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Screen-and-Treat Approach in Secondary Prevention of Cervical Cancer among HIV-Infected w.men in Faith Alive Hospital, Jos Nigeria

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 792-801页

作者： John Onyeji mercy w. isichei Charles U. Anyaka Emmanuel Osayi Olabanjo O. Ogunsola Oluw.tomiini Ademuyiw. Abeeblahi Olafare Oluseye Ajayi Christian O. isichei Solomon A. Sagay Perpetual C. Christopher Department of Obstetrics and Gynaecology Bingham University Teaching Hospital Jos Nigeria Faith Alive Foundation Hospital Jos Nigeria Department of Surgery Jos University Teaching Hospital Jos Nigeria Department of Obstetrics and Gynaecology Jos University Teaching Hospital Jos Nigeria APIN Public Health Initiatves Abuja Nigeria Department of Chemical Pathology Jos University Teaching Hospital Jos Nigeria

Background: Cervical cancer is the fourth most common cancer among w.men globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, w.rld Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. How.ver, in resource-poor settings, Visual Inspections w.th Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions w.th thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among w.men Living w.th HIV (w.HIV). Methods: A retrospective study on sexually active w.HIV aged 16 - 55 years screened for cervical cancer using VIA and VILI w.thin 16 months period in Faith Alive Hospital Jos. Data w.re analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results w.re presented in frequency tables, and logistic regression w.s performed to determine risk factors of pre-cancerous lesions. Results: 1113 w.men w.re screened for cervical cancer using VIA/VILI. 994 (89.3%) w.re negative, 101 (9.1%) w.re positive for precancerous lesions, and 18 (1.6%) w.re suspicious of cervical cancer. The mean age of clients w.th pre-cancerous lesions w.s 41.32 ± 9.89 years. A higher positivity yield (69.4%) w.s found in ages betw.en 36 and ≥55 years w.ile a less positivity yield (30.6%) w.s found in age’s ≤ 35 years. History of STI had 1.64 fold risk association w.th precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among w.HIV;bimodal age distribution for cancer-suspicious lesions and risk associated w.th STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until w.despread HPV testing to triage clients is feasible.

关键词： Faith Alive w.men Living w.th HIV VIA Screen-and-Treat

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Screen-and-Treat Approach in Secondary Prevention of Cervical Cancer among HIV-Infected w.men in Faith Alive Hospital, Jos Nigeria

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第4期

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HIV Prevalence amongst Pregnant w.men Clients Attending Antenatal Clinic at the Faith Alive Foundation and PMTCT Centre, Jos Plateau State

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w.rld Journal of AIDS 2016年第2期6卷 59-64页

作者： Anyaka Charles Oyebode Tinuade Musa Jonah isichei mercy Anyaka Ifechi isichei Christian Department of Obstetrics and Gynaecology University of Jos/Jos University Teaching Hospital Jos Nigeria Faith Alive Foundation and Hospital Jos Nigeria Department of Surgery University of Jos/Jos University Teaching Hospital Jos Nigeria Our Lady of Apostles Hospital Jos Nigeria Department of Chemical Pathology University of Jos/Jos University Teaching Hospital Jos Nigeria

Introduction: HIV infection and AIDS is a public health problem w.rldw.de, particularly affecting the populace in resource challenged setting like sub-saharan Africa. w.men of reproductive age are mostly affected and infected w.th the HIV disease. Methodology: A cross-sectional study of 216 randomly selected w.men that booked for antenatal care at the Faith Alive Foundation and PMTCT centre Jos betw.en 1st July to 31st December, 2014 w.s carried out. Information regarding age, parity, gestational age at booking, educational status and HIV sero-status of the clients w.s analysed. Screening test w.s conducted in a serial tw. step approval using determine and UNIGOLD as the confirmatory test, w.ile STAT-PAK w.s the tie-beaker w.th discordant result as per the national algorithm. Positive samples w.re confirmed by w.stern blot method. Result: A total of 18 w.men out of the 216 w.men studied w.re positive giving a sero-prevalence rate of 8.3%. The highest sero-prevalent rate w.s amongst 25 - 29 years age group (31.5%). w.men of parity 1 - 4 constituted the highest group of 62.9%. Majority of the w.men 65.7% booked in the second trimester w.ile 26.9% booked in the 3rd trimester. Most of the w.men 47.2% had secondary school education w.ile only 5.6% of them had no form of education. Conclusion: HIV infection prevalence rate among antenatal attendants at Faith Alive Foundation and PMTCT centre Jos is still high. Multisectorial approach and intervention strategies should be further scaled up for the prevention of vertical transmission of the virus. How.ver, it is w.rth noting that it is mainly an HIV/AIDS hospital w.ich should have affected the outcome.

关键词： HIV Prevalence Antenatal Clinic Faith Alive Foundation and PMTCT Centre Jos Plateau State

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The general surgeon in inter-disciplinary gynaecological cancer care

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w.rld Journal of Obstetrics and Gynecology 2013年第3期2卷 37-41页

作者： mercy w.kili isichei Bashiru Omeiza Ismaila Department of Surgery University of Jos and Jos University Teaching Hospital930001 Plateau State Nigeria

Gynaecological cancers pose a significant cancer burden globally. In 2008 cancers of the cervix, uterus and ovaries accounted for 529000(4.2%), 287000(2.3%) and 225000(1.8%) cancers, respectively, and together w.re responsible for 486400 deaths. Inter-disciplinary gynaecological care is an emerging concept aimed at providing more effective care by integrating different disciplines into a team w.rking together to perform the various aspects of management at one time. This model has both advantages and potential shortcomings. In advanced healthcare systems there appears to be little role for the general surgeon. How.ver in developing w.rld, the general surgeon has a valuable, but complementary role in inter-disciplinary gynaecological cancer care. This role depends on the available w.rkforce and includes, but is not limited to, the establishment of a diagnosis and treatment, including the management of complications. There is how.ver little evidence-based research to provide guidance on the general surgeon's role in inter-disciplinary gynecologic cancer care and more research is needed.

关键词： General surgeon Inter disciplinary Diagno-sis Treatment Gynaecological Cancer

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Factors Associated w.th Delay in Presentation of Symptomatic Cancers among HIV Infected Persons in Plateau State, Nigeria

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w.rld Journal of AIDS 2017年第3期7卷 157-165页

作者： mercy w.kili isichei Ayedima Michea Misauno Femi Alexander Ale isichei Christian Ogoegbunem Aisha Abubakar Kabiru Sabitu Patrick Nguku Prince Anyaw. Jos University Teaching Hospital Jos Nigeria Faith Alive Foundation Jos Nigeria Ahmadu Bello University Zaria Nigeria Nigeria Field Epidemiology and Laboratory Training Program Abuja Nigeria Excellence Community Education w.lfare Scheme Abuja Nigeria

There is increased incidence of cancer w.rldw.de but much of the burden of morbidity and mortality w.ll occur in the developing w.rld because of cancer associated infectious diseases of w.ich HIV infection carries a large proportion. Site-based studies show.that proportion of late stage cancer presentation range betw.en 60% - 92% in the last 10 years. There is paucity of information on reasons for the late presentation. This study is aimed to find out the factors associated w.th delay in presentation of symptomatic cancers among HIV infected persons in Plateau State, Nigeria. A mixed method study consists of quantitative and qualitative component. Participants w.re sampled from HIV infected persons diagnosed w.th cancer and referred to the Oncology unit. Variables on Patient and health service factors associated w.th late presentation of cancers w.re collected. Quantitative data w.s analyzed using Epi info version 3.5.3 and Microsoft Excel w.ile thematic analysis w.s done for qualitative data. There w.re 503 respondents and the mean age w.s 48.7 ± 13.5 years. Male sex OR 2.5, (P = 0.002);Farming occupation OR 1.7, (P = 0.0005) and Primary education OR 2.0, (P = 0.0005) w.re associated w.th delay. Majority of respondents 349(69%) presented more than six months after onset of symptom. Common symptoms w.re pain 462(45.70%), sw.lling 237(23.44%) and skin discoloration 210(20.77). Their Initial reaction w.s mainly the use of alternative remedies 234(46.5) CI 42.1 - 51.0. Up to 274(54.47%) of participants obtained diagnosis 3 months after presenting to a health facility. Laboratory related issues 199(39.56%) and long booking time 163(32.40%) w.re the most common reasons for delay. Delay w.s found to be both patient and services related. The study also suggests that cancer symptom aw.reness is poor among the participants. There is no tangible cancer prevention program in the HIV/AIDs treatment program. A more in-depth know.edge of cancer is required for both the sufferer a

关键词： Delay Cancer Presentation HIV/AIDS Factors

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Unpow.red Scooter-Related Injuries among Adolescents and Adults in the United States 2007-2017

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Open Journal of Emergency Medicine 2020年第1期8卷 13-20页

作者： mercy w.kili isichei Alexander Femi Ale Michael Ayedima Misauno Pamela Brow. Nicholas Dean Soulakis Department of Surgery Jos University Teaching Hospital Plateau State Nigeria 727 Tulane Drive NE Albuquerque NM USA Division of Health and Biomedical Informatics Department of Preventive Medicine Northwestern University Chicago IL USA

United States Consumer Product Safety Commission (CPSC) reported a 700% increase in Emergency Department (ED) visits for injuries attributed to unpow.red scooter use from January through October 2000. Our objective is to investigate injuries associated w.th the use of unpow.red scooters among adolescents from the age of >9 years to 20 years in the National Electronic Injury Surveillance Study (NEISS) data set from 2007-2017. w. analyzed unpow.red scooter-related injuries in the NEISS data set using variables: SCOOTER, INJURED, AFTER, OFF, AT and IN;the product code for injuries related to unpow.red scooters is 1329, and age ≥9 years and 9 - 19 - w.ite 39.65%, Not Specified (NS) 38.94%, Black/African American 13.98% and Others (Asian, American Indians, Alaskan natives, Native Haw.iians, and Pacific Islanders) 7.43%. Body parts injured: head 16.19%, follow.d by face 8.49%, finger 8.30%, low.r trunk 8.30%, ankle 5.60%, upper trunk 5.35%, internal injuries 0.99% and others 14.28%. Most of the injuries w.re mild: Treated and Discharged 89.80%, Hospitalized 7.68%, and Death in ED 0.05%. The locations of injuries w.re: Occurred at Home 43.47%, UNK 29.78%, Sports 12.63%, Public 6.49%, School 5.35%, and Street 2.22%. Injury trend: a rise until 2010, a decline until 2015 and, then a sharp rise through 2017. Injuries from the use of unpow.red scooters are a rising threat that should be given attention. Outcome: Most of the injuries 69.80% w.re mild treated and discharged, 7.68% w.re hospitalized, w.ile death in ED w.s 0.05%. w.ereas: Transfer to referral hospital w.s about the same as in adults. Although most of these injuries w.re minor, head injuries could lead to more serious problems, and severe injuries could be life-threatening.

关键词： Unpow.red Scooter Injuries Adolescents Adults

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Presentation of Undescended Testis to a Paediatric Referal Centre in Jos

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Open Journal of Pediatrics 2020年第3期10卷 438-446页

作者： Andrew.Haruna Shitta Solomon Danjuma Peter Ezekiel Dido Dung Danaan Joseph Shilong Alexander Femi Ale mercy w.kili isichei Emmanuel Olorundare Ojo Michael Ayedima Misauno Lohfa Bali Chirdan Department of Surgery Jos University Teaching Hospital Jos Nigeria

Background: Undescended testis is the commonest disorder affecting the male urogenital tract. Late presentation has significant socio-medical impact on the individual’s quality of life. Aim: To evaluate the presentation of undescended testis and age at surgery in our centre. Methods: A 9-year retrospective analysis of the clinical records of patients Results: A total of 73 records were analysed, 58 (79.5%) presented > 1 year. Median age at presentation was 4 years, range 1 day - 16 years. Males 73 (100%), only 17 (23.3%) were referred by health personnel, while 56 (76.7%) self-referred. Commonest site involved was the left 33 (45.2%), 29 (39.7%) right and 11 (15.1%) bilateral. There were 13 (17.4%) who had associated congenital malformations. Hypospadias 7 (53.8%), isolated micropenis 4 (30.8%) and 1 each (7.7%) had myelomeningocele and hernia. Median age at presentation for bilateral involvement was 30 days, with associated hypospadias was 12 days, while those with isolated micropenis was 7.5 years. Median age at surgery for bilateral involvement was 2 years, overall median age at surgery was 4 years. Surgery Findings: Supra-scrotal testis 47, canalicular 25 (34.2%), and bilateral abdominal 1 (1.4%). Outcome: w.und infections 4 (5.5%), scrotal w.und breakdow. 1, Recurrence 3 and testicular atrophy 1. <

关键词： Undescended Testis Age at Presentation Orchidopexy

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Baseline Laboratory Profile of HIV Positive Patients on Antiretroviral Therapy in Jos North Central Nigeria: Implications for Pre-vention, Treatment, Care and Support

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w.rld Journal of AIDS 2015年第4期5卷 328-334页

作者： Christian Ogoegbunem isichei mercy w.kili isichei Jean Emile Njab Johnson Ibidun Rotimi Tinuade Abimbola Oyebode Charles Ujunw. Anyaka Kenneth Emeka Enw.rem Ayuba Ishiaku Affi Lucius Chidiebere Imoh Alexander Ogielu Abu Solomon Abiola Asorose Noel Omuya Amadu Propser Ihenacho Okonkw. Ngozi Ijeoma Okoro Department of Chemical Pathology Faculty of Medical Sciences University of Jos Jos University Teaching Hospital Jos Nigeria Faith Alive Foundation Jos Nigeria Department of Surgery Faculty of Medical Sciences University of Jos Jos University Teaching Hospital Jos Nigeria Department of Chemical Pathology Bingham University Jos Campus Jos Nigeria Department of Obstetrics and Gynaecology Faculty of Medical Sciences University of Jos Jos Nigeria AIDS Prevention Initiative in Nigeria (APIN) Abuja Nigeria

Background: w. characterized baseline laboratory data of patients to identify priority treatment areas, most affected populations, anticipated clinical complications and assessed the potential burden of retention in care in Jos, Plateau State—North Central Nigeria. Methods: This study w.s a cross-sectional design from January 2004 to December 2005 at Faith Alive Foundation (FAF). All participants w.re HIV-positive and underw.nt pre-antiretroviral therapy counseling based on the national antiretroviral therapy (ART) guidelines and baseline laboratory testing. Data w.re captured on Microsoft Excel, validated on Epi Info and analyzed on SPSS version 21 at P w.men) participants w.re evaluated in this study. The age and sex related distribution of participants show.d that majority (80.3% for males and 92.5% for females) w.re 16 - 45 years old. Amylase and creatinine w.re significantly higher in males than females (P = .02). Anaemia w.s the most common baseline abnormality (63% for females and 58% for males), w.ile baseline CD4 count w.s significantly low.r in males than females (P w.s characterized by anaemia, elevated creatinine, and abnormal liver transaminase levels (AST and ALT). This pre-ART laboratory result suggests that HIV-positive individuals have multiple clinical abnormalities w.ich may require more extensive care than just treating the HIV disease.

关键词： Baseline Laboratory Profile HIV-Positive Patients PEPFAR HTC Nigeria

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Performance Characteristics of Urine HIV Screening Methods against Blood-Based Methods for Surgeons Guide

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w.rld Journal of AIDS 2020年第2期10卷 119-127页

作者： M. w. isichei T. T. Selow. D. Meshak A. F. Ale S. D. Peter M. A. Misauno A. Affi O. Olaniru C. O. isichei Department of Surgery University of Jos Jos Plateau State Nigeria Department of Chemical pathology University of Jos Jos Plateau State Nigeria Department of Chemical Pathology Bingham University Jos Jos Plateau State Nigeria

Testing for Human Immunodeficiency Virus (HIV), w.dely distributed in sub-Saharan Africa since it is mainly invasive but, could be non-invasive and quick also, reducing w.iting time especially w.en required for presurgical procedures. This study determined the HIV status of patients using Urine screening test method and to compare its performance to blood-based testing methods. The routine pre and post-test counselling for HIV screening w.re done for all provider-initiated HIV testing using blood-based screening methods. Due to the cost and unavailability of enough urine testing kits, only patients w.o tested positive for HIV w.th blood-based methods and w.re scheduled for surgery or a surgical procedure w.re enrolled in the study. Informed consent w.s obtained. Paired urine and blood samples w.re collected at the same visit into clean universal bottles and analyzed immediately. A colloidal gold enhanced rapid immuno-chromatographic assay (Alliance Biomedical) kit for the rapid qualitative detection of antibodies to Human Immunodeficiency Virus (HIV) I and II in urine w.re used in comparison to the standard HIV testing of ante-cubital venous blood collected in EDTA vacutainer and analyzed using Determine (T) HIV 1 and 2 in vitro qualitative immunoassay strip, UNI GOLD rapid test kit and the Chembio HIV 1/2 STAT PAK assay strip. A total of 7568 patients w.re tested for routine provider-initiated HIV testing, 521 tested HIV positive. There w.re 105 (20.15%) males and 416 (79.85%) females, age ranged from 15 years to >80 years. Most of the surgeries performed w.re Caesarian section 93 (37%), Hernia 55 (22%), Lumps 48 (19%), Acute appendicitis 33 (13%), Uterine fibroids 10 (4%), Ruptured ectopic pregnancy 2 (1%) and others (Intestinal obstruction, Postoperative adhesions, Ingrow. toe nails, Breast abscess, Hemorrhoids, Anal fissures etc.) 10 (4%). DETERMINE RAPID HIV TEST METHOD USING BLOOD: A total of 521 HIV positive samples w.re tested, 502 (96.35%) tested HIV

关键词： HIV AIDS Sensitivity Specificity HIV Rapid Testing

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