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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 16 | Issue 3
Page Nos. 75-104

Online since Wednesday, July 3, 2019

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ORIGINAL RESEARCH REPORTS  

Patient satisfaction with services at public and faithbased primary health centres in Lagos State: A comparative study p. 75
Adedoyin O Ogunyemi, Ayokunle A Ogunyemi, Tolulope F Olufunlayo, Tinuola O Odugbemi
DOI:10.4103/jcls.jcls_39_18  
Context: The primary health care is the first point of contact between a patient and the health-care system. The quality of services provided at public health facilities has gradually declined, precipitating the emergence of alternative service providers. Patient satisfaction is an important indicator for assessing the quality of care in health service provision. Aim: The aim of this study is to compare the patient's satisfaction among attendees at a public and a faith-based primary health center (PHC). Settings and Design: Study design involves comparative cross-sectional in PHCs. Materials and Methods: A total of 700 respondents were recruited consecutively from a public and a faith-based PHC. Data were collected using an adapted General Practice Assessment Questionnaire. Four domains of quality of care were assessed. Statistical Analysis Used: SPSS software version 17 was employed in the data analysis, and the level of significance was set at P < 0.05. Results: Affordability was the most important reason for the choice of a health facility by 47.0% of the public PHC patients, and this was higher than in 41.0% of the patients attending the faith-based PHC. The mean quality of care score was higher among the faith-based (0.90 ± 0.12) than in public (0.85 ± 0.21) PHC attendees (P < 0.001). Patients' satisfaction was higher among the respondents attending the faith-based PHC (P < 0.001). The factors significantly associated with high patient satisfaction among the public PHC attendees included older age, higher educational levels, being married, and perceived good quality of services, while for the faith-based PHC, it included the younger age group, higher levels of education, being married, and closeness to the facility (P < 0.001). Conclusion: Accessibility was scored lowest in both PHCs, while effectiveness was highest in the faith-based PHC. Patients' satisfaction was higher among those who attended the faith-based PHC. It is recommended aspects of accessibility such as waiting time should be a focus of health managers.
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Management of long segment corrosive esophageal stricture in children and adults: A 5 years' review p. 81
Ismail Mohammed Inuwa, Jameel Ahmad Ismail, Nurein Tunde Oyebanji, Lofty-John Chukwuemeka Anyanwu, Sani Ali Aji, Mohammad Aminu Mohammad, Abubakar Umar, Nuhu Garba, Ibrahim Aliyu
DOI:10.4103/jcls.jcls_24_19  
Introduction: The aim of this study is to highlight our experience in the management of long segment corrosive esophageal stricture using the left colon bypassing the strictured segment of the esophagus thereby maintaining continuity and restoring normal swallowing. Subjects and Methods: This was a retrospective study of patients with long-segment corrosive esophageal stricture who were managed by left colon bypass surgery in our center over a 5-year period between January 2012 and December 2016. Hospital records were reviewed and relevant information such as age, sex, clinical presentations, and operative procedure were obtained. The left colon grafts were taken under the pedicle of left colic artery in all cases, and three anastomoses were made at colocolic, cologastric, and colo-esophageal points. Feeding gastrostomy was done for all patients for early feeding. Results: There were 12 males (60%) and 8 females (40%) and age ranging from 2 years to 42 years; among them, there were 13 children (65%) and 7 adults (35%); caustic soda was the most common corrosive substance in 14 cases (70%) and acid in 2 cases (10%); the exact nature of the substances in 4 (20%) was not clear. Accidental ingestion was found in 90% of the cases. Psychiatric illness was associated in 2 adults (10%). Conclusion: The treatment of long segment corrosive esophageal stricture with left colon bypass graft surgery under the pedicle of the left colic artery is very effective with minimal postoperative complications; we, therefore, recommend this technique for relief of dysphasia from this form of injury.
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Preconception care: Assessing the level of awareness, knowledge and practice amongst pregnant women in a tertiary facility p. 87
Opeyemi Rebecca Akinajo, Gbemi Eniola Osanyin, Osemen Ehidiamen Okojie
DOI:10.4103/jcls.jcls_41_18  
Background: One of the components of health care for every woman of reproductive age is preconception care (PCC). The adoption of this care will assist the healthcare system to shift from the delivery of procedure-based acute care to the provision of counseling-based preventive care. Aims: The aim of this study is to determine the level of awareness, knowledge, and the practice of our women on PCC. Settings and Design: A descriptive cross-sectional study was carried out on 50 consenting pregnant women at the antenatal outpatient clinic. Subjects and Methods: All pregnant women who booked for antenatal care during the period of data collection were consecutively recruited through convenient sampling technique. Data were collected using pretested, semi-structured questionnaires to provide answers to the objectives of the study. Statistical Analysis Used: Data obtained were analyzed using SPSS software version 22 and expressed as frequency and percentages. The Chi-square was used to test for association with a value of P < 0.05 indicating statistical significance. Results: The mean age was 31.5 ± 3.8 years and majority (80%) had tertiary education. There is high level of awareness of PCC (76%); however, awareness of its practice in Nigeria is very low (34.2%). Only 34.2% had received PCC before index pregnancy. There is, therefore, a huge disconnection between their level of awareness and practice. Conclusions: There is the need to arm our women with detailed and accurate information on PCC, establish functional clinics with availability of evidence-based guidelines to improve uptake and pregnancy outcome.
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Normative value of the patellar tendon size: A sonographic study of a cohort of healthy adults in a suburb of Lagos, Southwest Nigeria p. 93
Cletus Uche Eze, Chinenye Emmanuella Nwaizugbo, Adekunle A Adeyomoye, Ernest Ruto Upeh
DOI:10.4103/jcls.jcls_20_19  
Aim: This study aimed to determine patellar tendon (PT) size using sonographic technique. Materials and Methods: PT thickness (PTT), width, and cross-sectional area (CSA) were measured in 277 healthy adults. Mean was computed for patella tendon thickness, its width and CSA for the population. Thereafter, PT was correlated with, height, weight, and body mass index (BMI). Results: In the sample, 31.0% were male and 69.0% were female. Mean PTT, width, and CSA for the population were 4.7 ± 0.4 mm, 22.4 ± 3.8 mm, and 8.3 ± 1.7 mm2, respectively. Mean PTT was 4.8 ± 0.9 mm for men and 4.7 ± 0.2 mm for women; PT was significantly wider and thicker in men than women (P < 0.05). Difference in left and right PT sizes was not statistically significant (P > 0.05). Correlation between PT size and BMI was statistically significant. Conclusion: In healthy controls, a sonographically measured PTT >6 mm could be diagnostic of patellar tendinopathy as it appears to be 4 standard deviations greater than the mean. When using sonographic method to define population-specific normal value of PT size, individuals' gender and weight should be taken into cognizance.
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CASE REPORTS Top

Laparoscopic adrenalectomy for a large adrenal cyst p. 98
Olanrewaju Samuel Balogun, Emmanuel A Jeje, Badmos Kabir Bolarinwa, Adedeji L Fatuga
DOI:10.4103/jcls.jcls_101_18  
Cystic masses/lesions of the adrenal gland are becoming common as a result of improved imaging facilities and techniques. Adrenal pseudocysts are rare neoplasms which occur more frequently in young and middle-aged women. Laparoscopic adrenalectomy is considered the gold standard treatment for benign adrenal lesions. This review describes our first experience and challenges of laparoscopic treatment of a large nonfunctional adrenal pseudocyst in a 41-year-old female. She presented with bothersome right flank pain and a computed tomography diagnosis of a calcified right adrenal cystic mass with benign features. She had laparoscopic right adrenalectomy, and the histopathological diagnosis of the cyst was confirmed as an adrenal pseudocyst.
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Hemophilic arthropathy of the knee: A case report with discussion on the role of imaging with review of literature p. 101
Rashmeet Kaur, Anshul Dahuja, Paramdeep Singh, Simmi Aggarwal
DOI:10.4103/jcls.jcls_88_18  
A diverse range of clinical and radiological findings can be seen in a patient with hemophilia. Bleeding in joints and soft tissues occur either spontaneously or with minor trauma. We present images and clinical findings of hemophilic arthropathy in an 18-year-old male who presented with limping, pain, and mild swelling in the left knee joint along with a brief review of the literature.
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