British Journal of Healthcare and Medical Research <p>British Journal of Healthcare &amp; Medical Research (<strong>BJHR</strong>) is an international, peer-reviewed, open access journal that provides an easy access to high quality manuscripts in all related aspects of diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. The journal also focuses upon the challenges and opportunities and how healthcare can benefit from it in terms of reduced costs and improved diagnosis, therapy, and care. Access to health care manuscripts provides an insight that varies across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place.</p> <p>The journal brings professionals in medicine, psychology, physiotherapy, nursing, dentistry, midwifery (obstetrics) and allied health, plus many other disciplines such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services in health care under single roof.</p> Services for Science and Education, United Kingdom en-US British Journal of Healthcare and Medical Research 2055-1266 Health Systems Response to Routine Maternal and Child Health Service Delivery Amidst COVID -19 Pandemic at Kanyama 1st Level Hospital - Lusaka District <p><strong>Aim:</strong> To ascertaining the health systems response to routine maternal and child health services amidst the COVID -19 pandemic at Kanyama 1st Level Hospital – Lusaka, Zambia.</p> <p><strong>Method:</strong> A qualitative research study was conducted on Antenatal Clinic and Post Natal Clinic mothers as targets; Community Health Workers, Health Care Workers, and policy makers as key informants, utilizing five (5) Focused group discussion to reach saturation. &nbsp;Data was collected using topic guides and analyzed manually by transcribing and coding it. Sample size for participants were selected using simple random sampling on ANC/ PNC mothers, while the three categories of key informants were purposefully selected. The indirect effects of COVID-19 pandemic framework which mirrors the WHO six building blocks adopted from the Global Health Life Saving Tools was used to analyze the health system’s readiness amidst the COVID-19 pandemic at Kanyama 1st Level Hospital – Lusaka, Zambia.</p> <p><strong>Results </strong></p> <p>Findings were that the facility had challenges with regards to health workforce, supplies and equipment, which ultimately affected quality provision of maternal health services as outreach services were disrupted. Although the health facility responded well in providing alternative schedule to cope with the influx of mothers at the center from the closed outreach posts, the epidemic preparedness in responding to the epidemic was not up to the expected standards. Later, reduction in PNC and ANC attendance was noted, and home deliveries and deaths suddenly increased. The HCW, CHWs also had challenges ranging from lack of psychosocial support / Personal Protection Equipments, and inadequate training.&nbsp; In addition, frontline workers had inadequate knowledge on triaging a Covid-19 suspected pregnant mothers. Also findings such as lack of tracking system for follow up on mothers who missed appointments due to fear of contracting COVID -19; and essential drug stock out&nbsp; was noted during the pandemic. Monitoring and evaluation system was in place but irregular and not in tandem with prompt feedback that was required. On the other hand, the &nbsp;study results also revealed one positive aspect of ANC/PNC &nbsp;mothers having knowledge on the importance of maternal services despite fears for COVID – 19 ,&nbsp; facility delivery, signs and symptoms of COVID -19 infections and preventive measures. However, the end users expressed myths on the transmission of the virus and the testing process.&nbsp;</p> <p><strong>Conclusion:</strong> the research revealed lack of epidemic preparedness at Kanyama 1st level hospital that would allow the continuation of maternal and child health services amidst the COVID-19 outbreak.&nbsp; The facility had needed a timely and comprehensive health system response to the epidemic that is elaborate and specific to respond to all specifics of the health system in relation to maternal services verses COVID -19 which would have been the answer to this call.</p> Tandwa Syakayuwa Regina Chansa Copyright (c) 2022 Tandwa Syakayuwa, Regina Chansa 2022-05-12 2022-05-12 9 3 1 58 10.14738/jbemi.93.12263 Advent Of Omicron: An Attempt to Decode the Third Wave Covid Variant <p>Currently, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has spread worldwide as an Omicron (B.1.1.529) variant, after alpha, beta, gamma, Delta. World Health Organization (WHO) has identified the Omicron variant as a variant of concern due to its heavily mutated nature. Phylogenetically, this variant with more than 50 mutations is very different from other variants. With an average doubling time of two days, the Omicron variant spreads rapidly. However, it has been milder than the Delta. Although previous infection and vaccination do not protect against infection with Omicron, they do appear to protect against hospitalization and severe disease. It is likely that Omicron will have enormous indirect effects, such as lockdowns, restrictions, travel bans, economic losses, infections of healthcare workers, and an overwhelming of healthcare facilities. However, as with previous variants, Omicron's direct effects are expected to be mild. Nevertheless, the indirect effects on mental, physical, and social health may be considerable. It is recommended to for all the people to follow the COVID-19 behaviours. In this review, we focused on the emergence, severity, genomics, effectiveness of vaccines, and treatment and management strategy against the Omicron variant, which will be helpful for further investigation of a new variant of SARS‐CoV‐2.</p> Dr Farah Iram Aditi Vats Dr. Anisha Raju Dr. Betina Chandolia Mohini Gahlot Dr. Niveditha Hariharan Dr. Saurav Deka Copyright (c) 2022 Dr Farah Iram, Aditi Vats, Dr. Anisha Raju, Dr. Betina Chandolia, Mohini Gahlot, Dr. Niveditha Hariharan, Dr. Saurav Deka 2022-05-12 2022-05-12 9 3 59 74 10.14738/jbemi.93.12213 Witch Doctors: Versus NHS <p>.</p> Wendy Thomson Copyright (c) 2022 Wendy Thomson 2022-05-17 2022-05-17 9 3 75 79 10.14738/jbemi.93.12324 Effect of Modified Male Infertox Treatment Plan in the Management of Oligoasthenozoospermia (Shukradushti) – Case Reports <p>As per WHO a man is diagnosed with asthenozoospermia when there are less than 32% progressive motile sperm in the ejaculate and when sperm concentration is less than 15 million per milliliter of seminal sample is called oligozoospermia. This can lead to infertility in male as the path of the sperm must travel to fertilize the egg is too long and due to low motility and low count. Ayurveda describes seven dhatus, out of which <em>Shukradhatu</em> (reproductive tissue) included not only testicular tissue and ovarian tissue but also the stem cells present throughout the body.&nbsp; In Ayurveda <em>Shukradhatu</em> refers to testicular tissue and any abnormality in this can cause <em>Beejdushti</em>. As per Ayurvedic pharmacology the herbs are classified into two special groups <em>Rasayana</em> and <em>Vajikarana</em>, which aid the nourishment and stimulate the sexual tissues. Also there are few herbs classified into <em>Shukrala</em> which increase the spermatogenesis process. As per Acharya Kashyapa due to <em>Virechana</em> procedure sperms become active and motile and increases in number. In this present study the efficacy of <em>Virechana</em> (Detoxification) and Ayushakti Ayurveda made herbal remedies was assessed in the management of <em>Shukrabeejdushti</em> (Oligoasthenozoospermia).</p> Smita Naram Deepak Mahajan Hemang Parekh Copyright (c) 2022 Smita Naram, Deepak Mahajan, Hemang Parekh 2022-05-24 2022-05-24 9 3 80 86 10.14738/jbemi.93.12356 Assessment of Partograph Utilization and its Association with Pregnancy Outcomes in Uganda. A Case of Kamwenge District <p>High maternal mortality rates remain a pressing public health problem in both developed and developing countries. In Kamwenge district 120 mothers die per 100,000 live births. The use of partograph to monitor labor markedly reduces maternal and newborn deaths through early detection and management of complications. However, the level of utilization of partographs to monitor labor as well as quality and, the association between maternal and newborn outcomes with quality of partograph in Kamwenge district has never been assessed. This study assessed the level of utilization and quality of partographs in monitoring labour against pregnancy outcomes.</p> <p><em>The level of partograph use was found to be high for all health facilities. The quality of partographs was however found to be low. This study found no statistically significant association between the quality of partographs and maternal and fetal outcomes. </em></p> <p><em>The study concludes that health workers do not monitor certain aspects of labour using partograph and most importantly decision action are taken after crossing the action line. This may have severe implications to maternal and fetal health. To increase the use and improve the quality of partographs in monitoring labour, peer-led onsite mentorships, coaching, supervision, staff technical competence and logistics are necessary. </em></p> Bahizi Archbald Copyright (c) 2022 Bahizi Archbald 2022-06-09 2022-06-09 9 3 87 106 10.14738/jbemi.93.11837 Validity for General Type Model Based on Fujimmon Growth Curve <p>Fujimmon's growth curve was proposed by Fujii[1], but unlike Scammon's growth curve, three growth patterns were set. Moreover, Scammon's growth curve was drawn freehand, but Fujimmon's growth curve is drawn by a wavelet interpolation model. The growth curve for each type is clearly independent, but no essential classification criteria were discussed. Here an attempt is made to examine indicators that could be classification criteria for the general growth type, from the fact that among human attributes many internal organs are classified as having the general growth pattern. The wavelet interpolation model was applied to the growth distance values for attributes classified as the general growth pattern, for example internal organs and morphological elements, and the maximum peak velocity (MPV) was derived from the described growth velocity curve. With the ability to calculate the MPV, it was demonstrated that the growth distance curves of various attributes show a sigmoid curve. The age at MPV was then compared between several organs that showed sigmoid curves, and the variability between different sexes and in the same sex was investigated. The results for differences between the sexes showed a trend for later age at MPV in various organs in girls. A relationship between the level of maturity and the variability in the age at MPV in people of the same sex may be suggested.</p> Katsunori Fujii Copyright (c) 2022 Katsunori Fujii 2022-05-27 2022-05-27 9 3 107 115 10.14738/jbemi.93.12340 Is There an “Inspiration” of Qol in the Field of Clinical Psychology and Psychiatry? <p>.</p> Paxinos Ioannis Copyright (c) 2022 Paxinos Ioannis 2022-06-10 2022-06-10 9 3 116 119 10.14738/jbemi.93.12415 Effects of Ventilator-Associated Pneumonia Among Saudian’s Critically Ill Patients, Systemic Review <p><strong>Introduction</strong>: Mechanically ventilated patients are vulnerable to infectious diseases, such as ventilator-associated pneumonia (VAP), due to the breach of normal defence mechanisms and relative immune paralysis during ventilation. This study aimed to determine the risk factors for developing VAP among ventilated patients, as well as the incidence and effects of VAP in Saudi Arabia.</p> <p><strong>Methods</strong>: A systematic review design was used. The included studies were published after 2015 in the English language and relevant to the topic of concern.</p> <p><strong>Results</strong>: Eleven articles were selected for inclusion in the study. The incidence of VAP in Saudi Arabia was low during the study period. Risk factors for developing VAP included a lack of adequate nurse training, a failure to closely supervise ventilated patients, chest and rib injuries, reintubation, the supine position, and old age. VAP led to increased rates of sepsis, multi-drug-resistant infections, mortality, and longer ICU and hospital stays, as well as developing complications</p> <p><strong>Conclusion</strong>: The use of the VAP prevention and treatment bundle and other strategies reduced the risk of ventilated patients developing VAP.</p> Ebtisam Hanshool Mauof Al-Gethami Copyright (c) 2022 Faiza Ahmed Abdalla Elnour 2022-06-12 2022-06-12 9 3 120 133 10.14738/jbemi.93.12434 Formation of Bezoar in an Elderly Patient with Alzheimer’s Disease: Bezoar in a Patient with Alzheimer <p>Bezoar is characterized as a mass that derives from a non-digestible foreign material and that accumulates in the gastrointestinal tract, usually in the stomach. This phenomenon usually occurs in people with some type of comorbidity or that have certain predisposing factors, such as gastrointestinal motility disorders or some psychiatric illness. There are different types of ingested materials that favor the formation of the bezoar and among the known materials we highlight the mattress foam, that generates an occupational bezoar. We report an unusual case of upper gastrointestinal bleeding due to gastric ulcers, resulting from an occupational bezoar in an elderly patient with Alzheimer's disease, which was only discovered due to the symptoms of frequent vomiting and subsequently due to hematemesis and melena, due to gastric ulcers formed. The prevention of these incidents is a safe practice that must be performed by all professionals who deal with the elderly people with some type of vulnerability, especially those who has Alzheimer's disease.</p> G. R. Casandra Copyright (c) 2022 G. R. Casandra 2022-06-12 2022-06-12 9 3 134 139 10.14738/jbemi.93.12425 The Future of L-Arginine Dietary Supplementation Research - The Impact on NOS Dependent and Independent Systems <p><strong>Introduction: </strong>The consumption of L-arginine is of particular concern, due to the importance of dietary supplements in people’s daily life, continually increasing. Also, the counter position is the impact of adulterants, contaminants and undeclared constituents in L-arginine products, and consequently to health/wellness.</p> <p><strong>Aim: </strong>To contextualize and provide new perspectives for L-arginine dietary supplement research, that would have an impact on the consumers, and patients, health/wellness.</p> <p><strong>Method: </strong>The approach was to do a literature search in multiple online electronic academic open-source scientific databases. These covered, PubMed, Scopus, Google Scholar, Elsevier, Taylor &amp; Francis, Sabinet, ScienceDirect,, and The Cochrane Collaboration. The search terms covered&nbsp; L-arginine, and the specific research related interest.</p> <p><strong>Outcome: </strong>The role of L-arginine in inhibition and control of disease is essentially via the dependent or independent NO metabolic pathways. In L-arginine deficiency, the selective delivery is exogenously taking the amino acid. That there is an impact of dietary arginine containing supplements consumption (or in combination) on human performance (exercise), including effects on cognitive flexibility, and/or mental ability. That L-arginine supplementation is indicated for stress reduction, anxiety, and adaptogenic capabilities in the healthy. However, L-arginine is not lacking, in side effects, including drug-interactions when taken in combination. Gastrointestinal disturbances being the most common adverse effects.</p> <p><strong>Conclusion: </strong>Of prominence is the potential benefit, pure L-arginine holds for the consumer. It is recommended that further scientific research scrutiny is warranted. This will provide awareness for an improved specific national regulatory framework, globally, but also set the tone for future research studies.</p> Gary Gabriels Copyright (c) 2022 Gary Gabriels 2022-06-12 2022-06-12 9 3 140 151 10.14738/jbemi.93.12237 A Scoping Review of Bacterial Vaginosis – A Silent but Potential Threat to Pregnancies and Gynecological Surgeries and Procedures <p>Bacterial vaginosis (BV) is a common vaginal disorder in women of the reproductive age group that causes offensive vaginal discharge. BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardnerella vaginalis. The prevalence is about 15-30% of women of reproductive age group. The reported risk factors include a high number of lifetime sexual partners, engagement in sexual intercourse at a younger age, practicing regular douching, and smoking. When BV occurs in pregnancy, there is an increased risk of preterm delivery and its associated complications. For decades, metronidazole has been the drug of choice for the treatment of BV, however, the rate of recurrence is as high as 50%. Therefore, prevention through lifestyle modifications will help to reduce the prevalence of BV.</p> Idowu Ade-Ojo Esther Abolarin Abimbola Okiki Oso Olufunke Copyright (c) 2022 Idowu Ade-Ojo, Esther Abolarin, Abimbola Okiki, Oso Olufunke 2022-06-12 2022-06-12 9 3 152 164 10.14738/jbemi.93.12421 Quality of Life, Lifestyle Behaviors, and Well-Being in Patients With Cancer: The Impact of Demographic Variables <p><strong>Background</strong>: Cancer can challenge all aspects of a person’s quality of life (QoL) and well-being, including physical, psychological, social and spiritual. QoL has long been a central question in cancer research.&nbsp; Optimal QoL has become a goal in health care. It can be argued that the improvement of QoL should be a primary goal of cancer care. Lifestyle factors have been repeatedly identified as cancer risk factors.&nbsp; Unhealthy lifestyle behaviors are associated with serious illnesses such as cancer. How lifestyle behaviors affect the cancer control continuum have not been well-studied.</p> <p><strong>Objective</strong>: This study evaluates the relation between lifestyle behaviors, perceived quality of life, well-being and tries to expand knowledge regarding the correlation between them.</p> <p><strong>Methodology</strong>: 105 oncology outpatients who have been submitted in pain therapy in the Pain Unit of an Ongological Hospital in Greece in 2021, were administrated the World Health Organization OoL instrument (WHOQOL-BREF) the WHO (10 items) Well-Being Index&nbsp; and an improvised questionnaire with Lifestyle indices. The present study is a cross-sectional, descriptive, correlational research design.</p> <p><strong>Results</strong>: This study suggests that <strong>male </strong>patients’ well-being scores were significantly higher. The patients also reported higher scores in the psychological and environmental domain of QoL but they scored significantly lower in the dimensions of physical health, smoking and alcohol use of <strong>Lifestyle</strong>. <strong>Older</strong> cancer patients reported lower levels on the well-being&nbsp; and also lower scores on the QoL in the physical, psychological and social relationships domains. They also reported less on <strong>the lifestyle variables,</strong> particularly on physical health(p=&gt;.05),food consumption(p=&gt;.05), observing weight control (p=.04)and exercise and well-being(p=0.02). <strong>More educated </strong>patients reported significantly higher scores in the psychological and environment domains of QoL and presented a significantly higher scores in physical health, smoking and alcohol use of lifestyle indices indicating more healthy lifestyle patterns.</p> <p><strong>Conclusions</strong>: Findings provide evidence that demographic variables such as being male, younger more educated relate to a more preserved <strong>QoL.</strong> Regarding <strong>lifestyle </strong>patterns being female, younger and more educated relate to a more healthy behaviors.</p> Paxinos Ioannis Ammari Michel Copyright (c) 2022 Paxinos Ioannis, Ammari Michel 2022-06-17 2022-06-17 9 3 165 180 10.14738/jbemi.93.12414 Assessment of Attitudes and Barriers of Ghanaian Radiographers Towards Postgraduate Radiography Education <p><strong>Introduction: </strong>There has been a great evolution since X-ray was discovered. The profession has expanded with advance medical imaging techniques such as computed Tomography (CT), Magnetic resonance imaging (MRI) and a host of them. The need therefore for radiographers to upgrade their knowledge and skills cannot be over emphasized. It is therefore imperative to assess the barriers that make most Ghanaian radiographers miss out opportunities for postgraduate radiography education in Ghana.</p> <p><strong>Methods: </strong>This was a mixed method study (qualitative and quantitative). Questionnaires with close and open-ended questions were employed as the data collection technique and Purposive sampling technique was used in the questionnaire administration.</p> <p><strong>Results:</strong> It was identified that 86.4% of the total respondents being aware of postgraduate radiography education opportunities in Ghana. 88% were willing to enroll in postgraduate radiography education and 76% willing to self- fund their postgraduate education. 170 responses were received from the questionnaire for this study giving a response rate of 70%. Seventy seven percent of respondents were males whiles 23% were females.</p> <p><strong>Conclusion:</strong> The study has shown that Ghanaian radiographers have a positive attitude towards postgraduate radiography education and have enthusiasm to self-sponsorship. However, factors such as high cost of postgraduate education, lack of funding, aging and increase responsibility of radiographers’ content against radiographers’ postgraduate education.</p> Evan Ohemeng Ba-Etilayoo Atinga Twum Barima Lina Nyarko Antwi Copyright (c) 2022 Evan Ohemeng, Ba-Etilayoo Atinga, Twum Barima, Lina Nyarko Antwi 2022-06-17 2022-06-17 9 3 181 197 10.14738/jbemi.93.12111