arch-2016-02

BALLA HJ, MUHAMMAD BG, BABA AH,BULAMA AA

Background: Water makes life possible on earth for all living organisms. It is next to air in importance for human existence. All living organisms require a wide variety of inorganic compound for growth, repair, maintenance, and reproduction. Currently, the emergence and proliferation of water vendors using carts with multiple jerry cans in Maiduguri Metropolis is an issue of concern in Public health sectors.
Objectives: The study aimed at ascertaining the microbiological quality of water supplied in jerry cans by vendors in Maiduguri Metropolis.
Methods: Bacteriological analysis was done using multiple tube fermentation technique and parasitological analysis was done using formol-ether concentration technique.
Results: Twenty six samples each of dams and water in jerry cans were analysed microbiologically using multiple tube fermentation test and direct wet preparation using Formolether concentration technique. The bacteria encountered were Escherichia coli, Klebsiella specie, Proteus specie and Coliform. Parasites encountered were cysts of Entamoeba histolytica, Ova of Hookworm and Giardia intestinalis respectively.
Conclusion: Regulatory agencies (both governmental and non-governmental) should intensify their efforts towards providing clean and portable water to the public.

MAIRIGA AG, JIMETA HB, UTHMAN SG, ISHAKU ED

Background: The burden of helminthes infections and their consequent morbidity and mortality continue to attract attention of global health expert and managers. The effect of helminthes infections among pregnant women contribute to increasing maternal and fetal morbidity and mortality.
Aim: The prevalence of intestinal nematode infection was studied among 405 pregnant women attending antenatal clinic at the Sunni Hospital Maiduguri, Maiduguri, over a period of 3 months, from March 2012 to May 2012. Study design: It was a hospital based cross sectional study. Macroscopic, wet preparation and the 2 methods of concentration, i.e., brine (floatation) and formol-ether (sedimentation) concentration methods were used to examine the stool for ova and the larvae of intestinal parasites.
Results: Of the 405 samples examined, one hundred and two (25.2%) women were found to be infected with one helminthes or another. Mean age of participants was 25.3 years. Ascaris infection was found to be most infecting helminthes. The prevalence tended to be more in the age bracket 16 to 30 years, multi-gravidas, and in 2nd trimesters. Although businesswomen were more affected, the effect was not statistically significant.
Conclusion: The study indicated that intestinal helminthiasis was more prevalent among multiparas, aged 16-30 years and in the second trimester of pregnancy. Hence, routine administration of antihelminthics to pregnant women during antenatal visits is recommended.

Background: Since the development of the computer and the evolution of the internet, information communication technology (ICT) has had a positive impact on health care delivery systems worldwide, particularly in the areas of disease control.
Objective: The purpose of this study was to determine the level of utilization of ICT in eye care services, among Nigerian Optometrists.
Method: This was a quantitative cross-sectionalstudy with the use of questionnaires. It was conducted in July of 2014 during the scientific conference and annual general meeting of the Nigerian Optometric Association which was held in Asaba, Delta State. The questionnaire investigated the practice, pattern, use and access to internet.
Results: Three hundred questionnaires were given out and 243 were returned properly filled. Among those who reported gender, there were 42.4% males and 56.4% females. Age of respondents ranged from 25 to 50 years with a mean age of 30 ±2.12 years. Majority of the respondents (86.6%) had access to internet often. Ninety four point two percent (94.2%) of the respondents owned a portable electronic device with internet access. Smartphones were the most commonly owned hand held device (72.9%). The younger age group spent significantly longer hours online per day than the older age group (p = 0.045). Length of time spent online per day was however not dependent on gender. Majority (42.2%), of the respondents used internet for 'personal matters'. Twenty point seven percent (20.7%) of the respondents often communicate with their patients via email. Communication with patients via email was not related to gender (X2 = 3.180, p = 0.204). A total of 47.5% often seek online assistance in patients' diagnosis while 40.9% rarely do so. Facebook (33.0%) and WhatsApp (29.0%) were the commonest social media platforms used. There was no significant relationship between respondents seeking online assistance in patients' diagnosis and gender (X2 = 4.787, p = 0.091) but was significantly related to age (X2 = 21.073, p = 0.021). Seventy percent (70.0%) of respondents researched patients' ailments online. Researching patients' ailment online was not related to gender (X2 = 5.507, p = 0.064) but was significantly related to age (X2 = 20.563, p = 0.024).
Conclusion: Most Optometrists have internet access on their digital devices which they used for both personal and professional matters. However, younger Practitioners were more inclined to use the internet for patient management than the older ones. The gains of ICT can only be fully harnessed in health care, when the majority, if not all professionals, become knowledgeable and are willing to utilize computers and ICT.

BALLA HJ, BULAMA AA, KUTDANG ET, BABAGANA M

BACKGROUND: Urinary schistosomiasis is endemic in Nigeria and continues to pose public health challenges especially in inhabitants of rural areas.
AIM: This study was undertaken to determine the incidence of urinary schistosomiasis among internally displaced persons (IDPs) in Borno State, Nigeria.
MATERIALS AND METHODS: Microscopic examination of the urine samples were employed to determine the presence of S. haematobium eggs. Questionnaires were also administered to consenting participants to collect information on socio-demographic data and water-contact activities.
RESULTS: An overall incidence of 35.5% infection with S. haematobium was observed out of the 200 IDPs examined, among which the age group (11-20) carries the highest prevalence rate of 37(48.7%). Out of the 71(35.5%) tested positive, 39(54.9%) presented with visible haematuria. There is no statistical significant difference between the number of samples tested positive and those tested negative in terms of haematuria as p = 0.543. Males recorded higher prevalence rate of 39.5% than females (28.9%), thus there is a statistically significant difference in prevalence rate between males and females as p = 0.0085.
CONCLUSION: The study draws attention to the health hazards posed by urinary schistosomiasis among residents of Local Government Areas forming the Internally Displaced Persons within the State. Hence, the urgent need for a decisive control intervention to stem this problem cannot be overemphasized.

ABUBAKAR ABDULKADIR

Background: Bladder outlet obstruction (BOO) is globally the foremost urologic disorder that affects all ages. However, the volume and diversity of lower urinary tract lesions causing BOO and warranting inpatient care in our community is unknown.
Objective: To retrospectively review the aetiology, interventions and outcome of BOO admissions at Abubakar Imam Urology Centre Kano as a foundation for further urologic care capacity building and upgrading in Nigeria.
Materials and Method: A three-year retrospective appraisal of all the patients admitted and managed for BOO at Abubakar Imam Urology Center Kano (AIUC). The Information extracted from patient's records included the patient's biodata, diagnosis, intervention, duration of Hospital stay and the outcome. The Data were evaluated using SPSS version 21.
Conclusion: The study revealed benign prostate hypertrophy (BPH) was the most prevalent lesion among the inpatients; its complications and bladder cancer progression are the most common causes of mortality. The study highlighted the need for revamping health planning and capacity development focused on the quartets of greater pleasant outcome, a shorter admission stay, less treatment spending plus patient's satisfaction.

GEIDAM AD, INUSA A, ISA B

Introduction: Although birth spacing is recognised as a major determinant of various infant health indicators, the effect of interpregnancy interval on maternal pregnancy outcomes has received less attention.
Aim: To determine the effect of interpregnancy interval on maternal outcome in our environment after controlling for confounding factors.
Method: A cross sectional study, conducted at the university of Maiduguri teaching hospital. The subjects were multiparous women carrying singleton pregnancy who come to deliver at the hospital Obstetrics and Gynaecology unit during the study period. A pretested questionnaire was used to obtain data which was analyse with SPSS. The effect of birth interval on maternal outcome was determined using multivariate analysis after controlling for confounding variables.
Result: Out of the 1334 participants that fulfilled the inclusion criteria and approached for the study, complete data was obtained in 1188 women; a response rate of 89%. The mean maternal age was 28.7±5.7 years, mean parity 4.3±2.2 and the mean birth interval was 32.9±18.4 months. Short birth interval was found to be associated with high parity OR (95%CI) =1.559(1.150-2.113), preterm delivery OR (95%CI)= 2.462(1.518-3.994) and development of anaemia in pregnancy OR (95%CI) =1.77(1.058-2.959) while long birth interval was associated with development of hypertension in pregnancy OR (95%CI) = 3.001(1.734-5.195) and delivery by caesarean section OR (95%CI) = 4.884(2.499-9.546)
Conclusion: Short birth interval was associated with higher parity, anaemia and preterm delivery while long birth interval was associated with hypertension and caesarean section.

Background and Objective: Endometrial cancers occur globally with wide geographical variation in prevalence and histopathological pattern related to the level of socioeconomic development in the society. The objective of this study was to determine the age, frequency distribution and histopathological spectrum of endometrial cancers in Kano, North-western Nigeria.
Materials and Methods: This was a 5-year retrospective study from 2nd January, 2011 to 31st December, 2015 of all endometrial cancers diagnosed at the pathology department of Aminu Kano Teaching Hospital, Kano, Nigeria.
Results: Forty-one cases of endometrial cancers were diagnosed during the five-year study period. The ages range from 32 to 80 years (mean age of 56.5 years) and relative peak age of incidence occurring in the 51 -60 years group. Carcinomas accounted for the majority (32 cases, 78%) of endometrial cancers distantly followed by malignant mesenchymal tumours (7 cases, 17.1%), while theremaining 2 cases (4.9%) were malignant mixed Mullerian tumours. Most lesions were Grade 2 or 3.
Conclusion: Malignant tumours of the endometrium are relatively uncommon in Kano afflicting people in the sixth and seventh decades, which were similar to most published reports in Nigeria and sub-Saharan Africa but at variance with the developed world where endometrial cancer is the most common invasive cancer of the female genital tract. Higher histological grades characterize our patients hence the need to control modifiable risk factors like sedentary life style, obesity and oestrogen usage.

BUKAR A, OBI SO, DIGBAN KA, WAZIRI G, MEDUGU JT, GEIDAM UM, AUDU N, OSAKUE EO, PEYOU GAB, OLANIYAN MF, JEREMIAH ZA.

Background: Hepatotropic virus infection, such as Hepatitis C Virus (HCV) infection is altering the gains of highly active Antiretroviral therapy HAART; and rapidly increasing non-AIDSrelated mortality in people living with HIV disease.
Aim: This warranted the investigation of some biochemical indices in a Cohort of 94 HIV Seropositive Subjects, out of which 11 were co-infected with HCV. Controls consisted of 80 subjects Seronegative for HIV and HCV antibodies.
Method: We analysed Aspartate Transaminase (AST), Alanine transaminase (ALT), Alkaline Phosphatase (ALKP), Creatinine, Total Cholesterol (TCH), Random Blood Glucose (RBG) and Potassium (K+) in the HIV, HIV/HCV and HCV subjects and the controls.
Result: The liver enzymes mean values (AST, ALT, ALP) were significantly higher in the HIV/HCV subjects compared to the HIV, HCV mono-infections and the controls (P<0.01). Similarly, Creatinine mean value was also higher in the HIV/HCV compared to the other studied groups (P< 0.001). Total cholesterol (TCH) and potassium (K+) were incomparable in the studied groups (P> 0.05). Conversely, random blood glucose showed a significant difference in the mean values with the highest value registered in the HIV/HCV subjects (P<0.05).
Conclusion: HIV/HCV Co-infection may worsen the biochemical profile in HIV setting, and may increase non-AIDS-related morbidity and mortality in people living with HIV disease. Understanding the scope of this phenomenon, in addition to rapid interventional measures may be necessary to ameliorate its impact.

Background: Implanon is an implantable, subdermal rod-shaped contraceptive device designed to provide a long acting contraception for up to three years.
Aim: to determine Implanon acceptance and socio-demographic characteristics of women accepting it.
Materials and methods: a retrospective study was carried out in the family planning Unit, Bauchi Teaching Hospital, Nigeria, between January 1, 2010 and December 31, 2013. The records of the clients from the family planning clinic were studied. Socio-demographic characteristics, years of distribution and source of information were analyzed using SPSS Version 20 software.
Results: Of the 4091 acceptors of contraception, 601 had Implanon representing 14.7% of the acceptors. The age range was 20 to 45 years, with mean age of 24.4±3.6 years. Most of them 518(86.2%) were aged 20-34 years. All the acceptors were married. Many 476(79.2%) of the clients were multiparous. Majority 242(40.3%) of the clients had 2-3 living children and about 481(80.0%) had secondary education. Five hundred and sixty three clients (93.7%) desired more children after discontinuation of Implanon. Some of them 38(6.3%) weighed more than 80 kg. The main source of knowledge of Implanon was clinical personnel 462(76.9%). Mass media constituted the least source of information 76(12.6%).
Conclusion: Implanon is an acceptable method of contraception among our women

Background: The knowledge, attitude and practices of patients which may influence the treatment outcomes are often given poor attention.
Aim and Objectives: The objectives of the study was to assess gaps in patients' knowledge about diabetes mellitus, the information conveyed to them by health care professionals as well as their compliances to lifestyle modification, medical and medication instructions.
Materials and Method: Cross-sectional and prospective design through questionnaire was adopted for the study. Information regarding demographic data; medical and social history of the patients, the knowledge about diabetes; dietary intake; exercise; diabetic complication; glucose measurement and medication were obtained. Oral interviews were used to enhance information collection in those with low literacy levels.
Results: The proportion of patients with knowledge on diabetes as a disease, benefits of exercise and uncontrolled diabetes mellitus were 78.9%, 70.6% and 68.9% respectively. The knowledge in other areas are high cholesterol levels (22.8%), cigarette smoking(30.6%), alcohol intake (26.1%), ocular complications (42.8%), foot care(38.3%), sugar in urine (45.0%), medication side effects (37.2%), comorbid diseases (46.7%), ocular complications (42.8%) and high blood pressure (43.5%). The ability to recognise signs of hyperglycaemia and hypoglycaemia were 90.6% and 30.0% respectively. Only about 18.3%, 24.4% and 38.3% regularly check their cholesterol, eye and foot respectively. About 86.1%, 92.8%, 91.7% and 75.3% respectively check blood pressure, sugar levels, and compliant with medication and dietary schedules.
Conclusion: The proportions of patients having knowledge in areas of exercise, diabetes as disease and problems of poorly controlled DM were above average while those having knowledge on lifestyle modifications or risk factors (cigarette smoking, alcohol intake, high BP and high cholesterol levels), ocular complication, foot care and sugar in urine were below average. Majority of patients have received information or education on high glucose levels in the blood and urine, medication compliance, exercise, dietary issues and food schedule but information on low sugar levels, shoes to wear/foot care and glucose home monitoring were lacking in majority of patients. The ability to recognise the signs/symptoms of hyperglycaemia, compliances with medication, regular exercise, and dietary compliances were generally high. Many patient-focused areas of care need improvement upon in the care of the diabetes patients.

Background: To compare the postoperative analgesia and complications of caudal block and dorsal penile nerve block in children aged 1- 5 years for day case circumcision.
Method: This was a prospective randomized double blind study of paediatric patients aged 1-5 years, who had day-case circumcision at Federal Teaching Hospital, Gombe. Group A had caudal block with 0.5% plain bupivacaine and group B who had dorsal penile nerve block (DPNB) with 0.5% plain bupivacaine. Post-operative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). Patient's age and complications, average pain score, time for the first postoperative analgesia demand and total analgesics consumed in 24 hours were recorded and analyzed.
Results: A total of two hundred and nine (209) patients completed the study, made up of 107 and 102 in group A and B respectively. There was no significant difference in block success rate between the two groups (p = 0.34). Group A had significantly lower average CHEOPS pain score in the immediate postoperative period than the Group B p = 0.02. Group A consumed significantly lower number of paracetamol doses than group B (p = 0.05). There was no significant difference in the incidence of postoperative vomiting between the two groups. The caudal block group had fewer complications than dorsal penile nerve block.
Conclusion: It has shown that caudal block has a higher success rate, better postoperative analgesia and fewer complications than dorsal penile nerve block in children aged 1- 5 years for day case circumcision.