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  Access statistics : Table of Contents
   2016| October-December  | Volume 25 | Issue 4  
    Online since February 25, 2020

 
 
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ORIGINAL ARTICLES
Caesarean section at usmanu danfodiyo university teaching hospital: A cross sectional study
AA Ladan, EI Nwobodo, KA Tunau, A Panti, AT Burodo, BA Magaji, M Umar, UA Ibrahim
October-December 2016, 25(4):341-347
DOI:10.4103/1115-2613.279415  
INTRODUCTION: Caesarean section remains the most common major operation performed on women worldwide and the rate is increasing. The World Health Organization (WHO) consider caesarean section rate of 5- 15% to be optimum. OBJECTIVE: To determine the rate of caesarean section, major indications, pregnancy out-come and the complications. SUBJECTS AND METHODS: This is a prospective study of all the cases of caesarean sections performed between 1st of January, 2012 and 31th of December, 2013 at UDUTH, Sokoto-Nigeria. The data were collated and analyzed using statistical soft package ware for social sciences (SPSS) version 20. RESULTS: A total of 4,115 deliveries were recorded during the study period and 435 of them (10.6%) were through caesarean section (CS). Emergency CS accounted for 65.1% of caesarean deliveries. The mean age was 28±6 years. Previous CS was the commonest indication for caesarean section (25.7%). Elective CS had better fetal outcome (t = 7.440, df =388.523, p< 0.001), while spinal anaesthesia was associated with less blood loss (t = 4.569, df=63.223 and p< 0.001)and better fetal outcome (t = 4.237, df = 57.224, p < 0.001). Anaemia (19.8%) was the commonest complications encountered in the post operative period. CONCLUSION: The CS rate from this study is within the WHO recommended rate. Previous CS was the commonest indication, the outcome was better among women that had elective CS under regional anaesthesia.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Macroprolactinaemia in a 33-year old premenopausal Nigerian woman: A case report
HC Okpara, TU Agan, EC Ekanem, UB Akpan, OE Enang
October-December 2016, 25(4):391-394
DOI:10.4103/1115-2613.279423  
BACKGROUND: Macroprolactin is a 150-170kDa heteropolymeric complex of monomeric prolactin and immunoglobulin G (IgG) that contributes less than 1% of circulating prolactin concentration in plasma. It exerts little or no biological action in vivo. Its elevated plasma concentration (macroprolactinaemia) is a notable cause of frequent misdiagnosis, unnecessary investigation, and inappropriate treatment in patients with biochemical hyperprolactinaemia. OBJECTIVE: To highlight the need for macroprolactin screening in premenopausal women with biochemical hyperprolactinaemia. METHOD: We report an investigated case of macroprolactinaemia in a 33-year old premenopausal nulliparons woman with sustained hyperprolactinaemia, normoovulatory and regular menstrual cycles, and no radiological evidence of pituitary tumour (prolactinoma). RESULT: The patient had persistent hyperprolactinaemia even after treatment with bromocriptine for 1month. The menstrual cycle remained regular with clinical and biochemical presumptive evidence of ovulation. CONCLUSION: Macroprolactinaemia is a potential cause of (pseudo) hyperprolactinaemia in women of childbearing age. Its occurrence should be suspected and investigated especially in patients with hyperprolactinaemia and regular normoovulatory cycles. The polyethyleneglycol (PEG) precipitation test is a simple and cost-effective screening test for macroprolactinaemia.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Challenges in the management of cervicofacial necrotizing fasciitis in a developing economy: Our experience
T Umeanuka Obiora, C Okechi Uchenna, N Chukwuneke Felix
October-December 2016, 25(4):368-373
DOI:10.4103/1115-2613.279419  
BACKGROUND: Necrotizing fascitis is uncommon but a life threatening cervico-facial infection, which is characterized by aggressive spread of inflammation and necrosis of the tissues. In our environment clinical presentation is often late and patient's management at this stage is very challenging. We present the challenges in the management of this lesion as experience in our centres. METHODS: We carried out clinical evaluation on the management and treatment options amongst the 11 patients that presented with cervicofacial necrotizing fascitis at two tertiary hospitals in South east, Nigeria over a 3-year period from 2012 to 2015. The focus was on the management challenges which include diagnosis, lack of modern facilities and treatment options, associated co- morbidities such as retroviral disease and diabetes mellitus, financial constraint and incessant industrial action by the medical and allied workforce. RESULT: There were 7 males (63.6%) and 4 females (36.7%) giving a male-to-female ratio of 1.8: 1 aged between 27 &8211; 78 years with a mean of 57.4 ± 17.9 years. All presented as emergency and were hospitalized. Six (54.5%) were treated successfully with mortality rate of 9.1% (one patient) recorded. Four (36.4%) were lost to follow up., two of which were referred as a result of industrial action while the other 2 were discharged against medical advice. CONCLUSION: Patients often presents late and with limited options of treatment in a depressed economy treatment is often very challenging. Since poor oral hygiene is a modifiable risk factor, emphasis on oral health care should be a preventable measure.
[ABSTRACT]   Full text not available  [PDF]
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Prevalence and pattern of osteoarthritis of the knee at national orthopaedic hospital Enugu
VO Ogbu, UN Enweani, KA Madu, EC Iyidobi
October-December 2016, 25(4):336-340
DOI:10.4103/1115-2613.279414  
OBJECTIVES: To determine the prevalence of osteoarthritis of the knee and the risk factors associated with its development at National Orthopaedic Hospital Enugu. DESIGN: Cross sectional descriptive study. SETTING: A regional orthopeadic centre in Nigeria SUBJECTS: Two thousand three hundred and ten adults aged 30 years and above. RESULTS: One hundred and fifty one patients were diagnosed as having symptomatic osteoarthritis of the knee with a male to female ratio of 1:2.6. The prevalence of osteoarthritis increased with advancing age. It peaked at 70- 79 years age group. The prevalence of osteoarthritis of the knee was noted to be higher in the female sex, house wives and farmers. The overall prevalence of knee osteoarthritis was 6.5%. Multiple risk factors played roles in the aetiology of osteoarthritis of the knee. The majority of the patients were obese. Obesity was noted in 49.7% of the patients while 24.5% of the patients reported having previous knee injuries. A positive family history of osteoarthritis of the knee was noted in 17.2% of the patients while it was noted to be idiopathic in 4.6% of the patients. CONCLUSION: The prevalence of osteoarthritis of the knee at National Orthopaedic Hospital Enugu is 6.5%. Prevalence was higher in the female sex, house wives and farmers. Obesity was the major risk factor while valgus knee was the commonest presentation.
[ABSTRACT]   Full text not available  [PDF]
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REVIEW ARTICLES
Making sense of thyroid function tests
ID Gezawa, AE Uloko, MA Ramalan
October-December 2016, 25(4):381-386
DOI:10.4103/1115-2613.279421  
BACKGROUND: Thyroid disorders are second only to diabetes mellitus among endocrine problems encountered in practice. Many patients with thyroid disorders tend to present with nonspecific symptoms to clinicians in different specialties, who are often quick to request for a thyroid function test. Although interpretation of the results of most thyroid function tests (TFTs) is straightforward, in a small number of situations the results seem to point in different directions, thereby producing clinical confusion. Knowledge of the different patterns of TFTs and their causes will help clinicians to properly manage their patients and avoid unnecessary, and often expensive further investigations. OBJECTIVE: To highlight the causes of the different patterns of abnormal thyroid function tests seen in clinical practice and to provide a practical approach to the evaluation of patients with such results. METHOD: We searched PubMed, Google scholar and Medline for articles written in English on the interpretation and pattern of thyroid function tests. RESULT: Interpretation of the results of most TFTs is straightforward especially when combined measurements (TSH with T4 or T3 or both) are ordered. Careful clinical reassessment of thyroid status and consideration of possible confounding factors such as pregnancy, intercurrent (non-thyroidal) illness or drug therapy will readily identify the cause of such apparently discordant TFTs. CONCLUSION: A sound knowledge of the conditions that can be associated with different patterns of TFTs will go a long way in guiding the choice of additional investigations and allowing a correct diagnosis, thus avoiding inappropriate treatment.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Sonographic assessment of liver dimension among school aged children in Calabar, South-South Nigeria
DU Eduwem, BE Udoh, JC Eze, NC Okoro
October-December 2016, 25(4):363-367
DOI:10.4103/1115-2613.279418  
BACKGROUND: One of the organs readily assessed during abdominal scanning is the liver and this is due to the wide range of diseases associated with changes in liver size. Ultrasound scan remains a very important modality for liver evaluation because it is simple, not expensive, non-invasive and readily available but yet there is no record of ultrasound measurement of liver sizes among school - age children in Calabar. METHOD: Four hundred and seventy apparently healthy school-age children (3-14 years) were studied. 244(52%) were females, mean age 8.2±1.6 years and 226(48%) were males, mean age 8.0±1.4 years. Liver size of the subjects was measured sonographically in the right midclavicular line to determine anteroposterior (AP) and longitudinal diameters of the liver. Biodata of the subjects (sex, age, height, weight and body mass index (BMI) were evaluated prospectively .The subjects were divided into four groups according to age, sex, height and weight. RESULTS: The mean AP and longitudinal diameter of the liver for males was 102.5±7.3mm and 130.9±7.4mm respectively and that of females was 98.3±6.6mm and 121.0±5.1mm respectively. Age, height and BMI significantly correlated with the longitudinal and AP diameter of the liver (r > 0.5, P < 0.002). CONCLUSION: School age children in Calabar have a mean AP diameter of liver as 100.3±7.3mm with a range of 75.2-129mm and a mean longitudinal diameter of liver as 125.0±10.4mm with a range of 100 - 158mm.
[ABSTRACT]   Full text not available  [PDF]
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REVIEW ARTICLES
Fat embolism syndrome: A review of the literature
F Mustapha Adekunle, A Adesokan Olalekan
October-December 2016, 25(4):374-380
DOI:10.4103/1115-2613.279420  
Fat embolism syndrome is a serious manifestation of fat embolism phenomenon characterized clinically by triad of dyspnoea, petechiae and mental confusion and usually follows long bone fractures. Its classic presentation consists of an asymptomatic interval followed by pulmonary and neurologic manifestations combined with petechial haemorrhages. The syndrome follows a biphasic clinical course. Unlike other embolic events, the vascular occlusion in fat embolism is often temporary or incomplete since fat globules do not completely obstruct capillary blood flow because of their fluidity and deformability. The late presentation is thought to be a result of hydrolysis of the fat to more irritating free fatty acids which then migrate to other organs via the systemic circulation. There is no specific therapy for fat embolism syndrome; prevention, early diagnosis, and adequate symptomatic treatment are of paramount importance. It is a self-limiting disease and treatment is mainly supportive
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
An isolated tuberculousorchitis mimicking testicular tumour as a primary presentation of HIV: A case report
MS Haruna, AA Sule, A Abubakar
October-December 2016, 25(4):387-390
DOI:10.4103/1115-2613.279422  
BACKGROUND: An isolated tuberculousorchitis is a rare lesion and is distinctly unusual as the primary presentation of human immunodeficiency virus (HIV) infection. A high index of suspicion remains decisive to this diagnosis especially when the clinico-radiological findings of such lesion affirmed features of the testiculartumour. CASE REPORT: A 32-year old man presented with a three-months history of left sided painless progressive testicular swelling. Further clinico-radiological findings revealed traits of a left testicular tumour. He was found to be HIV positive only at the index presentation whilst the histopathology of the left sided orchidectomy tissue confirmed tuberculous (TB) orchitis. CONCLUSION: High index of suspicion for TB orchitis with HIV in a patient with clinico-radiological findings of the testicular tumour from areas with high HIV and TB prevalence help in an expeditious diagnosis and therapy.
[ABSTRACT]   Full text not available  [PDF]
  182 31 -
ORIGINAL ARTICLES
How ophthalmologists and ophthalmologists-in-training in nigeria use the social media
GI Nathaniel, O Adio
October-December 2016, 25(4):358-362
DOI:10.4103/1115-2613.279417  
BACKGROUND: The social media has revolutionized the practice of medicine in the area of communication and information dissemination. AIM: This study aims at examining the ways ophthalmologists who practice in Nigeria use the social media and how they impact on their practice. MATERIALS AND METHODS: This was cross-sectional study of eighty-seven (87) consenting ophthalmologists and ophthalmology residents at the 40th Annual Scientific and General Meeting of the Ophthalmological Society of Nigeria held from 24th to 28th August, 2015 in Jos, Nigeria. Self-administered questionnaires and data obtained were recorded in the data sheets and analysed using the SPSS version 20 (2014). Simple statistics and comparisons of associated variables were made using Chi-square. RESULTS: Of the 87 respondents, 82 (94.2%) used the social media while only 5 (5.8%) were not on any social media platform. WhatsApp was the preferred social media platform with 50 (50.5%) of the respondents using it, followed by Facebook (38; 38.4%), LinkedIn (8;8.1%), Instagram (2;2.0%) and Twitter (1; 1.0%). Majority of the respondents (66; 46.5%) used the social media for social interaction; 43 (30.3%) of them used them to interact and collaborate with colleagues; 21 (14.8%) utilized them for patients' education. Only 6 (4.2%) of the respondents used the social media for marketing of their practice. Fifty-two (59.9%) of the respondents believed that the use of social media had enhanced their practice CONCLUSION: The study has shown that majority of the ophthalmologists and residents interviewed were on the social media platform. However, social interaction with friends was the major reason they use the social media.
[ABSTRACT]   Full text not available  [PDF]
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Oral health awareness, practices and status of patients with diabetes attending a tertiary health institution in Nigeria
Taye J Lasisi, Folake B Lawal, Adesoji A Fasanmade
October-December 2016, 25(4):307-314
DOI:10.4103/1115-2613.279410  
BACKGROUND: Despite the reported increasing prevalence of diabetes mellitus, very few studies have documented report on oral health awareness and oral health conditions of individuals with diabetes mellitus from our environment. Thus this study aimed at assessing the oral health awareness, practices and status of individuals with diabetes mellitus attending a tertiary health facility in Nigeria. METHODS: A cross sectional survey of 143 patients with diabetes attending the medical outpatients' clinic of the hospital. Information was obtained from participants using pretested structured questionnaires and oral examination. Tests of associations were determined using Chi-square and student t test. RESULTS: One-fifth (20.3%) of the respondents were aware of good oral health preventing oral diseases in diabetes. Thirty-five (24.5%) knew that diabetes could worsen oral health condition and only 3 (2.1%) could correctly explain the association between diabetes and oral health conditions. Forty-three (30.1%) had participated in an oral health education program focused on diabetes and oral health. The majority (88.6%) had calculus accumulation while none had a healthy periodontium. CONCLUSION: Oral health awareness, practices and status of patients with diabetes were poor in our environment. Thus, these individuals need to be better informed of the relationship between oral health and diabetes.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Impacted metallic foreign body in colon following ingestion: Report of a case
PO Igwe, BO Ezeobika, CD U Efika
October-December 2016, 25(4):395-398
DOI:10.4103/1115-2613.279424  
INTRODUCTION: Foreign body ingestion is a common clinical problem in early childhood. However, it may occur even in adults, unknowingly especially in depressed patients. Most ingested foreign bodies entering the stomach pass through the gastrointestinal tract uneventfully. Management protocol may vary depending on patient type. PRESENTATION OF CASE: A 19-year-old male who presented with a history of sudden abdominal pain and no abdominal distension following ingestion of door bolt .He was pale. His pulse rate was 76 per minute and blood pressure was 120/60 mmHg. Plain radiograph done on first day and second showed impacted L-shaped metallic object at the right iliac fossa region. He was resuscitated and had exploratory laparotomy on second day after presentation. The findings were normal peritoneal fluid, impacted door bolt at mid portion of transverse colon. He had enterostomy and foreign body removal, analgesics and antibiotics. His outpatient follow-up has been uneventful. DISCUSSION: This is to report a case metallic foreign body ingestion with colonic impaction in 19 year old patient with the hope of increasing awareness especially in patients with depressive episodes. CONCLUSION: Impacted metallic foreign body in colon following ingestion, though rare but can occur. Careful resuscitation and skillful surgical intervention will improve outcome.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Assessment of the knowledge, attitude and practice of voluntary non-remunerated blood donation among residents of ekpoma, a peri-urban community in Edo State
FA Ehimen, EF Osagiede, SO Abah, FO Enahoro, Itaman Usifoh
October-December 2016, 25(4):348-357
DOI:10.4103/1115-2613.279416  
BACKGROUND: The importance of use of blood and blood products in medical practice cannot be over emphasized. Voluntary non remunerated blood donation forms the basis for ensuring regular availability of safe blood during blood donation and transfusion. However, volunteer blood donors account for less than one-half of blood supply in developing countries. METHODOLOGY: To assess the knowledge, attitude and practice of voluntary blood donation by residents of a peri-urban community. A descriptive cross sectional study was carried out using a pre-tested semi-structured selfadministered questionnaire among 422 respondents using the multistage sampling technique. The target population were residents of Ekpoma comprising the general public &8211; workers, students of senior secondary schools and tertiary institutions. Variables were entered and analyzed using SPSS software package. The association between participants level of education and other socio-demographic factors was tested using chi square were appropriate. RESULTS: The study involved 422 participants, majority of which were males (58.1%). A large proportion of them were between ages 16 and 26. The overall knowledge on blood donation was good, attitude towards voluntary donation was fair conversely practice was poor as 91.5% of respondents had never donated blood. A significant association was observed between sex and blood donation as only 2% of females have been donors. The commonest reason for not donating blood was fear to damage of health as reported in 40.7% of the participants. CONCLUSION: This study elicits the importance of adopting effective measures in our communities to motivate voluntary blood donation as majority of the participant express willingness in donating blood in the future. Health awareness campaign and motivational programmes should be organized regularly to arouse the interest of the general public in voluntary blood donation exercises.
[ABSTRACT]   Full text not available  [PDF]
  163 32 -
Histopathologic pattern of neoplastic testicular and paratesticular lesions in university of Maiduguri teaching hospital: A 10-year retrospective review
K Abba, MB Tahir, HA Nggad
October-December 2016, 25(4):330-335
DOI:10.4103/1115-2613.279413  
OBJECTIVE: The present study is undertaken to describe the spectrum of histopathological features and age distribution of neoplastic testicular and paratesticular lesions in the University of Maiduguri Teaching Hospital. MATERIALS AND METHODS: A retrospective descriptive study of 14 testicular and paratesticular neoplastic lesions was conducted over a period of 10 years; between January-2005 and December-2014 in the Department of Histopathology, University of Maiduguri Teaching Hospital. Histopathological examination was done after routine processing and staining with Haematoxylin & Eosin. RESULTS: There were 14 cases of neoplastic testicular and paratesticular tumours of which 12cases (85.7%) were malignant lesions and 2 (14.3%) were benign. There were 7 cases (50.0%) of testicular germ cell tumours, 4 cases (28.6%) of paratesticular tumoursand 3 cases (21.4%) of metastasis to the testis. The testicular germ cell tumours also accounted for 100% of all primary testicular tumours. These included 3 cases (42.9%) of seminoma and teratoma each and a case (14.3%) of endodermal sinus tumour (yolk sac tumour). The age distribution of the testicular and paratesticular tumours in this study shows that the majority of malignant lesions were present in the third and sixth decades of life (66.6%), while the only two benign lesions have also one case each in the third and sixth decades of life. The study also shows thatonly 2 cases were seen in the second decade of life; a case of seminoma in a 14-year-old boy and rhabdomyosarcoma in 15 years old, while the oldest patient was a 61-year-old male whose diagnosis was yolk sac tumour. CONCLUSION: This study highlights the rarity of testicular tumours in Maiduguri, Northeastern Nigeria and correlates well with the histopathological spectrum of testicular tumours in other parts of the world. The relative higher percentage of up 21.4% of cases of metastasis to the testis also emphasizes the need for thorough evaluation of testicular specimens especially in cases of advanced carcinoma of the prostate.
[ABSTRACT]   Full text not available  [PDF]
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Epidemiology of skin diseases in university of Nigeria teaching hospital, Ituku-Ozalla, Enugu State
CL Onyekonwu, UR Ojinmah, GA O Ozoh, NU Okoh, JB Uche-Ejekwu, CG Onyekonwu
October-December 2016, 25(4):315-324
DOI:10.4103/1115-2613.279411  
BACKGROUND: Several studies have been carried out to determine the patterns of skin diseases across Nigeria and results have shown changing patterns with the trend reflecting a higher tendency for allergic dermatoses in a majority of these studies. This study was carried out to evaluate the current clinical picture of patients presenting to our clinic. MATERIALS AND METHODS: A prospective study of new patients seen in the skin clinic of University of Nigeria Teaching Hospital(UNTH), Ituku-Ozalla, between November 2013 and August 2014 was carried out. A total of 387 patients' data was analysed. Data collected on patients' sociodemographic status and diagnosis were entered into SPSS Version 17 and analyzed. Diagnosis was based on clinical findings, laboratory diagnosis including biopsy and histopathology were requested when necessary to make a diagnosis. RESULTS: There were more females 245(63%) than males 142 (37%). Most of the patients (81.9%) were aged above 16years and the commonest skin disease was infections (29.5%) followed by allergic skin diseases (13.6%). There was a significant difference in levels of income of study participants across gender and females who were engaged in unskilled labour were more likely to earn lower than males. CONCLUSION: Comparing the study findings with an earlier one from the same center,there is a change in pattern with infections being the most common skin disease. These are largely preventable; public enlightenment campaigns and policies to discourage over the counter purchase of prescription strength corticosteroid creams are highly desirable.
[ABSTRACT]   Full text not available  [PDF]
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The preference of radiology as a postgraduate medical specialty among final year medical students of usmanudanfodiyo university, Sokoto
SA Saidu, FK Umar
October-December 2016, 25(4):325-329
DOI:10.4103/1115-2613.279412  
BACKGROUND: Recruitment into medical specialties outside the core clinical departments remains a stumbling block to advancing medical practice in Nigeria. We set out to determine the factors influencing choice of diagnostic radiology as a field of specialization by the final year medical students in Usmanu Danfodiyo University College of Health Sciences, Sokoto. METHODOLOGY: A descriptive cross sectional study was done. All the 2015/2016 session final year medical students of Usmanu Danfodiyo University were administered a structured questionnaire by the authors. SPSS version 20.0 was used for the result analysis. Univariate and bivariate analyses were done where appropriate to describe variables. RESULTS: A total of 62 out of 65 final year medical students responded. Fifty one(82.3%) had interest in specializing after school. However, only 4(6.5%) of the students had interest in radiology. Male sex was found to be a predictor for the choice of radiology. CONCLUSION: Career guidance/re-orientation and clarification of general misconception about radiology is necessary to avoid shortage of trained radiologists in the near future.
[ABSTRACT]   Full text not available  [PDF]
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