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Volume 16 | Issue 1

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

Jibo AM, Abulfathi, AA Iliyasu Z

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




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

Mohammed B. Mahre, Saidu I. Ngulde, Bukar Umaru, Fakilahyel M. Mshelbwala, Dauda Yahi1, Abubakar Waziri, Aji T. Goni, Bitrus Wampana

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




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

Saleh MK, Danbatta AH

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




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

Ahmadu MS, Luntsi G, Umar UH, Farate A

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




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

Umar UH, Yunusa DM, Farate A, Bakari AA

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




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

Adamu A, Ugege MO, Onankpa BO, Yusuf T, Isezuo KO, Jiya FB, Abubakar FI

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




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

Musa Muhammad Babandina1, Idris Nasir Abdullahi, Anthony Uchenna Emeribe, Halima Ali Shuwa, Lawal Olayemi, Peter Omale Musa

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




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

Yakubu Surajuddeen, Abdurrahman Alhaji Mamuda, Bashir Bello

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




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

Sulaiman MM, Shettima J, Ndahi K, Abdul H, Baba MM, Ummate I, Hussein K

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


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