Background: Neonatal jaundice (NNJ) is one of the most common causes of hospital visit in the first 30 days of life. It is one of nine danger signs of neonatal illness recognized by the World Health Organization. Understanding its clinical and laboratory features will enhance early diagnosis and management to forestall associated morbidities. This study explored the clinical and laboratory features of newborns admitted for NNJ in a tertiary hospital in the south-eastern Nigeria. Methods: It is a descriptive study carried out prospectively over a 18-month period on all newborns admitted for jaundice at the Enugu State University Teaching Hospital. Patients were enrolled consecutively at presentation and relevant clinical and laboratory features in these newborns were documented in a structured admission register designed for this study. These data were subsequently transferred to Microsoft Excel and analyzed with SPSS version 20. Results: A total of 83 (17.0%) out of 487 newborns were admitted for NNJ during the study period. More female newborns (P = 0.321), newborns delivered outside Enugu State University Teaching Hospital (P = 0.09), mothers ≤ 30 years (P = 0.648), and mothers with lower educational attainment (P = 0.502) had delayed presentation to hospital. Poor suckling (42%), fever (38%), and depressed primitive reflexes (38%) were the most common clinical features seen in admitted newborns. Yellowish discoloration of newborns was noticed within the first 24 h of life in only 13%, between 2 and 7 days in 81%, and after the seventh day of life in 6% of newborns. The median (interquartile range, IQR) of the age jaundice was first noticed and when infant was brought to the hospital for evaluation was 3.0 days (IQR 2–5) and 5.0 days (IQR 4–7), respectively. This resulted to a mean onset–presentation delay time of 2.8 ± 2.3 days (∼67.2 h). The mean total serum bilirubin and unconjugated hyperbilirubinemia was 307 ± 145.2 and 257.5 ± 127.6 μmol/L, respectively. Malaria parasite (17%), glucose-6-phosphate deficiency (5%), and ABO incompatibility was seen in 8% of newborns surveyed. Conclusions: NNJ remains a common health problem in our setting. This underscores the need to upscale education of the mothers and caregivers especially those that prefer to deliver outside a tertiary health institution on the need for early presentation in newborns with jaundice associated with poor suckling and reduced activities.

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Background: There has been increased interest in improving access of the rural poor to essential healthcare through community-based health insurance schemes to create an alternative from the dominant OOP expenditure being currently experienced. Aim: We performed a systematic review with the aim to determine the global effect of health insurance systems on maternal and child health. Methods: A search for primary studies reporting on the effect of health insurance on maternal and child health was done. Results: Eight articles met the inclusion criteria with four of them from low-income countries. We found that the cesarean section rates (P = 0.01) and proportion of women with low birth weight babies (P < 0.0001) were statistically significantly better in the insured women. However, the prevalence of (pre)eclampsia, the proportion of women with anemia/excessive blood loss at delivery, and mean birth weight at delivery were similar between the insured and uninsured women (P > 0.05). The risk of wasting among insured children was also reduced, although not statistically significant (P = 0.26). Conclusions: The findings suggest that health insurance probably has a beneficial effect in reducing the number of low birth weight babies born. Insurance also seems to reduce the risk for cesarean section. More research on the impact of health insurance on both maternal and child health outcomes need to be done to further establish these outcomes.

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Introduction: Many patients with noncommunicable diseases such as obesity are attended to in Family Practice Clinics where quick dietary assessment along with estimation of food sizes as part of lifestyle modification and appropriate intervention could be offered. We performed a systematic review to determine the dietary assessment methods with the best evidence that can be employed in a Family Practice Clinic. Methods: Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines were used to conduct a systematic review of PubMed, Google, and Google Scholar databases from 1992 to 2017. Results: We found 730 original research articles, case–control studies, review articles, proceedings, transactions, and textbooks. Thirty-seven articles were selected out of which two were secondary data, 12 were review articles, 10 were descriptive surveys, and one was a prospective cohort study. There were two randomized controlled trials, two mixed study designs, one working paper, and seven guides. Food portion size estimation using household objects and the hand guide, then the food pyramid guide along with the food-sized plate intervention was documented. Conclusion: In view of the busy nature of Family Practice Clinics in several countries, in performing dietary assessment, food portions can be estimated using household measures and the hand portion guide. The pyramid guide and the portion-sized plate can then be used for intervention.

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Introduction: Breast cancer is the second most common malignancy in pregnant women. Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy and the first postpartum year. PABC is associated with difficulty in detection, diagnosis, and definitive management. Management of these patients is centered on the wellbeing of both the fetus and the mother. We report the epidemiology, pathology, treatment, and outcome of patients with PABC managed at our institution. Patients and Methods: Twelve patients were managed for PABC by the Division of General Surgery from January 2012 to December 2017. Their records were retrieved and relevant information extracted. Results: Nine patients were diagnosed during pregnancy and three while lactating. All patients presented with stage III and IV disease, with all stage IV patients dying within 6 months of presentation. None of the children born to patients who had neoadjuvant chemotherapy had any obvious congenital anomaly at birth. Conclusion: The late stage at presentation of our patients means that antenatal screening of pregnant women for PABC should be strongly encouraged. Treatment of PABC in our setting should be aggressive and similar to that of nonpregnant patients. The use of taxane-based chemotherapy may improve outcome.

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Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common occurrence among patients who have received neurotoxic chemotherapy for hematological and other malignancies. Case Presentation We report a case of a 28-year-old man with Hodgkin lymphoma, who received cumulative doses of vinblastine and vincristine among his combination regimen and subsequently developed severe neurotoxicity, which led to withholding of cytotoxic chemotherapy, and the patient eventually succumbed to the disease. Discussion The incidence of CIPN varies considerably for each chemotherapeutic agent when administered alone or in combination, but often ranges from 30% to 40% of patients. Sensory complaints are often the first symptoms and are far more common than motor or autonomic symptoms, and may interfere with treatment, by limiting therapeutic options, doses, or warrant the early cessation of chemotherapy, thereby potentially impacting negatively on patient survival. Conclusion Our case report therefore emphasizes the need for clinicians and hemato-oncologist to be more alert to CIPN, which is a debilitating adverse effect of these commonly used, first-line agents.

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Background: Job satisfaction has been identified as a key factor determining patient satisfaction in health care organizations. This study was undertaken to assess the job satisfaction index among staff in the facility, and to identify factors influencing job satisfaction as a means of improving services in the hospital. Methodology: This was a cross-sectional survey of health care workers conducted using the Linda Powells (Mountains State Group Inc) self-administered questionnaire. This is a 50-item questionnaire assessing eight thematic areas; 1. Overall satisfaction, 2. Planning, 3. General Attitudes, 4. Performance issues, 5. Management issues, 6. Supervisory issues, 7. Training and salary issues, 8. Benefits. Results: Overall, 64.8% of respondents were satisfied with their jobs. The thematic area that had the highest job satisfaction score was general attitudes; while the lowest was benefits 37.7%. Conclusion: The overall job satisfaction was found to be 64.8%. The thematic area that scored highest for level of satisfaction was general attitudes followed by performance issues, supervisory issues and planning. Staff were not satisfied with management issues, training and salary issues and benefits.

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Background: One of the serious health problems in the world today is the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome pandemic, with Nigeria having the second largest number of new cases. During pregnancy, HIV-infected women face more adverse effects than uninfected women. This study aimed at evaluating ultrasound features of placentas of HIV-positive women and controls to demonstrate a difference in vasculoplacental complications between the two groups. Methods: A comparative study was conducted among HIV-positive women and their matched controls. Informed consent was obtained and a pretested interviewer-administered questionnaire was used. The women had ultrasound assessment of the placenta and an obstetric ultrasound scan. Results: There were no differences in placental surface area (t = −1.122, df = 6, P = 0.305, 95% confidence interval: −17.46 to 15.56) and placental thickness (t = 1.846, df = 58, P = 0.07, 95% confidence interval: −0.405 to 9.99). Calcifications were found but not related to HIV status. The most common complication among the HIV-infected women was miscarriage. No complications were recorded among the controls. Conclusion: There was no difference in the vasculopathological changes detectable by ultrasound scan in the placentas of HIV-infected and uninfected pregnant women.

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Background: Healthcare facilities are workplaces where healthcare-associated infections (HCAIs) predominate and disease pathogens are harbored by fomites. This situation could be aggravated by increase in number of resistant organisms and inadequate knowledge especially in developing countries. Objective: The aim of this article was to assess the knowledge on role of healthcare personnel attire in spread of HCAIs among healthcare workers (HCWs). Methodology: A descriptive cross-sectional study was carried out using a pretested structured interviewer-administered questionnaire. A total of 127 respondents were interviewed. Data was collected and analyzed using IBM Statistical Package for Social Sciences (SPSS) version 23. Data was presented using frequencies and percentages for categorical variables. Results: All respondents (100.0%) had heard of fomites and 124 (97.6%) of them knew that HCAIs could be spread through fomites. Among the respondents who wore ward coats/uniforms, 91.3% perceived that ward coats/uniforms have the potential of spreading infections. The rate of HCAIs was said to be low in about half (56.7%) the respondents and 54 (42.5%) reported that they did not have a HCAIs reporting system in their unit. Most respondents, 114 (89.8%), had good knowledge. Conclusion: Although knowledge of the role of HCWs’ attire in spread of HCAIs was good among HCWs, it can still be improved upon by training and retraining of HCWs by management. Most respondents reported lack of HCAIs reporting system in their units. Therefore, HCAIs reporting systems should be established in all units of the hospital by the management.

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The concept of fever is an interesting subject that has intrigued clinicians for centuries. As pain is an important stimuli to withdraw from a noxious stimuli that may be potentially harmful, so is fever an important sign of a possible microbial invasion. Back and forth, there has been arguments and debates about whether fever is deleterious, a foe, or actually beneficial. There has also been question about whether or not to treat it, and when to treat it. This review article tries to paint a broad picture of both sides of this coin.

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