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   2005| December  | Volume 8 | Issue 2  
    Online since January 11, 2011

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Health care workers' knowledge on HIV and AIDS : universal precautions and attitude towards PLWHA in Benin-City, Nigeria
AO Aisien, MO Shobowale
December 2005, 8(2):74-82
OBJECTIVE: Health care workers are at risk of becoming infected with blood-borne pathogens, including HIV. The study was designed to test health care workers knowledge about HIV transmission, universal precautions and their attitude towards people living with HIV and AIDS. DESIGN: A cross-sectional study. SETTING: University of Benin Teaching Hospital, Benin-City, Nigeria. PARTICIPANTS: 120 Health Care Workers (HCWs) who were occupationally exposed to patient's blood and body fluids completed a self administered structured questionnaire between March and May 2004. The HCWs consisted of 50 doctors drawn from obstetrics and gynaecology (25) and surgery departments (25). 70 nurses from accident and emergency unit (23), labour ward (18), labour ward theatre (4), main surgical theatre (22) and family planning clinic (3). RESULTS: The mean age of the health care workers and duration of practice were 39.8 +/- 8.0 years and 14.0 +/- 8.2 years respectively. Though many of the respondents demonstrated good knowledge about HIV transmission, more than 25% of them thought that HIV could be transmitted through saliva, vomit, faeces and urine. They over estimated their risk of acquiring HIV infection following needle stick injury, exposure of mucocutaneous membrane and intact skin to infected blood and body fluids. There was poor adherence to universal precautions which was attributed to lack of knowledge and availability of materials in 48% and 60% of the workers respectively. Over 40% of the health care workers exhibited discriminatory attitude towards people living with HIV and AIDS. There was no statistical significant difference (p > 0.05) in the knowledge of HIV and AIDS transmission and infection prevention practices amongst the doctors and nurses. Similarly there was no significant difference in their discriminatory attitude towards PLWHA. CONCLUSION: We recommend that seminars, workshops should be organized on a continuous basis for health care workers on universal precautions, stigma and discrimination reduction. Those trained should train others on the job. The institution should also make available materials needed to protect workers against the risk of acquiring pathogenic infection in the course of providing health services to their patients.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Genitourinary tuberculosis in Nigeria; a review of thirty-one cases
JC Orakwe, PI Okafor
December 2005, 8(2):69-73
OBJECTIVE: To report and discuss the characteristics of genitourinary tuberculosis as observed in a sub-Saharan African setting, where reports suggest its rarity despite reported high incidence and prevalence of pulmonary tuberculosis. PATIENTS AND METHOD: Thirty one consecutive patients with discharge diagnoses of genitourinary tuberculosis seen in a small community-based hospital over a five-year period were retrospectively studied. RESULT: There were 28 males and three females, with a mean age of 37.6 (SD 11.5) years. Forty- three sites were involved in seven organs: epididymis 25 (58.1%), kidney 7 (16.3%), testis 4 (9.3%), bladder 3 (7.0%), ureter 2 (4.7%), prostate 1 (2.3%), and cord of the testis 1 (2.3%). The commonest presenting features were scrotal/testicular mass with or without pain/tenderness (80.6%), fever/headache (51.6%), and dysuria (22.6%). Other common features were back, loin, or abdominal pain/tenderness. hydrocoele, scrotal abscess, and haematuria. 26.9% had evidence of concurrent or previous pulmonary tuberculosis, and 9.1% were positive on HIV 1 & 11 screening. CONCLUSION: With the prevailing conditions in sub-Saharan Africa and most of the developing world and the slightly different characteristics of the disease in our environment, diagnosis of genito-urinary tuberculosis may be difficult. It is advised that patients with unexplained symptoms in the urinary tract should be investigated for tuberculosis.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Increasing incidence of bacterial, resistance to antibiotics by isolates from the urinary tract
UC Ozumba
December 2005, 8(2):107-109
This is a prospective study to determine the prevalence of antibiotic resistance among organisms causing urinary tract infections in a Teaching Hospital between August 2003 and July 2004 and to compare them with an earlier study in 1993. A total of 1,104 urine samples were collected in sterile universal containers from patients attending University of Nigeria Teaching Hospital and studied. All samples showing significant bacteriuna were studied and isolates identified using standard bacteriogical methods. Antibiotic sensitivity testing was performed on sensitivity test agar (Biotec, UK) using the disc diffusion method in accordance with the National Committee for Clinical Laboratory Standards (5). The results were compared with a previous study in 1993. A total of 3.36 urinary isolates were identified, with the coliforms being the most predominant (51.2%). followed by Staphylococcus aureus and Proteus species (28.9% and 7.1%) respectively. Compared to the earlier study, a significant increase in the resistance of the urinary pathogens to ofloxacin, ciprofloxacin and nalidixic acid was observed, however there was a decrease in the resistance to nitrofurantoin (p < 0.05) using chi-square test. The results of this study should now alert doctors about the increasing possibility of treatment failures, when ciprofloxacin, ofloxacin and nalidixic acid are used for the treatment of urinary tract infections without laboratory testing. A multi-faceted approach including continued and improved surveillance, a reduction in the unnecessary use of antibiotics and infection control are necessary.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Knowledge and perceptions of HIV/AIDS and mother to child transmission among antenatal mothers at Nnamdi Azikiwe University Teaching hospital, Nnewi
AO Igwegbe, AL Ilika
December 2005, 8(2):97-101
OBJECTIVE: Knowledge of HIV/AIDS by pregnant mothers is very important in the prevention of mother to child transmission. This study evaluates the knowledge and perceptions of HIV/AIDS and mother to child transmission among pregnant women attending antenatal clinic at a University Teaching Hospital. METHODOLOGY: Pre-tested questionnaires were interviewer administered to 312 pregnant women randomly selected at the antenatal clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi. RESULTS: The level of awareness of HIV/AIDS among antenatal mothers was very high (99%) and the main sources of information were radio (44.7%), television (38.8%), and print media (34.0%). Though majority (94.2%) was aware HIV infection can coexist with pregnancy, only 76.9% were aware of mother to child transmission. Transplacental (46.1%), breastfeeding (31.7%), and vaginal delivery (16.3%) were the commonly identified routes of vertical transmission. Surprisingly, eighteen respondents (5.8%) indicated that caesarean section is a possible route of vertical transmission. CONCLUSION: Though the percentage of HIV/AIDS knowledge is high, the level of knowledge and perceptions of mother to child transmission is inadequate. This suggests the need to scale up health education about mother to child transmission in our health facilities.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Tuberculosis : current trends in diagnosis and treatment
AK Bello, CH Njoku, AK Njoku
December 2005, 8(2):118-124
Among communicable diseases, tuberculosis (TB) is the second leading cause of death worldwide, killing nearly 2 million people each year. It is estimated that about one-third of the world population are infected with TB (2 billion people) and about 10% of this figure will progress to disease state. Most cases are in the less-developed countries of the world. Tuberculosis incidence has been on the increase in Africa, mainly as a result of the burden of HIV infection. Definitive diagnosis of tuberculosis remains based on culture for Mycobacterium tuberculosis, but rapid diagnosis of infectious tuberculosis by simple sputum smear for acid fast bacilli remains an important tool, as more rapid molecular techniques are being developed. Treatment with several drugs for 6 months or more can cure more than 95% of patients. Direct observation of treatment, a component of the recommended five-element DOTS strategy, is judged to be the standard of care by most authorities. Currently only a third of cases worldwide are treated using this approach. There may be need to modify the treatment modalities especially with the choice of drugs and duration of therapy when TB infection occurs in special situation like pregnancy, liver disease, renal failure or even in coexistence with HlV/AIDS or the drug resistant state.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Arterial injuries in civilian practice in Lagos, Nigeria
MO Thomas, SO Giwa, TO Adekoya-Cole
December 2005, 8(2):65-68
OBJECTIVE: This is a retrospective study of patients managed at the Lagos University Teaching Hospital for peripheral arterial injuries from January 1995 to April 2003. The aim was to study the pattern of peripheral arterial injuries in Lagos. Nigeria and to look at the outcome of management and see what improvements could be made in future. METHOD: Data was collated from case notes of patients, operation register in theatre and admission and discharge books from the surgical wards and the data bank of consultants involved in patients' management. RESULT: Forty-one patients. 37 males and 4 females. were treated within the study period (M:F ratio of 9:1). Twenty three patients (56.1%) suffered gunshot injuries during armed robbery attacks while 9 patients (22.0%) had stab injuries in civilian violence. Twenty-one patients (3 with gunshot injuries and 18 non gunshot penetrating injuries) were managed by direct suturing of vessels. Eight patients had prosthetic graft interposition while 2 patients had reversed saphenous vein grafts. Two patients had the superficial branches of their radial arteries tied up at the wrist. CONCLUSION: Gun shot injuries from armed robbery attack was the commonest cause of peripheral arterial injuries in this environment during the period of study.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Prevalence of dermatophytosis in University of Nigeria Teaching Hospital, Enugu, Nigeria : any change in pattern?
UC Ozumba, R Nlemadim
December 2005, 8(2):83-85
A total of 344 specimens of skin, hair and nail clippings, were examined for the presence of dermatophytes during the period May 2003 - April 2004 at the UNTH.Enugu. Out of these, 65 were found positive for dermatophytes. T. soudanense was the most frequently isolated species representing 70.8% of isolates, followed by T. mentagrophytes 12.3%. Adults were more predominantly infected than children. 89.2% and 10.8% respectively. T. soudanense was the only dermatophyte that was recovered from all sites apart from the buttocks. Compared to an earlier study in 1975, there was a significant decrease in the prevalence of T. capitis (P < 0.05) and this explains the decrease in the prevalence of M. andounii, as this dermatophyte is the most common cause of T. capitis in Enugu. Nigeria. An improvement of Personal hygiene, better living conditions and improved socio economic conditions has led to a decrease of T. Capitis, as well as general awareness by the populace.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Heterotopic pregnancy in a natural conception cycle. A case report
AU El-Nafaty, GS Melah, AA Massa, UR Yahaya, M Bukar, DD Kizaya
December 2005, 8(2):128-129
We report a case of combined intrauterine and tubal pregnancy in a 32 year old para. The patient presented at the Gynaecological emergency unit, with lower abdominal pain, and vaginal bleeding. A pelvic scan confirmed an intrauterine pregnancy. While being managed as a case of threatened abortion, her condition deteriorated and the likelihood of an ectopic pregnancy was entertained. A repeat scan revealed significant peritoneal collection. suggestive of haemoperitoneum, and laparotomy confirmed heterotopic pregnancy. She had a right salpingectomy without complications. The patient had a supervised antenatal care and safe delivery of the intrauterine pregnancy.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Knowledge, attitude and practice of aspects of laboratory safety in Pathology Laboratories at the University of Port Harcourt Teaching Hospital, Nigeria
AA Ejilemele, AC Ojule
December 2005, 8(2):102-106
OBJECTIVE: To assess current knowledge, attitudes and practice of aspects of laboratory safety in pathology laboratories at the University of Port Harcourt Teaching Hospital in view of perceived inadequacies in safety practices in clinical laboratories in developing countries. MATERIALS AND METHODS: Sixty (60) self- administered questionnaires were distributed to all cadres of staff in four (4) different laboratories (Chemical Pathology, Haematology, Blood bank and Medical Microbiology) at the Hospital. RESULT: Gross deficiencies were found in the knowledge, attitudes and practice of laboratory safety by laboratory staff in areas of use of personal protective equipment, specimen collection and processing, centrifuge--related hazards, infective hazards waste disposal and provision and use of First Aid Kits. CONCLUSION: Issues pertaining to laboratory safety are not yet given adequate attention by both employers and employees in developing countries in this ear of resurgence of diseases such as HIV/AIDS and Hepatitis Band C, is emphasized.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Prevalence of gynaecological diseases in Nnewi, Nigeria
JI Ikechebelu
December 2005, 8(2):136-137
Full text not available    [CITATIONS]  [PubMed]
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Histological review of melanocarcinoma in Port Harcourt
D Seleye-Fubara, EN Etebu
December 2005, 8(2):110-113
BACKGROUND: Melanocarcinoma is a malignancy of melanocytes affecting more females; and commoner in the farming population. It is also associated with high morbidity and mortality. OBJECTIVE: To determine the pattern, outcome of melanocarcinoma and a survey of presentation of the tumor in Port Harcourt was undertaken. DESIGN: A retrospective descriptive study for 11 years (1st January 1990- 31st December 2000). SETTING: University of the Port Harcourt Teaching Hospital, Port Harcourt. METHOD: Histological slides previously stained with hematoxylin and eosin of 15 cases of melanocarcinoma were retrieved and re- evaluated for the study. Special stain like Mason Fontana stain was also used for proper diagnosis of some of the tumors. Tissue slides or blocks which could not be located and those with inadequate documentations were excluded from the study. The 15 cases were staged according to Clark's Staging System. RESULT: Melanocarcinoma is rare in this environment as it accounted for 0.8% of total malignancies for the period under review. The age ranged from 39-76 years. Majority of the cases were female with F:M ratio of 3:2. The peak (73.3%) frequency of occurrence was among the age group (51-70) years. Only the nodular and the acral leniginous types were seen, of which the nodular type was the commonest (80%). The feet and the legs were the commonest predilection sites (46.7%) while the head and neck as well as the knee were the least site of occurrence. There was no stage I and II melanocarcinoma in this study. The cancers were seen in stage V, IV and III in decreasing frequency. CONCLUSION: melanocarcinoma. thought rare in this environment, present at advanced stage of the disease. Public enlightenment and awareness campaign as to the physical characteristics of the tumor is needed to make patients present early for diagnosis of the disease and treatment.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Facial neuralgias : analysis of the different types seen at Lagos University Teaching Hospital, (Luth)
GA Agbelusi, AA Wright, MA Danesi
December 2005, 8(2):114-117
OBJECTIVE: To highlight the presentations, characteristics. the difficulties in diagnosis, treatment and response to treatment types of facial neuralgias seen at Lagos University Teaching Hospital. METHODS: Twelve patients with facial neuralgias diagnosed and treated in dental clinic of the Lagos University Teaching Hospital were studies. Using strict for diagnosis, patients were categorized into: trigeminal, glosspharyngeal and post herpetic neuralgias. RESULTS: Eight patients had trigeminal neuralgia; three patients had post -herpetic neuralgia and one patient had glossopharyeal neuralgia. In six patients with Trigeminal neuralgia. mandibular branch was affected, while in the two patients maxillary branch was affected. Six patients with Trigeminal neuralgia responded to carbamazepine alone and 2 had additional drugs. The only patients with glosspharyngeal neuralgia responded to carbamazepine. One patient with post herpetic neuralgia tested positive for HIV. All the post herpetic neuralgia responded poorly to carbamezepine. CONCLUSION: Facial neuralgias are uncommon and usually present in the dental clinic. They can easily be misdiagnosed with resulting inappropriate. Correct diagnosis and treatment with carbamezepine is beneficial in majority of patients.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Antimicrobial susceptibility pattern of Klebsiella species from Ebonyi State University Teaching Hospital Abakaliki, Nigeria
CN Akujobi
December 2005, 8(2):90-93
Klesiella specie isolated from clinical specimens from Ebonyi State University Teaching Hospital (EBSUTH). Abakakliki were studied to determine the antimicrobial susceptibility pattern. Between January, 2003 and September 2004 a total of 3.600 specimens processed in the routine Medical Microbiology laboratory of EBSUTH, of which 245(6.8%) yielded Klebsiella species, with 84 from out - patients and 161 from in - patients. The number of isolates from various samples were: Urine 126, Sputum 37 Endocervical swab 13, Aspirates 8, High Vaginal Swab 7, Blood 3, Eye Swab, Ear Swab and Cerebrospinal fluid were 2 samples each. Organisms were identified by conventional methods. Antimicrobial susceptibility was done by the disk diffusion methods. The antimicrobial disk used include: Ceftazidime, Cefuroxime, Cefotaxine, Augmentin, Pefloxacin (30ug), Doxycyline (25ug) Genticin (10 ug) Ciprofloacin and Ofloxacin (5ug) each and Erythromycin (15ug). All were Oxoid products. Results were interpreted according to NCCLS criteria. Klebsilla species were isolated mostly from urine specimens (51.4%) followed by wound swabs (18.4%). Antimicrobial susceptibility to various groups drugs used was generally poor. The most sensitive antimicrobial was Ciprofloxacin with 121(49.4%) isolates susceptible to it, followed by Gentamicin with 95 (38.8%) and Ceftazidime with 90(36.7%). Seventeen isolates were multiresistant to all the antimicrobial agents used. The result of this study will help in the empiric therapy of infection caused by Klebsiella species in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria but continuous surverillance of antimicrobial resistance of the organnisn is very necessary in the formulation of a sound antibiotic policy in the hospital.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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The determinants of seizure severity in Nigerian epileptics
I Imam, OA Talabi, EO Sanya, A Ogunniyi
December 2005, 8(2):94-96
BACKGROUND: Epilepsy is a chronic disease and the control of seizures is central to its management. While seizure frequency has been the traditional index of epilepsy control. severity of seizures is probably as important as seizure frequency in this regard. Seizure severity scales have therefore been developed to assess the impact of antiepileptic drugs on seizure control. The eight items of the national hospital seizure severity scale were applied in this study to Nigerian subjects with epilepsy to determine which aspects of seizure severity were considered relevant from the patients' perspective. MATERIALS AND METHODS: Twenty-eight confirmed subjects with epilepsy at the University College Hospital, Ibadan, were studied. The National Hospital seizure severity scale questionnaire was administered to all subjects. This assesses generalisation of seizures, falls, injuries, urinary incontinence, warning interval before loss of consciousness, automatisms and time of recovery on a graded scale. RESULTS: The most frequent indices of seizure severity in Nigerian epileptics is the generalisation of seizures in 85.7% of subjects, incontinence of urine in 78.6%, absence of protective warning time in 75% and occurrence of serious injuries in 71.5%. Occurrence of falls and disruptive automatisms were less frequent. Seizure severity scores were worse in subjects with longer duration of epilepsy and in those on monotherapy. CONCLUSIONS: The indices of seizure severity that occurred most frequently in Nigerian subjects with epilepsy were generalisation of seizures, incontinence of urine, absence of protective warning time and serious injuries. These may need to be addressed in the management of epilepsy patients. Subjects on monotherapy in this study had worse seizure severity scores and this may indicate the need to consider early rational polytherapy in order to improve seizure control.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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An accessory flexor of the fifth toe
AL Asomugha, TO Chukwuanukwu, GI Nwajagu, U Ukoha
December 2005, 8(2):130-132
The presence of accessory muscles and other organs on the lower limbs of some individuals have variously been reported in the literature. We report an unusual muscle located on the plantar surface of the left foot of a cadaver, which had not been previously described. This muscle originated from the tendon of tibialis posterior and inserted into the middle phalanx of the fifth toe. It differed from the 'expansions' of the tibialis posterior tendon, which usually pass from its insertion on the navicular bone to other tarsal bones and are ligamentous in nature. The muscle produced flexion of the fifth toe and is innervated by the medial plantar nerve. Awareness of this is important to Anatomists and surgeons, especially those working on the foot.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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A comparison of sphygmomanometric and oscillometric methods of blood pressure measurements in adult in-patients
FE Amadasun, JI Isa
December 2005, 8(2):86-89
The study compared two non-invasive methods of blood pressure measurements used in the anaesthetic management of patients, the conventional sphygmomanometric and the oscillometric methods. One hundred adult in-patients were involved, and 400 blood pressure measurements were done with the two devices. The sphygmomanometric measurements were higher in systolic, diastolic and mean arterial pressure values. Correlation coefficient values between the two methods were r = 0.97, 0.81, 0.95 for systolic, diastolic and mean arterial pressures respectively, (p < 0.05). We conclude that there is a statistically significant difference in haemodynamic values determined by the two devices. This difference is however, not clinically significant to warrant a recommendation of adjustment when comparing values determined by the two devices.
[ABSTRACT]   Full text not available     [PubMed]
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Familial thyrotoxicocis in five Nigerians
AO Afolabi, OO Akute
December 2005, 8(2):133-135
We describe the occurrence of thyrotoxicosis in four Nigerian families. Hitherto. the descriptions of familial thyrotoxicosis have been confined to the Caucasian population and only recently in a Chinese family. This is the first description of familial thyrotoxicosis in the Nigerian population. The mutation analysis of the genomic DNA of the TSH receptor of these patients is required to define the genetic mutations that caused the disease. We recommend that a high index of suspicion for familial thyrotoxicosis should be exercised in the clinical evaluation of patients who present with hyperthyroidism.
[ABSTRACT]   Full text not available     [PubMed]
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Prosthetic management of an epileptic patient
PA Akeredolu, OT Temisanren, MA Danesi
December 2005, 8(2):125-127
This case report illustrates the problems of tooth loss in an epileptic patient. The patient presented with a broken denture following a seizure. She gave a history of breaking and swallowing her dentures during seizures. Before presentation she had worn five upper removable partial dentures. An upper removable partial denture with increased thickness of the acrylic palatal was fabricated and fitted satisfactorily. The patient was taught how to insert and remove the prosthesis as quickly as possible. Epileptic patients can use dentures but run the risk of frequently breaking and swallowing them during seizures. The risk can be reduced if patients and relatives are taught how to remove the dentures prior to or during seizures.
[ABSTRACT]   Full text not available     [PubMed]
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