Assessment of workhour feeding practices, healthy behaviour score and body mass index of physicians in Northern Nigeria: a cross-sectional multi-centre study.

Background: The increasing prevalence of obesity and overweight among health workers calls for an appraisal of their lifestyle. This study assessed medical practitioners' workhour feeding and lifestyle practices and explored the relationship between these practices and their body mass index (BMI). Methods: The survey involved 321 medical practitioners selected from 9 northern Nigeria hospitals in 2021. Data collected included biodata, medication history, workhour feeding characteristics, lifestyle behaviours, blood pressure, height, and weight measurements. Data were analyzed using Epi info software (version 7). Results: Most respondents were male (70.7%). Their mean age was 38 ± 7.4 years. During their last workhours, 84.1% had lunch, and 46.4% took sugary drinks. Usually, 41.7% source their lunch from the hospital canteen, and 18.7% patronize their canteen at least weekly. Most reported healthy behaviour towards alcohol consumption (99.7%), fruit and vegetable consumption (54.8%) and smoking (98.4%). However, only 22.4% were physically active. Their mean healthy behaviour score and BMI were 2.8 ± 0.7 and 26.1 ± 4.6 kg/m2, respectively. The obesity and overweight rates were 18.4% and 37.7%, respectively. Their source of lunch during workhours, age, sex, years of practice, employment duration, marital status, job category, systolic blood pressure, anti-hypertensive, and antidiabetic medication use were significantly associated with mean BMI. However, only antihypertensive medication use, being married, inadequate fruit/vegetable consumption and workhour sugary drinks consumption predicted obesity. The predictors of overweight/obese were years of practice (< 10 y) and use of antihypertensive medications. Conclusions: Obesity and overweight rates were high. Most were physically inactive. Workhour sugary drink consumption predicted obesity. Effective workplace and community interventions to improve practitioners' lifestyle behaviour and curtail obesity and overweight are needed.

Transient binocular vision loss and pain insensitivity in Klippel-Feil syndrome: a case report.

BACKGROUND: Klippel-Feil syndrome is a rare congenital bone disorder characterized by an abnormal fusion of two or more cervical spine vertebrae. Individuals with Klippel-Feil syndrome exhibit diverse clinical manifestations, including skeletal irregularities, visual and hearing impairments, orofacial anomalies, and anomalies in various internal organs, such as the heart, kidneys, genitourinary system, and nervous system. CASE PRESENTATION: This case report describes a 12-year-old Pashtun female patient who presented with acute bilateral visual loss. The patient had Klippel-Feil syndrome, with the typical clinical triad symptoms of Klippel-Feil syndrome, along with Sprengel's deformity. She also exhibited generalized hypoalgesia, which had previously resulted in widespread burn-related injuries. Upon examination, bilateral optic disc swelling was observed, but intracranial pressure was found to be normal. Extensive investigations yielded normal results, except for hypocalcemia and low vitamin D levels, while parathyroid function remained within the normal range. Visual acuity improved following 2 months of calcium and vitamin D supplementation, suggesting that the visual loss and optic nerve swelling were attributed to hypocalcemia. Given the normal parathyroid function, it is possible that hypocalcemia resulted from low vitamin D levels, which can occur after severe burn scarring. Furthermore, the patient received a provisional diagnosis of congenital insensitivity to pain on the basis of the detailed medical history and the findings of severe and widespread loss of the ability to perceive painful stimuli, as well as impaired temperature sensation. However, due to limitations in genetic testing, confirmation of the congenital insensitivity to pain diagnosis could not be obtained. CONCLUSION: This case highlights a rare presentation of transient binocular vision loss and pain insensitivity in a patient with Klippel-Feil syndrome, emphasizing the importance of considering unusual associations in symptom interpretation.

Evaluating the competency of community pharmacists in identifying and managing malnourished patients: A cross sectional survey.

Background: Malnutrition is a global health issue that affects all age groups and regions. The integration of malnutrition screening into community pharmacy practices help address malnutrition. Community pharmacies, with their accessibility and reach, are well-suited to provide essential malnutrition screening services, contributing to improved public health outcomes. Objective: The research objectives encompass evaluating community pharmacists' knowledge, screening proficiency, range of malnutrition services provided, and competence in identifying patients at risk of malnutrition. Method: The study used a cross-sectional design to gather data from CPs in Kaduna State, Nigeria, using an online, self-administered, semi-structured questionnaire. Convenience sampling was used, and the data were evaluated using descriptive statistics. Results: Eighty five percent of the 80 CPs who took the survey and provided responses practiced in urban areas. Approximately 37% and 18% of pharmacists, respectively, had a good and fair understanding of therapeutic nutrition. Additionally, while 33% of pharmacists provided nutritional advice in response to a prescription, 41% of them did so based on specific observations. Patients with severe dehydration (28%), infants and children with growth impairment (25%), and neonates with low birth weight (20%) were identified as high-risk. A little over 30% of survey participants thought patients should have both dietary and medical treatment. Additionally, 34% of pharmacists reported nutritional supplements had a positive impact on public health, while 28% believed they should be sold in pharmacies under pharmacist supervision. Conclusion: Study findings revealed knowledge gaps in addressing malnutrition among CPs. While they play a significant role, improvements are needed in understanding therapeutic nutrition and providing advice. Identifying high-risk patients and recognizing the value of nutritional supplements can enhance public healthcare services and patient well-being.

Shedding Light on the Hidden Curriculum: A Systematic Review of Ethics Education during General Surgery and Subspecialty Training.

INTRODUCTION: Ethics education in surgical residencies is often delivered in an informal and nonstructured manner as part of a "hidden curriculum", leading to few residencies routinely including it in their core curriculum. This systematic review aimed to summarize the delivery modes, curriculum, structure, and effectiveness of ethics educational interventions for surgical trainees. METHODS: We performed a comprehensive database search including MEDLINE, Embase, Scopus and CENTRAL to search for articles describing the implementation of ethics educational interventions for general surgery or subspecialty trainees. RESULTS: A total of 14 studies were included. Only 2 centers performed targeted needs assessment. Curricula covered included informed consent, the doctor-patient relationship, breaking bad news, decision-making, end-of-life care, conflicts of interest, considering patients' personal contexts, and surgical research ethics. Modes of delivery varied across studies, including case-based learning, group discussions, didactic lectures, reading material, role-playing, simulated patients, and ethics morbidity and mortality (M&M) meetings. Evaluations were most commonly via surveys exploring knowledge and self-reported confidence, with only 3 studies measuring actual trainee performance using objective structured clinical examinations. In general, the educational interventions increased trainees' confidence/preparedness in handling ethical dilemmas. CONCLUSION: We recommend comprehensive local needs assessment to guide curricular development and designing specific learning objectives and measurable milestones to ensure evaluation. Educational interventions are best delivered in a graduated manner with the complexity of the topic mirroring residents' real-life clinical responsibilities and experiences. Teaching modalities should be tailored according to the nature of the curricular content being taught to make the learning experience more interactive and effective.

Knowledge, attitude, and practices of patients and caregivers attending a Northern Nigerian family medicine clinic regarding the use of face mask during COVID-19 pandemic: a hospital-based cross-sectional study.

Introduction: facemask use is well recognized as an effective public health strategy for preventing COVID-19. However, facemask can only provide enough protection if people recognize its importance and learn how to use it properly. The objective of the study was to assess the knowledge, attitudes, and practices (KAP) of patients or caregivers regarding the use of facemasks as a COVID-19 preventive measure and identifies the factors associated with its practice. Methods: a cross-sectional study where 480 patients or caregivers attending the Family Medicine Clinic were systematically selected over four weeks. A self-administered questionnaire was used to collect data on KAP regarding facemasks use. Student t-test and analysis of variance (ANOVA) were used to examine the relationship between the socio-demographic characteristics and KAP. Pearson's correlation coefficient was used to determine the relationship between knowledge, attitudes and practices. A p-value ≤ 0.05 was considered statistically significant. Results: about 82% of the respondents knew the correct steps of wearing a facemask, but with low positive attitudes. Further analyses showed that respondents were more likely to wear a facemask at clinics and public places than at home. There was a moderately strong correlation between knowledge and practices but weak correlations between attitude and knowledge, and attitude and practices of facemask use. Conclusion: the study revealed good knowledge and practices but low attitudes towards facemask use. Therefore, public health programmes or interventions on facemask usage as a COVID-19 preventive measure, should address the attitudinal problems and also involve the family and community leaders to enhance compliance.

Prevalence and sociodemographic predictors of perceived family functionality, marital satisfaction and intimate partner violence during the COVID-19 lockdown among married primary healthcare users.

Background: The impact of COVID-19 lockdown on family experiences has not been thoroughly evaluated, given the consequent stressful home environment it reportedly caused that can adversely affect family dynamics. This study examined the prevalence and sociodemographic predictors of perceived family functionality, marital satisfaction and intimate partner violence (IPV) during the lockdown among married healthcare users in a Nigerian primary care setting. Materials and Methods: The study was cross sectional. Data were collected randomly from 432 eligible attendees of a primary care clinic in Kano, Nigeria. Information regarding participants' sociodemographic characteristics, family functioning, marital satisfaction and IPV were measured using a sociodemographic questionnaire, APGAR-, Kansas marital satisfaction- and verbal HITS-scales. Results: Respondents' mean (range) age was 30 (15-70) years; 293 (67.8%) were females. Family dysfunction, marital dissatisfaction and probable IPV were found in 44.2, 56.5 and 50.5% of respondents, respectively. The odds of a functional family were higher among caregiver and female respondents but lower among those aged ≥50 years, students, non-Hausa/Fulani, those with low education and residing outside the Kano metropolis during the lockdown. Marital satisfaction was higher among caregivers and respondents from polygamous families and lower among respondents aged ≥50 years. No studied sociodemographic variable predicted probable IPV. Conclusion: There was a high prevalence of family dysfunction, marital dissatisfaction and probable IPV among the respondents during the lockdown. These findings suggest screening married patients for family dysfunction, marital dissatisfaction and IPV during similar lockdowns for appropriate interventions. The predictor variables could form essential considerations for the screening.

Post-COVID Opsoclonus Myoclonus Syndrome: A Case Report From Pakistan.

Background: Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory distress syndrome-coronavirus-2 (SARS-CoV-2), is primarily a respiratory infection but has been recently associated with a variety of neurological symptoms. We present herewith a COVID-19 case manifesting as opsoclonus-myoclonus syndrome (OMS), a rare neurological disorder. Case Presentation: A 63-year-old male diagnosed with COVID-19 infection developed behavioral changes, confusion, and insomnia followed by reduced mobility and abnormal eye movements within 48 h of recovery from respiratory symptoms associated with COVID-19. On examination, he had rapid, chaotic, involuntary saccadic, multidirectional eye movements (opsoclonus), and limb myoclonus together with truncal ataxia. CSF analysis, MRI of the brain, and screening for anti-neuronal and encephalitis related antibodies were negative. Extensive testing revealed no underlying malignancy. The patient was successfully treated with intravenous immunoglobulin (IVIG) with complete resolution of symptoms within 4 weeks of treatment. Conclusion: COVID-19 infection can be associated with the manifestation of opsoclonus myoclonus syndrome, a rare neurological disorder that can be treated with IVIG if not responsive to corticosteroids.