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arch-2017-02

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2017
Volume 14 | Issue 2

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

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ORIGINAL ARTICLES


 
 
 

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

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

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

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ORIGINAL ARTICLES


 
 
 

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

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

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

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ORIGINAL ARTICLES


 

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

Bello US , Babayo UD

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

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ORIGINAL ARTICLES


 
 

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

 

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

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

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ORIGINAL ARTICLE


 
 

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

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

 

Babayo UD, Bello US

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

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ORIGINAL ARTICLE


 
 

NASOMUCOCILIARY CLEARANCE TIME AMONG HEALTHY NIGERIANS

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

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

 

Ogbebor OG, Azodo CC

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

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

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

 

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ORIGINAL ARTICLE


 
 

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

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

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

[FULL ARTICLE (PDF)]

SHORT COMMUNICATION


 
 

PATTERN OF GLOMERULAR DISEASES IN GOMBE, NORTHEASTERN NIGERIA

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

[FULL ARTICLE (PDF)]

SHORT COMMUNICATION


 
 

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

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

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

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

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CASE REPORT


 
 

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

RENAL ARTERY STENOSIS WITH SEVERE HYPERTENSION: A CASE REPORT

 
Suwaid MA

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

[FULL ARTICLE (PDF)]

Print

arch-2017-01

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2017
Volume 14 | Issue 1

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

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

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

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

 

 

REVEIW ARTICLES


 
 
 

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

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

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

[FULL ARTICLE (PDF)]

REVEIW ARTICLES


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

Ladu AI, Aisha MA

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

Usman Bello, Samaila Moodupeola Omotara , Yawale Iliyasu

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

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

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

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

 

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 

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

 
Yusuf Edirin O, Airauhi Lucy U.

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 

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

 
Paul I. Idon

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

[FULL ARTICLE (PDF)]

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July - December 2016
Volume 13 | Issue 2

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

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ORIGINAL ARTICLES


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

BALLA HJ, MUHAMMAD BG, BABA AH,BULAMA AA

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


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

MAIRIGA AG, JIMETA HB, UTHMAN SG, ISHAKU ED

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 

USE OF INFORMATION COMMUNICATION TECHNOLOGY AMONG OPTOMETRISTS IN NIGERIA.

EBEIGBE JA, OVENSERI-OGBOMO G.

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


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

BALLA HJ, BULAMA AA, KUTDANG ET, BABAGANA M

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

ABUBAKAR ABDULKADIR

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

GEIDAM AD, INUSA A, ISA B

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


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

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

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

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ORIGINAL ARTICLE


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

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

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ORIGINAL ARTICLE


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

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

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ORIGINAL ARTICLE


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

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

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vol12-issue2-july-december-2015

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July - December 2015
Volume 12 | Issue 2

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

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ORIGINAL ARTICLES


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

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

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

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ORIGINAL ARTICLES


 

SONOGRAPHIC EVALUATION OF CAROTID INTIMA MEDIA THICKNESS (cIMT) IN ADULT DIABETIC PATIENTS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, NORTH EASTERN NIGERIA

AHMADU MS , MUBI BM , ADEYOMOYE AAO , AHIDJO A , ADEYINKA AO , TAHIR AA

Background:Intima media thickness of the carotid arteries has been used as a subclinical index of atherosclerosis in patients with diabetes mellitus and has also been used in epidemiological and interventional studies as a surrogate index of atherosclerosis. However, to date, there is paucity of data on sonographic carotid artery intima media thickness (IMT) measurements and the prevalence of carotid atherosclerosis and stenosis among adult diabetic patients in our environment. Objective: The objective of this study was to evaluate carotid artery intima media thickness among adult diabetic patients using carotid duplex ultrasonography (CDUS). Methods: This was a cross-sectional study carried out at the University of Maiduguri Teaching Hospital, Nigeria. One hundred and twenty adult diabetic patients aged 20 - 78 years had CDUS for measurements of carotid artery intima media thickness. Measurements were taken at 1cm below and 1cm above the carotid bulb for the common carotid (CCA) and internal carotid arteries (ICA) respectively. Pearson's correlation and Student t-test were used to compare the means between the variables. Results: There were 72(60%) male and 48(40%) female diabetic patients aged 20 to 78 years (mean = 50.03±11.4 years). Mean intima-media thickness, in millimeters (mm), for normal (non-stenotic) carotid arteries on the right and left were (CCA=0.71±0.09 and 0.70±0.08; ICA=0.71±0.08 and 0.69±0.09) and abnormal (stenotic) on the right and left were (CCA=0.84±0.17 and 0.83±0.19; ICA=0.98±0.10 and 1.03±0.10) respectively. A total of 75 patients (62.5% of study population) had no carotid artery stenosis; 38 patients (31.7%) had <50% carotid stenosis; 6 patients (5.0%) had 50-69% carotid stenosis; and 1 patient (0.8%) had 72% carotid stenosis. The prevalence of carotid stenosis in diabetic patients was 37.5% in this study. There was positive and significant correlation between percentage degree of stenosis with IMT (r=≥ +0.5; p=<0.05). Conclusion: The findings of this study have indicated the presence of atherosclerotic and haemodynamic changes in the carotid arteries of adult diabetic patients in this environment who are at risk of developing stroke from carotid stenosis. CDUS has proved to be a valuable diagnostic and screening tool in the evaluation of these patients because of its safety, low cost, wide availability, and accuracy in detecting carotid artery disease

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

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

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ORIGINAL ARTICLES


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

TAKAI IU, RAHILA G, IBRAHIM AS

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

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ORIGINAL ARTICLE


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

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

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

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ORIGINAL ARTICLE


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

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

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

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SHORT COMMUNICATION


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

YAYA UM

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

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CASE REPORT


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

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

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

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vol12-issue1-jan-june-15

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2015
Volume 12 | Issue 1

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

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

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

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

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ORIGINAL ARTICLES


 
 
  EVALUATION OF PATTERN OF UTERINE AND CERVICAL ABNORMALITIES POTENTIALLY RESPONSIBLE FOR NFERTILITY IN ZARIA, NIGERIA: HYSTEROSALPINGOGRAPHIC ASSESSMENT

Ibinaiye PO, Lawan RO, Polite O, Hamidu HU, Igashi B

Background:Structural abnormalities are amongst the important causes of female infertility. Hysterosalpingography (HSG) is an invasive but safe method of detecting both cervical and uterine pathologies. Objectives: The objective of this study was to determine the relationship between types of uterine and cervical abnormalities and fertility outcome. Materials and Methods: A prospective study of 220 consecutive women who underwent hysterosalpingography using ionic water-soluble contrast media (urografin) between 1st December, 2011 and 31st May, 2013, at department of radiology, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Clinical notes and radiological findings were analyzed for demographic data and abnormal uterine cavity and cervical canal findings. Abnormal findings were correlated with treatments and fertility outcomes. Fertility outcome in women with normal and abnormal findings were compared. P- Value of less than 0.05 was considered as statistically significant. Results: The mean age and duration of infertility were 27.37years ± 4.50 and 4.48years respectively. Women with secondary infertility were 133 (60.50%) while 87 women (39.5%) suffered from primary infertility. The uterine cavity was normal in 167 (75.9%) of the women while 53 (24.1%) women had uterine cavity abnormalities; among these were 16 (30%) with primary infertility and 37 (70%) with secondary infertility. Cervical canal was normal in 210 (95.5%) of the women while 10 (4.5%) women had abnormalities among whom are 5 (50%) that suffered from primary infertility and 5 (50%) that suffered from secondary infertility. The fertility outcome after one year follow up showed 7 (11.1%) of the 63 patients with abnormal findings (cervical canal and endometrial cavity) got pregnant, while 25 (34.72%) of the 72 patients with normal findings (cervical canal, endometrial cavity, tubal and pelvic peritoneum) got pregnant. The difference noted was statistically significant (p – value = 0.001). High (12: 34.3%) spontaneous pregnancy rate was noted in patient with normal HSG, hormone and semen analyses. Conclusion: Fertility outcome among women with uterine cavity and cervical canal abnormalities but with normal hormone and semen analyses was low. The high spontaneous pregnancy rate in patients with normal HSG, hormones and semen analyses may be due to therapeutic effect of HSG.

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ORIGINAL ARTICLES


 

THE EFFECT OF GLYCAEMIC CONTROL ON CORTISOL LEVELS IN TYPE II DIABETICS IN UNIVERSITY OF CALABAR TEACHING HOSPITAL

Bassey IE, OGBOLU IA, GALI RM, ESSIEN OE, USORO CAO

Background:A high prevalence of subclinical hypercortisolism has been suggested in patients with type II diabetes mellitus with poor metabolic control and several observations have suggested that in type II diabetes patients, subclinical hypercortisolism may be more frequent than previously expected, however, results are inconclusive. Objectives: This study investigated the effect of glycemic control on serum cortisol levels in type II diabetics. Materials And Methods: The levels of serum cortisol, fasting plasma glucose and glycated haemoglobin were estimated in fifty five (55) type II diabetic patients attending the Diabetic Clinic of University of Calabar Teaching Hospital, Calabar and thirty three (33) non-diabetic controls. Consecutive sampling method was used. Serum cortisol was determined using enzyme immunoassay; fasting plasma glucose using colorimetric method and glycated haemoglobin using cation-exchange resin separation method. Results: The mean serum cortisol levels were significantly higher in diabetics as compared to the controls. The diabetics with poor glycemic control had significantly higher mean fasting plasma glucose and glycated haemoglobin compared to those with good glycemic control. However, there was no significant difference in the mean cortisol levels between the diabetics with poor control and those with good control. Conclusion: The diabetics in this study had elevated levels of serum cortisol. Cortisol levels in the diabetics were not affected by glycemic control..

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ORIGINAL ARTICLES


 
  ARE ROADSIDE PETROL DISPENSERS AT RISK OF RENAL DYSFUNCTION? A STUDY FROM GOMBE, NORTH EAST NIGERIA  

ADAMU S , AKINOSUN OM , ABBIYESUKU FM , KUTI MAO , JIBRIL M. EL-BASHIR, OLUWATOYIN GO, ALAYA RO MARAFA B.

Background:Occupational exposure to toxic chemicals is a major public health concern worldwide. Gasoline, especially the leaded form is a leading cause of this occupational exposure in developing countries such as Nigeria. Exposure to gasoline has been shown to generate oxygen free radicals which are implicated in the pathogenesis and progression of many diseases including renal dysfunction. The objective of the study is to evaluate the possibility of increased risk of renal dysfunction among roadside petrol dispensers in Gombe, Nigeria. Objectives: To determine the risk of renal dysfunction among road side petrol dispensers in Gombe. Materials And Methods: A cross sectional analytic study, where serum levels of uric acid, urea and creatinine were compared between 90 road side gasoline dispensers and 90 matched controls. These were measured using standard colorimetric methods. Results: The mean age of the exposed and control groups are 29.03 ± 3.7 and 29.24 ± 3.5 years respectively. The plasma level of uric acid (5.35± 0.9mg/dl) of the exposed group was significantly (p< 0.05) higher than the control (4.48± 0.9mg/dl). There was no significant difference in the plasma levels of urea and creatinine in the two groups studied. Conclusion: This study has shown that road side gasoline dispensers may be at a higher risk of renal impairment. Creating awareness of this risk among roadside gasoline dispensers could help reduce the burden of renal disease associated with exposure to gasoline.

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ORIGINAL ARTICLES


 
  TOTAL ABDOMINAL HYSTERECTOMY AT THE CENTRAL HOSPITAL, WARRI: A FIVE YEAR REVIEW  

OKHIONKPAMWONYI O & OKONTA PI

Background:Hysterectomy is a common gynaecological surgical procedure which improves womens's quality of life. Objectives: To determine the indications and complications of Total abdominal hysterectomy (TAH) at the Central Hospital, Warri (CHW). Materials and Methods: This was a retrospective descriptive study of TAH performed at the CHW from 1st January 2007 to 31st December 2011. Medical records of all patients that had TAH were reviewed. Results: Two hundred and thirty six patients had TAH. It constituted 11.6 % of all gynaecological surgeries at the CHW. The mean age was 44.78 ± 1.28 years. The mean parity was 3.79 ± 1.08. Uterine fibroids accounted for majority of cases (66.1%). About 54.2% of patients had TAH with bilateral salpingooophorectomy (BSO). Fifty patients (21.2%) had complications. Wound sepsis/breakdown, anaemia, prolonged hospital stay, urinary tract infection and pyrexia were the common morbidities. Conclusion: The indications for, and surgical outcome following TAH is comparable to that from other public hospitals across the country.

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ORIGINAL ARTICLES


 
  GLAUCOMA AWARENESS AMONG TERTIARY HEALTH CARE WORKERS IN MAIDUGURI, NIGERIA.  

ASKIRA BH, WAZIRI MA, MUSA ZY, RIBADU DY, KYARI FA.

Background:Glaucoma is second only to cataract as the leading cause of preventable blindness in the world. The devastating effect of this disease is often neglected. Most people with glaucoma are usually unaware that they have the disease until significant loss of vision has occurred. Objectives: The aim of the study is to establish the level of awareness to glaucoma among staff of University of Maiduguri Teaching Hospital. Materials and Methods: This cross sectional descriptive study conducted as part of glaucoma awareness campaign to mark the World Glaucoma Week. The entire staff of the University of Maiduguri Teaching Hospital that voluntarily consented to the study were recruited. A structured questionnaire was designed and administered in the clinic during the screening exercise. Results: A total of 285 participants were recruited. The ratio of male (M) to female (F) was 1.4:1. The most frequent age group was 40-49. Glaucoma awareness was found to be 60.4% .The sources of awareness of glaucoma were 41.8% from doctors, 29.7% from news media and 14.0% from nurses. A total of 40.7 % know that glaucoma can cause blindness and 32 % know that glaucoma blindness is irreversible. Conclusion: In this study the awareness of glaucoma is high. Further studies to determine the knowledge and adverse affect of glaucoma on vision are advocated.

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CASE REPORT


 
  ENDOSCOPIC TRANS-NASAL CHOANOTOMY: A CASE SERIES  

KOLO ES

Background:Choanal atresia is a rare congenital failure of communication of the nasal cavity and the nasopharynx. The technique for the surgical repair of choanal atresia has evolved from the blind transnasal puncture to the currently favored endoscopic transnasal approach. This study aims at
assessing the technique of endoscopic transnasal choanotomy; and highlight if any its benefits in our practice. This is an on-going study of all consecutive patients with choanal atresia, who had endoscopic transnasal choanotomy at the Otorhinolaryngology department of Aminu Kano Teaching Hospital from January to October, 2014. Four patients were recruited into the study and they all had endoscopic transnasal choanotomy with stenting of the neo- choanae. There were 3 females and 1male and their ages ranged between 12days and 18years. They all presented with varying degrees of persistent nasal obstruction, rhinorrhea and respiratory distress. Diagnostic nasal endoscopy and CT scan confirmed 1 patient had a bilateral membranous type atresia, 1 had bilateral bony atresia and 2 had right sided mixed membranous/bony atresia. Post-operative complications included rhinosinusitis, stent extrusion and granulation tissue formation. Follow ups at various intervals revealed 3 patients had adequate neo-choanal patency and 1 had a restenosis and was re-operated. This study found endoscopic choanotomy safe and effective in the treatment of choanal atresia in our practice

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CASE REPORT


 
  UTERINE RUPTURE FOLLOWING A MOTORCYCLE ACCIDENT AT N'DJAMENA (CHAD). A CASE REPORT  

GABKIKA BM, MANGDAH BE, KAIMBA Bm, ADOUM T

ABSTRACT:-Rupture of a gravid uterus is a rare complication of motorcycle accident. We report the case of a 33-year old woman, gravida 6, referred as a case of uterine rupture with intrauterine fetal death at 36 weeks gestation, following a motorcycle accident. Emergency laparotomy revealed an anterior - lateral uterine rupture on the right side about 11 cm which involved the ipsilateral uterine artery. A conservative surgical treatment was employed. Splenectomy was also performed.

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CASE REPORT


 
  COLLISION COLORECTAL ADENOCARCINOMA AND HODGKIN LYMPHOMA: A CASE REPORT  

PINDIGA UH, ABDULLAHI YM, ADOGU , GUDUF M , TAHIR NM

ABSTRACT:-Collision cancers of the gastrointestinal tract involving lymphomas are very rare. We report a case of collision cancer involving a well differentiated colonic adenocarcinoma and corresponding mesenteric Hodgkin lymphoma. The sentinel lymph node shows metastatic adenocarcinoma however, lymph nodes further away within the mesentery revealed mixed cellularity Hodgkin lymphoma. We want to emphasise that collision adenocarcinoma and Hodgkin lymphoma especially of the mesenteric lymph nodes is a very rare event.

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CASE REPORT


 
  PROLAPSED VAGINAL MULLERIAN CYST MASQUERADING AS UTERO-VAGINAL PROLAPSE: A CASE REPORT  

EHALAIYE B, NDONYA-SALEH D, YOHANNA J, KWAGHE BV

Background:A 20 year old para 2, presented at our gynaecological clinic with a 4 year history of “something protruding from her vagina”. She was referred to us with a diagnosis of utero-vaginal prolapse. Examination revealed a 6x6 cm, cystic, anterior vaginal wall mass, which was confirmed to be a vaginal cyst on ultrasound. Surgical excision of the cyst was done and histopathology confirmed it was of mullerian origin. Vaginal mullerian cysts are usually small and asymptomatic, but may rarely enlarge as reported in this case. They are therefore important in the differential diagnosis of utero-vaginal prolapse or cystocele.

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CASE REPORT


 
  AN UNUSUAL BLEEDING FOLLOWING CIRCUMCISION: A CASE REPORT.  

IBRAHIM AG, ALIYU S, LAWAN AM, SALIM UM.

Background:Male circumcision is a common surgical procedure that involve excision of the prepuce, which is practiced all over the world for religious and cultural reasons. Medically it has the advantages of preventing phimosis, paraphimosis, balanitis, and decreases the risk of cancer of the penis. Common complications of circumcision are hemorrhage, sepsis, and inadvertent trauma. Excessive unusual bleeding may follow circumcision in hemophilia and other bleeding disorders. We report a case of such bleeding that necessitated transfusion of blood and fresh frozen plasma.

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

PROF. BALA MOHAMMED AUDU

EDITOR-IN-CHIEF, BORNO MEDICAL JOURNAL

DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL P.M.B
1414 MAIDUGURI, BORNO STATE, NIGERIA
TEL:08035129840
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.  


DR ALIYU M. KODIYA

ASSISTANT EDITOR-IN-CHIEF, BORNO MEDICAL JOURNAL

UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL P.M.B
1414 MAIDUGURI, BORNO STATE, NIGERIA
TEL:08036289875
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

NMA BORNO STATE CHAPTER

Chairman: Dr. Baba Shehu Mohammed


Vice Chairman: Dr. Mohammed Kabir Ahmed

Secretary: Dr. Kumshe Mohammed Abba


Assistant Secretary: Dr. Abubakar Kaka Sanda


Treasurer: Dr. Musa Abbas Waziri


Financial Secretary: Dr. Yakubu M. El-Yakub


PRO: Dr. Abdulhakeem M. Ngulde


Ex-Officio I: Dr. Mala B. Sandabe


Ex-Officio II: Dr. Babagana K. Machina

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Chairman: Dr Aliyu M. Kodiya

Vice-Chairman: Dr Adamu S. Abubakar

Secretary: Dr Ibrahim M. Sanusi

Assist Secretary: Dr Hassan Dogo

Treasurer: Dr Yusuf B. Ngamdu

Publicity Secretary: Dr Abubakar A. Kullima

Ex-Officio I: Dr Abubakar A. Alhaji

Ex-Officio II:Dr U. M. Tela

Editor-in-Chief: Prof. BM Audu

 

. . .