Archive 2009 - No 2

BALLA HJ, MM ASKIRA

Correspondence to: Mrs Habiba Jimeta Balla Department of medical laboratory science, college of medicine, university of maiduguri email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Cryptosporidium specie is an enteric, coccidian parasite that is associated with diarrheal diseases in children and immunocompromised patients; and it is responsible for high mortality particularly in developing countries. Objectives: To determine the prevalence of Cryptosporidium oocyst in diarrheic patients seen at the University of Maiduguri Teaching Hospital. Result: Two hundred and sixty-five (265) diarrheic faecal specimens were received and examined for Cryptosporidium oocyst using the Modified Zeihl-Neelsen staining technique. 60 (22.7%) faecal specimens were positive for the oocyst, frequency of occurrence of the oocyst were high among retroviral and malnourished patients; and featured prominently in the adult age groups compared to the children age group. Conclusion: Though the prevalence level of 22.7% is low, it however reveals the association of Cryptosporidium species with diarrhoea in this environment and the need for its awareness and inclusion in the routine laboratory request; particularly in diarrheic cases of the malnourished and immunocompromised patients.

CHIJIOKE A, MAKUSIDI AM
Correspondence to: Dr. Adindu Chijioke Baboko Post Office, P.O. Box 13945, Ilorin, Nigeria Phone: 234 (+8056507210) E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Mortality rates in acute kidney injury (AKI) are still very high despite enormous research and technological advances in its management. It varies between 40-50% in hospitalized patients and 70-90% in cases admitted into intensive care units. Management of severe AKI is capital intensive and majority of Nigerians with the disease die prematurely because they can hardly afford cost of renal replacement therapy (RRT). Reasons for the persistent poor survival may vary from one region to another, even in the same environment. Objective: To review clinical features and factors contributing topoor outcome of patients with AKI in Ilorin, Kwara State.Subjects and Method: Retrospective appraisal of acute kidney injury at University of Ilorin Teaching Hospital, Ilorin, Nigeria (Jan.1989- Dec. 2009.) All patients that met stage 3 RIFLE criteria forAKI and presented primarily or referred to our renal care centre were studied. RIFLE is the acronym for staging AKI which means Risk of renal dysfunction, Injury to the kidneys, Failure of renal function persisting for 24hours, Loss of renal function persisting formore than 1 month and End stage kidney disease (loss of function for more than 3 months). A total of 113(52males and 61 females) outof 1,275 renal patients that had AKI (8.86%) were reviewed. Results: Unusual weakness, oliguria, altered sensorium, vomiting and hiccups were major presenting features. About 80.5% of the patients were less than 40 years of age with male and female meanages of 27.29 + 7.77 and 29.15+ 6.98 years respectively. The aetiological factors were septicaemia, severe gastroenteritis, acute glomerulonephritis, drug induced, ante/post partum haemorrhage and obstructive uropathy. Overall mortality rate was 47.6%. Sixtythree patients were managed conservatively with 62% mortality while 33 and 9 patients had haemodialysis and peritoneal dialysiswith mortality rates of 15% and 67% respectively. Conclusion: Aetiological factors were largely preventable and treatable conditions. The main contributory factors to highmortality rate were ignorance, late presentation, delayed intervention therapy, bleeding diathesis, severe infections, financial constraints and high cost of dialysis. Haemodialysis appear to be abetter modality of treatment than peritoneal dialysis for severe AKI in our environment.

Ibrahim Ummate, Emeka Nwankwo, Abba Wakil

Correspondence to: Dr Ibrahim Ummate Department of Medicine, University of Maiduguri Teaching Hospital Maiduguri, Nigeria Mobile; 08035138334, 08023552876 E-mail; This email address is being protected from spambots. You need JavaScript enabled to view it.

Aim and objectives: This study is aimed at assessing the psychological status of patients with CKD undergoing haemodialysis. Method: 52 consenting adult patients with CKD undergoing maintenance Haemodialysis were included to assess their psychological status and compared with 57 physically fit individuals to serve as controls. General health questionnaire (GHQ28 designed by Dr David Goldberg) was administered to the patients and controls. Scores of 1-3 were considered as “no psychological disturbance”; score of four is considered as “indeterminate” while scores of five and above are considered as “positive evidence of psychological disturbance”. Patients’ demographic data were compared with controls. Serum samples were taken from the patients for electrolytes, urea, creatinine, calcium, phosphate, total protein albumin and virology. Ultrasonography was also done on all the patients. Results; 52 patients aged between 14 and 75yrs with a mean±SD of 35.29±14.17 and 57
controls aged 15 to 75 with mean±SD of 32.46±13.82 were studied. There is no significant difference in the ages of the patients and controls (p=0.79). They comprise of 41 males and 11 females, and 45 males and 12 females among patients and controls. There is no significant difference in the sex distribution of the study groups (p=0.99). Majority of both patients and the control groups are married and have attained degree with no significant difference in the marital status and highest educational status attained (p=0.23 and p=1.72 respectively). Majority of the patients (17) and controls (20) were
professionals with no significant difference in the occupation (p=0.70) We have found a significant difference in the prevalence of psychological disturbance in the study groups with more among the patients than controls (p=0.03). Conclusion and recommendation; Psychological disturbance is common among CKD patients undergoing haemodialysis compared to controls. The reason for this finding needs to be investigated.

Wakil MA,Abdulmalik JO, Salawu FK, Ahidjo A
Correspondence to: Dr. Musa Abba Wakil, Department of Mental Health, University of Maiduguri, Maiduguri, Nigeria; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: There is a paucity of competent mental health professionals, including psychiatric nurses, in most developing countries such as Nigeria. The origins of this problem appear to be multi-factorial, but inadequate exposure to psychiatry, during the course of basic nursing training may be contributory to the apathy towards the specialty of psychiatry. Objectives To examine the attitudes of nursing students to psychiatry and their intention to pursue psychiatry as a career after their basic training. Methodology: A cross-sectional survey was conducted on a convenience sample of 100 final year nursing students who were undergoing their clinical posting in psychiatry. A modified version of the 30-item Attitudes to Psychiatry (ATP- 30) Questionnaire and a Socio-demographic Questionnaire were utilized. Results: The students had a mean ATP-30 score of 101.7 (s.d = 9.2, range = 77- 124). There was no gender difference in scores (102.9 vs. 100.4, X 2 =21.95, p = 0.639), but a significant association was found between the age group 21-25 years and general knowledge of psychiatry (X 2 = 40.2, p = 0.012). Psychiatric nursing was ranked fourth on the basis of expressed ‘definite intention’ about choice of future career specialization. Conclusion: The findings from this study confirm the unpopularity of psychiatric nursing as a future area of specialization among students of basic nursing. There is the need for concerted and systematic efforts to ensure adequate exposure to psychiatry during the basic training. It is hoped that this will result in better appreciation and interest in the specialty as a consideration for subsequent specialization.

Muhammad Z, Ibrahim SA and *AGU OC
Correspondence to: Dr. Muhammad Zakari. Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Total abdominal hysterectomy is a common major gynaecological operation. A significant proportion of the surgeries are done for benign gynaecological tumours. Objectives: This study aimed to determine the prevalence of total abdominal hysterectomy for benign gynaecological tumours, the morbidity and mortality associated with the surgery and the duration of hospital stay. Study design: A retrospective study of all cases of total abdominal hysterectomy done for benign gynaecological tumours over a four year period. Results: Total abdominal hysterectomy for benign gynaecological tumors accounted for 10.6% of all major gynaecological surgeries for the period under study. The age group of 40 – 44 years contributed 45% of the patients that had total abdominal hysterectomy for benign gynaecological tumours. Uterine fibroid was the commonest indication, accounting for 90.37% of all cases. About 35% of the cases had postoperative complications. There was no mortality recorded.