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REVIEW ARTICLE
Retrospections on road traffic injuries as a social burden: The role of public health education initiatives in a developing country
Dim Edwin Maduakonam, Dim Uchenna Miriam, Nwashindi Arthur
April-June 2015, 24(2):169-174
BACKGROUND Road traffic injuries are a major cause of trauma related morbidity and mortality in our modern society.They have since been recognized as disease entities on their own, as well as a societal problem of serious public health concern. AIM The aim of this review article is to promote the understanding of road traffic injuries as both a social burden and a disease entity and to highlight suggested measures capable of curtailing the menace that these injuries pose to human population. METHOD A review of the literature on the subject of road traffic injuries as both a social problem and disease entity was done. Historical perspectives, epidemiological information, causative factors and preventive measures were extracted and presented. RESULT Human factors contribute to 95% of road traffic accident. Current deaths from road traffic injuries account for 2.2% of th global mortality affecting all age groups. Health education and enforcement of legislation are key measures in combating road traffic injuries.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Persistent catatonia in a pregnant Nigerian woman: A case report
NC Aghukwa, MG Takai
April-June 2015, 24(2):179-182
BACKGROUND The syndrome of catatonia appears to exist with many conditions, yet goes undetected by the skillful eyes of clinicians. This case which is rarely reported in literatures shows the effectiveness of antipsychotic augmenting in a persistent catatonic schizophrenia disorder. METHOD This is a case narration of persistent catatonia in a 24-years old pregnant Nigerian woman with schizophrenia disorder. RESULTS First line management with benzodiazepines and electroconvulsive therapy (ECT) failed to resolve the syndrome which later responded to Electroconvulsive Therapy with low dose antipsychotic augmentation. CONCLUSIONS Cautious augmenting of electroconvulsive therapy with neuroleptics may be a quick and relatively safe procedure in the relief of schizophrenia with catatonia in pregnancy.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Assessment of knowledge and sexual behaviour among undergraduates in a Nigerian tertiary institution
EF Osagiede, E Tobin, SO Abah, NS Awunor, FA Ehimen
January-March 2016, 25(1):78-85
BACKGROUND AND INTRODUCTION: The achievement of the Millennium Development Goals (MDGs), particularly goals 5 and 6, is strongly underpinned by the progress that can be made on sexual and reproductive health education of young adults. The large population of young single adults in tertiary institutions in Nigeria and the present dearth of human resources for health necessitates that interventions for this group of individuals are tailored to meet identified gaps in awareness and sexual behaviour. This study sets out to assess the sexual behaviour and practice among single-undergraduates in a tertiary institution in Nigeria. METHOD: A descriptive cross sectional study was carried out among 410 consenting students selected through a multistage sampling method. Data was collected using a structured self- administered questionnaire and analysed using Statistical Package for Scientific Solutions (SPSS) version 16.0. RESULTS: Mean age of respondents was 20 + 4.4 years, 228 (55.6%) were females and 182 (44.4%) males. The respondents' awareness of contraceptive devices was 81.7% (335) for condoms and less than 20% knew about other forms of contraception such as intrauterine device, tubal ligation and vasectomy. Over 65.7% (270) opined abstinence and use of condom to be the ideal methods for prevention of HIV/AIDS/ STI transmission. The overall mean age at first sexual contact was 14.0+1.4((14.2+1.6) in males and (13.8 +1.2) in females). A Very high proportion of sexually active respondents (93.6%) volunteered they do not routinely use condom in their sexual encounter. Undesired pregnancies occurred in about 11% of females. RECOMMENDATIONS: There is an urgent need for the establishment of specially designated youth friendly centres in the tertiary institutions in the country, manned with staff appropriately trained in the delivery of reproductive health information and services.
[ABSTRACT]   Full text not available  [PDF]
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Prevalence of sickle cell gene among apparently healthy under-two South-East Nigerian children: What is the role of parental premarital counselling and socio-demographic characteristics? A pilot study
Okocha Chide, Onubogu Chinyere Ukamaka, Aneke John, Onah Christian, Ajuba Ifeoma, Ibeh Nancy, Egbuonu Ifeoma
April-June 2016, 25(2):176-181
OBJECTIVE: This cross-sectional descriptive study examined the role of parental premarital counselling and socio-demographic characteristics on the prevalence of sickle cell gene among 82 apparently healthy under-two children. METHODS: Subjects were recruited from under-two children attending child welfare clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East, Nigeria. RESULTS: More than half of their mothers were aware of their hemoglobin phenotype (64.6%) and that of their husbands (53.6%). In about half of the families (52.4%), the parents had a premarital counselling intervention against sickle cell disease (SCD). Among the 44 families where parents were aware of their phenotype before marriage, only one couple (2.3%) was at risk of having an offspring with SCD. None of the subjects had SCD and the prevalence of sickle cell trait (SCT) among them was 22%. Premarital counselling intervention in families seemed to increase the prevalence of SCT when compared to those not counselled but this was not statistically significant (p = 0.30). The lower prevalence of SCT among children of more educated women suggests that educational status may affect the distribution of the sickle cell gene in the population. CONCLUSION/RECOMMENDATION: Premarital counselling and screening may be effective in reducing the prevalence of SCD but the higher prevalence of SCT among the population where this intervention occurred portends an ominous sign for the future. Integration of malaria eradication and competent genetic counselling, with avoidance of discrimination against people with SCT or SCD, into screening programmes are essential for reducing the burden and impact of SCD.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
A case of pica following a paramilitary pre-employment orientation camp
SP Ogundeji, C Akunwata, O Aworanti, YA Aken'Ova
April-June 2015, 24(2):183-185
BACKGROUND Pica is an unusual craving for and ingestion of either edible or inedible substances first observed in pregnant women but has been reported in all groups of people. Pica poses a significant health risk that often requires medical attention but the awareness of pica among physicians seems to be have reduced. METHOD We report a case study of a young lady who presented with anaemia (pcv=21%) and craving for sand. Laboratory investigations carried out were in keeping with iron deficiency anaemia. CONCLUSION It is therefore postulated that pica may actually be a sign of iron deficiency anaemia.
[ABSTRACT]   Full text not available  [PDF]
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Emergency inevitable caesarean myomectomy, challenge to obstetrician/ gynaecologist: A case report
S Eli, DG B Kalio, DS Abam, K Onumbu, DK O Pepple, HA A Ugboma
April-June 2017, 26(2):185-187
BACKGROUND: Caesarean myomectomy is not routinely done by Obstetricians/Gynaecologists due to associated complications and increased risk of maternal morbidity/mortality.The incidence of fibroid in pregnancy varies from 1.6% to 10.7% globally. AIM: To present an uncommon management modality. +0 CASE REPORT: Mrs BD is a 34-year-old unbooked G1 Para 0+0 at 3 weeks' gestation who presented on selfreferral from a maternity with complaints of increasing abdominal pain and breathlessness of 1day duration. Examination at presentation revealed fundal height of 44cm, intra-abdominal mass consistent with huge uterine fibroid extending from the fundus to the lower segment, oblique-lying foetus with normal heart tones. Obstetric ultrasound done on admission were in keeping with above clinical findings with uterine fibroid measuring 22cm by 20cm. She was billed for elective caesarean section but went into labour which necessitated an emergency caesarean section with delivery of a live male baby, birth weight 3.2kg and myomectomy for uterine fibroid at the lower uterine.The estimated blood los was 800mls,She had a unit of blood intra-operatively. Her post-operative period was uneventful. She was counselled on the extent of the surgery including her future fertility and family planning.She was discharged home on her 7th post-operative day in satisfactory clinical condition. CONCLUSION: Caesarean myomectomy may be a hazardous surgical procedure to the attending Obstetrician/Gynaecologist. However,adequate pre-operative preparation,the skill and speed of the surgeon may help improve maternal /perinatal outcome.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Digital habits and use of the internet as source of sexual and reproductive health information among undergraduates in northern Nigeria
Z Iliyasu, AY Mohammed, AU Gajida, AM Jibo, MH Aliyu
April-June 2017, 26(2):138-145
BACKGROUND: Surfing the internet and networking via social media have evolved at a startling pace. OBJECTIVES: To determine internet and social media habits and identify predictors of their use as sexual and reproductive health resource among Bayero University students. STUDY DESIGN: A cross section of 385 students was interviewed using pre-tested anonymous structured selfcompleted questionnaires. RESULTS: Nearly all students 98.4% (n=377) had accessed the internet and most 96.3% (n=363) had visited social media sites.Face book 57.3% (n=208),Twitter 22.3% (n=81) and Blackberry Messenger 8.8% (n=32) were the most popular among students.Of those with internet access, 51.2%, 46.2%, 39.2% and 38.5% mainly searched for information on HIV/AIDS, STI, sexual activities and menstrual problems respectively. There was more than twofold likelihood of accessing online sexual information among female students compared to males, adjusted Odds ratio (aOR=2.52); 95% Confidence Interval (95%CI= 2.41-4.86). Similarly, ever-married students had more than twice the chance relative to single students (aOR=2.2, 95%CI=1.17-4.28). Furthermore, younger students (<20 years) were twice more likely to have used online resources compared to their older colleagues (=30 years) (aOR=2.12,95%CI=1.32-4.17). CONCLUSION: Undergraduate students are increasingly turning to the internet for sexual and reproductive health information.This presents an opportunity for programming.
[ABSTRACT]   Full text not available  [PDF]
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Aetiology and pattern of bone and joint infection presenting at a regional orthopaedic hospital
UE Anyaehie, OA Lasebikan, II Orikpe, KC Eze, TO Ikpegbu
April-June 2017, 26(2):128-131
BACKGROUND: Bone and joint infection is one condition that can either be rewarding,or a night mare to the surgeon.This work reports the auses and pattern of presentation of bone and joint infections in our sub region. METHOD: A retrospective review of 73 cases of non granulomatous bone infection seen over two years fromJanuary 2012 to December 2013 was done. Patients' biodata,complaint,time to presentation in the hospital and if any intervention by the traditional bone setters, limbs involved, primary cause, diagnosis, organism cultured and retroviral status were obtained from the folders.Results:Commonest age group involved was in the second decade with 21.9%. Male to female ratio is 2.2:1. Chronic osteomyelitis was the commonest infection with 46.6% (34 patients) followed by septic arthritis with 26%.The lower limb was more involved than the upper limb with a ratio of 5.6: 1.A significant number of patients 59 (80.8%) presented more than two weeks after onset of symptoms while 27 patients (36.9%) visited the traditional bone setters for treatment before presenting to the hospital. Staphylococcus aureus was the commonest organism isolated. CONCLUSION: Chronic osteomyelitis is the commonest bone and joint infections in our environment mainly from trauma and closely followed by improperly treated haematogenous acute osteomyelitis.Acute osteomyelitis is a rare occurrence as late presentation and patronage of traditional bone setters is rife.
[ABSTRACT]   Full text not available  [PDF]
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Clinical practitioners' knowledge of ionizing radiation doses in diagnostic radiology examinations in calabar
NO Egbe, DU Eduwem, OE Ukweh, CH Odumegwu
April-June 2016, 25(2):147-151
BACKGROUND: Observation has shown a preponderance of irrelevant, unjustified and perhaps unnecessary radiological requests in the study area. The consequences of this on the patients' doses and population collective dose may be dire. OBJECTIVE: To assess Clinicians/Referrers' knowledge of radiation doses of patients undergoing radiological examinations. METHODOLOGY: A prospective, non-experimental, cross-sectional survey of clinicians (except radiologists) in various hospitals in Calabar metropolis, Cross River State, Nigeria, was conducted. A pretested and validated questionnaire was designed to extract responses on rating of effective doses for commonly requested imaging examinations, using the value for the posterior-anterior (PA) chest x-ray as reference. Questions on radiosensitivity of different organs, imaging modalities that use ionizing radiation and considerations for the choice of ionizing radiation (IR) based examinations were included. Participants were also asked for their preferred methods of filling any knowledge gap on IR issues. Responses were presented in simple percentages. RESULTS: A total of 104 respondents, made up of 63.5% males and 36.5% females participated in the study. At least 70% and 42% of the respondents, respectively, were aware that Ultrasound and Magnetic Resonance Imaging were not IR based modalities. About 67.3% of the respondents did not know the doses of commonly requested radiological examinations. This result was not dependent on clinicians' demography. A total of 61.5% of the respondents referred patients for IR examinations even when the result was unlikely to alter their diagnosis or treatment; but to reassure the patient (98.8% ), meet expectations of patients (35%) or to give the patient the feeling of being taken seriously (75%). CONCLUSION: Participating Clinicians in this study have showed poor knowledge of radiation doses of commonly requested radiological examinations. Most participants suggested improvement of their knowledge of radiation doses through continuous medical education and by the provision of referral guidelines.
[ABSTRACT]   Full text not available  [PDF]
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FEV1, FVC, FEV1/FVVC As predictors of rhinitis among saw mill workers in North Central Nigeria
Jacob Amos Dunga, Nura Hamidu Alkali, Yakubu Mamman Adamu, Sule Bathna, Yerima Suleiman, Christian Ukoli, Jafiada Jacob Musa
April-June 2016, 25(2):152-158
BACKGROUND: Rhinitis is one of the commonest occupational related respiratory disorders that is only restricted to the upper airway but can involve the lower respiratory tract with considerable airflow limitation, this study was conducted assess the ventilator function of persons exposed to saw dust with rhinitis symptoms METHODS: This is a cross sectional study carried out among 200 randomly selected saw mill workers and 200 healthy staff of Jos University Teaching Hospital staff in Jos metropolis from September to November 2008. Data on sociodemographic variables, symptoms of rhinitis, etc was obtained using a modified semi structured British medical research council questionnaire while respiratory function data was measured using aspirometry RESULT: A total of 400 responds comprising of 200 saw mill workers and 200 controls participated in this study. Based on diagnostic criteria. 43% of the subjects fit into diagnosis of rhinitis, 33% had asthma symptoms and 24 % did not fit into any category compared to none of < 5%of the control group. The ventilatory function based on FEV1, FVC, FEV1/FVC ratio and PEFR showed a significant decline when matched with controls and predicted value, suggesting an airflow limitation among the rhinitis group. CONCLUSION: Rhinitis associated with wood dust exposure is not restricted to airway but involves the entire respiratory tract with airflow limitation as one of its consequences.
[ABSTRACT]   Full text not available  [PDF]
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An evaluation of intra-operative and post-operative blood loss in total knee arthroplasty at the national orthopaedic hospital, Lagos
ME Ugbeye, WO Lawal, OJ Ayodabo, IP Adadevoh, IJ Akpan, U Nwose
April-June 2016, 25(2):159-163
BACKGROUND: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this study was to evaluate blood loss after total knee replacement PATIENTS AND METHODS: A prospective study of blood loss after Total Knee Arthroplasty in 53 patients in the National Orthopaedic Hospital, Lagos. Consecutive patients with established indications, presenting for total knee arthroplasty were recruited into the study after obtaining their consent. RESULTS: The mean intra-operative blood loss was 342.4 mls, with a range of 50 - 1500 mls. The mean post-operative blood loss and total blood loss were 603.6 mls and 940.3 mls respectively, showing a strong positive correlation (r = 0.884, p < 0.01). The average pre-operative and post-operative haemoglobin concentration were 12.5 ± 1.2 g/dl and 9.8 ± 0.9 g/dl, respectively. The mean haemoglobin loss was 2.6 ± 1.2 g/dl (r = 0.46, p < 0.001). CONCLUSION: Post-operative blood loss as measured by suction drainage, is a good predictor of total blood loss, showing a strong and positive correlation.
[ABSTRACT]   Full text not available  [PDF]
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Effect of education and training on patient referral by public primary health care workers in mushin local government area to state general hospitals
Adetunji Labiran, Bayo Onajole, Oladimeji Adebayo, Ifeanyichukwu Obi, Paul West Okojie, R Okupon, Emmanuel Olukoya, Leslie Omoruyi
April-June 2016, 25(2):164-175
BACKGROUND: Poor referral linkages had been noted and documented by various researchers on the health care delivery system in Nigeria. This study is designed to find out the situation of referral practices and make recommendations on how to improve the situation. MATERIALS & METHODS: A quasi-experimental study was carried out to determine the effect of health education and training on the Knowledge, attitude and practices of patient referral by primary health care workers in Mushin and Surulere Local Government Areas of Lagos State of Nigeria. A total sample of 170 primary health care workers was involved in the study: 85 in each of the Local Government Areas. The study involved three stages, the pre-intervention, the intervention phase, and a post intervention phase of the study. RESULTS: Analysis of the responses of the two groups showed that there was no statistically significant difference in the responses in the areas concerning their attitude towards, and knowledge of patient referral at the pre-intervention phase. In the post-intervention phase the differences in the responses between the two groups in the area of practice of patient referral were statistically significant. In the control group 18.8% of the workers used the two-way referral form in the pre-intervention phase. This rose to 27.1% in the post intervention phase. In the experimental group, 17.5% used the two-way referral form in the pre-intervention phase, and this rose to 69.4% in the post intervention phase. CONCLUSION: The conclusion was that education and training on patient referral could improve the patient referral activities of primary health care workers.
[ABSTRACT]   Full text not available  [PDF]
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Control and prevention of cholera transmission in low resource clinical setting
Owoeye David, Adebayo Oladimeji
January-March 2018, 27(1):14-19
DOI:10.4103/1115-2613.278225  
INTRODUCTION: Cholera is a serious Public Health Emergencies of International Concern (PHEIC). The recurrence of outbreaks depicts lack of appropriate control and prevention, thereby contributing to high morbidity, mortality and socioeconomic burden. The clinical setting, aside from treatment of the infected, plays a big role in the ultimate prevention and control of the disease. AIM: This article highlights the necessary prevention and control practices in low-resource clinical settings. METHODOLOGY: We extracted relevant articles from various databases such as PubMed, Google Scholar and African Journal Online(AJOL) and summarized them. RESULT: Cholera caused by the organism, Vibrio cholera is of great global burden and majority of cases are in poor and low resource setting like Nigeria, where there are challenges with water supply and sanitation. The key preventative and control strategy in clinical setting include clinical and administrative policy toward cholera prevention and control, rapid case identification, compliance with Standard Precaution, adoption of Transmission Based Precautions for patient isolation, contact tracing and treatment, effective case referral system, cholera education and enlightenment of health workers and the community. CONCLUSION: With the current wave of cholera in many countries, there is need for health practitioners to upgrade their skills in both clinical and infection prevention and control practices.
[ABSTRACT]   Full text not available  [PDF]
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Prevalence of obesity and ethno-geographic variation in body sizes of Nigerians with type 2 diabetes mellitus - A multi-centre study
WO Balogun, AE Uloko, A Ipadeola, O Enang, AN Adamu, BM Mubi, CI Okafor, I Odeniyi, IU Lawal, JO Adeleye, OA Fasanmade
January-March 2018, 27(1):69-77
DOI:10.4103/1115-2613.278232  
BACKGROUND: Excess weight gain is common in people with type 2 diabetes mellitus (DM) but little is known about its ethno-geographic variation among the Nigerian populace. We aimed to report the prevalence and regional variation of overweight/obesity among subjects with type 2 DM in all the six geo-political regions of Nigeria. METHOD: Basic demographic and anthropometric data were consecutively collected from patients with type 2 DM attending out-patient clinics of seven designated teaching hospitals in the six geographic regions of the country using a pre-agreed method of measurement of anthropometry including waist circumference. The study was hospital-based descriptive cross-sectional in design. Body Mass Index (BMI) was categorised using the WHO criteria. Based on recommendations of the International Diabetes Federation (IDF) cut-off values for waist circumference, values >94 cm and > 80 cm were taken as abnormal for men and women respectively. RESULTS: A total of 709 subjects with DM comprising 378 (53.3%) females and 331 (46.7%) males (female: male ratio 1:1.14)with an overall mean age (SD) of 51.9 (13.9) years were evaluated. The prevalence of excess body weight among Nigeriansubjects with type 2 DM was: peripheral (417 or 58.8%) and abdominal obesity (449 or 63.3%). Also, there was a significantwide variation in excess weight gain (both peripheral and central) across ethno-geographic regions (p=0.001) and between both sexes (p=0.001). In both peripheral and abdominal obesities, whether intra or inter centres, the female subjects with type 2 DM demonstrated relatively higher proportions of anthropometric measures. Generally, subjects from south-south and south-east Nigeria had higher BMI and abdominal obesity compared to those from south-west who had the lowest. The female subjects with type 2 DM were heavier peripherally and centrally compared to their male counterparts. CONCLUSION: The prevalence of peripheral and central obesity among Nigerians living with type 2 DM (especially the female subjects) is unacceptably high. Additionally, there is a wide variation in the proportion and absolute values of both peripheral and central obesity across different parts of Nigeria.
[ABSTRACT]   Full text not available  [PDF]
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Predictors of lower extremity amputation among patients with diabetic foot ulcer in a tertiary health facility in North Central Nigeria
M Enamino, G Odoh, JN Uwakwe, FH Puepet
January-March 2018, 27(1):92-96
DOI:10.4103/1115-2613.278236  
INTRODUCTION: Diabetic foot ulcer is a complication of diabetes mellitus of great public health importance. It has the potential of leading to the dreaded sequelae of lower extremity amputation. This outcome is associated with significant morbidity and mortality, hence the need to explore its predictors among persons with diabetic foot ulcers. METHODOLOGY: The study involved the review of the medical records of seventy (70) in-patients who had received treatment for diabetic foot ulcer at the Federal Medical Centre, Keffi, North Central Nigeria. In addition to obtaining sociodemographic and medical history, information on the Wagner grade of the ulcer, the presence of peripheral sensory neuropathy (using the 10g monofilament) and the presence of osteomyelitis (using plain X-ray of the foot) were obtained and documented. The prevalence rate of lower extremity amputation was also determined. RESULTS: The study population comprised 52.9% males and 42.1% females. The mean age for male and female participants were 53.4±10.5 and 58.8±13.0 years respectively ( t = 2.35; p = 0.061). Majority of study subjects (37.1%) had Wagner grade 2 disease. Prevalence rate of amputation was 38.6%. Among the potential predictors of lower extremity amputation analyzed (Age, sex, foot care education, duration of diabetes, cigarette smoking, walking bare feet, impaired vision, peripheral neuropathy, hypertension, previous foot ulcer, osteomyelitis), none of them demonstrated a significant association with lower extremity amputation. CONCLUSION: The list of potential predictors of lower extremity amputation considered in this study is by no means exhaustive. More studies involving larger study populations and other potential predictors of lower extremity amputation not considered in this work (such as peripheral artery disease and glycated haemoglobin) are encouraged.
[ABSTRACT]   Full text not available  [PDF]
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An appraisal of retained placenta at the university of port harcourt teaching hospital: A five-year review.
CO John, N Orazulike, J Alegbeleye
April-June 2015, 24(2):99-102
BACKGROUND Retained placenta is associated with an increased risk of maternal morbidity and mortality especially in developing countries. OBJECTIVE To determine the incidence and evaluate the mode of presentation, risk factors and method of treatment of patients with retained placenta. METHODOLOGY A retrospective review of retained placenta managed at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt over a 5 year period (January 2009 to December 2013). Data obtained were analyzed using statistical software SPSS 17.0. RESULTS There were 93 cases of retained placenta out of 15,789 deliveries, giving an incidence of 0.59%. 85 patients' case records were available for analysis. Majority of the patients 69(81.2%) were unbooked (had no antenatal care) with 60(70.6%) having home deliveries.Previous history of dilatation and curettage and preterm deliveries,accounted for the major identifiable risk factors at 55(64.7%) and 22(25.9%) respectively. At presentation, 22(25.9%) were in hypovolemic shock. Manual removal of the placenta was the commonest treatment modality (87.1%).There was one maternal death giving rise to a case fatality rate of 1.18%. CONCLUSION Retained placenta is a major cause of maternal morbidity and mortality from postpartum haemorrhage and other complications related to its removal. The incidence can be reduced by antenatal care, skilled birth attendance and provision of emergencyobstetrics care services.
[ABSTRACT]   Full text not available  [PDF]
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Epidemiology of diabetes and impaired fasting glucose in a rural community of Nigerian niger delta region
CA Alikor, PC Emem-Chioma
April-June 2015, 24(2):114-124
BACKGROUND The prevalence of diabetes mellitus is reaching epidemic rates globally. It had an estimated global incidence of 220 million in 2010. Different studies in SSA and Nigeria in particular have reported increasing prevalence of diabetes in the rural areas. This may be attributed to the rapid 'westernization' of lifestyle in the rural African community. Only few rural survey have been conducted in the Nigeria oil-rich Niger Delta region necessitating this study with the aim of determining the prevalence of diabetes and impaired fasting glucose (IFG). METHODS This was a cross-sectional survey involving 500 subjects aged 15 years and above in a typical rural community of Rivers State,Niger Delta region of Nigeria. A questionnaire administered by face-to-face interview was used to assess socio-demographic characteristics of the subjects. Medical history such as prior knowledge of blood sugar status and family history of diabetes were all elicited by the questionnaire. Anthropometric and blood pressure measurements were taken in a standardized manner and body mass indices (BMI) calculated as weight in kilogram divided by the square of height in meters. Venous blood glucose was measured by the glucose oxidase method. Diabetes mellitus was defined using fasting plasma glucose (FPG) ≥7.0 mmol/l (126 mg/dl) and individuals who were previously known to have diabetes based on history of treatment were also classified to have diabetes. Lipid profile and uric acid of patients were also checked. RESULTS There were 156 males and 344 females with male to female ratio of 1:2.3.The females were relatively of younger age than the males (40.62±16.6 years versus 42.84±17.8).The overall mean age was 41.32±17.The mean fasting plasma glucose among those with diabetes was 11.14±4. 00mmol/L while the mean for the subjects with impaired fasting glucose was 6.31±0.25mmol/l. The prevalence of diabetes was 2.2% with no significant gender difference (2.6% in males versus 2.0% in females;X2=0.35;p=0.84). The prevalence of Impaired fasting glucose (IFG) was 2.4% with no significant gender difference (Female 2.6% versus males 1.9%;p=0.88). The mean fasting glucose increased significantly with blood pressure (p=0.05),waist circumference (p<0.001),uric acid level (0.02), triglyceride level (<0.001) and age (p= 0.02).The correlation analyses showed that age, systolic blood pressure, waist-hip-ratio and triglycerides are positively correlated with diabetes and impaired fasting glucose in this study. CONCLUSION There is a low prevalence of diabetes and IFG in this rural community which may be associated to the high level of physical activity found among the study subjects in this community. However, this study confirmed that increasing age, abdominal obesity, systolic blood pressure and triglyceride level have positive relationship with the prevalence of diabetes and IFG.There is hence more need for intensified screening for diabetes,pre-diabetes and associated risk factors in order to curb or at least reduce diabetes prevalence and its attendant complications.
[ABSTRACT]   Full text not available  [PDF]
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Tuberculosis control in security challenged states of North-East Nigeria. Are there significant impact?
M Gidado, JO Obasanya, J Onazi, R Eneogu, N Chukwueme, K Joseph, S Useni, AO Adejumo
April-June 2015, 24(2):155-161
BACKGROUND Nigeria in the past few years is faced with various security challenges in different parts of the country. The most severe in the last three years has been the crisis in northern Nigeria and specifically the north-eastern States, where three of the States have been under emergency rule for a year. Health care delivery system is usually one of the major casualties in a security challenged environment leading to unavailability or low utilization of services. The aim of this paper is to share the experience of TB services in states under emergency rule. METHODOLOGY A retrospective review of program data (reportable indicators for TB case finding,TB/HIV and treatment outcome for periods of eight years (2006-2013) comparing national data with north-east and the three states most affected by security challenges (Borno,Adamawa &Yobe). RESULTS A national positive trend on case notification for all forms of TB and smear positive, with a declined in 2011 but generally the case notification has remain low (59/100,000 in 2013 compared to estimated prevalence of 338/100,000). North east data is a negative trend for case notification and this is worse for 2 states (Borno and Yobe) while Adamawa shows and increase CNR from 2012 because of TB Reach active case finding. Treatment success rate has a positive trend both national,north east states and in the 3 challenged states (TSR above 84%).TB/HIV indicators for north east are 81%, 75%, and 58% for HCT, CPT and ART respectively, these figures has serious fluctuations within and among the three security challenged states with Borno most affected. CONCLUSIONS Insecurity can pose a challenge for TB control activities especially case finding, therefore the need for innovative approaches for case finding in areas of insecurity. Chronic infectious diseases like TB and HIV should be incorporated into emergency responses offered by organisations and agencies for internally displaced persons.
[ABSTRACT]   Full text not available  [PDF]
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Ruptured uterus: Fetomaternal outcome among unbooked mothers and antenatal care defaulters at the university of portharcourt teaching hospital
S Eli, DS Abam, DG B Kalio, V Oriji, DO Allagua, K Green, J Ikimalo
January-March 2018, 27(1):46-51
DOI:10.4103/1115-2613.278229  
BACKGROUND: Unbooked emergencies are major reasons for the high maternal and perinatal mortality and morbidity in Nigeria. Rupture of the gravid uterus in women without antenatal care usually present late to hospital as unbooked emergencies with high perinatal deaths and very poor maternal outcome. AIM: To determine the factors implicated in the poor feto-maternal outcome with ruptured uterus amongst the unbooked mothers at the University of Port Harcourt Teaching Hospital(UPTH). METHOD: A retrospective analysis of case records of 82 consecutive patients without antenatal care who had ruptured uterus between January 2008 and December 2012. RESULT: There were 2133 deliveries among unbooked mothers at the University of Port Harcourt Teaching Hospital over this 5-year period. The incidence of ruptured uterus for the period under review was 3.8%. The mean age was 28.1years and the modal parity was 2. Abdominal massage and prolonged obstructed labor were the commonest predisposing factors, occurring in 43.9% and 34.1% of these women respectively. There were 80 perinatal deaths contributing to 12.2% of the perinatal mortality rate. There were 6 maternal deaths from ruptured uterus which was 10.9% of the maternal mortality ratio of 2578.5 per 100,000 live birth during the study period. CONCLUSION: Perinatal and maternal mortality rates from ruptured uterus were high. The major causes of uterine rupture are abdominal massage and prolonged obstructed labor, which are both preventable. Public enlightenment and condemnation of practices that promote these factors is advocated.
[ABSTRACT]   Full text not available  [PDF]
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Extraction of mesioangularly impacted third molar: Dental drill versus crane pick elevator on treatment outcome
Charles E Anyanechi
January-March 2018, 27(1):52-58
DOI:10.4103/1115-2613.278230  
BACKGROUND: The use of dental drill during extraction of impacted mandibular third molars lead to production of aerosol, fear in some patients and this necessitates the need for an alternative instrument. OBJECTIVE: To compare the treatment outcome in two cohorts of patients after surgical extraction of symptomatic mesio-angularly impacted mandibular third molars. PATIENTS AND METHODS: Apparently healthy subjects who presented to the oral and maxillofacial surgery clinic of our institution, with an indication for surgical extraction of symptomatic mesio-angularly impacted mandibular third molar were assessed. Those classified as Pell and Gregory class 2 ramus relationship, class A and B depth, with favourable root morphology were uniformly randomized into dental drill and Crane pick elevator groups. Information on demographics, reasons for extraction, trismus, swelling, pain and complaints during follow-up were obtained and statistically analyzed. RESULTS: Overall 86 subjects, evenly distributed between the two groups were studied. Post-operative mean for trismus, swelling and pain were lower on the 3rd day in those treated with Crane pick elevator than dental drill. However, by the 7th day, the results were the same as the trismus, swelling and pain resolved clinically, without complication. CONCLUSION: Crane pick dental elevator could serve as a useful substitute to dental drill in the extraction of mild mesioangularly impacted mandibular third molars.
[ABSTRACT]   Full text not available  [PDF]
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REVIEW ARTICLE
Dentine hypersensitivity: Real or imagined
Shakeerah O Gbadebo, Folake B Lawal, Modupe O Arowojolu
April-June 2016, 25(2):182-188
BACKGROUND: Dentine hypersensitivity is a common presentation of cause of pain and or discomfort with mastication which has been shown to affect the quality of life of the affected individual. It is also a common cause of presentation at the dental clinics. However, the cause, diagnosis and possible management to give relief can be a dilemma for the clinician who at times may wonder if the sensation the individual is presenting with, is real or imagined. AIM: The purpose of this paper was to review dentine hypersensitivity in view of causes, diagnosis and management. METHODOLOGY: Articles used were found by searching the key words: dentine hypersensitivity, tooth wear lesions, desensitization, gingival recession, treatment of hypersensitivity. RESULT: There are a variety of causes of dentine hypersensitivity with a variety of ways to manage and provide adequate treatment, but the condition must be well understood. CONCLUSION: Many options of treatment are now available to eliminate the pain from dentine hypersensitivity and thus improving the quality of life of these patients because the sensitivity they experience is real.
[ABSTRACT]   Full text not available  [PDF]
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REVIEW ARTICLES
Monopolar transurethral resection of the prostate for benign prostatic hyperplasia: What are the outcomes and complications in our patients?
IC Akpayak, SI Shuaibu, VE Onowa, LE Nabasu, ZZ Galam
April-June 2017, 26(2):173-177
BACKGROUND: Transurethral resection of the prostate (TURP) is the current gold standard for the operative management of symptomatic Benign prostatic hyperplasia (BPH) and has excellent long term efficacy. Currently there is a gradual shift towards bipolar TURP and Holmium enucleation of the prostate (HoLEP) due to fear of complications, particularly transurethral resection (TUR) syndrome associated with monopolar TURP. However, bipolar generator and high powered holmium laser resectoscpe remain very expensive and make the bipolar TURP/HoLEP out of reach for majority of our patients.This study seeks to review our experience with monopolar TURP with a view to appraising its outcomes and complications seen in our patients. PATIENTS AND METHODS: Records of 42 patients, who underwent monopolar TURP for BPH between October, 2013 and September, 2016 were reviewed retrospectively.The data of patients who had undergone monopolar TURP,following standardized technique,were retrieved and subjected to statistical analysis. RESULTS: The mean age of the 42 patients was 67.07±9.38 (range 51 – 86).Those in the age range 60-69 years had most of the procedure.The mean prostate volume was 70±23.74 (ml);the mean prostate specific antigen (PSA) was 5.32±5.4ng/ml. All the patients had spinal anaesthesia.The mean intraoperative time was 71.05±19.07 (mins), awhile the mean hospital stay for the patients was 61.14±27.13 (hrs).The mean volume of 5% dextrose-water used for irrigation at surgery was 30L.Most of the patients,33(78.6%) had their catheters removed at 3-5 postoperative days. Only, 9(21.4%) had catheter for more than 5 days.The mean weight of resected prostatic chips was 29±9.2g. Intraoperatively, 1(2.4%) patient had bleeding that needed blood transfusion, 6(14.3%) had capsular perforations while none of our patients had TUR syndrome. Postoperatively, 3(7.2%) patients had clot retention while 2(4.8%) had UTI and 32(76%) had retrograde ejaculation. All patients except 1(2.4%) had satisfactory voiding at removal of catheter and subsequent follow up visits. CONCLUSION: Improved antibiotics, perioperative care and instrumentation have greatly improved the morbidity of modern monopolar TURP and make it still useful for our patients.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Posterior perforation of gastric ulcer: A rare surgical emergency
MO Afolayan, TO Olajide, OS Balogun
April-June 2017, 26(2):178-180
BACKGROUND: Gastric ulcer perforation is a rare surgical emergency.Posterior gastric ulcer is even rarer and usually has a delayed presentation with attendant greater morbidity and mortality. AIM: To report a case of posterior perforation of gastric ulcer and review the literature. CASE REPORT: A 65yr old driver was seen in the hospital with a 4- day history of epigastric pain which became generalized. Examination revealed a patient in shock with a board-like rigidity of the abdomen. Chest x-ray confirmed pneumoperitoneum. He had an exploratory laparotomy. Findings at surgery include moderate peritoneal fluid collection and 1.5cm diameter perforation on the posterior gastric wall which was closed primarily with an omental patch. Biopsy of the ulcer edge was negative for malignancy. He was discharged 10 days after surgery. CONCLUSION:To the best of our knowledge,perforation of a posterior gastric ulcer is an unusual encounter in surgery.A high index of suspicion is needed to prevent high mortality.
[ABSTRACT]   Full text not available  [PDF]
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Bilateral gluteal abscesses and myofibrosis complicating intramuscular pentazocine abuse: A case report
NO C Onyemaechi, AE Arunsi, P Ojobo, AG Obiefuna, S Ugwu, Olibe Alexander
April-June 2017, 26(2):181-184
BACKGROUND: There is paucity of reports on the musculoskeletal complications of pentazocine abuse in Nigeria.The aim was to report a case of bilateral gluteal abscesses and myofibrosis as a consequence of parenteral pentazocine abuse. CASE SUMMARY: We report a case of a 39 year old housewife who presented with bilateral gluteal pyomyositis and myofibrosis following intramuscular pentazocine abuse.The patient had received parental pentazocine for pain relief for about 3 weeks seven years ago.She gradually developed dependence on this drug and received increasing doses of this drug by self injection on both buttocks. She subsequently developed bilateral gluteal abscesses and myofibrosis that was treated by surgical drainage,debridement,wound dressing and antibiotics. CONCLUSION: Pentazocine abuse should be considered a differential diagnosis in cases of multiple gluteal abscesses.Clinicians should be cautious in the use of pentazocine as routine painkillers.
[ABSTRACT]   Full text not available  [PDF]
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Otologic foreign body: An undeclared and unusual impaction
Taiwo O Adedeji, James E Tobih, Abdulraman Adeshina Bello
April-June 2015, 24(2):175-178
BACKGROUND This study reports two cases of undeclared and unusual foreign body (FB) impaction in the ears of Nigerian adult patients that were accidentally discovered and successfully managed. AIM The report aims to create awareness,and encourage Otorhinolaryngologist to have proper otoscopy done for all patients with suspected ear FB and double check again following FBs removal. CONCLUSION It has recommended a need for an increased public enlightenment to raise awareness about the danger of cleaning the ears with cotton swab or other sharp materials.
[ABSTRACT]   Full text not available  [PDF]
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