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   2008| September  | Volume 11 | Issue 3  
    Online since December 1, 2010

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A 20-year review of twin births at Mater Misericordiae Hospital, Afikpo, South Eastern Nigeria
I Sunday-Adeoye, ED Twomey, VE Egwuatu
September 2008, 11(3):231-4
OBJECTIVES: To provide information on twin deliveries among Igbos in a rural/semi-urban community of South-Eastern Nigeria, and compare the twinning rate with data from the other two major tribes. METHODS: An analysis of the records of deliveries conducted over a 20-year period in a rural/semi-urban community of South-Eastern Nigeria. RESULTS: The twinning rate of the community was 1:24, and increased with increasing maternal age, and generally with birth rank. Twin births were associated with a MMR of 895/100,000, and PMR of 213/1000 maternities, figures 3.4 and 1.7 times those of the total maternal and perinatal mortalities respectively. Ninty percent of the twin mothers delivered vaginally, 2% with the aid of symphysiotomy. Caesarean section rate was 10.6%. CONCLUSION: The twinning rate within Nigeria may probably be dictated by location rather than ethnicity. The maternal and perinatal mortalities associated with twin pregnancies in this study appear higher than for singleton births.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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The pattern of admissions into the medical wards of the University of Nigeria Teaching Hospital, Enugu (2)
SO Ike
September 2008, 11(3):185-192
OBJECTIVE: To study the pattern of medical admissions at the University of Nigeria Teaching Hospital (UNTH), Enugu, with a view to determining the disease trend and providing a comparative analysis with the previous study conducted in the same centre in the preceding five-year period. METHOD: A review of admissions into the medical wards of the UNTH, Enugu, over the five year period between December, 1998 and November, 2003, was done using the register of admissions and discharges; as well as a review of the case file where necessary. RESULTS: The patients admitted during the period numbered 7399, with age range of 15 to 102 years. There were 4324 (58.4%) males and 3075 (41.6%) females, with a male to female ratio of 1.4:1. Disorders of the cardiovascular system accounted for 1389 (18.8%) of the admissions, and those of the central nervous system 1178 (15.9%) while HIV-related disorders accounted for 501 (6.7%) respectively. Non-communicable diseases accounted for 4493 (60.3%) of the cases while communicable diseases accounted for 2906 (39.3%). There were more admissions in the wet season (April to September), with 56.8%, while the month of December cumulatively recorded the least admission rate. The mean hospital stay was 15.5 (+/- 15.4) days. CONCLUSION: The study shows an increasing trend in medical admissions at the UNTH, Enugu, with non-communicable diseases and male gender preponderance, while 53% of those affected are in the 30 60 years range. Serious efforts at revamping the health sector services and facilities, and particularly, national and local strategies to combat non-communicable diseases, are emphasized.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Knowledge, attitude and practice of screening for cervical cancer among female students of a tertiary institution in South Eastern Nigeria
CN Akujobi, JI Ikechebelu, I Onunkwo, IV Onyiaorah
September 2008, 11(3):216-219
BACKGROUND: Cervical cancer is the second commonest cancer of females worldwide and the commonest cancer of the female genital tract in our environment. It can be prevented through early detection by cervical screening (Pap smear). OBJECTIVE: The objective of this study is to determine the knowledge, attitude and practice of cervical cancer screening among female undergraduates. METHOD: A pre tested questionnaire was administered to third and fourth year female students of the Faculty of Natural Sciences, Nnamdi Azikiwe University Awka, Nigeria. RESULT: Out of the 220 students involved in the study, 134 (60.9) had knowledge of cervical cancer and 118 (53.6%) were sexually active with the average age at sexual debut being 21.2 years. The mean age of the students was 23.8 years and the age range was 17 to 39 years with 175 (80%) in the age range of 20-29 years. About 2/3 of the students did not know about Pap smear and worse still, none of them had undergone a Pap screening test before. This low participation in screening for cervical cancer was attributed to several reasons including ignorance of the existence of such a test, lack of awareness of centers where such services are obtainable, ignorance of the importance of screening and the risk factors to the development of cervical cancer. CONCLUSION: There is good level of awareness of cervical cancer among the female undergraduates but poor knowledge and participation in cervical cancer screening. The development of a comprehensive cervical cancer screening strategy is being recommended to improve participation with a view to prevent cervical cancer by early detection and treatment of the pre-malignant stages.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Neonatal morbidity and mortality in Calabar, Nigeria : a hospital-based study
JJ Udo, MU Anah, SO Ochigbo, IS Etuk, AD Ekanem
September 2008, 11(3):285-289
BACKGROUND: The morbidity and mortality pattern amongst neonates admitted into the University of Calabar Teaching Hospital were reviewed from 1st June 2003 to 30th November 2004. RESULTS: The major indications for admission for inborn babies were infections (27.4%), jaundice (21%) and low birth weight (LBW) (18.4%). The out born babies were admitted largely for sepsis (26.8%), jaundice (17.7%), tetanus (13.9%) and low birth weight (11.2%). Staphylococcus aureus (61.2%) and unclassified coliforms (21.9%) were the dominant isolates of septicaemia. The overall mortality rate of 19.3% was largely contributed by outborn infants (73.2% of the deaths). In descending order of magnitude, the total of 153 deaths during the period was due to infections (neonatal tetanus 20.9%, septicaemia 19.6%), birth asphyxia 23.3% and LBW 19%. Most of the deaths (70.6%) occurred within the first 7 days of life. Fifty-three (34.6%) of the deaths (most outborn infants) occurred within 24 hours of admission. CONCLUSION: Nigerian government needs to improve funding of the health sector in order to reduce neonatal wastage. Training and retraining of traditional birth attendants is inevitable. More effort should be made towards improving coverage rate of tetanus toxoid among women of childbearing age.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Outcome of eclampsia at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife
IP Ade-Ojo, OM Loto
September 2008, 11(3):279-284
OBJECTIVE: Eclampsia is a serious obstetric complication with attending high maternal and perinatal morbidity and mortality. There is need for periodic audit of our management of these cases so as to identify potential areas for possible intervention aimed at improving the management outcome of this pregnancy complication. METHODS: The records of cases of Eclampsia managed at the OAUTHC Ile-Ife between January 1, 1994 and December 31, 2003 were retrospectively analysed. RESULTS: The incidence of Eclampsia was 0.91% of total deliveries. It was highest in teenagers and young adults who are less than 25 years (1.56%), who were carrying their first pregnancy (2.64%) and were unbooked (6.3%). Headache was the commonest symptom (100%), while hypertension and fever were the commonest signs being present in 75% and 20.2% of the patients respectively. Antepartum Eclampsia accounted for 56.5% of the cases and majority was delivered by emergency caesarean section. Maternal and perinatal mortality were 8.0% and 19.1% respectively. CONCLUSION: Provision of good quality and widespread antenatal care, improving the capacities of the hospitals to handle emergencies and intensive care unit management of all cases of Eclampsia are measures that could reduce the burden ofEclampsia in this environment.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Validation study of the Siriraj stroke score in North-east Nigeria
YW Nyandaiti, SA Bwala
September 2008, 11(3):176-180
BACKGROUND: The management and prognosis of stroke depends on the correct assessment of its pathological sub-type. It is therefore pertinent to have a simple and quick means of evaluating patients with stroke. The Siriraj stroke score (SSS) was developed in Thailand based on clinical parameters and have a good predictive value. This study aims at validating the Siriraj stroke score, as the predictive value of any diagnostic score depends on the prevalence of the disease in the community. METHODOLOGY: Patients who had stroke less than fourteen days before admission were enrolled into the study. Clinical variables for calculating the Siriraj stroke score were documented all patients subsequently had computerized tomography scan performed. A total of fifty patients were studied from University of Maiduguri Teaching Hospital and the State Specialist Hospital Maiduguri. RESULTS: Twenty-seven patients had infarction while twenty-three patients had hemorrhagic strokes respectively, based on the CT scan findings. The Siriraj stroke score correctly diagnosed fourteen as infarction and twenty as having hemorrhagic strokes, sixteen subjects were unclassified. The SSS correctly diagnosed thirteen cases as infarctive and seventeen as hemorrhagic strokes as confirmed by CT scan. The sensitivity and the predictive value of the SSS were 76.2% and 93% for infarction and 94.4% and 85% for hemorrhagic stroke respectively with overall accuracy of 84.6%. The clinical variables such as headache, vomiting and atheroma markers did not show discriminant value independently in differentiating CI and CH. However, level of Consciousness (coma) and diastolic blood pressure of greater than 110 mmHg are discriminant variables in differentiating CI and CH. CONCLUSION: Siriraj stroke score is recommended to be used in this community especially where CT scan is not available or affordable and the physician wishes to start thrombolytic or/and anticoagulation therapy.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Neonatal bacterial meningitis and dexamethasone adjunctive usage in Nigeria
KI Airede, O Adeyemi, T Ibrahim
September 2008, 11(3):235-245
OBJECTIVE: Neonatal bacterial meningitis is devastating, with attendant high mortality and neurological sequelae. We, therefore, aimed to delineate its current incidence, etiologic, clinical, laboratory spectra, and the effect of steroid therapy on the outcome. METHODOLOGY: Babies admitted from 1992 to 1995 in the Special Care Baby Unit of the University of Maiduguri Teaching Hospital, Maduguri, Nigeria, with bacterial meningitis were studied prospectively. Neonatal bacterial meningitis was confirmed if the cerebrospinal fluid (CSF) microbiological, chemical, immunological and clinical criteria were satisfied. Detailed neurological follow-up was made. RESULT: Sixty-nine cases of neonatal bacterial meningitis were encountered, (25 were early-onset, and 44 late-onset); the incidence was 6.5/1000 live births. 22 Positive CSF cultures were grown in early-onset meningitis, and 28 in late-onset disease. Low birth weight showed higher risk of bacterial meningitis and it was significantly more likely in the preterm. X2 = 24.19, p = 0.000001). Gram-negative pathogens were more isolated (28/50, 56%); Escherichia coli (11) being the commonest, while of the Gram-positive pathogens Staphylococcus aureus was most predominant overall (13/50). Concomitant blood culture was positive in 39/50 (78%), inclusive of all 22 "definite" early-onset disease. The CSF WBC was minimally raised (25-30 x 10(6)/L) in 11 (22%) of "definite" neonatal bacterial meningitis. Detection of unusual pathogens was noteworthy: N. meningitidis (2) and H. influenzae (2), contributing 0.6 and 2.2 per 1000 live births and admissions, respectively. Overall mortality was 24.6%. Of the forty survivors, 9 (22.5%) had neurological sequelae: sensorineural hearing deficit (3), hydrocephalus (2), subdural effusion (2), hemiparesis (1), afebrile (recurrent) seizure (1), and there was reduced developmental quotients at 24 months follow-up in 33. Dexamethasone therapy decreased mortality significantly; p = 0.0004. CONCLUSION: The new information highlighted by this research includes the lack of Group B Streptococcus isolation, the finding of S. pneumoniae, N. meningitidis, H. influenzae and S. aureus as significant pathogens, usefulness of blood cultures in the detection of neonatal bacterial meningitis, increasing resistance of Gram-positive neonatal pathogens to cloxacillin, low CSF WBC, and the finding that the adjunctive use of dexamethasone significantly decreases case fatality and neurological sequelae.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  4 533 0
Age related pattern and outcome of head injury in indigenous Africa
TO Odebode
September 2008, 11(3):265-269
BACKGROUND: Most studies of patients with head injury managed outside of indigenous Africa have shown poorer outcome with increasing age, but data on this subject is scanty in this part of the world. AIM: To determine age related pattern and outcome of head injury in an indigenous African setting. METHODS: A retrospective analysis of clinical characteristics, mechanism of head injury, associated injury, trauma scores and outcome in patients admitted for head injury at the University Teaching Hospital, Ilorin, Nigeria, between 1989 and 1999. RESULTS: The 648 patients comprised of 39 older subjects (= 60 yrs), 357 adults (17-59 yrs) and 252 children (= 16 yrs). They were aged 1 to 105 years (mean = 37years). Road traffic injury was the commonest cause of trauma to the head. Children were most often injured as pedestrians while adults and older patients were more often victims of passenger vehicular accidents. Older patients had the poorest outcome with a mortality rate of 48.7%. They were more prone to severe head injury (41.0%) and multi-system trauma (51.3%), with higher mean injury severity scores and lower probability of survival than younger patients. Outcome was predictable by age and GCS (p = 0.0206 & 0.0000) in all age groups put together and in children while GCS was a predictor in adults (p = 0.0000), and none of the variables could predict outcome in the older patients. CONCLUSION: The study reaffirms that outcome of head injury worsens with advancing age and indicates that severity of head injury and higher frequency of multi-system trauma may contribute to worse outcome in older patients.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Relation between Helicobacter pylori, inflammatory (neutrophil) activity, chronic gastritis, gastric atrophy and intestinal metaplasia
MN Tanko, AN Manasseh, GO Echejoh, BM Mandong, AO Malu, EN Okeke, N Ladep, EI Agaba
September 2008, 11(3):270-274
BACKGROUND: To determine the relation of Helicobacter pylori infection with chronic inflammation, atrophy, activity level and intestinal metaplasia. PATIENTS AND METHODS: A cross-sectional study of 100 consecutive patients with dyspepsia. These patients were fasted for 12 hours and gastroscopic biopsy specimens were obtained from their gastric mucosae. The specimens were histologically evaluated for H. pylori, inflammatory activity, chronic inflammation, gastric atrophy and intestinal metaplasia. RESULTS: There were 50 (50%) females and 50 (50%) males. The average ages of women and men were 36.3 +/- 11.5 and 42.9 +/- 12.8 respectively. Helicobacter pylori was found in 79%. Neutrophil activity was observed in 83%. Inflammation was found in 95%, glandular atrophy in 38%, intestinal metaplasia in 28% of the cases. Incidental (early gastric) cancer was found in 3%, dysplasia in 2% and reactive gastropathy in 7% of the cases. A statistically significant relationship was found between Helicobacter pylori colonization intensity and the degrees ofneutrophil activity, chronic inflammation and intestinal metaplasia. CONCLUSION: We concluded that Helicobacter pylori infection results in neutrophil activation and chronic gastritis, and that it has a role in the development of intestinal metaplasia. The greater the intensity of Helicobacter pylori infection, the greater the degrees of neutrophil activation, chronic gastritis and intestinal metaplasia.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Worm infestation and anaemia among pre-school children of peasant farmers in Calabar, Nigeria
MU Anah, OE Ikpeme, IS Etuk, KE Yong, I Ibanga, BE Asuquo
September 2008, 11(3):220-224
BACKGROUND: Worm infection and anaemia are common childhood conditions in Nigeria. We assessed the status of helminthiasis and associated anaemia among pre school children of peasant farmers aged 1-5 years living in a rubber plantation near Calabar, Nigeria. DESIGN: Cross sectional. METHOD: Three hundred and fifty children were selected by multi-stage cluster sampling technique. Freshly passed stool was examined using Kato-Katz method while anaemia was estimated using haematocrit technique. RESULT: Of the 350 children, 174 (49.7%) had intestinal helminths: Ascaris lumbricoides 64.4%, hookworms 10.9% and Trichuris trichuria 1.1%. There were 41(23.6%) children with polyparasitism, 33 of them were due to Ascaris lumbricoides and hookworms. The worm load was generally light in intensity with egg per gram of stool ranging from 24-60,960. Males (28.9%) were infected more than females (20.8%). The frequency of infection increases with age. The prevalence of anaemia among the entire study population and in those infected with worms was 56.6% and 56.9% respectively. With polyparasitism there was a relative increase in the frequency of anaemia females > males. CONCLUSION: Worm infections and anaemia are common in our children. A comprehensive control strategy involving good sanitation, sinking of bore hole for clean water supply and regular deworming exercises are recommended.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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A clinico-pathological study of cervical carcinoma in South Eastern Nigeria; a five-year retrospective study
GO Udigwe, CA Ogabido
September 2008, 11(3):202-205
OBJECTIVE: To determine the pattern of clinical presentation of carcinoma of the cervix in Nnewi Southeast Nigeria with a view to determining strategies for intervention. METHOD: This is a retrospective descriptive study involving all cases of clinically diagnosed carcinoma of the cervix seen over a five year period. RESULTS: Forty three case notes were available for study. The age range was 38 to 87 years with a peak age incidence of 51 to 60 years. The commonest symptom at presentation were postmenopausal bleeding (51.2%), vaginal discharge (32.6%), postcoital bleeding (9.3%) and irregular vaginal bleeding (7%). Nearly 80% presented with the advanced form of the disease with 20 (46.5%) and 14 (32.6%) presenting in stage III and IV respectively. 27(62.8%) were lost to follow up at various stages ofmanagement. CONCLUSION: The pattern of presentation follow known trends. Lack of facilities for radiotherapy and loss to follow up are major obstacles in the management of carcinoma of the cervix.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Informed consent in surgery : an audit of practice in Ile-Ife, Nigeria
AO Adisa, UU Onakpoya, AO Oladele, OO Lawal
September 2008, 11(3):206-210
OBJECTIVES: This study was conducted to assess patients' knowledge of their diagnoses and proposed surgical procedures before giving consent for such procedures in the various surgical units of Obafemi Awolowo University Teaching Hospitals Complex, (OAUTHC), Ile-Ife. MATERIALS AND METHODS: A structured questionnaire was administered to 80 consecutive patients who had just undergone an elective major surgery in general surgery, gyneacology, orthopaedics and surgical subspecialty units of the hospital. RESULTS: Sixty patients (75%) gave consent themselves, while other consents were obtained from close relations. Thirty-seven (46.25%) respondents were informed of the diagnoses and procedure by the unit consultants but no consultant was involved in the completion of the consent form. Seventy-five (93.75%) respondents had a knowledge of the diagnoses, 68(85%) understood the procedure but only 21(26.25%) knew any alternative to the procedure, 29(36.25%) knew at least one complication of the procedure and 12(15%) knew an option or complication of anaesthesia. Forty-five (56.25%) of the consent forms were properly filled while other forms had one error or another. CONCLUSION: Well structured and standardized method of obtaining informed consent from surgical patients should be adopted. While educating patients, the various alternatives to the procedure and possible complications should be carefully explained to the patients who should be carried along in decision making.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Radiological assessment of the uterus and fallopian tubes in infertile women at Abakaliki, Nigeria
AO Imo, I Sunday-Adeoye
September 2008, 11(3):211-215
OBJECTIVES: This study is aimed at determining the pattern of abnormalities in the Hysterosalpingograms of patients who attended the Radiology Unit of Ebonyi State University Teaching Hospital, Abakaliki. METHOD: The 188 hysterosalpingograms conducted between January 2002 to December 2005 were analysed.. RESULTS: The mean age in this study was 31 years. Forty-one (21.8%) Hysterosalpingograms were normal. Abnormality of the Fallopian tubes constituted 54.6% of all abnormalities recorded, uterine 33.6% and cervical 11.8%. Cornual occlusion and hydrosalpinx were the leading abnormalities of the Fallopian tube, 32.2% and 20.3% respectively, while beading of the Fallopian tubes was the least tubal abnormality recorded in 1.4%. Uterine fibroid was the leading uterine abnormality in the study (44.5%), and uterine unicornis unicollis and bicornuate uterus were the least abnormalities of the uterus recorded with 0.8% respectively. Cervical synechiae was the only cervical abnormality recorded in the study (11.8%). CONCLUSION: Hysterosalpingogram is relevant in outlining abnormalities of the fallopian tube and uterus especially in patients with infertility. The study suggests that abnormalities of the Fallopian tube are probably still a prominent contributor to infertility in our community.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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AIDS-associated Kaposi's sarcoma in Sokoto, Nigeria
N Mbah, IH Abdulkareem, A Panti
September 2008, 11(3):181-184
BACKGROUND: Since the advent of the HIV/AIDS pandemic, Kaposi's sarcoma (KS) is now seen in places not previously considered endemic for this disease. In Nigeria, the African-endemic KS had been known to be prevalent in the southern parts of the country, particularly the southeast. Until now, reports on the disease from northern Nigeria are few. OBJECTIVE: To describe the prevalence ofKaposi's sarcoma in Sokoto, northwestern Nigeria. METHOD: A retrospective review of 27 cases of histologically confirmed KS seen over an 11-year period (Jan.1994-Dec.2004) at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Northwestern Nigeria. RESULTS: The average hospital incidence of KS in this review was 2.5 cases per annum (27 cases in 11 years). The modal age was the 4th decade of life (range 18-70 years). Fifteen percent were females; M: F = 5.8: 1. There was no case of childhood involvement identified. More cases of the disease were HIV-positive (59.3%). The commonest symptom was cutaneous nodules in 96.3% of cases. The body region with the highest affectation of the lesions was the lower limb (70.4%). CONCLUSION: Kaposi's sarcoma is still uncommon in the northwestern region of Nigeria. The epidemic variant of the disease predominates among the few cases diagnosed. The finding of nodular lesions and/or indurated leg swelling in any adult male in our environment must be considered to be KS until histologically investigated.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  2 530 0
Outcome of early posttraumatic seizure : an experience in Nigeria
OT Odebode, EO Sanya
September 2008, 11(3):193-198
PURPOSE: To determine the frequency, causes, risk factors and outcome following early posttraumatic seizure. METHODS: A retrospective analysis of age, sex, mechanism of injury, type and onset of unprovoked seizure occurring within one week of injury, admission coma score, and Glasgow outcome score in patients with nonpenetrating head injury. RESULTS: Eighty six (10.2%) of 845 head injuredpatients developed early posttraumatic seizure. They were 55 (64%) children and 31 (36%) older subjects. The seizure was partial in 35% but generalized in 65% of cases. The frequency of seizure increased significantly with decreasing age (p = 0.00002) and coma score (p = 0.00009) in the seizure group and also in relation to the entire sample (n = 845) of head injured patients (p = 0.00000). Traffic accident was the leading cause of head injuries (58%), while fall from height (32.5%), domestic injuries (4.2%) and non-penetrating assault (3.5%) were miscellaneous causes. Pedestrian vehicular injury and falls were the commonest mechanisms of injury in children, while older patients were most frequently involved as passengers in auto-crash. Early posttraumatic seizure worsened outcome of head injury, the case mortality rate being 27.9% and 19.2% in patients with and without posttraumatic seizure respectively. CONCLUSIONS: The frequency of early posttraumatic seizure in our setting is 10.2%. This varies significantly with patients' age and initial coma score.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Neurological complications of chronic myeloid leukaemia : any cure?
DE Joseph, JD Emmanuel, MA Durosinmi, MA Dorusinmi
September 2008, 11(3):246-249
OBJECTIVE: To attempt to explain the non-reversal, contrary to the widely held view, of the neurological deficits complicating chronic myeloid leukaemia. METHOD: Using patients' case folders and haematological malignancy register all cases of chronic myeloid leukaemia seen in Jos University Teaching Hospital between July 1995 and June 2005 were retrospectively studied. All the available literature on the subject was also reviewed. RESULTS: Thirty-three cases of chronic myeloid leukaemia were seen within the study period. Five (15.15%) of them had one or more sensori-neural defects. Of the five, two (40%) patients presented with bilateral hearing impairment, each beginning with the left ear; one (20%) presented with left ear hearing loss; one (20%) came with severe left ear tinnitus; one (20%) presented with complete bilateral hearing and bilateral visual losses. Fundoscopy showed leukaemic deposits on the retina. Other causes of blindness and deafness, e.g. trauma and foreign body in the ear respectively, were excluded. CONCLUSION: While the complications due to hyperleucocytosis-induced stasis recover following the conventional treatment, those due to other pathogenetic mechanisms such as leukaemic deposits do not return to their pre-morbid states following disease control despite the use of the currently available treatment protocols. For future research, more still needs to be done to elicit other uncommon pathogenetic mechanisms underlying these complications with a view to finding specific treatment measures for worrisome chronic myeloid leukaemia-related sensori-neural deficits.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  2 473 0
Gastrointestinal injuries following blunt abdominal trauma in children
LB Chirdan, AF Uba, OO Chirdan
September 2008, 11(3):250-253
PURPOSE: Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. PATIENTS AND METHODS: From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. RESULTS: There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and at presentation over 80% had abdominal signs. Diagnosis was mainly by physical examination supported by plain abdominal x-ray in 15 children. All 19 children had laparotomy. There were a total of 23 injuries. Gastric and duodenal injuries accounted for one each. Most of the injuries were in the jejunum and ileum (10 perforations, two contusions with one mesenteric haematoma and one mesenteric tear). There was one caecal perforation and six colonic injuries, one of which was associated with intraperitoneal rectal injury. Five children had other associated injuries (three splenic injuries, one renal injury, one bladder contusion associated with long bone fractures and one severe closed head injury). Treatment included segmental resection with end to end anastomosis, wedge resection with anastomosis, exteriorizations stomas, simple excision of the perforation and closure in two layers (gastric perforation). The total mortality was four (21.1%), two of them due to associated injuries. CONCLUSION: Gastrointestinal injuries due to blunt abdominal trauma pose a management challenge. Management based on decisions from serial clinical examinations and simple tests without recourse to advance imaging techniques may suffice.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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A report of two cases of uncemented total hip replacement in patients with sickle cell disease
AU Ekere, CB Eze, LN Ebirim
September 2008, 11(3):257-259
This is a report of two sickle cell patients (HbSS) with advanced osteoarthritis of the right hip. The patients were in Ficat and Arlet's stage 3 and 4 respectively. Both were females aged 23 and 46 years and they had uncemented hydroxyapatite coated omnifit (Stryker Howmedica Osteonics) total hip prosthetic replacement. The results so far have been quite encouraging. The procedure is technically demanding, fraught with risks and expensive but very useful. This is the first of such reports in Nigeria.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Implementing the new WHO antenatal care model : voices from end users in a rural Nigerian community
OU Umeora, BN Ejikeme, I Sunday-Adeoye, RN Ogu
September 2008, 11(3):260-264
CONTEXT: The recommended WHO antenatal focused visits with reduced number of visits and tests is yet to be implemented in many communities in rural Nigeria. AIM: This paper evaluated the attitude of antenatal clients in a rural mission hospital to the new antenatal model. STUDY DESIGN: Focus group discussions were carried out bi-weekly for 12 weeks with consenting booked antenatal clients. The topic guide was developed following interactions with prenatal clients at a referral tertiary center. RESULTS: One hundred and forty-four clients were interviewed. Prior to discussion, none had heard of the new antenatal care model. More than half of them will prefer the traditional policy with multiple visits to the new model. The traditional visit was said to be more reassuring and provides the clients time away from their routine chores/occupations and afford them the opportunity to interact with other expectant mothers and get acquainted with the health care providers. CONCLUSION: To realize the goals of the new WHO recommended antenatal model in rural Nigeria, mass enlightenment and education must precede its gradual and cautious introduction.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Seroprevalence of hepatitis C virus infection in Nigerians with type 2 diabetes mellitus
OA Adegoke, BA Kolawole, RT Ikem, A Adediran, AO Aboderin, A Salawu
September 2008, 11(3):199-201
BACKGROUND: Several studies have suggested a strong epidemiologic association between Diabetes Mellitus (DM) and Hepatitis C Virus (HCV) infection in some populations. However, the reasons why chronic HCV infection is prevalent in DM remain unknown. Our aims were to determine the prevalence of HCV infection in a population of Nigerian diabetics compared with the general population as well as assess the influence of sex and age on HCV infection in the same diabetic population. DESIGN AND METHODS: A total of 115 diabetic patients were compared with 2,301 blood donors matched by recognized risk factors to acquire HCV infection. Serologic testing for anti HCV was done using a commercial enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: Sixty (60) type 2 diabetic patients were males while fifty-five (55) were females. Their mean age was 55.4 +/- 9 years and mean blood glucose level was 8.5mmol/l. One subject tested positive for HCV infection. The control group consisted of 2,031 adults recruited from the blood donor's clinic. Forty five of them (2.2%) tested positive for HCV. CONCLUSION: Our preliminary results suggest a low sero-prevalence of HCV infection among our patients with type 2 diabetes. Presently, routine screening for HCV infection in persons with diabetes may not be necessary.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Chronic calcific pancreatitis presenting with stunting and diabetes mellitus
MU Amadife, DC Muogbo
September 2008, 11(3):254-256
We report the case ofa 16 year old boy who presented with 8 months history of weight loss, 3 months history of polydypsia, polyuria and polyphagia. The child had poor growth since age of 5 years, during which time he developed recurrent abdominal pain for 4 years. A diagnosis of chronic calcific pancreatitis complicated by stunting and diabetes mellitus was made on the basis of weight/height ratio less than 5th NCHS percentile for his age, fasting blood sugar of 233mg/dl, and presence of calcifications over the pancreatic area on a plain abdominal X-ray. This case is reported due to the rarity of this condition in children. It is also the first to be seen in our hospital. It will serve to alert the Paediatrician to such clinical condition in children with chronic abdominal pain. In this case, symptoms of diabetes mellitus were the reasons for seeking medical attention and it also shows how chronic pancreatits led to insulin dependent diabetes mellitus.
[ABSTRACT]   Full text not available     [PubMed]
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Urinary findings in young adults in Abakaliki, Nigeria
EI Ugwuja, NC Ugwu
September 2008, 11(3):275-278
OBJECTIVE: To determine the prevalence of urinary abnormalities in young adults living in Abakaliki, Southeastern Nigeria. METHOD: Two hundred and fifty (250) clean-catched mid-stream urine samples obtained between October 2005 and June 2006 from apparently healthy young adults, aged 18-25 years (mean = 19.7 +/- 4.1 years) resident in Abakaliki, comprising 151 (60.4%) females and 99 (39.6%) males were analysed using standard laboratory procedures and techniques. RESULTS: The prevalence of urinary abnormalities was found to be 20.7%. In addition to leucocyte esterase and pyuria, which were found in significantly more female samples than the males' (p < 0.05), there were generally more abnormalities in female urine samples than their male counterparts (p < 0.05). The major abnormalities recorded were pyuria (47.1%), bacteriuria (21.6%), proteinuria (14.0%) and haematuria (8.0%). CONCLUSION: The finding supports routine urine screening as an important disease surveillance approach in young adults Nigerians resident in Abakaliki metropolis.
[ABSTRACT]   Full text not available     [PubMed]
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Post-anaesthetic respiratory complaints following endotracheal anaesthesia in lower abdominal obstetric and gynaecology surgery
IK Kolawole, MS Ishaq
September 2008, 11(3):225-230
BACKGROUND: Postanaesthetic respiratory complications represent a significant negative aspect of surgical care. OBJECTIVE: To assess the incidence and possible associated risk factors for postanaesthestic respiratory complaints following endotracheal anaesthesia in lower abdominal surgery in obstetric and gynecology patients in our hospital. SETTING: A Teaching Hospital in Nigeria. DESIGN: Prospective study METHODOLOGY: All consenting adult patients, aged 16-45 years, undergoing caesarean section and major gynaecological abdominal operations, under general anaesthesia with endotracheal intubation, over a period of 8months, were studied. Postoperative respiratory symptoms, (sorethroat, hoarseness and cough), were assessed in the ward, by direct questioning method, daily for 5 days. Those presenting with cough had their chest examined, and fever (T degrees > 37 degrees C), was noted. Patients with positive chest signs had radiological examinations of the chest done for confirmation. RESULTS: A total of 202 patients were studied. Out of these, 152 (75.2%) patients had various forms of postoperative respiratory complaints. Overall, it was observed that caesarean section patients were more likely, than gynaecology patients, to report these respiratory complications in the postoperative period (88.4% vs. 58.9%). This difference was statistically significant (p < 0.05). The incidence of sorethroat directly correlated with the size of the endotracheal tube used (r = 0.936). There was a statistically significant difference in the incidence of sorethroat between the caesarean section patients and gynaecology patients (p < 0.00), particularly with endotracheal tube sizes larger than 7.5mm ID (p < 0.03). Duration of intubation, which was slightly longer in gynaecology patients (mean = 72.48 +/- 30.62), and number of intubation attempts, did not have statistically significant effect on the incidence of respiratory complaints. CONCLUSION: The use of small endotracheal tube sizes (< 8.5mm) should be preferred in women, particularly in obstetric anesthesia (6.5-7.5mm), to minimize the incidence of postoperative respiratory complications.
[ABSTRACT]   Full text not available     [PubMed]
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