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July - December 2021
Volume 18 | Issue 2

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

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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




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




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




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




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




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




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




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.




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




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




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




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




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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Written by Administrator On Sunday, 24 March 2013 17:23
Prof MG Mustapha, 
Department of Paediatrics, University of Maiduguri and University of Maiduguri Teaching Hospital. 
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