Background: In developing countries most women deliver at home for some reasons and such deliveries are not attended by a skilled birth attendant. In Nigeria 63% of births occurred at home.
Objective: To determine the reasons and experiences of home and hospital deliveries among women in Kano, Nigeria.Methods: The study was a comparative cross-sectional study. The study employed a mixed method study. A total of 614 women were selected by multistage sampling technique and enrolled for the study. Focus group discussions with a group of women and husbands as well as key informant interviews with health care workers were conducted in the communities. Quantitative data was analysed using Minitab V17 software. Thematic content analysis was performed for the qualitative data. Data was gathered and analysed using triangulation methods. Results: The questionnaires response rate was of 96.7%. The mean age of respondents was 32.6 ± 6.5 years for home delivery group, and 28.1 ± 5.6 years for the hospital delivery group. Reasons for home deliveries were custom (24.5%), unfriendly attitude of health workers (17.5%), financial barriers (15.5%), and safety was the main reason for hospital delivery (56.7%). Determinants of choice of place of delivery were lower age at first pregnancy AOR=4.06 95%CI (1.633-10.076) and higher education AOR=2.70 95%CI (1.927-3.792) respectively. Conclusion: Mothers have different reasons and experiences with regard to choice of delivery location. Hospital deliveries should be encouraged

Background: Caesarean section is today one of the commonest surgical operations performed on women. The increased refinement in anaesthetics and surgical skills has reduced the morbidity and mortality associated with the procedures. Most of the studies on caesarean rates in Nigeria are from tertiary centres in the main cities. They may not reflect the situation in secondary facilities in rural and sub-urban areas which do not have the adequate number of staff, equipment and logistic support. Objectives: To determine the rates of caesarean section, indications and outcome in the general hospital located in Dutse, Jigawa, North-Western Nigeria. Methods: It was a retrospective review of records of women that had caesarean delivery between January 2013 and December 2015. Socio-demographic and obstetric information were extracted and analysed using SPSS statistical software. Analysis of the data was done using descriptive statistics. Ethical approval was obtained from the state ministry of health research ethics committee. Results: There were a total of 9,362 deliveries of which 543 were caesarean births giving a caesarean section rate of 5.8%. Majority of the procedures were emergency (90%). More than half of the women had prolonged obstructed labour as the indication. Mean age (±SD) of the women was 25.5 ±7.21 years. There were 69 stillbirths and 4 maternal deaths. The main complication was wound breakdown seen among 9.8% of patients. Conclusion: The rate of caesarean section was lower compared to other secondary and tertiary facilities in Nigeria. Nine out of every 10 caesarean sections were emergency and were associated with high perinatal and maternal morbidity

Background: Contraceptive prevalence rate (CPR) is generally very low in Nigeria, but particularly lowest in northern Nigeria. Barriers to access and utilization have been variously studied, but there is need to consider specific contexts. Objective: The aim of this study is to determine the level of awareness, acceptability, and barriers to the utilization of modern methods of family planning in Bayero University, Kano, North-west, Nigeria. Methodology: This was a cross-sectional study conducted at the antenatal section of BUK staff clinic, among 152 pregnant women between May and October 2013. Ethical approval and informed consent were obtained. Descriptive statistics was used to report categorical variables. Results: Awareness of modern methods of contraception was high (86.18%) and the majority (86.19%) knew at least one method of family planning. The commonest methods known by the respondents were: Oral contraceptive pills (39.47%), injectables (22.37%) and condom (14.47%). Out of the152 respondents, 77(50.66%) accepted the use of modern methods of family planning and 39(25.65%) out of these number had ever used at least one method, while 38(25.00%) did not. Fear of side effects (42.11%), desire for more children (15.79%), and lack of awareness (13.82%), religious prohibition (10.53%) and opposition by male partners (7.89%) constituted the major barriers to the utilization of modern methods of family planning. Conclusion: The level of awareness was found to be high but acceptability and utilization were low, this is due to the existing barriers to utilization of modern methods of family planning. Effort should be made to allay the fear of side effects and to educate women on the implication of frequent childbirth

Background: Tetanus is a vaccine-preventable disease but its incidence has remained unacceptably high in developing countries. Objective: To determine the prevalence, risk factors and outcome of post-neonatal tetanus at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Methods: A retrospective descriptive study from 1st January 2010 to 31st December 2015. Children aged 1 month to 15 years diagnosed with post-neonatal tetanus were studied. Information from the admission files was extracted. Data was analysed using SPSS version 20. Results: Total admissions during the study period were 14,458; 61 had post-neonatal tetanus, giving a prevalence of 0.4%. The M: F ratio was 1.5:1. The mean age was 7.4±3.2 years. Fifty-nine (96.7%) were not immunised against tetanus. Portal of entry for the organism was trauma injuries to the foot in 33(54.1%). Thirty-one (50.8%) were discharged, 5(8.2%) DAMA, while 25(41.0%) died, and case fatality was 41.0%. Conclusion: Post-neonatal tetanus is a major cause of morbidity and mortality in Sokoto. There is need for improved health education, sustainability of immunisation programmes and coverage to eradicate this scourge

Background: Neonatal Jaundice (NNJ) is a common occurrence in about 60% of term infants and 80% of preterm infants worldwide and a leading cause of hospitalization during the first week of life. Available evidence suggests that low- and middle-income countries (LMICs) bear the greatest burden of severe neonatal jaundice characterized by very high rates of morbidity, mortality and long-term sequel compared to high-income countries (HICs). Aims: To document the prevalence, risk factors and short-term outcome of babies with neonatal jaundice in a secondary health facility with free health services in South-West Nigeria. Method: Babies were recruited from both in-born and out-born arms of the Special Care Baby Unit (SCBU). It was a prospective study of all babies admitted for neonatal jaundice from January to December 2014; the babies were followed up till discharge. Patients’ information including socio-demographic characteristics, risk factors, treatment modalities and outcomes were collected and entered directly into an Excel sheet. Results: There were a total of 1,309 admissions: 734 males and 575 females giving a M: F ratio of 1.3:1. NNJ was present in 125 (9.5%) of them. Thirty-five (28%) of the affected babies were preterm babies while 90 (72%) were term babies. Ten (8%) of them presented within the first 24 hours of life, 103 babies (82.4%) presented between 1st and 7th day of life while 12 (9.6%) presented after the 7th day of life. Neonatal sepsis, prematurity, perinatal asphyxia and prolonged rupture of membrane (PROM) were the leading causes and risk factors for NNJ in our setting. One hundred and seven (85.6%) of them had only phototherapy as treatment modality while 18 (14.4%) had exchange blood transfusion (EBT). One hundred and twenty babies (96%) were discharged alive, 5 (4%) had bilirubin encephalopathy and 2 babies (1.6%) died. Conclusion: Neonatal Jaundice is common in our setting with possible dire consequences. Health education of the public on its associated modifiable risk factors is desirable

Background: Chronic kidney disease in the absence of traditional CKD risk factors has been found to contribute to the burden of kidney disease in communities all over the world. This hospital-based study is aimed at determining the prevalence of CKDu among CKD patients admitted into the renal unit of Federal Medical Centre, Nguru. Methods: Patients consisted of adults sequentially admitted into the renal unit of the medical ward of Federal Medical Centre Nguru. Clinical parameters such as age, sex, presence of risk factors for kidney disease were obtained from each patient. Laboratory parameters such as PCV, electrolytes, urea and creatinine, phosphate, calcium were also obtained. Glomerular filtration rate was calculated using the modification of diet in renal disease (MDRD) formula. Results: Two hundred and seventy-eight patients were admitted during the study period. Their ages ranged from 18 to 75 years with a mean±SD of 44.64±16.09 years. There were 138 (49.5%) males and 140 (50.5%) females; male:female ratio 1:1.02. Out of the study population, 83.6% were married. Mean blood pressures were 120.00±14.14 mmHg and 75.25±9.91 mmHg for systolic and diastolic respectively. Mean PCV was 20.25±7.05%, urea and creatinine were 27.46±8.95mmol/l and 1243.25±651.46µmol/l. Mean GFR was 7.44±9.80 ml/minute/1.73m2 with 90.3% of patients presenting in stage 5. The prevalence of CKDu amongst them was 20.5%. Conclusion: This study showed that the prevalence of CKDu is high in Northern districts of Yobe State, North Eastern Nigeria. Further studies will be required to define environmental or cultural factors that contribute to the high prevalence in this region

Background: To determine the prevalence of respiratory symptoms and lung function status of the firefighters in Benin City, Nigeria. Methods: A descriptive cross-sectional study carried out among firefighters in Benin City, Nigeria. Data was collected using relevant section of the Burden of Obstructive Lung Disease Initiative (BOLD) questionnaire. The lung function parameters were measured using the Koko Legend® spirometer. Data was analyzed using IBM SPSS Statistics version 20. Results: A total of 59 firefighters were studied. Their mean age (SD) was 42.1 (11.6) years. Males constituted 69.5%. The commonest respiratory symptoms were nasal congestion 11.9%, chest pain 10.2%, dyspnoea 8.5%, cough 6.8%, shortness of breath 5.1%, wheezing 3.4% and sputum production 3.4%. The mean FEV1 (2.69 ± 0.98L vs 2.15 ± 0.74L), FVC (3.29 ± 1.15L vs 2.54 ± 0.90L) and PEF (7.84 ± 3.30L/s vs 6.19 ± 2.07L/s) values were significantly higher among firefighters actively involved in firefighting than those in the administrative department (p = 0.024, 0.010 and 0.038 respectively). The FEV1/FVC ratio of the active firefighters was lower, 81.8% ± 8.0 vs 84.1% ± 7.4 (p = 0.262). Firefighters in the administrative department were four and five times more likely to have lower predicted FEV1 (Adjusted OR = 4.02, 95% CI = 0.87, 18.57) and FVC (Adjusted OR = 5.16, 95% CI = 1.11, 23.89) respectively than those in the operations department. Conclusion: The prevalence of respiratory symptoms was generally low in the firefighters studied. Most of those in operations showed obstructive abnormality while a higher proportion of those in administrative department showed restrictive abnormality. We recommend yearly lung function testing on all firefighters and long-term medical monitoring

Background: Hypertension as a global public health challenge is a major risk factor for cardiovascular (CVD) and coronary heart diseases (CHD) because of its chronic sequelae. It is accompanied by dyslipidemia and oxidative stress leading to increase in lipid peroxidation. This study aimed to measure the fasting serum lipid profile and malondialdehyde (MDA) and determine the atherogenic index as well as the cardiovascular risk ratio among hypertensive patients in Kano, Nigeria. Patients and Methods: Two hundred subjects (100 hypertensive patients vs. 100 normotensive controls) were recruited for the study. The fasting serum lipid profile and MDA were assayed using routine laboratory methods. Lipid ratios that predict and identify an individual’s increased risk for cardiovascular diseases were then determined from the results of the profile. Results: The serum total cholesterol (7.0±0.5 vs 4.1±0.4 mmol/L), triglycerides (2.9±0.2 vs 2.0±0.3 mmol/Lg/dl), LDL cholesterol (3.8±0.4 vs 2.6±0.4 mmol/L), VLDL cholesterol (3.0±0.2 vs 2.1±0.2 mmol/L) and MDA (TBARS) (9×10-5±1.4×10-5 vs 3×106±0.9×10-6 mol/l) were significantly (p<0.05) increase in hypertensive patients compared to normotensive controls. HDL cholesterol was significantly higher (p<0.05) in normotensive controls compared to hypertensive patients (31.4±8 vs 23.9±6 mg/dl). A statistically significant (p<0.05) positive correlation was observed between LDL cholesterol and MDA only. Both the atherogenic index (AI) ratio and the CardioRisk ratio were significantly higher in Hypertensives than Normal controls (10.4 vs 4.1; 11.7 vs 5.1 respectively). Conclusion: This study demonstrated an increased occurrence of atherogenic lipid profile and oxidative stress among hypertensive patients. It further showed a strong correlation between dyslipidaemia and oxidative stress. Therapeutic lifestyle changes and use of statins should be considered an integral part of the treatment for hypertensive patients in Nigeria

Background: Kidney dimensions, including volume, of a patient is a valuable diagnostic parameter in nephrology and urologic practice and vary with age, gender, body mass index, pregnancy and co-morbid conditions. Congenital and some important morbid conditions affect renal dimensions and some of these pathologic conditions have close relationship with BMI. Aim and Objectives: To determine the normal ultrasound volume in healthy adults and to correlate it with the Body Mass Index (BMI). Materials and Methods: This was a descriptive cross-sectional study in which kidney dimensions were acquired and from which the volumes were determined using the ellipsoid formula. The anthropometric variables of the patients were documented, and the BMI calculated. Variations of the renal volume with sex and age, and the relationship of the renal volumes with BMI were determined. Results: A total number of 400 adult subjects were recruited for the study, with a M:F ratio of 3:1. The mean age was 39±13.2 years. The mean BMI was 22.95±3.20kg/m2. The mean renal volumes were 140.0±30.5cm3 and 149.5±34.6cm3 on the right and left sides respectively. There was a positive correlation between the BMI and right renal volume (p<0.01; r= 0.188) and BMI with left renal volume (p<0.01; r= 0.218). There was also positive correlation between the right and left renal volumes and age (P<0.01) and gender (P<0.01; P<0.05). Conclusion: Positive correlations were noted between the renal volumes and body mass index, age, sex and sides

Background: Osteoarthritis (OA) is a leading cause of disability and reduced quality of life. The disability associated with OA depends on the cultural and socioeconomic context. Therefore, the role of family in the management of OA cannot be over emphasized. Objective: To determine the levels of family functioning and the predictors of poor family functioning amongst patients with knee OA. Method: A multicentre cross-sectional study involving 250 adults satisfying the American College of Rheumatology (ACR) clinical criteria for Knee OA were recruited over a period of 3 months after approval by the Ethical Review Committee of each of the study centres. Interviewer-administered questionnaire was used to obtained relevant demographic and clinical information. Family functioning was assessed using Family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve) questionnaire. Other variables assessed were pain, functional class, Sleep Quality, depression and radiographs. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21. Binary logistic regression was used to determine predictors of family functioning. A P value < 0.05 was considered significant. Results: The mean age was 59.9±10.62 and 209 (83.6%) were females. One hundred and ninety-nine (79.6%) reported a highly functional family, 40 (16.0%) and 11 (4.4%) had moderate and severely dysfunctional family respectively. APGAR scores were significantly associated with ethnicity (p=0.007) and functional class (p=0.020) and depression (p=0.013) and was best predicted by ethnicity (p=0.018, OR-1.360, CI [1.054 – 1.754]. Conclusion: Patients with knee OA seen in this study have a good level of family support. Ethnicity was the best predictor of dysfunctional family

Background: Musculoskeletal pain is one of the factors that limit movements at a joint and impede functional use of the limb as well as rehabilitation activities after stroke. Objective: This study determined the prevalence, pattern and distribution of musculoskeletal pain among stroke survivors receiving physiotherapy care in Maiduguri. Methods: A cross-sectional study design was used to recruit 94 stroke survivors from the physiotherapy clinics of two randomly selected tertiary hospitals in Maiduguri. In addition to sociodemographic and clinical characteristic information, musculoskeletal pain was assessed with the Box-Numerical Rating Scale. Prevalence, pattern and distribution of musculoskeletal pain were computed with frequency and percentages. Chi-square test was employed to compare the difference in the prevalence of musculoskeletal pain among participants with various socio-demographic and clinical characteristics. Results: The mean age, post-stroke duration and duration of physiotherapy intervention of the participants were 54.2±12.5 years, 18.27±23.98 months and 13.04±15.09 months, respectively. Majority of the participants experienced musculoskeletal pain within the first 3 months after stroke. The most commonly affected body region was the shoulder (80.7%) followed by the wrists/hand (60.2%) and the least affected body region was the elbow (38.5%). The overall prevalence of musculoskeletal pain was 88%. The prevalence was significantly (χ2 =4.5, p-value=0.034) higher among males (57.8%) than females (42.2%). Conclusion: The study found high prevalence of musculoskeletal pain among stroke patients with males more commonly affected than females, and the shoulder being the most commonly affected joint. Assessing musculoskeletal pain and effective interventions for improving pain should constitute an integral part of a stroke rehabilitation plan

Background: Mangled Extremity Severity Score (MESS) and Predictive Salvage Index (PSI) are two common diagnostic tools used to assess traumatic limb for amputation or salvage. However, there is paucity of local data with regards to accuracy of the tools. Objective: This study is therefore aimed at comparing the accuracy and predictive value of MESS and PSI in lower limb salvage and amputation following trauma in National Orthopaedic Hospital Dala (NOHD), Kano. Methodology: Twenty-three individuals with mangled extremity participated in this hospital-based one-year prospective, interventional study. Socio-demographic data of participants were collected and recorded as well as the severity of the injury at the time of initial presentation using both MESS and PSI by the researcher while the Consulting surgeons went ahead to make their decision as per their clinical routine without any influence from the researcher. Results: Findings of the study showed that MESS has a high sensitivity score of 89% and a low to medium specificity score of 43.8% with a positive predictive value (PPV) of 47.1% while PSI had a high specificity with low to medium sensitivity scores of 81.25% and 55% respectively with a PPV of 62.50%. Conclusion: The result of this study showed that MESS had high sensitivity and low specificity than PSI which had higher specificity and lower sensitivity than MESS in predicting amputation and limb salvage in patients with mangled lower extremity injuries. It is, therefore, recommended that surgeons should use both tools in decision making of limb salvage and amputation for optimal outcomes

Background: Thisstudy was carried out to determine the effects of sildenafil citrate on morphology of the testes and spermatogenesis during wound healing process in diabetic rats. Eighteen adult male Wistar rats randomly divided into two groups (A and B) of 9 rats per group were treated orally with sildenafil citrate at a dose of 50 mg/kg for 21 days and or/single dose of intraperitoneal injection of insulin (10 IU). Before treatment, type 1 diabetes mellitus was induced in group A by a single intraperitoneal injection of alloxan (130 mg/kg) and a square-shaped wound measuring 1.5 cm2 was created under anesthesia with ketamine at the dose rate of 50 mg/kg intraperitoneal injection on the dorsum of rats in all groups with the exception of 3 rats in group B. From each of the two groups (A and B), 9 rats were humanely sacrificed for histology and sperm count. This was done after the administration of the sildenafil citrate on day 21. The results of the study showed significant (p<0.05) decrease in testicular and epididymal sperm head counts. Sections of the testes showed severe vacuolar degeneration of germinal epithelial cells in the seminiferous tubules in diabetic rats during the 21 days of treatment with sildenafil citrate. This indicates that sildenafil citrate may not have any protective effect against testicular injury due to wound healing process in diabetic rats

Background: Hypertension is an important public health problem globally with an increasing prevalence, severity and attendant complications on the heart and other internal organs. It was described as a silent killer due to its insidious onset and no obvious symptoms. Electrocardiogram (ECG) is a basic tool that can help determine some of the changes induced on the heart by systemic hypertension especially when it’s not diagnosed early. Objectives: To determine the pattern of ECG change in newly diagnosed hypertensives (HTN) at Federal Teaching Hospital, Gombe. Methods: The ECG results of 1015 newly diagnosed HTN patients referred for electrocardiographic study between Jan 2012 and Dec 2016 were retrieved and reviewed. All the patients had their basic anthropometric parameters, systolic and diastolic blood pressure (BP) recorded. Descriptive statistics was used in analyzing the different ECG findings. Results: The mean age of patients was 49.3±14.8 years. The mean BMI was 28.9±6.5 kg/m. The mean systolic and diastolic BP were 154.7±22.0 mmHg and 93.7±12.5 mmHg respectively. The mean ECG’s Heart Rate (HR), PR interval and QTc interval were; 85.9±16.8ms, 154.1± 23.9ms, and 433.5±32.5ms respectively. The commonest ECG abnormality was left ventricular hypertrophy (LVH) seen in 315(31.0%) of the patients. Some other abnormal ECG findings include; LAD (19.9%), LAE (18.7%), ST-T wave changes (14.1%), SB (1.8%), BBB (1.5%), AF (0.5%). Only 284(29%) of the patients had normal ECG. Conclusion: Most of the newly diagnosed hypertensives have already developed one or more cardiac related complications at the time of diagnosis. This further emphasizes the need for public enlightenment on regular BP check for early diagnosis and management of HTN.

Background: The trio; hypertension, obesity and type-2 diabetes mellitus (T2DM) share similar risk factors and frequently co-exist. This hospital-based case-control study investigated the relationship between high blood pressure, body mass index and plasma glucose concentration among persons attending Nigeria National hospital, Abuja. Materials and methods: After ethical approval, 45 case subjects (known T2DM) and 45 controls (non-diabetics) within the age range of 25-60 years were enrolled and their body mass index and blood pressure (BP) measured. Furthermore, the case group were subdivided into 15 Diabetic patients ≤ 5 years on treatment (group 1), 15 Diabetic patients with cardiovascular disease (group 2), 15 Diabetic patients with nephropathy (group 3) and the control group subdivided into 15 apparently healthy subjects (control 1), 15 Non-diabetic patients with cardiovascular disease (control 2), and 15 Non-diabetic patients with nephropathy (control 3). Results: Seventy-five (83.3 %) of both the subject and control had no family history of diabetes while only 15 (16.7 %) were reported to have family history of diabetes. There was significant association between family history of diabetes with the presence of T2DM among participants (p = 0.001). Forty-one (45.5 %) of the subjects had normal BMI as against 49 (54.4 %) that were obese. Forty-four (48.8 %) of all groups were normotensive while 46 (51.1%) had high blood pressure (> 140/100 mmHg). Similarly, 41 (45.5 %) of the subjects had normal BMI as against 49 (54.4 %). There was significant difference in the proportions of overweight among the different study groups (p =0.007). High BMI occurred mostly in diabetic subjects with nephropathy. The diabetic subjects with nephropathy and apparently health non-diabetic subjects had the most cases of high BP. There is significant difference in blood pressure among the study groups (p=0.002). Conclusion: Findings from this study revealed that obesity and a family history of diabetes are important risk factors for T2DM. Hence, early BP management and body weight regulation are needed to prevent DM and its complications

Background: For the past decades there has been an increase in type 2 diabetes mellitus worldwide including this environment, subsequently, baseline data is needed particularly in environment dependent on transferred reference values to access the level of fasting blood glucose. Objectives: This study was conducted to evaluate fasting blood glucose in apparently healthy adults in Maiduguri, Nigeria. Methodology: This is a cross-sectional study involving 308 participants: 258 apparently healthy non-pregnant adults, comprised of 162 males and 96 females and 50 pregnant women. A structured questionnaire was administered to those that consented and the subjects did overnight fast (between 10 and 12hours) before blood sampling. Blood glucose was measured using standard methods. Mean values of fasting blood glucose and body mass index were presented as mean ± standard deviation. Results: There was no significant difference in the fasting blood glucose of male (4.38±0.67 mmol/L) and female (4.38±0.60 mmol/L) subjects, (p = 0.93). The body mass index of female subjects 24.57±5.01 kg/m2 was significantly higher than their male counterparts 23.39±4.46 kg/m2 (p =0.05). There was an increasing trend of fasting blood glucose level (p = 0.85) and body mass index (p = 0.01) and also with increasing parity among the pregnant women. Conclusion: The fasting blood glucose level increases with weight, age, gestational age, and parity in pregnant women

Background: Throat foreign bodies are surgical emergencies in both children and adults all over the world. Some patients may present with no obvious symptoms and for those that have symptoms, their symptoms may suggest which passage is involved. Children below the age of 10years are more affected than adults. Smooth objects like coins and seeds may pass through the gastrointestinal tract with little or no problem in about 30% of cases and so, such patients should be placed under close observation in the wards. Aims/Objectives: To determine the types, site of impaction and method of removal of such foreign bodies among patients seen in our health facility. Methodology: This is a 3-year retrospective study conducted at the ENT Unit of the Department of Surgery Federal Medical Centre Lokoja, North Central Nigeria. From the hospital Medical Records, a total of 82 patients were managed for foreign body in the throat. However, folders for seven patients could not be traced, five folders had incomplete information in them, and the remaining 70 folders were included in the study. Data about their age, sex, presentation, duration, type, site of impaction, method of removal were extracted, studied and analysed. Results were presented in text, figure and table format. Results: A total of 70 patients were studied, 36 (51.4%) were males and 34 (48.6%) were females. The male to female ratio was 1.06:1, mean age was 17.14years ± 8.36 standard deviation and the most frequent age group involved was of 21-30 years with 26 (37.1 %) patients. Commonest site of impaction was the oropharynx (74.3%) followed by the upper oesophagus (11.4%). The most common foreign body was fishbone (57.2%) followed by denture (8.6%)

Background: Gastric tuberculosis (TB), occurring as primary or secondary infection, is a rare manifestation of extrapulmonary tuberculosis infection and the signs and symptoms of this infection are nonspecific and can simulate gastric neoplasms. This case report aimed to draw attention to the possibility of gastric TB simulating a gastric malignancy and to remind clinicians to consider gastric TB as a differential diagnosis in a patient presenting with features simulating gastric tumour, especially when there is past history of PTB. We, therefore, present a rare case of secondary gastric TB simulating gastric malignancy in a 45-year-old man with past history of pulmonary tuberculosis

Background: Endometriosis causing intestinal obstruction could be misdiagnosed as colon cancer due to similarities in clinical presentation. This is a case of endometriosis of sigmoid colon in a 37-year-old nulliparous woman who presented with intestinal obstruction that necessitated partial colectomy. Histological examination revealed endometriosis of the sigmoid colon and the report was received by both the surgeons and patient with joyous surprise. We present this case for its mimic of colon cancer clinically, rarity and abnormal presentation

Background: Pseudoaneurysms are vascular abnormalities due to disruption of the arterial wall. Pseudoaneurysm of the superficial femoral artery following bomb-blast injury is extremely rare. We report a case of 9-year-old girl who presented with one-month history of painful progressive swelling in the left thigh with previous history of improvised explosive device trauma. Doppler ultrasound scan confirmed the diagnosis of pseudoaneurysm of the superficial femoral artery and the patient had an uneventful surgical repair. High index of suspicion following penetrating trauma of the limb and Doppler ultrasound (US) scan are important for accurate diagnosis of pseudoaneurysm. Prompt treatment is also warranted to prevent life threatening complications such as rupture and thromboembolism. The classical findings of ‘ying-yang’ sign on colour Doppler US and ‘to and fro’ spectral waveform on pulse Doppler US for diagnosis of pseudoaneurysm were demonstrated.

 

Background: Postoperative nausea and vomiting have remained significant causes of morbidity in patients undergoing general anaesthesia for gynaecological laparoscopic procedures.

Objectives: This study compared the severity of postoperative nausea and vomiting following gynaecological laparoscopic procedures after prophylaxis with metoclopramide and ondansetron.

Methods: Sixty-six consenting patients aged 18-55 years undergoing day case gynaecological laparoscopic procedures were recruited and randomly allocated into two groups with each receiving either intravenous ondansetron 4mg or intravenous metoclopramide 10mg prior to induction of anaesthesia. The severity of nausea and vomiting were then assessed over a period of 4 hours before discharge.

Results: Nausea was mild in 24.2% and 6.1% of patients that received metoclopramide and ondansetron respectively, and severe in 9.1% of patients in both groups. In the metoclopramide group, 6.1% experienced 1 bout of vomiting compared to 3% in the ondansetron group. 3% had 2 bouts of vomiting in the metoclopramide, none in the ondansetron group had up to 2 bouts of vomit.

Conclusion: Ondansetron was more effective in the prevention of the mild form of nausea, the two study drugs are similarly effective for the prevention of vomiting.
Key words: Nausea, vomiting, ondansetron, metoclopramide

 

Background: Knowledge of Ante-Natal Care interventions (ANC) and removal of barriers associated with access to the interventions can significantly reduce the burden of maternal, neonatal, and infant morbidity and mortality in Sub-Saharan Africa.

Objective: This study assessed the knowledge and barriers to ANC interventions among pregnant women attending PHC in Kano.

Methods: Descriptive cross-sectional study design was used to study 383 pregnant women attending ANC in primary health care centers in Kano metropolis using a three-staged sampling technique. Data was collected using interviewer administered semi-structured questionnaire and analyzed at univariate, bivariate and multivariate levels using IBM SPSS Statistics for Windows, version 20.

Results: Out of the 383 questionnaires distributed 374 were retrieved and analyzed, giving a response rate of (97.7%). The mean age of respondents was 25.7±4.8years. The majority of the pregnant women studied (60.0%) were greater than 24 years of age with most of the respondents having formal education (96.8%) and married pregnant women constituted most (89.0%) of the respondents. The maximum knowledge score was 39 and the minimum was 10 with a mean of 24.8±5.8. Many pregnant women (97.0%) had satisfactory knowledge of ANC interventions. Age greater than 24 years (p<0.001), employment (p<0.001), gestational age between 4-6 months (p<0.001), urban residence (p=0.02) were found to be significantly associated with satisfactory knowledge. Age greater than 24 years {AOR=2.0, 95%CI= (1.1-3.7)}, Gestational age ranging between 4-6 months {AOR=0.5, 95%CI= (0.3-0.8)}, and urban residence {AOR=2.0, 95%CI= (1.1-3.7)} were found to be independent predictors of knowledge of ANC interventions. Variable barriers to using various interventions were reported. The barrier to using iron and folic acid reported by about a half of the respondents (50.0%) was forgetting to use the tablets, the financial capacity to transport self to the facility was reported to serve as a barrier to using Long Lasting Insecticides Treated Nets by about one-fourth (25.0%) of the pregnant women. Similarly, up to one-fourth (25.0%) had fear of side effects as the barrier to using IPT(sulphadoxine/pyrimethamine). Barrier to using some health education interventions was reported to be due to rejection by the spouse.

Conclusion: Pregnant women were knowledgeable on the available ANC interventions but are faced with many barriers to accessing them. The government should, therefore, formulate policies directed to addressing the identified barriers

 

Background: Compliance with recommended hand hygiene practice among healthcare providers is important in the prevention of morbidity and mortality associated with hospital acquired infections including drug resistant microorganisms.

Objective: This study determined the predictors of compliance with recommended hand hygiene practices among healthcare workers in specialist hospitals of Kano metropolis, Northwest Nigeria.

Method: World Health Organization recommended observation checklist for hand hygiene compliance and Key Informant Interviews involving members of Infection Prevention and Control teams of the two selected hospitals were used to collect data using two staged and purposive sampling techniques respectively. Quantitative data from the observation checklist was analyzed at univariate, bivariate and multivariate levels using SPSS version 22 while verbatim transcripts from qualitative interviews were analyzed using thematic framework analysis.

Results: The overall compliance with hand hygiene was (42.4%). Use of alcohol based hand rub and soap and water constituted (26.7%) and (15.7%) respectively. Statistically significant association was found between type of the ward (P<0.001), Professional cadre (P<0.001), indication for hand hygiene (P<0.001), time of the day (P<0.05) and compliance with hand hygiene. Key Informant Interviews revealed lack of materials needed for hand hygiene to be associated with non-compliance. Working in medical ward and being a doctor were associated with 86% increased likelihood of compliance with recommended hand hygiene practice {AOR=0.14, 95% CI= (0.0-.4)}.Similarly, contact with patients’ surrounding/environment was associated with four fold increased likelihood of compliance with hand hygiene { AOR= 3.7, 95% CI= ( 2.7-5.0)}, further, evening and night shifts were associated with 2 folds increased likelihood of compliance with hand hygiene than morning shift { AOR=2.0, 95% CI=(1.0-3.7)}.

Conclusion: Compliance with recommended hand hygiene practices was not encouraging and may pose significant risk of hospital acquired infection. Therefore, Hospital management should ensure the existence of functional infection prevention and control team, regular training and re-training of healthcare workers