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ORIGINAL ARTICLES
Determinants of contraceptive use among women attending antenatal care at federal teaching hospital Abakaliki, Nigeria
Edmund Ndudi Ossai, Elizabeth Uzoamaka Nwonwu, Pearl Adaoha Agu
April-June 2018, 27(2):168-179
DOI:10.4103/1115-2613.278776  
Background:Contraception is of immense relevance in reproductive health. It is also one of the effective strategies towards improving maternal health. This study was designed to determine the awareness and use of contraceptives among women attending antenatal care at Federal Teaching Hospital Abakaliki, Nigeria. Method: A descriptive cross sectional study design was used. Systematic random sampling technique was used to select 415 women receiving antenatal care at the facility. Information was obtained using a pre-tested, interviewer- administered questionnaire. Data analysis was done using Statistical Package for Social Sciences statistical software version 22 and level of statistical significance was determined by a p-value <0.05. Results: The mean age of the respondents was 29.3±4.5 years. Majority of respondents, (288) 69.4% had attained tertiary education. Majority, (350)84.3% were aware of contraception and the male condom,(292)70.4% and the pill, (244) 58.8% were the most known methods. Source of information on contraception were mostly from television, (201)48.4% and health workers, (186)44.8%. Use of contraceptives was low among the respondents, (99)23.9% and the male condom, (52) 52.5% and natural method, (28)28.3% were the common methods used. Contraceptives were obtained mainly from pharmacy shops/patent medicine vendors, (50)50.5% and public health facilities, (21) 21.2%. Majority of those who used contraceptives had the support of their husbands, (94) 94.9% and majority also (83)83.8% were satisfied with the methods used. Predictors of contraceptive use among the respondents included being unmarried, (AOR=3.6; 95% CI: 1.3- 10.5), Nullipara, (AOR=0.09; 95% CI: 0.02-0.3) and having 1-4 children, (AOR=0.1; 95% CI: 0.05-0.4). Conclusion: Awareness of contraception was high, however utilization was low among the respondents in the study area. There may be the need for increased public enlightenment on the use of contraceptives. Health workers will have a role to play through counselling of clients. Changing the preference of the people for large family sizes may increase the use of contraceptives in Nigeria and there should be greater emphasis on female education.
[ABSTRACT]   Full text not available  [PDF]
  69 22 -
REVIEW ARTICLES
Comparison of two different ways of passing urethral catheter after transurethral resection of the prostate
IC Akpayak, SI Shuaibu, VE Onowa, CA Agbo
July-September 2017, 26(3):231-234
DOI:10.4103/1115-2613.278845  
OBJECTIVES: To determine and compare the rate of success of two methods of passing urethral catheter following TURP using silicone Foley catheter: passing the urethral catheter with introducer into an empty bladder and passing the catheter without introducer into bladder filled with normal saline. PATIENTS AND METHODS: This was a prospective study carried out between October, 2013 and November,2016 on 64 patients. Patients who had TURP for BPH where divided into 2 groups based on method of passing urethral catheter after the procedure:Group A: passing silicone urethral catheter with introducer into an empty bladder after TURP. Group B: passing silicone urethral catheter without introducer with bladder filled with normal saline. The outcomes of comparing the groups were computed using appropriate statistical tools. RESULTS: Catheter was passed at single attempt for 15 patients in group A and 14 patients in group B. Successful passage of the catheter was achieved at 2 attempts for 7 patients in group A and 13 patients in group B. Whereas success was achieved at 3 attempts for 10 patients in group A and 5 patients in group B. On comparing the success 2 of attempts to pass the catheter in each group, x2 = 0.721, p = 0.396. Fisher exact test also did not reveal any significance,p = 0.286. CONCLUSION: Passing silicone Foley urethral catheter into a bladder filled with normal saline after TURP is as effective as passing the catheter with the aid of introducer and guarantees no further injury to the urethra.
[ABSTRACT]   Full text not available  [PDF]
  70 16 -
COMMENTARY
Histopathology practice and training in nigeria - A model
D Sabageh, AO Daramola, O Rotimi
April-June 2016, 25(2):197-200
DOI:10.4103/1115-2613.278278  
OBJECTIVES: Contemporary histopathology practice and training in Nigeria have been plagued by the fundamental issue of inadequate exposure to surgical pathology material by both trainees and trainers. This paper critically examines the factors that affect the discipline and profers practical solutions to aid its advancement. MATERIALS AND METHOD: This review is based on the authors experience and observations of histopathology practice in Nigeria. RESULTS: The Nigerian health sector is plagued by many ills including poor funding, weak policies, dilapidated structures, disgruntled and frustrated practitioners, amongst others - and pathologists are not immune to all these. In recent times, there has been a proliferation of accredited training centres as well as medical graduates interested in the specialty of histopathology. The busiest histopathology laboratories in the country ascession between 2200 and 5500 surgical samples yearly. Thus there is inadequate exposure by histopathologists and trainee pathologists to surgical materials with the attendant consequences. Many centres still rely principally on routine haematoxylineosinstains. There are no nationally agreed standard reporting formats for most diseases. CONCLUSION: The development of a deanery or regional system of accredited histopathology laboratories may form the fulcrum for improving the overall quality of histopathological services and training in Nigeria. This will help develop local expertise and ensure adequate exposure to teaching aids and surgical materials. We hope that the proffered solutions will help encourage local pathologists to continue and increase their efforts to raise the profession up to enviable heights.
[ABSTRACT]   Full text not available  [PDF]
  71 13 -
ORIGINAL ARTICLES
The childhood trauma questionnaire: Validity, reliability and factor structure among adolescents in calabar, Nigeria
Emmanuel Aniekan Essien, Olusola Ruth Attoe, Godwin Akepu Anake, Emmanuel Effiong Uwah, Ehiaghe Jennifer Aigbomian, Franklin Ifeanyi Eleazu, Owoidoho Udofia
July-September 2018, 27(3):252-259
DOI:10.4103/1115-2613.278787  
Introduction: Child abuse is a cause of increasing concern globally and is known to have significant negative effects on the physical and psychological well-being of children. Validated instruments for screening child abuse in Nigeria are scarce. Aim: This study aimed to determine the validity, reliability and factor structure of the 28 item version of the Childhood Trauma Questionnaire among Secondary School students in Calabar South, Cross River state, Nigeria. Methodology: In a cross-sectional study, a sample of 161 students was drawn from two secondary schools in Calabar South, Cross River State, using multi-stage technique. A socio-demographic questionnaire, the Childhood Trauma questionnaire (CTQ-28), the General Health Questionnaire (GHQ-12) and the Self-reporting Questionnaire (SRQ-20) were administered to the selected students. Convergent validity between CTQ and other scales, reliability using Cronbach alpha and the factor structure of CTQ using principal component analysis were assessed. The data was analyzed with the Statistical Package for Social Sciences, 21st edition (SPSS-21). Results: Cronbach alpha was 0.80. Internal consistency for the subscales were 0.69 for emotional abuse, 0.60 for physical abuse, 0.60 for sexual abuse, 0.79 for emotional neglect and 0.21 for physical neglect. For convergent validity, correlation coefficients with the GHQ-12 and the SRQ-20 were 0.39 and 0.45 respectively (p<0.05). Principal Components Analysis yielded a four factor solution. Conclusion: The 28 item version of the Childhood Trauma Questionnaire has acceptable reliability and validity and can be useful as a screen for child abuse among adolescents in Nigeria.
[ABSTRACT]   Full text not available  [PDF]
  68 16 -
The causes and prevalence of road traffic accidents amongst commercial long distance drivers in Benin City, Edo State, Nigeria
KC Okafor, EC Azuike, PW Okojie
July-September 2017, 26(3):220-230
DOI:10.4103/1115-2613.278844  
The prevalence of road traffic accidents is on the rise,thus contributing to morbidity and mortality. In the year 2000, road traffic injuries was the 11th leading cause of death globally, currently, it is the 9th leading cause of death. Despite the tragedy behind the loss of life and injuries due to road traffic crashes,there is less mass media attention and public awareness than other less frequent types of tragedy. This study was done to assess the causes and prevalence of road traffic accidents among commercial long distance drivers in Benin City A descriptive cross sectional study design was used, and data was collected from 315 commercial long distance drivers and their vehicles. Study was done from January to October, 2013. Respondents were recruited using systematic random sampling technique. Study instruments included structured interviewer administered questionnaires and focus group discussion guide. The results showed that 114 (36.2%) were within the age group of 31-40 years. Ninety-one (28.9%) were in the 41- 50 years age group while 18 (5.7%) fell within the 61-70 years age group. Most of the respondents 272 (86.3%) were married, 28 (8.9%) were single, 10 (3.2%) were cohabiting, while 2 (0.6%) were separated. Almost all the respondents 311 (98.7%) were males while 4 (1.3%) were surprisingly females. More than half of the respondents 172 (54.6%) had a secondary level of education,112 (35.6%) had a primary level of education while 12 (3.8%) had no formal education. The study showed a prevalence of road traffic accidents of 47.9% in Benin City occurring more in day time and the common causes of road traffic accidents include careless driving, speed violation, brake failure, traffic violations, faulty overtaking, burst tyre, bad roads, alcohol use and armed robbery attack. Thus measures should bemade to ensure proper maintenance of the roads to ensure the risk of RTA due to bad road is reduced and also provide adequate security for road users to prevent armed robbery attacks.
[ABSTRACT]   Full text not available  [PDF]
  67 16 -
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
DOI:10.4103/1115-2613.278257  
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]
  55 28 -
REVIEW ARTICLES
Surgical emergency presentation in a private teaching hospital in Nigeria: A 2- year review
EO Onuoha Clement, I Njoku Emmanuel, Ogundipe Moyosore, Uche Uchenna, Onuoha Kelechukwu
April-June 2018, 27(2):188-192
DOI:10.4103/1115-2613.278778  
BACKGROUND: Pattern of admissions into the accident and emergency units vary worldwide with most studies showing surgical preponderance. Unlike the outcome of our study that showed more of medical cases, another study done in University College Hospital (UCH), Ibadan, Nigeria showed that 61% of admissions into the accident and emergency unit were surgical with trauma in general constituting 45.1%. With rising population and reduced funding, most tertiary care hospitals in developing countries grapple with high patient admissions into their emergency units. Lack of adequate personnel and facilities to cater for such patients result in poor patient satisfaction and management. Adequate funding and regular training of personnel should therefore be emphasized if we are to approach the standard care provided in developed countries 4 and reap a satisfactory outcome in care of emergency surgical situations. METHOD: This is a 2-year retrospective study, data of all patients admitted in the adult accident and emergence section of Babcock University between January 2016 and December 2017 were retrieved and reviewed. Frequencies were presented as absolute values, charts and percentages. RESULTS:In 2016, a total of 1901 emergency cases presented to the adult accident and emergency unit of Babcock University Teaching Hospital of which 341 were surgical. In 2017, a total of 1887 emergency cases were seen in the adult accident and emergency unit of Babcock University Teaching Hospital of which 363 [17.24%] were surgical. Overall, a total of 3788 emergency cases presented of which 704 [17.24%] were surgical cases. Of these 704 cases ,457 of them [64.9%] were acute surgical emergencies like head injuries, burns, cholecystitis, intestinal obstruction, testicular torsion, deep laceration injuries, acute urinary retention, fractures, appendicitis, pleural effusion, upper GI bleeding, , cervical spine injuries [table 1] and the remaining 247 cases [35.1%] were non-emergencies (cold) cases. Of these 457 surgical emergencies, appendicitis accounted for 133 [ 29.10%] of cases making it the commonest surgical emergency that presented in our hospital in these two years. CONCLUSION: The most common surgical emergency was acute appendicitis 133 cases [40.06%]followed closely by deep lacerations resulting from road traffic accidents 98 cases [25.83%] and head injuries 47cases [13.4%] among others This study also highlights the pattern of emergency surgical cases expected from the accident and emergency department of a typical private hospital which does not always mimic the pattern seen in other public hospitals. This information may help the management in recruiting appropriate staff for the surgical emergency unit/department of a t aching hospital
[ABSTRACT]   Full text not available  [PDF]
  67 15 -
ORIGINAL ARTICLES
Determinants of length of hospitalization in a federal psychiatric hospital in Nigeria
CJ Okafor, AA Audu, EA Essien, EE Ekpe, J Okegbe, BE Edet
April-June 2018, 27(2):147-152
DOI:10.4103/1115-2613.278773  
Objective: The present study aims to determine the association between clinical-demographic variables and length of stay of patients admitted into Federal Psychiatric Hospital, Calabar. Design: Retrospective review of case records. Methods: 280 case records of patients (discharged from September 1st, 2015 to August 31st, 2016) were assembled for review, out of which twelve cases were excluded for various reasons. Clinical and demographic data collected from the remaining 268 case records were subjected to univariate and multivariate analyses to determine variables associated with prolonged length of stay. Results: Mean length of stay was 56.2 ± 40.9 and the commonest clinical diagnosis was schizophrenia (45.9%). Although gender, age, marital status and clinical diagnoses tended to influence length of stay, gender (p =0.007) and clinical diagnosis of schizophrenia (p =0.044) were the only variables that significantly predicted prolonged length of stay. Conclusion: We found that gender and clinical diagnoses were important determinants of length of stay. If validated in future studies, these factors may help in accurate identification of cases at risk of prolonged hospitalization and act as guide to clinicians who may need to optimize intervention strategies early enough in managing such cases.
[ABSTRACT]   Full text not available  [PDF]
  69 12 -
CASE REPORTS
Hypereosinophilic syndrome with severe hypokalaemia in a Nigerian woman: A case report
AE Alagbe, CU Akunwata, SP Ogundeji, OW Aworanti, TR Kotila
January-March 2016, 25(1):93-96
DOI:10.4103/1115-2613.278260  
INTRODUCTION: Hypereosinophilic syndrome (HES) is a rare disorder. It is defined as eosinophilia of greater 9 than1.5x109/L persisting for at least 6 months or death before 6 months without an identifiable cause and with eosinophil-mediated organ dysfunction. We present a rare case of hypereosinophilic syndrome with severe hypokalaemia in a Nigerian female patient. CASE PRESENTATION: A 43year old food vendor referred to the Haematology Department, University College Hospital, Ibadan on account of a 6-week history of cough productive of mucoid, brownish, foul smelling sputum with associated breathlessness, high grade intermittent fever,and intense pruritus. She had accompanying non-projectile,non-bloody vomiting of recently ingested meals. There was absolute eosinophilia of 83x109/L and bone marrow cytology revealed marked eosinophilia with blasts of less than 5%. She also had asymptomatic severe hypokalaemia (1.9mmol/l) likely due to vomiting and reduced dietary intake. The aetiology of the hypereosinophilia could not be ascertained. She was admitted and commenced on intranasal oxygen,Tabs Loratidine, intravenous hydration. The severe hypokalaemia was corrected with IV KCL over 48hours followed with the administration of slow K tablets 600mg tds. She also had tabs Hydroxyurea forcytoreduction and Allopurinol to prevent hyperuricaemia. She improved with the above line of management. CONCLUSION: This appears to be the first reported case of HES with asymptomatic severe hypokalaemia in the literature. Being a rare disorder it could easily have been missed without a review of the peripheral blood film and marrow aspirate. This finding suggests a possible relationship between hypereosinophilia and hypokalemia which needs to be explored.
[ABSTRACT]   Full text not available  [PDF]
  54 26 -
ORIGINAL ARTICLES
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]
  54 25 -
Skeletal injuries in children presenting in a tertiary health facility in Lagos state, Nigeria
OI Akinmokun, SO Giwa, CO Bode
January-March 2018, 27(1):20-28
DOI:10.4103/1115-2613.278226  
BACKGROUND: Injury remains a major health problem for children worldwide. Traumatic injuries cause substantial mortality and morbidity with temporary or permanent disability in children METHODS: This was a prospective observational hospital based study conducted on all the patients aged 16 years and below who presented in the Accident and Emergency room and at the orthopaedic outpatient clinics in the LagosUniversity Teaching Hospital (LUTH) with musculoskeletal injuries over a period of fifteen months. All patients who met the inclusion criteria were recruited. Questionnaires were used for data collection. Thorough examination of the injured paediatric patient was done and finding documented in the questionnaire. Fractures of long bones were confirmed in all cases with radiographs. Data obtained was analyzed with Microsoft Excel Starter 2010 by Microsoft Corporation. Redmond, Washington. RESULTS: The age ranged from 4 day (0.01 year) to 16 year with a mean age of 6.35± 4.58. Male to Female ratio was 1.9:1. Road traffic accidents were the leading cause of skeletal injuries (49.2%), followed by falls (27.0%). Fractures associated with birth trauma accounted for 12.7%. Younger children were more prone to injuries from falls. The home environment was the second most common environment for children to sustain fractures, the first being the roads. Majority (58.7%) were from families within the lower socioeconomic class. Ninety five percent (95%) of the children who got injured were without adult supervision while crossing the road. Injuries from road traffic accidents peaked between 3pm and 6pm while injuries resulting from falls peaked between 12 noon and 3pm. The femur was the most commonly fractured bone (21.7%). Green stick fractures occurred in 7.9% of the patients seen. Open fractures were seen in 6.3% of the patients. Physealinjuries occurred in 4.8% of paediatric fractures. Some injured paediatric patients (12.3%) were taken to the traditional bone setters prior to presentation at LUTH with 3(4.7%) of them presenting with gangrene of the affected limb. CONCLUSION: Road traffic accident remains the commonest cause of fractures in children. However, injuries sustained at the home environment were quite significant. Emphasis on increase supervision and safety practices at home are strongly recommended.
[ABSTRACT]   Full text not available  [PDF]
  60 18 -
Acceptance of malaria vaccine by a rural community in Nigeria
D Ughasoro Maduka, I Bisi-Onyemaechi Adaobi, U Okafor Henrietta
July-September 2018, 27(3):199-204
DOI:10.4103/1115-2613.278781  
Background: Introduction of malaria vaccine is imminent. This study evaluated the prevalence of malaria among a non-febrile population and their willingness to accept a malaria vaccine. Methods: This was a cross-sectional, community-based study done in a rural community in south east Nigeria. A total of 156 household heads were interviewed using a structured questionnaire. The questionnaire was pre-tested before commencement of the study to correct ambiguity. Results: Majority (78.2%) acknowledged that malaria is the commonest illness in the community, while 55.1% believed that presumptive treatment is the best malaria preventive measure. Most (98.7%) of the study participants immunized their children against childhood vaccine preventable diseases, while 91.6% would be willing to accept a malaria vaccine. The prevalence of malaria parasitaemia among non-febrile respondents was 35.4% and the use of mosquito nets was 17.9%. Conclusion: The high prevalence of malaria among non-febrile populations, the practice of presumptive treatment of unconfirmed fever as malaria preventive measure and the low use of bed nets, points that it is time to introduce malaria vaccine. The high willingness to receive the vaccine is positive to the introduction of the vaccine.
[ABSTRACT]   Full text not available  [PDF]
  66 12 -
Predictors of cephalopelvic disproportion in labour a tertiary hospital in Bayelsa State, Nigeria
Ikobho Ebenezer Howells, Jeremiah Israel
July-September 2018, 27(3):205-211
DOI:10.4103/1115-2613.278782  
Background: Cephalopelvic disproportion (CPD) is a disparity between the fetal head and maternal pelvis, usually in the absence of fetal or maternal jeopardy. It is a very common complication during labour, and it is associated with a very high caesarean section rate. Delay in intervention could lead to obstructed labour. Short stature, fetal macrosomia and pelvic abnormalities are common risk factors. The aim of this study was to determine the influence of maternal height, age, clinical pelvimetry, and birth weight on cephalopelvic disproportion in the Niger Delta University Teaching Hospital, Bayelsa State. Materials and Methods: This is a retrospective case controlled analysis of 5,205 parturients who received antenatal care, and delivered at the Niger Delta University Teaching Hospital, from January 2010 to December 2015. Of these, 588 patients who had cephalopelvic disproportion were identified. Data concerning their maternal age, parity, height, pelvimetry, gestational age at delivery, and fetal demographic characteristics were collected and analyzed. This was compared to a control group of 588 parturients who were randomly selected among parturients who had spontaneous vaginal delivery (SVD) during the study period. Results: A total of 5,205 women delivered during the period of study, out of these, 588 women had cephalopelvic disproportion, giving a rate of 11.3%. Majority of the women who had CPD were nulliparous (47.6%). Women who were 150.0 cm tall or less were 3 times more likely to have cephalopelvic disproportion in labour than those who were over 150.0cm tall. P = 0.001, Odds Ratio = 3.69 [CI, 2.49 -5.47]. Women who delivered babies with birth weight ≥ 4000 grams had significantly more cephalopelvic disproportion, than those who delivered babies with birth weights of 2501 – 3999 grams. Odds Ratio = 0.22, p = 0.001 [CI, 0.14 -0.33]. There is a significant negative correlation between maternal height and parity with cephalopelvic disproportion. [r = -295, p = 0.001] and [r = -197, p = 0.001] respectively. There is also a significant positive correlation between birth weight and gestational age at deliverywith CPD [r = 0.24, p = 0.001] and [r = 0.149, p = 0.001]. Linear regression analysis of the independent variables reveal that maternal height was the biggest predictor to CPD. Coefficient of determination R2 = 0.089(8.9%), F= 112.2, p = 0.001. Conclusion: Short stature is independently associated with an increased risk of intrapartum caesarean section in Nigerian women. We advocate for an early recourse to caesarean section to avoid undue morbidity.
[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]
  49 27 -
Perception of mothers on environmental risk factors for childhood diseases in Kebbi State of Nigeria
Mundi Rhoda, Ishaya Sunday, Dakyes Samuel Panse, Nwankwo Beatrice Biyaya, Stephen Yohanna
October-December 2019, 28(4):481-498
DOI:10.4103/1115-2613.278640  
Background: This study examined the perception of mothers on environmental risk factors for childhood diseases in Kebbi State of Nigeria. The study adopted the Environment-Agent-Host chain of germ theory. Methods: The study employed the cross-sectional survey research design. The household constituted the unit of analysis. Data on demographic and socio-economic characteristics of the respondents such as mother's educational attainment, income, occupation, marital status and religion as well as data on environmental risk factors of inhabitants were obtained using structured and semi-structured questionnaires and multi-stage sampling technique was employed to select respondents. Koko-Bese and Yauri LGA were sampled for the study and five of the 15 wards were sampled using the 2006 census locality and enumeration area list. Using table of random numbers 47 women aged 15-49 years for Yauri and Koko/Besse were selected. Tabulation involving frequencies and percentage was employed to analyze the socio-economic characteristics and environmental risk factors of women. Chi square was use ascertain dependency of child's death on as mother's educational attainment, income, occupation and marital status. Results: Findings show that incidences of childhood diseases were linked to mothers' age, education, income, social and religious affiliation in Kebbi State. The critical environmental risk factors for childhood diseases were food contamination, indoor and outdoor air pollution. Poor water sources, poor hygiene of water storage containers, unreliable methods of purification and treatment of water, and poor toilet facilities increase the risk of transmitting childhood diseases. Poor waste disposal, water pollution, climate change, use of pesticides, housing type/quality and community housing facilities were perceived as not conspicuous environmental risk factors to childhood diseases in Kebbi State. All null hypotheses postulated in this study were accepted meaning that mother's age, educational level, occupation, average monthly income, ethnic group, marital status are independent of the child's cause of death as seen from the samples. Conclusion: There is need to create awareness on environmental risk factors of childhood diseases through radio programmes and through community health workers in Kebbi State. There is a strong need for improving existing quality of health/sanitation with particular reference to environment risk factors of childhood diseases by conveying such concern to the stakeholders and policy makers in Kebbi State.
[ABSTRACT]   Full text not available  [PDF]
  60 15 -
Awareness and utilisation of postnatal care services among antenatal clinic attendees at ahmadu bello university teaching hospital Zaria
John Kingsley C. Nwajagu, Nkeiruka Ameh, Adekunle O Oguntayo
April-June 2017, 26(2):112-116
DOI:10.4103/1115-2613.278282  
BACKGROUND: Postnatal period is the period from one hour to six weeks after the birth of an infant. It is a critical period for the woman,her new born and her family on a physiological,emotional and social level especially because 50-70% of all maternal deaths occur during this period. AIM: To identify the determinants of women's utilization of postnatal clinic services (PNCs). METHODS: A descriptive study on 188 eligible antenatal clinic attendees at the Obstetrics and Gynaecology Department of Ahmadu Bello University Teaching Hospital (ABUTH) Shika-Zaria from October to December 2013.Structured questionnaires were used for the study.Approval was obtained from the Ethical committee of the ABUTH, Shika-Zaria.TheSPSS version 16 was used for data analysis and the results was subjected to descriptive analysis. RESULTS: The majority were Hausas. 39.9% had tertiary school education. Majority of them (42%) were multiparous women, 77.7% were aware of the postnatal services they should receive. Previous antenatal clinic (ANC) attendance was 95.1% and 74.4% attended PNC. Educational level affected PNC utilisation, tertiary education (60%),secondary (28%) and primary (5%).Employed respondents had more PNC attendance (84%) than the unemployed (25%). CONCLUSION:The study shows that awareness, education, employment and antenatal clinic attendance are the promoting factors to utilisation of PNC services and the hindering factors to utilisation of PNCs include lack of awareness,distance and lack of transportation,poverty or lack of money.
[ABSTRACT]   Full text not available  [PDF]
  54 21 -
CASE REPORTS
Subepithelial connective tissue graft in the management of gingival recession: A 4-year follow-up of a case
OI Opeodu, MO Adesakin, MO Arowojolu
October-December 2019, 28(4):548-554
DOI:10.4103/1115-2613.278648  
Gingival recession may cause aesthetic challenge for affected individuals, which may be the reason for definitive treatment. Other possible side effect is that because of the exposure of the root surface, it may predispose to root caries and dentinal hypersensitivity. Many surgical procedures have been described as part of the options for the management of gingival recession, the use of subgingival connective tissue is one of such surgical methods. This report describes a case of a gingival recession managed with the use of subepithelial connective tissue graft. The main reason for the surgical intervention was the concern of the patient and the tendency for progression of the recession. Connective tissue was sourced from the palate and sutured in the recipient site with a 4.0 vicryl suture. The case had been followed up for 4 years with good root coverage (100%) and colour match. The resulting improved aesthetics has enhanced the selfimage of the patient.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Tonsillar enlargement in apparently healthy adults in a rural community in Nigeria
Segun A Ogunkeyede, Ayotunde J Fasunla, Oyedunni S Arulogun, Olawale A Lasisi
July-September 2018, 27(3):260-264
DOI:10.4103/1115-2613.278788  
Background: Tonsillar enlargement could worsen airway obstruction thereby causing apnea and hypoventilation. This is rarely investigated especially in developing country, hence this study which was aimed at determining the prevalence of enlarged palatine tonsils and comparing the degree of obstruction with selected anthropometric measurements in healthy adults in a rural community. Methods: A cross-sectional study of apparently healthy adults (≥ 18 years) in Oyo community, South Western Nigeria. The participants were selected using multistage random sampling technique. Interviewer assisted structured questionnaire was administered to obtain information on age, gender, occupation, history of smoking and snoring. Ear, nose and throat examination was done and Brodsky grading of tonsil documented. The neck circumference (cm), weight (kilogram) and height (meter) were measured and their Body Mass Indices (BMI) calculated. The data was analysed using IBM- Statistical Package for Social Sciences (SPSS) version 20 and text of association between tonsillar grade, and BMI and Neck circumference was performed using Chi Square. Results: Participants were 408 subjects, consisting 202 (49.5%) males and 206 (50.5%) females, the mean age was 37 ± 15.2 years. One hundred and fifteen (28.2%) participants had enlarged Palatine tonsils of which; 70 (17.2%) had grade 1 enlargement, 33(8.1%) had grade II enlargement, and 12(2.9%) had grade III enlargement. None of the participants had grade IV tonsillar enlargement. The Mean Body Mass Index was 24.32 ± 4.50 kg/m2 and mean neck circumference was 34.08 ± 2.70cm. Palatine tonsillar enlargement was significantly associated with young age (p = 0.01), female gender (p = 0.02), and neck circumference (p =0.01), but not with high BMI (P = 0.06). Conclusion: Tonsillar enlargement is prevalent, and it is associated with young age, and female gender, but not with Body Mass Index and neck circumference.
[ABSTRACT]   Full text not available  [PDF]
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Frequency of percutaneous achilles tenotomy in the treatment of idiopathic clubfoot using the ponseti method
Chukwuemeka Okechukwu Anisi, Joseph Effiong Asuquo, Innocent Egbeji Abang
April-June 2018, 27(2):163-167
DOI:10.4103/1115-2613.278775  
Background: Percutaneous Achilles tenotomy is an integral component of congenital clubfoot treatment using the Ponseti method. This study was designed to assess the frequency and outcome of percutaneous Achilles tenotomy in the conservative treatment of congenital clubfoot by the Ponseti method. Patients and methods: A prospective study of all congenital clubfoot patients between the ages of zero and two years who attended our clubfoot clinic between January, 2013 and December, 2017 was carried out. At presentation, each clubfoot was assessed clinically and scored using the Pirani scoring system, and treated using the Ponseti method. Percutaneous Achilles tenotomy was performed for feet with persistent equinus deformity. Statistical analysis of the distribution and associations of percutaneous Achilles tenotomy was done using IBM SPSS version 22 was done. Results: A total of 97 patients with 147 clubfeet were studied. The median total Pirani score (TPS), midfoot contracture score (MFCS) and hindfoot contracture score (HFCS) at presentation were 4.5, 2.5 and 2.5 respectively. Percutaneous Achilles tenotomy was performed on 97 (66.4%) feet belonging to 63 patients. Eighty five out of 108 feet with initial total Pirani score of 3.0 and above required percutaneous Achilles tenotomy to achieve correction (p < 0.001). Conclusion: Treatment of congenital clubfoot using the Ponseti method was associated with a tenotomy rate of 66.4%. High Pirani scores as well as increasing age at presentation were associated with the need for percutaneous Achilles tenotomy.
[ABSTRACT]   Full text not available  [PDF]
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Comparative analysis of chromogenic vs clot based cdc modified, nijmegen-bethesda assay for detection of factor VIII inhibitor titre
Mirza Asif Baig, Mohammad Shahid Iqbal, Abdel Rahim Mahmoud Muddathir, Aisha Tabassum, M Syeda Sarah
October-December 2019, 28(4):423-430
DOI:10.4103/1115-2613.278634  
Background:- Inhibitors to infused factor VIII are the most significant complication of hemophilia treatment. These inhibitors are usually IgG antibodies, that react with FVIII in a time and temperature dependent manner. Coagulation factor VIII inhibitors can be detected by Chromogenic, clot based and immunological assays. However, there is lack of consensus as to what constitutes a positive inhibitor, including the appropriate cut-off for inhibitor measurement The main objective of this study is to compare the sensitivity and specificity of chromogenic Nijmegen Bethesda assay (CNBA) with Centre for disease control modified Nijmegen Bethesda (CDC-NBA) assay against the Reference control method (RCM). Materials and Methods: The Coagulometer used for inhibitor titre quantification is Sysmex CS-5100. APTT reagent used isPathromtin SL supplied by seimensSeimens. All data were expressed as Mean ± SD. Statistical formulae were used for sensitivity and specificity calculations. Unpaired students t test was used whereever necessary and a P value of <0.05 is considered as statistical significance Results: A total of 150 cases were tested for inhibitor titre using CNBA vs CDC-NBA. For low titre Inhibitor (<2 NBU), CNBA has 92% and 86% and CDC-NBA has 80 and 60% sensitivity and specificity respectively. These results show that CDC-NBA shows false positive results at low inhibitor titre. For High titre Inhibitor ( >2 NBU) CNBA has 88% and 80% and CDC-NBA has 85 and 70 % sensitivity and specificity respectively. Conclusion :- These results shows that CNBA is more sensitive and specific than CDC-NBA at both low and high inhibitor titre. Moreover chromogenic assays can differentiate factor specific inhibitor from nonspecific inhibitors like lupus anticoagulant and unfractionated heparin therapy.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
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
DOI:10.4103/1115-2613.278294  
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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REVIEW ARTICLES
Urological emergencies at the university of abuja teaching hospital Gwagwalada, Nigeria: Spectrum and initial outcome
T Atim, KO Obiatuegwu, SB Eniola, HO Ajibola, OI Aisuodionoe-Shadrach, NK Dakum
July-September 2017, 26(3):235-239
DOI:10.4103/1115-2613.278846  
INTRODUCTION: Urological emergencies are urologic conditions that may require urgent treatment. With the exception of acute urinary retention, urological emergencies are not common compared to other fields of medicine. Immediate management of urologic emergencies will forestall complications. AIMS AND OBJECTIVES: To present the spectrum of urological emergencies and the initial outcome in the emergency unit. METHODS: This is a prospective study carried out in the emergency department of UATH. The authors conducted a 6month study starting from January 2014. Data collected were age, sex,working diagnosis and initial outcome in the emergency room within the first 24 hours. RESULTS: A total of 92 patients were seen, most of them (65.2%) were above 40 years. The majority of the patients (53.3%) had acute urinary retention. The conditions that presented as emergencies were benign prostatic enlargement (42.4%), prostate cancer (16.3%), genitourinary infections (13.1%), urethral stricture diseases (9.8%), urolithiasis (3.3%), testicular torsion (9%). Of these patients, 51.1% were admitted for further treatment while 44.6% were treated and discharged from the emergency room. CONCLUSION: Acute urinary retention was the commonest urological emergency in our center. The incidence of benign prostatic enlargement was quite high. The large number of patients discharged from the emergency room after treatment implied they could have had medical attention at other nearby health facilities and not overburdens the emergency services at our center which is a referral center or perhaps they preferred the services in our center.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
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
DOI:10.4103/1115-2613.278293  
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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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
DOI:10.4103/1115-2613.278286  
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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Comparative analyses of three radiographic dental age estimation methods amongst Nigerians
I Olaopa Olusegun, OO Gbolahan, VN Okoje, Mellikam Sylvia, Oyelaran Philip
October-December 2019, 28(4):403-412
DOI:10.4103/1115-2613.278632  
Background: Age estimation is a critical step in constructing biological profiles from human skeletal remains. This study aimed to compare three radiographic methods of age estimation with tested validity in different populations for accuracy and applicability in forensic investigations amongst Nigerians. Methods: This was a retrospective study of panoramic radiographs (Planmeca Romexis®) captured from 46 young Nigerian patients between ages 6 to 21 years in a Federal Tertiary Health Institution in Southwest Nigeria between July and December, 2017. Parameters on the panoramic radiographs were measured and scored based on Demirjian, Cameriere and Kvaal radiographic dental age estimation methods. Data were analysed using SPSS version 20 at p<0.05. Result and Conclusion: There was no significant difference between chronological ages and estimated ages of subjects considering Demirjian and Cameriere methods, but there was a significant age difference when Kvaal method was used (p>0.5). Demirjian method was found to be strongly correlated with chronological age (rs = 0.763); Cameriere method moderately correlated (rs = 0.684) and Kvaal method weakly correlated (rs = 0.476). Demirjian method showed the strongest direct relationship (R2 = 0.56) followed by Cameriere (R2 = 0.44) and Kvaal method (R2 = 0.22). Demirjian system was the only significant predictor of the chronological age of Nigerian subjects using multiple linear regression.
[ABSTRACT]   Full text not available  [PDF]
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