:Our results concur with findings in Caucasian study cohorts. This indicates that in black-Africans, primary glaucoma, and ARC are associated with increased systemic oxidative stress. This supports the existing evidence on the role of oxidative stress in these ocular disorders and reinforces the rationale for the use of anti-oxidants in the management and possible prevention of these conditions.
Low levels of serum testosterone may have negative implications on morbidity in HIV-infected men. The purpose of this study was to determine demographic and clinical characteristics that predict low serum testosterone among men attending our HIV clinic. A cross-sectional study of 587 HIV-positive male patients who presented at the Louisiana State University HIV Outpatient (HOP) Clinic between August 1997 and January 1999 was conducted. Demographic and clinical characteristics were collected and analysed. Of the 587 men studied, 119 (20.3%) had a serum testosterone level below 400 ng/dl. Significantly more men with low serum testosterone levels had a presence of opportunistic infection (especially HIV wasting syndrome, oesophageal candidiasis, or dementia), CD4+ cell counts below 200 cells/mm3, or were taking megestrol acetate. Early detection of low serum testosterone will allow for expedient testosterone supplementation therapy, which could improve morbidity and quality of life for HIV-infected men.
Blood pressure (BP) control remains sub-optimal all over the world. Medication adherence is an important determinant of BP control. None of the available methods for measuring medication adherence is currently regarded as a universal consensus gold standard. In this study, we evaluated the correlation between self-report (Morisky's Medication Adherence Self-assessment Scale) and electronic (eCap) methods of medication adherence assessment. The self-report measure was administered at study entry while electronic compliance data was collected prospectively. Almost all (97.4%) of enrolled patients completed the study. Medication adherence scores ranged from 0 to 100% (69.33, ± 27.57) and 6.6-100% (66.92 ± 22.59) for Morisky's scale and eCap, respectively (Wilcoxon rank sum test, p = 0.253). Modal class interval for adherence scores were 61-80% (n = 28, 37.3%) and 81-100% (n = 23, 30.7%) for the eCap and Morisky's scale respectively. Overall, a weak correlation was found between the two methods (r = 0.056). The weak correlation was also maintained in subgroup analysis defined by attainment of BP control (r = 0.109 vs 0.0009), age (range r = -0.53 to 0.067), sex (0.009 to 0.151), level of education (-0.217 to 0.276), and Mini Mental State Examination score (-0.107 to 0.258). Our findings suggest that these methods are not equivalent in the evaluation of medication adherence.
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