vol12-issue1-jan-june-15

Ibinaiye PO, Lawan RO, Polite O, Hamidu HU, Igashi B

Background:Structural abnormalities are amongst the important causes of female infertility. Hysterosalpingography (HSG) is an invasive but safe method of detecting both cervical and uterine pathologies. Objectives: The objective of this study was to determine the relationship between types of uterine and cervical abnormalities and fertility outcome. Materials and Methods: A prospective study of 220 consecutive women who underwent hysterosalpingography using ionic water-soluble contrast media (urografin) between 1st December, 2011 and 31st May, 2013, at department of radiology, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Clinical notes and radiological findings were analyzed for demographic data and abnormal uterine cavity and cervical canal findings. Abnormal findings were correlated with treatments and fertility outcomes. Fertility outcome in women with normal and abnormal findings were compared. P- Value of less than 0.05 was considered as statistically significant. Results: The mean age and duration of infertility were 27.37years ± 4.50 and 4.48years respectively. Women with secondary infertility were 133 (60.50%) while 87 women (39.5%) suffered from primary infertility. The uterine cavity was normal in 167 (75.9%) of the women while 53 (24.1%) women had uterine cavity abnormalities; among these were 16 (30%) with primary infertility and 37 (70%) with secondary infertility. Cervical canal was normal in 210 (95.5%) of the women while 10 (4.5%) women had abnormalities among whom are 5 (50%) that suffered from primary infertility and 5 (50%) that suffered from secondary infertility. The fertility outcome after one year follow up showed 7 (11.1%) of the 63 patients with abnormal findings (cervical canal and endometrial cavity) got pregnant, while 25 (34.72%) of the 72 patients with normal findings (cervical canal, endometrial cavity, tubal and pelvic peritoneum) got pregnant. The difference noted was statistically significant (p – value = 0.001). High (12: 34.3%) spontaneous pregnancy rate was noted in patient with normal HSG, hormone and semen analyses. Conclusion: Fertility outcome among women with uterine cavity and cervical canal abnormalities but with normal hormone and semen analyses was low. The high spontaneous pregnancy rate in patients with normal HSG, hormones and semen analyses may be due to therapeutic effect of HSG.

Background:A high prevalence of subclinical hypercortisolism has been suggested in patients with type II diabetes mellitus with poor metabolic control and several observations have suggested that in type II diabetes patients, subclinical hypercortisolism may be more frequent than previously expected, however, results are inconclusive. Objectives: This study investigated the effect of glycemic control on serum cortisol levels in type II diabetics. Materials And Methods: The levels of serum cortisol, fasting plasma glucose and glycated haemoglobin were estimated in fifty five (55) type II diabetic patients attending the Diabetic Clinic of University of Calabar Teaching Hospital, Calabar and thirty three (33) non-diabetic controls. Consecutive sampling method was used. Serum cortisol was determined using enzyme immunoassay; fasting plasma glucose using colorimetric method and glycated haemoglobin using cation-exchange resin separation method. Results: The mean serum cortisol levels were significantly higher in diabetics as compared to the controls. The diabetics with poor glycemic control had significantly higher mean fasting plasma glucose and glycated haemoglobin compared to those with good glycemic control. However, there was no significant difference in the mean cortisol levels between the diabetics with poor control and those with good control. Conclusion: The diabetics in this study had elevated levels of serum cortisol. Cortisol levels in the diabetics were not affected by glycemic control..

ADAMU S , AKINOSUN OM , ABBIYESUKU FM , KUTI MAO , JIBRIL M. EL-BASHIR, OLUWATOYIN GO, ALAYA RO MARAFA B.

Background:Occupational exposure to toxic chemicals is a major public health concern worldwide. Gasoline, especially the leaded form is a leading cause of this occupational exposure in developing countries such as Nigeria. Exposure to gasoline has been shown to generate oxygen free radicals which are implicated in the pathogenesis and progression of many diseases including renal dysfunction. The objective of the study is to evaluate the possibility of increased risk of renal dysfunction among roadside petrol dispensers in Gombe, Nigeria. Objectives: To determine the risk of renal dysfunction among road side petrol dispensers in Gombe. Materials And Methods: A cross sectional analytic study, where serum levels of uric acid, urea and creatinine were compared between 90 road side gasoline dispensers and 90 matched controls. These were measured using standard colorimetric methods. Results: The mean age of the exposed and control groups are 29.03 ± 3.7 and 29.24 ± 3.5 years respectively. The plasma level of uric acid (5.35± 0.9mg/dl) of the exposed group was significantly (p< 0.05) higher than the control (4.48± 0.9mg/dl). There was no significant difference in the plasma levels of urea and creatinine in the two groups studied. Conclusion: This study has shown that road side gasoline dispensers may be at a higher risk of renal impairment. Creating awareness of this risk among roadside gasoline dispensers could help reduce the burden of renal disease associated with exposure to gasoline.

OKHIONKPAMWONYI O & OKONTA PI

Background:Hysterectomy is a common gynaecological surgical procedure which improves womens's quality of life. Objectives: To determine the indications and complications of Total abdominal hysterectomy (TAH) at the Central Hospital, Warri (CHW). Materials and Methods: This was a retrospective descriptive study of TAH performed at the CHW from 1st January 2007 to 31st December 2011. Medical records of all patients that had TAH were reviewed. Results: Two hundred and thirty six patients had TAH. It constituted 11.6 % of all gynaecological surgeries at the CHW. The mean age was 44.78 ± 1.28 years. The mean parity was 3.79 ± 1.08. Uterine fibroids accounted for majority of cases (66.1%). About 54.2% of patients had TAH with bilateral salpingooophorectomy (BSO). Fifty patients (21.2%) had complications. Wound sepsis/breakdown, anaemia, prolonged hospital stay, urinary tract infection and pyrexia were the common morbidities. Conclusion: The indications for, and surgical outcome following TAH is comparable to that from other public hospitals across the country.

ASKIRA BH, WAZIRI MA, MUSA ZY, RIBADU DY, KYARI FA.

Background:Glaucoma is second only to cataract as the leading cause of preventable blindness in the world. The devastating effect of this disease is often neglected. Most people with glaucoma are usually unaware that they have the disease until significant loss of vision has occurred. Objectives: The aim of the study is to establish the level of awareness to glaucoma among staff of University of Maiduguri Teaching Hospital. Materials and Methods: This cross sectional descriptive study conducted as part of glaucoma awareness campaign to mark the World Glaucoma Week. The entire staff of the University of Maiduguri Teaching Hospital that voluntarily consented to the study were recruited. A structured questionnaire was designed and administered in the clinic during the screening exercise. Results: A total of 285 participants were recruited. The ratio of male (M) to female (F) was 1.4:1. The most frequent age group was 40-49. Glaucoma awareness was found to be 60.4% .The sources of awareness of glaucoma were 41.8% from doctors, 29.7% from news media and 14.0% from nurses. A total of 40.7 % know that glaucoma can cause blindness and 32 % know that glaucoma blindness is irreversible. Conclusion: In this study the awareness of glaucoma is high. Further studies to determine the knowledge and adverse affect of glaucoma on vision are advocated.

KOLO ES

Background:Choanal atresia is a rare congenital failure of communication of the nasal cavity and the nasopharynx. The technique for the surgical repair of choanal atresia has evolved from the blind transnasal puncture to the currently favored endoscopic transnasal approach. This study aims at
assessing the technique of endoscopic transnasal choanotomy; and highlight if any its benefits in our practice. This is an on-going study of all consecutive patients with choanal atresia, who had endoscopic transnasal choanotomy at the Otorhinolaryngology department of Aminu Kano Teaching Hospital from January to October, 2014. Four patients were recruited into the study and they all had endoscopic transnasal choanotomy with stenting of the neo- choanae. There were 3 females and 1male and their ages ranged between 12days and 18years. They all presented with varying degrees of persistent nasal obstruction, rhinorrhea and respiratory distress. Diagnostic nasal endoscopy and CT scan confirmed 1 patient had a bilateral membranous type atresia, 1 had bilateral bony atresia and 2 had right sided mixed membranous/bony atresia. Post-operative complications included rhinosinusitis, stent extrusion and granulation tissue formation. Follow ups at various intervals revealed 3 patients had adequate neo-choanal patency and 1 had a restenosis and was re-operated. This study found endoscopic choanotomy safe and effective in the treatment of choanal atresia in our practice

GABKIKA BM, MANGDAH BE, KAIMBA Bm, ADOUM T

ABSTRACT:-Rupture of a gravid uterus is a rare complication of motorcycle accident. We report the case of a 33-year old woman, gravida 6, referred as a case of uterine rupture with intrauterine fetal death at 36 weeks gestation, following a motorcycle accident. Emergency laparotomy revealed an anterior - lateral uterine rupture on the right side about 11 cm which involved the ipsilateral uterine artery. A conservative surgical treatment was employed. Splenectomy was also performed.

PINDIGA UH, ABDULLAHI YM, ADOGU , GUDUF M , TAHIR NM

ABSTRACT:-Collision cancers of the gastrointestinal tract involving lymphomas are very rare. We report a case of collision cancer involving a well differentiated colonic adenocarcinoma and corresponding mesenteric Hodgkin lymphoma. The sentinel lymph node shows metastatic adenocarcinoma however, lymph nodes further away within the mesentery revealed mixed cellularity Hodgkin lymphoma. We want to emphasise that collision adenocarcinoma and Hodgkin lymphoma especially of the mesenteric lymph nodes is a very rare event.

EHALAIYE B, NDONYA-SALEH D, YOHANNA J, KWAGHE BV

Background:A 20 year old para 2, presented at our gynaecological clinic with a 4 year history of “something protruding from her vagina”. She was referred to us with a diagnosis of utero-vaginal prolapse. Examination revealed a 6x6 cm, cystic, anterior vaginal wall mass, which was confirmed to be a vaginal cyst on ultrasound. Surgical excision of the cyst was done and histopathology confirmed it was of mullerian origin. Vaginal mullerian cysts are usually small and asymptomatic, but may rarely enlarge as reported in this case. They are therefore important in the differential diagnosis of utero-vaginal prolapse or cystocele.

IBRAHIM AG, ALIYU S, LAWAN AM, SALIM UM.

Background:Male circumcision is a common surgical procedure that involve excision of the prepuce, which is practiced all over the world for religious and cultural reasons. Medically it has the advantages of preventing phimosis, paraphimosis, balanitis, and decreases the risk of cancer of the penis. Common complications of circumcision are hemorrhage, sepsis, and inadvertent trauma. Excessive unusual bleeding may follow circumcision in hemophilia and other bleeding disorders. We report a case of such bleeding that necessitated transfusion of blood and fresh frozen plasma.