bomj Vol 20 No 2

O. Ariyo, B. O. Olaniyi, O. D. Onojade and F. S. Oladipo

Background: Knowledge and attitude of health workers affect caregivers’ infant feeding practices. However, information on the knowledge and attitudes of health workers in private hospitals is lacking. This study was designed to assess the infant feeding knowledge, attitude, and personal experiences of health workers in private hospitals in Ibadan, Nigeria. This cross-sectional study involved sampling of 108 consenting health workers of registered private health facilities offering ante-natal care services in Ibadan North communities of Oyo State, Nigeria. Data were collected using a semi-structured questionnaire including the socio-demographic characteristics, knowledge, and attitude of infant feeding practices. Knowledge was assessed using a 19-point scale categorized as good (≥13) and poor (<13). Attitude was assessed using a 65-point scale, categorized as good (≥33) and poor (<33). Data were analysed using descriptive statistics at p<0.05. Eighty five percent of the health workers were female, 51.9% were aged 21-30 years, 48.1% were married, and 25.9% were degree holders. Only 47.2% had attended infant feeding training recently, 57.0% had good knowledge and 53.0% had good attitude. Only 30.6% knew early initiation of breastfeeding, and 30.6% knew continued breastfeeding up 24 months and beyond. Just 49.1% considered breastfeeding in public non-embarrassing, and 33.3% agreed that infants less than six months should not be given water. There is evidence of limited knowledge and poor attitude towards the recommended infant feeding practices among the health workers in private health facilities in Ibadan. Periodic training on infant feeding for health workers in private health facilities is hereby recommended.

Key words: Exclusive breastfeeding, early initiation, private hospital, personal experience

Raji S.O., Ismaila A.I., Amina S.M., A. Adam.

Introduction: Hajj and Umrah are the main pilgrimages recommended in the Islamic faith to be performed at least once in a lifetime by those who have the wherewithal. It is one of the largest mass gatherings worldwide. 1 Muslims all over the world (over 180 countries) visit the Great Holy Mosque in the city of Mecca to perform the prescribed religious rites of the main pilgrimage (Hajj) which spans the second week of the twelfth month (Zul-hijja) of the Islamic lunar Calendar. The lesser/minor pilgrimage (Umrah) can be performed at any time of the year. Most hujajs (pilgrims) from outside Saudi Arabia perform Umrah and Hajj in a single journey (tamatui). Some faithfuls also perform the lesser pilgrimage (Umra) in the last ten days of the month of Ramadan (9 th month of the Islamic lunar calendar) due to the additional merits and blessings of this last third of the fasting month and additional opportunity of performing other meritorious and rewarding acts of worship such as i'tikaf (seclusion) in the Great Holy Mosque.

Umweni A.A, Otaren N.J.

Background: Although digit sucking is normal in infants and young children, prolonged duration of these habits might have consequences for the developing orofacial structures and occlusion. It is advisable to intercept the habit between the ages of 4 and 7 years. We report the case of a 9 year old boy who presented with a history of chronic digit sucking habit with associated hyperkeratosis/hyperpigmentation of the left cheek from repeated mechanical trauma from his left ring finger while he sucked his left index and middle fingers. The lesion is about 5mm in diameter. Full orthodontic assessment of the patient was carried out and habit breaking appliance instituted after counseling mother and child. Occlusal problems were reversed after habit cessation. Six months after breaking the habit, the hyperkeratosis/hyperpigmentation of the left cheek was still present even though it is reduced. This is an unusual finding in a child with chronic digit sucking habit.

Umar H.U., Mohammed L.M., Farouk A.G., Mustapha Z.

Background: Spondylocostal dysostosis (Jarcho-Levin Syndrome) is a rare congenital abnormality of spines and ribs which usually presents with trunk dwarfism, scoliosis, and respiratory symptoms. Its occurrence can be sporadic or familial. The clinical characteristics are vertebral abnormalities of hemivertebrae, butterfly vertebrae, scoliosis and variable rib abnormalities. Imaging is critical in its evaluation and management. Case Presentation: A 4-day-old child of a non-consanguineous couple delivered with swelling at the back. The family history was unremarkable for congenital anomalies. Clinical examination and radiological findings was consistent with spondylocostal dysostosis. Conclusion: Spondylocostal dysostosis is a rare musculoskeletal abnormality. Imaging plays a vital role in its diagnosis. An early diagnosis is necessary to prognosticate and institute appropriate management.

Key words: Spondylocostal dysostosis, Jarcho-Levin, Hemivertebrae , Rib anomalies, Congenital scoliosis.

Muhammad A.S., Aminu M.B., Dattijo L.M., Oluwagbemiga U.O., Ezugwu O.P.

Background : Fibroids are benign neoplasms of the uterus arising from smooth muscle. They are also termed uterine leiomyomas. It is the most common growth found in the female reproductive system and may undergo malignant transformation in less than 1% of cases to form leiomyosarcoma. Fibroids may present with abnormal uterine bleeding and pelvic pressure symptoms. Fibroid polyp can be a cause for concern especially if it grows so large to cause symptoms of obstructive uropathy. Thus, the patient may present with dysuria, anuria, or even necroturia as seen in our patient. Case summary: We present a case of 40-year-old P 5 + 0, A 3 lady, whose last childbirth was 10 years before presentation. She presented with 3 years history of recurrent vaginal bleeding, dizziness, and a mass protruding through her vagina. Her packed cell volume was 14%. She was fully investigated and upon catheterization, nectroturia was observed. She was counselled and had vaginal polypectomy. Conclusion: Necroturia associated with uterine fibroid polyp is a rare occurrence, hence physicians should have a high index of suspicion when evaluating patients with necroturia.

Baba M.M., Buba F., Talle M.A., Garbati M.A, Abdul H., Mairari F.G.

Background : Human immunodeficiency virus-infected patients are at increased risk of cardiovascular diseases compared with the general population, and right ventricular systolic dysfunction is said to be associated with poor outcomes. We therefore assessed right ventricular systolic function using tissue Doppler-derived tricuspid lateral annular systolic velocity (S`) among HIV-infected patients on highly active antiretroviral therapy (HAART). We evaluated its relationship with viral load and cd4 cells count. Methods: The study was a cross-sectional conducted among HIV-infected patients receiving HAART at the Federal Medical Centre, Nguru, Yobe State, Northeastern Nigeria using tissue Doppler-derived tricuspid lateral annular systolic velocity (S`). Results : One hundred and seven (107) subjects were recruited into the study comprising thirty-seven (34.6%) males and seventy (65.4%) females. Ninety-six (89.71%) had preserved right ventricular systolic function (RVSF) while 11(10.28%) had reduced RVSF. The mean CD4 cells count of patients with preserved RVSF and those with reduced RVSF were 838.37±27.50 and 301.66±12.38 respectively (P = <0.001). Similarly, the mean viral load of patients with preserved and reduced RVSF were 547.90±10.75 and 10293.00±74.67 respectively (P = <0.001). Pearson Correlation analysis between CD4 cell count and S` revealed a positively significant relationship (r = 0.894, P = < 0.001); while the relationship between viral load and S` was negative but significant (r = -0.879, P = < 0.001). Conclusion: The prevalence of right ventricular systolic dysfunction among patients with HIV on HAART was found to be 10.28%. There was a positive and significant correlation between the parameter of RVSF (tissue doppler derived tricuspid lateral annular systolic velocity) with CD4 cell count and a negative but significant correlation with HIV viral load.

Keywords: Right ventricular systolic function, Tissue Doppler derived lateral tricuspid annular systolic velocity (S`), CD4 cells, viral load.