The impact of non-closure of the platysma muscle layer on the cosmesis of thyroidectomy scar – a randomised double-blind controlled trial

BACKGROUND: The relevance of closing the platysma muscle layer after open thyroidectomy has received little interest in terms of research. The objective was to determine whether non-closure of the platysma muscle layer after open thyroidectomy impacts significantly on the cosmetic outcome of the resulting collar scar. METHODS: In this prospective randomised controlled clinical trial, patients were assigned randomly to have the platysma muscle layer closed or not closed. The primary endpoint was the cosmesis of the collar scar six weeks after surgery assessed using the patient and observer scar assessment scale (POSAS). Additional endpoints included operation time and early postoperative wound complications. RESULTS: Ninety-two patients were recruited, with 46 randomised to each group. The patient scar assessment subscale (PSAS) of the POSAS showed no significant difference in the scar cosmesis between the two groups six weeks after surgery (median PSAS: 16.5 vs 17.5; p = 0.514). The observer scar assessment subscale (OSAS) showed that the platysma muscle layer closure group had marginally better scars (median OSAS: 15 vs 17; p = 0.045). The size of the goitre did not make any significant difference in the scar cosmesis. There was no significant difference in the incidence of early postoperative wound complications as well as the median operation time. CONCLUSION: Not closing the platysma muscle layer had no significant impact on the scar cosmesis six weeks after open thyroidectomy, with no significant difference in the incidence of early postoperative wound complications and the operation time.

A scope review on the global impact of COVID-19 lockdown on adolescents' health

Background

The implementation of COVID-19 lockdown measures across the globe could affect adolescents' health.

Objective

This review was conducted to assess the impact of the COVID-19 lockdown on the health of the adolescents.

Methodology

We conducted this study using the scope reviews methodological framework. We searched for articles on the effects of COVID-19 lockdown among adolescents on four databases; MedLine, PubMed, Directory of Open Access Journals and Google Scholar. Screening of articles was done for relevance to the study objective.

Results

The positive effects of the COVID-19 lockdown on adolescents included increased physical activity for adolescents 17 years and below, increased resource mobilization for healthy lifestyle, and psychosocial support programs for schools. The negative effects of the lockdown period were decreased physical activity with resulting disruptive sleep patterns; increased screen time, behavioral addictive disorder from excessive use of the internet, increased levels of domestic abuse, and worsening of existing mental health disorders. Overall, the COVID-19 lockdown period has had considerable adverse effects on adolescents' health.

Conclusion

To curb the negative effects of the COVID-19 lockdown, we recommend parental supervision of adolescents' screen time. Adolescent health should be prioritized by policymakers to ensure that future lockdown does not adversely affect them.

The prospective COVID-19 vaccine: willingness to pay and perception of community members in Ibadan, Nigeria

Background

The introduction of the COVID-19 vaccine necessitates the assessment of individual perception regarding the vaccine. This study aimed to assess the perception of community members and willingness to pay for the prospective COVID-19 vaccine in Ibadan, Nigeria.

Methods

A descriptive cross-sectional study design was used. Data were collected using an interviewer-administered questionnaire in September 2020. We studied community members aged 15 years and above using a multi-stage sampling technique. The perceptions of respondents about the COVID-19 vaccine were assessed on eight questions using the five-point Likert scale with a score point of “1” assigned for “Strongly Agree”, “2” for “Agree”, “3” for “Not decided”, “4” for “Disagree”, and “5” for “Strongly disagree”. During analysis, we reverse-coded the options by assigning a point of “1” for “Strongly disagree”, “2” for “Disagree”, “3” for “Not decided”, “4” for “Agree”, and “5” for “Strongly disagree”. However, questions asked in the negative directions were not reverse-coded during analysis. Eight questions were used to assess the perception of community members regarding the prospective COVID-19 vaccine, and overall, the maximum point was 40. Points greater than or equal to 32 points (80%) implied positive perception. Descriptive statistics were done. Chi-square tests were used for the assessment of associations between sociodemographic characteristics and willingness to pay for the prospective COVID-19 vaccine. We conducted logistic regression tests on statistically significant variables at p-values <0.05.

Results

The mean age of the 440 respondents studied was 37.22 ± 15.36 years, 193 (49.00%) were males, and 292 (67.30%) of the respondents had heard of the prospective COVID-19 vaccine. Among them, 232 (79.50%) respondents had positive perception regarding COVID-19 vaccine. Individuals in the fifth wealth quintile were ten times more likely to be willing to pay for the prospective COVID-19 vaccine compared to those in the first wealth quintile (Adjusted Odds Ratio = 9.57, 95% CI [2.88–31.82], p = <0.01).

Conclusion

The prospective COVID-19 vaccine should be subsidized or made freely available to everyone.

Perception and practices during the COVID-19 pandemic in an urban community in Nigeria: a cross-sectional study

Background

Various perceptions and practices have been associated with the COVID-19 pandemic. In this study, we assessed the perception and practices regarding COVID-19 among residents in selected urban communities of Ibadan, Oyo State, Nigeria.

Methods

A descriptive cross-sectional study design using a multi-stage sampling technique was used to recruit 360 respondents (Mean age: 33.2 ± 10.6 years; 62.5% females) from households in Ibadan. Data were collected using an interviewer-administered questionnaire from 3rd to 6th June 2020. Those who demonstrated washing of the palm, back of the hand, spaces between the fingers, fingernails, wrist, and thumbs had six points and were categorized to have had a good practice of handwashing. Descriptive statistics were conducted. Bivariate analyses of sociodemographic characteristics and good handwashing practices were conducted using Chi-square test. Logistic regression was conducted to identify the determinants of good handwashing practices. P-values < 0.05 were statistically significant.

Results

Going to the hospital (95%) and calling the COVID-19 help number (58.3%) were the frequently reported practices among respondents following the development of COVID-19 symptoms. Also, 89 (26%) knew they could contract COVID-19, while 41 (12%) perceived it as an exaggerated event. The effects most frequently reported by respondents were hunger/low income (48.8%) and academic delay (8.8%). Use of face masks by 64.5% and social distancing (48%) were the most frequently reported practices for prevention. Only 71 (20.8%) demonstrated good handwashing practices. The perception of the likelihood to contract COVID-19 and practices to prevent COVID-19 had a weak correlation of 0.239 (p < 0.001).

Conclusion

Gaps exist in the practices that prevent COVID-19. There is a need to improve handwashing, use of face masks and other practices that prevent COVID-19. Implications across public health communication and policies were stated.

Time to Move from Vertical to Horizontal Approach in our COVID-19 Response in Nigeria

The novel Coronavirus (COVID-19) has adversely affected the already weak health system in Nigeria. The choice of whether to use vertical or integrated approach in solving health problems is determined by the peculiarity of the challenges. Vertical programs imply a variety of specific interventions that have not been fully integrated into the health system. The COVID-19 response in Nigeria still operates almost a vertical approach which is headed by the Federal Government through the Nigeria Centre for Disease Control (NCDC). Vertical healthcare programs address health problems through the application of specific measure(s). However, vertical approach alone has proved insufficient in the containment and control of COVID-19. The health system with the integrated services option is required in the proper management of COVID-19. The development of strategies by policymakers is required in the integration of COVID-19 response into the national health system.

Item analysis of university-wide multiple choice objective examinations: the experience of a Nigerian private university

Teachers and Students worldwide often dance to the tune of tests and examinations. Assessments are powerful tools for catalyzing the achievement of educational goals, especially if done rightly. One of the tools for ‘doing it rightly’ is item analysis. The core objectives for this study, therefore, were: ascertaining the item difficulty and distractive indices of the university wide courses. A range of 112–1956 undergraduate students participated in this study. With the use of secondary data, the ex-post facto design was adopted for this project. In virtually all cases, majority of the items (ranging between 65% and 97% of the 70 items fielded in each course) did not meet psychometric standard in terms of difficulty and distractive indices and consequently needed to be moderated or deleted. Considering the importance of these courses, the need to apply item analyses when developing these tests was emphasized.

Magnesium sulphate for treatment of eclampsia: the Nigerian experience

The preliminary result of an ongoing study in 4 major hospitals across Nigeria on the use of magnesium sulphate (MgSO4) as an anticonvulsant in the management of eclampsia is presented. All the 21 obstetric patients with eclampsia (recruited so far) were treated with MgSO4 as the only anticonvulsant. All the patients responded well to the treatment regime in terms of control of fit, and remained conscious thereafter. There was no incidence of severe adverse reactions to the drug. The mean number of convulsions in the patients treated was 4. The observed side effects were nausea, vomiting and dizziness in 3 patients and there were 3 perinatal deaths. The findings so far on maternal and fetal outcomes support the routine administration of MgSO4 as the drug of choice for the control of convulsion in women with eclampsia.