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January - June 2019
Volume 16 | Issue 1

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

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ORIGINAL ARTICLES


 
 
 

Reasons and Experiences of Home and Hospital Deliveries Among Women in Kano, North Western Nigeria

Jibo AM, Abulfathi AA, Iliyasu Z

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

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ORIGINAL ARTICLES


 
 
 

A Three-Year Review of Caesarean Delivery at a Secondary Health Facility in North-Western Nigeria

Lamaran Makama Dattijo, Mahmud Abdulwahab, Ayyuba Rabiu

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

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ORIGINAL ARTICLES


 
 
 

Awareness, Acceptability and Barriers to the Utilization of Modern Methods of Family Planning Among Women Attending Antenatal Clinic in Bayero University, Kano

Auwal Umar Gajida, Idris Usman Takai, Emmanuel Ajuluchukwu Ugwa, Murtala Yusuf

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

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ORIGINAL ARTICLES


 
 
 

A 6-year review of Post-Neonatal Tetanus at Usmanu Danfodiyo University Teaching Hospital, Sokoto

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

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

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ORIGINAL ARTICLES


 
 
 

Chronic kidney disease of unknown origin in Northern Yobe, Nigeria: Experience from a regional tertiary hospital in northeastern Nigeria

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

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ORIGINAL ARTICLES


 
 
 

Prevalence of Respiratory Symptoms and Lung Function Status of Firefighters in Benin City, Nigeria

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

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ORIGINAL ARTICLES


 
 
 

Oxidative Stress and Lipid Profile among Hypertensive Patients at a Tertiary Centre in Kano, Northwest, Nigeria

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

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ORIGINAL ARTICLES


 
 
 

Sonographic Determination of Renal Volume and its Correlation with Body Mass Index Among Healthy Adults in Kano, Nigeria

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

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ORIGINAL ARTICLES


 
 
 

Assessment of Family Functioning amongst Patients with Knee Osteoarthritis in Nigeria: A Multicentre Cross-Sectional Study

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

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ORIGINAL ARTICLES


 
 
 

Musculoskeletal Pain after Stroke: Prevalence, patterns and distribution among survivors in Maiduguri, North Eastern Nigeria

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

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ORIGINAL ARTICLES


 
 
 

Comparative Evaluation of Diagnostic Accuracy of MESS and PSI in Lower Limb Amputation Following Trauma Presenting at the National Orthopaedic Hospital, Dala Kano

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

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ORIGINAL ARTICLES


 
 
 

Effects of Sildenafil Citrate On Testicular Histology and Sperm Count During Wound Healing Process in Diabetic Rats

Mohammed B. Mahre, Saidu I. Ngulde, Bukar Umaru, Fakilahyel M. Mshelbwala, Dauda Yahi1, Abubakar Waziri, Aji T. Goni, Bitrus Wampana
Background: Thisstudy was carried out to determine the effects of sildenafil citrate on morphology of the testes and spermatogenesis during wound healing process in diabetic rats. Eighteen adult male Wistar rats randomly divided into two groups (A and B) of 9 rats per group were treated orally with sildenafil citrate at a dose of 50 mg/kg for 21 days and or/single dose of intraperitoneal injection of insulin (10 IU). Before treatment, type 1 diabetes mellitus was induced in group A by a single intraperitoneal injection of alloxan (130 mg/kg) and a square-shaped wound measuring 1.5 cm2 was created under anesthesia with ketamine at the dose rate of 50 mg/kg intraperitoneal injection on the dorsum of rats in all groups with the exception of 3 rats in group B. From each of the two groups (A and B), 9 rats were humanely sacrificed for histology and sperm count. This was done after the administration of the sildenafil citrate on day 21. The results of the study showed significant (p<0.05) decrease in testicular and epididymal sperm head counts. Sections of the testes showed severe vacuolar degeneration of germinal epithelial cells in the seminiferous tubules in diabetic rats during the 21 days of treatment with sildenafil citrate. This indicates that sildenafil citrate may not have any protective effect against testicular injury due to wound healing process in diabetic rats

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SHORT COMMUNICATION


 
 
 

Electrocardiographic changes in newly diagnosed hypertensive patients at Federal Teaching Hospital Gombe

Yekeen Ayodele Ayoola, Ismail Olayemi Ayanbisi, Adah Bonny Ejeh, Okezie Ejeagba, Adamu Adamu, Henry Ifeanyichukwu Okolie

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

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SHORT COMMUNICATION


 
 
 

Inter-relationship between type-2 diabetes mellitus, obesity and Hypertension in Nigeria

Musa Muhammad Babandina, Idris Nasir Abdullahi, Anthony Uchenna Emeribe, Halima Ali Shuwa, Lawal Olayemi, Peter Omale Musa

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

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SHORT COMMUNICATION


 
 
 

Fasting Blood Glucose Level Among Apparently Healthy Adults in Maiduguri North-Eastern Nigeria

Tukur MA, Gali RM, Mshelia DS, Geresis RY, Numan AI, Medugu JT

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

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SHORT COMMUNICATION


 
 
 

Foreign Body in the Throat: Any Trend Change?

Stephen Agbomhekhe Ogah

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

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CASE REPORT


 
 
 

Gastric Tuberculosis Simulating Gastric Malignancy: Case Report and Review of Literature

Ahmadu MS, Luntsi G, Umar UH, Farate A

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

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CASE REPORT


 
 
 

Endometriosis of Sigmoid Colon Mimicking Cancer: A Rare and Abnormal Presentation

Nasiru Raheem, Dauda W Wadinga, Haruna A Nggada, Jesini Ngamdu

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

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CASE REPORT


 
 
 

Superficial Femoral Artery Pseudoaneurysm Following Blast Injury in a Child: A Case Report

Umar UH, Yunusa DM, Farate A, Bakari AA

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

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arch-2017-02

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2017
Volume 14 | 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.

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

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

 

 

ORIGINAL ARTICLES


 
 
 

FACTOR V- LEIDEN GENE MUTATION AMONG NATURAL POPULATION OF MAIDUGURI, NORTH EAST NIGERIA

Obi, SO, Bukar, A, Amilo, GI, Medugu, JT, Waziri, G, Digban, KA, Osareniro, OE, Aladenika, ST, Olaniyan, MF, Jeremiah, ZA.

Background: The emergence of inexplicable thrombotic events with unrecognised mechanism in the recent times warranted the investigation of otherwise-uncommon risk factors for thromboembolic phenomena. It is a common cause of inherited thrombophilia associated with venous thromboembolism (VTE), recurrent pregnancy loss, infertility, contraceptive or hormone replacement related coagulopathy, and cerebral palsy. This study therefore aimed at exploring the of factor V –Leiden (FVL) gene mutation among the natural population of Maiduguri.
Methods: This is a cross-sectional study which was carried out between January 2013 and March 2014. Ninety-eight (98) healthy blood donors from ethnic population of Maiduguri, northeast of Nigeria were recruited prospectively & consecutively. They were investigated for factor VLeiden genotype by- Amplification Created Restriction Enzyme Site (ACRES) polymerase chain reaction. Data was presented as percentage and Newman-Keuls post hoc was used to compare variables.
Result: Factor V-Leiden mutation was not detected in any of the 98 subjects screened; all expressed normal genotype for factor V gene (F5) 1619 G/G. Protein C (PC) and Proteins S (PS) analysis revealed that all the subjects had normal plasma percentage (%) activities for these natural anticoagulants.
Conclusion: FVL mutation is probably a rare genetic trait among ethnic population of Maiduguri northeast of Nigeria

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

COMPARATIVE EVALUATION OF ENZYME LINKED IMMUNOSORBENT ASSAY METHOD AND IMMUNOCHROMATOGRAPHIC RAPID TEST STRIP IN THE DIAGNOSIS OF HEPATITIS B VIRUS INFECTION AMONG HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENTS IN NORTH WESTERN NIGERIA

Bello Hali, Halima Yunusa Raji, Ahmad Abdurrahman Elfulaty, Odugu Jude, Abubakar Umar Musa, Nasiru Abubakar.

Background: This study aimed at comparing results of the rapid test strips and ELISA method in the detection of HBsAg among HIVinfected patients.
Methods: The study was a cross sectional in which 180 treatment naïve adult HIV infected patients were screened for HBsAg using rapid test strips and these were re-tested for HBsAg with ELISA method. The + CD4 T cell counts was performed with Cyflowcounter machine. Interviewer administered questionnaire technique was adopted in obtaining information about the study participants.
Results: Eighteen (10%) and thirty seven (20.6 %) patients were positive for HBsAg using HBsAg rapid test strips and HBsAg ELISA kit respectively. The false positive and false negative of the rapid test strips with ELISA as a gold standard were 11.11 % and 12.96 % respectively. The sensitivity and specificity of rapid test strips with ELISA as a gold standard were 43.24 % and 98.60 % respectively. About 22(59.5 %) of those positive for HBsAg with ELISAmethod were severely immunosuppressed.
Conclusion: Rapid test strips were inferior compared to ELISA in the detection of HBsAg among HIV infected patients and severe immunosuppression might impair the performance of rapid test strips. Manufacturing companies need to improve on their rapid test strips. Validation of rapid test strips prior to their usages should be ensured. WHO and member states should come up with standard protocol for the screening and diagnosis of HBVinfection and there is need to step up HBVimmunization strategies.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 

SYRINGE PLUNGER ASPIRATION TECHNIQUE (SPAT): A SIMPLE BEDSIDE AND FIELD TECHNIQUE FOR ASSESSING PNEUMOTHORA

Bello US , Babayo UD

Background: A simple technique for diagnosing pneumothorax caused by disease or trauma using the syringe plunger aspiration technique (SPAT) is discussed. It's simple, reproducible and can be helpful where radiographs are not readily available or inconclusive radiographic findings,in patients living at remote places and during mass casualty. Therapeutic needle aspiration is an established strategy for diagnosing pleural fluid collection but its place as a diagnostic tool for pneumothorax is unclear. SPAT minimizes any potential iatrogenic pneumothorax that may occur with a wide bore needle hence the use of size 21G needle and is a favorable screening test.
Objectives: The objective is to provide an easy, reliable appendage for assessing pneumothorax, determining its sensitivity / specificity, and to compare the efficacy of SPAT with other methods
Methodology: This study investigates pneumothorax diagnosis from 2010 to 2012 using 5mls 1 syringe and needle (21G × 1 / “).The study method is a primary intervention one, where a 5mls 2 th th syringe and hypodermal needle (21G) were inserted at the 4 or 5 intercostal space between the anterior axillary line and midaxillary line under aseptic technique and the plunger drawn, in patients with suspicion of pneumothorax. The presence of aspirated air in the syringe from pneumothorax retains the plunger in place, preventing its retraction back.
Result: A total of 21 patients were reviewed. Syringe plunger aspiration technique's (SPAT) was carried out in all cases with sensitivity of 1, specificity of 0.66, positive predictive value (PPV) of 0.94, negative predictive value (NPV) of 1, and accuracy 0.95. The graduation on the syringe using SPAT was accurate in estimating massive pneumothorax in 4 patients as complete lung collapse by radiograph tally fully with plunger displacement exceeding the 5mls mark.
Conclusion: Our SPAT sensitivity of 100% makes it important as a screening test of pneumothorax where a missed diagnosis can have a grim consequences.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 

EXPECTATIONS AND CHALLENGES OF GENERATION Y FEMALE DOCTORS: FINDINGS FROM A TERTIARY TEACHING HOSPITAL, NORTH CENTRAL NIGERIA

 

Lar, LA , Wudiri, ZW , Wash-Pam AA ; Abubakar JD , Banwat, ME

Background: There is increasing number of women joining the medical profession and the expectations and challenges they face are unique to their profession and role as homemakers. Notable are the “Generation Y” female doctors, whose peculiar characteristics distinguished them. Objectives - This study aimed to identify the expectations and challenges faced by female millennial doctors, brought about by misunderstanding of their peculiar needs as a generation.
Methods: This was a descriptive, cross sectional study, involving 108 participants selected by cluster sampling technique. A pre–tested, interviewer administered questionnaire was used to collect data that was analyzed using Epi-info statistical software; version 3.4.5. A p value =0.05 was considered statistically significant.
Results: They had a mean age of 30.54 ± 3.96 years and 46 (42.6%) of them were aged 26-30 years. Majority 75(69.4%) of the respondents were House Officers, Medical Officers and Juniour Registrars. Ninety eight (90.7%) of them had less than 120 months working experience. Senior Registrars and Consultants totaled 33 (30.6%), while those with work experience greater than 120 months were 10 (9.3%). Most; 60 (55.6%) of them had fulfilled work expectations, while 48 (44.4%) did not. There were statistically significant relationship (p= 0.0208) between the cadres of the Doctors and the negative effect of work on the family and between long working hours and its negative effects on the family; (p=0.0500). More; 67 (89.3%) Juniour doctors had negative work related effects on their family p=0.0170.
Conclusion: The study demonstrated that some work related challenges impact negatively on the family. This includes general quality of family life including happiness and family health.Therefore, the Government and relevant institutions at all levels should revise policies that promote work family balance for the female worker. A culture of interactions and mentorship between the older and younger doctors; particularly female doctors should also be encouraged

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

A FIVE-YEAR REVIEW OF FEMALE GENITAL TRACT MALIGNANCIES AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, NIGERIA

 
Hadiza A. Usman , Bala M. Audu , Mohammed Bukar , Ahmed Mayun , Ibrahim M. Sanusi
Background: The burden of female genital track malignancies is of public health concern worldwide. Determining the prevalence will help in policy formulations and priority setting for disease prevention and management in health institutions in Northeast Nigeria.
Objectives: To determine the frequency, trend and age pattern of female genital cancers in a referral tertiary health facility in Northeast Nigeria.
Methods: A retrospective descriptive analysis of histologically confirmed cancers of the female st genital tract managed at the University of Maiduguri Teaching hospital for the period 1 st January, 2011 to 31 December, 2015.
Results: Female genital tract malignancies constituted 32% of all female cancers and 7% of gynaecological admission in this study. Cervical cancer was the most common gynaecological malignancy constituting 59.3 % (n=128) followed by ovarian cancer (n=46; 21.3%). Other genital tract malignancies seen include uterine cancer (n=22; 10.2%; majority of which were endometrial cancer (n=19; 8.8%) while uterine sarcoma constituted 3(1.4%)). Choriocarcinoma and vulva cancers contributed 7% (n=15) and 1.4% (n=3) respectively. While cervical cancer was on the decrease, ovarian cancer showed a rising trend during the period under review. The age range for all gynaecological cancers was 18 to 85 years and the mean age (SD) was 43.8 (± 14.5) years. The mean age (SD) for cervical cancer was 51.5(± 12.1). A third of the cervical cancer cases were 20-39 years old. Choriocarcinoma is commoner in younger age groups with a mean age (SD) of 26.6(± 8.0).Vulva and vaginal cancers are least common and occurred in those greater than 60years.
Conclusions: Thirty two per cent of all female cancers were of female genital tract and cervical cancer was still the common female genital tract cancer in this facility. The high prevalence of cervical cancer and increasing trend of ovarian cancer calls for awareness campaign and targeted population screening program for female genital cancer in this region.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

OUR EXPERIENCE WITH LITTLE HOLE APPENDICECTOMY AND DESCRIPTION OF HOW WE DO IT

 

Babayo UD, Bello US

Background: Appendicectomy is among the commonest performed surgery. Scarless or minimal scar is now sought by patients. The value of laparoscopic over open appendicectomy is not establish to draw definitive conclusions and generalization, unlike in cholecystectomy; with higher cost, three scars sites and longer operative time. Minimal access appendicectomy is performed via open surgery with only a scar and has been documented. Our technique is also a modified Lanz that places the skin incision 1.5cm medial to the anterior superior iliac spine which gets easily on to the caecum with limited obscured small bowel. The description of technique adds to medical literature and experience in homogenous black population which this paper addresses.
Objectives: To review our little hole open appendicectomy and describe how we do it. To serve as a teach-book for rising scarless surgery requests in our African setting, though not intended for apprentice surgeon.
Methodology:This is a retrospective study of little hole appendicectomies from 2000 -2010.
Result: Thirty nine (39) patients were reviewed,33 females (84.6%) and 6 males (15.38%). 4 patients had incision size 1 cm, 27 patient had 1.5 cm and 8 patients had incision of 2cm.The shortest operative time was 20 minutes and the longest was 55 minutes with a mean operative time of 27.9 minutes.
Conclusion: with appropriate patient selection, little hole open appendicectomy is effective and has a good outcome

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

NASOMUCOCILIARY CLEARANCE TIME AMONG HEALTHY NIGERIANS

 
Afolabi Olushola A, Shaibu Stephen B, Segun-Busari Segun, Omokanye Habeeb K, Olosunde Lanre J, Ajodoh O Monday, Ehalaiye Bolorunduro F
Background: Objective:To determine reference values for Nasal Time (NMCT) among healthy Nigerian population using the saccharine test.
Methods: This was a prospective, cross-sectional, descriptive study that was carried in a Nigerian tertiary hospital using consented healthy relative of patients, hospital staffs, students and civil servants as participants after ethical approval from the institution. Using questionnaire, Information retrieved included socio-demographic profile and saccharine transit time. All information were entered into SPSS version 20.0 and analysed.
Results: one hundred and eighty eight (188) of the 200 volunteers screened satisfy the inclusion. Eighty five (85) male and 103 females, M: F of 1: 1.2. Age range was 10-85years, modal age group was 18-40years, mean age was 31.01years. Minimum NMCT recorded was 6 minutes and maximum was 43minutes with Mean NMCT 15.5minutes.
Conclusion: NMCT among healthy Nigerians was in the range of Mucociliary clearance is an important defence mechanism in the human respiratory system. Mucociliary Clearance 12.5 minutes-18.5 minutes with a mean duration of 15.5 minutes, slightly higher in females than the males and NMCT increases with age.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

ORAL HEALTH KNOWLEDGE AND DENTAL ATTENDANCE AMONG ADOLESCENTS WITH AND WITHOUT DENTAL FEAR

 

Ogbebor OG, Azodo CC

Objective: To determine the prevalence of dental fear and to compare oral health knowledge and dental attendance among the adolescents in north central zone of Nigeria with and without dental fear.
Methods: This cross-sectional study was conducted among 350 children aged 15-19 years old recruited using multistage sampling technique from State owned secondary schools in Minna, Niger State. A self-administered questionnaire elicited information on demographic characteristics, oral health knowledge, toothache experience, gingival bleeding, dental attendance and dental fear.
Results: The majority (92.8%) of the participants reported that they give equal care to their teeth and bodies. Less than half (42.8%) reported poor/fair oral health knowledge; toothache (40.2%) while 56.4% and 54.9% reported gingival bleeding and dental attendance respectively. A total of 128 (3.7.0%)of the 346 participants reported dental fear .Participants with poor/fair oral health knowledge and toothache experience reported significantly more dental fear (P=0.003 and 0.016) respectively. The prevalence of severe dental fear among participants that visited dental clinic was 36.8%. The only determinant of dental fear among the participants was oral health knowledge.
Conclusion: The prevalence of dental fear in this study was high and it was found to be significantly associated with oral health knowledge and toothache experience. However, it was only oral health knowledge that emerged as the determinant of dental fear

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

HISTOPATHOLOGICAL REVIEW OF MALE BREAST CANCER IN KANO, NORTHWESTERN NIGERIA: A TEACHING HOSPITAL EXPERIENCE

 
Imam Mohammed Ibrahim, Akinfenwa Taoheed Atanda
Background: Male breast cancer is rare worldwide and accounts for about 1% of all breast cancer cases. Previous studies in Nigeria and other parts of the world attest to the rarity of male breast cancer. However, there is no published report on male breast cancer from Kano, Northern Nigeria despite the increasing incidence in Africans.
Objective: This study describes the age frequency and morphological pattern of male breast cancer in Kano, Northwestern Nigeria.
Materials and Methods: This was a 16-year (2001-2016) retrospective study of all male breast cancer cases that were histologically diagnosed at the histopathology department of Aminu Kano Teaching Hospital, Kano. The histology slides were retrieved and reviewed. Fresh sections from archival paraffin blocks were obtained when original slides could not be retrieved and special stains deployed where necessary. The cases were then classified by the authors and the results were then analyzed, presented using frequency table and line diagram while the tissue microscopy presented as photomicrographs.
Results: A total of 1,006 breast cancer cases were diagnosed during the 16-year review period. Out of this number, 61(6.1%) cases were males. The age range was between 28 and 79 years with a mean age of 64.5 years. The highest frequency of 26 (42.6%) cases occurred between 61-70 years while the lowest frequency of 2 (3.3%) cases occurred in the third decade. Invasive Carcinoma NST was the predominant histological type accounting for 42 (68.9%) cases. This was followed by papillary carcinoma with 6 (9.8%) cases, medullary carcinoma with 4 (6.6%) cases and lobular carcinoma with 3 (4.9%) cases.
Conclusion: Breast cancer though uncommon in males, it accounts for 6.1% of all breast cancer cases in this study, which further confirms the higher incidence in Africans. Most of the presentations were in the seventh decade and invasive Carcinoma was the predominant histological subtype.

 

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ORIGINAL ARTICLE


 
 

RIFAMPICIN RESISTANT TUBERCULOSIS: PREVALENCE AND RISK FACTORS AMONG PULMONARY TUBERCULOSIS PATIENTS IN MAIDUGURI, NORTHEASTERN NIGERIA

 
Kida IM, Garbati MA, Ummate I, Goni BW, Bakki B, Dayar AD, Yusuph H.
Background: The introduction of GeneXpert technology for the diagnosis of tuberculosis and detection of rifampicin resistance has revolutionised the efforts of TB control in Africa. Even with this renewed efforts, there is paucity of data on Multidrug Resistant/Rifampicin Resistant Tuberculosis (MDR/RR-TB) in North eastern Nigeria. This study aimed to assess the prevalence of rifampicin resistant-TB and its associated risk factors in this region plagued by insurgency.
Methods: A retrospective review of records of 136 sputum smear positive pulmonary TB cases between September 2014 and January 2017 was undertaken. The sociodemographic and risk factors were obtained from the patients' case notes. Detection of MTB and rifampicin resistance was done using automated polymerase chain reaction (GeneXpert MTB/RIF). Data were analyzed using statistical Package for social sciences (SPSS) version 20; bivariate logistic regression was used to assess associations between various risk factors.
Results: The age range of the patients was 18 to 85 years, with a mean age of 33.1 ±7.67 years. Males constituted a majority (61.8%) of the patients. Overall, 94.1% of the samples from the studied population were susceptible to rifampicin and 5.9% were resistant. Previous use of antiTB medication was the only statistically significant risk factor associated with rifampicin resistance.
Conclusion: Rifampicin resistant TB is prevalent in our community housing many internally displaced persons, and high index of suspicion is required to avoid its spread. Use of previous anti-TB medication was identified as an independent risk factor for acquisition of rifampicin resistant TB, and this calls for the strengthening of TB control programmes in the region

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

HEALTH SEEKING BEHAVIOUR OF CAREGIVERS OF UNDER-FIVES DURING EPISODES OF ACUTE RESPIRATORY INFECTION IN AN URBAN COMMUNITY IN EDO STATE

 
Osarogiagbon WO, Isara AR
Background: Early recognition of symptoms and signs of acute respiratory infection by caregivers at home and reporting quickly in a health centre is key to a favourable outcome during episodes of acute respiratory infection in underfives. However, several variables may determine early or late presentation in the hospital.
Objective: To determine the level of awareness concerning acute respiratory infection among caregivers. To assess the pattern of and determinants of health seeking behaviour of caregiver of under-five children with acute respiratory infection in Edaiken Community, Benin City, Edo State.
Method: A descriptive cross-sectional community-based study was carried out in Egor Local Government Area of Edo State, Nigeria. A multi-staged, sampling technique was used to select the caregivers. Data collection was by a pretested researcher administered questionnaire.
Results: Of the 346 caregivers that participated in this study, 293 (84.7%) were mothers. The respondents were predominantly in the age range 21 – 30 years which was 191 (55.2%). Those with secondary education were majority with 214 (61.8%). Majority of the mothers were in the middle economic class, 199 (57.5%). Of the 346 caregivers, 337 (97.4%) agreed that they have heard of ARI. Concerning health seeking behaviour, 121 (35.0%) will visit a health facility, 297 (85.8%) will buy drugs in the chemist, 192 (55.5%) will treat at home with native remedies. The higher the educational level of the caregiver the higher the proportion of those with good health seeking behaviour.
Conclusion: Caregiversin Edaiken community had high level of awareness. Majority of the caregivers exhibited poor health seeking behaviour, majority preferred to buy drugs in the patent medicine stores during acute respiratory infection episodes.

[FULL ARTICLE (PDF)]

SHORT COMMUNICATION


 
 

PATTERN OF GLOMERULAR DISEASES IN GOMBE, NORTHEASTERN NIGERIA

 
Sulaiman MM , Lawan AI , Bakki B , Abdullahi YM , Aliyu UB , Sanni IO , Ummate I , Usman AU , Shettima J , Pindiga UH .
Background: Glomerular diseases contribute significantly to the burden of chronic kidney disease and end stage kidney disease in Nigeria. Most patients present with end stage kidney disease when the primary diagnosis could not be made coupled with the fact that there is also very low rate of kidney biopsies in our hospitals. In most developed countries, IgA nephropathy is the most frequent histological entity diagnosed. Studies in the United States have found that focal segmental glomerulosclerosis (FSGS) is the leading glomerular disease among African American population. Genetic factors such as having the APOL1 gene have been implicated in the preponderance of FSGS among Africans. Improved kidney biopsy will add to the understanding of the epidemiology of chronic kidney disease in Africa.
Materials and Methods: The study is a cross sectional study carried out at the Federal Teaching Hospital Gombe between October 2016 and May 2017 on consenting adults who had indication for kidney biopsy. All patients were negative for hepatitis B, C and HIV. Kidney biopsyspecimen were stained and examined with light microscopy.
Results: Out of the ten (10) patients biopsied, 70% (7) were male, their ages ranged from 19 to 54 years with a mean of 34.25±12.45 years. Nephrotic syndrome was the commonest indication for renal biopsy (60%). Focal segmental glomerulosclerosis was seen in 50% of patients.
Conclusion: Focal segmental glomerulosclerosis is the commonest glomerular disease in Federal Teaching Hospital Gombe

[FULL ARTICLE (PDF)]

SHORT COMMUNICATION


 
 

PREVALENCE OF HEAD AND NECK CANCERS IN LOKOJA, KOGI STATE, NORTH CENTRAL NIGERIA

 
Stephen Agbomhekhe Ogah
Background: Head and Neck cancers constitute about 5-8% of total body cancers and are more common among the elderly, those with previous exposure to radiation, petrochemical byproducts and anti-cancers' drugs. Alcohol and tobacco have a synergistic causal effect on these cancers. Managing these cancers is challenging due to late presentation, funds and lack of necessary facilities.
Objectives: To determine the prevalence of head and neck cancers in Lokoja, to have a baseline data for future references and for public awareness programs.
Materials and Methods: A review of the data obtained from the Cancer Registry at Federal Medical Centre Lokoja North Central Nigeria from 2009 January to 2016 December was under taken and results presented in text and table format.
Results: A total of 303 cancers were histological diagnosed and registered in the hospital cancer register. They were 114 breast (37.8%), 99 prostate (32.7%), 31 skin (1023%), 28 lymphatic (9.24%), 18(5.9%) head and neck cancers and 13(4.2%) others. Of the 18 head and neck cancers found, Males were 8 and females were 10, and the male to female ratio was 1:1.25. Their ages range from 11 to 80 years, with a mean age of 28.33 years and a modal age of 51-60 years. Nasopharyngeal cancers were found commonest (38.8%), followed respectively by parotid cancers (22.2%) and thyroid cancers (11.1%).
Conclusions: Although head and neck cancers are relatively uncommon, this study had shown that they exist and with nasopharyngeal cancer being the commonest.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

BILATERAL SECOND BRANCHIAL ARCH FISTULA IN A 19 YEAR OLD - A CASE REPORT

 
Abubakar Adamu, Hamman Ibrahim Grandawa, Yusuf Bukar Ngamdu, Haruna Ngadda

SUMMARY
Developmental anomalies involving the branchial apparatus result in branchial cysts, sinuses and fistulas. A congenital branchial fistula is not as commonly encountered as a cyst or sinus. Branchial fistulas mostly arise from the second branchial arch and present at birth. Only few cases are bilateral. Complete branchial fistulas with both external and internal openings are rare. We present a case of bilateral branchial fistula with both external and internal openings in a 19 year old male which is a rare occurrence

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

STAGE IIB CARCINOMA OF THE UTERINE CERVIX IN A PATIENT WITH BILATERAL PELVIC KIDNEYS: A RADIOTHERAPEUTIC CHALLENGE

 
Adamu D. Bojude, Musa Ali-Gombe, Aminu U. Usman, Atara I. Ntekim

SUMMARY
Background:
The occurrence of invasive cervical cancer in a patient with a congenital pelvic kidney is a rare clinical condition that complicates the use of external beam radiotherapy to the pelvis for cervical cancer because the kidney(s) lies within the radiation field a situation associated with risk of radiation injury, nephritis and malignant hypertension.
Objectives: To report a case of a lady with stage 2B cancer of the cervix who has bilateral pelvic kidneys.
Case: A case of 45-year old para 6 lady with stage 2B cancer of the cervix and a bilateral pelvic kidney, she was managed with external beam radiotherapy (box technique), brachytherapy and chemotherapy. The pelvic kidneys were shielded from the radiation beam appropriately. Six years after treatment she was free of locoregional recurrence and distant metastasis, her blood pressure and renal function were normal.
Conclusion: Chemoradiotherapy was offered to this patient after shielding of the pelvic kidneys. All patients with cancer of the cervix or pelvic tumours should have a thorough abdominopelvic examination before treatment to rule out and prevent unintended radiation injury to the kidney(s)

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

RENAL ARTERY STENOSIS WITH SEVERE HYPERTENSION: A CASE REPORT

 
Suwaid MA

SUMMARY
Background:
Renal artery stenosis (RAS) is found in 77% of hypertensive patients and is responsible for 1-2% of systemic hypertension. Arteriosclerotic renal artery disease is commonly seen in older patient and rarely seen below 50years, while fibromuscular dysplasia is seen in young adult female with age range of 15-30years.
Objectives: A case of incidentally diagnosed congenital RAS with severe hypertension in a 28- year old lady and the role of radiology in diagnosis of RAS is reported.
Case: A 28-year old lady who presented to the general outpatient department of Aminu Kano Teaching Hospital with 3days history of headache, dizziness and malaise. The patient was not a known hypertensive or diabetic. Examination revealed high blood pressure of 160/120mmHg. Abdominal ultrasound revealed a shrunken right kidney, Intravenous urography showed delayed nephrogram and delayed excretory phase with decrease density in the collecting systems, computed tomogram confirmed shrunken right kidney. Digital subtraction angiography (DSA) showed the stenosed right renal artery involving the ostium and the proximal one-third.
Conclusion: Renal artery stenosis should be suspected in young people with unexplained hypertension and radiologic investigations are key in confirming diagnosis

[FULL ARTICLE (PDF)]

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arch-2017-01

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2017
Volume 14 | Issue 1

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

 

 

REVEIW ARTICLES


 
 
 

REVIEW ON THE USE OF DEXAMETHASONE AND ITS IMPACT ON FERTILITY AND PREGNANCY

Dauda Yahi1, Nicholas A. Ojo, Gideon D. Mshelia, Chukwuka N. Uchendu, Abba B. Zarami, Adenrele O. Adebayo

Purpose: Although benefit/risk analysis is usually undertaken prior to starting a treatment, some conditions will inevitably require the use of drugs with known side effects even during pregnancy. This is the case with dexamethasone use in ante natal care. The purpose of this review was to provide an overview of the uses of dexamethasone and its impacts on pregnancy and fertility in humans.
Data source: The review is based on literature searches using PubMed and MeSH and authors' personal manuscript/abstract files and citations of known references. Study selection: The selection of articles reflects the authors' opinion as to originality and importance in the context of the review. The review included human and some aspects of animal study.
Data extraction: The electronic searches were scrutinized and full manuscripts of all quotes considered relevant to the study were obtained. All the articles whose abstracts were not available were excluded.
Results: Dexamethasone use has evolved over the years to include fertility treatment in both males and females in addition to its use in pregnancy to prevent respiratory distress syndrome in neonates despite its side effects due to the fact that its benefits outweigh the risks.
Conclusions: Dexamethasone use has evolved over the years to include fertility treatment in addition to use in the prevention of respiratory distress syndrome. Low doses have no major adverse effects; however, repeated doses and long-term therapy are associated with more serious sequelae. It is recommended that dexamethasone therapy be incorporated into maternal and neonatal health care services

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REVEIW ARTICLES


 
 
  IMATINIB THERAPHY IN CHRONIC MYELOID LEUKAEMIA:REVIEW OF MECHANISMS OF RESISTANCE AND THERAPHEUTIC OPTIONS IN IMATINIB FAILURE.

Ladu AI, Aisha MA

ABSTRACT: Chronic myeloid leukaemia is triphasic, clonal malignancy, arising from the haemopoeitic stem cell. It is characterized by the presence of philadelphia chromosome, which result from reciprocal translocation between chromosome 9 and 22. The resulting oncogen- brc-abl has proliferative activity and survival advantage against normal cell and this account for the clinical and laboratory manifestation of this myeloproliferative disorder. Imatinib, a tyrosine kinase inhibitor (TKIs) is currently the first line of treatment, however, one third of patient develope resistance to it, thus necessitating alternative TKIs. Many factors are associated with the development of resistance to imatinib, such as mutation in the brc-abl gene, increase production of the mutant protein and activation of alternatve pathways amongst other causes. The aim of this reveiw is to explore these factors, and also to avaluate current TKIs that are use as alternative in Imatinb resistant cases.

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ORIGINAL ARTICLES


 

ACCEPTABILITY OF TRANSVAGINAL, TRANSLABIAL AND TRANSRECTAL SONOGRAPHY IN A CONSERVATIVE SOCIETY IN NORTHERN NIGERIA: A CROSS SECTIONAL STUDY.

Bukar M, Bilkisu I, Maisaratu B, Ibrahim SM, Numan AI.

Background: Trans-vaginal sonography has revolutionized the assessment of the gynaecology patient and evaluation of early pregnancy complications. Trans-labial and trans-rectal sonographies also play some role in the evaluation of such group of women.
Objective: To assess the acceptability of women to trans-vaginal, trans-labial and trans-rectal sonography. Materials and methods: This is a cross sectional study of unselected women attending obstetrics and gynaecology clinics of the University of Maiduguri Teaching Hospital from January to March 2015.
Results: There were 164 participants with a mean age of 29±5.19 years. Majority 52(31.7 %) were aged between 25-29 years; while 26(15.9%) were more than 35 years. A large proportion of women were currently married 149(90.8%). Most, 81(49.4%) were multipara. Majority of respondents 69(42.1%) had tertiary education while 17(10.3%) had no formal education. Muslims, 144(87.8%) were in the majority. The highest proportion of women were Kanuri/Shuwa ethnic group 83(50.6%), with most 117(71.3%) being housewives. The acceptance for Trans-vaginal scan (TVS), Trans-labial scan (TLS) and Trans-rectal scan (TRS) were 106(64.6%), 124(75.6%) and 97(59.1%) respectively. Only 2(1%) had TVS previously. Reasons for not accepting the various methods include pain, fear, lack of privacy, not comfortable, may cause problems, may affect the uterus and never done it before. Peculiar reasons for not accepting TRS include the fact that it is disgusting and shameful.
Conclusion: The highest level of acceptance was for TLS, closely followed by TVS and the least was acceptability of TRS. Overall, the level of acceptance high for all the modalities studied. The reasons for not accepting the studied modalities concerns that could be allayed during counseling for the procedure as the reasons are groundless.

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ORIGINAL ARTICLES


 
  ASSESSMENT OF SERUM HEPCIDIN LEVEL IN FIRST TIME AND REPEAT BLOOD DONORS AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, NIGERIA.  

Abba AM , Ladu AI, Bukar AA, Abjah UAM, Kagu MB

Background: Iron deficiency remains one of the frequent complications encountered by regular blood donors, with each unit (450mls) of donated blood containing about 250mg of iron. Although most centers utilize capillary haemoglobin in determining the eligibility to serve as a donor, haemoglobin level is a poor indicator of body iron status since depletion of iron store can be present in the absence of overt anaemia. Serum hepcidin has been found to be low in people with iron deficiency, and may serve as a surrogate for depleted iron stores.
Aim: To study the levels of serum hepcidin as a marker of iron deficiency in first time blood donors and subjects with history of multiple blood donation at a tertiary hospital in North-East Nigeria.
Methods: Eligible and consenting voluntary first time and repeat blood donors were consecutively recruited at the transfusion unit of the University of Maiduguri Teaching Hospital. Serum hepcidin level was assayed in all participants using quantitative ELISA technique, and classified into low, normal and high based on recommendation of the manufacturer of assay kits.
Results: One hundred and eighty apparently healthy donors comprising 90 first time donors (control) and 90 repeat donors (subjects) were studied. Their ages ranged from 18 years to 60 years, with a mean of 30+6.20 years and 27.43+5.28 years for subjects and controls respectively (p=0.45). The median serum hepcidin of subjects and controls was 1.43(2.47) and 1.23 (2.43) respectively (p=0.375). Twenty one (23.3%) of subjects had low serum hepcidin compared to 22 (24.4%) of the controls. Serum hepcidin level did not significantly differ between male subjects and controls (p=0.079) or female subjects and controls (p=0.77) No correlation was observed between the frequency of donation and hepcidin (p=0.323).
Conclusion: There is a high prevalence of low hepcidin levels among individuals deemed eligible for blood donation in this environment. This implies that screening for donor eligibility using haemoglobin could result in use of iron deficient individuals as donors. Detection of low hepcidin in blood donors will help identify donors with low iron store, which may be important in preventing them from becoming anaemic following further donation

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ORIGINAL ARTICLE


 
  A TEN YEAR REVIEW OF FEMALE STERILIZATION AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, NIGERIA  

Buba AA, Kullima A, Isa B, Ibrahim SM, Bukar M, Audu BM

Background: In most developing countries like Nigeria, female sterilization is not a popular method of contraception.
Objective: The objective of this study was to determine the prevalence of female sterilization and socio-demographic characteristics of women who had sterilization in our setting.
Methodology: This was a retrospective study carried out between 1st January 1997 and 31 December 2006.A total of two hundred and one female sterilisation operations were performed but ten case notes were incomplete and therefore, one hundred and ninety one 191 were analyzed. Information retrieved from the case notes included the age, parity, religion, literacy, and type of bilateral tubal ligation. The data collected were analyzed using SPSS Version 16.0 statistical package and the results represented in simple tables and percentages.
Results: There were 16,319 deliveries during the study period and 201women had bilateral tubal ligation (BTL), giving a prevalence of 1.2%. The mean age at BTL was 30.18, while the mean parity was 4±0.6. Women between the ages of 30-39 constituted majority of the patients. In most of the women 138 (72.3%) bilateral tubal ligation was performed during caesarean section, while few women 16 (8.4%) had the procedure at laparotomy. The rest, 37(19.4%) women opted for interval BTL. Significantly more literate women (73%) sought for interval tubal ligation compared to non literate (23%) ones. A large number of the Muslims (87.5%) had BTL at laparotomy compared to the Christians (12.5%). P=0.002.
Conclusion: The prevalence of bilateral tubal ligation in this study is low. There is need to encourage the uptake of female sterilization in our environment

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ORIGINAL ARTICLE


 
  HISTOPATHOLOGIC SPECTRUM OF CHILDHOOD LIVER DISEASES IN A TERTIARY HOSPITAL IN NORTH-WESTERN NIGERIA  

Usman Bello, Samaila Moodupeola Omotara , Yawale Iliyasu

Background: Diseases of the liver are a significant cause of morbidity and mortality in children. The patterns of hepatic disorders in this age group differ greatly from adults and show marked regional variations. The objective of this study is to document the histopathologicpattern of liver disorders in children at a major referral laboratory in Northern Nigeria.
Materials and Method: Consecutive liver biopsies received in the department of pathology, Ahmadu Bello University Teaching Hospital Zaria over a fifteen year period (2001-2015) were processed accordingly. Information on age, sex and duration of disease was retrieved from request cards. Diagnosis was made based on morphological criteria. Collected data were analyzed and presented in frequency distribution table, figures and photomicrographs.
Results: Forty seven cases were analyzed comprising 27 (57.4%) males and 20 (42.6%) females with male to female ratio of 1.3: 1. Their ages ranged from two months to 15 years with mean age of 7.5 years Children aged five years and below accounted for 44.7% of cases and of these, ten cases (47.6%) had neonatal hepatitis. Children aged 11-15 years accounted for 42.5% of cases with chronic viral hepatitis being the predominant disease occurring in 15 cases in this age group. All the chronic hepatitis cases were of hepatitis B virus (HBV) infection. Children aged 6- 10 years were the least affected and constituted 12.8% (6 cases) only with hepatic schistosomiasis accounting for half of their liver pathologies. Five of the cases were neoplastic; 4 cases (8.5%) of hepatoblastoma and 1 case (2.1%) of hepatocellular carcinoma (HCC).
Conclusion: Liver disorders in children were age specific; the most common disease in this study was chronic HBV hepatitis seen in older age group while neonatal hepatitis and biliary atresia predominates in younger children

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ORIGINAL ARTICLE


 
  EVALUATING THE EFFECTIVENESS OF UNILATERAL SPINAL NAESTHESIA COMPARED TO BILATERAL SPINAL ANAESTHESIA FOR UNILATERAL LOWER LIMB SURGERY  
Jauro Pobe Degri, Adamu Sadiq Abubakar, Isamade Erdoo Suckie, Embu Henry Yammoh, Sambo Yusuf Tanimu, Abdulrazak Esin

Background: Unilateral spinal anaesthesia offers a number of advantages over the bilateral spinal technique which includes better haemodynamic stability and patient's satisfaction.
Method: Sixty four (64) patients were randomly assigned to two groups, unilateral spinal anaesthesia, (U group) and conventional bilateral spinal anaesthesia, ( B group) .The 'U'group received 2ml of 0.5% bupivacaine made up to 3ml with distilled water while, 3ml of 0.5% bupivacaine was administered to 'B' group. Patients in the 'U' group had the procedure in the lateral decubitus position and remained in that position for 20 minutes, while those in group B had the spinal injection in sitting position and were immediately positioned supine.
Results: All the 64 patients had their surgeries done under the chosen technique successfully. There were more patients in group 'B' that attained Bromage score of IV at 5min than those in group 'U' an indication that motor block was faster in the bilateral group. The haemodynamic parameters were comparable between the study groups at 5, 10, 20, 30 and 50 minutes. There was a statistically significant difference in pulse rate between the two groups at 30 minutes (p=0.04)
Conclusion: Unilateral spinal anaesthesia was more effective compared to bilateral spinal anaesthesia. However, the duration of sensory blocks was shorter and the less haemodynamic disturbances in unilateral spinal anaesthesia compared to the bilateral spinal anaesthesia for lower limb surgery.

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ORIGINAL ARTICLE


 
  PATTERN OF PRESENTATION AND MANAGEMENT OF UROLITHIASIS AT FEDERAL MEDICAL CENTRE, NGURU, NIGERIA  

Abubakar BM, Abubakar A, Suleiman IE, Makama BS, Abdulhafeez AA, Gashua MG

Background: Urolithiasis has been with mankind since ancient time. Although it is more common in the developed world, the pattern of presentation in the developing countries is tending towards that of developed countries. Objectives: To evaluate the pattern of presentations and treatments offered to patients with urolithiasis over the last 2 years at Federal Medical Centre (FMC), Nguru.
Materials and Methods: The study is a 2-year retrospective review of patients managed for urolithiasis at FMC Nguru. The patients' bio-data, pattern of presentation and radiological features of the stones, as well as the treatment given to the patients, were reviewed.
Results: The records of 55 patients were reviewed; the mean age was 24.1 years with a range of 1.5 to 70years. The male to female ratio was 10:1. The most common presenting symptom was painful micturition in 21 patients (38.18%). The total number of stones extracted was 58, one patient had multiple right renal pelvic calculi, another had bilateral renal pelvic stone and the third patient had bladder and distal ureteric stone. Two patients (3.64%) expelled their calculi while awaiting surgery, the remaining 53 patients (96.36%) had opened surgical treatment. Most of the stones are in the bladder in 29 patients (52%). Twenty-one patients (38.18%) had upper urinary tract stones out of which 13 were in the renal pelvis.
Conclusion: Urolithiasis is also common in the developing communities. Despite the changing pattern from lower to the upper tract in developed countries, we found lower tract stone dominating as seen in many underdeveloped. This may be attributable to yet to establish environmental or genetic factors.

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ORIGINAL ARTICLE


 
 

MORBIDITY AND MORTALITY ASSOCIATED WITH CONSERVATIVE MANAGEMENT OF SPINAL CORD INJURY IN MAKURDI, NORTH CENTRAL NIGERIA

 
Yongu T Williams, Elachi C Itodo, Mue D Daniel, Kortor N Joseph, Atokolo Stephen.

BackgroundSpinal cord injury is commonly associated with morbidity and mortality. This is further worsened by inadequate rehabilitation because of dearth of infrastructure, equipment and personnel
Objectives:To identify the complications and causes of death in traumatic spinal cord injury patients.
Methodology: A 4-year retrospective review of all traumatic spinal cord injured patients treated at Benue State University Teaching Hospital Makurdi was conducted. The information on age, sex, occupation, cause, associated injuries, level of injury, neurological deficit, American spinal cord injury association (ASIA) score at presentation, complications and outcome were obtained from medical records department. Data were analyzed using Statistical Package for Social Sciences (SPSS) 17.0 (SPSS Inc. Chicago, IL, USA).
Results: There were 62 patients with a mean age of 36.02±1.67 years (range 8-77 years) consisting of 54 males and 8 females giving a male to female ratio of 6.8:1. They included students 13(21%) and farmers 10(16.1%). Road traffic crash accounted for 35(56.5%). Majority had cervical spine injury 22(62.8%) and accounted for complications in 20(36.4%). Bed sores occurred in 22(35.5%). ASIA A had the highest frequency of complications 22(35.5%). Eleven patients died giving a case fatality of 31.4%. The patients died from respiratory failure 4(36.4%) and sepsis 2(18.2%).
Conclusion: Many complications including bed sores and orthostaticpneumonia result from spinal cord injury leading to high morbidity and death from sepsis and respiratory failure

 

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ORIGINAL ARTICLE


 
 

SEROPREVALENCE OF TOXOPLASMA GONDII AMONG HIV PATIENTS IN THE UNIVERSITY OF BENIN TEACHING HOSPITAL (UBTH), BENIN CITY, EDO STATE, NIGERIA

 
Yusuf Edirin O, Airauhi Lucy U.

Background: Toxoplasmosis among the human immunodeficiency virus (HIV) positive individuals with low CD4+cell count can be severe leading to the reactivation of dormant bradyzoites which can lead to morbidity and/or mortality. A reservoir for T. gondii, cat is common around our study area both as pets and stray animals.
Study Objective: Is to determine the seroprevalence of T. gondii infection in this community and also to investigate the association between T. gondii infection and CD4 count other risk factors.
Methods: Blood specimens were collected from a total of 282 adult HIV positive patients attending a tertiary health facility clinic by systematic sampling and the IgG and IgM levels were detected using the enzyme-linked immunosorbent assay (ELISA) technique. Similarly blood was also collected from 60 healthy blood donors as control group.
Results: Out of a total of 282 samples analyzed, 189 were positive for IgG (67%) and 93 were negative. All 282 samples were negative for IgM antibody. A total of 280 had their CD4+cell count above 200cells/microlitre of blood and only 2 recorded less than 200. Nineteen (31.7%) of the 60 blood donors in the control group were positive for IgG and all negative for IgM. The high seroprevalence rate of IgG toxoplasma antibody among HIV positive patients as reported in this study suggests that there should be a high index of suspicion of the recrudescence of toxoplasmosis among HIV and AIDS patients in our environment and possibly elsewhere

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ORIGINAL ARTICLE


 
  AN AUDIT OF CHEMICAL PATHOLOGY LABORATORY INVESTIGATION REQUEST FORMS RECEIVED AT A PRIVATE TERTIARY HOSPITAL IN NIGERIA  
Onyenekwu Chinelo P, Dada Adeyemi O, Gbadebo Abiola A, Oshunbade Adebamike A

Context: Laboratory testing constitutes an integral part of patient management and has an extensive influence on medical decision-making. The completion of laboratory investigation request forms is a vital aspect of the highly variable pre-analytical phase of laboratory testing.
Aim: We aimed to assess the adequacy of completion of investigation request forms received at our laboratory.
Methods: An audit of systematically selected laboratory investigation request forms received over a six-month period at our laboratory was performed to assess the degree of completion of these forms by requesting clinicians. Data was analysed using Microsoft Excel®.
Results: Two hundred and fifty four request forms were reviewed. None of the reviewed forms was adequately completed. The clinician's contact number was missing in all the request forms. About two-thirds of the request forms did not have the patient's hospital number (66.1%) and the referring clinician's signature (66.9%) available on them. The clinical diagnosis of the patient was not stated in 18.9% of the request forms. The patient's name, gender and age were the most frequently completed parameters in 100.0%, 98.4% and 97.2% of the request forms respectively.
Conclusion: Basic information required for the accurate interpretation of laboratory results are missing in several request forms. This may have deleterious impact on laboratory turnaround time, healthcare costs and patient management as most medical decisions are influenced by laboratory results

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
  PATTERN OF REFERRALS BY OPTOMETRISTS IN NIGERIA IN RELATION TO GLAUCOMA AND DIABETIC RETINOPATHY  
Ovenseri-Ogbomo GO, Amiebenomo O, Obahiagbon AE

Background: Referrals from primary care practitioners such as optometrists to other health care providers is critical to the health care delivery system of any society.
Aim: To explore the atterns of referrals of Nigerian optometrists with respect to glaucoma and diabetic retinopathy.
Methodology: A cross-sectional exploratory survey using a 28-item questionnaire was administered to optometrists attending the 37th annual general meeting of the Nigerian Optometric Association. Responses were coded and analyzed using the Statistical Package for Social Sciences (SPSS) version 17. Appropriate descriptive and inferential statistics were used to report the pertinent findings of the study relevant to the study objective.
Results: About 70% and 93.1% of respondents refer glaucoma and diabetic retinopathy patients respectively to other care givers mainly ophthalmologists. Majority initiate treatment before referral. Female optometrists were more likely to refer both conditions. Both male and female respondents were more likely to refer diabetic retinopathy than glaucoma patients.
Conclusion: Majority of Nigerian ptometrists refer glaucoma and diabetic retinopathy patients to ophthalmologists; though more than half of the respondents will initiate treatment for glaucoma before referral. However prompt referral is highly advocated

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

UNUSUAL VESICAL CALCULUS: A RARE CONSEQUENCE OF SELF-INSERTED FOREIGN BODY PER-URETHRA FOR SEXUAL GRATIFICATION

 
Tela UM, Abubakar A, Ahmed M, Abubakar BM, Jidda MS

Background: Self insertion of foreign body into the urethra to achieve orgasm is a rare secretive sexual practice, patients usually presents in the hospital with complications of the act. Vesical calculus encasing the foreign body is a rare complication.
Objectives: To report a case of vesical stone as a sequel of a rare sexual practice
Case: We report the case of 21-year-old male student who presented with progressive lower urinary tract symptoms and background history of self-insertion of foreign body into the urethra and got retained in the bladder for long. He had cystolithotomy done with findings of doughnutlike calculus encasing a coiled cable. Post-operative outcome was satisfactory.
Conclusion: Sexual gratification derived by inserting foreign body into the urethra is rare. Public health enlightenment will discourage this act and its potential complications.

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CASE REPORT


 
 

GENERALISED AGGRESSIVE PERIODONTITIS: A CASE REPORT AND REVIEW OF THE LITERATURE

 
Paul I. Idon

Background: Generalized aggressive periodontitis is a rare periodontal disease characterized by generalized loss of alveolar bone usually affecting young individuals and may result in early tooth loss and psychological effects. Severity of the periodontal effects vary among patients and depends on duration before presentation, and may also determine the options and outcome of treatment.
Objectives: A case report of generalized aggressive periodontitis managed in our centre and review of available literature on the subject in English language.
Case: A 32-year-male who presented with 18months history of mobile, mal-aligned teeth and bad breath at the oral diagnosis clinic of the University of Maiduguri Teaching Hospital, Maiduguri. Extra-oral examination revealed bilaterally enlarged submandibular lymph nodes- firm, mobile and not tender. Intra-orally, the patient had a full complement of teeth except the lower right first premolar. Oral hygiene was fair but with presence of suppuration from the gingiva around the lower incisors and the lower right first molar
Conclusion: Clinical outcome of treatment is better with early diagnosis. A consensus on case definition is needed for epidemiological studies. The case presented demonstrated the clinical and radiological features necessary for diagnosis of the condition

[FULL ARTICLE (PDF)]

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July - December 2016
Volume 13 | Issue 2

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

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ORIGINAL ARTICLES


 
 
  MICROBIOLOGICAL ANALYSIS OF WATER SOLD BY WATER VENDORS “MAIMOYA” WITHIN MAIDUGURI, NORTH EASTERN NIGERIA

BALLA HJ, MUHAMMAD BG, BABA AH,BULAMA AA

Background: Water makes life possible on earth for all living organisms. It is next to air in importance for human existence. All living organisms require a wide variety of inorganic compound for growth, repair, maintenance, and reproduction. Currently, the emergence and proliferation of water vendors using carts with multiple jerry cans in Maiduguri Metropolis is an issue of concern in Public health sectors.
Objectives: The study aimed at ascertaining the microbiological quality of water supplied in jerry cans by vendors in Maiduguri Metropolis.
Methods: Bacteriological analysis was done using multiple tube fermentation technique and parasitological analysis was done using formol-ether concentration technique.
Results: Twenty six samples each of dams and water in jerry cans were analysed microbiologically using multiple tube fermentation test and direct wet preparation using Formolether concentration technique. The bacteria encountered were Escherichia coli, Klebsiella specie, Proteus specie and Coliform. Parasites encountered were cysts of Entamoeba histolytica, Ova of Hookworm and Giardia intestinalis respectively.
Conclusion: Regulatory agencies (both governmental and non-governmental) should intensify their efforts towards providing clean and portable water to the public.

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ORIGINAL ARTICLES


 
 
  PREVALENCE OF HELMINTHES INFECTION AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT THE SUNNI HOSPITAL, MAIDUGURI, NIGERIA.

MAIRIGA AG, JIMETA HB, UTHMAN SG, ISHAKU ED

Background: The burden of helminthes infections and their consequent morbidity and mortality continue to attract attention of global health expert and managers. The effect of helminthes infections among pregnant women contribute to increasing maternal and fetal morbidity and mortality.
Aim: The prevalence of intestinal nematode infection was studied among 405 pregnant women attending antenatal clinic at the Sunni Hospital Maiduguri, Maiduguri, over a period of 3 months, from March 2012 to May 2012. Study design: It was a hospital based cross sectional study. Macroscopic, wet preparation and the 2 methods of concentration, i.e., brine (floatation) and formol-ether (sedimentation) concentration methods were used to examine the stool for ova and the larvae of intestinal parasites.
Results: Of the 405 samples examined, one hundred and two (25.2%) women were found to be infected with one helminthes or another. Mean age of participants was 25.3 years. Ascaris infection was found to be most infecting helminthes. The prevalence tended to be more in the age bracket 16 to 30 years, multi-gravidas, and in 2nd trimesters. Although businesswomen were more affected, the effect was not statistically significant.
Conclusion: The study indicated that intestinal helminthiasis was more prevalent among multiparas, aged 16-30 years and in the second trimester of pregnancy. Hence, routine administration of antihelminthics to pregnant women during antenatal visits is recommended.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 

USE OF INFORMATION COMMUNICATION TECHNOLOGY AMONG OPTOMETRISTS IN NIGERIA.

EBEIGBE JA, OVENSERI-OGBOMO G.

Background: Since the development of the computer and the evolution of the internet, information communication technology (ICT) has had a positive impact on health care delivery systems worldwide, particularly in the areas of disease control.
Objective: The purpose of this study was to determine the level of utilization of ICT in eye care services, among Nigerian Optometrists.
Method: This was a quantitative cross-sectionalstudy with the use of questionnaires. It was conducted in July of 2014 during the scientific conference and annual general meeting of the Nigerian Optometric Association which was held in Asaba, Delta State. The questionnaire investigated the practice, pattern, use and access to internet.
Results: Three hundred questionnaires were given out and 243 were returned properly filled. Among those who reported gender, there were 42.4% males and 56.4% females. Age of respondents ranged from 25 to 50 years with a mean age of 30 ±2.12 years. Majority of the respondents (86.6%) had access to internet often. Ninety four point two percent (94.2%) of the respondents owned a portable electronic device with internet access. Smartphones were the most commonly owned hand held device (72.9%). The younger age group spent significantly longer hours online per day than the older age group (p = 0.045). Length of time spent online per day was however not dependent on gender. Majority (42.2%), of the respondents used internet for 'personal matters'. Twenty point seven percent (20.7%) of the respondents often communicate with their patients via email. Communication with patients via email was not related to gender (X2 = 3.180, p = 0.204). A total of 47.5% often seek online assistance in patients' diagnosis while 40.9% rarely do so. Facebook (33.0%) and WhatsApp (29.0%) were the commonest social media platforms used. There was no significant relationship between respondents seeking online assistance in patients' diagnosis and gender (X2 = 4.787, p = 0.091) but was significantly related to age (X2 = 21.073, p = 0.021). Seventy percent (70.0%) of respondents researched patients' ailments online. Researching patients' ailment online was not related to gender (X2 = 5.507, p = 0.064) but was significantly related to age (X2 = 20.563, p = 0.024).
Conclusion: Most Optometrists have internet access on their digital devices which they used for both personal and professional matters. However, younger Practitioners were more inclined to use the internet for patient management than the older ones. The gains of ICT can only be fully harnessed in health care, when the majority, if not all professionals, become knowledgeable and are willing to utilize computers and ICT.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
  SURVEY OF URINARY SCHISTOSOMIASIS AMONG INTERNALLY DISPLACED PERSONS (IDPs) IN BORNO STATE.  

BALLA HJ, BULAMA AA, KUTDANG ET, BABAGANA M

BACKGROUND: Urinary schistosomiasis is endemic in Nigeria and continues to pose public health challenges especially in inhabitants of rural areas.
AIM: This study was undertaken to determine the incidence of urinary schistosomiasis among internally displaced persons (IDPs) in Borno State, Nigeria.
MATERIALS AND METHODS: Microscopic examination of the urine samples were employed to determine the presence of S. haematobium eggs. Questionnaires were also administered to consenting participants to collect information on socio-demographic data and water-contact activities.
RESULTS: An overall incidence of 35.5% infection with S. haematobium was observed out of the 200 IDPs examined, among which the age group (11-20) carries the highest prevalence rate of 37(48.7%). Out of the 71(35.5%) tested positive, 39(54.9%) presented with visible haematuria. There is no statistical significant difference between the number of samples tested positive and those tested negative in terms of haematuria as p = 0.543. Males recorded higher prevalence rate of 39.5% than females (28.9%), thus there is a statistically significant difference in prevalence rate between males and females as p = 0.0085.
CONCLUSION: The study draws attention to the health hazards posed by urinary schistosomiasis among residents of Local Government Areas forming the Internally Displaced Persons within the State. Hence, the urgent need for a decisive control intervention to stem this problem cannot be overemphasized.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
  AETIOLOGICAL PATTERN OF BLADDER OUTLET OBSTRUCTION ADMISSIONS IN A NIGERIAN UROLOGY CENTRE.  

ABUBAKAR ABDULKADIR

Background: Bladder outlet obstruction (BOO) is globally the foremost urologic disorder that affects all ages. However, the volume and diversity of lower urinary tract lesions causing BOO and warranting inpatient care in our community is unknown.
Objective: To retrospectively review the aetiology, interventions and outcome of BOO admissions at Abubakar Imam Urology Centre Kano as a foundation for further urologic care capacity building and upgrading in Nigeria.
Materials and Method: A three-year retrospective appraisal of all the patients admitted and managed for BOO at Abubakar Imam Urology Center Kano (AIUC). The Information extracted from patient's records included the patient's biodata, diagnosis, intervention, duration of Hospital stay and the outcome. The Data were evaluated using SPSS version 21.
Conclusion: The study revealed benign prostate hypertrophy (BPH) was the most prevalent lesion among the inpatients; its complications and bladder cancer progression are the most common causes of mortality. The study highlighted the need for revamping health planning and capacity development focused on the quartets of greater pleasant outcome, a shorter admission stay, less treatment spending plus patient's satisfaction.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
  BIRTH INTERVAL AND MATERNAL OUTCOME IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL – A CROSS SECTIONAL STUDY  

GEIDAM AD, INUSA A, ISA B

Introduction: Although birth spacing is recognised as a major determinant of various infant health indicators, the effect of interpregnancy interval on maternal pregnancy outcomes has received less attention.
Aim: To determine the effect of interpregnancy interval on maternal outcome in our environment after controlling for confounding factors.
Method: A cross sectional study, conducted at the university of Maiduguri teaching hospital. The subjects were multiparous women carrying singleton pregnancy who come to deliver at the hospital Obstetrics and Gynaecology unit during the study period. A pretested questionnaire was used to obtain data which was analyse with SPSS. The effect of birth interval on maternal outcome was determined using multivariate analysis after controlling for confounding variables.
Result: Out of the 1334 participants that fulfilled the inclusion criteria and approached for the study, complete data was obtained in 1188 women; a response rate of 89%. The mean maternal age was 28.7±5.7 years, mean parity 4.3±2.2 and the mean birth interval was 32.9±18.4 months. Short birth interval was found to be associated with high parity OR (95%CI) =1.559(1.150-2.113), preterm delivery OR (95%CI)= 2.462(1.518-3.994) and development of anaemia in pregnancy OR (95%CI) =1.77(1.058-2.959) while long birth interval was associated with development of hypertension in pregnancy OR (95%CI) = 3.001(1.734-5.195) and delivery by caesarean section OR (95%CI) = 4.884(2.499-9.546)
Conclusion: Short birth interval was associated with higher parity, anaemia and preterm delivery while long birth interval was associated with hypertension and caesarean section.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
  HISTOPATHOLOGICAL PATTERN OF ENDOMETRIAL CANCERS IN KANO, NORTH-WESTERN NIGERIA: A 5-YEAR RETROSPECTIVE REVIEW  
HARUNA MS, SULE AA

Background and Objective: Endometrial cancers occur globally with wide geographical variation in prevalence and histopathological pattern related to the level of socioeconomic development in the society. The objective of this study was to determine the age, frequency distribution and histopathological spectrum of endometrial cancers in Kano, North-western Nigeria.
Materials and Methods: This was a 5-year retrospective study from 2nd January, 2011 to 31st December, 2015 of all endometrial cancers diagnosed at the pathology department of Aminu Kano Teaching Hospital, Kano, Nigeria.
Results: Forty-one cases of endometrial cancers were diagnosed during the five-year study period. The ages range from 32 to 80 years (mean age of 56.5 years) and relative peak age of incidence occurring in the 51 -60 years group. Carcinomas accounted for the majority (32 cases, 78%) of endometrial cancers distantly followed by malignant mesenchymal tumours (7 cases, 17.1%), while theremaining 2 cases (4.9%) were malignant mixed Mullerian tumours. Most lesions were Grade 2 or 3.
Conclusion: Malignant tumours of the endometrium are relatively uncommon in Kano afflicting people in the sixth and seventh decades, which were similar to most published reports in Nigeria and sub-Saharan Africa but at variance with the developed world where endometrial cancer is the most common invasive cancer of the female genital tract. Higher histological grades characterize our patients hence the need to control modifiable risk factors like sedentary life style, obesity and oestrogen usage.

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ORIGINAL ARTICLE


 
  HEPATITIS C VIRUS (HCV) SEROPOSITIVITY IN A COHORT OF HIV CO-INFECTED ART NAÏVE SUBJECTS: ASSESSMENT OF BIOCHEMICAL PROFILE  

BUKAR A, OBI SO, DIGBAN KA, WAZIRI G, MEDUGU JT, GEIDAM UM, AUDU N, OSAKUE EO, PEYOU GAB, OLANIYAN MF, JEREMIAH ZA.

Background: Hepatotropic virus infection, such as Hepatitis C Virus (HCV) infection is altering the gains of highly active Antiretroviral therapy HAART; and rapidly increasing non-AIDSrelated mortality in people living with HIV disease.
Aim: This warranted the investigation of some biochemical indices in a Cohort of 94 HIV Seropositive Subjects, out of which 11 were co-infected with HCV. Controls consisted of 80 subjects Seronegative for HIV and HCV antibodies.
Method: We analysed Aspartate Transaminase (AST), Alanine transaminase (ALT), Alkaline Phosphatase (ALKP), Creatinine, Total Cholesterol (TCH), Random Blood Glucose (RBG) and Potassium (K+) in the HIV, HIV/HCV and HCV subjects and the controls.
Result: The liver enzymes mean values (AST, ALT, ALP) were significantly higher in the HIV/HCV subjects compared to the HIV, HCV mono-infections and the controls (P<0.01). Similarly, Creatinine mean value was also higher in the HIV/HCV compared to the other studied groups (P< 0.001). Total cholesterol (TCH) and potassium (K+) were incomparable in the studied groups (P> 0.05). Conversely, random blood glucose showed a significant difference in the mean values with the highest value registered in the HIV/HCV subjects (P<0.05).
Conclusion: HIV/HCV Co-infection may worsen the biochemical profile in HIV setting, and may increase non-AIDS-related morbidity and mortality in people living with HIV disease. Understanding the scope of this phenomenon, in addition to rapid interventional measures may be necessary to ameliorate its impact.

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ORIGINAL ARTICLE


 
  EXPERIENCE WITH IMPLANON USE AT THE ABUBAKAR TAFAWA BALEWA UNIVERSITY TEACHING HOSPITAL BAUCHI NIGERIA  
ISA B, MAIRIGA AG, IBRAHIM SM, KULLIMA AA, KADAS AS.

Background: Implanon is an implantable, subdermal rod-shaped contraceptive device designed to provide a long acting contraception for up to three years.
Aim: to determine Implanon acceptance and socio-demographic characteristics of women accepting it.
Materials and methods: a retrospective study was carried out in the family planning Unit, Bauchi Teaching Hospital, Nigeria, between January 1, 2010 and December 31, 2013. The records of the clients from the family planning clinic were studied. Socio-demographic characteristics, years of distribution and source of information were analyzed using SPSS Version 20 software.
Results: Of the 4091 acceptors of contraception, 601 had Implanon representing 14.7% of the acceptors. The age range was 20 to 45 years, with mean age of 24.4±3.6 years. Most of them 518(86.2%) were aged 20-34 years. All the acceptors were married. Many 476(79.2%) of the clients were multiparous. Majority 242(40.3%) of the clients had 2-3 living children and about 481(80.0%) had secondary education. Five hundred and sixty three clients (93.7%) desired more children after discontinuation of Implanon. Some of them 38(6.3%) weighed more than 80 kg. The main source of knowledge of Implanon was clinical personnel 462(76.9%). Mass media constituted the least source of information 76(12.6%).
Conclusion: Implanon is an acceptable method of contraception among our women

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ORIGINAL ARTICLE


 
  PATIENTS' KNOWLEDGE ON DIABETES MELLITUS, ITS COMPLICATIONS, MEDICATION, RISK FACTORS AND LIFESTYLE MODIFICATION IN MAIDUGURI - CITY, NIGERIA.  
OHIEKU JD, CHIFOR FM.

Background: The knowledge, attitude and practices of patients which may influence the treatment outcomes are often given poor attention.
Aim and Objectives: The objectives of the study was to assess gaps in patients' knowledge about diabetes mellitus, the information conveyed to them by health care professionals as well as their compliances to lifestyle modification, medical and medication instructions.
Materials and Method: Cross-sectional and prospective design through questionnaire was adopted for the study. Information regarding demographic data; medical and social history of the patients, the knowledge about diabetes; dietary intake; exercise; diabetic complication; glucose measurement and medication were obtained. Oral interviews were used to enhance information collection in those with low literacy levels.
Results: The proportion of patients with knowledge on diabetes as a disease, benefits of exercise and uncontrolled diabetes mellitus were 78.9%, 70.6% and 68.9% respectively. The knowledge in other areas are high cholesterol levels (22.8%), cigarette smoking(30.6%), alcohol intake (26.1%), ocular complications (42.8%), foot care(38.3%), sugar in urine (45.0%), medication side effects (37.2%), comorbid diseases (46.7%), ocular complications (42.8%) and high blood pressure (43.5%). The ability to recognise signs of hyperglycaemia and hypoglycaemia were 90.6% and 30.0% respectively. Only about 18.3%, 24.4% and 38.3% regularly check their cholesterol, eye and foot respectively. About 86.1%, 92.8%, 91.7% and 75.3% respectively check blood pressure, sugar levels, and compliant with medication and dietary schedules.
Conclusion: The proportions of patients having knowledge in areas of exercise, diabetes as disease and problems of poorly controlled DM were above average while those having knowledge on lifestyle modifications or risk factors (cigarette smoking, alcohol intake, high BP and high cholesterol levels), ocular complication, foot care and sugar in urine were below average. Majority of patients have received information or education on high glucose levels in the blood and urine, medication compliance, exercise, dietary issues and food schedule but information on low sugar levels, shoes to wear/foot care and glucose home monitoring were lacking in majority of patients. The ability to recognise the signs/symptoms of hyperglycaemia, compliances with medication, regular exercise, and dietary compliances were generally high. Many patient-focused areas of care need improvement upon in the care of the diabetes patients.

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ORIGINAL ARTICLE


 
  COMPARISON OF CAUDAL BLOCK AND DEEP PENILE NERVE BLOCK FOR POSTOPERATIVE PAIN RELIEF IN PAEDIATRIC DAY-CASE CIRCUMCISION.  
ADAMU SA, PANDA US, SAMBO YT, SANI A.

Background: To compare the postoperative analgesia and complications of caudal block and dorsal penile nerve block in children aged 1- 5 years for day case circumcision.
Method: This was a prospective randomized double blind study of paediatric patients aged 1-5 years, who had day-case circumcision at Federal Teaching Hospital, Gombe. Group A had caudal block with 0.5% plain bupivacaine and group B who had dorsal penile nerve block (DPNB) with 0.5% plain bupivacaine. Post-operative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). Patient's age and complications, average pain score, time for the first postoperative analgesia demand and total analgesics consumed in 24 hours were recorded and analyzed.
Results: A total of two hundred and nine (209) patients completed the study, made up of 107 and 102 in group A and B respectively. There was no significant difference in block success rate between the two groups (p = 0.34). Group A had significantly lower average CHEOPS pain score in the immediate postoperative period than the Group B p = 0.02. Group A consumed significantly lower number of paracetamol doses than group B (p = 0.05). There was no significant difference in the incidence of postoperative vomiting between the two groups. The caudal block group had fewer complications than dorsal penile nerve block.
Conclusion: It has shown that caudal block has a higher success rate, better postoperative analgesia and fewer complications than dorsal penile nerve block in children aged 1- 5 years for day case circumcision.

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vol12-issue2-july-december-2015

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2015
Volume 12 | Issue 2

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

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ORIGINAL ARTICLES


 
 
  ABSOLUTE LYMPHOCYTE COUNT AS A SURROGATE OF CD4+ T LYMPHOCYTE CELL COUNT IN INITIATING ANTIRETROVIRAL THERAPY IN HIV-INFECTED NIGERIANS

BABADOKO, AA., MUKTAR, HM., MAMMAN, AI.

Background:Background: Most laboratories in resource-constrained countries, cannot routinely use standard methods to measure markers of disease progression useful in staging and initiation of antiretroviral therapy due to high cost more so with the ongoing reduction of support by the implementing partners. The objective of this study is to determine whether Absolute Lymphocyte Count (ALC) can serve as a surrogate for CD4+ T-Lymphocyte Cell Count (CCC) for initiating highly active antiretroviral therapy (HAART) in HIV-infected treatment naïve patients in our setting. Methods: A total of 400 adult Nigerians infected with HIV-1 and who were previously antiretroviral naïve, were recruited into the study at Ahmadu Bello University Teaching Hospital, HIV subspecialty clinic. They were assessed clinically and immunologically and categorized into three clinical stages; A, B, and C according to CDC criteria. Absolute Lymphocyte Count and CCC values were tested for correlation and their validity determined using SPSS version 20 and Chi square statistics. Results: The patients comprised of 187 males (46.8%) and 213 (53.2%) females. One hundred and eight (27%) of the study subjects were in stage A, 153 (38.5%) in stage B, and 139 (34.8%) in stage C. The mean ALC of stage C subjects is significantly lower than that of stage A subject's p < 0.05. The mean CCC values declines significantly from stage A through B to C p ≈ 0. There was a positive and significantly correlation coefficient between ALC and CCC in stage C; r 0.28, P < 0.05. In all the subjects and in the stages, sensitivity and specificity of a low ALC value to predict a low CCC value were low. Conclusion: Absolute Lymphocyte Count is not a reliable and sensitive surrogate of CCC in all HIV infected patients however it is only useful in immunocompromised patients to determine the optimal time to initiate HAART..

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ORIGINAL ARTICLES


 

SONOGRAPHIC EVALUATION OF CAROTID INTIMA MEDIA THICKNESS (cIMT) 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:Intima media thickness of the carotid arteries has been used as a subclinical index of atherosclerosis in patients with diabetes mellitus and has also been used in epidemiological and interventional studies as a surrogate index of atherosclerosis. However, to date, there is paucity of data on sonographic carotid artery intima media thickness (IMT) measurements and the prevalence of carotid atherosclerosis and stenosis among adult diabetic patients in our environment. Objective: The objective of this study was to evaluate carotid artery intima media thickness 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 intima media thickness. Measurements were taken at 1cm below and 1cm above the carotid bulb for the common carotid (CCA) and internal carotid arteries (ICA) respectively. Pearson's correlation and Student t-test were used to compare the means between the variables. Results: There were 72(60%) male and 48(40%) female diabetic patients aged 20 to 78 years (mean = 50.03±11.4 years). Mean intima-media thickness, in millimeters (mm), for normal (non-stenotic) carotid arteries on the right and left were (CCA=0.71±0.09 and 0.70±0.08; ICA=0.71±0.08 and 0.69±0.09) and abnormal (stenotic) on the right and left were (CCA=0.84±0.17 and 0.83±0.19; ICA=0.98±0.10 and 1.03±0.10) 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. There was positive and significant correlation between percentage degree of stenosis with IMT (r=≥ +0.5; p=<0.05). Conclusion: The findings of this study have indicated the presence of atherosclerotic and haemodynamic changes in the carotid arteries of adult diabetic patients in this 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

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ORIGINAL ARTICLES


 
  ANALYSIS OF MATERNAL DEATHS IN SOUTHERN N'DJAMENA DISTRICT HOSPITAL (CHAD)  
GABKIKA BM, DAMTHÉOU S, MASNGAR K, TCHOUBOU BM, ADOUM T, BOYANNET BM

Background:The maternal mortality ratio in Chad is 1099 per 100,000 live births. According to the WHO, 80% of the maternal deaths are preventable if appropriate measures were taken. Objective: to determine the proportion of preventable deaths and to identify the elements linked to maternal death in N'Djamena south District Hospital. Materials and Methods: This was a retrospective, descriptive study spanning over two years, from January, 1st 2013 to December, 31th 2014 carried out in N'Djamena South District Hospital concerning analysis of maternal deaths in southern N'Djamena district. All patients that died during the pregnancy or within 42 days postpartum in N'Djamena south district hospital during this survey were included. Results: During this survey, we recorded 52 maternal deaths for 7439 deliveries giving a maternal death rate of 699 per 100,000 deliveries.The age group between 25-29 years was the most represented with 34.6%.The majority of patients (73.1%) were referred and 48 patients (92.3%) had less than 4 prenatal consultations. The causes of maternal deaths were dominated by: delay seeking medical care, delay in accessing health facilities, and the delay in accessing efficient care .Obstetrical pathologies (direct causes) were responsible for 92.3% of deaths, these pathologies were: hemorrhage, eclampsia, abortion and infections. In 07.7% indirect causes were noted. Twenty five patients (48.2%) received medical care within 30min-1h after diagnosis. Conclusion: The maternal death remains a public health problem that persists in Chad. Its reduction requires the removal of delays.

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ORIGINAL ARTICLES


 
  MALARIA PARASITAEMIA AMONG HIV POSITIVE PREGNANT WOMEN ON INTERMITTENT PREVENTIVE THERAPY ATTENDING A TERTIARY HEALTH CARE CENTRE IN KANO  

TAKAI IU, RAHILA G, IBRAHIM AS

Background:The use of 3 doses of intermittent preventive therapy (IPT) for malaria among HIV positive pregnant women is an ante-natal preventive measure for malaria. Objectives: The study is aimed at determining the prevalence of malaria parasitaemia and clinical malaria among HIV positive antenatal clinic attendees who had intermittent preventive therapy for malaria. Materials and Methods: This was a one year retrospective study of HIV positive pregnant women in Aminu Kano Teaching Hospital, Kano, who had antenatal care between 2nd January and 31st December, 2013. Information such as parity, gestational age at booking, number of IPT given, previous malarial treatment and results of blood smear for malarial parasites, were obtained and analysed. Results: A total of 1800 women had antenatal care over the study period, out of which 110 were HIV positive, giving a sero-prevalence rate of 6.1%. Up to 55.5% of them booked at gestational age of 16-20weeks. Ninety women (81.8%) had 3 doses of sulphadoxinepyrimethamine (SP) for IPT. Thirty eight women (34.5%) had positive smear for malarial parasites, with 68.4% occurring among the primigravidae at 16-20 weeks of gestation in 60.5%. Thirty four (30.9%) women were treated for clinical malaria. Thirteen of them (38.2%) had recurrence with 9 (60.2%) occurring in primigravidae. Conclusion: The prevalence of malarial parasitaemia is high despite the use of 3 doses of SP for IPT. The prevalence and recurrence was higher in primigravidae. Other means to support drug preventive measures should be stressed.

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ORIGINAL ARTICLE


 
  FACTORS THAT COULD INFLUENCE MEDICAL STUDENTS' CHOICE OF PSYCHIATRY AS A CAREER: A POTENTIAL OPPORTUNITY FOR IMPROVING MENTAL HEALTH CARE ACCESS IN NIGERIA  

YERIMA MM, IBRAHIM AW, PINDAR SK, WAKIL MA, MUSAMI UB

Background: Mental disorders are quite prevalent and cause significant burden and disabilities. The access of much of the world's population, especially in low and middle- income countries (LMICs), to mental health services is inadequate despite the enormous needs for those services. There is a potential opportunity in recruiting medical students to take up psychiatry as a career to ensure the future of mental health services delivery in Nigeria. This study examines the factors that determine the choice of specialty, especially psychiatry, with the aim of improving mental health care delivery. Materials And Methods: A cross-sectional study of medical students from the University of Maiduguri to determine factors that affect their career choices with special emphasis on psychiatry. Results: Participants in the study were 117 students mean age of 26years ± 2.9 SD. Majority were males (66.7%). Most were fifth year students (83.8%). All participants said they would specialize and some of the factors they would consider were “sheer interest" and clinical man-hours required in 41.9% and 23.1% respectively. Obstetrics and gynecology (O&G) had the highest number of prospective specialists followed by Surgery, Internal medicine, and Pediatrics in 27.4%, 22.2%, 15.4%, and 12.8% respectively. Laboratory medicine and Psychiatry, respectively, trailed with 6.0% and 5.1%. Most (54.7%) would consider Psychiatry as a second option while 45.3% wouldn't. “Longer duration of Psychiatric clinical posting” as well as “more mentoring” will make them consider psychiatry (60.6% and 68.3% respectively). Only 29.1% of the respondents were discouraged by Stigma from considering Psychiatry. There was association between potential specialty and sex of the students (÷2 =23, p=0.028). There was also significant association between being Muslim and considering psychiatry as second option (÷2= 6.2, p= 0.013) with odds ratio of 2.74 and (95% CI, 1.23- 6.12). Conclusion: Medical students could be encouraged to take up psychiatry as a specialty by paying attention to the factors that determine how they choose a specialty and the factors that may encourage or dissuade them from taking up psychiatry. This will have far reaching positive consequences towards improving the population access to mental health services.

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ORIGINAL ARTICLE


 
  PATTERN OF OTORHINOLARYNGEAL, HEAD AND NECK DISEASES IN THE INPATIENT UNIT OF A TERTIARY HEALTH INSTITUTION IN SOKOTO, NORTH WESTERN NIGERIA.  

AMUTTA SB, ABDULLAHI M, ALIYU D, MANYA C, YIKAWE SS, SOLOMON JH

Background:The pattern of ear, nose, throat, head and neck diseases varies from one geographical location to another and hospital admission usually required for optimum management. Objective: The aim of this study is to assess the pattern of Ear, Nose and Throat in-patient diseases and make recommendations to improve health care services. Methods: This was a six year retrospective study of ear, nose, throat, head and neck in-patients. Data analysed include demographic data, religion and diagnosis. Results: A total of Eighteen thousand and ninety three (18,093) patients were managed in the Ear, Nose and Throat department from January 2006 to December 2012. One thousand two hundred and twenty six (1,226) patients were managed in the in-patient unit comprising male708 (57.8%) and female 518 (42.3%) with male: female ratio 1.4:1. Hospitalisation rate was 6.8%. The six most frequent reasons for the hospital admission were tonsillitis 224 (18.3%) patients, followed by epistaxis 105 (8.6%), nasal masses 100 (8.2%), neck and laryngeal trauma 91 (7.4%), chronic suppurative otitis media 74 (6.0%), nasal and facial trauma accounted for 74 (6.0%). Conclusion: The pattern of otorhinolaryngeal, head and neck diseases among the in-patients in this study varied with age and site of the lesion. Tonsillitis and Epistaxis being the most common reasons for admission, they can be handled by the general practitioners, hence, the need to create awareness on the management of these lesions to provide the Otorhinolaryngologist ample time to attend to complicated diseases

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SHORT COMMUNICATION


 
  IMPACT OF JOB STRESS ON WELLBEING OF EMPLOYEES AND ITS IMPLICATION FOR COUNSELLING  

YAYA UM

ABSTRACT: Job Stress comes as a result of incongruity between an employee and his job. This brings about psychological and physiological changes in the life of the worker, thus it, affects his/her general wellbeing and productivity. This article focused on the impact of job-related stress on the wellbeing of employees and the role of counselling in its prevention and management. The paper talked about the concepts of stress, job stress, causes, signs and symptoms, adverse effects and prevalence rate of job-related stress on employees. Lastly, the article presented empirical findings, such as counselling employees on how to cope with psychological distress and adverse effect of psychological trauma, which improve wellbeing of workers.

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CASE REPORT


 
  A RARE PATHOLOGICAL TRIAD UNMASKED BY TYPHOID ENTERITIS: REPORT OF A CASE OF ACUTE APPENDICITIS, APPENDICEAL SCHISTOSOMIASIS AND VILLOUS ADENOMA OF THE APPENDIX.  

PINDIGA UH, MALAMI SA, ADOGU IA, KEFAS JB, EMUAN TO

Background: A villous adenoma of the appendix is an extremely rare tumour of the appendix even rarer is its occurrence on schistosomal granulomatous appendicitis. It is therefore usually an incidental finding during appendicectomy. Most series on appendiceal tumours accounts for less than 7% as villous adenomas. The index case histologically shows acute appendicitis, schistosomal granulomata and a villous adenoma. There may be an aetiological relationship between schistosomiasis and the villous adenoma of the appendix in this case since schistosoma related colonic squamous cell carcinomas have been observed in endemic arrears. Treatment is limited to appendicectomy and praziquantel therapy but post-operative colonoscopy is recommended due to the risk of colonic schistosomiasis and malignancy in patients with appendiceal neoplasms. We therefore report this rare pathological triad.

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Written by Administrator On Sunday, 24 March 2013 17:23

Professor Mohammed Bukar

EDITOR-IN-CHIEF, BORNO MEDICAL JOURNAL

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Professor ALIYU M. KODIYA

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UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL P.M.B
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TEL:08036289875
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Treasurer: Dr. Aliu A. Usman


Financial Secretary: Dr. Mohammed Y. Mahmood


PRO: Dr. Aminu A. Aji


Editor-in-Chief: Prof. Mohammed Bukar


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Ex-Officio II: Dr. Kumshe Mohammed Abba

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Editor-in-Chief: Prof. Mohammed Bukar

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