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bomj Vol 20 No 1

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January - June 2023
Volume 20 | Issue 1

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

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ORIGINAL ARTICLES


 
 
 

Asymptomatic Bacteriuria and Foetomaternal Outcome at the University of Maiduguri Teaching Hospital

Kwari SD, Chama CM, Gadzama GB

Background: Asymptomatic bacteriuria (ASB) is a common medical complication of pregnancy and may be associated with acute pyelonephritis, preterm labour and delivery, intrauterine growth restriction (IUGR), low birth weight (LBW), anaemia, hypertension and long-term renal dysfunction. Routine screening and treatment of ASB in pregnancy are recommended. Objectives: This study determined the prevalence, common organisms implicated, their antibiotic sensitivity pattern and the foetomaternal outcome of pregnant women with ASB. Methods: We conducted a prospective study at the Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria. One hundred and fifty pregnant women attending antenatal booking were consecutively recruited. We collected demographic and clinical information. A clean catch midstream urine specimen was collected for culture and sensitivity. The women were followed up to delivery and foetomaternal outcome were obtained. Results: The prevalence of ASB was 22%. Escherichia Coli was the most predominant organism isolated in 45.4%. Nitrofurantoin (90.9%), Ceftriaxone (87.8%) and Co-Amoxiclav (84.8%) showed the highest activity against the isolated microbes and were resistant to Ampicillin (87.9%) and Cloxacillin (79.7%). ASB is associated with an increased risk for UTI (P-value = 0.001), pyelonephritis (0.002), anaemia later in pregnancy ( ? 0.001), preterm delivery ( ? 0.001), low birth weight ( ? 0.001) and admission to SCBU (0.023). Conclusion: The prevalence of ASB is high and associated with significant maternal and perinatal morbidity. We recommend screening all pregnant women attending antenatal clinics for ASB and appropriate treatment given.

Key words: Asymptomatic bacteriuria, pregnancy, prevalence, foetomaternal outcome, urine culture, Nigeria.

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ORIGINAL ARTICLES


 
 
 

Elective Gynaecological Surgeries in Aminu Kano Teaching Hospital, Kano, Nigeria: a 5-year review

Usman AU, Natalia A, Ibrahim DM

Background: Elective surgeries include procedures done to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risks to patients. This study described the pattern of elective Gynaecologic surgeries conducted in Obstetrics and Gynaecology department of Aminu Kano Teaching hospital, over a five-year period. Objective: To describe the pattern of elective gynaecologic surgeries conducted in Obstetrics and Gynaecology Department of our hospital over a five-year period. Methods: A retrospective study of all elective surgical procedures conducted at the Obstetrics and Gynaecology department of Aminu Kano Teaching hospital from 1st September, 2012 to 31st August, 2017 was conducted. Theatre operation register and gynaecological ward admission records were retrieved and reviewed. Information extracted include: age of patient, indication for the surgery, type of surgery conducted, nature of procedure (minor, intermediate and major), the cadre of surgeon and assistant(s) performing the surgery and the type of anaesthesia used for the surgery. Results: The total number of elective gynaecologic surgeries conducted over the study period was eight hundred and two (802) accounting for 19.4% of all surgical procedures. Uterine fibroid was the commonest indication for surgery with myomectomy being the commonest surgical procedure performed constituting 181(30%) of all gynaecologic operations. Hysterectomy was the second commonest procedure 115 (19%) indicated most commonly by uterine fibroids 53(46%). Conclusion: This study demonstrated 19.4% prevalence of elective gynaecological procedures in our centre. Consultants are the leading surgeons in most of the procedures and a significant association was found between the nature of the procedure and the cadre of surgeon. There is need to strengthen the postgraduate training of Resident doctors by exposing them to more hands-on training on major procedures.

Key words: Elective, gynaecological surgery, procedure

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ORIGINAL ARTICLES


 
 
 

Prevalence and risk factors/predictors of seizure-related injuries among children with Epilepsy at the University of Benin Teaching Hospital, Benin City.

Okunola P.O. Ani C.K

Background: Children with epilepsy are considered to be at an amplified risk for injuries as compared to the general population. The increased risk may occur directly as a result of the seizure or due to other comorbid conditions that predispose to injuries. Objectives: This study aimed to determine the frequency and the pattern of seizure-related injuries in children aged 0-17 years with epilepsy seen at the University of Benin Teaching Hospital, (UBTH), Benin City, Nigeria. Methods: Consecutive cases of children with epilepsy seen at the Paediatric Neurology Clinic of UBTH, Benin-City over a period of 6 months were evaluated for injuries in the preceding 12 months using a structured questionnaire. Results: A total of 119 respondents were involved in the study, 50 (42.02%) sustained an injury at some point in the preceding 12 months. Participants in the middle socio- economic class had more seizure-associated injuries (n = 25, 59.5%), compared to those in the low socio-economic class (n = 20, 42.0%) and high socio-economic class (n = 5, 18.5%); P = 0.003. Seizure-related injuries were associated most with generalized seizure (50.5%) when compared with focal seizures (14.3%) P = 0.001. Among the subjects, a tonic-clonic seizure was the most common subtype of generalised seizure (p =22.306, p = < 0.001). The commonest seizure-related injuries are skin bruises (35.1%), followed by soft tissue lacerations (22.8%). Strong association between epilepsy-related injuries and compliance to anti-epileptic drugs (AEDs) were noted. Conclusion: Children with epilepsy are at higher risk of injury and this risk is modified by some factors like socioeconomic status, seizure type, and compliance with medication

Key words: Seizure, Children, Injuries, Epilepsy

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Complications of Ventriculoperitoneal Shunt for Infantile Hydrocephalus: A Single Nigerian Centre Experience

Usman B, Abubakar AM

Background: Ventriculoperitoneal shunt (VP–shunt) is one of the easiest and most common ways of treating hydrocephalus worldwide. Common post-operative complications include shunt malfunction (obstruction, disconnection, fracture), infection of skin and hardware, exposed/extruded shunt, calcification and per anal extrusion. Objectives: A 5-year retrospective review of all complications observed among infants with VP Shunt in our centre. Methods: The study period was between July 2017 and June 2022. Extracted data included: Demographic data on the Age and sex at presentation, type of Hydrocephalus, and the observed complications. Results: Forty-six infants comprising 32 (70%) boys and 14(30%) girls had VP Shunt, with ages (number) of < 1 month (26.1%), 1 – 6 Months (43.5%), and 7 – 12 Months (30.4%). Types of Hydrocephalus were congenital (A. S. in 13, NTD associated in 18) and acquired (post meningitis in 13, IVHP in 2). Complications were observed in eight (17.4%), consisting of 6(75%) Males and 2(25%) Females, with M: F of 3:1. Complications among the eight (8) patients include: Shunt Obstruction (50.0 %), Shunt Disconnection (12.5 %), Shunt Infection (50.0 %), Skin Infection (25.0 %), Shunt calcification ( 12.5 %), Exposed Shunt( 12.5 %), Extruded Shunt (12.5%), Per anal protrusion (12.5 %) and Death (25.0 %). Conclusions: Outcomes were very good, with few manageable complications.


Keywords: Children, Complications, Hydrocephalus, Infants, VP – Shunt

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ORIGINAL ARTICLES


 
 
 

Twenty Years of Experience with Lichen Planus in Kaduna, North-West Nigeria

Husain Yahya

Background: Background: Lichen planus (LP) is a chronic inflammatory papulosquamous autoimmune disease which predominantly affects the skin but may also affect mucous membranes and nails. It is commoner in adults and occurs in all races. Reports about LP from northern Nigeria are scanty. Objective: To report the relative prevalence, duration, clinical presentation, and outcome of treatment for patients with LP seen over 20 years. Methods: Retrospective review of records of patients diagnosed with LP in two dermatology clinics in Kaduna, Nigeria from September 2001 – August 2021. Results: Of 39,037 patients with new skin disease, 335 (0.9%) were diagnosed with LP: mean age 37.6 years (range 5 -81), 11.3% < 18 years and 55% < 40 years, male- female ratio 1:1. The median duration at presentation was 8 weeks (75% = 16 weeks). The lower legs (65%), lower arms (61.2%), abdomen (31.6%), upper arms (29%), upper back (28.1%), lower back (27.2%), chest (22.4%) and thighs (21.5%) were the most frequently affected sites. The oral mucosa, penis and nails were affected in 6, 9 and 2 patients only. Itching (97%), hyperpigmentation (26.6%), and Koebner’s phenomenon (23%) were also present. Classic LP accounted for 88.1% while hypertrophic LP (12.5%) and annular LP (6.3%) were other variants, some patients with multiple variants. Just over 7 % of patients had previous disease (median interval 7 years). Hepatitis C virus antibody was positive in 6.2%. All patients were treated with topical steroids but 45% required oral prednisolone. On follow-up, LP had resolved in 79.4% of patients. Conclusion: Lichen planus affected a younger population, presented in a classic way in most patients, affected the oral and other mucosae much less frequently and responded well to topical and systemic steroids.


Key words: Lichen planus, clinical presentation, Kaduna-Nigeria

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Symmetrical Peripheral Gangrene Resulting from the Application of Henna: A Rare Clinical Occurrence

Abdullahi MA, Kabir MA, Mustapha MI, Mamuda AA, Shamsudeen MB

Background: Symmetrical peripheral gangrene (SPG) is a rare clinical entity leading to ischemic necrosis of extremities. We report a case of SPG in patient brought into the orthopaedic clinic of Aminu Kano Teaching Hospital (AKTH), Kano, two days after applying a beautification substance called Henna. Case Summary: We report a case of a 28-year-old lady who presented at the emergency department of AKTH with a complaint of extreme pains in both hands and feet. The patient noticed a gradual darkening of the fingers and toes two days after applying the Henna, associated with severe pain at rest. She was thoroughly evaluated and examined for other possible risk factors or illnesses, but none was found. The patient was counselled and she subsequently consented to amputation. The gangrenous parts of the digits of her fingers and the tarsometatarsal of her feet were amputated bilaterally and the procedure was carried out successfully. Conclusion: To our knowledge, this is the first case report of symmetrical peripheral gangrene occurring after routine application of Henna as a beautification agent. No other possible risk factor was identified. We highlight the possibility of a beautification agent (Henna) as a causative factor of SPG. Thus, women should be careful of the mixtures in Henna that could lead to SPG.


Key words: Symmetrical, Bilateral, Gangrene, Henna, Amputation

[FULL ARTICLE (PDF)]

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vol19no2

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2022
Volume 19 | Issue 2

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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PRELIMINARY PAGES

 

EDITORIAL

 
 
 

COP27 Climate Change Conference:Urgent action needed for Africa and the world

AtwoliL,1ErhaborGE,2GbakimaAA,3HaileamlakA,4NtumbaJ-M K,5KigeraJ,6Laybourn-Langton L,7Mash B,8Mohia J.9MulaudziFM,10Ofori-AdjeiD,11OkonofuaF,12RashidianA,13El-Adawy M,14SidibéS,15Snouber A,16TumwineJ,17YassienMS,18YongaP,19ZakhamaL,20ZielinskiC.21

1. Editor-in-Chief,East African Medical Journal.

2. Editor-in-Chief,West African Journal of Medicine.

3. Editor-in-Chief,Sierra Leone Journal of Biomedical Research.

4. Editor-in-Chief,Ethiopian Journal of Health Sciences.

5. Chief Editor,Annales Africaines de Medecine.

6. Editor-in-Chief,Annals of AfricanSurgery.

7. University of Exeter.

8. Editor-in-Chief,African Journal of Primary Health Care & Family Medicine.

9. London School of Medicine and Tropical Hygiene.

10. Editor-in-Chief,Curationis.

11. Editor-in-Chief,Ghana Medical Journal.

12. Editor-in-Chief,AfricanJournal of Reproductive Health.

13. Executive Editor,Eastern Mediterranean Health Journal.

14. Director of Health Promotion,Eastern Mediterranean Health Journal.

15. Director of Publication,Mali Médical.

16. Managing Editor,Journal de la Faculté de Médecined’Oran.

17. Editor-in-Chief,African Health Sciences.

18. Editor-in-Chief,Evidence-Based Nursing Research.

19. ManagingEditor,East African Medical Journal.

20. Editor-in-Chief,La Tunisie Médicale.

21. University of Winchester.

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

ChangesAssociated with Facilitation of Endotracheal Intubation with Either Fentanyl or Suxamethonium in Children

Mikhail A, Salahu D, Atiku M, Adesope S,Abdurrahman A, Abdullahi MM

Background:Endotracheal intubation usually aided by the muscle relaxant suxamethonium can elicit responses and changes which are hazardous in some patients including children; suxamethonium is also contraindicated in some patients. Fentanyl, a short-acting opioid maybe a suitable alternative with varying results.

Objective: This study compares the changes associated with the facilitation of endotracheal intubation with either the commonly used suxamethonium or fentanyl.

Methods: Eighty two American Society of Anaesthesiologist (ASA) physical status classification I and II patients aged between 3 and 12 years scheduled for surgeries requiring general anaesthesia with endotracheal intubation received either 3 μg/kg fentanyl (group F) or 1.5 mg/kg suxamethonium (group S)following induction of anaesthesia with propofol. Haemodynamic parameters: pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were assessed post-intubation at 1, 3, 5 and 10 minutes respectively. The incidence of side effects and post-intubation upper airway events were also observed.

Results:Patients in group S experienced a significant increase in HR when compared to baseline values (p=0.0001). The SBP and DBP were significantly lower than baseline values in patients in group F (p<0.023). MAP increased in group S and declined in group F at all study timings. However, the post-intubation MAP was significantly lower than the baseline only at the 5th minute (p=0.026). There were no records of postoperative upper airway injuries, hypotension, bradycardia, desaturation, masseter spasm and malignant hyperthermia in the two study groups.

Conclusion: Propofol-Fentanyl produced more stable parameters compared to propofol-suxamethonium. No significant difference in terms of side effects between Propofol-Fentanyl and propofol-suxamethonium.

Key words: Fentanyl, Suxamethonium, Propofol, Facilitation, Endotracheal intubation

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Laparoscopic General Surgeries in aDeveloping Country: A 5-Year Private Hospital Experience in Abuja, Federal Capital Territory, Nigeria

Aghahowa ME, Salu IK, Esomonu SN, Umar MU, Bello O,6Gali BM.

Background: Laparoscopic surgical services are well established in most hospitals in developed countries but not in developing countries like Nigeria. Moreover, the scope of healthcare financing like the health insurance scheme in Nigeria has not expanded to accommodate laparoscopy. Basic surgeries like appendicectomy, cholecystectomy and advanced surgery like hemicolectomy form common surgical procedures now performed via laparoscopy in Nigeria. Objective: To share our experiences with laparoscopic general surgical operations performed in a private hospital in Abuja, Nigeria.

Methods: Retrospective study of 119 patients who had laparoscopic general surgeries over 5 years period at a private hospital in Abuja, Nigeria, from January 2017 to December 2021. The variables analysed were patients’ demographic data, diagnosis, type and duration of operations and outcome.

Results: One hundred and nineteen patients had laparoscopic surgery over the period. Of these, majority were females 71 [59.7%] and males 48 [40.3%] giving M:F of 1:1.5. The age range of patients was 12 to 81 years and the mean age was 43.4 years ± 14.0. A higher proportion of the patients [58%, n=69], were aged 40 years and above. The commonest procedures done were laparoscopic cholecystectomies [49.6%, n=59], followed by appendicectomies [21.0%, n=25]. Seven [5.9%] patients had laparoscopic adhesiolysis and drainage of liver cysts each, laparoscopic fundoplication 5 [4.2%] and left hemicolectomy 3 [2.5%]. The commonest postoperative complication was surgical port site infection 4 [3.4%].

Conclusion: The scope of laparoscopic general surgeries provided in a private hospital in Abuja, Nigeria is broad and safe. The outcomes are comparable to those from other centres in the region.

Keywords: General surgery, laparoscopy, Private Hospital, Abuja

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Practice of ophthalmology and work satisfaction: an overview of Nigerian ophthalmologists

Oyediji FJ,Mpyet CD

Background: With multiple medical specialities and subspecialties, the choice of a lifelong speciality can be a daunting task. Most medical students commence undergraduate training without complete knowledge of all the medical specialities available. Considering that various factors affect the choice of a speciality, practice
location and productivity, this study sought to assess ophthalmologists’ job satisfaction, remuneration and scope of practice.

Methods: A semi-structured, pre-tested self-administered questionnaire was distributed to 140 consenting Ophthalmologists and ophthalmic Residents that attended the 2016 Annual Scientific Conference of Ophthalmological Society of Nigeria. Information obtained included participants’ socio-demographic data, practice environment, remuneration, job satisfaction, and areas participants felt required a change in their ophthalmic practice. Responses were analysed using IBM Statistical Package for the Social Sciences 16.0 (IBM Corp., Armonk, NY, USA).

Results: One hundred and five (75%) of the 140 questionnaires were filled and returned. The median age of participants was 35 years (range: 21-70 years) and 54.3% were females. Most Nigerian ophthalmologists practice in urban area. Consultants do more research spending an average of 6.44 hours per week on research. Most respondents (70, 66.7%) felt fairly compensated for their work with government-employed earning significantly less (₦4.2million/annum) than their private sector counterparts (₦6.3 million/annum). Most respondents (99[94.3%]) reported high levels of job satisfaction and 69(65.7%) were fairly productive.

Conclusion: Despite the discrepancies in remuneration in private versus public sector ophthalmologists and trainees, most survey participants feel satisfied with their current level of remuneration and productivity.

Keywords: Practice, Remuneration, Work satisfaction, Nigeria, Ophthalmologists, Ophthalmology residents

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

HIV-Related Skin Disease in Kaduna, North-West Nigeria: A 20-Year Experience

YahyaH.

Background: Skin diseases are common in African patients with HIV infection. They are often the first clinical manifestations of immune deficiency and their frequency increases as impaired immunity worsens and decreases as immunity improves with antiretroviral drugs (ARV). Objective: To report the relative incidence and clinical presentation of HIV-related skin disease over 20 years when diagnosis and treatment availability varied.

Methods: Records of patients with HIV-related skin disease attending a dermatology clinic in Kaduna, Nigeria from 2001 to 2021 were reviewed.

Results: HIV-related skin disease was diagnosed in 525/29,278 (1.8%) patients with 610 episodes of skin disease: Mean age 36.2 years (range:4 68 years), 60% age < 40, males 55%. Almost 72% of patients were seen between 2001 and 2010 and only 9.3% were seen after 2015. Patients seen between 2001 and 2010 were significantly less likely to know their HIV status (19.9% vs. 80.1%, P = 0.000) and be receiving ARV (21.5%, vs. 51.4%, P = 0.000) than those seen between 2011 and 2021. The most common skin conditions were: pruritic papular eruption 33%, herpes zoster 19.7%, Kaposi sarcoma 11%, atopiform dermatitis 8.9%, and seborrheic dermatitis 3.8%. Plane warts, adverse drug reactions, folliculitis, furunculosis, genital herpes simplex, psoriasis, dermatophyte infection, and molluscum contagiosum were also seen. Almost 60% of patients a had CD4 count < 200 cells/ml at presentation.

Conclusion: We noted a marked change in the frequency and pattern of disease between 2001-2010 and 2011-2021 likely due to the increased availability of care and treatment over the period.

Keywords: HIV, Skin disease, Relative incidence, Kaduna-Nigeria, sub-Saharan Africa

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Stroke in Babcock University Teaching Hospital, Nigeria: a two-year retrospective study of CT imaging findings

BadukuTS, YusufA,ThompsonM.

Background: Stroke is a leading cause of morbidity and mortality worldwide, most of which occur in low and middle-income countries. Neuroimaging is the cornerstone for guiding its management, and computed tomography (CT) is an established tool for its diagnosis.

Objective: The purpose of this study was to examine recent CT brain findings among stroke patients in a rural-based, private teaching hospital in south-west Nigeria, and to compare them with previous findings within Africa.

Methods: This is a retrospective study conducted for thirty months in the Radiology Department of Babcock University Teaching Hospital, Ilisan- Remo, Nigeria. Brain CT images and reports performed between 1st November 2019 and 30th April 2022 were retrieved, processed and analyzed.

Results: The patients were 199 males (62.6%) and 119 females (37.4%), with a mean age of 61.7 years. The highest frequency wasbetween the ages of 70 and 74 years. The most frequent presenting complaint was the inability to move (21.5%). Infarcts constituted the majority of lesions while the most frequent CT findings were left-sided hemispheric infarcts (13.7%).

Conclusion: The result of the study showedamalepreponderanceintheincidenceofcerebrovascularaccidents(CVA).Thereisalsoa preponderance of ischaemic over haemorrhagic CVA. Left-sided hemispheric lesions are more frequent.

Keywords: Cerebrovascular accident, Computed Tomography, Babcock University Teaching hospital, South-
West Nigeria

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

GiantSolitaryPlasmacytomaoftheSkull:ManagementofaRare Differential Diagnosis

Usman B, Mohammed B, Daibu U,Bukar A A, Zarami A B

Background: Solitary plasmacytoma of the skull (SPS) is a condition arising from the pathological proliferation of plasma cells. It is a rare condition, especially giant ones and may often mimic many conditions. Total excision may be curative. However, in some cases, chemotherapy or radiotherapy or chemoradiation may be necessary post-excision.

Case summary: S.S. was a 44-year-old male with a rapidly growing swelling in the middle of his forehead for eight months. Physical examination revealed an otherwise healthy-looking young man, an obvious forehead mass covered with normal intact skin, sessile with a base circumference of 31cm, non-tender, mixed consistency (hard with cystic areas), fixed to the frontal bone but skin over it was freely mobile. No pulsation and no bruit. A clinical diagnosis of osseous meningioma was made. Fine Needle Aspirate Cytology (FNAC) revealed features consistent with a plasmacytoma. Urinary Bence jones protein and bone marrow biopsy were negative for Myeloma. Surgical excision was via a craniectomy and a cranioplasty was done. Clinical condition one year after surgery remained satisfactory with no evidence of recurrence or development of myeloma. No chemotherapy or radiotherapy was administered.

Conclusion: Giant solitary plasmacytoma of the scalp is a very rare condition and may clinically be misdiagnosed. May be managed with a total wide excision with or without chemotherapy or radiotherapy.

Keywords: Giant, plasmacytoma, skull, solitary

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Bulky Perineal Naevocytoma with a Rare Variant of Giant Congenital Melanocytic Nevus in a Female Neonate

IbrahimBA,AkuhwaRT,AdamuAI, IbrahimHU,AliyuI

Background:Congenital melanocytic nevi are common and vary in size. Some can be quite extensive but are usually benign. However,a giant congenital nevus is rare and has the potential for malignant transformation. Giant nevus could occur in any part of the body; though it is most common on the trunk, it rarely covers over three-quarters of the skin. It is known to be associated withother congenital malformations such as spina bifida and foot deformity. Very few cases of bulky perineal naevocytoma associated with giant congenital melanocytic naevi have been reported in the literature.

Case summary:We report a case of a 2 day old female neonate with a giant melanocytic nevus that covers about 85% of the whole body associated with a bulky perineal naevocytoma arising within the lesion.

Conclusion: Such extensive lesion is at high risk of malignant transformation and has a major psychosocial impact on the caregivers.

Keywords: perineal naevocytoma, congenital, melanocytic, nevus, neonate.

[FULL ARTICLE (PDF)]

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archive-2022-no1

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2022
Volume 19 | 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

 

PRELIMINARY PAGES

 

ORIGINAL ARTICLES


 
 
 

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

Key words: Emotional disorders, sickle cell disease, Nigeria

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Rabiu A, Getso HA, Mahmud A

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Timothy A. Ehwarieme1 and Anwuli Emina2

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Kaposi Sarcoma of the Nasal Cavity: A Rare Presentation

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 
 

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

Feigoudozoui H.V, Parteina D, Koné S.

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

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

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

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

Keywords: Femur; Mosaicoplasty; Osteochondritis

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

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

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

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

[FULL ARTICLE (PDF)]

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vol18no2

Written by Administrator. Posted in Archives pages

 
 

 

July - December 2021
Volume 18 | Issue 2

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

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REVIEW ARTICLES


 
 
 

Talon Cusps- A Review of Literature

Karthik Shunmugavelu

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

Keywords: Talon Cusps, Aetiology, Features, Treatment

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Ebeigbe JA, Onoabhagbe SI

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES

 
 
 

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

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

 

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Gestational Gigantomastia: Report of a Rare Case and Literature Review

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

 

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

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

Keywords: Breast, Bilateral, Gestational gigantomasti

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Ehwarieme Timothy A 1 and Awhim Blessing 2

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT

 
 
 

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



Abdullahi Mohammed1 , Aliyu G. Ganiyu2

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

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

Usman B1 , Dodo M.M 2

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLE


 
 
 

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

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

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

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

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

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

Keywords: Hematological, Parameters; Obesity, Sapel

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Murtala Yusuf, 1,2 Aisha Aminu Sharif1

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

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

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

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

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

Keywords: Audit, Antenatal, investigation

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ORIGINAL ARTICLE

 
 
 

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

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

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

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

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

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

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

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vol18no1

Written by Administrator. Posted in Archives pages

 
 

 

January - June 2021
Volume 18 | Issue 1

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

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ORIGINAL ARTICLES


 
 
 

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

Otaniyenuwa Obarisiagbon, Andrew Obi

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

Management Pattern of Epistaxis in Sokoto, Nigeria

Adeyeye FM, Iseh KR, Aliyu D

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

Baduku TS, Sheyin J, Isa FB

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Malposition of Haemodialysis Central Venous Catheter: Case Report

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

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

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

 

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

REVIEW ARTICLE


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

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

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

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

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

 

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

 

[FULL ARTICLE (PDF)]

CASE REPORT


 
 
 

Bilateral Mandibular Tori- A Case Report and Review of Literature

Karthik S

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


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

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

 

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

[FULL ARTICLE (PDF)]

ORIGINAL ARTICLES


 
 
 

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

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

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

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

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

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

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

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