24 results on '"Ugwu CN"'
Search Results
2. Prevalence and Pattern of Risk Factors for Chronic Kidney Disease among Health Workers in a Tertiary Institution in South East Nigeria
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AFOLABI, OF, NWOBODO, MU, IFEBUNANDU, N, ULASI, II, EZE, CO, UGWU, CN, NWIKWU, OJ, UDEZE, CO, AGBO, AC, and OLOGWU, CC
- Subjects
Health Workers ,Risk Factors ,Renal Function ,Assessment - Abstract
Background: Chronic kidney disease (CKD) is one of the leading causes of mortality globally. The prevalence of risk factors associated with CKD is on the rise in Nigeria. Early recognition and treatment of risk factors can prevent or slow down disease progression. Objectives: This study aimed to determine the prevalence of chronic kidney disease and some of its risk factors among health workers at Alex-Ekweueme Federal University Teaching Hospital, Abakaliki. Methodology: This was a cross-sectional study conducted as part of the activities to commensurate world kidney day. Consecutive volunteers were screened. Their biodata, anthropometric data, and blood pressures were obtained. Blood glucose was determined by glucometer, a urine sample was collected for urinalysis, and a blood sample was taken for serum creatinine. The estimation of glomerular filtration rate (eGFR) was calculated using the modification of diet in renal disease ( MDRD) formula. Results: 390 members of staff were screened. There were 152 (39%) males and 238 (61%) females. The mean age was 38.19 ± 10.24years. CKD risk factors were obesity (32.8%), hypertension (26.4%), proteinuria (11.0%) and diabetes mellitus (6.2%). 31.0% had CKD (eGFRConclusion: Chronic kidney disease and its risk factors were prevalent among the participants. A healthy lifestyle and regular screening among health workers should be encouraged to curb CKD and its risk factors.
- Published
- 2023
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3. Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study
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Isiguzo, GC, Santo, K, Panda, R, Mbau, L, Mishra, SR, Ugwu, CN, Virani, SS, Odili, AN, Atkins, ER, Isiguzo, GC, Santo, K, Panda, R, Mbau, L, Mishra, SR, Ugwu, CN, Virani, SS, Odili, AN, and Atkins, ER
- Abstract
BACKGROUND: Hypertension control remains a significant challenge in reducing the cardiovascular disease burden worldwide. Community peer-support groups have been identified as a promising strategy to improve medication adherence and blood pressure (BP) control. OBJECTIVES: The study aimed to evaluate the feasibility and impact of adherence clubs to improve BP control in Southeast Nigeria. METHODS: This was a mixed-methods research involving a formative (pre-implementation) research, pilot study and process evaluation. Hypertensive patients in two communities were recruited into peer-support adherence clubs under the leadership of role-model patients to motivate and facilitate medication adherence, BP monitoring, and monthly medication delivery for six months. The primary outcome was medication adherence measured using visual analogue scale (VAS), with BP level at six months as a key secondary outcome. RESULTS: We recruited a total of 104 participants. The mean age was 56.8 (SD-10.7) years, 72 (69.2%) were women, mean BP was 146.7 (SD-20.1)/86.9 (SD-11.2) mmHg, and the mean percentage of medication adherence on the VAS was 41.4% (SD-11.9%). At six months, 67 patients were assessed; self-reported adherence on the VAS increased to 57.3% (SD-25.3%) (mean difference between baseline and follow-up of 15.5%, p < 0.0001), while the mean BP decreased to 132.3 (SD-22.0)/82.9 (SD-12.2) mmHg (mean difference of 13.0 mmHg in systolic BP, p < 0.0001 and of 3.6 mmHg in diastolic BP, p = 0.02). Five in-depth interviews and four focus groups discussions were conducted as part of the qualitative analyses of the study. The participants saw hypertension as a big issue, with many unaware of the diagnosis, and they accepted the CLUBMEDS differential service delivery (DSD) model concept in hypertension. CONCLUSIONS: The study demonstrates that the implementation of adherence clubs for hypertension control is feasible and led to a statistically significant and clinically meaningful improve
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- 2022
4. Voluntary non-remunerated blood donation: Awareness, perception, and attitude among potential blood donors in Abakaliki, Nigeria
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Ugwu, NI, primary, O Oti, WJ, additional, Ugwu, CN, additional, and Uneke, CJ, additional
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- 2019
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5. Medical students' perception of their learning environment at a Nigerian University.
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Ugwu, NI, primary, Nwannadi, AI, additional, Ugwu, CN, additional, and Oghagbon, EK, additional
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- 2019
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6. GLOBAL LONGITUDINAL LEFT VENTRICULAR STRAIN AND ITS CORRELATES IN BLACK NIGERIAN SICKLE CELL DISEASE (SCD) PATIENTS: PROTOCOL FOR A PILOT STUDY.
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Ugwu CN, Antia SE, Antia GA, Chika-Igwenyi NM, Alu QU, Ajaero CC, Isiguzo GC, and Ugwu NI
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- Humans, Pilot Projects, Nigeria, Child, Adolescent, Male, Adult, Female, Young Adult, Child, Preschool, Case-Control Studies, Black People, Heart Ventricles diagnostic imaging, Heart Ventricles physiopathology, Cardiomyopathies physiopathology, Cardiomyopathies etiology, Anemia, Sickle Cell physiopathology, Anemia, Sickle Cell complications, Echocardiography methods, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Left etiology, Electrocardiography
- Abstract
Background: Sickle cell cardiomyopathy is becoming a neglected tropical cardiovascular disease, yet the most common cause of death in HbSS patients. Myocardial strain using speckle tracking has recently been validated as a tool for the detection of subclinical left ventricular systolic dysfunction. Its utility in sickle cell disease in Nigeria is unknown., Objectives: The study aims to evaluate global longitudinal left ventricular (GL LV) strain pattern in black SCD patients in steady state, and correlate that with clinico-laboratory and electrocardiographic (ECG) measurements. Furthermore, we will evaluate the timeline for the earliest detectable cardiac changes in SCD detectable by ECG or speckle tracking., Method: 60 sickle cell patients between ages 5 and 40 years will be matched with 60 controls. Baseline clinic-laboratory data will be collected. All participants will have electrocardiography and speckle-tracking echocardiography of the left ventricle. The primary outcome is the global LV longitudinal strain in HBSS and matched control. Secondary outcomes are the clinico-laboratory and electrocardiographic correlates of LV strain in black HBSS patients as well as tracking the earliest detectable cardiovascular change in the life spectrum from childhood to adulthood. Regression analysis and other statistical models will be used., Conclusion: The simplicity of the study design is crafted to spark interest in life-threatening cardiovascular complications of sickle cell disease beyond pulmonary hypertension., Competing Interests: The authors declare no conflict of interest, (Copyright © 2024 by West African Journal of Medicine.)
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- 2024
7. Artificial Intelligence and Cardiology Practice in Nigeria: Are We Ready?
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Antia SE, Ajaero CC, Kalu AU, Odili AN, Ugwu CN, and Isiguzo GC
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- Humans, Nigeria, SARS-CoV-2, Pandemics, Artificial Intelligence, Cardiology, COVID-19 epidemiology, Cardiovascular Diseases therapy, Cardiovascular Diseases epidemiology
- Abstract
Cardiovascular diseases are the leading cause of death globally. As cardiovascular risk factors continuously rise to pandemic levels, there is intense pressure worldwide to improve cardiac care in preventive cardiology, cardio-diagnostics, therapeutics, and interventional cardiology. Artificial intelligence (AI), an advanced branch of computer science has ushered in the fourth industrial revolution with myriad opportunities in healthcare including cardiology. The developed world has embraced the technology, and the pressure not to be left behind is intense for both policymakers and practicing physicians/cardiologists in low to middle-income countries (LMICs) like Nigeria. This is especially daunting for LMICs who are already plagued with a high burden of infectious disease, unemployment, physician burnt, brain drain, and a developing cardiac practice. Should the focus of cardiovascular care be on men or machines? Is the technology sustainable in a low-resource setting? What lessons did we learn from the COVID-19 pandemic? We attempt to zero in on the dilemmas of AI in the Nigerian setting including AI acceptance, the bottlenecks of cardiology practice in Nigeria, the role of AI, and the type of AI that may be adapted to strengthen cardiovascular care of Nigerians., (Copyright © 2024 Copyright: © 2024 Nigerian Journal of Clinical Practice.)
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- 2024
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8. Harnessing technology for infectious disease response in conflict zones: Challenges, innovations, and policy implications.
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Ugwu OP, Alum EU, Ugwu JN, Eze VHU, Ugwu CN, Ogenyi FC, and Okon MB
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- Humans, Armed Conflicts, Disease Outbreaks prevention & control, Health Policy, Communicable Disease Control methods, Telemedicine ethics, Communicable Diseases epidemiology
- Abstract
Epidemic outbreaks of infectious diseases in conflict zones are complex threats to public health and humanitarian activities that require creativity approaches of reducing their damage. This narrative review focuses on the technology intersection with infectious disease response in conflict zones, and complexity of healthcare infrastructure, population displacement, and security risks. This narrative review explores how conflict-related destruction is harmful towards healthcare systems and the impediments to disease surveillance and response activities. In this regards, the review also considered the contributions of technological innovations, such as the improvement of epidemiological surveillance, mobile health (mHealth) technologies, genomic sequencing, and surveillance technologies, in strengthening infectious disease management in conflict settings. Ethical issues related to data privacy, security and fairness are also covered. By advisement on policy that focuses on investment in surveillance systems, diagnostic capacity, capacity building, collaboration, and even ethical governance, stakeholders can leverage technology to enhance the response to infectious disease in conflict settings and, thus, protect the global health security. This review is full of information for researchers, policymakers, and practitioners who are dealing with the issues of infectious disease outbreaks in conflicts worn areas., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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9. Ebstein's Anomaly in a Young Nigerian Lady.
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Antia SE, Isiguzo GC, Ajaero CC, Okpala PO, and Ugwu CN
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- Humans, Female, Adult, Echocardiography methods, Nigeria, Anti-Arrhythmia Agents therapeutic use, Ebstein Anomaly physiopathology, Ebstein Anomaly complications, Electrocardiography
- Abstract
Background: Ebstein's anomaly (EA) is a rare congenital heart disease with a wide spectrum of presentation from the womb to adulthood characterized by apical displacement of tricuspid valve leaflets into the right ventricle. This is due to defects in embryological processes of uncertain etiology., Case Summary: A 28-year-old woman who presented with palpitations from childhood occurring in short paroxysms daily and limiting her from strenuous activities. Physical examination findings revealed a small stature with no associated birth defects. The cardiovascular system revealed tachycardia, a small volume irregular pulse with a split S2 heart sound. ECG showed premature atrial complexes, fragmented QRS with Sodi-Pallares sign, and echocardiographic features in keeping with atrialization of right ventricle with apical displacement of septal leaflet of the tricuspid valve into the right ventricle in keeping with EA. The patient was placed on anti-arrhythmics and anticoagulants., Conclusion: The diagnosis of EA in adults is often delayed in low-resource settings for multifaceted reasons. However, medical therapy offers a conservative measure to preserve life while surgical correction is advocated for the majority of cases when picked up early., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)
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- 2024
10. Atypical Mpox in a Nigerian Tertiary Health Facility.
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Chika-Igwenyi NM, Unigwe US, Ajayi NA, Onwe OE, Ewa RL, Ojide CK, Una AF, Igwenyi C, Chukwu KS, Okorie GM, Nnadozie UU, Ifebunandu NA, Ugwu CN, Emeka S, Ibemesi D, Nnaji TO, Primus NO, and Odianosen E
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- Humans, Male, Child, Preschool, Child, Adolescent, Young Adult, Adult, Middle Aged, Female, Skin, Black People, Health Facilities, Mpox (monkeypox), Coinfection
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Background: We describe diverse clinical characteristics and course of confirmed mpox cases managed in a Nigerian tertiary health facility., Methods: Clinical and epidemiologic data were analyzed, highlighting the unusual presentations of polymerase chain reaction (PCR)-confirmed mpox cases observed during the 2022 outbreak., Results: Out of 17 suspected cases, 13 (76.4%) were PCR confirmed for mpox. The mean ± SD age for the participants was 28.62 ± 10.29 years (range, 2-55), of which 9 (64.3%) were male. Of the 13 PCR-confirmed cases, 5 (38.5%) had varicella zoster virus coinfection, 2 (15.4%) had HIV coinfection, and 1 (7.7%) had diabetes mellitus comorbidity. All patients experienced rash, with 6 (46.2%) having significant genital lesions and 1 (7.7%) having a severe perianal lesion. A lack of prodromal symptoms was reported in 3 (23.1%), and a prolonged prodrome (>1 week) occurred in 5 (38.5%). Skin lesions were polymorphic in 6 (46.2%), and solitary skin lesions occurred in 3 (23.1%), which persisted for >120 days in 7.7%., Conclusions: Clinical recognition, diagnosis, and prevention remain a concern in resource-limited settings. Our findings highlight the need to further evaluate unusual skin lesions and to include mpox screening for genital skin lesions that are presumed to be sexually transmitted infections. Revision of clinical case definition and enhanced surveillance are key to early recognition and prevention of spread., Competing Interests: Potential conflict of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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11. Insecticide Treated Net Usage and Its Predictors among HIV Patients Attending an Antiretroviral Therapy Clinic in Ebonyi State, Nigeria.
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Afolabi OF, Eze CO, Ugwu CN, Ajayi NA, Aja DO, and Uneke CJ
- Abstract
Background: Malaria prevention is important among HIV patients to mitigate its associated complications. This study explored the predictors of insecticide-treated net (ITN) usage among HIV patients attending an antiretroviral therapy (ART) clinic in Ebonyi state, Nigeria., Methodology: It was a cross-sectional study that involved 297 patients who attended an ART clinic in Ebonyi State. An interviewer-administered questionnaire was used to collect relevant data which included perception of malaria prevention, ownership of ITN, condition of ITN, duration of use and ITN usage. The relationship between ITN usage and other variables was assessed using bivariate analysis and the predictors were determined using multivariate logistic regression., Results: There were 64 (21.5%) males and 233(78.5%) females. Knowledge of the use of ITN (mean= 4.24 ±0.93) was rated better than knowledge of the use of mosquito repellent (mean = 3.79 ± 1.21) and knowledge of the use of protective clothes (mean= 3.86 ±1.26). 246 (83%) of the study population owned ITN. Only 48% (118) of those who had ITNs reported having optimal nets (nets without holes). 135 (45.5%) of the participants reported sleeping under the net every day in the past week. There was a significant relationship between ITN usage and knowledge of the use of ITN, ownership of ITN, duration of use and condition of nets. Predictors of usage of ITN were duration of use (AOR=0.386, 95%C.I for AOR=0.224-0.665) and condition of the nets (AOR=0.399, 95%C.I for AOR=0.226-0.706)., Conclusion: Perception of malaria prevention was high among the study group. Ownership of ITN was high although many of the ITNs were not in good condition. Usage of ITN was largely determined by duration of use and good condition of nets. Yearly assessment of the condition of ITNs and replacement exercise of ITNs (2-3 years) at ART clinics to replace old and worn-out nets among HIV patients are recommended., Competing Interests: The authors declare no conflicts of interest regarding this study., (Copyright © 2023 Nigerian Medical Association.)
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- 2023
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12. Blood Coagulation Normalization Effect of Parkia Biglobosa Seed on Potassium Bromate-induced Coagulopathy.
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Ugwu NI, Uche CL, Ogbenna AA, Okite UP, Chikezie K, Ejikem PI, Ugwu CN, Otuka OAI, Ezirim EO, Onyekachi OIN, Nwobodo MU, Abali IO, Iwuoha CE, and Airaodion AI
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- Adult, Male, Humans, Animals, Rats, Rats, Wistar, Vitamin K, Body Weight, Blood Coagulation, Fibrinogen
- Abstract
Background: Potassium bromate (KBrO3) has been reported to be toxic, adversely affecting many body tissues and organs. The aim of this study was to determine the blood coagulation effect of Parkia biglobosa (P. biglobosa) seed on potassium bromate induced coagulopathy., Methodology: P. biglobosa was extracted with soxhlet extractor with ethanol as the solvent. Twenty-four adult male Wistar rats were acclimatized under laboratory conditions and were randomly grouped into A, B, C and D. Group A was given distilled water orally. Animals in groups B, C and D were administered 100 mg/kg body weight of potassium bromate, but groups C and D were also treated with 100 and 200 mg/kg body weight of P. biglobosa respectively. Both potassium bromate and P. biglobosa were freshly prepared on daily basis and administered to rats by oral gavage for 28 days. At the end of the treatment period, blood samples were collected in sodium citrate bottles and were used for analysis of Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), fibrinogen and vitamin K levels using standard methods., Results: Administration of potassium bromate increased Prothrombin Time (PT) from 11.67±2.15 seconds (in control animals) to 19.53±2.83 seconds. Treatment with 100 and 200 mg/kg body weight of P. biglobosa seed extract neutralized this effect in a dose-dependent manner. Likewise, KBrO 3 was observed to have significantly elevated Activated Partial Thromboplastin Time (APTT) from 29.67±3.93 to 41.10±4.79 seconds and Thrombin Time (TT) from 15.36±2.06 to 25.43±2.83 seconds when compared with those in the control group. The result further showed that exposure of animals to KBrO3 significantly declined the levels of fibrinogen (from 4.05±0.72 to 2.59±0.30 g/dL) and vitamin K (from 3.18±0.73 to 1.84±0.18 ng/mL) when compared with the untreated animals. The effect of KBrO 3 on PT, APTT, TT, Fibrinogen and vitamin k were attenuated by P. biglobosa in a dose-dependent manner., Conclusion: The results of this investigation demonstrated that potassium bromate caused prolongation of PT, aPTT and TT and decreased levels of fibrinogen and vitamin K, but P. biglobosa treatment counteracted these effects. Thus, it is recommended that these results be investigated in clinical trials in human volunteers., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2023 by West African Journal of Medicine.)
- Published
- 2023
13. Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria.
- Author
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Olawoye IB, Oluniyi PE, Oguzie JU, Uwanibe JN, Kayode TA, Olumade TJ, Ajogbasile FV, Parker E, Eromon PE, Abechi P, Sobajo TA, Ugwu CA, George UE, Ayoade F, Akano K, Oyejide NE, Nosamiefan I, Fred-Akintunwa I, Adedotun-Sulaiman K, Brimmo FB, Adegboyega BB, Philip C, Adeleke RA, Chukwu GC, Ahmed MI, Ope-Ewe OO, Otitoola SG, Ogunsanya OA, Saibu MF, Sijuwola AE, Ezekiel GO, John OG, Akin-John JO, Akinlo OO, Fayemi OO, Ipaye TO, Nwodo DC, Omoniyi AE, Omwanghe IB, Terkuma CA, Okolie J, Ayo-Ale O, Ikponmwosa O, Benevolence E, Naregose GO, Patience AE, Blessing O, Micheal A, Jacqueline A, Aiyepada JO, Ebhodaghe P, Racheal O, Rita E, Rosemary GE, Solomon E, Anieno E, Edna Y, Chris AO, Donatus AI, Ogbaini-Emovon E, Tatfeng MY, Omunakwe HE, Bob-Manuel M, Ahmed RA, Onwuamah CK, Shaibu JO, Okwuraiwe A, Ataga AE, Bock-Oruma A, Daramola F, Yusuf IF, Fajola A, Ntia NA, Ekpo JJ, Moses AE, Moore-Igwe BW, Fakayode OE, Akinola M, Kida IM, Oderinde BS, Wudiri ZW, Adeyemi OO, Akanbi OA, Ahumibe A, Akinpelu A, Ayansola O, Babatunde O, Omoare AA, Chukwu C, Mba NG, Omoruyi EC, Olisa O, Akande OK, Nwafor IE, Ekeh MA, Ndoma E, Ewah RL, Duruihuoma RO, Abu A, Odeh E, Onyia V, Ojide CK, Okoro S, Igwe D, Ogah EO, Khan K, Ajayi NA, Ugwu CN, Ukwaja KN, Ugwu NI, Abejegah C, Adedosu N, Ayodeji O, Liasu AA, Isamotu RO, Gadzama G, Petros BA, Siddle KJ, Schaffner SF, Akpede G, Erameh CO, Baba MM, Oladiji F, Audu R, Ndodo N, Fowotade A, Okogbenin S, Okokhere PO, Park DJ, Mcannis BL, Adetifa IM, Ihekweazu C, Salako BL, Tomori O, Happi AN, Folarin OA, Andersen KG, Sabeti PC, and Happi CT
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- Humans, Nigeria epidemiology, COVID-19 epidemiology, SARS-CoV-2 genetics
- Abstract
Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates., (© 2023. The Author(s).)
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- 2023
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14. The Impact of Co-Morbidities on the Pattern of Blood Pressure Control in Elderly Hypertensives in Nigeria.
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Ugwu CN, Okafor CI, Ejim EC, Ugwu NI, Chika-Igwenyi NM, Obeka N, Ikeagwulonu RC, Iyidobi TC, Nnadozie UU, Afolabi FO, Kalu AU, and Isiguzo GC
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- Aged, Female, Humans, Male, Blood Pressure, Nigeria epidemiology, Obesity epidemiology, Morbidity, Obesity, Abdominal, Hypertension epidemiology
- Abstract
Introduction: The elderly hypertensive patients often have increased prevalence of cardiometabolic risk factors and their attendant co-morbidities. The aim of this study was to determine the prevalence of cardiometabolic risk factors and blood pressure control among elderly hypertensive patients, and to determine the influence of modifiable cardiometabolic risk factors on the control of hypertension among elderly hypertensive patients., Subjects and Methods: A case-control comparative and hospitalbased study involving a total of 190 consenting elderly (>65 years), hypertensive patients (subjects) (n=100) and normotensive controls (n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding their lifestyle was obtained. Standard protocols were used to measure blood pressure, weight, height, waist circumference, fasting plasma glucose and fasting lipid profile of the subjects. Body mass index was derived from weight and height., Results: The mean age of the subjects was 71.5 ± 6.3 years and the controls was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% of the subjects and controls were females (p = 0.651). The level of control of hypertension was poor in over two-thirds (68%) of the elderly hypertensive patients. The prevalence of modifiable cardiometabolic risk factors burden was higher in the hypertensive subjects when compared with the controls. Prevalence of Dyslipidaemia was 76% in the subjects and 51% in the controls (p = 0.004). Prevalence of Diabetes Mellitus was 40% among the subjects and 17.8% in the controls (p = 0.0001); prevalence of Obesity was 24% in the subjects and 4.4% in the controls (p=<0.001); prevalence of excess alcohol intake was 49% in the subjects and 14.4% in the controls (p=<0.001). Prevalence of sedentary life style was high in both the subjects (53%) and controls (50%), p=0.679. Poor blood pressure control was predicted by dyslipidaemia and central obesity., Conclusion: The level of control of hypertension was poor among the elderly and modifiable cardiometabolic risk factors were relatively prevalent. Central obesity and dyslipidaemia were predictive of poor control of hypertension. Addressing these factors may therefore improve blood pressure control., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)
- Published
- 2022
15. Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study.
- Author
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Isiguzo GC, Santo K, Panda R, Mbau L, Mishra SR, Ugwu CN, Virani SS, Odili AN, and Atkins ER
- Subjects
- Antihypertensive Agents therapeutic use, Blood Pressure, Feasibility Studies, Female, Humans, Male, Medication Adherence, Middle Aged, Nigeria epidemiology, Pilot Projects, Hypertension drug therapy, Hypertension epidemiology
- Abstract
Background: Hypertension control remains a significant challenge in reducing the cardiovascular disease burden worldwide. Community peer-support groups have been identified as a promising strategy to improve medication adherence and blood pressure (BP) control., Objectives: The study aimed to evaluate the feasibility and impact of adherence clubs to improve BP control in Southeast Nigeria., Methods: This was a mixed-methods research involving a formative (pre-implementation) research, pilot study and process evaluation. Hypertensive patients in two communities were recruited into peer-support adherence clubs under the leadership of role-model patients to motivate and facilitate medication adherence, BP monitoring, and monthly medication delivery for six months. The primary outcome was medication adherence measured using visual analogue scale (VAS), with BP level at six months as a key secondary outcome., Results: We recruited a total of 104 participants. The mean age was 56.8 (SD-10.7) years, 72 (69.2%) were women, mean BP was 146.7 (SD-20.1)/86.9 (SD-11.2) mmHg, and the mean percentage of medication adherence on the VAS was 41.4% (SD-11.9%). At six months, 67 patients were assessed; self-reported adherence on the VAS increased to 57.3% (SD-25.3%) (mean difference between baseline and follow-up of 15.5%, p < 0.0001), while the mean BP decreased to 132.3 (SD-22.0)/82.9 (SD-12.2) mmHg (mean difference of 13.0 mmHg in systolic BP, p < 0.0001 and of 3.6 mmHg in diastolic BP, p = 0.02). Five in-depth interviews and four focus groups discussions were conducted as part of the qualitative analyses of the study. The participants saw hypertension as a big issue, with many unaware of the diagnosis, and they accepted the CLUBMEDS differential service delivery (DSD) model concept in hypertension., Conclusions: The study demonstrates that the implementation of adherence clubs for hypertension control is feasible and led to a statistically significant and clinically meaningful improvement in self-reported medication adherence, resulting in BP reduction. Upscaling the intervention may be needed to confirm these findings., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2022 The Author(s).)
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- 2022
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16. Recent and advanced nano-technological strategies for COVID-19 vaccine development.
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Nwagwu CS, Ugwu CN, Ogbonna JDN, Onugwu AL, Agbo CP, Echezona AC, Ezeibe EN, Uzondu S, Kenechukwu FC, Akpa PA, Momoh MA, Nnamani PO, Tarirai C, Ofokansi KC, and Attama AA
- Abstract
The outbreak of the COVID-19 pandemic in 2019 has been one of the greatest challenges modern medicine and science has ever faced. It has affected millions of people around the world and altered human life and activities as we once knew. The high prevalence as well as an extended period of incubations which usually does not present with symptoms have played a formidable role in the transmission and infection of millions. A lot of research has been carried out on developing suitable treatment and effective preventive measures for the control of the pandemic. Preventive strategies which include social distancing, use of masks, washing of hands, and contact tracing have been effective in slowing the spread of the virus; however, the infectious nature of the SARS-COV-2 has made these strategies unable to eradicate its spread. In addition, the continuous increase in the number of cases and death, as well as the appearance of several variants of the virus, has necessitated the development of effective and safe vaccines in a bid to ensure that human activities can return to normalcy. Nanotechnology has been of great benefit in the design of vaccines as nano-sized materials have been known to aid the safe and effective delivery of antigens as well as serve as suitable adjuvants to potentiate responses to vaccines. There are only four vaccine candidates currently approved for use in humans while many other candidates are at various levels of development. This review seeks to provide updated information on the current nano-technological strategies employed in the development of COVID-19 vaccines., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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17. Distribution pattern and prevalence of haematological cancers among adults in Abakaliki, South-Eastern Nigeria.
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Ugwu NI, Okoye AE, Ugwu CN, Iyare FE, Edegbe FO, Ugwu GC, Chukwurah EF, Richard IC, John DO, Nnadozie UU, and Nwokwu EU
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- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Nigeria epidemiology, Prevalence, Retrospective Studies, Young Adult, Hematologic Neoplasms epidemiology, Leukemia
- Abstract
Background: Haematological cancers are clonal diseases of the blood and blood-forming organs, with the distribution pattern not known in our locality. This study aimed to describe the distribution pattern and prevalence of haematological cancers among adults in Abakaliki, Nigeria., Materials and Methods: This was an 8-year retrospective study in which the hospital records/case notes of adult patients diagnosed and managed for haematological cancers from May 2012 to April 2020 were reviewed. Data obtained were analysed with the SPSS software, version 20., Results: One hundred and thirty-five cases of haematological cancers were included in the study, with 72 (53.4%) males and 63 (46.6%) females and male-to-female ratio of 1.1:1. The age range was 18-82 years, with a mean age of 49 ± 17 years. Lymphoid malignancies predominate more than myeloid (101 [74.8%] vs. 34 [25.2%]). The leukaemias were more predominant than the lymphomas and myeloma accounting for 48.2%, 36.3% and 7.4%, respectively. Chronic leukaemias were more common than the acute leukaemias with chronic lymphocytic leukaemia (CLL) being the most common accounting for 24.4% of haematological cancers. In general, non-Hodgkin's lymphoma (NHL) was the most common haematologic cancer accounting for 35 (25.9%), followed by CLL 33 (24.4%), chronic myeloid leukaemia (CML) 17 (12.6%), Hodgkin's lymphoma (HL) 14 (10.4%) and multiple myeloma (MM) 10 (7.4%). Others include acute lymphoblastic leukaemia (ALL) 9 (6.7%) and acute myeloblastic leukaemia (AML) 6 (4.4%). Myelodysplastic syndrome (MDS) and polycythaemia vera (PV), each contributed 3% while myelofibrosis (MF) and essential thrombocythaemia (ET) contributed 1.5% and 0.7%, respectively., Conclusion: This study has shown that haematological cancers are not uncommon in our locality with NHL being the most common, followed by CLL, CML, HL, MM, ALL, AML, MDS, PV. MF and ET in that order. The burden of haematological cancers in Ebonyi State, Nigeria is therefore significant and should be prioritised in health-care policy formulation and management., Competing Interests: None
- Published
- 2021
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18. Chronic Myeloid Leukaemia with Sudden Bilateral Deafness and Leg Ulcer Associated with Hydroxyurea Therapy.
- Author
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Ugwu NI, Okoye AE, Ugwu CN, Ibiam FA, Nnachi OA, Ugwu GC, and Okoh NU
- Subjects
- Hearing Loss, Bilateral, Humans, Hydroxyurea adverse effects, Male, Middle Aged, Antineoplastic Agents therapeutic use, Leg Ulcer chemically induced, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy
- Abstract
Deafness occurs rarely in patients with chronic myeloid leukaemia. Hydroxyurea-induced leg ulcer has been found in patients on long-term hydroxyurea therapy. We present a 53 year old man who developed spontaneous bilateral deafness shortly after he was diagnosed with chronic myeloid leukaemia and subsequently developed hydroxyurea induced leg ulcer in the course of treatment. A 53 year-old male presented to our clinic with six months history of left abdominal mass, associated with easy satiety, occasional fever, night sweats, loss of appetite, weight loss, easy fatiguability and bilateral leg swelling. Physical examination showed a middle-aged man in no obvious distress, afebrile, anicteric, pale, with no peripheral lympadenopathy but had bilateral pitting pedal edema to the lower third. There was no significant finding on the chest. Abdominal examination showed hepatosplenomagaly. Full blood count showed anaemia, hyperleucocytosis and thrombocytosis. Peripheral blood film and bone marrow aspiration examinations were in keeping with chronic myeloid leukaemia. The BCR/ABL-1 transcript was negative, thus he was started on hydroxyurea in addition to other supportive treatment. Before commencement of hydroxyurea therapy, he spontaneously developed bilateral sensorineural deafness. Subsequently, he also developed leg ulcers, having been on hydroxyurea therapy for seven years which healed within eight weeks on discontinuation of hydroxyurea. Spontaneous deafness can occur in patients with chronic myeloid leukaemia due to hyperleucocytosis and urgent cytoreduction may help to prevent this complication. In addition, leg ulcer due to long-term hydroxyurea therapy can occur and usually do not respond to the conventional treatment but discontinuation of hydroxyurea., Competing Interests: The authors certifies that there is no conflict of interest in connection with the submitted article., (Copyright © 2021 by West African Journal of Medicine.)
- Published
- 2021
19. Evaluation of Foetal Haemoglobin Status among Nigerian Patients with Sickle Cell Anaemia Using High Performance Liquid Chromatography.
- Author
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Ugwu NI, Nna EO, Ugwu CN, Ogah OE, Okike C, Ikeagwulonu RC, Nnadozie UU, Madu AJ, Okoye HC, Uzoma IC, Alo C, Ugwu GC, Ekpeagu VN, and Okeke UI
- Subjects
- Adult, Child, Chromatography, High Pressure Liquid, Cross-Sectional Studies, Female, Humans, Male, Nigeria, Anemia, Sickle Cell, Fetal Hemoglobin
- Abstract
Background: Sickle cell anaemia (SCA, HbSS) is a genetic disorder of haemoglobin with marked variation in clinical manifestation. The aim of this study was to determine the foetal haemoglobin (HbF) status of patients with HbSS, compared with that of individuals with HbAS and HbAA control as well as to establish the relationship between HbF level and age and gender of the participants., Methods: This was a cross-sectional study in which HbF values of known HbSS patients along with HbAS and HbAA controls were analysed using High Performance Liquid Chromatography. Socio-demographic and other information were obtained with the use of questionnaire. Data was analyzed using SPSS software, version 20.0. Ethical approval was obtained for the study., Results: One hundred and two (102) participants were recruited for the study, comprising 60 patients with HbSS, 22 HbAS and 20 HbAA controls, with mean age of 11.0 years±9.6, 11.7 years ±8.8 and 12.3 years±8.1 respectively. There were 30 (61.2%) males and 30 (56.6%) females for HbSS group, 9 (18.4%) males and 13(24.5%) females for HbAS group and 10(20.4%) males and 10(18.9%) for HbAA group. Mean HbF level among HbSS participants was 8.0 ±6.1% and was significantly higher than that of HbAS (3.0 ±3.4%) and HbAA (2.2 ±4.1%) control (P<0.05). Mean HbF level was higher in children (<18 years) than adults (e"18 years) among HbSS, HbAS and HbAA participants, though not statistically significant (p >0.05). Mean HbF level was also higher among female HbSS, HbAS and HbAA groups compared to corresponding male groups, though only HbSS female group was significant (p = 0.031)., Conclusion: Patients with HbSS have significantly higher HbF level than individuals with HbAS and HbAA. Foetal haemoglobin level tend to decrease with advancing age and higher in females. Increased HbF level may play a compensatory mechanism in sickling in HbSS, thus the use of agent that increase HbF level may improve clinical outcome., Competing Interests: The Authors declare that no competing interest exists.
- Published
- 2021
20. Early onset of neurological features differentiates two outbreaks of Lassa fever in Ebonyi state, Nigeria during 2017-2018.
- Author
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Chika-Igwenyi NM, Harrison RE, Psarra C, Gil-Cuesta J, Gulamhusein M, Onwe EO, Onoh RC, Unigwe US, Ajayi NA, Nnadozie UU, Ojide CK, Nwidi DU, Ezeanosike O, Sampson E, Adeke AS, Ugwu CN, Anebonam U, Tshiang JK, Maikere J, and Reid A
- Subjects
- Adult, Consciousness Disorders, Female, Hearing Loss, Humans, Lassa Fever mortality, Lassa Fever pathology, Lassa virus genetics, Male, Middle Aged, Neck Pain, Nigeria epidemiology, Retrospective Studies, Reverse Transcriptase Polymerase Chain Reaction, Rural Population, Seizures, Urban Population, Disease Outbreaks, Lassa Fever epidemiology, Lassa virus isolation & purification
- Abstract
Lassa fever (LF) is an acute viral haemorrhagic illness with various non-specific clinical manifestations. Neurological symptoms are rare at the early stage of the disease, but may be seen in late stages, in severely ill patients.The aim of this study was to describe the epidemiological evolution, socio-demographic profiles, clinical characteristics, and outcomes of patients seen during two Lassa fever outbreaks in Ebonyi State, between December 2017 and December 2018. Routinely collected clinical data from all patients admitted to the Virology Centre of the hospital during the period were analysed retrospectively. Out of a total of 83 cases, 70(84.3%) were RT-PCR confirmed while 13 (15.7%) were probable cases. Sixty-nine (83.1%) patients were seen in outbreak 1 of whom 53.6% were urban residents, while 19%, 15%, and 10% were farmers, students and health workers respectively. There were 14 (16.8%) patients, seen in second outbreak with 92.9% rural residents. There were differences in clinical symptoms, signs and laboratory findings between the two outbreaks. The case fatality rates were 29.9% in outbreak 1 and 85.7% for outbreak 2. Neurological features and abnormal laboratory test results were associated with higher mortality rate, seen in outbreak 2. This study revealed significant differences between the two outbreaks. Of particular concern was the higher case fatality during the outbreak 2 which may be from a more virulent strain of the Lassa virus. This has important public health implications and further molecular studies are needed to better define its characteristics., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2021
- Full Text
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21. Improved antimalarial activity of caprol-based nanostructured lipid carriers encapsulating artemether-lumefantrine for oral administration.
- Author
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Akpa PA, Ugwuoke JA, Attama AA, Ugwu CN, Ezeibe EN, Momoh MA, Echezona AC, and Kenechukwu FC
- Subjects
- Administration, Oral, Animals, Biological Availability, Humans, Lipids, Mice, Nanostructures administration & dosage, Nanostructures chemistry, Particle Size, Antimalarials administration & dosage, Antimalarials pharmacology, Artemether, Lumefantrine Drug Combination administration & dosage, Artemether, Lumefantrine Drug Combination pharmacology, Malaria drug therapy, Plasmodium berghei drug effects
- Abstract
Background: Artemether and lumefantrine display low aqueous solubility leading to poor release profile; hence the need for the use of lipid-based systems to improve their oral bioavailability so as to improve their therapeutic efficacy., Aim and Objective: The objective of this work was to utilize potentials of nanostructured lipid carriers (NLCs) for improvement of the oral bioavailability of artemether and lumefantrine combination and to evaluate its efficacy in the treatment of malaria. This study reports a method of formulation, characterization and evaluation of the therapeutic efficacies of caprol-based NLC delivery systems with artemether and lumefantrine., Method: The artemether-lumefantrine co-loaded NLCs were prepared using the lipid matrix (5% w/w) (containing beeswax and Phospholipon® 90H and Caprol-PGE 860), artemether (0.1%w/w) and lumefantrine (0.6%w/w), sorbitol (4%w/w), Tween® 80(2%w/w as surfactant) and distilled water (q.s to 100%) by high shear homogenization and evaluated for physicochemical performance. The in vivo antimalarial activities of the NLC were tested in chloroquine-sensitive strains of Plasmodium berghei (NK-65) using Peter´s 4-day suppressive protocol in mice and compared with controls. Histopathological studies were also carried out on major organs implicated in malaria., Results: The NLC showed fairly polydispersed nano-sized formulation (z-average:188.6 nm; polydispersity index, PDI=0.462) with no major interaction occurring between the components while the in vivo study showed a gradual but sustained drug release from the NLC compared with that seen with chloroquine sulphate and Coartem®. Results of histopathological investigations also revealed more organ damage with the untreated groups than groups treated with the formulations., Conclusion: This study has shown the potential of caprol-based NLCs for significant improvement in oral bioavailability and hence antimalarial activity of poorly soluble artemether and lumefantrine. Importantly, this would improve patient compliance due to decrease in dosing frequency as a sustained release formulation., (© 2020 Akpa PA et al.)
- Published
- 2020
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22. Abdominoplasty for male truncal obesity: case report.
- Author
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Nnadozie UU, Okorie GM, Maduba CC, Omoke NI, Ugbala A, Uchendu E, and Ugwu CN
- Subjects
- Abdominal Wall surgery, Aged, Humans, Male, Postoperative Complications epidemiology, Abdominoplasty methods, Obesity, Abdominal surgery, Quality of Life
- Abstract
Truncal obesity and its associated health risk is an enormous burden. The traditional surgical treatment modality is liposuction or lipoabdominoplasty. An uncommon mode of the treatment is the use of abdominoplasty alone or as a surgical component. The aim of this report is to show a satisfactory outcome of abdominoplasty as the only surgical component in the management of severe truncal obesity in elderly male patient. We report a 75 year old Nigerian trader who had truncal obesity with gross abdominal asymmetry and cardiovascular and diabetes mellitus co-morbidities as well as bilateral knee osteoarthritis and social isolation due to truncal disfigurement. He was offered abdominoplasty as a sole surgical option for correction of anterior abdominal wall asymmetry. Apart from post operative wound complications and blood transfusion reactions, the patient had a good recovery and improved quality of life. Abdominoplasty is a rewarding treatment when used as a sole surgical option in centrally obese patients with anterior abdominal wall asymmetry and significant subcutaneous fat thickness., Competing Interests: The authors declare no competing interests., (© Ugochukwu Uzodimma Nnadozie et al.)
- Published
- 2020
- Full Text
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23. Effect of Blood Donor Educational intervention on the knowledge and Attitude towards Voluntary Blood Donation among Medical Students at a Nigerian University.
- Author
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Ugwu NI, Uneke CJ, Ugwu CN, Oti WJO, Agbo UN, and Akamike IC
- Abstract
Background: Blood is a veritable tool in many life-saving situations. Despite the increased demand for blood, the supply of safe blood has been inadequate. This study was aimed to determine the effect of educational intervention on the knowledge and attitude of medical students of a Nigerian University to voluntary blood donation., Materials and Methods: This was a cross-sectional study involving 158 undergraduate medical students of Ebonyi State University in South-East Nigeria. Participants were recruited by stratified sampling technique. A pretested semi-structured participant administered questionnaire was used to baseline knowledge and attitude to voluntary blood donation. This was followed by educational intervention in the form of a workshop by experts in blood transfusion medicine. Then, postintervention assessment was done using the initial questionnaire 30 days later. The study was approved by the Research and Ethics Committee of Ebonyi State University, Abakaliki. Data obtained were analyzed using SPSS 20 software, and P value was set at ≤0.05., Results: Of the 158 medical students who participated in the study, there were 90 (57%) males and 68 (43%) females. Baseline proportion of the participants who had good knowledge was high (72.8%), while baseline attitude of the participants was positive to most aspects of voluntary blood donation. Post intervention, the level of knowledge about voluntary blood donation increased to 99.4%, and similarly attitude to voluntary blood donation improved., Conclusion: Educational intervention was effective in improving the knowledge and attitude towards voluntary blood donation among medical students. Continuous enlightenment will influence potential blood donors to have better knowledge and positive attitude toward voluntary blood donation., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Nigerian Medical Journal.)
- Published
- 2020
- Full Text
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24. Anaphylactic reaction to vitamin B12 appearing after several years of therapy.
- Author
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Ugwu CN and Gibbins FJ
- Subjects
- Aged, Anemia, Pernicious drug therapy, Female, Humans, Injections, Intramuscular, Vitamin B 12 administration & dosage, Anaphylaxis chemically induced, Drug Hypersensitivity etiology, Vitamin B 12 adverse effects
- Published
- 1981
- Full Text
- View/download PDF
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