Background: University communities are typically large and diverse, requiring intentional strategies to foster communication, collaboration, mentorship, and primary healthcare interventions for impactful health outcomes. This paper underscores the potential benefits of organizing and participating in a Research Fair and Exhibition within the academic environment. Methods: The Faculty of Clinical Sciences, College of Medical Sciences, University of Calabar, was invited by the Directorate of Research and Development to participate in the 2024 University Convocation Research Fair and Exhibition. A five-member committee was constituted with clearly defined terms of reference. A survey was conducted for participants to the faculty exhibition stand to gather and analyze data regarding the planning, participation, and outcomes of the fair. Results: Consistent meetings with the Directorate facilitated clearer understanding and improved interaction, fostering synergy and enhancing familiarity with the Directorate’s operations. Collaborative efforts emerged across clinical specialties, notably Family and Community Medicine, as well as interfaculty partnerships, including with the Faculty of Agriculture. A two-way mentorship structure was observed between the senior members of the Faculty who were consultants and their mentees (resident doctors). A total of 76 individuals visited the Faculty’s exhibition booth, 84% rated the presentation and services as ‘good,’ and 78% reported increased interest in Medicine and Surgery. Primary care was actively promoted through disease screening, health education, and wellness activities. Conclusion: The Convocation Research Fair and Exhibition served as an innovative and informal platform for strengthening communication, collaboration, linkages, mentorship, and the promotion of SDG 3 (Good Health and Well-being) within the university community. The participation by the Faculty of Clinical Sciences was evaluated as a successful and promising model.

Aim/Objectives:This study aims to ascertain the prevalence and influencing factors of diabesity among adult patients visiting the General Outpatient clinic of three government healthcare facilities in Calabar, Nigeria. The objective is to enhance healthcare delivery to at-risk patients. Methods:A cross-sectional descriptive study design incorporating a mixed method approach, including quantitative and qualitative components such as Focused Group Discussions (FGD) and Key Informant Interviews (KII), was employed. The study population consisted of 190 participants aged 18 to 72 years with a body mass index (BMI) of ≥ 30kg/m2, selected using a systematic random sampling technique and analysed using SPSS and Atlas.ti. Results:Sociodemographic variables indicated that the highest number of respondents fell within the 35-44 years (37.3%), with 83.7% being female and 76.8% married. Furthermore, 65.8% were classified as having class 1 obesity, while only 38% self-identified as obese. The occurrence of diabesity was found to be 12.6% (i.e., BMI ≥30 vs. FBS ≥ 7.0), with 38% of cases being previously undiagnosed. Qualitative assessment through KIIs and FGDs revealed that unhealthy diets and lack of exercise were major contributing factors to diabesity. Conclusion:This study has disclosed a 12.6% occurrence of diabesity within the study population, with 38% of cases being previously undiagnosed. Unhealthy diets, snacking, and lack of exercise were identified as significant indicators of diabesity.

Background: Childhood immunization remains one of the most cost-effective preventive strategies against mortality and morbidity among children. The study sought to identify determinants of full vaccination status among children aged 12 to 23 months in Calabar South LGA, Cross River State. The study was a community-based cross-sectional study among 460 children in the 12 to 23 months age bracket, and information about them was obtained from their caregivers. The sample size of 460 was calculated using the Cochran formula. The study is a quantitative component of a bigger mixed-method study conducted from October to December 2023 among 5 wards selected from the 12 wards in Calabar South through a 2-stage cluster sampling. SPSS was used for data entry and analysis, and ethical approval was obtained from the CRS ethical committee (CRSMOH/RP/HREC/2023/401). The prevalence of full vaccination was presented as a pie chart. Bivariate analysis was carried out using Chi-square test statistics while significant variables at 5% were subjected to multivariable regression to identify independent determinants of full vaccination at a 95% confidence interval. The proportion with full vaccination status was 67%, factors associated with full vaccination included the child's sex/age, caregiver's age, education, occupation, relationship to the child, knowledge, and attitude towards vaccination. Independent determinants of full vaccination included caregivers' age, education, occupation, knowledge, attitude, and the occurrence of missed opportunities. Understanding these variations is crucial for policymakers and healthcare professionals to tailor interventions effectively, addressing region-specific challenges and enhancing overall vaccination coverage.

Immunization serves as a cost-effective shield against vaccine-preventable diseases, promoting population health and sustainable prosperity. This study aimed to determine vaccination coverage and assess the timeliness of vaccination (BCG, PENTA1, and measles vaccines) among children aged 12 to 23 months in the wards of Calabar South Local Government Area (LGA) in Cross River State. A community-based cross-sectional descriptive design was employed, with the number of children sampled being 460 to account for non-response and design. Information about children were obtained through interviews with proxy caregivers. Data analysis was performed using SPSS version 25.0. Ethical approval was obtained from the CRS Ministry of Health. There were 190 male children (41.3%) and 275 female children (58.7%) in the study. The age group of 12-15 months (55.2%) represents the largest category. The overall vaccination coverage was 88.3%, varying across wards (100% in ward 4, followed by 96.1% in ward 8, then 96% in ward 5, 91.6% in ward 12, and 80.8% in ward 11). The proportion of overall timely vaccination was 71.5%, with PENTA1 having the highest timeliness (88.3%). The proportions of timely vaccination for BCG and PENTA1 were highest in ward 4, followed by ward 5, but lowest in ward 11. Timeliness for all vaccines was also highest in ward 4, followed by ward 12, then ward 5, ward 8 and ward 11. Vaccination coverage and timeliness differed between locations, highlighting the need for Government interventions to be context-specific, addressing challenges within different ward locations rather than applying a one-size-fits-all approach.

Background and objective Infant survival depends on proper nutrition. Breastfeeding enhances infant health and offers some benefits to the mother as well. However, in the setting of the HIV pandemic, it is important to assess the benefits and the risk for each individual in choosing a feeding option. The purpose of this research was to determine the infant-feeding practices among women living with HIV/AIDS (WLWHA) and compare them with the general population of women. Methods A mixed comparative survey was conducted among 246 HIV-positive mothers nursing infants of at least one year of age. An equal number of matched HIV-negative women from the same locality were selected as controls. Quantitative data were analyzed using IBM SPSS Statistics version 23 (IBM Corp., Armonk, NY) while qualitative findings were presented in a thematic approach. Results The prevalence of exclusive breastfeeding (EBF) among WLWHA was 73.6% compared to 55.2% in the controls [p=0.002; chi-square (X2)=5.264]. Only 6.5% of WLWHA practiced exclusive replacement feeding (ERF). Vaginal birth was associated with increased odds for early initiation of breastfeeding [p=0.001; odds ratio (OR): 3.135; 95% confidence interval (CI): 2.130 to 4.616]. Also, urban dwellers commenced breastfeeding earlier than women residing in rural communities (p=0.002; OR: 5.58; 95% CI: 3.85 to 8.07). Based on in-depth interviews, cultural influences and non-disclosure of HIV status to family members promoted mixed feeding. Concomitant intake of anti-tuberculosis drugs was a major reason for adopting ERF in some women. Conclusion There was a high prevalence of EBF among WLWHA. Counseling on infant feeding is an effective component of the Prevention of Mother-to-Child Transmission (PMTCT) programs. Cultural beliefs and fear of stigmatization are major challenges to infant nutrition in sero-exposed babies.

The COVID-19 pandemic has reawakened the necessity of wearing a face mask in public places in several countries including Nigeria. The effect of prolonged use of face mask on pregnant women is not yet evaluated. The objective of this study was to assess the impact of wearing a surgical face mask on the cardiopulmonary functions of pregnant women. A prospective and case-control study was conducted among 85 healthy pregnant women at gestational ages between 20 weeks and 37 weeks. Equal number of age and parity-matched healthy non-pregnant women were recruited as controls. Their baseline S p O 2 and arterial pulse were measured. The participants were then instructed to wear surgical face masks and remain at a resting position for 1 h; thereafter, the S p O 2 and pulse rates were measured using a mobile electronic pulse oximeter. Data analysis was done using SPSS version 23. The level of significance was set at 0.05. There was no significant difference in their mean S p O 2 (97.44% ± 3.365) and (98.86% ± 1.014) for the pregnant women and the controls, respectively ( P = 0.146). However, the mean pulse rate of the pregnant women was significantly higher than that of the controls (97. 58b/m ± 10.731 and 93.17b/m ± 8.850; P = 0.012). The incidence of hypoxemia (S p O 2 < 90%) was very low (2.35%) in the pregnant women but non among the non-pregnant control. The incidence of hypoxia-related symptoms was also very low (1.8%). There was a weak negative correlation between the S p O 2 and pulse rate (r = −0.0881; P = 0.464 in the pregnant group compared to the controls (r = −0.309; P = 0.004). A vast majority of healthy pregnant women can safely wear a surgical face mask for a long time.

Classified as self and non-self-referrals, the ideal situation is that patients begin from lower levels of healthcare to higher levels. This improves the utilization of the primary care units, reduces unnecessary congestion of higher levels and makes for efficient healthcare delivery in general. This study aimed to assess the prevalence and predictors of self-referral among patients accessing healthcare in a tertiary hospital in Calabar, Nigeria. Ethical approval and informed consent were obtained. The study adopted quantitative data collection methods. This facility-based, cross-sectional study was carried out among 400 patients aged 18 years and above accessing care in the General Outpatient Clinic of the University of Calabar Teaching Hospital, Calabar in Cross River State. Overall, 191(47.8%) were males while 209(52.3%) were females. The mean age of study participants was 40.5±13.4 years, the most common age group was 31 to 40 years (28.2%). Prevalence of self-referral was 68.3%. Factors significantly associated with self-referral practices were sex (p<0.001), age group (p<0.001), marital status (p<0.001) and occupation (p=0.006). At multivariate regression analysis, females compared with males (OR: 5.299; 95% CI: 3.271 to 8.587), as well as those who were presently unmarried compared with those presently married (OR: 1.920; 95% CI: 1.052 to 3.505) were significantly more likely to practice self-referral. Self-referral practice is common and sex and marital status were identified as predictors. This is more so with unmarried females. Interventions to promote utilization and referral by healthcare providers through the prescribed channel is strongly recommended. Keywords: Self- referral, Prevalence, Predictors, Healthcare, tertiary, Practice.

Background and objective A facemask is often indicated for the control of the spread of airborne pathogens. At the peak of the COVID-19 pandemic, there was mass enforcement of mask use across the globe. Pregnant women were not excluded. While several studies have been conducted to evaluate and compare the efficacy of various mask types, data on their effects on pregnant women during exercise are scarce. The objective of this study was to evaluate and compare the effects of N95 and surgical facemasks on the cardiopulmonary functions of pregnant women during moderate-intensity exercise. Methods A prospective randomized study was conducted among 104 healthy women with advanced singleton pregnancies performing moderate-intensity exercise wearing either surgical or N95 masks during routine antenatal care. Their respiratory rates were counted, and arterial oxygen saturation (SPO2) and radial pulses (heart rates) were recorded with a mobile digital pulse oximeter at baseline and after 30 minutes of exercise. The mean values were calculated. Data analysis was done using Statistical Product and Service Solutions (SPSS, version 25; IBM SPSS Statistics for Windows, Armonk, NY). An independent t-test was used to compare the mean SPO2 and radial pulse between the two groups. Chi-square was used to examine differences in categorical variables. The level of significance was set at 0.05.Results Their demographic profiles and measured baseline parameters were comparable. Following a 30-minute exercise, the N95 mask group had lower mean SPO2 compared to the surgical mask group (95.5% versus 97.0%; P=0.028, 95%CI;-2.607 to 0.15). Further, the N95 group recorded a higher mean heart rate than the surgical mask group ((97.23 b/m versus 95.02b/m, respectively, mean difference (MD)=2.212, P=0.021, 95%Cl: 1.249-3.672). The mean respiratory rates were also higher among women in the N95 mask group (32.1 c/m versus 29.08 c/m, MD=3.018, 95%CI: 1.392-4.662, P=0.001).Conclusion The study, comparing the relative effects of the surgical and N95 facemask on the cardiorespiratory functions of exercising pregnant women, findings suggest that surgical facemasks may be better tolerated in advanced pregnancy when performing routine antenatal aerobic exercise in comparison with N95 masks.

BACKGROUND:The older people in most rural communities depend on family members to provide resources for their healthcare. However, such payments for health services are mostly out of pocket. In trying to protect the health of elderly persons who by nature are prone to high morbidity, other younger family members may be contacted for financial support for their healthcare through contributions to the Community based Health Insurance (CBHI). This study assessed the willingness of the significant other in the family to subscribe to the CBHI for the elderly person within the family.METHODS:A cross-sectional survey was used to study 358 elderly people, and their significant other (identified by using the family circle tool). The respondents were selected by a multistage sampling technique from nine clusters of villages within the community. The data were generated with an interviewer-administered semi-structured questionnaire. For the significant other that lived outside the community phone call was used for the interview. Descriptive and inferential analyses were done using SPSS 22.RESULTS:Majority of the significant others (97.8%) were aged less than 60 years and mostly female (67.9%) and had attained the tertiary level of education (75.4%). Most of the significant others were civil servants (83.0%); 94.7% were Christians; 87.4% were married, and 83.2% lived in urban locations. Only 7.5% were aware of CBHI and 56.7% were willing to buy N10,000 (naira) subscriptions for CBHI. Socio-demographic characteristics that were significantly associated with willingness to subscribe for CBHI were age < 60 years (p=0.040), tertiary education (p<0.001), occupation (p<0.001), religion (p=0.008), marital status (p<0.001), place of residence (p<0.001) and monthly income (p<0.001).CONCLUSION:There is a need to create awareness of CBHI in communities, as the majority of the significant others identified in this study were ready to subscribe to CBHI for the elderly members of their families at a convenient cost.

Antenatal care is an important entry point to the health system and provides access to essential obstetric care. Satisfaction with different aspects of antenatal care, has the potential to improve health. This study aimed to determine the prevalence of satisfaction with Antenatal care services and identify factors influencing client satisfaction among antenatal clinic attendees in University of Calabar Teaching Hospital Calabar (UCTH), Cross River State. A descriptive cross-sectional study was conducted among 200 pregnant women attending the ANC in UCTH. Systematic random sampling technique was used to recruit participants and the Client Satisfaction questionnaire (CSQ8) measured satisfaction. Data was analysed using bivariate (Chi-square test) and multivariate (binary logistic regression) analysis. The overall level of satisfaction recorded in this study was 92%. Reasons for dissatisfaction were long waiting time 57%, cost of services 40.3%, clinic environment 31%, doctors assigned to ANC attendees 19% and attitude of doctors 13%. Being satisfied with their previous experience in the health facility was the only significant predictor of satisfaction in this study(p<0.05). Although a high level of satisfaction with ANC services was noted among pregnant women in UCTH, it is pertinent that waiting time, cost of services, toilet facilities and infrastructure be addressed.

Background: The Lassa fever outbreak has claimed the lives of numerous healthcare personnel in recent years and this reflects the poor infection prevention control practices and ill-preparedness for such contagious epidemic. Objective: The aim of the study was to assess the knowledge and quality of practice with regard to prevention of Lassa fever transmission among health workers. Methods: In this cross sectional study 230 health workers including intern nurses & doctors were assessed using pretested self- administered questionnaire adopting the WHO & Nigerian Centre for Disease and Control (NCDC) recommended prevention protocols against the deadly virus. Data were analyzed using Statistical Package for Social Science version 25. Results: Two hundred and twenty-four completed questionnaire (97.4% response rate) were analyzed. A vast majority 172 (76.8%) possessed satisfactory knowledge about Lassa fever transmission and infection prevention whereas only 77(44%) actively practiced the recommended protocols for infection prevention against Lassa fever virus satisfactorily. In the regression analysis, duration of service was the only significant factor positively associated with satisfactory knowledge on Lassa fever infection prevention (X 2 9 (0.05) = 19.559, P value= 0.001) . Almost all the participants practiced hand washing before and after attending to patients. However, only 1.34% of the respondents utilized full personal protective equipment (PPE) kits consistently while attending to high risk patients. Overall, their infection preventive practices were not significantly influenced by their occupation designation (P=0.586), duration of service or training in years and demographic profile such as: gender (P=0.118), age (P=0.840), marital status (P=0.819) and residing in urban area (P = 0.561). There was a weak positive correlation between knowledge scores and practice scores (r=0.137). Conclusion: It is recommended that the standard infection prevention practice protocols be adopted consistently in caring for patients with suspected or confirmed endemic viral infection like Lassa fever. Hospital management and policy makers should provide adequate PPE to minimize nosocomial infection in healthcare workers. Regular hospital-based seminars on infection prevention is recommended. Keywords: Nosocomial infection, hand washing, personal protective equipment, healthcare workers, endemic viral infection. DOI: 10.7176/JEP/13-7-08 Publication date: March 31 st 2022

Background: Pregnancies complicated by threatened miscarriage (TM) may be associated with adverse pregnancy outcomes. The objective of this study was to compare the differences in pregnancy outcomes between the women who experienced TM and asymptomatic controls.Methods: This was a 10-year retrospective review. Case records of 117 women who were managed for TM from January 1, 2010, to December 31, 2019, were retrieved and studied. The control group was developed from an equal number of asymptomatic clients matched for age, parity, and BMI who were receiving antenatal care (ANC) during the same period. Data on demography, clinical and ultrasound findings, treatment, and pregnancy outcomes were retrieved and analyzed.Results: Spontaneous abortion rate of 13.7% was recorded among the study group compared with 3.4% in the control (P-value [p] = 0.005, odds ratio [OR]: 4.475; 95% confidence interval [CI]: 1.445 -13.827). Women with TM had higher odds for placenta previa (p = 0.049, OR: 4.77, 95% CI: 2.19 -23.04), premature rupture of membranes (PROM) (p = 0.028, OR: 1.918, 95% CI: 1.419 -2.592), postpartum hemorrhage (PPH) (p = 0.001, OR: 2.66, 95% CI: 20.8 -8.94), and preterm birth (OR: 2.5, 95% CI: 1.75 -3.65). They were also more likely to undergo cesarean section (p = 0.020, OR: 1.70, 95% CI: 1.053 -2.964). There was no statistically significant difference in their infants' mean birth weight (3.113 +/- 0.585kg for the TM group and 3.285 +/- 0.536kg for the control, P=0.074). Other maternal and perinatal complications were similar. Admission for bed rest significantly improved fetal survival. Women who were not admitted for bed rest had higher odds of pregnancy loss (OR: 3.443, 95% CI: 1.701-7.99). Other treatment plans did not significantly contribute to a positive outcome.Conclusion: Threatened miscarriage is a significant threat to fetal survival and may increase the risk for operative delivery. Bed rest improves the live birth rate.

Background: Owing to the novel nature of COVID-19, management strategies are poorly understood by most Primary Care Providers (PCPs) especially in the Low and middle-income Countries (LMIC) of the world. If the knowledge of PCPs concerning COVID-19 is enhanced, awareness, perception and attitude towards patient care will improve. Consequently, maximum prevention and control will be achieved. This study aims at assessing the awareness, knowledge and willingness of the PCPs to care for COVID-19 patients in Calabar, Nigeria. Methods: A cross-sectional descriptive study was used to evaluate one thousand one hundred and twenty-six (1126) PCPs actively working in government primary, secondary and tertiary healthcare facilities in Calabar, Nigeria. A total population sampling method was employed and a validated, semi-structured, 33-item questionnaire was used to explore the objectives of the study. Results: Majority (99.4%) of the study participants were aware of COVID-19. Most (68.4%) information regarding COVID-19 came from the social media. Bonferroni Post Hoc test of multiple comparisons revealed that the knowledge score for PCPs in tertiary was significantly higher compared to those in secondary and primary levels of care. Approximately fifty-five percent (55.3%) of the participants did not want to be involved in the management of COVID -19 patients. Conclusion: There is the need to focus and intensify training of the PCPs working at the primary and secondary levels of care in order to increase their awareness, knowledge base, willingness to care for patients and eventually reduce morbidity and mortality associated with COVID-19 in the study setting.

Background Globally, diabetes is a leading cause of impairment of quality of life. In the sub-Saharan African region, there is a need for studies that provide more valid assessment of effect of diabetes on quality of life (QoL). This study aimed at assessing quality of life among patients with diabetes attending a tertiary health service in Nigeria. Methods The study design was a case-control. Diabetic cases were randomly recruited from the University of Calabar Teaching Hospital, while non-diabetic controls were civil servants and retirees. The validated and pretested WHOQoL-BREF instrument was used to assess quality of life, with higher scores indicating higher quality of life. Results Three hundred and thirty subjects were studied, with mean ages of males and females of 55.2 ± 4.8 and 51.8 ± 6.3 years, respectively. The mean total QoL score was 75.77 ± 11.2, with no significant difference between males and females. Among male and female cases, the mean score of the physical health domain was significantly lower for cases compared with controls ( p = 0.05). Male cases compared with controls had higher scores for the environment domain ( p < 0.05). Older age and higher systemic blood pressure were associated with lower QoL scores for both sexes ( p < 0.05). Unmarried status, obesity, and poor glycemic control (HbA1c > 7%) were associated with lower QoL scores ( p < 0.05). Fasting blood sugar (FBS) level and lipid profile were not significantly correlated with QoL score in both sexes ( p > 0.05). Conclusion Diabetes contributes to low quality of life among males and females, with significant differences in the affected domains. Diabetes care providers should identify affected domains during clinic consultation, in order to improve provision of more effective care.

Objectives: The introduction of highly active antiretroviral therapy and innovations in healthcare has contributed in improving the lives of persons living with human immunodeficiency virus (HIV)/AID. Patients infected with HIV are more susceptible to develop psychiatric illnesses. Depression is common among patients suffering from chronic illness such as HIV/AIDS and can exacerbate these illnesses. Depression has been observed to be twice as common in HIV seropositive individuals than in the general population. Undiagnosed and untreated depression in patients suffering from HIV/AIDS could lead to poor adherence to medications and lower quality of life. Depression is associated with rapid HIV disease progression. The diagnosis of HIV infection may be associated with feelings of anger, denial, sadness, guilt feelings, loss of self-esteem among others. These negative feelings could lead to suicidal ideation and attempted suicide or suicide. We sought to determine the prevalence rates, sociodemographics and predictors, of depression and suicidal ideation among study participants. Material and methods: Two hundred and two adult participants who met the inclusion criteria were recruited into the study. Mini International Neuropsychiatric Interview English version 6.0.0 was employed to diagnose depression and suicidal ideation. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Significant levels were set at P < 0.05. Results: This study revealed prevalence rates of 11.4% for depression and 7.9% for suicidal ideation among study participants. Majority of the participants were females in the young age group category of 30–40 years (45%) with mostly secondary education (47.8%), most had a higher CD4 count greater than 200 cells/µL (82.6%) and were mainly on zidovudine/lamivudine/nevirapine combination therapy (56.5%). Mean age, CD4 count, and viral load levels were lower in HIV patients with depression but were not statistically significant (P > 0.05). CD4 count and viral load were not significantly associated with suicidal ideation. Lower age (30–40 years) was significantly associated with suicidal ideation (P < 0.05). Suicidal ideation is a predictor of depression in the same way depression is a predictor of suicidal ideation (P < 0.05). Conclusion: Routine screening for depression and suicidal ideation especially among younger HIV/AIDS patients is recommended in the clinic setting.

Exclusive Breastfeeding (EBF) has a lot of benefits to the infants and the mothers in preventing and reducing the risks of common and preventable childhood illnesses. Many of the breastfeeding mothers do not practice EBF and are not equally aware of the benefits associated with such practice. This may be due to misconceptions and inadequate information regarding breastfeeding practices in their communities. The aim of this study was to evaluate the proportion of breast feeding mothers practicing EBF, the role antenatal care (ANC) plays in educating prospective mothers on EBF, the support breastfeeding mothers receive and their perception of the impact of breastfeeding on the shape and beauty of their breasts. Nine Hundred and thirty two (932) consenting breastfeeding mothers attending immunization clinics in selected Primary Health centres (PHCs) in the state were recruited. An interviewer administered questionnaire was used to collect data. The data was entered and analysed using SPSS version 22 and the level of significance for all statistical anaylsis was taken at P< 0.05. The overall prevalence rate of practicing EBF was 69.6%. The practice of EBF was statistically significant for mother’s in the 26-35 year age group, with a secondary education, residing in the rural area and southern senatorial district of the state. Also, significant were mothers who attend ANC, being aware of EBF, knew the meaning of EBF as well as the general benefits of EBF to the infant. . Furthermore, other significant factors were mothers that were married, encouraged to practice EBF and those that believed that EBF did not affect the beauty of their breasts. Women of child bearing age should be encouraged to book and attend ANC when pregnant and education on the benefits of EBF should be maintained and sustained during ANC visits in all healthcare facilities in Cross River State of Nigeria. Awareness on misconceptions on EBF and its effect on the beauty of breasts should be advocated. The community should be encouraged to support breastfeeding mothers.

Background: Sleep disorders are a common and often undiagnosed chronic health problem associated with an increased incidence of metabolic syndrome and pregnancy complications. Aim: The purpose of this study was to find out how common sleep disturbances are among pregnant women in Calabar, as well as their patterns and risk factors. Materials and Methods: A cross-sectional study was conducted among 360 antenatal attendees in the three major public health facilities in Calabar and 338 completed questionnaires were included in the analysis. Socio-demographic, medical, and obstetrics information were obtained using interviewer-administered questionnaires. Major international sleep classification tools were used to identify the patterns of sleep disturbance. Their weights and heights as well as their blood pressures (BPs) were measured. Data were analyzed using SPSS version 23. The predicting factors were extracted using a logistic regression model. Results: The prevalence of sleep disorder was 44.1%. The most common pattern of sleep disorder was insomnia (34.6%). Nineteen (5.6%) of them reported mixed disorders. On logistic analysis, pregnant women with normal BP (odds ratio [OR]: 0.440, 95% confidence interval [CI]: 0.230–0.843, P = 0.013), normal body mass index (OR: 0.365, 95% CI: 0.133–1.001, P = 0.050) and maternal age 20–30 years, (OR: 0.169, 95% CI: 0.30–0.969, P = 0.046) were significantly less likely to suffer from sleep disorders. Residing in a single a room apartment with family members was an independent social determinant of sleep deprivation (OR: 2.009, 95% CI: 1.003–4.025, P = 0.049). Conclusion: The study suggested that the prevalence of sleep disturbance is high among pregnant women. Counseling on good quality sleep during pregnancy may improve pregnancy outcome by ensuring appropriate weight gain and good BP control.

BACKGROUND: Primary postpartum hemorrhage (PPH) contributes significantly to the high maternal mortality ratio, especially in the low resource nations. Placenta previa and retained placenta are major causes of postpartum hemorrhage. Uterotonics like misoprostol are medication used to improve uterine contractility with the purpose of reducing uterine bleeding after delivery of baby. Most studies on misoprostol for the prevention of obstetric hemorrhage have been focusing on its postpartum use. AIM: The aim of this study was to assess the effectiveness of pre-operative misoprostol in reducing blood loss during cesarean section for placental previa and manual removal of retained placenta. METHODS: This was a placebo-controlled study involving 154 women who were randomly assigned to the treatment and control groups. The study group received 400 ug of misoprostol rectally just before the commencement of the procedure. Estimation of blood loss was done in a standardized way. Data were analyzed using SPSS version 23. The level of significance was set at p < 0.05. RESULTS: The average age of the participants was 31.64 years. The overall incidence of PPH was comparable in both groups (0.070), however, misoprostol group experienced lower incidence of severe PPH compared to the placebo (p = 0.013). Other maternal and perinatal outcomes were comparable. CONCLUSION: Excessive intraoperative and immediate post-operative bleeding can be prevented with pre-operative misoprostol. It should be made available for high-risk obstetrics procedures.

Background: The nature of our psychosocial environment and one's response to stressful daily events are key determinants of current and future mental health status. The school environment is one of such settings which expose young people to potentially undue stress, especially through bully-prone interpersonal interaction with peers and older individuals. Although bullying is thought to be prevalent in secondary schools, only a few studies have investigated the association between bullying and the mental health status of secondary school students in developing countries. The present study seeks to obtain data that may be helpful in addressing this research gap. Methodology: This was a cross-sectional analytic study. A stratified sampling technique was used to select six secondary schools within Calabar metropolis. Proportional allocation using a simple random sampling method was employed to recruit the required number of senior secondary students from the selected schools. Multidimensional Peer Victimization Scale and Child and Youth Mental Health General Screening Questionnaires were used to assess for presence/degree of bullying and mental health problems, respectively. Mann–Whitney U-test and Spearman's correlation analysis were used as inferential statistics, and P-value was considered significant if it was < 0.05. Results: Three hundred and four (304) respondents were surveyed, but complete data were obtained from 292. Their ages ranged from 13 to 20 years, with a mean age of 16.5 ± 2.1 years. The male-to-female ratio was 1:0.7. Within the past 12 months, 54.8% of the respondents had bullied someone, while 62.3% had witnessed someone being bullied. Attack on the property was the most common form of bullying (61%), followed by social manipulation (52.7%), verbal (52.1%), and physical (47.9%) forms of victimization. Moderate-to-severe forms of social manipulation, physical victimization, verbal victimization, and attack on property forms of bullying were found in 26.0%, 26.7%, 28.8%, and 32.2% of respondents, respectively. The most frequently elevated component of mental health score in the respondents was conduct symptoms (50.7%), followed by mood symptoms (34.2%) and symptoms of generalized anxiety (19.2%). Respondents with abnormally elevated scores for hyperactivity/distractibility, conduct, generalized anxiety, and mood symptoms had significantly higher mean scores for each of the components of bullying assessed (P < 0.001). Elevated scores on oppositional defiant symptoms did not significantly influence the mean scores of each component of bullying, except for verbal victimization (P = 0.04). A significant positive correlation was observed between each component of bullying and each domain of mental health assessed (P < 0.001). A positive correlation was also observed between the total bullying score and each domain of mental health as well as the total mental health scores (P < 0.001). Of all the domains of mental health assessed, symptoms of hyperactivity/distractibility showed the strongest positive correlation with a total bully score (r = 0.69, P < 0.001). Conclusion: The results from this study suggest that bullying is prevalent in our secondary schools, with a potential adverse effects on the mental health of affected individuals in the near or remote future. These findings may be useful for improvement in existing policies for school health programs in developing countries.