vol132_jult_dec_2016

DAUDA YAHI, NICHOLAS ADETAYO OJO, GIDEON DAUDA MSHELIA

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

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

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

ABDULLAHI MOHAMMED, MOHAMMED MANU.

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

ABDULAZEEZ AHMED

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

ABBA K,TAHIR MB, DOGO HM , NGGADA HA

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

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

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

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

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

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

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

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

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

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