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BoMJ vol17no1

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January - June 2020
Volume 17 | Issue 1

This journal has been online since Saturday, April 05, 2013

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ORIGINAL ARTICLES


 
 
 

Dose Fractionation Schemes for Palliative External Beam Radiotherapy on Painful Bone Metastasis from Breast Cancer

Hassan Ibrahim, Usman Bello

Background: The efficacy of palliative external beam radiotherapy (PRT) for relief of metastatic bone pain had been well established, a single fraction is as effective as multiple fractions in relieving bone pain, but variation exist among the radiation oncologist in our environment on the ideal dose per fraction regimen.

Methods: We retrospectively reviewed data from breast cancer patients treated with PRT using linear accelerator for metastatic bone pain in University College Hospital Ibadan between 2005 and 2009. The extracted information includes bio-data, presenting symptoms, metastatic sites, and bone pain assessment before and after four weeks of PRT using visual analogue pain scale (VAS), radiation doses, fractionation numbers and number of re-irradiation.

Results: There were 161 eligible breast cancer patients who were treated with PRT secondary to painful bone metastases between 1st January 2005 and 31st December 2009. Majority were females with only 1.2% male patients (Figure 1). Table 1 showed demographic characteristics of treated patients with mean age of 45.2 years, pain was the major presenting complaint (92.5%) and multiple bony metastases constituted the highest metastatic presentation (52.2%). Table 2 shows patient’s responses to PRT treatment for pain relief (complete responses of 88.8% and 11.2% partial responses). No significant association between patient’s responses to PRT and magnitude of radiation doses delivered. However, fractionation sizes were significantly associated with re-irradiation p-value < 0.05.

Conclusion: No differences exist between various dose fractionation schemes in terms of relief from painful bony metastases. However, shorter dose fractionation schemes are associated with re-irradiation of previously irradiated sites.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Anterior Tibial TuberosityAvulsion: A Case of Late Diagnosis

Dabkana Theophilus Maksha, Nyaku Titus Friday

SUMMARY: Avulsion fracture of the anterior tibial tubercle (ATT) results from an abrupt traction of the patella tendon mostly occurring in adolescent males. Early diagnosis is critical for proper patient management. We report a case of an 18-year-old male student with a sixteen months history of pain in the anterior aspect of the right knee and inability to fully extend the right knee following injury sustained while playing football. The patella tendon was not palpable when the knee was extended, with a palpable bony mass floating below the patella. Lateral X-Ray of the right knee showed a triangular bony mass below the lower pole of the Patella. A diagnosis of an anterior tibial tuberosity avulsion was made

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Knowledge and awareness of undergraduate university students towards eye donation in north-west, Nigeria: a cross-sectional study

Monsudi KF, Abubakar IB, Ayodapo AO, Ribadu DY

Background: Corneal blindness still remains a large contributor of childhood blindness in Africa. Corneal transplant is a sight saving procedure that is still lacking in most of African countries despite the first successful corneal transplant in 1905 by Dr. Eduard Zirm. The cornea eye bank and transplant procedure in Nigeria is still in the infancy stage despite Federal Government of Nigeria acknowledged the need for an eye bank and promulgated the decree No. 23 titled Corneal Grafting Decree 1973.

Objectives: To assess the level of knowledge and awareness on eye donation among the undergraduate students of Kebbi State University of Science and Technology.

Methods: A cross-sectional study was undertaken among undergraduate university students, using a pre-tested, self-administered questionnaires. Information on the socio-demographics, the participants’ knowledge and willingness to donate eye was obtained. The questionnaires were analyzed using SPSS version 20.

Results: Of 281 participants, 157 (55.9%) were males and Muslim 204 (72.6%). Few students 59 (21%) were willing to donate their eyes after death, while131 (46.6%) were not willing to donate their eye because of their religious belief. Ninety-three (33.8%) of the students support eye donation. Television was the main 94 (33.5%) source of information about eye donation.

Conclusion: The knowledge and awareness of eye donation among the students was low. Furthermore, majority were not willing to donate their eye mostly because of their religious belief. Health education on eye donation is needed to increase the uptake of eye donation among population

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Giant Dermatofibrosarcoma: A case report

Ogah SA, Fadahunsi OO, Awelimobor D, Adeyemi OW, Agu EE, Ajiboye OO

SUMMARY: Dermatofibrosarcoma Protuberans (DFSP) is a rare skin tumour with high recurrences. World Health Organization report has shown it to be a slow growing, nodular neoplasm of intermediate grade malignancy that is found almost exclusively in the dermis from where it often invades the subcutaneous tissue. It is more common in adults than children, in blacks than whites and on the trunk than other parts of the body. Management is challenging due to its propensity to recur after local wide excision and for this reason, it is believed that combining either wide local excision with Mohs micrographic surgery or adjuvant chemotherapy or radiation therapy may reduce its recurrence. In this follow up case report, we present a 53year-old man who had wide local excision of his recurrent facial DFSP 14months post-surgery. His past medical history has shown that the man has had this tumour excised 13 times in other hospitals prior to his first presentation to us 14 months ago. In multiple recurrences with previous surgical scars in which free margin is doubtful as noticed in our case, adjuvant radiotherapy will be of benefit. This was recommended to the patient during his first surgery but could not have it done due to some logistics reasons

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Self-reported prevalence of missing teeth and unmet prosthetic treatment needs among a population of Nigerian undergraduate students

Omo JO, Enabulele JE

Background: Tooth loss is an indicator of the oral health status of the population. In developing countries, missing tooth/teeth replacement constitutes a high unmet dental need. Missing tooth/teeth among undergraduate student is a cause for concern.

Objective: This study was designed to assess the self-reported prevalence of missing teeth and unmet prosthetic needs among university undergraduate students.

Methods: Data for the study was collected by means of a self-administered questionnaire. The questionnaire consisted of 3 sections: the first section sought demographic information, the second section consisted of 5 questions that tried to find out the missing teeth status of the respondents and the third section tried to find out prevalence of missing teeth and the unmet prosthetic needs of the respondents. Data obtained was analyzed using IBM SPSS version 21.0. Descriptive statistics (frequencies and counts), cross-tabulations as well as Chi square were used to analyze the data.

Result: More than half (64.1%) were females while 67.3% were between 16 and21 years of age. The prevalence of missing teeth among the respondents was 38.3% with missing anterior teeth making up 56.1%. Of the respondents who had missing teeth 60.5% had a form of replacement for their missing teeth bringing the unmet prosthetic need to 39.5%. There was a statistically significant association between tooth missing and replacement status with a higher proportion (66.3%) of anterior teeth being replaced. There was no statistically significant association between missing teeth and gender, age group, marital status, faculty of study and level of study.

Conclusion: The prevalence of missing teeth and unmet prosthetic need was high, highlighting the need for oral health education and increased awareness of the possible prosthetic rehabilitation procedures available for replacing missing teeth.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Recurrent transverse lie in an Arcuate Uterus: A Case Report and Literature Review

Okonkwo Susan Gana

Arcuate uterus is a mild form of uterine anomaly that may go unnoticed during a reproductive life of a woman. While it is shrouded in controversy in categorization and diagnosis, studies have shown that arcuate uterus is associated with Endometriosis. Arcuate uterus is rarely associated with reproductive failure. However, malpresentation, preterm birth and miscarriages have been found to be associated with arcuate uterus. Transverse lie is a presentation commonly associated with uterine anomalies. The uterine cavity distortion and reduction in capacity seen in arcuate uterus may explain the increase incidence of Transverse lie as demonstrated in the case report

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Comparative Analysis of Psychiatric Morbidity of Women with Infertility and Those Attending Family Planning Clinic in a Tertiary Facility in North-East Nigeria

Hauwa Ahmed Kudale, Aishatu Yusha’u Armiya’u, Lubuola Issa Bamidele
 

Background: Infertility is a major life crisis often associated with mental health consequences. It is particularly relevant in African setting including Nigeria where women are largely blamed for the cause of infertility with its attendant shame, guilt, anxiety and hopelessness.

Objective: The aim of this comparative study was to assess and compare psychiatric morbidity of women with infertility and those who attend family planning clinic.

Methodology: This descriptive cross-sectional study was done using consecutive sampling technique to select 400 women in each group of those attending fertility and family planning clinics. Data were collected using semi-structured socio-demographic questionnaire, self-administered General Health Questionnaire-12 and Hamilton Depression and Anxiety Scale after matching the groups by their age, marital status and years of education.

Results: The study found 37.6% of those who attend fertility clinic to have met HADS cut off score for depression as against 6.8% of the family planning clinic attendees. Similarly, for anxiety subscale; a high proportion of infertile group (40.3%) met anxiety cut off compared to those who attend family planning clinic. In the same manner, attendees of the fertility clinic significantly experienced high rate of psychiatric morbidity (52.9) on the GHQ compared to those attending family planning clinic (32%).

Conclusions: This study revealed that Nigerian infertile women seeking treatment are exposed to several mental health consequences such as anxiety and Depression amongst others with devastating effects on the mental health and well-being of the infertile women. Consequently, a comprehensive biopsychosocial intervention should be integrated into the overall management of infertility to improve their quality of life and chances of conception

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Association between maternal lipid profile and gestational diabetes mellitus

Jibrin BI, Akaba GO, Isah. AY, Dalili MS, Ekele BA

Background: Dyslipidemia is the third component of metabolic syndrome and is a well-known cardiovascular risk factor. However, the association of dyslipidemia with gestational diabetes mellitus is still a subject of ongoing research in Nigerian obstetric populations.

Objective: To determine the relationship between second trimester maternal fasting plasma lipid constituents and gestational diabetes mellitus.

Methods: This was a prospective nested case-control study that enrolled 288 pregnant women out of which 36 women with GDM (cases) where matched with 72 without GDM (controls) following results of oral glucose tolerance testing and plasma fasting lipid profiles done between 24-28 weeks. The patients were followed up until delivery to document maternal and fetal outcomes. Data was analyzed using Statistical Package for Social Sciences (SPSS). Categorical variables were presented in percentages while continuous variables were expressed as means (±Standard Deviation). Student t-test and Chi-square test or Fishers exact test were used for comparing variables between the two groups. A p-value of <0.05 at 95% confidence interval was considered statistically significant.

Results: The overall mean plasma lipid levels for the four lipid constituents in the study population were 187.9mg/dL, 163.5mg/dl, 49.1mg/dL and 108.1mg/dL for TC, TG, HDL-c and LDL-c respectively. The mean plasma triglyceride was significantly higher in cases compared to the controls: 187.0±67.7mg/dL vs. 151.7±66.4mg/dL, (p = 0.01). Abnormal triglyceride was significantly associated with GDM (AOR: 4.8, 95% CI (1.6-14.4), (p= 0.005).

Conclusion: Maternal dyslipidemia (abnormal triglyceride) was shown to be significantly associated with GDM in this study and it appeared to be causally related

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Changes in Corneal Endothelial Cells Following MSICS VERSUS Conventional ECCE in a Tertiary Eye Hospital in North Western Nigeria

Saudatu M Umar, Murtala M. Umar, Mansur Rabiu, Mahmoud B Alhassan, Victoria Pam

 

Background: This study was undertaken to compare the effect of two surgical techniques of cataract extraction on corneal endothelial cell density in eyes of Nigerian adults with uncomplicated age-related cataract with the view to improving surgical visual function and quality of life.

Materials and Methods: It was a prospective randomized non blinded hospital based interventional study. Two hundred and seventy-seven (277) eyes of 269 eligible patients with cataract were randomized to either manual small incision cataract surgery (MSICS) or conventional extracapsular cataract extraction (ECCE). The endothelial cell density (ECD), Coefficient of variation (CV), and Hexagonality (%) were measured pre-operatively, at one, four and twelve weeks post-operatively with a non-contact specular microscope (CSO SP 02). Statistical analysis – Data obtained were entered into microsoft Excel and analyzed using SPSS version 16 software.

Result: Of the 277 eyes studied, 263 (94.9%) were analysed. The mean age of patients for MSICS and ECCE was 64.03 (SD + 11.2, range 40 – 95 years) and 62.69 (SD +10.48, range 42 – 94 years) respectively. The Male to female ratio was 1.9:1, in the two study groups. Pre-operatively, corneal parameters (mean ECD, CV and hexagonal cells) were similar between the two surgery groups. Postoperatively cataract surgery induced a mean endothelial cell density loss of 5.31% at one week, 7.28% at 4 weeks and 7.06% at 12 weeks in the study population. There was no statistically significant difference in the mean endothelial cell density loss between MSICS and ECCE groups.

Conclusion: Both MSICS and ECCE induced fairly equal moderate and reversible degree of endothelial cell density loss in adults with uncomplicated age related cataract.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
  Ease of Laryngeal Mask Airway Insertion – Comparison of Propofol versus Thiopentone and Lignocaine in Adult Patients
Samuel Isaiah Nuhu, Gabriel Adanu Ajogwu, Henry Yammoh Embu, Erdoo Suckie Isamade

Background: A patient is required to be fully relaxed and airway reflexes should be adequately suppressed to allow for smooth insertion of a laryngeal mask airway (LMA).Propofol and a variety of other induction agents and their combinations have been tried to ease its insertion. The use of cheaper alternatives in our environment is highly desirable.

Aims and objectives: To compare the ease of insertion of LMA in patients given propofol alone versus thiopentone with lignocaine, as well as assessing the cost effectiveness of these agents in our hospital setting.

Methods: This is arandomised single blind prospectivestudy carried out in a Public Tertiary Academic Health Institution. Sixty-four ASA I and II patients equally randomized into 2 groups scheduled for short (not lasting more than one hour) elective gynaecological, orthopaedic, urological and general surgical procedures were recruited into this study. Patients were premedicated with 1g.kg-1 fentanyl intravenously and pre-oxygenated for five minutes. This was followed by an induction dose of either 2.5mg.kg-1propofol (group A) or a sequence of 2mg.kg-1 lignocaine and 5mg.kg-1thiopentone (group B) given by a trained assistant. With the patients in the sniffing position, LMA insertion was attempted immediately after induction of anaesthesia by the anaesthetist (researcher) who observed the ease of LMA insertion using presence or absence of adverse airway responses to LMA insertion such as coughing, gagging, laryngospasm, head and limb movement or inadequate jaw relaxation. These responses were graded as; no response, mild response, moderate response and severe response. Overall assessment of the ease of LMA insertion was then done combining these graded adverse airway responses as; excellent if there were no adverse airway responses, good if responses were mild, satisfactory if responses were moderate and poor if responses were severe with additional anaesthetic required to allow LMA insertion.

Results: The average age in group A was 36.5±14 whereas in group B it was 38.7±05 with the p=0.493.There were 22 (56.4%) male patients in group A compared to 17 (43.6%) male patients in group B with p=0.528; whereas, there were 10 (40.0%) female patients in group A compared to 15 (60.0%) female patients in group B with p=0.326. Excellent LMA insertion were observed in 28 (87.5%) patients in group A compared to 27 (84.4%) patients in group B (P= 0.893); Good LMA insertion in 2 (6.3%) patients in group A compared to 1 (3.1%) patient in group B (p= 0.564); Satisfactory in 2 (6.3%) patients in group A compared to 4 (12.5%) patients in group B (p= 0.655).

Conclusion: Thiopentone together with Lignocaine provided optimum conditions for laryngeal mask airway insertion comparable to that provided by propofol alone.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Socio-demographic and Nutritional Assessment of Under five Children in Benue State North Central Nigeria

Ogbeyi Ofikwu Gabriel, Ochoga Martha Omoo, Afolaranmi Tolulope Olumide, Ajeh Anthony

Background: Globally, malnutrition is a major public health concern. Under nutrition in Nigeria is a long standing problem since independence and the magnitude is on the increase. This is so because food consumption both in quantity and quality has decreased considerably due to unemployment and other harsh economic conditions.

Objectives: The study aimed at assessing the socio-demographic and Nutritional status of under- five Children in Benue State North Central Nigeria.

Methods: A cross sectional survey was conducted using quantitative data collection methods. The study involved interviews using questionnaires for socio-demographic variables, immunization, breast feeding practices and anthropometric measurements. Data were analyzed using SPSS version 21. Ninety five percent confidence interval was used while a p-value of ≤ 0.05 was considered statistically significant.

Results: Two hundred and twenty three under five children and their mothers were assessed for nutritional status using selected and sensitive anthropometric methods. The results showed that children with mothers/caregivers without formal education had weight and height 36.4% and 70.5% below normal respectively. Mothers with income less than twenty thousand per annum had children with height 53.3% below normal while those earning above twenty thousand naira per year had weight 41.0% and height 62.9% below average respectively. Furthermore, children without appropriate immunization for age had 29.9%, 53.2%, and 36.9% below normal for weight, height and mid upper arm circumference respectively. There was a statistically significant relationship between weight, height and mid upper arm circumference with the age of children (p=0.00, 0.002, 0.001 respectively) with respect to their nutritional status.

Conclusion: The nutritional need of a child is complex. There is need for proper nutritional education

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Glomerular Filtration Rate in Homozygous Sickle Cell Disease children in Steady State and Healthy Nigerian Children: A Comparative Study in north-eastern Nigeria

Farouk AG, Ibrahim BA, Sulaiman MM, Asheikh MM, Yusuf H, Musa AH

Background: Homozygous sickle cell disease (HSCD) is the most common inherited blood disorder of public health importance worldwide, with Sub-Saharan Africa accounting for a third of the global burden. The effect of HbS on the kidneys results in sickle cell nephropathy, which contributes to increased mortality among HbSS patients beyond third decade of life. Glomerular filtration rate (GFR) is an important renal function test for evaluating progress of sickle cell nephropathy, however, this is seldom done to HbSS patients especially in the insurgency that devastated the North-eastern part of Nigeria, where displacement of people has led to increase in diarrhoeal diseases with its complications which also contributes to renal diseases, hence the need for this study.

Objective: To determine the baseline glomerular filtration rate of homozygous SCD in steady state and compare same with normal controls.

Methods: This is a prospective comparative study conducted at the University of Maiduguri Teaching Hospital (UMTH). The study population consisted of age and sex matched HbSS subjects in steady state and children with haemoglobin AA genotypeaged 3-14 years. The study was conducted over a period of 6 months. Anthropometry and serum creatinine of the subjects were determined and GFR calculated using Schwartz formula.

Results: Two hundred and twenty children consisting 110 HbSS and 110 controls were enrolled. This consist of 106 males and 114 females with M:F ratio of 0.9:1. Mean ages of HbSS patients and HbAA subjects were 8.2years and 7.9 years respectively. The mean GFR (SD) was 125.9 (31.9) ml/min/1.73m2 and 93.0 (16.1) ml/min/1.73m2 for the HbSS and HbAA controls, the difference between the means was significant (P<0.001). The normal GFR range for the controls was 77 to 109 ml/min/1.73m2. Sixty-seven (61%) casesand 86 (78%) controls had GFRs within normal range. There was statistically significant difference for GFRs above and below the normal range (Z-score=6.2 & -2.9, p<0.001 & p<0.004).

Conclusion: About a third of HbSS children in steady state have elevated GFR, this suggests the presence of moderate renal pathology. Regular monitoring of these children will lead to improvements in management of sickle cell nephropathy and their quality of life

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 
 

Duration of Breast Feeding and Outcome of HIV-Exposed Infants seen at a Tertiary Health Facility in Sokoto

Yusuf T, Jega MR

Background: Appropriate infant feeding is still a challenge to HIV-positive mothers especially in the developing world despite their desire to breast feeding beyond the WHO recommended 12 months’ duration.

Objective: To determine the duration of breast feeding and correlate with outcome of HIV-exposed infants in UDUTH, Sokoto.

Methods: This descriptive observational study was conducted among HIV-exposed infants attending Paediatric ART(PMTCT) clinic, UDUTH, Sokoto. The demographics, infant post-exposure prophylaxis, duration of breast feeding and results of early infant diagnosis (EID) of the infants using HIV-DNA PCR machine; and maternal highly active antiretroviral therapy (HAART) history were documented. The data were analyzed using SPSS version 24.0. A p-value of ≤0.05 was taken as significant.

Results: One hundred and sixty-three HIV-positive mother-infant pairs were studied, 103(61.7%) of the HIV-positive mothers were aged 25-34 years, 105(62.9%) were of lower socio-economic class and 94(56.3%) had informal education. One hundred and fifteen (62.5%) were on TDF/3TC/EFV and 143 (85.6%) were on HAARTs prior to the index pregnancy. One hundred and sixty-three of the HIV-exposed infants studied were breast-fed and 165 (98.8%) had nevirapine as infant PEP. The mean duration of breast feeding among HIV-exposed infants was 13.2(±3.5) months with a range 6 – 20 months. Ninety-eight (60.1%) infants were breastfed beyond 12months. All the HIV-exposed infants were not infected at the end of breastfeeding for 12 months or more.

Conclusion: Majority of the HIV-positive mother’s breastfed beyond WHO recommended 12 months and their infants were uninfected. This may support the upward review of the duration of breast feeding of HIV-exposed infants in our community

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Lateral Ventricle Epidermoid Cyst Presenting with Right Hemiparesis and Blindness: A Case Report and Review of Literature

Mohammed B, Zarami AB, Usman B, Pindiga UH

Summary:Epidermoid cyst of the CNS is rare, slow growing, benign neoplasm derived from the remnant of neural tube. It accounts for 0.2% of all intracranial neoplasms. Intraparenchymal and lateral ventricles are the rarest sites within the CNS. The lesion is asymptomatic at the early stage but later may present with mass effects and cranial neuropathies. We present our index case of a 23year old male who presented late with a rare lateral ventricle epidermoid cyst associated with calcification resulting to left hemiparesis and blindness. The excised tumour mass aggregate was 11cm and weighed 15g. This is an index case in our region. Lateral ventricle epidermoid cyst is a rare neoplasm that may mimic neurocysticercosis, choroid plexus papilloma and dermoid cyst at both clinical and imaging levels. The treatment of choice is surgical excision; however, there is recurrence rate of 33%with increased chances of chemical meningitis. Nevertheless, the tumour rarely transforms to squamous cell carcinoma.

[FULL ARTICLE (PDF)]

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109-bomj-vol16no2

Written by Administrator. Posted in Archives

 
 

 

July - December 2019
Volume 16 | Issue 2

This journal has been online since Saturday, April 05, 2013

PDF access
This Journal allows immediate access to content in HTML + PDF for both current and archived editions.

Mobile access
Full text of the articles can be accessed via our android application and mobile site free of charge.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License

 

 

ORIGINAL ARTICLES


 
 
 

Nigerian Dental Students’ Knowledge of HIV Prevention, Stigma and Discrimination

M Okoh, JE Enabulele

Background: Knowledge of prevention and removing the barriers of stigma and discrimination is a critical public health issue for HIV/AIDS prevention strategies in Nigeria.

Objective: This paper is aimed at accessing the knowledge of HIV/AIDS prevention, causes and effects of stigma and discrimination towards people living with HIV/AIDS (PLWHA), among the final year dental students.

Methodology: This was a descriptive cross-sectional study among final year dental students in accredited dental schools in Nigeria, 2016. At the time of conducting this study there were 8 accredited dental schools in Nigeria. Simple random sampling technique was used to pick four schools from the existing eight. All data obtained was analysed using IBM SPSS version 21.0.

Results: Out of the 70 questionnaires administered 60 were filled and returned giving a response rate of 85.7%. Half (50.0%) of the respondents exhibited a good level of knowledge of HIV prevention. About two-thirds (66.7%) of the respondents exhibited good level of knowledge of HIV discrimination and stigma. The main cause of stigma against PLWHA was lack of knowledge about HIV (86.7%). The main effect of stigma on PLWHA as stated by 83.3% is that they hide their HIV status.

Conclusion: The study showed that most final year dental students have good knowledge of HIV prevention; causes; and effects of stigma and discriminations among people living with HIV/AIDS. However, they need more training on how occupational HIV exposure should be handled in the clinic.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Assessment of Baseline Biochemical Thyroid Function in Patients with MultiDrug Resistant Tuberculosis in Maiduguri

Garbati MA, Mubi BM, Gali RM, Jidda BU, Mshelia DS

 

Background: Most publications on disturbance of thyroid function among patients with drug resistant tuberculosis (DR-TB) have focused mainly on the effects of treatment with second line drugs. Some patients with newly diagnosed DR-TB are likely to have disturbed thyroid function at baseline. These groups of patients need to be actively looked out for in order to institute appropriate therapy to prevent further deterioration.

Methods: This is a prospective review of thyroid function on patients newly diagnosed with RifampicinResistant TB/Multidrug resistant TB (RR-TB/MDR-TB) who underwent baseline thyroid function test (TSH, T3 and T4) at the University of Maiduguri Teaching Hospital (UMTH) between January 2016 and December 2018.

Results: Sixty-two patients were diagnosed with RR-TB, 58% of them were females, with ages ranging between 16 and 70 years. Forty-seven (75.8%) were aged between 20 and 49 years. The baseline results showed that 77.4% were euthyroid, while 16.1% had one form of thyroid disorder or another; Nonthyroidal illnesses (NTIs) were reported in 6.5% of the study population. Of the 16.1% of results that indicated presence of thyroid disorders, 60% were hyperthyroid, 10% had subclinical hyperthyroidism, 20% subclinical hypothyroidism and only 10% were hypothyroid.

Conclusion: Determination of baseline thyroid function in newly diagnosed patients with DR-TB is vital to identify patients with baseline thyroid dysfunction. This will guide proper intervention before commencing second line anti-TB medications that are known to affect thyroid function. Follow-up thyroid function tests, especially among those with hyperthyroidism will show the effect of thionamide therapy and whether they progress to develop any alterations in the reported parameters.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Conjunctival Bacterial Normal Flora and Antibiotic Sensitivity in Patients Undergoing Cataract Surgery in Maiduguri

Musa ZY, Askira BH, Waziri MA, Zailani SB, Ali KB

 

Background: Bacterial infections are the most common cause of postoperative endophthalmitis with gram positive bacteria accounting for most cases. The flora of the eyelids and conjunctiva are the most frequent source of infection. Knowledge of the conjunctival bacterial flora is therefore important to provide an informed choice of appropriate antibiotics for postoperative prophylaxis in patients undergoing cataract surgery or other intraocular surgeries.

Objectives: To determine the bacterial normal flora of the conjunctiva and their antibiotic sensitivity with a view to determine the appropriate choice of prophylactic postoperative antibiotic in patients undergoing cataract surgery in Maiduguri.

Materials and Methods: This was a prospective cross-sectional study conducted on adult patients scheduled for cataract surgery at the University of Maiduguri Teaching Hospital and the State eye hospital Maiduguri from February 2018 to October 2018. Surgery was either small incision cataract surgery (SICS) or extra capsular cataract surgery (ECCE) with lens implantation. The sample included one hundred eyes of one hundred patients

Results: A total of 95 eyes of 95 patients was analysed. The patients were between the ages of 18-85 years with a mean age of 58.11+- 12.3 years, with a male to female ratio of 1.1:1. Positive bacterial cultures were found in 31 (32.6%) of the patients and negative cultures were found in 64 (67.4%) of the patients. In 28 (90.3%) of the patients the bacteria cultured were gram positive while in 3 (9.7%) the bacteria were gram negative rods. The commonest bacterial isolate was Staphylococcus epidermidis, isolated in 14 (45.2%) patients followed by Staphylococcus aureus in 13 (41.9 %). Ciprofloxacin was the most sensitive (93.3%) antibiotics tested followed by chloramphenicol (87.5%),

Conclusion: The commonest bacterial isolate was Staphylococcus epidermidis, followed by Staphylococcus aureus. Ciprofloxacin was the most sensitive antibiotic tested followed by chloramphenicol

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Prevalence, risk factors and short-term outcome of babies with Neonatal Jaundice in a secondary facility with free-health services in South-West, Nigeria

Oluwafemi, Rosena Olubanke, Abiodun, Moses Temidayo, Owa, Joshua A

 

Background: Publication of a scientific research in a peer-reviewed journal is one of the most common written means of disseminating of findings which is of importance to all researchers. However, it is also an area that often present challenges, and can result in disagreements among researchers, especially regarding the choice of journal for publication Objective: To determine the factors influencing journal publication choice among University of Benin lecturers.

Methods: This prospective cross-sectional study was conducted among lecturers across the thirteen (13) faculties in University of Benin, Benin City. Data collection tool was a nineteen (19) item, selfadministered questionnaire which elicited information on demographic characteristics, human determinant of journal publication choice and factors influencing journal publication choice. Six (6) of the questions were demographic characteristics which assessed age, sex, status, experience, faculty and department of participants. One question which assessed the human determinants of journal choice was a semi-structured question containing both closed and open-ended response options. The remaining twelve (12) questions assessed factors influencing the journal choice. The responses were scored as irrelevant = 1, less important = 2, important = 3 and extremely important = 4. The mean and standard error of mean were computed for each variable to determine the most ranked factor.

Results: A total of 53 lecturers who have worked between 1 and 38 years compromising 39 (73.6%) males and 14 (26.4%) females from 33 departments of all the 13 faculties were studied. The journal choice is mainly a sole decision (66.0%) of the principal investigator. Prestige, promotion and journal impact factor were the three most ranked factors in journal publication choice. The ranking of the factors was not influenced by sex, faculty, academic status, and years of experience of the participants.

Conclusion: Data from this study revealed that journal choice is mainly a sole decision of the principal investigator and the factors that influenced the choice were prestige, promotion and journal impact factor. Nation-wide study is highly recommended

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Gender Difference in the Level of Blood Pressure Control among Hypertensive Patients on Treatment

Musa Mohammed Baba, Mohammed Abdullahi Talle, Faruk Buba, Habu Abdul

 

Background: Hypertension has been identified as the leading risk factor for mortality, and is ranked the third leading cause of disability-adjusted life-years. Men are generally at greater risk for cardiovascular and renal disease than age-matched premenopausal women. Our study aimed to determine the variation in blood pressure control between male and female hypertensive patients receiving care in a Nigerian tertiary hospital.

Method: The study was a cross-sectional study of consecutive hypertensive patients receiving care at the Federal Medical Centre Nguru Yobe State Nigeria from June 2016 to December 2016. A prevalidated questionnaire was used, and controlled hypertension defined as blood pressure of less than 140mm Hg systolic and less than 90mm Hg diastolic was determined based on a blood pressure reading at the time of consultation.

Results: Two hundred and ninety-one (291) participants comprising 134 (46%) males and 157 (54%) females were consecutively recruited. Two hundred and thirty-eight (81.7%) were hypertensive, while 53 (18.2%) had hypertension and diabetes. The mean age of the participants was 56.15 ± 12.72. Males were older than the females (60.11±11.63 and 52.78±12.68, p value<0.001). Mean systolic blood pressure was comparable in males (135.97±23.40) and females (139.81±24.79) participants (P = 0.17). However, the females had a higher diastolic blood pressure than males (84.52±12.58 vs 81.42±12.51, p=0.03), uncontrolled hypertension was documented in 172 (59.1%) participants. The rate of hypertension control did not differ between males and females (44.8%vs 37.6%, p=0.213).

Conclusion: The rate of uncontrolled hypertension was high among the participants. Women were found to have a significantly higher diastolic blood pressure compared to the male counterpart however, there was no significant difference in systolic blood pressure between the male and female subjects. Age, body mass index and eGFR independently predicted uncontrolled hypertension.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Challenges of Distance to Access of Radiotherapy Management of Breast Cancer in Nigeria

Adamu Danladi Bojude, Musa Ali-Gombe, Yahaya Salisu Sadiq, Auwal Abubakar, Mohammed Mustapha Inuwa

 

Background: The shortage of radiotherapy services in Nigeria has led to tremendous suffering for breast cancer patients across the country. The aim of this study is to explore the effect of distance on the care of breast cancer patients in Nigeria.

Materials and Methods: This was a retrospective study of breast cancer patients from 1st January 2003 to 31st December 2012 in University College Hospital (UCH), Ibadan. Data obtained included biodata, disease features and follow-up information using a structured questionnaire. Univariate, bivariate and multivariate statistics was used to analyse the data.

Results: We studied 504 breast cancer patients. The mean age of the patients was 47.7 (±10.6) years, late presentation with symptoms beyond 3 months was seen in 88.1% while advanced stage disease was seen in 58.7% of patients. Patients that lived at distances within 50 km and beyond 50 km from UCH, Ibadan were 74 (14.7%) and 430 (85.3%) respectively. Majority of the patients 87.3% completed treatment, however, 94.8% of patients treated during the period discontinued follow-up care at the end of the study. The reasons for discontinuation were “death”, “financial constraints” and “referred back to distant primary surgeon after treatment” accounting for 90 (18.8%), 230 (48.1%) and 158 (33.1%) respectively. The factors affected by distance were socioeconomic status [OR=2.9; 95% CI=1.42-6.01], bilateral breast cancer disease [OR=14.22; 95% CI = 7.32 – 27.620], left breast disease (OR=11.45; 95% CI = 5.89 – 22.62) and reasons for discontinuing follow-up care: financial constraints [OR=2.0; 95% CI =0.9 – 3.2], and referred back to primary breast surgeon [OR=3.0; 95% CI =1.3 – 6.0].

Conclusion: Long distance and shortage of functioning radiotherapy centres in Nigeria are critical challenges for breast cancer treatment, leading patients to late presentation with advanced disease and poor compliance with follow-up care. Therefore, more centres should be built in each state to minimise these challenges.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Nasal Carriage of Methicillin Resistant Stapylococcus aureus among Healthcare Workers in University of Maiduguri Teaching Hospital

Abubakar Adamu, Hamman Ibrahim Garandawa, Zailani Sambo B, Mohammad Y, Aliyu Mohammad Kodiya, Yusuf Bukar Ngamdu, Abubakar Sadiq Baba, Mala Bukar Sandabe, Babagana Ahmad Mohammad, Abdullahi Isa, Ajiya Abdulrazaq
 
Background:Methicillin resistant Staphylococcus aureus (MRSA) has been recognized as an important pathogen causing Nosocomial infections with severe consequences despite antibiotic therapy. Nasal carriage among healthcare workers, play an important role in the transmission of this organism within the hospital setting.
 
Objectives: To determine the MRSA carriage rate among health care workers’ in University of Maiduguri Teaching Hospital Materials and Methods: We conducted a cross sectional studies on healthcare workers (HCW) in University of Maiduguri Teaching Hospital Nigeria. A total of 385 healthcare workers and students on rotation in all surgical units, intensive care unit (ICU), accident and emergency, operating theatre and special care baby unit were randomly recruited and screened for nasal carriage of MRSA using nasal swab.
Results: The overall carriage rate of MRSA was 13.5%; it was higher among Nurses and in ICU/theatre. The MRSA isolates showed variable resistant to commonly used antibiotics but are highly sensitive to clindamycin and mupiricin.
Conclusion: Periodic screening of HCWs and decolonization of carriers should be considered.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Correlation of Clinical and Ultrasound Findings in Ocular Trauma at The University of Benin Teaching Hospital, Nigeria

Ademola A. Adeyekun, Sally N. Ozougwu, Efe E. Efe-Aluta, Juliet N. Ese-Onakewhor
 
Background: The eye is very vulnerable to external injuries and accidents. Clinical evaluation is usually the first line in management of ocular trauma. Ultrasonography is a useful tool for evaluating ocular trauma due to its ready availability and relative safety. The eye provides a perfect acoustic window for ocular imaging, being a fluid filled structure. Data on level of correlation between clinical and sonographic findings in ocular trauma is sparse in the Nigerian literature.
 
Objectives: The aim of this study was to correlate clinical findings with sonographic assessment in patients who presented with ocular trauma at the University of Benin Teaching Hospital (UBTH), Benin-City, Nigeria.
 
Materials and Methods: Eighty patients were studied, over an eight-month period, SeptemberApril 2014. After history taking and clinical examination, and following informed consent, each patient was scanned with a linear array probe of transducer frequency 5-12MHz (SONACE X4; Medison Inc, Korea), using the closed eye technique. Data was analyzed with Statistical Package for the Social Sciences, version 17 (SPSS Inc; Chicago USA). Statistical tests were considered significant at ‘p’ level ˂ 0.05.
 
Results: The modal age group involvement was 18-35 years, and most of the causes of ocular trauma were work related. The right eye was more commonly involved (44 patients or 56.4%). The most common source of injury was intraocular foreign bodies (26 patients or 32.5%). Vitreous hemorrhage was the most common sonographic finding (36 patients or 45.0%). Ultrasound examination significantly identified more abnormalities (50 cases or 62.5%), compared with clinical or ophthalmologic assessment alone (27 cases or 33.8%).
 
Conclusion: Ultrasound significantly identified more abnormalities than ophthalmologic examination. The posterior segment was more involved than the anterior, with vitreous hemorrhage as the most common abnormality. Ultrasound findings correlated significantly with clinical findings.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Changes in Corneal Endothelial Cells Following MSICS VERSUS Conventional ECCE in a Tertiary Eye Hospital in North Western Nigeria

Saudatu M Umar, Murtala M. Umar, Mansur Rabiu, Mahmoud B Alhassan, Victoria Pam

 

Background: This study was undertaken to compare the effect of two surgical techniques of cataract extraction on corneal endothelial cell density in eyes of Nigerian adults with uncomplicated age-related cataract with the view to improving surgical visual function and quality of life.

Materials and Methods: It was a prospective randomized non blinded hospital based interventional study. Two hundred and seventy-seven (277) eyes of 269 eligible patients with cataract were randomized to either manual small incision cataract surgery (MSICS) or conventional extracapsular cataract extraction (ECCE). The endothelial cell density (ECD), Coefficient of variation (CV), and Hexagonality (%) were measured pre-operatively, at one, four and twelve weeks post-operatively with a non-contact specular microscope (CSO SP 02). Statistical analysis – Data obtained were entered into microsoft Excel and analyzed using SPSS version 16 software.

Result: Of the 277 eyes studied, 263 (94.9%) were analysed. The mean age of patients for MSICS and ECCE was 64.03 (SD + 11.2, range 40 – 95 years) and 62.69 (SD +10.48, range 42 – 94 years) respectively. The Male to female ratio was 1.9:1, in the two study groups. Pre-operatively, corneal parameters (mean ECD, CV and hexagonal cells) were similar between the two surgery groups. Postoperatively cataract surgery induced a mean endothelial cell density loss of 5.31% at one week, 7.28% at 4 weeks and 7.06% at 12 weeks in the study population. There was no statistically significant difference in the mean endothelial cell density loss between MSICS and ECCE groups.

Conclusion: Both MSICS and ECCE induced fairly equal moderate and reversible degree of endothelial cell density loss in adults with uncomplicated age related cataract.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
  Burden of Severe Malaria in Children at General Sani Abatcha Specialist Hospital, Damaturu, North-Eastern Nigeria
Jose Pwavimbo Ambe, Bello Abdullahi Ibrahim, Simon Pius, Aisha Bintu Gubio

 

Background: Malaria still remains the leading cause of morbidity and mortality among children in Nigeria. The initial decrease in the global burden of uncomplicated malaria reported by World Health Organization in 2014 was lost; presently 80% of cases of Malaria reported in the world are in the sub-Saharan African region in which Nigeria is the most populous country. In the insurgency-infested north eastern Nigeria, effort at reduction of malaria cases has not only stagnated but the gains have been reversed. Objective: To determine the burden of severe malaria during the period of high transmission in a region infested by insurgency.

Materials and Methods: We retrospectively reviewed all the records of children admitted with malaria into the paediatric wards of the specialist hospital in 2017, at the peak of malaria infestation. Rapid assessment kit was used to make the diagnosis of malaria. Children with packed cell volume of less 15% transfused with blood were recorded.

Results: Of the 2,316 children admitted, severe malaria constituted 1832 (79.1%), of which 104 (5.7%) died. About a quarter (23.4%) of these children had blood transfusion.

Conclusion: Malaria infestation was high especially in the latter half of the raining season; there is need to have a multi-pronged and coordinated strategy to halt this ugly trend and ensure qualitative blood transfusion services in the community during this peak period.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Recovery Time and Time of First Request for Postoperative Analgesia in Day-case Surgery: Propofol-Ketamine Vs Propofol-Fentanyl

Ahmed Mohammed Nuhu, Sandabe Fatima Kyari, Adamu Abubakar, Ali Mohammed Ramat, Mohammed Abubakar Abiso Ahmed Mohammed Alhaji

 

Background: The significance of recovery time and adequate postoperative analgesia for day case surgery has led to various trials of drug combinations in other to get the benefit of both early recovery with prolonged postoperative analgesia. Various intravenous analgesic agents in combination with propofol has been tried in an attempt at finding the ideal drug combination for short surgical procedures.

Objectives: This study compared the recovery time and time of first request for postoperative analgesia of two drug combinations: propofol-ketamine and propofol-fentanyl used as the sole anaesthetic agents for short surgical procedures in adult’s day case surgery.

Methods: One hundred and eight adults aged 18 to 50 years of either gender with ASA physical status I or II scheduled for elective short surgical procedures were randomly allocated into group K and F, comprising of 54 patients each. Group K received propofol-ketamine while group F received propofol-fentanyl for induction and maintenance of anaesthesia. Vital signs were recorded at the time of induction, maintenance and recovery. Recovery time was assessed using Steward Recovery Score. Postoperative analgesic requirement was assessed based on pain score using the Verbal Rating Scale.

Results: Demographic and clinical characteristics such as age, sex, weight, duration of surgery and types of surgical procedures used were comparable between the two groups. Recovery time was prolonged in group K compared to group F (p=0.01). Time for first request of postoperative analgesia was found to be significantly shorter in group F (p=0.01).

Conclusion: Both propofol-ketamine and propofol-fentanyl combinations produced effective postoperative analgesia and appreciable recovery time for daycase surgery. While Propofol-fentanyl has a shorter recovery time, Propofolketamine has a longer period of postoperative analgesia.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Giant Bladder Calculus: Case Report and Literature Review

B.M. Abubakar, A. Abubakar, Y.M. Saleh, I.E. Suleiman

 

Background: The existence of calculi in the urinary tract are well known urological conditions. A giant bladder calculus is one weighing more than 100g and is a rare finding in present-day urological practice.

Case summary: The patient is a 58-year-old man who presented with a 20year history of progressive irritative Lower Urinary Tract Symptoms (LUTS) associated with poor stream which improves with change in posture. He had episodes of intermittent painful terminal haematuria and pyuria with occasional fever. About three months to his presentation, he developed progressively worsened constipation. He also had weight loss and anorexia. On examination, His vital signs were normal. There was a suprapubic mass about 6cm above pubic symphysis, smooth surface, hard, mobile and bi-manually palpable. The prostate was not enlarged on digital rectal examination. His Abdominopelvic ultrasound scan and KUB revealed a giant bladder calculus with bilateral hydronephrosis. Urine Microscopy, Culture and Sensitivity (M,C,S) showed numerous red blood cells, pus cells, and cultured Klebsiella spp sensitive to Ciprofloxacin. Serum Electrolytes, Urea and Creatinine were normal. He was treated for Urinary tract infection then had cystolithotomy. Intraoperative findings were a giant bladder calculus, thickened bladder wall and hyperaemic bladder mucosa. The bladder mucosal biopsy revealed chronic inflammation on histology. The calculus weighed 1000g. Post-operative recovery was uneventful, the catheter was removed and the patient was discharged home 2 weeks after surgery with resolution of all lower urinary tract symptoms. He had remained symptom-free in his last follow up visit which was 1year post operation.

Conclusion: A giant bladder calculus is a rare finding in contemporary urological practice.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 
 

Prevalence of Suicidal Ideation Among Secondary School Adolescents Exposed to Boko Haram Conflict in Maiduguri, Northeastern Nigeria

Jidda MS, Amodu M, Victor CO, Abdu W, Wakil MA

 

Background: Suicide is the second leading cause of death among youths aged 10-24 years worldwide. Suicidal ideation, therefore, represents a growing global public health issue among youths and adolescents. Exposure to psycho-trauma due to Boko Haram conflict puts the adolescent in especially difficult circumstances that predisposes them to a range of mental health challenges including suicide.

Aim and Objective: The aim of the study is to assess the rate of suicidal ideation and attempt and the significant variables associated with these phenomena.

Methodology: A cross sectional study with stratified sampling techniques was used to recruit a sample of 300 secondary school adolescents. Data was extracted using the BDI and BSI.

Results/ Discussion: A total of 300 students were recruited into the study with a mean age of 16.5 years and SD (2.3). 52.3% were females. 40.7% have been directly exposed to violent acts of terrorism. 28% report suicidal ideation and 1.3 have attempted suicide. Spearman’s rank correlation was run to determine the relationship between the level of depression and suicidal ideation. There was a moderate positive correlation between the degree of depression and suicidal ideation which was statistically significant (rs=0.413; p=0.0001).

Conclusion: There is a high rate of exposure to psycho-trauma and suicidal ideation among adolescent students in Maiduguri. Targeted intervention to assist this demographic is relevant to the postconflict reconstruction effort to be designed by the national health system. Key

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Acute Coronary Syndrome in FSGS: A Case Report

Sulaiman MM1, Shettima J2, Lawan M1, Loskurima U1, Ummate I1, Pindiga UH3

Background: A 38-year-old male, who has been on treatment for nephrotic syndrome for 2 years, presented with sudden onset of chest pain, vomiting and excessive sweating. His ECG showed features of STEMI with elevated serum troponin. Coronary angiography was unavailable in our centre. He was treated with antiplatelets and anticoagulants and subsequently discharged on cyclophosphamide.

[FULL ARTICLE (PDF)]

Case Report


 
 
 

Left-sided Congenital Diaphragmatic Hernia Coexisting with Anorectal Malformation and Recto-vesical Fistula

Ahmadu MS, Farouk AG, Ahidjo A, Tahir A

Background: Although congenital diaphragmatic hernia (CDH) is a common congenital anomaly with incidence ranging from 1 in 2,500 to 1 in 5,000 live births, its coexistence with anorectal malformation (ARM), and recto-vesical fistula is rare. The aetiopathogenesis of CDH remains unclear, and its coexistence with other congenital anomalies suggests that CDH occurs as a result of multiple, complex, and varied developmental abnormalities. The most common associations of CDH are with cardiac, gastrointestinal tract, genitourinary tract, central nervous system, as well as musculoskeletal anomalies. This report described a case of congenital diaphragmatic hernia associated with anorectal malformation (ARM) and recto-vesical fistula (RVF) in a 2-day-old neonate.

[FULL ARTICLE (PDF)]

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bomj-volume15no2

Written by Administrator. Posted in Archives

 
 

 

July - December 2018
Volume 15 | Issue 2

This journal has been online since Saturday, April 05, 2013

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ORIGINAL ARTICLES


 
 
 

KNOWLEDGE OF SUDDEN INFANT DEATH SYNDROME AND RECOMMENDED SLEEP PRACTICES FOR INFANTS AMONGST DOCTORS AND NURSES: A MULTICENTRE STUDY IN SOKOTO, SOKOTO STATE, NIGERIA

Isezuo KO1, Adamu A, Jiya FB, Ibitoye PK, Onankpa BO, Sani UM1, Bolajoko TA, Sanni MA, Bello LA

Background: The American Academy of Paediatrics (AAP) started the Back to sleep campaign since 1992 to reduce the incidence of Sudden infant death syndrome (SIDs) and expanded its recommendations in 2011 to include provisions to ensure safe sleep environment for infants. Health workers, especially doctors and nurses are to ensure correct information is given to parents. However, knowledge gaps still exist among health workers even in developed countries.
Objective: To assess knowledge on SIDs and recommended sleep practices for infants among doctors and nurses in two major hospitals, Usmanu Danfodiyo University Teaching Hospital (UDUTH) and Specialist Hospital Sokoto (SHS) in Sokoto town in order to bridge knowledge gap among healthcare providers.
Methods: This was a cross-sectional multicentre study of 154 health workers carried out between 1st August, 2016 and 31st October, 2016. Doctors from the Paediatrics and Obstetrics departments, nurses in all the Paediatric and Obstetrics units of both hospitals were consecutively recruited. A structured questionnaire on knowledge of Sudden infant death syndrome and sleep recommendations was administered. Data was analysed with SPSS version 22
Results: Out of 154 health workers that participated, only 25 (16.2%) were aware of the AAP recommendations. Seventy-six (49.4%) selected side position as the recommended position while 62 (40.3%) selected supine position. More nurses than doctors (57.6% vs 32.3%) gave advice to mothers on sleep position even though the doctors were more aware of the AAP recommendations and correct infant sleep position. Although, the paediatric nurses had more knowledge of the recommended supine sleep position, more obstetric nurses gave advice to mothers about sleep position (p =0.005). Also, paediatricians had more knowledge of the supine sleep position (p = 0.03) compared to obstetricians.
Conclusion: More doctors and nurses in this study selected the side sleeping position as the recommended one. Also, frequency of giving advice to mothers on sleep position was also low.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

FEEDING DISORDERS IN CHILDREN ATTENDING THE NEUROLOGY CLINIC IN A TERTIARY HOSPITAL IN SOUTHERN NIGERIA.

Anthony O. Atimati, Olusola P. Okunola

Background: Feeding disorders are estimated to occur in up to 25 - 35% of healthy children and 80% of neurologically impaired children. Dysfunctional oral-motor control, abnormal neurologic maturation, poor seating posture during feeding among others result in feeding problems in children with neurologic disorders. Early detection and nutritional support are important in preventing poor growth and development which may result from feeding disorders.
Objective: To ascertain the presence of feeding disorders in children attending the neurology clinic of the University of Benin Teaching Hospital.
Materials and Method: A descriptive cross-sectional study carried out in the University of Benin Teaching Hospital. A semi-structured interviewer-administered questionnaire was used in obtaining information from the parents/caregivers of the children who were recruited consecutively from the neurology clinic.
Results: Of the 154 subjects recruited for the study 63 (41%) and 59 (38%) had cerebral palsy and seizure disorder/epilepsy respectively. Fifty-six caregivers (36.4%) had unpleasant experience during mealtimes. Excessive salivation, choking and chewing difficulties ranked highest among the feeding problems in the children. Forty-four (28.6%) children had multiple feeding problems. Gender, age group, feeding experience and neurological diagnosis were significantly associated with multiple eating problems. Forty-one (26.6%) children were underweight while 7.1% were overweight.
Conclusion: Feeding problems, which are often accompanied by unpleasant mealtime experience for caregivers, are common in children with neurological impairments. Assessment of the feeding pattern and nutritional status of children should be undertaken in the outpatient neurology clinic.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

CORRELATION BETWEEN AETIOLOGY, STAGE AND DURATION OF CHRONIC KIDNEY DISEASE AND HEARING LOSS

Adekwu A, Ibiam F A, Ogbeyi G A, Abah R, Agaba E I, Ezeanolue B C,

Background: The incidence of chronic kidney disease (CKD) in Nigeria and the Black race in general is on the increase with attendant high morbidity and mortality. Several aetiologic factors have been implicated in CKD which include hypertension, diabetes mellitus, glomerulonephritis, obstructive uropathy, recurrent pyelonephritis and adult polycystic kidney disease (ADPKD) amongst others. Whatever maybe the aetiologic factor of the CKD, there is reported effect of this condition on the auditory organ at the level of cochlea because of certain similarities.
Objective: To determine if there is any correlation between the aetiology, stage and duration of chronic kidney disease with the severity of hearing loss.
Methodology: A one-year prospective study which sought information on demographics, aetiologic factors, otologic, drug and occupational histories of patients with chronic kidney disease using a structured interviewer administered questionnaire. Additionally, body weight, height, blood pressure, fasting blood sugar and serum creatinine were measured for all the patients while pure tone audiometry(PTA) and glomerular filtration rate (GFR) were measured or calculated respectively.
Results: One hundred CKD patients were analysed, comprising of 66 males and 34 females with a male to female ratio of 1.9:4. Their ages ranged from 15years to 75years with mean age of 40.2(SD±18.4). The majority of the studied population was in the 45-54 years (28%). Sensorineural high frequency hearing loss was found in 60 patients, made up of 49 in both ears and 11 unilateral (3 and 8 in right and left ears respectively). These gave a total of 109 ears (54.5%). Chronic kidney disease resulting from chronic glomerulonephritis or hypertension accounted for 45.0% and 36.0% cases respectively. Hearing loss increases with the CKD stage accounting for 15.6%, 34.9% and 48.6% for stages 3, 4 and 5 respectively. The longer the duration of the CKD, the more depressed was the mean hearing threshold (P=0.0047; r=0.870).
Conclusion: There is significant correlation between hearing loss in the high frequencies and duration and stage of chronic kidney disease patients. Therefore, we recommend health education with a view to identifying this category of patients’ early and effecting periodic hearing assessment in them.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

SOCIOCULTURAL BELIEFS REGARDING MIDLINE DIASTEMA AMONG UNDERGRADUATE STUDENTS ATTENDING A NIGERIAN UNIVERSITY

Enabulele Joan E, Aghamiogie Ehis

Introduction: Perception of maxillary midline diastema as an aesthetic trait varies in relation to culture, age group, and racial background. This study determined the self-reported prevalence of maxillary midline diastema as well as assessed the sociocultural beliefs regarding maxillary midline diastema among undergraduate students of different ethnicity attending a Nigerian university.
Methods: A descriptive cross-sectional study of undergraduate students in University of Benin. A self-administered structured questionnaire was utilized for this study. The questionnaire sought information on socio-demographic profile of the participants, self-reported presence of midline diastema, the characteristics of the diastema and sociocultural beliefs regarding midline diastema. Statistical analysis was done using IBM SPSS 21.0. Cross tabulation was used to report categorical variables which were presented as counts and percentages. Chi-square test was applied to determine associations between variables with the level of significance set at p<0.05.
Results: A total of 400 students aged 16 to 46 years and a mean age of 21.86 years (±3.07) took part in this study. 29% of the study population had maxillary midline diastema. Most cases were recorded in the maxillary arch (96.6%). All ethnic groups and students in lower age group saw maxillary midline diastema as a sign of beauty and perceived it to be more attractive in female.
Conclusion: Based on the study, midline diastema is regarded as a sign of beauty, all ethnic groups perceived midline diastema as an aesthetic attribute.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

FACTORS ASSOCIATED WITH EARLY MORTALITY IN HIV PATIENTS THAT PRESENTED FOR CARE IN A TERTIARY HEALTH FACILITY IN NORTHEASTERN NIGERIA

Ballah Akawu Denue, Wadzani Gashau

Background: Despite huge success achieved in HIV management through early detection of cases and use of potent antiretroviral therapy (ART), human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) remains amongst the leading causes of death in sub-Saharan Africa. Aim: To identify factors associated with death within one year of initiating ART in HIV/AIDS patients that presented for care with advanced disease (in WHO clinical stages III/IV).
Methods: This study analysed the records of patients admitted with advanced HIV disease, between January 2009 and December 2013. Information needed was sourced from patients’ medical records and death certificates. During the study period, 273 patients were admitted, out of whom 119 satisfied the inclusion criteria. Of the 119 patients, 108 with complete data were analysed giving a retention rate of 90.1%. Among the participants, 51 cases died within one year of initial evaluation and 57 were alive after one year (survivors).
Results: Males were older than females in both the mortality cohort (p = 001) and survivor cohort (p = 0.01). Male gender (Crude odds ratio [COR] 2.27, 95% confidence interval [CI]: 1.08 – 5.21); HIV RNA viral load = 100,000 copies/ml (COR 2.69, 95% CI: 1.20 – 6.03) and anaemia (haemoglobin concentration < 10.5g/dl) (COR 6.66, 95%CI: 2.74 – 16.17) were predictors of mortality in univariate analysis. After adjusting for confounding variables on multivariate analysis, anaemia (Adjusted odds ratio [AOR] 4.33, 95%CI: 1.27 – 14.83) remained the only predictor of death
Conclusion: Anaemia is an independent predictor of early mortality in patients that present with advanced HIV disease in our environment.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS HEPATITIS B VIRUS SCREENING AND VACCINATION AMONG AUXILIARY HEALTH WORKERS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL (UMTH)

Kida IM, Umar B, Goni BW, Garbati MA, Adamu I, Ogah D, Bakki B, Dayar AD, Ummate I, Yusuph H.

Background: Hepatitis B is one of the important blood-borne diseases that pose a challenge to public health. It is the most common cause of liver infection globally. Despite the high risk of hepatitis B in healthcare workers, the knowledge, attitude, and practice concerning hepatitis B infection among them is low.
Aim: To document the level of awareness of HBV infection among auxiliary health workers and to identify the source of information on the knowledge of auxiliary health workers towards HBV infection.
Methods: A cross-sectional descriptive study involving 240 auxiliary health workers in the University of Maiduguri Teaching Hospital that were interviewed using an interviewer-administered questionnaire.
Results: The study population comprised an equal number of males (50%) and females (50%). The mean age of the respondents was 32.9 years. Majority had secondary education 96(40%) and were Kanuri tribe. In total, 81.1% of respondents knew that HBV is caused by a virus, and 70.8% believed the virus can be transmitted through blood transfusion and 71 (29.6%) through unprotected sexual intercourse. One hundred and sixty-eight (74.2%) respondents were aware of the availability of HBV screening programmes in the facility, 131 (54.6%) of them had been screened for HBV and received HB vaccine. Majority (96.7%) of the respondents believed that HBV is a public health problem, 93.8% agree their job puts them at high risk of HBV infection.
Conclusion: The study concluded that majority of the respondents had information about HBV, and the major source of information was through other health workers. A good number of the respondents had been screened or taken vaccination against HBV.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

SOCIO-DEMOGRAPHIC AND CLINICAL PROFILE OF BREAST CANCER PATIENTS IN BENIN CITY, NIGERIA

Oludare Folajimi Adeyemi,1 Godwin Enosakhare Okungbowa,2 Osesogie Usuale Ogbeide

Background: Although breast cancer is reported as the commonest cancer in women, there is a dearth of literature and research concerning patient profile and utilization of hospital radio-therapeutic services.
Aim: The aim of the study was to document the knowledge of socio-demographic profile and clinical pattern which is a requirement for control measures and appropriate treatment of cancers.
Method: This was a retrospective study made up of 257 patients seen in University of Benin Teaching Hospital (UBTH) and undergoing their radio-therapeutic clinic visits for breast cancer. The data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0.
Result and Conclusion: The age ranged between 23 - 83 years, with a mean of 48.94 ± 11.09 years, median of 48 years and mode of 43 years. Out of these total 47.6% of the breast cancers were located in the right breast and 51.2% were on the left, with invasive ductal carcinoma (93.7%) as the most common histological type. This basic information on socio-demographic and clinical profile of patients can help plan and optimize the utilization of hospital services, more especially in a resource poor country like Nigeria.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

HEAD INJURY IN MAIDUGURI: AN 18 MONTH REVIEW

Usman B, Mohammed B

Background: Traumatic brain injury is a leading cause of death and disability in young adults (?44years) and in children (>1 year). Early diagnosis, prevention of secondary injury and treatment of complications reduces the morbidity and mortality. However, with the on-going civil-military conflict in our region (Boko Haram), achieving this is difficult.
Method: A retrospective analysis of case records of all patients with traumatic brain injury managed by our unit from May 2015 to October 2016 (18 months).
Results: A total of 1529 trauma cases were recorded in the Emergency Department. There were 269 traumatic brain injuries. One hundred and forty-seven (147) were treated at the emergency department, while 122 patients were transferred to the wards and Intensive Care Unit (ICU) for further management. Road traffic accident (RTA) was the leading cause (62.87%) followed by missile injury (bomb blast/Improvised Explosive Device [IED] and Gunshot) in 65 patients (24.17%). Neuro-imaging was not readily available for assessment. Fourteen (14) had various surgical interventions. Good outcome was recorded in 239 patients (88.91%). Mortality was recorded in 50% of ICU patients.
Conclusion: In addition to RTA, missile injuries are common causes of head injury in our society ravaged by a civil-military conflict (Boko Haram). The severity of the primary injury, non-availability of functional neuroimaging to guide subsequent intervention contributed to the mortalities.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

PARAPLEGIA: AN UNCOMMON PRESENTATION OF PARASAGITTAL CONTUSIONS; A CASE SERIES

Babagana Mohammed, Nasiru Ismail Jinjiri, Mohammad R. Mahmud, Ali Lassieni

Background: In our hospital setting, the presence of a sudden bilateral lower limb paraplegia following trauma directs the mind of the clinician towards injury to the spinal cord; however, cerebral causes of paraplegia do occur even though such presentations are rare entities after traumatic brain injury. Patients presenting with acute inability to move both lower limbs were diagnosed to have spinal cord injury following multiple trauma or road traffic accident by casualty staff.
Methods: We report three cases seen over a period of two years, with the patients presenting with a history of acute paraplegia following trauma: assaults or road traffic accident. Further evaluation revealed alteration or loss of consciousness and evidence of injuries to the skull. Neurological examinations revealed flaccid weakness of the lower limbs with power of grade 0 (MRC grade: 0/5), all sensory modalities of the lower limbs were preserved. Normal anal tone and superficial abdominal reflexes; there were no areas of tenderness or deformity over the spine.
Results: Initial radiologic evaluations of the spine showed normal findings, and all patients had computed tomography (CT) of the brain that revealed acute bilateral parasagittal contusions in the fronto-parietal region. Following active physiotherapy over a period of three to seven (3-7) weeks, all patients regained muscle power of at least 4/5, ability to walk, and were later discharged from the hospital.
Conclusion: A high index of suspicion is needed in diagnosing paraplegia secondary to different aetiologies such as parasagittal contusion. A low threshold in requesting for neuroimaging scan of the brain is required, although, Computed tomography (CT) done within first 1-3 days may be falsely negative.

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archives-15-1

Written by Administrator. Posted in Archives

 
 

 

January - June 2018
Volume 15 | Issue 1

This journal has been online since Saturday, April 05, 2013

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ORIGINAL ARTICLES


 
 
 

PHYSICAL ACTIVITY AND QUALITY OF LIFE AMONG ADULTS IN MAIDUGURI, NIGERIA

Rufa’i AA, Oyeyemi AL, Salamatu UA, Saidu IA, Aishatu US, Oyeyemi AY

Background: Engaging in sufficient physical activity (PA) improves health and quality of life (QOL) across all ages.
Objective: The objective of this study was to determine the relationship between demographic variables, PA and QOL among adults in Maiduguri, Nigeria.
Methods: A total of 390 apparently healthy male and female adults (age range =18–65 years) in Maiduguri participated in the study. PA level was assessed with the International Physical Activity Questionnaire- Short Form. Health-related QOL was assessed using the physical and mental components summary scales (PCS & MCS) of the MOS Short Form-12 health survey questionnaire. Pearson’s correlation was used to explore the relationships between age, PA and QoL of the participants.
Results: The mean age of the participants was 29.51±10.12 years. About half of the participants were males (52.8%) and employed (54.4%). Age was inversely correlated with total PA (r= -0.13, P<0.001) and PCS (r= -0.32, P<0.001). Total PA was negatively correlated with PCS (r= -0.13, P= 0.010) but positively with MCS (r= 0.17, P= 0.001). There was significant difference in total PA (P<0.001), PCS (P<0.001) and MCS (P<0.05) between female and male, and also between the employed and unemployed. Also, there was significant difference in PCS (P<0.001) and MCS (P= 0.003) between participants with higher education and those with non-formal education.
Conclusion: Significant relationships were found between demographic variables, PA and QOL components among the participants. These results affirm that PA is important to improving the QOL of adults in Maiduguri.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

PREVALENCE AND CAUSES OF OCULAR MORBIDITY AMONG PRIMARY SCHOOL CHILDREN IN SOKOTO METROPOLIS, NORTH-WESTERN, NIGERIA

Olatunji Lawal K, Oche Mansur O, Adamu Habibullah1, Mohammed Dantani A, Abdulsalam Latifatu B, Arisegi Sarafadeen A

Background: Vision plays an important role in child development, as this is essential for receiving visual sensory information from the external environment and social development.
Objectives: This study aims at determining the prevalence and causes of ocular morbidity among primary school children within sokoto metropolis.
Materials and Method: A descriptive cross sectional survey of primary school children in Sokoto metropolis was carried out between July 2016 and August 2016. Relevant socio-demographic history and ocular examination was carried out on the primary school children that were selected using a multi-stage sampling technique. Data were entered and analysed using the MS Excel 20 and Statistical Package for Social Sciences (IBM SPSS) version 20.
Results: A total of 184 pupils were surveyed; 85 (46.2%) were males and 99 (53.8%) were females. The age range was between 5 and 15 years and the mean age was10.84years ± 2.19. The prevalence of ocular morbidity among the primary school children was 29.3%. Conjunctivitis was found to be the commonest ocular morbidity with a prevalence of 17.9% followed by refractive error with a prevalence of 7.6% while no cases of colour vision or cataract were seen.
Conclusion: The sheer magnitude of ocular morbidity among primary school children calls for need to introduce or improve the school eye health program as part of the routine school heath services.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 

PTERYGIUM EXCISION WITH PRIMARY CLOSURE IN SOKOTO, NORTH WEST NIGERI

Mohammed Dantani Adamu

Background: The essence of pterygium surgery is to excise the pterygium and inhibit recurrence. Multiple surgical techniques have evolved over the years to excise the pterygium and inhibit its recurrence.
Objective: To determine the outcome of pterygium excision with primary closure in terms of recurrence.
Methods: A retrospective review of medical records of all patients who had pterygium excision with primary repair during the study period at Usmanu Danfodiyo University Teaching Hospital and Specialist Hospital, Sokoto was undertaken. Data on demographic variables, extent of pterygium and pterygium recurrence after 6 months and postoperative
complications were extracted and analyzed.
Results: There were a total of 32 eyes in 32 patients studied with age range between 26 to 68 years {mean age of 47.2 (SD +12.32)}. There were 15 males and 17 females (M:F = 1:1). Majority of the patients had stage 3 pterygium (65.3%) followed by stage 2 (27.2%) and stage 4 pterygium (7.5%) was the least in frequency P=0.02, CI (2.50-2.95). There were twenty-nine patients (90.6%) with primary pterygia while three (9.4%) had recurrent pterygia. 56.2% of the patients had occupations with possible significant exposure to actinic damage. Recurrence occurred in 12.5% of the patients after 6 months’ follow-up.
Conclusion: Pterygium excision with primary closure appears to be safe and effective. Future comparative case series and randomized controlled studies are recommended

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 

Pattern of Cancers at a Rural Referral Centre in North-Eastern NIGERIA

 

Hadiza A. Usman, Bala M. Audu, Ibrahim M. Sanusi, Mohammed Bukar, Pindiga U. Hamidu2

Background: Cancers have wide regional, urban/rural variations in reported prevalence.
Objectives: To determine the baseline pattern of cancers in the first 5 years from Hospital-based records of cancer cases at Federal medical centre Nguru, Northeast Nigeria.
Methods: A retrospective review of all histologically confirmed cancer cases managed at a rural referral tertiary health facility in Northeast Nigeria for the period 1st January, 2009 to 31st December, 2013 was undertaken.
Results: Of the 237 histological specimens during the period under review, 165 (69.6%) were cancers. Female cancers (n=101; 61%) were more than male cancers (n=64; 39%) and the mean age (±SD) for all cancers was 48.1(±18.7) years. The mean age for cancer was lower in females (Student t-test 5.103, P < 0.001). The mean ages for the 3 commonest cancers in this centre were; 45.1 ± 15.2 years for breast; 49±10.9 years for cancer of the cervix and 67.4±7.6 years for prostate cancer. The commonest cancer sites were in the female and male genital tracts. However, review of individual cancers showed that breast cancer was the commonest (n=31; 18.8%) followed by prostate cancer (n=29; 17.6%). The 3rd commonest cancer was that of the cervix which constituted 11.5% (n=19). Skin (excluding melanoma), gastrointestinal, head and neck and melanoma constituted 8.0%, 6.6%, 6.0% and 4.2% respectively. Only 1 case of childhood cancer (endodermal sinus tumour) was seen in an 18 months old child while cancers in teenage age group (13- 19 years) constituted 3% (n=5); there were 2 squamous cell carcinoma of the skin, 1 each for Hodgkin’s lymphoma, osteosarcoma and a retinoblastoma.
Conclusion: The pattern of cancers in this rural population is similar to findings in other parts of the country. Women have the highest burden but a lower mean age of cancers in this study. Breast, prostate and cervical cancers were the 3 commonest cancers constituting 48% of the cancer burden. There is the need for strategic preventive measures, including the establishment of an oncology unit, to reduce the burden of cancers in this community.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

RELATIONSHIP BETWEEN GASTRIC CANCERS AND TRIO OF HELICOBACTER PYLORI INFECTION, CHRONIC GASTRITIS AND GASTRIC MUCOSAL INTESTINAL METAPLASIA AS SEEN IN JOS UNIVERSITY TEACHING HOSPITAL, NIGERIA

 
Kwaghe BV, Ochigbo AJ, Nggada HA, Emmmanuel I, Abobarin OI, Akpa PO, Richard KS
Background: In 1994 Helicobacter pylori was classified as class 1 human carcinogen by the IARC (WHO), based on epidemiological evidence. Experimental evidence was subsequently provided by Wantabe et al. This has triggered several studies on the prevalence of H. pylori in patients with Gastric cancers in various regions of the world. In Africa the infection rate in various populations as reported by some studies are not parallel to the incidence of morbidity caused by this infection.
Objective: To determine the relationship between Helicobacter pylori infection, Chronic gastritis, Gastric mucosal intestinal metaplasia with Gastric cancers.
Methodology: This was a retrospective histopathological study of all gastric cancers with adjacent non – cancerous epithelium seen between January 2005 and December 2012 in the department of Histopathology, Jos University Teaching Hospital (JUTH). Blocks and archival slides were used for the study.
Results: Out of the 79 cases of gastric cancers seen within the study period, only 46 cases had adjacent non-cancerous epithelium and were included in the study. This comprises of 38 cases of Adenocarcinoma and 8 other tumours. Chronic gastritis was seen in 33 (71.7%) cases. Intestinal metaplasia was present in 14 (30.4%), while H. pylori was seen in only 7 (15.2%) cases.
Conclusions: Gastric cancers are not rare in Jos and there is a relationship between it and the trio of H. pylori infection, chronic gastritis and gastric mucosal intestinal metaplasia.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

COLORECTAL POLYPS IN KANO: A TEN YEAR HISTOPATHOLOGICAL REVIEW

 

Yusuf Ibrahim, Aminu Dahiru MC

Background: Colorectal polyps are mucosal growths that occur in the large intestines. The adenomatous variants are precursors of colorectal cancer which is the third and fourth most common cancer among males and females respectively.
Objectives: This study documents the frequency, distribution and histopathological characteristic of colorectal polyps in our centre.
Method: This was a 10-year retrospective study of colorectal polyps diagnosed in the Pathology laboratory of a tertiary hospital from 2007 to 2016. Archived histopathology slides were reviewed to confirm the diagnosis. Relevant clinical information was obtained from patients' request forms. Data were presented as mean, standard deviation, frequencies and percentages. Relationships between neoplastic polyps and age, gender and anatomic site were measured using Fishers exact test.
Result: There were 124 cases of colorectal polyps recorded. Of these, were 82 (66.0%) males and 42 (34.0%) females (M:F=1.9:1). The average age at presentation was 29.0 ±23.6 years. Highest frequency of 45(36.2%) cases was in the 1st decade of life. There were 87(70.0%) cases in distal colon/rectum while 37(30.0%) were in the proximal colon. Juvenile polyps had the highest frequency overall, (60 cases, 48.0%), followed by tubular adenoma (31 cases, 25.0%), hyperplasic polyp (11 cases, 8.9%), villous adenoma (9 cases,7.3%), inflammatory polyp (6 cases,4.8%), tubulo-villous adenoma (3 cases, 2.4%), retention polyp (2 cases, 1.6%) and sessile serrated polyp (2 cases, 1.6%). There were 43 (34.7%) cases of neoplastic polyps. The average age of patients with neoplastic polyps was 47.3 years and they are located mostly in proximal colon (23/37 cases) (P<0.05).
Conclusion: Colorectal polyps are common in our environment especially juvenile polyp encountered mostly in children. We recorded significantly lower prevalence, lower mean age at presentation of neoplastic polyps compared to Western populations. This highlights the need for earlier age screening colonoscopy to detect and treat premalignant polyps.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

SONOGRAPHIC EVALUATION OF CAROTID ARTERY LUMINAL DIAMETER AND DEGREE OF STENOSIS IN ADULT DIABETIC PATIENTS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, NORTH EASTERN NIGERIA

 
Ahmadu MS, Mubi BM, Adeyomoye AAO, Ahidjo A, Adeyinka AO, Tahir AA
Background: Carotid artery luminal diameter measurements have been used as clinico-radiological index of carotid artery atherosclerosis in patients with diabetes mellitus. Luminal diameter values have also been used in epidemiological and interventional studies as surrogate index of carotid atherosclerosis. However, values for luminal diameter measurements in diabetic patients are scarce in our environment.
Objectives: This study evaluates the carotid artery luminal diameter dimensions and degree of stenosis among adult diabetic patients using carotid duplex ultrasonography (CDUS).
Methods: This was a cross-sectional study carried out at the University of Maiduguri Teaching Hospital, Nigeria. One hundred and twenty adult diabetic patients aged 20 - 78 years had CDUS for measurements of carotid artery luminal diameter and degree of stenosis. Measurements were taken at 1cm below and 1cm above the carotid bulb for the common carotid (CCA) and internal carotid arteries (ICA). Pearson’s correlation and Student t-test were used to compare the means between the variables.
Results: There were 72 males and 48 female diabetic patients aged 20 to 78 years (mean = 50.03±11.4 years). The mean luminal diameter, in millimeters (mm), for normal (non-stenotic) carotid arteries on the right and left were (CCA=6.58±0.52 and 6.51±0.50; ICA=4.80±0.29 and 4.79±0.31); and abnormal (stenotic) were (CCA=6.41±0.62 and 6.35±0.62; ICA=3.44±0.44 and 3.11±0.29) respectively. A total of 75 patients (62.5% of study population) had no carotid artery stenosis; 38 patients (31.7%) had <50% carotid stenosis; 6 patients (5.0%) had 50-69% carotid stenosis; and 1 patient (0.8%) had 72% carotid stenosis. The prevalence of carotid stenosis in diabetic patients was 37.5% in this study. Negative and significant correlation was noted between percentage degree of stenosis and luminal diameter (r== - 0.5; p=<0.05).
Conclusion: The findings of this study have indicated the presence of atherosclerotic changes in the carotid arteries of adult diabetic patients in our environment who are at risk of developing stroke from carotid stenosis. CDUS has proved to be a valuable diagnostic and screening tool in the evaluation of these patients because of its safety, low cost, wide availability, and accuracy in detecting carotid artery disease.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

LUND-MACKAY SCORING OF INCIDENTAL PARANASAL SINUS COLLECTION ON COMPUTED TOMOGRAPHY SCAN OF HEAD AND NECK IN THE UNIVERSITY OF BENIN TEACHING HOSPITAL, NIGERIA

 

Ighodaro O. Emmanuel, Ehigiamusoe O. Festus

Background: Many a times during computed tomography scan of the head and neck, incidental density is noted in the paranasal sinuses in patients who are asymptomatic and there is need to document the degree of such opacification.
Objectives: To document the opacification and generate a numerical scoring system described as Lund Mackay Score which eases communication between the Radiologist and the referring Ear, Nose and Throat Surgeon in describing sinusitis.
Methods: This is a prospective study done in the Radiology Department of University of Benin Teaching Hospital, Benin, Edo, Nigeria. A total of 150 patients were enrolled for this study with 62% being male and 38% being females. They were patients who had cranial and neck computed tomography scans for pathologies other than that related to the sinuses.
Results: The mean age of the study population was 52.70±18.71years. Cerebro-vascular accident was the commonest indication for computed tomography scan in this study (49.3%). The total Lund Mackay Score was 0.803±2.90 for all sinuses being 0.417±1.47 for the right sinuses and 0.386±1.43 for the left sinuses. For the right, the maxillary sinus had the highest Lund Mackay Score with a value of 0.210±0.46 while the posterior ethmoidal sinus had the least Lund Mackay Score with a value of 0.027±0.16. For the left sinuses, the maxillary sinus also had the highest Lund Mackay Score value of 0.173±0.40.The posterior ethmoidal sinus also had least Lund Mackay Score value of 0.033±0.18. The Lund Mackay Score of the osteomeatal complex was 0.013±0.12 and 0.007±0.08 for the right and left respectively.
Conclusion: This study has documented the Lund Mackay score for incidental paranasal sinus
opacification as seen on computed tomography scan in our environment.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

MOLECULAR AND CONVENTIONAL METHODS OF DETECTING RESPIRATORY VIRUSES AMONG CHILDREN WITH LOWER RESPIRATORY TRACT INFECTION IN SOKOTO, NIGERIA

 
Shuaibu A. Hudu, Nabil S. Hamal
Background: Most infections of respiratory tract are caused by viruses but bacteria with viruses contributing to a higher proportion of infection.
Objectives: The aim of the study was to assess the epidemiology of respiratory viral infections among children less than five years of age hospitalized with acute lower respiratory tract infections (ALRTIs) at Specialist Hospital, Sokoto using conventional and molecular detection methods.
Methods: The cross-sectional study was designed to investigate the occurrence of respiratory viruses including (RSV), human Metapneumovirus (HMPV), influenza virus A and B (IFV-A and B), parainfluenza virus 1, 2, 3 and 4 (PIV 1, 2, 3 and 4), human rhinoviruses (HRV), human enterovirus (EV), human coronaviruses (HCoV) 229E and OC43, human Boca virus (HBoV) and human adenovirus (HAdV) among hospitalized children with acute lower respiratory tract infections (ALRTIs), at Specialist Hospital, Sokoto, from June 16 to December 21, 2010. The present study was also designed in part to assess the performance of the conventional methods against molecular methods.
Results: Etiologic agents were detected in 158 (95.8%) of the patients. Single virus was detected in 114 (67.9%) patients; 46 (27.9%) were co-infected with different viruses including double-virus infections in 37 (22.4%) and triple-virus infections in 9 (5.5%) ca;ses. RSV (50.3%), with predominance of group B, played a major role. Other etiological agents including HAdV, HMPV, IFV-A, PIV 1-3, HBoV, HCoVOC43 and EV were detected in 14.5, 9.6, 9.1, 4.8, 3.6, 2.4 and 1.8 percent of the samples, respectively.
Conclusion: Our results demonstrated the potential usefulness of molecular detection methods compared with conventional methods for the diagnosis of ARTIs among hospitalized children. This is the first report of HMPV, HBoV and HRV infections among hospitalized children in Sokoto.

 

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

A TEN-YEAR REVIEW OF CHILDHOOD PATTERN OF ENDOCRINE DISORDERS SEEN IN FEDERAL TEACHING HOSPITAL GOMBE

 
Alkali YS, Adamu S, AB Ningi, A Girbo
Background: The endocrine system is a network of glands which produce hormones that regulate metabolic functions of other cells and organs. Disruption of this system results in abnormalities of growth, development and reproduction. These conditions are not rare in childhood but due to lack of diagnostic facilities, they are not looked for and are therefore under-reported. However, they should be detected early and managed promptly to avert the morbidity and possible mortality that may be associated.
Objectives: To describe the pattern of childhood endocrine diseases in Federal Teaching Hospital Gombe.
Methodology: A retrospective hospital-based study in which data were extracted from case notes of children with endocrine disorders. These case notes were traced from the registers of all paediatrics units and general out-patient departments. These case notes were subsequently reviewed and relevant data extracted and entered unto a proforma. Outcome measures as well as complications of those admitted were also noted.
Results: Ninety-four out of 14,943 paediatric cases seen were endocrine disorders giving a prevalence of 6.3/1000 with a male/female ratio of 1.5/1. Most of the cases (75%) presented before the age of ten years and Type 1 Diabetes Mellitus was the commonest disorder recorded.
Conclusion: Type 1 Diabetes Mellitus is the commonest paediatric endocrine disorder seen in Federal Teaching Hospital Gombe.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

EFFECT OF SUB-CHRONIC ORAL EXPERIMENTAL EXPOSURE OF MONOSODIUM GLUTAMATE ON BIOMARKERS OF HEPATIC AND RENAL FUNCTION IN MALE WISTAR RATS

 
Hassan Abdulsalam, Jamila A. Atata, Ali Waziri, Mohammed A. Chiroma, Joseph J. Gadzama, Modu B. Monguno, Sani N. Abdulazeez, Israel J. Barde
Background: Monosodium glutamate (MSG) is a food additive that acts as a preservative or as enhancer of palatability and is locally called Ajinomoto or white magi in Nigeria.
Objectives: This study assessed the effect of sub-chronic oral exposure to monosodium glutamate (MSG) on some plasma biomarkers of hepatic and renal function in adult male Wistar rats.
Methods: Sixty-four adult male Wistar rats of average weight 150 to 200 g were randomly assigned into two groups of MSG-treated and non-MSG-treated control rats (n=64). The control rats were orally given distilled water only while the MSG-treated rats were administered 5 g/kg body weight of MSG at concentration of 500 mg/ml daily throughout the period of the experiment that lasted 8 weeks; feed and water were provide to both groups ad libitum. A total of 8 rats, 4 per group were sacrificed weekly for blood sample collection and analysis of hepatic and renal biochemical indices.
Results: the result of biochemical analysis showed significant increase (P = 0.05) in mean of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Urea and Creatinine activities in the MSG-treated rats.
Conclusion: The increases in the levels of plasma biochemical parameters signal some level of alteration in the normal physiologic function of both liver and kidney.

[FULL ARTICLE (PDF)]


ORIGINAL ARTICLE


 
 

CAREER ASPIRATIONS OF MEDICAL STUDENTS AND MEDICAL INTERNS IN GHANA. IS THERE A DIFFERENCE?

 
Yifieyeh AC, Duduyemi BM, Kumahor E, Kotoku E, Moses MO, Fefemwole P, Akwetey FM
Background: Understanding the reasons for the selection of medical specialties by medical graduates is necessary for policy formulation and targeted mentoring to prevent a skewing of the lean resources and maximize the improving doctor to patient ratio in Ghana. This is particularly so due to an increase in the desire for specialization among medical graduates since the establishment of the Ghana College of Physicians and Surgeons.
Methodology: A cross-sectional study was designed. To consenting first and final year clinical students of the School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana and first and second year medical interns at Komfo Anokye Teaching Hospital and Sunyani Regional Hospital respectively were administered semi – structured questionnaires. Data were analysed with SPSS version 24 and result put in tables and graphs
Result: Three hundred and forty and 100 questionnaires were administered to students and interns with 92% and 75% responders’ rate respectively. The M: F ratio for students and interns were 1.23:1 and 1.34:1 respectively. Postgraduate specialization and additional qualification were desired by all categories irrespective of sex, financial or family consideration. Surgery (43.9% students; 33.3% interns) and Internal Medicine (23.8% students; 24% interns) were the 2 most popular choices.
Conclusion: While Surgery and Internal Medicine appeared to be the favoured choices by our students and interns, deliberate effort through mentoring is required to avert lop-sidedness in workforce in our hospitals.

[FULL ARTICLE (PDF)]


ORIGINAL ARTICLE


 
 

ANALYSIS OF BACTERIAL LOAD IN DOMESTIC WATER SOURCES IN EKPOMA, EDO STATE, NIGERIA

 
Jemikalajah, Daniel Johnson
Background: Drinking water must be free from harmful microorganisms that can cause serious ill health. Supplies of drinking water may be contaminated with sewage allowed to seep into wells or bore-holes, or faecal matter from man and animals passed into rivers, streams or pools of water.
Objectives: This study was carried out to ascertain the bacteriologic quality of domestic water sources used in Ekpoma, Edo State, Nigeria from February 2016 to June 2017.
Methods: Ten samples each of domestic water sources (sachet water, bore-holes, storage tanks, wells and river) were collected and bacteriological analysis was carried out using the total viable count and multiple tube fermentation technique to determine the most probable number of coliforms/ E. coli.
Results: The highest mean total viable count (TVC) of bacterial load of 4.1 x 106 CFU/ml was obtained for river water followed in descending order by 1.5 x 106 CFU/ml, 7.5 x 105 CFU/ml, 3.2 x 105 CFU/ml and 1.9 x 10 CFU/ml for reservoir well, reservoir tank, bore-hole and sachet water sources respectively on nutrient agar. The highest mean total viable count of bacterial load of 4.1 x 103 CFU/ml was recorded for reservoir tank followed by 1.3 x 103 CFU/ml, 3.7 x 102 CFU/ml, 3.6 x 102 CFU/ml and 0.0 CFU/ml for reservoir well, bore-hole, river water and sachet water sources respectively on macConkey agar. The highest mean of most probable number (MPN) for the presumptive total coliform counts of 140 MPN/100ml was observed for river and the lowest 0.4 MPN/100ml for sachet water. Also, the highest mean of most probable number (MPN) for faecal Escherichia coli counts of 31 MPN/100ml was obtained for reservoir well and the lowest 0.0 MPN/100ml for sachet water.
Conclusion: This study has shown that there is urgent need for an effective, thorough sanitary condition and proper purification given the bacteriological state of these water bodies in order to maintain good quality water.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

CONGENITAL CYSTIC EYE: A CLINICOPATHOLOGICAL REVIEW

 
Musa ZY, Askira BH, Zarami AB

SUMMARY
Congenital cystic eye is an extremely rare congenital anomaly that results from failure of the invagination of the primary optic vesicle between the 2mm and 7mm stage of fetal development in which the globe is replaced by a cyst. Management is multidisciplinary involving but not limited to the Ophthalmologist, Paediatrician, Radiologist, Histopathologist, an ocularist and a counsellor. Surgical intervention is usually carried out for cosmetic reasons and to confirm the diagnosis. We present the case of a seven-month female infant who presented with right orbital mass since birth and a normal left eye. She had excisional biopsy done and histology confirmed the diagnosis

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

BILATERAL PROXIMAL FEMORAL FOCAL DEFICIENCY IN A NEONATE: A CASE REPORT

 
Ahmadu MS, Farate A, Farouk AG

SUMMARY
Proximal femoral focal deficiency is a rare and complex skeletal anomaly characterized by failure of normal development of the proximal femur, shortening of the lower limb, and pelvic abnormality especially the acetabulum. It was first described by Aitken in the late 1950s. It commonly occurs as a unilateral form but the bilateral variant is rare occurring in 10-15 % of cases. To the best of our knowledge, bilateral proximal femoral focal deficiency has not been reported in Nigeria. We, therefore, present this case in a 25-day-old neonate who presented to our hospital with features consistent with this complex skeletal anomaly.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

HETEROTOPIC PREGNANCIES FOLLOWING NATURAL CONCEPTION; A REVIEW OF FOUR CASES

 
Muhammad B. Aminu, Lamaran M. Dattijo, Aliyu U. Elnafaty

SUMMARY
The occurrence of spontaneous pregnancy (viable or not) in one or more sites other than the endometrial cavity at the same time is an unusual phenomenon. We aimed to draw attention to
the varied clinical manifestations and outcomes of heterotopic pregnancy (HP) amongst four consecutive patients who were managed in our facility over a two-year period. It is imperative
for all clinicians to have a high index of suspicion for HP when seeing a woman of reproductive age with suspected ectopic.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

REMOVAL OF DISTALLY MIGRATED CANNULATED INTERLOCKING TIBIAL NAIL USING SCHANZ SCREW; A CASE REPORT

 
Mamuda AA, Bello, B.

SUMMARY
Background:
Distal migration of nails is one of the reasons for nails removal, though they are hardly reported in relation to cannulated interlocking nails.
Objectives: To present a rare case of distally migrated cannulated interlocking nail of the tibia and a proposed technique for the removal of the nail using Schanz screw.
Case: A 55year old woman had cannulated interlocking nailing for diaphyseal left tibial fracture 5 years prior to presentation. She later had septic loosening of the distal locking screw with subsequent symptomatic distal migration of the nail despite united osteosynthesis. Attempt at free hand removal using conventional instruments failed due to increased distance of the nail from the entry point, malrotation and lack of visibility of the nail following obliteration by fibrous and granulation tissues within the nail cavity. Thus, an improvisation with Schanz screw, due to its threading surface was used to capture and remove the nail successfully without any cortical damage of the bone.
Conclusion: The use of Schanz screw is a safe, cheap and effective means of free hand removal of distally migrated cannulated interlocking nails.

[FULL ARTICLE (PDF)]

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vol132_jult_dec_2016

Written by Administrator. Posted in Archives

 
 

 

January - June 2016
Volume 13 | Issue 1

This journal has been online since Saturday, April 05, 2013

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ORIGINAL ARTICLES


 
 
  SERUM LIPID PROFILES AND ATHEROGENIC INDEX IN PREGNANT SAHEL GOATS: PUBLIC HEALTH IMPLICATIONS

DAUDA YAHI, NICHOLAS ADETAYO OJO, GIDEON DAUDA MSHELIA

Background: Goat meat is very popular and has a great demand all over Nigeria. However, the slaughter of pregnant goats in abattoirs and slaughter slabs for meat is becoming a serious
concern not only for future livestock population, but also for public health. Dyslipidaemia of pregnancy in meat animals may constitute threat to consumers in terms of cardiovascular risks.
Objectives: The purpose of this study was to investigate the concentrations of serum lipids at different stages of gestation in Sahel goats and to evaluate the atherogenic capacity of the lipid profile. Materials and Methods: Serum lipids profiles and atherogenic indices in pregnant and nonpregnant Sahel goats were studied. Fourteen apparently healthy adult Sahel goats comprising 12 does with mean gestation length of 148.33 ± 1.52 days and 2 bucks were used for the study. They were managed in the University of Maiduguri livestock research farm on low fat diet. Sera samples were collected biweekly for 5 months and were used for the analysis of total Cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c) and very low density lipoprotein (VLDL-c). Atherogenic indices were calculated as base 10 log (TG/HDL-c). Results: Serum TG and VLDL-c concentrations increased significantly (p < 0.05) in pregnant does compared to non-pregnant. HDL-c and LDL-c concentrations did not vary significantly (p > 0.05) between the two groups. Atherogenic indices increased progressively with advancing pregnancy compared to non-pregnant. Conclusion: It was concluded that atherogenic capacity of the lipid profile in pregnant Sahel goats is high and therefore consumption of meat from pregnant animals has high potential for atherogenic risk. Routine antemortem inspection should be conducted at abattoirs to identify pregnant animals for restriction against slaughter. Legislation prohibiting the slaughter of pregnant animals should be enforced

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ORIGINAL ARTICLES


 

PREVALENCE AND OUTCOME OF PREGNANCY AMONG ELDERLY PRIMIGRAVIDA IN AMINU KANO TEACHING HOSPITAL, KANO: A 5 YEAR REVIEW

IBRAHIM SA, JABBO MA, ATTAH AR, GARBA ID, MUHAMMAD Z.

Background: As women increasingly delay child bearing, the proportion of women having their first delivery at ''advanced maternal age'' is expected to rise. These elderly primigravidae have traditionally been considered to be at increased risk of adverse maternal and perinatal outcomes compared to their younger counterparts, because of associated pregnancy and labour complications. Objectives: To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with that of younger primigravidae in Aminu Kano Teaching Hospital, Kano. Materials And Methods: This was a retrospective case control study comparing the pregnancy outcome of primigravid mothers aged 35 years and above (elderly primigravidae) with those of younger primigravidae aged 20-25 years, who delivered at Aminu Kano Teaching Hospital between January 2009 and December 2013. Results: There were 18,452 deliveries during the period under review, out of which 295 were primigravidae aged 35 years or above giving a prevalence of 1.6%. There was statistically significant higher preterm delivery rate ( X2= 10.30, P= 0.001) and caesarean delivery rate (X2= 12.15, P= 0.0001) among the elderly primigravidae compared to younger primigravidae. The elderly primigravidae were more prone to hypertensive disorders in pregnancy (X2=23.96, P=0.0001) and diabetes (X2=4.689, P=0.030) compared to the younger primigravidae. The prevalence of antepartum haemorrhage (X2=6.434, P=0.011) and uterine fibroids (X2=5.549, P=0.019) were also statistically significant among the elderly primigravidae compared to the younger primigravidae. There was no significant difference in the other maternal and foetal outcome measures. Conclusion: The prevalence of elderly primigravidae in this study was 1.6%. The prevalence of obstetric complications such as preterm delivery, antepartum haemorrhage, uterine fibroids coexisting with pregnancy and medical conditions like hypertensive disorders in pregnancy and diabetes mellitus are higher among elderly primigravidae compared to younger primigravidae. The elderly primigravidae were also more liable to have caesarean deliveries than the younger primigravidae. However there was no difference in the fetal outcome in the two groups.

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ORIGINAL ARTICLES


 
  TRADITIONAL UVULECTOMY AMONG THE NEONATES: EXPERIENCE IN A NIGERIAN TERTIARY HEALTH INSTITUTION  
ABDULLAHI M, AMUTTA SB.

Background: Traditional uvulectomy is widely practiced in some African countries with children more vulnerable to such practices, which may be associated with life threatening complications. Objectives: To determine the age at the time of the procedure, reasons and complication(s) following traditional uvulectomy. Materials And Methods: Retrospective study of hospitalized neonates presenting as emergencies following traditional uvulectomy to the accident and emergency department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, from June, 2004 to May, 2015. Results: A total of 21 cases were reviewed. Twelve(57.1%) males and 9(42.9%) were females: ratio of 1.3:1. The age ranged from 1 to 21 days with the mean age of 8.8 days. Majority 11(52.4%) of the thtraditional uvulectomies were performed before the 7 day of life. The mean duration before hospitalization was 8.4 hours. Post-uvulectomy haemorrhage 18(85.7%) was the most common complication and this was followed by septicaemia 3 (14.3%) with 2(9.5%) mortalities from the septicaemia. All the patients were anaemic. Prevention of sore throat 12(57.1%) was the main reason for traditional uvulectomy. Sixteen (76.2%) patients were lost to follow-up. Conclusion: Neonatal traditional uvulectomy was mostly done in the first week of life, prevention of sore throat was the common intent and complicated with post-uvulectomy bleeding and septicaemia. Health institutions have a role to play in public health education on the harmful effects of traditional uvulectomy.

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ORIGINAL ARTICLES


 
  SERUM ADIPONECTIN LEVELS IN PREGNANT WOMEN WITH GESTATIONAL DIABETES MELLITUS IN ZARIA, NORTH WEST NIGERIA: A CROSS SECTIONAL STUDY  

ABDULLAHI MOHAMMED, MOHAMMED MANU.

Background: Adiponectin is an adipocytokine that is exclusively produced by adipocytes with potent insulin-sensitizing property. It has been proposed to be involved in the pathogenesis of gestational diabetes mellitus, but its role is not clear; Findings from studies done across different ethnic groups are often inconsistent. Objectives: The aim of the study was to compare maternal serum adiponectin levels between Nigerian pregnant women with and without gestational diabetes mellitus. Materials And Methods: A cross sectional analytical study including one hundred and sixty nine pregnant women, 85 with gestational diabetes mellitus and 84 with normal gestation, who were evaluated between 24-28 weeks gestation. Diagnosis of gestational diabetes mellitus was made according to the WHO diagnostic criteria. Maternal serum level of adiponectin was measured and compared between pregnant women with gestational diabetes mellitus and the controls. Results: Mean maternal serum adiponectin level was significantly lower in pregnant women with gestational diabetes mellitus than in the controls (8.1 ± 1.6 vs. 10.1 ± 2.4 µg/ml, p< 0.05). When 2 2 subjects in the study groups were further categorized in to BMI < 25kg/m and BMI 25 kg/m , maternal serum adiponectin level remained significantly lower in the normal weight pregnant women with gestational diabetes compared to their BMI-matched controls (8.4 ± 1.7 vs. 11.4 ± 2.1 2µg/ml, p< 0.05). Among the overweight pregnant women (BMI 25 kg/m) on the other hand, there was no difference in maternal serum adiponectin level between pregnant women with gestational diabetes mellitus and the normal controls (7.8 ± 1.5 vs. 8.0 ± 1.1µg/ml, p> 0.05). Conclusion: It is concluded that normal weight Nigerian pregnant women with gestational diabetes mellitus in this study have lower serum adiponectin level compared to the normal weight pregnant women with normal gestation

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ORIGINAL ARTICLE


 
  SELF-REPORTED HEARING-RELATED COMPLAINTS AMONG DENTAL PROFESSIONALS: A QUESTIONNAIRE-BASED SURVEY  

ABDULAZEEZ AHMED

Background: As a result of workplace noise, dental personnel are potentially predisposed to auditory and non-auditory effects of noise which may expose hidden or imminent hearing impairment. There is the need to capture these self-reported hearing and hearing-related complaints using well designed questionnaires as a prelude to formal audiometric tests. Materials And Methods: This was a cross-sectional self-administered questionnaire study conducted between the periods April to August 2015. Participants were given questionnaires to fill and return which captured socio-demographic data and exposure to noise at workplace and symptoms experienced. Upon return of the questionnaire, each questionnaire was examined to ensure they were properly filled with signed consent. All data and findings were evaluated anonymously. Results: One hundred and thirty eight questionnaires were returned giving 86% response rate, 35(25.4%) reported hearing impairment. Eighteen (13.0%) respondents have experienced tinnitus, while 20 (14.5%) of the respondents experienced Hyperacusis, another 53(38.4%) of the respondents also have difficulty hearing in places with competing noise. Stress and sleep disturbance were also common complains. Conclusion: The presence of especially tinnitus, hyperacusis, impaired hearing in areas with competing sounds are all symptoms indicative of imminent hearing impairment that could be used to predict undetected hearing losses among dental personnel.

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ORIGINAL ARTICLE


 
  TESTICULAR AND PARATESTICULAR NON- NEOPLASTIC LESIONS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL: A 10-YEAR RETROSPECTIVE REVIEW  

ABBA K,TAHIR MB, DOGO HM , NGGADA HA

Objectives: The present study is undertaken to describe the spectrum of histopathological features and age distribution of non-neoplastic testicular and paratesticular lesions in the University of Maiduguri Teaching Hospital (UMTH). Materials and methods: A retrospective descriptive study of 70 testicular and paratesticular nonneoplastic lesions was conducted over a period of 10 years; between January-2005 and December2014 in the Department of Histopathology, UMTH. Histopathological examination was done after routine processing and staining with Haematoxylin and Eosin. Special stain (Ziehl-Neelsen stain) was done to confirm the presence of acid fast bacilli in cases of tuberculous epididymoorchitis. Results: There were of which
(24.3%) followed by testicular torsion and infarction (14.3%). The youngest patient was 2 years old and the oldest was 80 years of age. The highest incidence occurred in the age range of 30 – 59 years with a total of 25 cases representing 35.7%. The lowest incidence was observed in the elderly (= 60 years) with a total of 21 cases (30%). Conclusion: This study shows that inflammatory disorders are the predominant causes of the testicular and paratesticular non-neoplastic lesions capable of interfering with fertility and mimicking malignancy. There is also the need to emphasise the necessity of proper evaluation and treatment of acute orchitis and microabscess to avoid unnecessary orchidectomy.
70 cases of non-neoplastic testicular and paratesticular lesions the majority were inflammatory disorders accounting for 53 cases (75.7%). They included acute orchitis (4.3%), tuberculosis (12.9%), schistosomiasis (8.6%), hydrocoele (24.3%), chronic orchitis (10.0%), epididymal cyst (11.4%) and tumoral calcinosis (4.3%). Other categories of the lesions included congenital abnormalities (10.0%) and traumatic disorder (14.3%). Long-standing hydrocoele was the commonest lesion

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SHORT COMMUNICATION


 
  ROLE OF NATIONAL BLOOD TRANSFUSION SERVICE (NBTS) IN PROMOTING EMERGENCY OBSTETRICS CARE (EMOC)  
KULLIMA AA, KAGU MB, KAWUWA MB, BABA ZANNAH ALI, USMAN HA, BAKO BG

Background: Obstetrics haemorrhage is one of the leading cause of maternal mortality in our settings, this was compounded by the non availability to safe blood in situation of need. Hence the prompt access and availability of blood can avert this preventable cause of maternal death. Objectives: to highlight the benefits of effective collaboration with NBTS in ensuring prompt availability of blood for emergency obstetric services requiring blood for transfusion. Material And Method: All obstetrics cases requiring blood transfusion in FMC Nguru from 1st stJanuary 2006 – 31 December 2011 were retrospectively reviewed. Trends and pattern of the st strequest and source of blood were looked at within the two periods (from 1 January 2006 – 31 st stDecember 2008 and 1 January 2009 – 31 December 2011). Records of 1634 obstetric patients requiring blood transfusion or received blood transfusion in the maternity units were retrieved from the medical records, maternity ward record and blood bank. Information pertaining to their age, parity, indication for the transfusion or requests and source of blood was obtained for analysis. Data was analysed using simple percentage. st st Results: Between 1 January 2006 and 31 December 2008 only 513 (56%) of the units requested st st907 units of blood were supplied, while between 1 January 2009 and 1 December 2011 1367 ( 87%) of the 1567 units of blood requested were supplied. Within the earlier study period the only available source were from willing relatives and commercial blood donors, however between 2009 and 2011 more than 2/3 (64.2%) were supplied from the north east zonal NBTS office in Maiduguri. In 2006 through 2008, donation from relatives and commercial donors accounted for 53.22% and 46.78% respectively, but in 2009 and 2011 donation from relatives and commercial donors were recorded as 23.9% and 11.6% respectively. The commonest indication for the requests were anaemia, obstetrics haemorrhage (PPH, APH) and emergency C/S. Conclusion: Ready available source of blood will significantly improve timely availability of blood in our setting. There is the need to encourage this collaboration in other regions to ensure prompt availability of blood to attend to emergencies requiring blood transfusion.

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SHORT COMMUNICATION


 
  BONE MARROW ASPIRATION (BMA) IN ZARIA: A THREE-YEAR RETROSPECTIVE REVIEW  

AWWALU S, HASSAN A, DOGARA LG, MUSA AU, WAZIRI AD, BABADOKO AA

Background: BMA is a clinical procedure that exploits microscopy and lends itself to specialized biochemical and molecular assays for diagnosis, staging, prognostication and determining choice of therapy. Eligibility for BMA is determined following review of a patient's history, physical examination findings, Complete Blood Count and other relevant investigations. Bone marrow aspirates may be obtained from different sites of the body such as iliac crest, sternum etc. This study was to determine some patient characteristics, sites, indications and outcomes of all BMAs done between January 2002 and December 2004. It is hoped that this study will help haematologists and other physicians to understand the utility of BMA and some of its limitations. Material And Methods: It was a three-year retrospective, analytic review of all BMAs done in the stDepartment of Haematology, Ahmadu Bello University Teaching Hospital Zaria. Records from 1 stJanuary 2002 to 31 of December 2004 were retrieved, collated and analyzed using SPSS version 16. Results: A total of One hundred and thirty five (135) BMAs were done in the period under review. There was a male preponderance 77 (57.00%) with females constituting 58 (43.00%). The mean age was 31.78±20.76 years with a mode of 45 years. The minimum and maximum ages were 1 and 78 years respectively. The commonest site for BMA was the RPSIS 97(71.9%). Anaemia was the commonest indication for BMA 56(41.5%) followed by Splenomegaly 15(11.1%) and Lymphadenopathy 14(10.4%).The commonest diagnosis was combined deficiency anaemia 21(15.6%) followed by Megaloblastic anaemia 19(14.1%). Whereas 9(6.7%) were inconclusive, 14(10.4%) were normal. The complication rate was 0% and lymphadenopathy was the commonest indication that turned up with a normal BMA 5/14 (35.7%) . Conclusion: BMA is important in the evaluation of several conditions. However, there is a need to ensure proper consultation to ensure only patients that require BMA do so due to its invasive nature.

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CASE REPORT


 
  USE OF MAUERMAYER STONE PUNCH TO TREAT POSTERIOR URETHRAL DIVERTICULA CALCULUS IN A PATIENT WITH MULTIPLE CONGENITAL ANOMALIES OF URINARY TRACT  
ABUBAKAR ABDULKADIR

Background: Posterior urethral diverticulum calculus (PUD-C) is a rare urethral lesion that can pose as a diagnostic dilemma and in instances laborious to treat. Objectives: To report a rare case of posterior urethral diverticulum calculus (PUD-C) treated by the use of Mauermayer stone punch in a patient with double ureter , mal-development of the prostate and chronic viral hepatitis. Case: A 37year old male, who presented with a year history of bothersome Lower urinary tract symptoms (LUTS) with episodes of purulent urethral discharge. His posterior urethral diverticulum calculus (PUD-C) was confirmed at urethrocystoscopy alongside maldeveloped prostate, hanging verumontanum, urinary bladder trabeculations, and sacculations. He had urethrolitholapaxy using Mauermayer stone punch with a concurrent alleviation of the LUTS. Conclusion: The pertinent publications on the clinical features, treatment, and the outcome of PUDC were reviewed. Utilization of Mauermayer stone punch for PUDC urethrolitholapaxy is a novel treatment technique. It, however, alleviated the bothersome lower urinary tract symptoms and granted a satisfactory outcome in the index patient.

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CASE REPORT


 
  SPIGELIAN HERNIA: EXPERIENCE OF HOPITAL DE LA RENAISSANCE OF NDJAMENA (CHAD)  
KAIMBA BM, EDZIMBI AL, MOIFO B, PIERRE H.

Background: Spigelian hernia is an uncommon ventral hernia characterized by a defect in the semilunaris linea and is known as “hernias through the conjoint tendon”. The symptoms of Spigelian hernia are usually non-specific. CT scanning is considered the most reliable technique for diagnosis .These hernias require surgical treatment. Case: A case of Spigelian hernia was diagnosed in the patient of 56-year-old man presenting with abdominal pain associated with a reducible mass in the right iliac fossa. CT scan confirmed the diagnosis. We had performed successfully surgical treatment to repair the hernia defect. The recovery was uneventful.

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CASE REPORT


 
  MASSIVE CHRONIC BILATERAL GYNECOMASTIA IN A MIDDLE AGED MAN: A CASE REPORT  
ZAINAB MUSTAPHA, MOHAMMED A. SUWAID, MAIMUNA A. HALLIRU, SIRAJO D. YAKUBU AND ANAS ISMAIL

Gynecomastia is defined as enlargement of the male breast and derives its origin from 2 Greek words- 'gyne' and 'mastos' which mean "woman's" "breast". Gynecomastia is a clinical condition and often has three radiological patterns which are nodular, dendritic and diffuse glandular patterns. We report a case of a 42 year old man of Hausa-Fulani descent with massive bilateral breast enlargement of multifactorial origin. Investigations done included thyroid function test, liver function test and additional basic blood workup. A mammogram was done, which was followed by breasts ultrasound. Additional radiological imaging included abdominal and testicular sonograms and diagnosis of massive bilateral gynecomastia was made. Anti-psychotics are a documented cause of gynecomastia while thyroid dysfunction is an often overlooked etiology of male breast enlargement. Medical treatment may address the underlying pathology in some cases; however, surgical reconstruction must be considered in severe, chronic cases as it addresses the physical deformity which is a significant cause of depression in these patients. The role of radiology in excluding the causes of gynecomastia cannot be overemphasized and is pertinent in the management of this condition.

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CASE REPORT


 
  GIANT CELL TUMOUR OF THE FIRST METACARPAL - REVIEW OF LITERATURE  
LAWAL SULEIMAN, CHOM NUHU DUNG1, IGASHI JOSEPH BAKO, DAHIRU ISMAIL LAWAL IBRAHIM MUHAMMAD ZARIA

A case of giant cell tumour of the first metacarpal has been presented, its radiological features discussed and literature reviewed

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CASE REPORT


 
  ELLIS-van CREVELD SYNDROME IN A NIGERIAN WOMAN: A CASE STUDY  
AHMADU MS, TALLE MA, AHIDJO A, TAHIR AA

Ellis-van Creveld (EVC) syndrome or chondroectodermal dysplasia is a rare, autosomal recessive thdisorder that was first described by Ellis and van Creveld in the mid-20 century.The syndrome is characterized by a tetrad of chondrodystrophy, post axial polydactyly, and hidrotic ectodermal dysplasia, mostly involving teeth and nails and a high frequency of congenital cardiac anomalies, most frequently a common atrium.There has been no documented case report of EVC syndrome from Nigeria in the literature. We, therefore, present a 30 year-old Nigerian woman who presented to our hospital with features consistent with this rare syndrome.

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CASE REPORT


 
  CHRONIC MYELOID LEUKAEMIA PRESENTING WITH MASSIVE ASCITES: A CASE REPORT  
YUGUDA SALEH, GIREI I. AHMED, SAIDU ABUBAKAR, LAWAN I. ALIYU

Chronic Myelogenous Leukemia (CML) is a clonal disorder of the pluripotential stem cell characterized by anaemia, extreme blood granulocytosis and granulocytic immaturity, basophilia, often thrombocytosis, and splenomegaly.Only a few cases of extramedullary manifestation have so far been reported in CML. Wepresent a case of CML in accelerated phase with massive ascites who responded well to combination chemotherapy and oral hydroxyurea.

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Written by Administrator On Sunday, 24 March 2013 17:23
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NMA BORNO STATE CHAPTER

NIGERIA MEDICAL ASSOCIATION
BORNO STATE CHAPTER OFFICIALS

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