Exercise has a positive impact on bone mineral density in seropositive human immunodeficiency virus: do health professionals know? / El ejercicio tiene un impacto positivo en la densidad mineral ósea en seropositivos al virus de la inmunodeficiencia humana: ¿lo saben los profesionales de la salud?

Introduction: Despite the concomitant negative effects of human immunodeficiency virus on bone mineral density in HIV-infected persons, studies on knowledge of effect of exercise on this health parameter in HIV population among health professionals seem unavailable. This study therefore examined knowledge on effect of exercise on BMD in HIV-infected persons among health professionals. Material and methods: This cross-sectional survey employed researcher designed, experts - validated questionnaire to enroll 434 respondents. The reliability coefficient “r” of the questionnaire was 0.75 with 92% response rate. Descriptive and inferential statistics were used to summarize and analyze the data respectively. The alpha value was set at 0.05. Results: Age range and mean age in years of the respondents were 21–59 and 35.88 ± 9.09 respectively; age group of 30–39 years predominated (45.3%). Males were in preponderance (52.4%), and most (74.4%) were married; while majority (54.7%) were nurses. Substantial proportion (54.2%) had less than good knowledge on the subject examined in this study. Significant difference (p < 0.05; p = 0.015) in knowledge on effect of exercise on BMD in HIV population existed among the professions. Post hoc showed that knowledge of the physicians (p = 0.001) and laboratory scientists (p = 0.029) were significantly higher than that of the nurses. Physiotherapists’ knowledge on this subject compared to that of other health professionals was statistically insignificant (p > 0.05). Conclusions: Knowledge on effect of exercise on BMD in HIV infected persons among health professionals was surprisingly below expectation, and therefore should be seen as a cause for concerned exercise scientists and public health experts. (AU)

Introducción: A pesar de los efectos negativos concomitantes del virus de la inmunodeficiencia humana sobre la densidad mineral ósea en personas con VIH, los estudios sobre el conocimiento del efecto del ejercicio sobre este parámetro de salud en la población con VIH entre los profesionales de la salud parecen no estar disponibles. Por lo tanto, este estudio examinó el conocimiento sobre el efecto del ejercicio en la DMO en personas infectadas por el VIH entre los profesionales de la salud.Material y métodos: esta encuesta transversal empleó un cuestionario validado por expertos y diseñado por investigadores para inscribir a 434 encuestados. El coeficiente de confiabilidad “r” del cuestionario fue de 0,75 con una tasa de respuesta del 92%. Se utilizaron estadísticas descriptivas e inferenciales para resumir y analizar los datos respectivamente. El valor alfa se fijó en 0,05. Resultados: El rango de edad y la edad media en años de los encuestados fueron 21-59 y 35,88 ± 9,09 respectivamente; Predominó el grupo de edad de 30 a 39 años (45,3%). Predominaron los varones (52,4%) y la mayoría (74,4%) estaban casados; mientras que la mayoría (54,7%) eran enfermeras. Una proporción sustancial (54,2%) tenía menos que un buen conocimiento sobre el tema examinado en este estudio. Existió una diferencia significativa (p < 0,05; p = 0,015) en el conocimiento sobre el efecto del ejercicio en la DMO en la población con VIH entre las profesiones. Post hoc mostró que el conocimiento de los médicos (p = 0,001) y los científicos de laboratorio (p = 0,029) fue significativamente mayor que el de las enfermeras. El conocimiento de los fisioterapeutas sobre este tema en comparación con el de otros profesionales de la salud fue estadísticamente insignificante (p > 0,05). Conclusiones: El conocimiento sobre el efecto del ejercicio sobre la DMO en personas infectadas por el VIH entre los profesionales de la salud fue sorprendentemente inferior a las expectativas ... (AU)

The Burden and Quality of life of Caregivers of Stroke Survivors with Cognitive Impairment in Selected Healthcare Facilities in Anambra State, Nigeria.

Objective: To determine the burden and quality of life of caregivers of stroke survivors with cognitive impairment in selected healthcare facilities in Anambra State, Nigeria. Methods: This was a cross-sectional survey using the World Health Organization QOL-BREF and Caregiver Strain Index (CSI) as instruments. Descriptive statistics of frequency, percentage counts, mean and standard deviation were used to summarize the socio-demographics. Spearman's ranked order correlation; Mann-Whitney U test assessed the correlation and gender and age difference in QoL and caregiver's burden. Alpha level was set at 0.05. Results: Physical health domain of QOL was slightly moderate (53.29 ± 15.19), psychological health was low (46.33 ± 16.96), social relationship was slightly moderate (51.16 ± 0.31), environmental health was slightly moderate (51.22 ± 15.88), the burden of caregivers was high (6.35 ± 1.29). Conclusion: The quality of life of the caregivers of stroke survivors with cognitive impairment was moderate, and the caregivers' stress was high in the sample of the population studied.

Work-related musculoskeletal disorders among occupational drivers in Mubi, Nigeria.

Background. Studies on work-related musculoskeletal disorders (WMSDs) among drivers in northern Nigeria are modest. Objectives. This survey determined the prevalence of risk factors, onset of WMSDs and experience of ergonomic training, coping strategies and treatment options adopted by drivers. Methods. This cross-sectional survey utilized an adapted version of the standardized Nordic musculoskeletal questionnaire for examining WMSDs among drivers. Descriptive and χ2 statistics were employed to summarize and analyze data, respectively; the significance level was set at p < 0.05. Results. The prevalence of WMSDs among the respondents was 21.2%. The annual prevalence of the various WMSD domains was lower back pain (34%), neck pain (18.9%), upper back pain (22.3%), shoulder pain (18.2%), knee pain (14.9%), ankle pain (17%), wrist pain (7.5%), elbow pain (7.5%) and hip/thigh pain (15.1%). χ2 analysis showed that age (p = 0.006), marital status (p = 0.027) and educational level (p = 0.018) were significantly associated with prevalence of WMSDs. The majority of the drivers (92.5%) had no ergonomic training while 77.4% did not seek treatment. Conclusions. Adequate sensitization on health-seeking behavior and coping strategies through seminars and workshops should be conducted to improve health-seeking behavior and coping strategies of occupational drivers.

Pattern and outcome of traumatic spinal cord injury managed at University of Maiduguri Teaching Hospital, Nigeria: A retrospective study.

BACKGROUND: Understanding pattern and outcome of traumatic spinal cord injury (TSCI) will inform better management which expectedly would improve prognosis and minimise complications. METHODS: : A retrospective study was carried out on all managed TSCI cases from January 2009 to December 2018. Sociodemographic characteristics, injury type, cause and complications were extracted from patients' registers and case folders. Descriptive statistics summarised the data, and Fisher's exact test analysed associations between variables. RESULTS: Eighty-one cases met the inclusion criteria and were analysed. Most cases (91.4%) were males, aged 18-39 years (65.4%) and were civil servants (37.0%). Road traffic accident (RTA) was the leading cause of injury (37.0%) and incomplete lesion predominated (69.1%). Cases referred for physiotherapy constituted 77.8%, only 14.8% of cases recovered without neurological deficits. On discharge, most patients were wheelchair bound (33.3%). Region of spine affected showed significant association with complications developed (P = 0.01). RTA caused more dead as a cause of injury was found to be significantly associated with outcome (P = 0.04). Referral for physiotherapy showed significant association with outcome (P = 0.01), so also, region of spine affected with outcome (0.01). The study found a significant association between type of injury and functional status (P = 0.01). CONCLUSIONS: : The study concludes that young adults of working class were mostly affected, and RTA and gunshots injuries were the leading causes of TSCI. Findings such as the association found between regions of spine affect and complication developed on admission will help healthcare providers identify those susceptible and offer prompt preventive measures.

Aerobic Exercise Improves Quality of Life and CD4 Cell Counts in HIV Seropositives in Nigeria.

BACKGROUND: Studies that examine the effectiveness of exercise on quality of life and CD4 cells of HIV population are not easily available in developing countries. PURPOSE: This study was therefore aimed at investigating the effect of 12 weeks aerobic exercise on quality of life and CD4 cells of HIV seropositives in Nigeria. METHODS: Using convenient sampling, 91 volunteer and willing HIV infected persons were enrolled in the study. Based on inclusion criteria, 82 were eligible for the study, and randomly assigned to control and experimental groups. After determining the baseline values of the variables, the experimental group participated in moderate intensity aerobic exercise for 12 weeks. Weekly lectures were organized for the control group. Attrition rate of 22% was recorded at the end the study, leaving 32 participants in each group. The variables were re-assessed at the end of the Descriptive statistic summarized the socio-demographic characteristics of the participants. Paired Student t-test and Student t-test for two independent samples analyzed the significant difference in mean values of the variables. RESULTS: Mean ages in years of the control and experimental groups were39.38 10.03 and 40.84 ± 10.05 respectively, and that of the 64 participants was 39.57±10.13. There was significant improvement (p < 0.05) in the variables between pre- and post-tests in the experimental group. There was insignificant change (p > 0.05) in the four domains of quality of life of the participants, and significant reduction (p < 0.05) in the other four domains of this variable between pre- and post-tests in the control group, in CD4 cell counts, significant improvement was recorded. The variables at the end of the study showed significant difference (p < 0.05) between both groups. CONCLUSION: Quality of life and CD4 cells of HIV seropositives in the experimental group improved significantly after 12 weeks moderate intensity aerobic exercise.

Cardiovascular Response to Manual Acupuncture Needle Stimulation among Apparently Healthy Nigerian Adults.

This study investigated experience with acupuncture needle stimulation of apparently healthy adult Nigerians and the responses of the systolic blood pressure (SBP), diastolic blood pressure, heart rate (HR), and rate pressure products (RPP) to acupuncture at both real acupuncture points relevant to the treatment of cardiovascular disorder and sham acupuncture points not relevant to the treatment of cardiovascular disorder. Seventy-eight participants were randomly placed into three groups: the real acupuncture group (RAG); the sham acupuncture group (SAG); and the control group, with 26 participants per group. Data were collected preintervention, 15 minutes into acupuncture stimulation, postintervention, and 15 minutes after intervention. Changes (postintervention - preintervention scores) in the SBP, HR, and RPP were statistically lower in the RAG than in the SAG. Changes in the DBP showed a significant difference between the SAG and the RAG (p > 0.05). Findings from this study showed that among apparently healthy Nigerian adults, acupuncture needle stimulation at acupoints relevant to cardiovascular disorders was more effective than sham intervention in reducing the SBP, HR, and RPP. Participants reported heaviness, numbness, and increasing pain, but no dizziness, fainting and/or life-threatening side effects, during and after the acupuncture needle stimulation.

Co-morbidities and socio-demographic distribution of stroke survivors referred for physiotherapy in a Nigerian Teaching Hospital: a retrospective study.

AIMS AND OBJECTIVES: The study investigated some co-morbidities, and age, gender and occupational distribution of stroke survivors seen in the Physiotherapy clinic of University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria; A 3-year retrospective study (January, 2008 to December, 2010). PATIENTS AND METHODS: A total of 236 case notes of stroke survivors referred to the Physiotherapy clinic within the period of study were obtained and reviewed. RESULTS: Majority (50.8%) of the stroke survivors were hypertensive, type 2 diabetes mellitus accounted for 14.8%, HIV 11.4%, chronic renal and heart diseases constituted 8.1% and 3.8% respectively. Those with hperlipidaemia and obesity comprised 3.0% each, and not specified encompassed 5.1%. One hundred and forty-one (59.7%) of the cases seen were males and 95 (40.3%) were females. The average age of the male and female patients were 56.0 ± 15.8 and 49.8 ± 18.8 years respectively. Housewives (31.8%) constituted the highest occupational groups while students (5.9%) were the least. CONCLUSION: The most common co-morbidities found among the stroke survivors were hypertension (50.8%), diabetes mellitus (14.8%) and HIV (11.4%). Majority of the stroke survivors were at their peak age when they are most economically relevant and productive (below 60 years). This suggests that the disability resulting from stroke will have a great negative impact on quality of life and socio-economic lives of these patients as well as a burden on the society. To alleviate this impact and lessen the societal burden of the disease, the public should be well educated and informed on the importance of seeking prompt and appropriate health care services.

Professional Satisfaction and Desire to Emigrate among Nigerian Physiotherapists.

PURPOSE: Physiotherapists from developing countries are attracted to developed countries, where health personnel are in high demand. We investigated Nigerian physiotherapists' desire to emigrate, explored the possible relationship between job satisfaction and emigration, and elucidated common reasons why physiotherapists emigrate to other countries. METHODS: Nigerian physiotherapists (n=181) were surveyed using a three-part questionnaire. Part 1 elicited socio-demographic information; part 2 assessed satisfaction with work; and part 3 assessed the importance of some possible reasons that physiotherapists choose to emigrate. RESULTS: Close to half of the physiotherapists surveyed have plans to emigrate, but no relationship exists between job satisfaction level and desire to emigrate. An overwhelming majority felt that better or more realistic remuneration was the most important reason for them to leave their country, whereas age and practice experience were inversely related to physiotherapists' desire to emigrate. CONCLUSION: Policies aimed at mediating "brain drain" should take age and experience into consideration and should be geared toward creating opportunities for career advancement and continuing education.

Objectif : Les physiothérapeutes des pays en voie de développement sont attirés par les pays développés, où le personnel du secteur de la santé est en forte demande. La présente étude s'intéresse au désir des physiothérapeutes nigérians d'immigrer et explore le lien possible entre la satisfaction au travail et l'émigration. Elle s'attarde aussi aux raisons les plus courantes qui amènent les physiothérapeutes à émigrer vers d'autres pays. Méthode : Des physiothérapeutes nigérians (n=181) ont fait l'objet d'un sondage à l'aide d'un questionnaire en trois parties. La partie I de ce sondage s'intéressait aux caractéristiques sociodémographiques de l'échantillon; la partie II évaluait leur satisfaction au travail; la partie III évaluait l'importance et certaines raisons susceptibles d'expliquer pourquoi les physiothérapeutes souhaitaient émigrer. Résultats : Près de la moitié des physiothérapeutes sondés projettent d'émigrer, mais il n'y a pas chez eux de relation entre la satisfaction au travail et le désir d'émigrer. Une très vaste majorité des personnes sondées estiment qu'une meilleure rémunération et un salaire plus réaliste sont la raison la plus importante pour elles de quitter leur pays, alors que l'âge et l'expérience sont inversement liés au désir du physiothérapeute d'émigrer. Conclusion : Les politiques visant à susciter un « exode des cerveaux ¼ devraient tenir compte de l'âge et de l'expérience et devraient viser à créer des possibilités d'avancement professionnel et de formation continue.

Prevalence of musculoskeletal injuries among factory workers in Kano Metropolis, Nigeria.

BACKGROUND: Kano is a metropolis and commercial centre in northern Nigeria; it is highly industrialized. Most of the population does factory work. Purpose. The survey was undertaken to identify the prevalence of musculoskeletal injuries (MSIs) and other related occupational hazards among factory workers in Kano Metropolis. METHOD: Five hundred questionnaires were distributed to respondents recruited from tannery, steel rolling, textile and agrochemical factories at the 3 industrial estates of the metropolis. Only unskilled and manual labourers were considered. The respondents were selected using the nonprobability sample of convenience. RESULTS: Only 420 questionnaires were returned duly completed. Three hundred and fifty-three (84.05%) respondents were male and 67 (15.95%) were female. Their ages ranged between 21 and 58 years (M = 38.99 ± 1.01). RESULTS: Low back complaints had the highest prevalence (360, 85.71%), followed by upper limb injuries (171, 40.71%), shoulder complaints (156, 37.14%) and hip injuries (34, 8.10%). About 41% of the respondents reported 2 or more work-related MSIs. CONCLUSION: The study uncovered that a substantial percentage of factory workers had sustained MSIs. Body ache/discomfort in the low back region was the most common injury sustained among the subjects surveyed.

Lumbar spinal mobility changes among adults with advancing age.

BACKGROUND: Limitations in spinal mobility can interfere with the attainment of important functional skills and activities of daily living and restrictions in spinal mobility are usually the earliest and reliable indicator of diseases. OBJECTIVE: The aim of this study was to determine the differences of lumbar spinal mobility among healthy adults with advancing age. MATERIALS AND METHODS: The modified Schober's method was used to measure anterior flexion. The guideline of the American Academy of Orthopaedic Surgeons was adapted to measure lateral flexion and extension. RESULTS: The results of this study indicate that spinal mobility decreases with advancing age. The most significant (P < 0.05) differences occurred between the two youngest and the two oldest age categories. CONCLUSION: Using these data, we developed normative values of spinal mobility for each sex and age group. This study helps the clinicians to understand and correlate the restrictions of lumbar spinal mobility due to age and differentiate the limitations due to disease.