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archive-2022-no1

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January - June 2022
Volume 19 | Issue 1

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

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PRELIMINARY PAGES

 

ORIGINAL ARTICLES


 
 
 

Epstein-Barr virus DNA Detection in patients with gastric adenocarcinoma in a Nigerian Tertiary Health Centre

Zarami AB, Chiwar H, Bata MG, Nggada HA, Pindiga UH

Background: Epstein-Barr virus (EBV)-associated adenocarcinoma constitutes 10% of gastric carcinomas worldwide. The EBV-positive adenocarcinoma has a unique genomic aberration with a low mutation burden and thus carries a good prognosis. The distinct salient genomic features have provided a guide to targeted therapy and the possibility of a clinical trial for emerging drugs in EBV-positive gastric adenocarcinomas. We retrospectively reviewed ten cases to determine the frequency of this association in our environment. Methods: The study was an analytical case-control study. Non-probably purposive sampling method was adopted; ten formalin-fixed and paraffin-embedded tissue blocks from surgically resected gastric adenocarcinoma seen at the Histopathology Department of the University of Maiduguri Teaching Hospital were selected and used. The PCR was done at National Trypanosomiasis Centre, Kaduna using 129 bp primers. The patient biodata and EBV status were entered into a computer and analysed using SPSS version 23. Proportions were calculated using the Chi-square test and a p-value of <0.05 was considered statistically significant. Results: Ten cases were retrieved. There were 6 females and 4 males with F:M ratio of 3:2 and a mean age of 52.7 ± 10.26 SD with an SE of 0.661. Seventy percent of the cases were positive for EBV while 30% were negative. Four out of the 6 females were positive for EBV DNA and 3 out of the 4 males were positive for EBV DNA. Fifty percent of the positive cases were found within their 4th decade of Life. There was no statistical significance between the histological types and EBV status (p=0.467). Conclusion: The study has shown a high frequency of EBV-DNA detection in patients with gastric adenocarcinoma in our environment, with 50 % occurring in the 4th decade of life. We recommend a further study with larger sample size and analysis of exome and genome sequencing of EBV in patients with gastric adenocarcinoma to increase our understanding of its prognosis and treatment.

Keywords: EBV-DNA, PCR, Gastric adenocarcinoma, Targeted immunotherapy

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Achieving an optimal Endotracheal Tube Pressure: Comparison of Loss of Resistance and Pilot Balloon Techniques

Adam Ahmad, Dalhat Salahu, Atiku Mamuda, Saheed Adesope, Nasir Usman

Background: Inappropriate estimation of endotracheal tube pressure can result in significant harm to the patient, and the use of a manometer is the only reliable way of ensuring an optimal pressure range (20-30cmH2O). In the absence of a manometer, the Pilot balloon palpation (PBP) technique is commonly employed in our environment.

Aim: This study compared the accuracy of a newer method of ETTc inflation called passive release technique using loss of resistance (LOR) syringe with the PBP technique in determining optimal ETTc pressure.

Methods: One hundred and eighty ASA I and II patients, aged 18 – 65 years, scheduled for elective procedures under general anesthesia with ETT were randomized into 2 groups with one group having their cuff pressures measured by pilot balloon palpation (PBP) and the other using a loss of resistance syringe (LOR). The cuff pressure was then measured in each group using a sensitive manometer.

Results: The mean ETTc pressure was found to be significantly higher in the PBP group than in the LOR group (64.28 ± 31.12 and 29.64 ± 11.68; p= 0.0001). The LOR technique was found to be significantly more accurate in ETTc pressure estimation than the PBP techniques (59.3 vs 27.8%; p = 0.0001).

Conclusion: Passive release technique using LOR was found to be significantly more accurate compared to PBP in optimal ETTc pressure estimation.

Key words: Endotracheal tube cuff pressure, pilot balloon palpation, loss of resistance syringe.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Emotional Disorders and their Sociodemographic Correlates among Children and Adolescents Living with Sickle Cell Disease

Musami U.B, Abdulmalik J.O, M. W Ali, Dahiru A. M. C, Mahmood M. Y, Wakawa I. A

Background: North-Eastern Nigeria has high birth rates, low literacy levels and low rates of premarital screening for haemoglobin genotype. This probably explains the high prevalence of sickle cell disease (SCD) among children and adolescents. SCD is a chronic disease associated with high rates of co-morbid mental health disorders affecting both the sufferers and caregivers. Despite this burden, there are very few studies that evaluated mental health disorders among people living with SCD in this region.

Objectives: To determine the prevalence of depression, suicidality, and anxiety among children and adolescents with SCD and the sociodemographic correlates associated with them.

Methods: This was a single-centre, hospital-based, cross-sectional study conducted at the University of Maiduguri Teaching Hospital. Children and adolescents with SCD were recruited for the study and issued a pretested sociodemographic questionnaire (Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children Present and Lifetime Version [K-SADS-PL]). Data was analysed using SPSS version 20.

Results: There were a total of 165 participants with a mean age of 11.2 ± 3.2 years comprising 83 (51.9%) males. Majority (98.1%) had only primary education, and most (83.8%) reside in an urban area. About 77% were diagnosed to have SCD before the age of 8, and 57.5% have received care for more than 5 years. Emotional disorders were present in 53.1% of the participants. These consist of anxiety disorder 38.1%, separation anxiety 28.8%, depression 20.6%, agoraphobia 13.1%, suicidality 5%, panic disorder 3.8%, social phobia/ specific phobia 3.1%, and general anxiety disorder 2.5% respectively. Statistically significant association (P<0.005) was found between emotional disorders and monogamous families, and parents’ occupation,

Conclusion: There is a high prevalence of emotional disorders amongst children and adolescents living with sickle cell disease attending clinics in Maiduguri, which correlated with monogamous family structure, low socioeconomic status. Routine screening for emotional disorders among children and adolescents living with chronic disorders attending the paediatric clinic should be considered and psychosocial support should be provided.

Key words: Emotional disorders, sickle cell disease, Nigeria

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Practice of Breast milk Expression and Its Influence on Exclusive Breastfeeding among Working Mothers in Kano; North-West, Nigeria

Rabiu A, Getso HA, Mahmud A

Background: Many studies have shown that working mothers face challenges in achieving exclusive breastfeeding (EBF). The practice of breast milk expression (BME) is an important strategy to achieve EBF. Aim: To assess the practice and influence of BME on EBF among working mothers with infants up to six months of age attending the immunization clinic of Aminu Kano Teaching Hospital (AKTH), Kano.

Methods: This was across-sectionall study among working breastfeeding mothers attending the immunization clinic of AKTH. A structured interviewer-administered questionnaire was used to obtain data on knowledge and practice of BME. Data collected were analysed using SPSS windows version 21. A χ2 test was used to compare variables where appropriate.

Result: Three hundred and ten breast feeding mothers participated in the survey. The mean age ±SD of respondents were (30.68 ± 5.6). Their median parity was 3. Only 103(33.2%) practiced BME. Reason given by half (54.8%) of respondents who practiced BME was to achieve six months of EBF which was found to be statistically significant (p-value =0.001).

Conclusion: Although most working mothers have fair knowledge on expression and storage of breast milk, only a minority put that into practice, and the main reason for practicing BME was to achieve six months of EBF. Age of mother, ethnicity and reason for BME were found to be statistically significant (χ2 = 52.7, P= 0.01), (χ2 =7.99, P = 0.046), (χ2 = 305.5, P = 0.001).

Key words: Breast milk Expression, Exclusive Breast Feeding, Influence, Practice.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Utilisation of Skilled Birth Attendants among Recently Parturient Women in Rural Communities of Kano State, Nigeria: A Mixed-Methods Study

Nafisat T. Abdullahi, Rabiu I. Jalo, Abubakar S. Abubakar, Usman M. Ibrahim, Shaheeda L. Farouk, Aminatu A. Kwaku, Fatimah I. Tsiga-Ahmed, Aishatu L. Adamu, Musa M. Bello, Amole T. Gboluwaga, Auwalu U. Gajida, Isa S. Abubakar

Background: Ensuring access to skilled birth attendants (SBA) during childbirth is critical for maternal and newborn survival, especially in underserved rural communities of northern Nigeria.

Methods: We assessed the utilisation of SBA in rural communities of Kano state. Using a cross-sectional study design with a concurrent mixed method of data collection, multi-stage and purposive sampling techniques were employed to select respondents of the quantitative and qualitative components of the study, respectively. Focus group discussions and key informant interviews were conducted to assess the perception of women, husbands and delivery service providers regarding the utilisation of SBA.

Results: Of the 194 women, 38(19.6%) were attended to by SBA, 138(71.1%) by unskilled birth attendants and 18(9.3%) had solitary birth. Furthermore, facility-based delivery was only 14.9% as the majority of the women delivered at home. Previous hospital delivery (p=0.02, aOR = 4.5; 95% CI=1.4-14.8) and husband’s level of education (p=0.03, OR = 5.9; 95% CI=1.3-27.3) were found to be independent predictors of utilisation of SBA. Perceptions regarding utilisation of SBA varied, ranging from a general preference for home delivery with the assistance of a traditional birth attendant to a predisposition towards hospital delivery with the assistance of SBA. Factors that contributed to adherence to traditional birthing practices included healthcare workers’ negative attitudes, manpower gap, lack of equipment and supplies and inadequate functioning health facilities.

Conclusion: Utilisation of SBA in rural communities of Kano state is low. Efforts should be made to increase women’s and men’s awareness, improve health facilities, and ensure improved and equitable access and availability of skilled delivery care services.

Keywords: utilisation, skilled birth attendant, women, rural, Kano

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Prevalence and Characteristics of Overweight and Obese Adolescents in Egor L.G.A, Edo State, Nigeria

Nosakhare J. Iduoriyekemwen, Alphonsus N. Onyiriuka, Wilson E. Sadoh, Moses T. Abiodun

Background: Global childhood obesity prevalence reports a rise, especially in the adolescent age group. Since adolescence is a critical transitional period to adulthood, tracking changes in the characteristics of obesity in this group of children is essential to aid policy formulation on the prevention of obesity. Thus, this study was carried out to determine the prevalence and the characteristics of overweight and obese adolescents in Egor Local Government Area, Edo State, Nigeria.
Method: The cross-sectional study included 1036 adolescents aged 10 -17 years from two secondary schools in Egor Local Government Area, Edo State, Nigeria. The weight and height of these adolescents were measured, and the body mass index computed. Using the United States Center for Disease Control body mass index growth chart, the participants were categorised into three groups, namely normal weight (5th to <85th percentile); overweight (85th to <95th percentile); and obese (≥95th percentile).
Results: The combined prevalence of overweight and obesity among the participants was 8.9%. The prevalence rates of the overweight and obese were 5.9% and 3.0%, respectively. The proportion of overweight and obese participants was higher in pubertal than pre-pubertal female adolescents, while the opposite was observed amongst males. The proportion of overweight and obese adolescents was significantly more in participants from upper-class families than the middle- and lower-class families (p =0.007).
Conclusions: The prevalence of overweight/obesity in Nigerian adolescents revealed in this study is low. However, children from upper-class families were proportionately more affected than other classes. Targeted health educational programmes are advocated.
Keywords: Adolescence, Overweight, Obesity, Prevalence.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Prevalence of Hypertension and its Risk Factors Among Adult Residents in Imoru Community, Ose Local Government Area, Ondo State

Timothy A. Ehwarieme1 and Anwuli Emina2

Background: Hypertension is a public health challenge that has been increasing alarmingly in both low and high-income countries. This study aims to determine the prevalence of hypertension and its associated factors among adult residents in Imoru community.

Methods: A descriptive cross-sectional design was used to surveysample size of 316 randomly selected participants. A well-structured questionnaire, blood pressure apparatus, weighing scale, and calibrated meter rule were used to collect data. Data were analyzed using descriptive statistics and hypothesis tested using multiple logistic regression at a 5% level of significance. Result: Of the 316(100%) participants, 177(56%) were males with M: F ratio of 1:0.79. The prevalence of hypertension was found to be 37.7%. The level of knowledge of Hypertension is evenly distributed with 83(26.3%) having poor knowledge, 152(48.1%) having fair knowledge, and 81(25.6%) having good knowledge. Risk factors identified are consumption of fatty food, adding table salt to meals, performing stressful activities, consumption of red meat, consumption of processed and canned foods, and addition of condiments to foods (average mean >2.5). Factors influencing these practices are affordability, availability, culture, and ignorance. There is a positive significant correlation of SBP (R2 = 0.1854, p =0.021; p =0.002) /DBP (R2 = 0.0458, p =0.002) and BMI. Females are two times (OR: 1.86; CI = 0.343-2.159) more likely to have good knowledge than males.

Conclusion: There is a high prevalence of hypertension in the study population. There is a need for concerted efforts by health policymakers and all stakeholders towards putting in place effective primary and secondary preventive strategies.

Keywords: Knowledge, risk factors, hypertension, Prevalence, Practices associated with risk

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Kaposi Sarcoma of the Nasal Cavity: A Rare Presentation

Adamu Abubakar. Abba Bukar Z. Ahmed Mohammed N. Amina Muhammad A. Aliyu Mohammad Kodiya

Background: Kaposi sarcoma (KS) is an uncommon vascular neoplasm that commonly involves the skin of the upper and lower extremity and to a lesser extent, mucosa of the different anatomical sites of the body. It rarely occurs in the head and neck mucosa, the most common site being the oral cavity. Nasal mucosal involvement is extremely rare. To the best of our knowledge, only nine cases of KS of the nasal cavity were reported in the English literature. We present a rare differential to be considered when dealing with patients with nasal mass.

Case summary: A 47 year old Nigerian woman presented with 3 years history of recurrent epistaxis, a right nasal mass, progressive right nasal obstruction, rhinorrhoea and anosmia. She is diabetic and hypertensive. Examination revealed a polypoid mass occupying the whole of the right cavity with associated contact bleeding.

Conclusion: Nasal KS is a rare malignancy that involved the nasal mucosa. To our knowledge, only nine cases of primary nasal KS were reported in the literature of which only a few were not associated with AIDS. Though rare, it should be entertained as one of the differential diagnoses of nasal masses in adults even in those with HIV-negative status We present the fifth case of primary nasal KS not associated with AID
Keywords: Kaposi sarcoma, nasal cavity, acquired immunodeficiency syndrome

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 
 

A Late Osteochondritis of Femoral Condyle Treated by Modified Autoplastic Grafting of Wagner

Feigoudozoui H.V, Parteina D, Koné S.

Background: Osteochondritis is a necrotic involvement of the subchondral bone and cartilage opposite. Its most common location is the medial femoral condyle. The technique of Wagner’s autoplastic grafting was modified or adapted to a limited technical platform. To share an unusual experience with the scientific community.

Summary: A dissected osteochondritis of the left femoral condyle was diagnosed in a 15-year-old patient. The treatment was a modified open-centre surgery according to Wagner. The results were satisfactory in both immediate and late post-surgery.

Discussion: The classic Wagner technique uses a unique plugin that is fixed by patching. In this work, the graft was triple and fixed by screws.

Conclusion: The working conditions can lead to the use of a modified classical technique

Keywords: Femur; Mosaicoplasty; Osteochondritis

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Xanthogranulomatous Mastitis: Report of a Rare Case and Review of Literature

Zarami AB, Abe MA, Adamu AI, Tarfa H, Pindiga UH

Background: Xanthogranulomatous inflammation (XGI) is a rare form of chronic inflammation characterized by the presence of lipid-laden macrophages, multinucleated giant cells, and cholesterol crystals. It is an uncommon finding in the breast. Our literature search revealed twenty-four documented cases in the English literature.
Case report: An 18-year-old female presented with a mass in the left upper lateral quadrant of the breast with ulceration for a 1-month duration. The mass was initially small about 2cm in its widest diameter and continued to increase in size to 5 x 3 cm. The overlying skin is smooth and not attached to the underlying structures. It is firm with mild tenderness and ill-defined margins. Two months later she developed a left breast ulcer that measured 2 x 1 cm on the surface of the lump. It has a sloping edge with a necrotic floor. There was no associated axillary lymphadenopathy. Fine needle aspiration cytology suggested an inflammatory process. Tissue biopsy histology shows abundant foam cells, multinucleated giant cells of foreign body type as well as numerous lymphoplasma cells infiltrating the breast tissue with geographic areas of necrosis in keeping with xanthogranulomatous mastitis.
Conclusion: Xanthogranulomatous mastitis is a very rare entity, it is self-limiting in most cases. The diagnosis of XGM can be made by excluding other diseases that elicit inflammation in the breast. The lesion can mimic granular cell tumor, histiocytoid carcinoma, invasive carcinoma NST, and lipid-rich breast cancer; therefore, clinicians should always consider these as differential diagnoses to avoid unnecessary surgery.
Keywords: Xanthogranuloma, Mastitis, Rare

[FULL ARTICLE (PDF)]

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vol18no2

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2021
Volume 18 | Issue 2

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

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

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

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

 

 

REVIEW ARTICLES


 
 
 

Talon Cusps- A Review of Literature

Karthik Shunmugavelu

Background: A talon cusp is an accessory cusp-like dental anomaly that projects from the cingulum or cementoenamel junction to the incisal edge of the maxillary or mandibular anterior teeth in both primary and permanent dentition. A significant genetic impact has been proposed by the presence of talon cusp in immediate family members. Talon cusp affects both sexes and can be unilateral or bilateral in primary and permanent incisors. Males have a greater level of incidence than females. Hattab and colleagues suggested a classification scheme for these irregular cusps based on their degree of development and extension: type I, type II, type III. There have been many reported clinical cases of predominantly facial talon cusps, 75 % of which were found in permanent dentition. A talon cusp occurs radiographically as a “V”-shaped radiopaque structure. A radiopaque "V"-shaped form is superimposed on a regular picture of a tooth's crown. Depending on the individual appearance and complexities, talon cusp management may be traditional or progressive. Since small talon cusps are asymptomatic, there is no need for therapy. Objective: The purpose of this article is to give a comprehensive knowledge on talon cusps for etiology, prevalence, clinical features and management based on recent literature. Conclusion: Talon cusp is a serious dental anomaly, since it can make diagnosis and recovery preparation difficult for clinicians. The scale, presenting problems, and patient cooperation both affect how talon cusp is handled and treated.

Keywords: Talon Cusps, Aetiology, Features, Treatment

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Knowledge and Awareness of ocular problems associated with the use of eyelash extensions among female undergraduates

Ebeigbe JA, Onoabhagbe SI

Background: Eyelash extensions are used to enhance the length, curliness, fullness and thickness of the natural eyelashes. The use of eyelash extensions is a common cosmetic practice among young women. This involves attaching synthetic eyelashes by means of an adhesive to the eyelashes.

Objective: The aim of this study was to assess the awareness and knowledge of female undergraduates of the University of Benin on the possible dangers of use of eyelash extensions.

Method: This was a descriptive cross-sectional study using questionnaires. Study population comprised female undergraduates in the University of Benin. A structured questionnaire assessing demographic variables, knowledge of eyelash extensions, usage as well as awareness of ocular complications was distributed among 2057 females aged 16-35 years with a mean age of 20 (±2.1 SD) years. Data obtained from the participants was processed using the statistical package for social sciences (SPSS) version 22.0 and presented in percentages and tables.

Results: We found that 99.76% (n=2052) of respondents were knowledgeable about eyelash extensions. Over two-thirds of the respondents had fixed eyelash extensions (67.77%). Cosmesis/beauty was the most common reason for fixing eyelash extensions (65.42%, n=912). About seventy-one percent (70.73%) of those who had fixed eyelash extensions knew about some complications from the use of eyelash extensions. The most common complication experienced was itching (62.7%). Social event outings were the major reason given why over two-thirds of respondents fixed eyelash extensions (69.80%, n=973),

Conclusion: Eyelash extensions has become a very popular procedure especially among young female students of higher institutions and may cause ocular problems. Adequate attention should be paid to the potential ocular health risks of the procedure and those who want to undergo this procedure, should be enlightened.

Key words: Eyelash, cosmesis, complications, eyecare, extensions

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES

 
 
 

Comparative Study of the Cervical Cytopathological Changes Among Intrauterine Device and Injectable Contraceptive Users at Aminu Kano Teaching Hospital, Kano

Ibrahim JM, Ahmed ZD, Atanda TA, Rabiu A.

 

Background:The intrauterine contraceptive device (IUCD) is a commonly used method of birth control that requires minimal skill and does not interfere with fertility once removed. It has been reported to produce inflammation and cervical cytopathology which can result in premalignant changes.

Objective: To determine the cytopathological changes among copper-containing IUCD and injectable contraceptive users at Aminu Kano Teaching Hospital.

Method: This was a comparative cross-sectional study, of two groups of 140 consenting women using the copper T IUCD and another 140 using the injectable contraceptive who came for follow-up after four weeks of insertion at the family planning clinic over a period of 10 weeks. A structured questionnaire was administered and information on socio-demographic data and contraceptive behaviour were obtained. A Pap smear was taken from the two groups and reported according to the Bethesda system.

Results: A negative smear with inflammation was found among 60(43.5%) women using the IUCD, compared to 31(22.8%) using the injectable contraceptive. Also, negative smear without inflammation was found in 76(55.1%) of the women on IUCD compared with 105(77.2%) on injectable contraceptives (p-value 0.012). Only 2(1.5%) of the women on the IUCD had low-grade squamous intraepithelial lesion, but none in the other group. Parity and duration of use for each of the methods had no statistically significant association with cytological findings in each of the groups (p-value 0.533 and 0.495 for parity and duration respectively). However, marital status had a statistically significant association with inflammatory changes (p-value< 0.001).

Conclusion: There were more inflammatory cytological changes among women using IUCD compared with those using the injectables.

Keywords: cervical cytopathology, intrauterine device, injectable contraceptives, comparative study

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Gestational Gigantomastia: Report of a Rare Case and Literature Review

Abdullahi YM,1 Zarami AB, 1 Lawan AI,1 Guduf MI,2 Farouk HU,3 Pindiga UH

 

Background: Gestational gigantomastia is a rare disorder with unknown aetiology. It commonly occurs during the first and early second trimesters and mostly affects women during their second and third decades of life. The disease has been reported to be more common among Caucasians than Blacks and involves both breasts in 92% of cases. There are no standard treatment protocols for the disease, however, both medical use of bromocriptine and simple mastectomy have been applied.

Case summary: We present a case of 32-year-old un-booked female, G8P7+0, 7 alive, who presented with bilateral breast enlargement with ulceration at 25 weeks’ gestation. The diagnosis was confirmed by tissue biopsy and simple mastectomy was done and the pregnancy was allowed to continue to term. Conclusion: This case report describes the first case of gestational gigantomastia in our environment and the seventh case reported in Africa to increase our awareness on how to diagnose and rule out other causes of bilateral massively enlarged breasts during pregnancy and the treatment options for this distressing clinical condition.

Keywords: Breast, Bilateral, Gestational gigantomasti

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Sonographic Determination of Common and Internal Carotid Intima Media Thickness in Normal Adult Population in Northeastern Nigeria

Magaji OG1 , Annongu IT2 , Chia DM2 , Hameed M2 , Farate A3 , Angbalaga A1 , Bulus PU1

Background: Ear diseases and their associated problems are common presentations in clinics worldwide, but are seen more in developing countries. They are causes of morbidity and frequent hospital visits, thereby consuming many man-hours. There is limited literature regarding the burden of ear diseases among Africans, and Nigerians in particular. The advent of computed tomography (CT) and magnetic resonance imaging (MRI) have immensely changed the management pathway of hearing impairments, particularly in the developing world. CT has been shown to be useful for demonstrating the detailed anatomy and pathology of the temporal bone and its surrounding tissues.

Objective: This study aims to determine the clinical presentations and CT pattern of hearing impairments among patients that were referred for CT in the Radiology Department of an ENT hospital in Kaduna, Nigeria.

Method: The study is a twenty-four months’ hospital-based retrospective study at the Radiology Department of the National Ear Care Centre, Kaduna which is a mono-specialty referral centre for ear, nose and throat pathologies. CT of the petro-mastoid region was done for 117 patients as a result of hearing impairment. A retrospective analysis of request cards, duplicate copy of radiology reports, soft copy of their CT images and patients’ folders were considered. All patients with history of hearing loss from other causes were included.

Results: A total of 117 patients were recruited for this study, with a female preponderance. The most frequently affected age group were those within the 3rd decade of life. Ear discharge was the most frequent presenting complaint and mastoid opacification constituted the highest frequency of occurrence on CT followed by mastoid wall scleroses, but 5.9% of the CT images were normal.

Conclusion: CT findings, along with the clinical examination is a powerful diagnostic tool in the diagnosis of hearing loss and also provides sufficient information to the ENT surgeon regarding the extent of disease process, complications, and anatomical variants which may influence management.
Key words: clinical, computed tomography pattern, hearing loss

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Adherence to Haemodialysis Among Chronic Renal Failure Patients of a Tertiary Health Facility, Benin City, Edo State

Ehwarieme Timothy A 1 and Awhim Blessing 2

Background: The prevalence of chronic renal failure (CRF) is becoming alarming among patients which necessitates management with dialysis. Objective: This study assessed the level of adherence to haemodialysis among chronic renal failure patients.

Method: A descriptive cross-sectional survey design was adopted in a sample size of 200 patients attending a nephrology unit in a tertiary hospital in Benin using a standardized instrument (ESRD-AQ) and a convenience sampling technique. Data obtained was analysed using descriptive statistics while hypotheses were tested using Chi-square and multiple logistics regression at 5% significant level.

Result: Majority 167(83.5%) have a poor level of knowledge, 147(73.5%) have a poor level of adherence. Financial constraints, lack of transportation, forgetfulness, and long waiting times were factors affecting adherence. Multiple logistics regression shows that respondents 18 – 30years are nine times (O.R. = 9.23; C.I. = 0.94-90.92) more likely to adhere than those who are greater than 60years, Males are 12% (O.R. = 0.88; C.I. = 0.40-1.90) less likely to adhere than females. Married patients are twice (O.R. = 2.40; C.I. = 0.65-6.39) more likely to adhere than those who are not, while respondents who are not educated are less (O.R. = 0.80; C.I. = 0.19-3.49) likely to adhere than those with college/university certificate.

Conclusion: participants in this study had low level of knowledge as well as low adherence. There is a need for a structured teaching/awareness programme on the importance of adherence to dialysis to motivate individuals who have CRF and improve adherence thereby reducing suffering and improving quality of life. Keywords: Adherence, Knowledge, Haemodialysis, Perceived factors, Chronic renal failure

[FULL ARTICLE (PDF)]

CASE REPORT

 
 
 

Impact of Dietary Acid Load on Pancreatic β-cells Function and Insulin Resistance in Type 2 Diabetic Nigerians



Abdullahi Mohammed1 , Aliyu G. Ganiyu2

Background: The possible impact of high intake of dietary acid on pancreatic β-cells dysfunction and insulin resistance in type 2 diabetic patients has been suggested from previous studies; but findings across different study groups are conflicting. Objective: To determine the impact of dietary acid load on pancreatic β-cell dysfunction and insulin resistance in a group of patients with uncomplicated type 2 diabetes mellitus

. Method: Study subjects were categorized in to four quartiles according to their dietary acid intake. Assessment of dietary intake was done using a food frequency questionnaire and the Nigerian Food Composition Table. Acid forming potential of our local diets were estimated as Potential Renal Acid Load (PRAL) scores. Pancreatic β-cell function and insulin resistance were estimated as HOMA-β and HOMA-IR respectively. Results: Degree of pancreatic β-cells function was observed to be significantly lower in subjects in the highest quartile of the PRAL score (p for trend < 0.05). There was a statistically significant trend with higher intake of dietary acid associated with increased degree of insulin resistance (p for trend< 0.05). Dietary acid load was found to be a significant predictor of pancreatic β-cells dysfunction among the study subjects.

Conclusion: Among subjects with type 2 diabetes mellitus in this study, consumption of a diet loaded with high acid forming potential food items was associated with greater insulin resistance and lower insulin secretion ability. High intake of dietary acid might be an additive mechanism contributing to deterioration of glycemic control in type 2 diabetic patients in our setting.

Keywords: Dietary acid; Diabetes mellitus; Pancreatic β-cell functio

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Validity of exploring a head-injured patient with a unilateral fixed dilated pupil: A case report

Usman B1 , Dodo M.M 2

Background: Globally, head injury is a leading cause of morbidity and mortality among the young productive age group. Expanding Extradural haematoma is potentially a life-threatening condition, and could leave a surviving patient with a life-long disability. Usually, the clinical diagnoses supported by skull X-ray showing fracture are confirmed with Computed Tomography Scan (CT Scan) when available. When CT Scan is not available but all evidence is pointing towards an Extra Dural Haematoma, can one still go ahead with the Exploration?

Case Summary: We present a 27-year-old man with a 21-hour history of Motor Vehicle Accident, loss of consciousness, Lucid interval and right hemiparesis. No seizure or vomiting. Other systems were essentially normal. His Glasgow Coma Scale score was 10/15 (EO=2, BVR=3, BMR=5). He had Left-Sided Fixed Dilated Pupil (FDP). Skull X-ray revealed a left-sided comminuted fracture involving the temporal, parietal, and occipital bones. CT Scan was not available (non-functional at the time). Based on the clinical diagnoses supported by the fracture on the skull X-ray, he had an urgent Exploratory burr hole where Extra Dura Haematoma was found and evacuated. The postoperative period was uneventful.

Conclusions: The availability and functionality of CT Scans are still a problem in Low and Medium Income countries. Therefore, an Exploratory burr hole to diagnose an intracranial haematoma and its evacuation may be valid.

Key words: Head injury, Extradural Haematoma, Dilated pupil, Exploratory Burr hole.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Cutaneous metastasis as an initial presentation of prostate cancer: A case of long-term survival without a definitive treatment

Kefas Mari Mbaya1 , Abubakar Farate2 , Hassan Mohammed Dogo3 , Abba Bukar Zarami4 , Chubado Tahir1

Background: Carcinoma of the prostate is the most common cancer in Nigerian men but skin metastasis is infrequently encountered. Cutaneous metastasis is associated with poor prognosis and most patients rarely survive for more than one year from the time of appearance of skin lesion.

Case summary: We report a case of an 80-year-old man who presented with a history of recurrent nodular lesion of the right thigh for five years which later became ulcerated. The skin lesion was treated with wide local excision and split-thickness skin grafting. The patient refused bilateral orchidectomy; he was then treated with androgen deprivation therapy (ADT). The skin graft healed well after one month of surgery. Unfortunately, the patient died six months after the commencement of treatment from lung and liver metastases.

Keywords: Prostate cancer, Cutaneous metastasis, Long-term survival, Skin graft

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 
 

Haematological Parameters Among Obese and Non-Obese Individuals in Sapele, Southern Nigeria

Kingsley Chukwuka Amaihunwa1 , Emmanuel Asuquo Etim2 , Everista Odaburhine Osime3 , Zacchaeus Awortu Jeremiah4

Background: Obesity is a medical condition that is characterized by excess adipose tissue deposition and inflammatory state that result in poor health and changes in haematological parameters. Objectives: This study aims to evaluate pattern of changes in hematological parameters among obese and non-obese individuals in Sapele, Nigeria.

Method: This study was carried out at Central Hospital, Sapele, General Hospital, Oghara and Biomed Diagnostic Centre, Sapele in Southern Nigeria. 415 subjects with ages between 18 and 65years were enrolled for this study including 312 obese experimental subjects (comprising of 111 males and 201 females) and 103 non-obese normal control subjects (comprising 40 males and 63 females). 5.0mls of venous blood was collected from all subjects into EDTA container and Full Blood Count was determined using Sysmex XN330 automated haematology analyzer.

Result: Packed Cell Volume of the obese and non-obese individuals were 39.52±3.80% and 39.55±0.55% while obese and non-obese persons had total white blood cell count of 6.38±0.54 X109/L and 5.94±0.28X109/L respectively. Monocyte count of obese and non-obese individuals was 6.40±0.23X109/L and 5.14±0.18X109/L while Neutrophil-lymphocyte ratio (NLR) of obese and non-obese people was 1.57±0.21 and 1.18±0.05 respectively.

Conclusion: People with obesity had significantly higher values of monocyte count and NLR when compared to non-obese individuals while there was no significant difference in measured hematological parameters among obese and non-obese people in Sapele Southern Nigeria.

Keywords: Hematological, Parameters; Obesity, Sapel

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

A Review of Arrow Shot Injuries to the Head and Neck in Northeastern Nigeria

Abubakar Adamu1 , Hamman Ibrahim Garandawa1 , Ahmed Mohammed Nuhu2 , Abubakar Farate5 , Aliyu Mohammed Kodiya1 , Ajiya Abdulrazaq3 , Ibrahim Kayode Suleiman4 , Amina Abdullahi Muhammad1

Background: Arrow shot injuries remained rampant in developing countries. Involvement of the head and neck region is not uncommon and poses a significant management challenge due to the presence of so many vital structures within a relatively small anatomic region.

Objective: To review the pattern of arrow shot injuries to the head and neck region that presented to the University of Maiduguri Teaching Hospital (UMTH) in Northeastern Nigeria. Method: This is a retrospective review of patients who presented with arrow shot injuries involving the head and neck region, to the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria between January 2009 and December 2019.

Result: All the thirty patients studied were males. The mean age was 32.2±SD14.4 (range 8-60 years), the peak age group affected was 11-20 years. The majority (83.4%) are 40 years and below. The main reasons for the attacks were terrorism due to Boko haram (40%), cattle rustling (30%), and herdsmen/farmers clashes (20%). Affected sites were the neck (46.7%), the orbit (20%), and the nose (10%). Patient had wound exploration and arrow extraction, debridement, evisceration of the globe, fronto-ethmoidectomy, medial maxillectomy, and vascular repair as the case may be.

Conclusion: Arrow shot injuries still exist in our society and may involve the head and neck region leading to significant management challenges. Priority should be given to adequate resuscitation and airway management especially in unstable patients. Appropriate and timely intervention is necessary for a good outcome.

Key words: Arrow shot, head and neck region, Boko haram, penetrating neck injury

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Audit of Antenatal Investigation Results of Patients in Aminu Kano Teaching Hospital: A Two-Year Review

Murtala Yusuf, 1,2 Aisha Aminu Sharif1

Background: Antenatal screening forms an indispensable part of effective antenatal care and it helps to reduce maternal and perinatal morbidity and mortality.

Objectives: This audit aimed to identify how the study center complies with the antenatal investigations standards as recommended by WHO and NICE guidelines

. Method: The study was a 2-year retrospective study of antenatal investigation results of women who attended antenatal care in Aminu Kano Teaching Hospital. Data was collected through a review of the women’s antenatal cards and compared with the standard criteria from WHO 2016 recommendation on antenatal care and NICE 2008 Guideline on antenatal care. The study period was from 1st January 2018 to 31st December 2019.

Results: Majority of the women, 86.7% had PCV of more than 30%, 77.5% had hemoglobin genotype AA and 48.7% had O+ blood groups. Also, 5.3% of the women were Rhesus negative. Majority of those screened for gestational diabetes mellitus, 82.1% had normal oral glucose tolerance test. The seroprevalence for HIV, hepatitis B and syphilis was found to be 5.6%, 14.7% and 1.1% respectively. Most of the patients (97.1%) had an ultrasound scan done at booking but only 50.3% had it done before 24 weeks of gestation with 99.5% being normal.

Conclusion: Although most of the antenatal investigations recommended by WHO and NICE guidelines are done in the hospital, it still falls short of the required level from the standards and as such, the centre did not fully comply with the standards of WHO and NICE guidelines. There is therefore need for improvement in order to comply with the standards which will subsequently have an impact on maternal and perinatal health statistics

Keywords: Audit, Antenatal, investigation

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE

 
 
 

Pattern of Presentation and Management of Male Urethral Strictures in A Resource-Limited Community: Challenges and Outcome

BM Abubakar, UM Tela, MJ Isah, AS Muhammad4 , HM Dogo, AG Ibrahim2 , UH Malgwi

Background: Urethral stricture is an unnatural narrowing or loss of urethral compliance due to spongiofibrosis that leads to bladder outflow obstruction. Its management is still a great challenge in our region.

Objectives: To share our experience about urethral strictures managed in a rural tertiary health center in Nigeria. Method: Retrospective study of urethral strictures managed over 5-year period at a tertiary health center in Nigeria. Only Patients that had surgical procedures for urethral stricture with at least one post-op follow-up were included. Age, stricture characteristics, and treatment outcome were analyzed.

Results: Only 74 out of 91 patients have complete records, hence selected and studied. Their mean age was 49.66yr (±19.41), the principal symptom was a weak urinary stream (86.49%), with acute urine retention in 56.76%. Suprapubic cystostomy was done in 77.03%. The strictures were post-inflammatory (60.81%), Post-traumatic (27.03%) and recurrent (10.81%). The strictures were predominantly bulbar (55.41%). The median duration of symptoms to the time of presentation was 135days. Majority (55.41%) had anastomotic urethroplasty. Post-op complications were seen in 43.24%. Most patients (77.03%) had no significant lower urinary tract symptoms at a median (interquartile range) of 58days (37 to 135) postoperative period. There was a significant improvement in median international prostate symptom score at 6 weeks, 6 months, and 1 year after surgery compared to pre-operative symptoms.

Conclusion: Financial constraints, inadequate facilities and specialists are the major challenges. Increased patients’ health awareness, universal (free or subsidized) healthcare coverage may help in alleviating some of the challenges.

Keywords: urethral stricture, lower urinary tract symptoms, international prostate symptoms score, acute urine retentio

[FULL ARTICLE (PDF)]

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vol18no1

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2021
Volume 18 | Issue 1

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

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ORIGINAL ARTICLES


 
 
 

Prevalence, Knowledge, and factors affecting the care of Diabetes mellitus among adults in Egor L.G.A, Edo State, Nigeria

Otaniyenuwa Obarisiagbon, Andrew Obi

Background: Diabetes Mellitus (DM) is a disorder of carbohydrate, fat and protein metabolism characterized by high blood glucose levels, which could be a result of relative lack of, or insensitivity to insulin or both.

Objective: To assess the prevalence, knowledge, risk factors and factors affecting the care of Diabetes mellitus among adults in Egor Local Government Area (LGA), Edo State.

Methodology: This descriptive cross-sectional study was carried out among 400 adults using a multi-stage sampling technique. Pre-tested interviewer-administered questionnaires were tools for data collection. Data were analyzed with IBM SPSS version 20.0 software. Bivariate analysis was done using the Chi-squared test. The level of significance was set at p-value<0.05

Results: The mean age of the respondents was 43(±14.5). Knowledge of DM was poor in 152 (53.9%),73 (25.9%) respondents had fair knowledge while 57 (20.2%) respondents had good knowledge of Diabetes Mellitus (DM). Consumption of diet high in carbohydrate 272 (68.0%) and low level of physical activity 239 (58.0%) were identified as the major risk factors in this study. The prevalence of Diabetes was 4.0%. The high cost of treatment 35 (46.7%) and poor adherence to medication 7 (9.3%) were the major factors affecting the care of DM.

Conclusion: The knowledge of Diabetes among the respondents was poor and the prevalence of Diabetes among respondents was 4.0%. Community-based health education on diabetes mellitus is required to help improve knowledge of Diabetes.
Keywords: Diabetes, Prevalence, Knowledge, Risk Factors, Care

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Management Pattern of Epistaxis in Sokoto, Nigeria

Adeyeye FM, Iseh KR, Aliyu D

Background: Epistaxis is a life threatening otorhinolaryngological emergency presenting as acute or chronic recurrent bleeds.

Objectives: The study was designed to evaluate the treatment modality used in managing patients with epistaxis in Sokoto.

Methods: It was a prospective hospital-based study involving 135 patients presenting with epistaxis to Usmanu Danfodiyo University Teaching Hospital (UDUTH). Information on treatment received, blood transfusion, hospital admission and length of hospital-stay were obtained.

Results: A total of 133 (98.5 %) patients were managed non-surgically, while 2 (1.5 %) patients received surgical intervention. Of those who received non-surgical treatment; 60 (44.4%) had anterior nasal packing, while 27 (20.0%) had endoscopic cauterization. Out of this, 25 (18.5%) had endoscopic chemical cauterization for bleeding in the Little`s area, retrocolumellar and septum, whereas 2 (1.5%) had bipolar cauterization for bleeding on the Woodruff`s plexus. Twenty (14.8%) patients had both anterior and posterior nasal packing, 15 (11.1%) had combined nasal pinching and ice pack, while 11 (8.2%) had posterior nasal packing only. Two (1.5%) patients had ligation of the internal maxillary artery (surgical intervention).Of all the patients presented, 22 (16.3%) required blood transfusion during their management and 43 (31.9 %) needed admission. The duration of hospital-stay ranged from 1 to 9 days with a mean of 5.7 ± 1.9 days.

Conclusion: Non-surgical intervention is the most common modality used in managing epistaxis in the study centre, with anterior nasal packing as the major method employed. In addition, some patients required blood transfusion and hospital admission.
Keywords: Epistaxis, Nasal packing, Blood transfusion, Hospital-stay

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Patterns of Unnatural Deaths during Insurgency in Maiduguri, Borno State, North-Eastern Nigeria: A Ten-Year Retrospective Review

AB Zarami, A Kabir, SS El-Buba, UH Pindiga

Background: Unnatural death refers to premature death against the course of nature which results from homicides, accidents and suicides. The prevalence is rising worldwide and is considered one of the commonest causes of mortality. Among all the unnatural deaths in the western world, fire-arm death constitutes most of the cases and accounting for 4.43 deaths per 100,000 annually. In Nigeria, there is a paucity of data on unnatural deaths despite the rising incidence of deaths due to insurgency, banditry, kidnapping, political and ethnic crises, that prompted the need for this study.

Method: The study was a hospital-based, ten-year retrospective survey. Non-probability purposive sampling method was used from three selected hospitals in Borno State. All cases of unnatural deaths from the mortuary logbooks from 2009-2018 available were recorded along with the deceased demography. The results were analyzed using Microsoft Excel, 2010 and were displayed in a frequency table, bar charts and pie chart.

Results: There were 1,029(4.9%) cases of unnatural deaths during the study period (2009-2018). The unnatural death frequency peaked in 2014 with 260 (25%) cases. Gunshot death was the commonest and accounted for 387 (38%) cases. Road traffic accident and bomb blast were 2nd and 3rd with 291 (28%) and 196 (19%) cases respectively. Males were more affected than females by a ratio of 4:1. The age ranges were between 3 to 75 years. The commonest age group involved was 21-30 (34%) years. Most of the unnatural deaths occurred in urban [715 (69%)] than rural areas [(314 (31%)] cases respectively.

Conclusion: The study has highlighted an increased incidence of unnatural deaths in Borno state due to insurgency with gunshot fatality being the commonest cause of death. To the best of our knowledge, this is the first report of unnatural deaths during the civil unrest in Borno state. We suggest a community-based study to effectively plan for mitigation and prevention of unnatural death in Nigeria.
Keywords: Unnatural, Death, Insurgency, Borno State.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Maternal Characteristics and Immunization Status of Children Among Rural Ihotu Women Cooperative Society at Eke, Okpokwu Local Government Area, Benue State, Nigeria

Ogbeyi Ofikwu Gabriel, Jenewari Atiye Joseph, Abah John Paul, Rimamnunra Grace, Ogbeyi Aba Francis

Background: Nigeria is one of the countries that have the least routine immunization coverage in the world. Morbidity and mortality caused by vaccine preventable diseases are very high in Nigeria. Immunization could be routine or supplemental campaigns. Routine immunization refers to the nationally scheduled regular administration of vaccine dosages to infants at specified ages. Children are usually taken to the health facility by their parents or care givers to receive age-appropriate doses of antigens.

Objectives: The aim of this study was to assess maternal characteristics such as knowledge, perception and practice and the immunization status of their children 0 to 5 years.

Methods: This was a cross- sectional study of rural cooperative women who had an index child of less than five years and were eligible. The 252 respondents were selected using computer generated numbers. A questionnaire was used to collect information on demography, knowledge, perception and practice of immunization.

Results: The mean age of the respondents was 27.98±6.45 and over 59% of the children were between 0-6 months. Over 86% had formal education, 96.0% were aware of routine immunization and 94.0% believed vaccines could prevent diseases. Eight-five percent took their children for immunization and 92.0% immunized their children at appropriate age. Awareness of routine immunization and took child for immunization all had statistically significant association with mothers’ education (p=0.05).

Conclusion: Routine immunization coverage in Nigeria is low. The results of this study had shown that mothers in Nigeria had improved in taking their children for immunization. This indicated that immunization uptake had also improved compared to previous reports.
Keywords: Children, diseases, education, immunization, prevention, Nigeria

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Pattern of Computerize Tomography Findings in Hearing Loss: A Two Year Retrospective review

Baduku TS, Sheyin J, Isa FB

Background: Ear diseases and their associated problems are common presentations in clinics worldwide, but are seen more in developing countries. They are causes of morbidity and frequent hospital visits, thereby consuming many man-hours. There is limited literature regarding the burden of ear diseases among Africans, and Nigerians in particular. The advent of computed tomography (CT) and magnetic resonance imaging (MRI) have immensely changed the management pathway of hearing impairments, particularly in the developing world. CT has been shown to be useful for demonstrating the detailed anatomy and pathology of the temporal bone and its surrounding tissues.

Objective: This study aims to determine the clinical presentations and CT pattern of hearing impairments among patients that were referred for CT in the Radiology Department of an ENT hospital in Kaduna, Nigeria.

Method: The study is a twenty-four months’ hospital-based retrospective study at the Radiology Department of the National Ear Care Centre, Kaduna which is a mono-specialty referral centre for ear, nose and throat pathologies. CT of the petro-mastoid region was done for 117 patients as a result of hearing impairment. A retrospective analysis of request cards, duplicate copy of radiology reports, soft copy of their CT images and patients’ folders were considered. All patients with history of hearing loss from other causes were included.

Results: A total of 117 patients were recruited for this study, with a female preponderance. The most frequently affected age group were those within the 3rd decade of life. Ear discharge was the most frequent presenting complaint and mastoid opacification constituted the highest frequency of occurrence on CT followed by mastoid wall scleroses, but 5.9% of the CT images were normal.

Conclusion: CT findings, along with the clinical examination is a powerful diagnostic tool in the diagnosis of hearing loss and also provides sufficient information to the ENT surgeon regarding the extent of disease process, complications, and anatomical variants which may influence management.
Key words: clinical, computed tomography pattern, hearing loss

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Predictors of splenic size in children with Sickle Cell Anaemia in Steady-state using ultrasonography in Maiduguri, Nigeria

Ibrahim HU, Farouk AG, Ahmadu MS, Usman AU, Mala MB, Ibrahim BA

Background: North-eastern Nigeria has the second-highest regional prevalence of sickle cell gene in the country after the South-west. This high prevalence has been believed to be sustained by the high rates of consanguineous marriages and intermarriages between the ethnic group in this region particularly the Kanuris and Shuwa Arabs. The dearth of data on splenic sizes among these patients living in this malaria-endemic sub-region. Narrative reports from the African region in general, have suggested that splenomegaly tends to persist to a comparatively much older age in these patients, attributed to the effect of recurrent malaria infection and/or hyperactive malarial splenomegaly syndrome.

Objectives: This study was aimed to determine the sizes of the spleen in children with homozygous sickle cell disease using ultrasonography and the variations that occur in advancing age, and to compare it with foetal haemoglobin levels (HbF).

Methods: Children with homozygous sickle cell disease aged 5-15 years, attending the Paediatric Haematology clinic of the University of Maiduguri Teaching Hospital (UMTH) were consecutively selected over six months. Demographic data, clinical details of previous crises and transfusions were recorded and had their foetal haemoglobin (HbF) quantified for all the subjects with the use of the Betke method of Alkali denaturation. Splenic sizes were determined using an ultrasound scanner (Aloka SSD 3500, Japan) with a 3.5 MHz sector transducer and ultrasound gel was used to optimize the image. A slightly lateral decubitus position during deep inspiration was used to expose the area of interest appropriately. Longitudinal size measurement was taken in the oblique plane between the most superior medial and the most inferior lateral borders of the spleen and the coronal size were determined along with the eleventh intercostal space. Values obtained was correlated with the height, a standard in assessing the longitudinal dimension of the spleen.

Results: A hundred and twenty children with SCA in steady-state were evaluated, comprising 59 boys and 61 girls. Their ages ranged from 5-15 years, with a mean of 10.1 ± 3.5 years. Autosplenectomy was seen in 12 (10%) of our patients who were seven years and above while seven (5.83%) had splenomegaly. The mean HbF of the total population studied was low 6.2% ± 0.98 and the difference in the mean HbF level of patients with autosplenectomy (6.6% ± 0.96) compared to those with splenomegaly (6.1% ± 0.54) was not statistically significant (p-value = 0.28)

Conclusion: The Foetal haemoglobin level was not significantly related to the presence or absence of splenomegaly in these children, although those with splenomegaly had lower mean HbF than those with autosplenectomy. It is recommended that early determination of HbF and possibly commencing hydroxyurea may improve the care of children with HSCD.
Keywords: Autosplenectomy, foetal haemoglobin, homozygous sickle cell disease, splenic size, ultrasonography.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Malposition of Haemodialysis Central Venous Catheter: Case Report

Lawan M, Sulaiman MM, Shettima J, Yauba MS, Loskurima U

Background: Central venous catheterization is a common procedure done to access a large vein for obtaining blood in haemodialysis, monitoring of central venous pressure and administration of fluids and drugs. Complications such as malposition of the CVC may occur following catheterization. Case Summary: We report a case of a 12-year-old male child managed for end stage kidney disease who had malposition of CVC into the left internal jugular vein after left subclavian vein insertion.

Conclusion: Complications following CVC insertion are common. Real-time ultrasound guidance and post procedure chest radiograph are useful means for prevention and early detection of complications.
Key words: Malposition, central venous catheter, haemodialysis

 

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Burden and outcome of Childhood Tuberculosis at a Tertiary Health Facility in North-Central, Nigeria

Bello Surajudeen, Ogunkunle Taofik, Hassan Ikrama, Ibrahim Olayinka, Audu Esther Solomon

Background: Tuberculosis (TB) remains a disease of public health importance owing to its contribution to morbidity and mortality. It is a chronic infectious respiratory disease that is vaccine preventable and therapeutically curable. Besides, TB is a leading cause of death across all age groups but worse among children. Malnutrition has been shown to be a common risk factor of childhood tuberculosis.

Objectives: The burden and treatment outcome of childhood TB was determined.

Methods: A retrospective study of childhood tuberculosis using purposely kept register at both the Emergency Paediatrics Unit (EPU) and the Directly Observed Treatment Short course (DOTS) centre of the Hospital. We included children aged < 18 years either admitted at the EPU or seen at the Paediatric and or General outpatient department of the Hospital from 1st January 2019 to the 31st December 2019, with presumptive TB and sent to the DOTS centre for treatment.

Results: The mean age of the children was 7.7±3.2 years. Childhood TB accounted for 88 (7.1%) of the 1243 EPU admissions and accounted for 25.2% of the TB cases managed at the DOTS unit in 2019. Of the 88 children, males were 49. More of the patients (84.1%) had pulmonary tuberculosis. Gene Xpert TB detection rate was 60.2%. Two - third (65.9%) of the cohort were successfully treated. One – quarter (26.1%) of the cases were loss to follow – up, while 8% died on treatment.

Conclusions: One quarter of the burden of tuberculosis at our facility occurred in childhood, and two – third had pulmonary affectation. Approximately two third of these study population were successfully treated. One quarter was loss to follow-up, while one out of every twelve died during the course of treatment.
Keywords: Burden, Childhood tuberculosis, Tertiary health facility, Outcome.

[FULL ARTICLE (PDF)]

REVIEW ARTICLE


 
 
 

Influence of Acute Phase Biomarkers on Mortality and Functional Outcome in Adults with Acute Ischemic Stroke in North-western Nigeria

Aliyu Ibrahim, Hasiya T. Ismail, Lukman Femi Owolabi , Adesola Ogunniyi

Background: Stroke play a leading role in emergency admissions in developing countries and has contributed immensely to the huge financial burden to both the patient and the society especially in sub-Saharan Africa. Assessment of some routine acute phase biomarkers may aid in predicting mortality and functional outcomes in acute ischemic stroke.

Objectives: To assess the role of routinely estimated C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), and platelet count in predicting mortality and short-term functional outcomes among patients with AIS in Kano, North western Nigeria.

Methods: A case-control study where one hundred and twenty acute ischemic stroke patients and sixty age and sex matched healthy controls, were enrolled over a period of 10 months. Data on socio-demographic information and clinical characteristics were collected. Blood samples for acute phase biomarkers; C-reactive protein (C-RP), Erythrocyte sedimentation rate (ESR), and platelet count were collected and analyzed. The patients were followed up for 30-days and data on mortality and functional outcome using Modified Rankin Scale (MRS) was collected and analyzed using SPSS version 20.0 (IBM Armonk, NY).

Results: The mean age of patients and their controls were 61.9±11.8 years and 61.8±12.4years and were predominantly of female gender (cases, 70/120 vs controls, 35/60). The mean of CRP, ESR, and platelets count for the cases and controls were 77.6±23.7 mg/L vs. 6.3± 2.8 mg/L, 53.4±30.2mm/hr vs. 12.2± 8.1mm/hr and 182.5±19.1/µL vs 251.4± 53.8/µL respectively. NIHSS was shown to independently predict 30-day mortality (Adjusted HR 1.10; 95% CI:1.02-1.18), p=0.011) after AIS. Additionally, elevated SBP, DBP, NIHSS and C-RP were shown to be associated with a poor 30-day functional outcome.

Conclusion: The study showed that elevated levels of serum C-RP and ESR and a reduced platelet count predict higher mortality and poor functional outcomes in acute ischemic stroke. Assessment of some inexpensive routinely estimated acute phase biomarkers will guide therapy and help reduce overall mortality and improve short term functional outcomes in our resource-challenged environment.
Key words: Biomarkers, mortality, functional outcome, ischemic stroke

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Severe Hypertension Coexisting with Hypokalaemia in A Young Adult: Case Report and Literature Review

Raheem YA, Loskurima U, Lawan M, Tukur A, Sulaiman MM

Systemic hypertension, affecting about one billion people worldwide, is the most prevalent modifiable risk factor for cardiovascular diseases and related disability. Secondary hypertension is a common problem among young adults. Case Summary: We report a case of a 23year old man who presented to the emergency room with 8-month history of progressive general body weakness preceded by numbness and paraesthesia initially involving the left then the right lower limbs with family history of hypertension. Blood Pressure was 150/80mmHg.His serum potassium was 1.6mmol/L (Normal range 3.0-5.0) other electrolytes, urea and creatinine were normal. Urinary potassium was 215mmol/24hr (Normal range < 20mmol/24hrs). A diagnosis of severe hypokalaemia in a hypertensive patient with Liddle’s syndrome was made. He was commenced on oral Moduretic (contains Amiloride and hydrochlorothiazide because Amiloride or triamterene only formulation is not available) and intravenous potassium replacement.

Conclusion: Our index case is a 23year old young man known hypertensive who presented with quadriparesis and spontaneous hypokalaemia with family history of hypertension. The likely cause of his hypertension and hypokalaemia is Liddle’s syndrome, however plasma aldosterone concentration, plasma renin activity and genetic studies were not available for us to confirm this diagnosis. Even though this form of hypertension is rare, there is a need for a high index of suspicion for it by the clinicians whenever hypertension is diagnosed in a young individual especially in Maiduguri, Nigeria which have a high prevalence of renal impairment among young individuals’ majority of whom have background hypertension.
Keywords: Hypokalaemia, Liddle’s syndrome, Quadriparesis, Secondary hypertension, Systemic hypertension

 

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Effect of cell phone usage and clinical correlates of male factor infertility amongst men attending infertility clinic in Benin City, Edo State Nigeria

Okungbowa Godwin Enosakhare, Osian Eunice A, Eze Sekegor E.

Background: Presently around us today in our world, there is high demand for phones and little or nothing has been said in Nigeria about the over usage and linking it to it influence on male factor infertility.

Objectives: This study aims to determine the effect of cell phone use and clinical correlates of male factor infertility amongst couples attending infertility clinic in Benin City.

Methods: The study is a prospective, descriptive, cross-sectional study conducted in the Department of Obstetrics and Gynaecology, Central Hospital Benin City. A cross-section of Three hundred and fifty-five (355) male partners of women who present with infertility at the gynaecological clinic were interviewed and physically examined. The Cell-phone Over-use Scale (COS) was used for mobile cell-phone addiction data which is a validated instrument with a reliability more than 90%. The semen sample was obtained by masturbation into a sterile wide-mouthed plastic container. Data was analysed using the IBM Statistical Package for Social Sciences (SPSS) and the level of significance is p <0.05.

Results: The study reported very high prevalence rate (66.5%) of male infertility, with a level of Cell-phone over usage proportion of 35.2%. It also established a significant association between cell phone over usage and prevalence of infertility.

Conclusion: This study concluded that cell phone over usage has significant effect on clinical correlates of male factors. It also established a significant association between cell phone over usage and seminal fluid parameters. The study therefore recommends that males should desist from keeping cell phones in their trouser pockets especially in talk mode to reduce the amount of non-ionizing radiation released to their reproductive organs.
Keywords: Infertility, Electromagnetic radiation, Cell phone, phone overuse

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Knowledge and Awareness About Wisdom Teeth Among Preclinical Dental Students in Chennai, India

Gowri Balakrishnana, Janani Anand Kumar, Jaganbabu Palaniappan, Karthik Shunmugavelu

The diagnosis and management of wisdom teeth impaction and its associated pathologies are unique. Impacted wisdom teeth occur because of a lack of space, obstruction, or abnormal position. This study focuses on the knowledge and awareness on wisdom teeth among preclinical dental students in Chennai. A cross-sectional study was performed using questionnaire. A majority of the preclinical students were not aware of the techniques involved in the management of impacted third molar removal. A greater effort into making the preclinical students aware about the knowledge about wisdom teeth must be imparted. Knowledge regarding the indications of removal and diagnosis imparts a significant difference in the quality of management of these patients
Keywords: Wisdom teeth, impaction, awareness

 

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Bilateral Mandibular Tori- A Case Report and Review of Literature

Karthik S

Mandibular tori are usually asymptomatic bony protuberances present unilaterally or bilaterally. They are formed by dense cortical bone externally and covered with a thin layer of poorly vascularized oral mucosa. They usually present as a very slow and progressive growth that can stop spontaneously. Treatment is not usually advocated unless it hinders prosthetic treatment or if any complication occurs.
Keywords: Mandibular tori, Asymptomatic, Bilateral

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
  Knowledge, Attitude and Practices of Energy Drinks Consumption Among Undergraduate Students of Bayero University, Kano

Usman Muhammad Ibrahim, Hafsat Umar Sani, Mustapha Zakariyya Karkarna, Abubakar Mohammed Jibo, Musa Muhammad Bello, Auwal Umar Gajida, Abba Ahmed Danzomo, Muktar Ahmed Gadanya

 

Background: Caffeine being the major component in the energy drink is known to produce some negative effects and therefore its abuse may result in significant public health challenges.

Objectives: This study aimed to determine knowledge, attitude and practice of energy drinks consumption among undergraduate students of Bayero University Kano, Northwest Nigeria.

methods: A descriptive cross-sectional study design was used to study 381 undergraduate students selected using a two-staged sampling technique. Data were collected using interviewer administered questionnaires. The SPSS version 21 was used for data analysis with a p- value of = 5% considered statistically significant.

Result: The age of the respondents ranged from 17 to 49 years with a Mean± SD of 23.1±3.6years. The majority of the respondents were Muslims (91.6%). More than one-quarter (31.0%) of the respondents were studying health-related courses in the University. Up to 13% of the respondents had satisfactory knowledge of energy drinks while 79% had negative attitudes towards energy drink consumption. The knowledge of energy drinks consumption was found to be significantly associated (p<0.05) with sex, residence, sponsorship and influence on choice. The practice was significantly associated with sex, faculty and influence on choice. Further, the attitude was significantly associated (p<0.05) with age, sex, tribe and influence on choice.

Conclusion: The majority of the respondents had unsatisfactory knowledge and practice of energy drinks and negative attitude towards its consumption. The government should ensure strategies that can promote healthy consumption of energy drinks.
Keywords: Prevalence, energy drinks, knowledge, attitude, practice

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Determination of Normal Renal Size Among Children in Maiduguri, Borno State, North-eastern Nigeria

Yauba MS, Sulaiman MM, Farouk AG, Mustapha Z, Abdurahaman A, Mbititng HW

Background: Measurement of the length and width of the kidneys using ultrasound scan is used to evaluate its rate of growth and the extent of kidney affectation by disease. Renal growth correlates well with somatic growth and is influenced by changes in the age, nutritional status and disease. Knowing renal size in relation to age and body size of a child will help to detect deviation from normal especially in diseased conditions that causes enlargement or reduction in renal size.

Objectives: To determine the renal size of normal children by ultrasonography and correlation of renal size with age of the children.

Methods: The data for renal size (renal length), sex and age of 404 children aged 1 month to 14 years were obtained. The (bipolar) lengths of both right and left kidneys were measured with ultrasonography by a sonographer. The age and sex each child was recorded in a preformed proforma. The weight was measured in the Children Outpatient Department (COPD) of State Specialist Hospital Maiduguri, Borno state using a standard weighing scale.

Results: Four hundred and four (404) normal children aged 1 month to 14 years had abdominal ultrasound scan (USS) done. Their mean age was 7.9 (± 4.2 SD) years. There were 208 (51.5%) females and 196 (48.5%) males with female to male ratio of 1.1: 1. The mean age of females was 7.8 ± 4.2 SD while that of males was 8.0± 4.2 SD. There was no significance difference in their mean ages; p=0.494. There was rapid increase in the renal length in the first year of life and there was no statistically significant difference (p=0.50) in the mean renal length between males and females. There is good correlation between age and right renal length (r = 0.680) but low correlation (r = 0.290) between age and left kidney.

Conclusion: There was rapid increase in the renal length in the first year of life and there is good correlation between age and renal size.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Barriers to Utilization of Antenatal Care Interventions among Pregnant Women Attending Primary Health Care Centres in Kano, Nigeria

Usman Muhammad Ibrahim, Auwal Umar Gajida, Rabiu Ibrahim Jalo, Usman Idris Takai, Abubakar Muhammad Jibo, Yusuf Saleh, Aisha Alto, Abubakar Sadiq Abubakar

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

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

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

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

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

[FULL ARTICLE (PDF)]

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archive vol17 no2

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2020
Volume 17 | Issue 2

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

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ORIGINAL ARTICLES


 
 
 

Severity of Postoperative Nausea and Vomiting Following Gynaecological Laparoscopic Procedures: Ondansetron vs Metoclopramide

Dalhat Salahu, Alhassan Mohammad Datti

 

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Arterial Blood Pressure in Children with Sickle Cell Anaemia and Controls: A Cross Sectional Study

Abubakar Garba Farouk, Halima Umar Ibrahim, Bello Abdullahi Ibrahim, Hassan Abdullahi Elechi, Jamila Audu Idrisa, Modu Gofama Mustapha

 

Background: Sickle cell anaemia (SCA) is a very common disorder among indigenous people of Borno and Yobe States in the North-eastern region of Nigeria. It is characterized by recurrent episodes of severe bone pain from occlusion of blood vessels by sickled red cells. Hypertension in children with sickle cell anaemia is rare and when present may be secondary to other disease process and more rarely may be essential hypertension. However, when hypertension occurs in SCA patients, it accelerates the progression of complications such as cerebrovascular accident and sickle cell nephropathy, hence the need to study the pattern of blood pressure in these patients. Early detection of hypertension can help in forestalling its progression and preventing its devastating complications such as cerebrovascular accident.

Objectives: To compare the arterial blood pressures of children with sickle cell anaemia in steady state with those of age and sex-matched healthy controls.

Methods: The study design was cross-sectional comparative. Minimum sample size of 54 was determined using Taylor’s formula. Subjects were recruited systematically by enrolling every other patient as they present at the Paediatric Haematology clinic. The controls were apparently healthy age and sex-matched haemoglobin AA children. Anthropometric parameters and the blood pressure were measured and recorded appropriately. Blood pressure was classified using published normative data.

Results: A total of 54 children with sickle cell anaemia in steady state and 159 normal children as controls were enrolled. The ages of both the SCA and controls ranged from 3 to 14 years, with median age of 8 years. Of the 54 SCA children 28 (52%) were males while 26 (48%) were females. Mean packed cell volume of the SCA children was 22 ± 3.5. Although 8 (14.8%) of the SCA children were hypertensive, there was no significant difference in the mean systolic blood pressure (96mmHg) of children with sickle cell anaemia compared to controls (99mmHg) P = 0.078 while, the mean diastolic blood pressure (65mmHg) of the control was significantly higher than that of SCA cohort (59) P ≤ 0.0001.

Conclusion: Hypertension is not rare among children with sickle cell anaemia. This stresses the need regular BP recording during follow-up in order to prevent devastating events such as cerebro-vascular accident.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Ease of Laryngeal Mask Airway Insertion in Nigerian Adults: Propofol Alone vs Propofol Combined with Low Dose Suxamethonium

Alhassan Datti Mohammed, Adesope Saheed, Salahu Dalhat

 

Background: Inadequate anaesthesia during Laryngeal Mask Airway (LMA) insertion may make correct positioning difficult or even impossible.

Objective: This prospective study was designed to compare the ease of LMA insertion in patients who received propofol alone and patients who received a combination of propofol with low dose (0.1 mg/kg) suxamethonium.

Methods: Eighty ASA I and II consenting patients aged 18 to 60 years undergoing elective procedures under general anaesthesia and spontaneous ventilation were recruited and randomly allocated into two groups with each receiving either 5 mls of 0.9% saline (group P) or 0.1 mg/kg suxamethonium, made up to 5 mls (group S), 30 seconds post induction with intravenous (iv) propofol 2.5 mg/kg delivered over 30 seconds. The overall insertion conditions (scored from grade of jaw relaxation, ease of insertion, severity of airway response in terms of coughing, gagging, laryngospasm and patient movement) during first attempt of LMA insertion and the number of attempts made were then accessed. The number of attempts before successful LMA insertion as well as incidence and duration of apnoea post induction were recorded.

Results: Excellent overall insertion condition occurred in 40% of patients in group S compared to 15% in group P, satisfactory in 30% of patients in group S compared to 35% in group P, and poor in 30% of patients in group S compared to 50% of patients in group P.

Conclusion: The combination of propofol plus low dose suxamethonium for LMA insertion was found to provide better grades of overall insertion condition. The number of attempts before successful insertion was however comparable.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

The Effect of Intracervical Lidocaine Versus Intramuscular Diclofenac for Pain Relief During Hysterosalpingography Among Infertile Women in A Tertiary Hospital in Kano

Attah Raphael Avidime, Sulaiman Daneji Muhammad, Ibrahim Saidu Adamu

 

Background: Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes and is used predominantly in the evaluation of infertility. HSG can cause discomfort or pain during or after the procedure, up to 72 % of women complain of significant discomfort with this test. This pain can hinder patient’s co-operation, therefore limiting the usefulness of the procedure, and willingness to do other similar diagnostic studies. It can also result in fortuitous tubal blockade by provoking cornual spasms.

Objectives: To compare the effect of intracervical block with 1% lidocaine and intramuscular diclofenac 75mg in decreasing pain perception during hysterosalpingography.

Methods: The study was carried out between September 2016 and January 2017. One hundred and forty women with infertility referred for hysterosalpingography were randomly recruited and assigned to two study groups. Women in the study group A were given an intracervical block with 1% lidocaine while women in the Study Group B were given intramuscular diclofenac sodium 75mg 30 minutes before the procedure. Pain levels during specified stages of HSG were assessed using visual analogue score. The statistical package for social sciences (SPSS) version 16.0 was used to analyze the data. The data obtained were presented in tables. Categorical data were analyzed using chi-squared test and Fishers exact correction, continuous data were analyzed using student t-test; level of significance (p-value) was set at p< 0.05.

Results: There was no statistically significant difference in the two study groups in their baseline characteristics; but there were statistically significant differences in some gynaecological characteristics that include previous vaginal delivery and previous pregnancy loss. The two most painful steps of the procedure were during grasping of the cervix and uterine distension with contrast medium mean visual analogue score (VAS) of 4.26±1.62 and 6.37±1.62 (t = -7.726, p-value <0.001), 6.14±1.85 and 7.37±2.23 (t = -3.543 p-value 0.001) respectively in groups A and B.

Conclusion: There was significant reduction in VAS pain scores with intracervical block with lidocaine when performing HSG for infertility.

[FULL ARTICLE (PDF)]

REVIEW ARTICLE


 
 
 

Influences on the Incidence and Pathomorphological Picture of Thyroid Disease

Innocent Emmanuel, Mansur Aliyu Ramalan, Abdulazis Longwap, Ayuba Madachi Dauda

Background: The thyroid serves the body with important endocrine functions. A variety of influences impinges on the incidence and pathomorphological picture of the thyroid gland. These influences that include: iodine deficiency; iodine sufficiency; gender and; imaging technology are elucidated further in this work. We used the Google search engine to search for literature on the subject from the internet. Iodine is associated with increased incidence of nodular goiter and follicular carcinoma. The world over the last few decades had transited from an era of iodine deficiency to its sufficiency leading to an increase in incidence of thyroiditis and papillary thyroid carcinoma. Estrogen and Estrogen receptor discovered in the thyroid is implicated in the increased frequency of thyroid disorders in females. Finally, advancement in thyroid imaging technology and its utilization has led to over-diagnosis and overtreatment of thyroid diseases

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Nutritional Status of Young Children newly diagnosed with HIV-Infection at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria

Yusuf T, Onankpa BO, Baba J, Ugege MO, Jega MR, Sanni-Amodu M, Isezuo KO, Adamu A, Jiya FB

 

Background: Poor nutrition contributes to deaths associated with the infectious diseases especially among under-5 children in developing countries. The growth of young children could be impacted with increasing burden of HIV/AIDS and increasing food insecurity. This results in an increased malnutrition among this vulnerable group.

Objective: To determine the nutritional status of children aged ≤5 years newly diagnosed with HIV infection in UDUTH, Sokoto.

Methods: A prospective descriptive cross-sectional study among children aged ≤5 years newly diagnosed with HIV infection at the Paediatric units and Paediatric ART Clinic, UDUTH, Sokoto between January 1st, 2015 and December 31st 2019. The nutritional status was determined using WHO growth standards. The data were analyzed using SPSS version 22.0 and p-value ≤0.05 was taken as significant.

Results: Sixty-seven children aged ≤5 years were diagnosed with HIV infection in UDUTH within the period. Twenty (30.3%) were aged 1.1 – 2.0 years with the mean age of 2.9(±1.4) years. The M:F ratio approximately 2:1. Forty-five (67.2%) were from lower socio-economic class. Sixteen (23.9%) were diagnosed using PCR for HIV-DNA. Forty-eight (71.6%) presented in clinical stage I. Twenty-three (34.3%), 24 (35.8%) and 12 (17.9%) of the children were stunted, underweight and wasted respectively. The rate of undernutrition was found to be significantly related to the age of the child (p=0.03) and socio-economic status of the family (p=0.02).

Conclusion: The nutritional status of young children newly diagnosed with HIV infection was suboptimal and majority was stunted and underweight in our environment

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Barriers to Utilization of Antenatal Care Interventions among Pregnant Women Attending Primary Health Care Centres in Kano, Nigeria

Usman Muhammad Ibrahim, Auwal Umar Gajida, Rabiu Ibrahim Jalo, Usman Idris Takai, Abubakar Muhammad Jibo, Yusuf Saleh, Aisha Alto, Abubakar Sadiq Abubakar

 

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Predictors of Compliance with Recommended Hand Hygiene Practices Among Healthcare Workers in Specialist Hospitals of Kano, Northwest Nigeria

Ibrahim UM, Ibrahim RJ

 

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

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Penetrating Intracranial Arrow Extraction

Usman B, Mohammed B, Shuwa FA, Garandawa HI

 

Background: Arrow injury is one of the causes of non-missile penetrating head injury. Penetration may be through natural openings like the eye, nose, or a thin bone. At presentations, most patients are clinically stable. However, some may present with catastrophic vascular injury. Non-contrast Computed Tomography (CT scan) with or without angiography, when indicated, is essential for surgical planning. When impacted to a bone, craniectomy is an option, but when not impacted the best option is a craniotomy with antegrade extraction under vision especially when the arrow is barbed. Often surgery may involve multiple specialists. Broad-spectrum antibiotic prophylaxis is advised likewise tetanus and seizure prevention. Postoperatively patients are followed up and complications are treated.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
  Superior Vena Cava Syndrome in End Stage Renal Disease Patients on Long Term Central Venous Catheters: A Report of Two Cases
Sulaiman MM, Shettima J, Lawan M, Ibrahim A

Background: Central venous catheters are increasingly becoming the most common access at initiation of hemodialysis. They are associated with short term complications such as infections and long term problems resulting in stenosis of the central venous systems.
We report two patients with end stage renal disease, who developed stenosis of the superior vena cava following long term placement of internal jugular catheters for maintenance hemodialysis.

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

A rare Case of Right Sided Bochdalek Hernia Co-existing with Intrathoracic Kidney

Dambatta AH, Saleh MK

Background: Congenital diaphragmatic hernias are developmental defects involving the diaphragm. Three major types have been identified; Bochdalek hernia, Morgagni hernia, and hiatus/hiatal hernia, with the postero-lateral Bochdalek type being the most common. Rare concomitant existence with intrathoracic kidney was reported. Cases of left sided Bochdalek hernia were previously reported in the literature but none is associated with intrathoracic kidney. A successfully surgically treated rare case of right sided Bochdalek hernia co-existing with intrathoracic kidney in a neonate is therefore presented.

[FULL ARTICLE (PDF)]

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108-bomj-vol16no1

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2019
Volume 16 | 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

 

 

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

[FULL ARTICLE (PDF)]

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

[FULL ARTICLE (PDF)]

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

[FULL ARTICLE (PDF)]

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Oluwafemi, Rosena Olubanke, Abiodun, Moses Temidayo, Owa, Joshua A
Background: 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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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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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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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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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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NMA BORNO STATE CHAPTER

NIGERIA MEDICAL ASSOCIATION
BORNO STATE CHAPTER OFFICIALS

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Dr. Umar Loskurima - Vice Chairman

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Prof. Modu Gofama Mustapha - Editor-in-chief

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MEDICAL AND DENTAL CONSULTANTS’
ASSOCIATION OF NIGERIA, UMTH CHAPTER OFFICIALS

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. . .