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   2009| December  | Volume 12 | Issue 4  
    Online since November 30, 2010

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Pattern of medical admissions at the Federal Medical Centre, Asaba-a two year review
CU Odenigbo, OC Oguejiofor
December 2009, 12(4):395-397
OBJECTIVE: A two-year retrospective evaluation of the pattern of medical admissions at the Federal Medical Centre (FMC), Asaba, Delta State, Nigeria. METHODOLOGY: Case notes of all admissions and deaths in the medical wards between November 2005 and October 2007 were retrieved and reviewed. The mean, standard deviation and percentages of relevant data were derived and presented in simple descriptive statistics. RESULTS: One thousand, eight hundred and sixty patients were admitted over the study period. One thousand and eight of these [1008; 54.2%], were male, while eight hundred and fifty two [850; 45.8%] were female, making a female/male ratio of 1:1.18.The patients ages ranged between fifteen and ninety years, with a mean of 51.56 +/- 18.35 years. The age range of male patients ranged from 16 to 88 years, with a mean of 55.55 +/- 17.99 years, while that of the female patients ranged from 15 to 90 years, with a mean of 57.14 +/- 13.79.The length of stay in the ward ranged from 1 to 97 days, with a mean of 10.32 +/- 10.93 days. There were 23.25 patients per bed per year and a bed occupancy rate of 65.74%. There were 240 deaths [12.90% of total admissions]. The interval between admission and death ranged between 1 and 31 days, with a mean of 7.14 +/- 6.7 days. One hundred and twenty four patients [124; 6.7%] were referred to other health facilities, while ninety six [96; 5.2%] left against medical advice.The commonest causes of admission in males was hypertension, diabetes mellitus and HIV, while in females, it was HIV, hypertension and diabetes mellitus. Commonest causes of death in males were hypertension, HIV and diabetes, while in female subjects, it was HIV, hypertension and diabetes. Conclusion: Non-communicable diseases- [hypertension, diabetes mellitus] and HIV/AIDS were the major causes of admissions and death in both genders.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  747 0 4
Beliefs and attitude towards spectacles
CO Adeoti
December 2009, 12(4):359-361
OBJECTIVE: The study was conducted in order to discover the beliefs and attitude of the people towards wearing glasses in order to improve acceptance of glasses when prescribed thus reducing blindness and visual impairment due to uncorrected refractive errors. METHOD: A cross sectional study of 198 participants using a pretested structured questionnaire was conducted during the parent-teacher association (PTA) meeting of three public secondary schools chosen at random from a list of schools in Osogbo. Information obtained included the age, sex, history of using glasses, experience if using glasses, whether or not they will allow their wards to use glasses if prescribed and ifno, why they will not. The data obtained was analyzed using Statistical Package for Social Sciences (SPSS 11.0 version) Computer Software. Association between variables was examined using chi-square and T-test accordingly. Level of significance was drawn at P<0.05. RESULTS: The male to female ratio was 1:1.5. Their ages ranged between 15 and 80 years with a mean of 36.20 years (SD +/- 13.44). Majority, 141(71.21%) were between 21 and 50 years. All but 4(3.70%) of those that use glasses had good experiences. A significant percentage (38.38%) of the participants will not use glasses if prescribed. One hundred and two (51.52%) participants will not allow their children to use prescribed glasses. CONCLUSION: Acceptance of glasses for the correction of refractive errors is not encouraging. This is particularly serious when children are concerned. A health education to enlighten the populace about the benefits of wearing prescribed glasses and the dangers of not using them when needed is necessary.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  669 0 1
Assessment of two emergency contraceptive regimens in Iran : levonorgestrel versus the Yuzpe
T Farajkhoda, A Khoshbin, B Enjezab, M Bokaei, M Karimi Zarchi
December 2009, 12(4):450-452
OBJECTIVE: The purpose of this study was to compare the efficacy and tolerability of two emergency contraception (EC) methods, levonorgestrel versus the Yuzpe. METHODS: In a prospective, randomized, comparative study, we included 122 healthy volunteers who in the observed cycle had had only one act of unprotected intercourse within 72 h of treatment. They were randomly allocated in levonorgestrol group (n=62) and Yuzpe (n=60). The levonorgestrel regimen consisted of two pills: 0.75 mg levonorgestrel, taken twice in the 12-h interval within 72 h after unprotected intercourse. The Yuzpe method included two HD contraceptive pills taken as another regimen. Data were collected by questionnaire at first and 3 weeks later. The differences were compared with X2 & Fisher exact tests. RESULTS: There were no significant differences between two groups in any of the observed parameters. The levonorgestrel regimen was found superior to Yuzpe because it's more effectiveness (respectively 100% vs 91%, p=0.026) and fewer side effects. CONCLUSION: The study showed more effectiveness and safety of the levonorgestrel regimen as emergency contraception. Thus we recommend levonorgestrel as an alternative EC method instead of the Yuzpe regimen in Iran or other developing countries in order to decrease unwanted pregnancy.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  666 0 4
Exclusive breastfeeding and postnatal changes in maternal anthropometry
AA Okechukwu, EC Okpe, AA Okolo
December 2009, 12(4):383-388
OBJECTIVE: To evaluate the impact of exclusive breastfeeding (EBFing) practice on maternal anthropometry during the first 6 months of birth. METHOD: Measurement of weight, height, triceps skin-fold thickness (TST), and mid-arm circumference (MAC) was carried out in a matched cohort of women practicing EBFing and those using other methods of infant feeding (non-EBFing group) in the first six months after delivery. RESULT: There were 322 women practicing EBFing and 205 in the non-EBFing group. Weight loss was significantly higher among the EBFing group than in the non-EBFing ones during the first six months of EBFing practice (4.13 Vs 1.06kg), p<0.05. This was primarily due to average weight loss of 3.43kg in EBFing mothers in the last 3-6 months of EBFing practice. There was also a significant loss in MAC in the EBFing mothers than in the non-EBFing one (2.78 Vs 0.75cm), (p<0.05). Whereas the non-EBFing group experienced an increase in their TST (2.12mm), the EBFing mothers had a mean net loss of -1.03mm, (p<0.05). A positive correlation was seen between the frequency ofbreastfeeding and maternal weight changes in the EBFing group ( r=0.56, p<0.05), same was also seen between frequency of breastfeeding and maternal changes in TST and MAC losses in the same group of mothers, (r = 0.08 for TST , and 0.28 for the MAC, p<0.05). The weight/height Z scores (WHZ), an index of thinness and body mass index (BMI) that determines the nutritional status of an individual however remained within normal limit for both groups of mothers despite their weight loss ( WHZ of 0.67, and BMI of 22.09 +/- 3.7 kg/m2) for EBFing mothers, and ( WHZ of 0.71 and BMI of 22.82 +/- 3.2 kg/m2) for the non- EBFing mothers. CONCLUSION: It was concluded that though EBFing enhances more maternal weight loss, the nutritional status of the women practicing it however remained normal limit despite their weight loss.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  661 0 2
Morbidity and mortality patterns of admissions into the Special Care Baby Unit of University of Abuja Teaching Hospital, Gwagwalada, Nigeria
AA Okechukwu, A Achonwa
December 2009, 12(4):389-394
OBJECTIVE: To determine the morbidity and mortality patterns of patients admitted into the Special Care Baby Unit (SCBU) of the University of Abuja Teaching Hospital (UATH), Gwagwalada, Nigeria. METHOD: A retrospective analysis of records of patients admitted into the SCBU of the UATH over an 18 month period ofJanuary 2005 to June 2006 was carried out. RESULT: A total of 654 patients were admitted into SCBU of UATH during the review period, there were 351 (53.7%) males, and 303 (46.3%) females given a male to female ratio of 1.2:1. The four leading causes of admissions were low birth weight (LBW) 32.7%, neonatal sepsis (NNS) 19.1%, severe birth asphyxia (SBA) 12.7%, and neonatal jaundice (NNJ) 8.7%. Eighty one (37.9%) of the LBW were term and small for gestational (SGA), while 133 (62.1%) were preterm. Of the 87 (13.3%) deaths recorded during the review period, SBA (21.7%), LBW (20.1%), neonatal meningitis (15.4%),and NNS (11.2%) were the four leading causes of preventable deaths, while congenital abnormalities (20.0%) was the commonest cause of non-preventable conditions. 71.2% of all deaths occurred within the first 72 hours of admission, while 57.7% of such deaths were babies of mothers from low socio-economic background. CONCLUSION: Patterns of admissions and mortality into SCBU of UATH were comparable to studies elsewhere, and points to preventable conditions as the leading causes of such admissions and deaths. Efforts to reduce LBW, SBA, NNS and NNJ through enhancement of good antenatal and delivery services, as well as improvement in the facilities in the unit will assist in death reduction. Health education and economic empowerment especially of women will be an added advantage.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  630 0 3
Perceptions and attitudes of a rural community to abortion in the Niger-delta region of Nigeria
LO Omo-Aghoja, VW Omo-Aghoja, FE Okonofua, O Aghedo, C Umueri, R Otayohwo, P Feyi-Waboso, CO Esume
December 2009, 12(4):443-449
OBJECTIVE: To determine the perceptions and beliefs relating to unwanted pregnancy, family planning and abortion, and identify issues that can be leveraged to initiate positive attitudes towards family planning and abortion in the area. MATERIALS AND METHODS: Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted in Amukpe, Delta State, Nigeria. A highly motivated and well-trained team versed in the local language and culture conducted the FGDs and IDIs. RESULTS: There was unanimity that unwanted pregnancies was quite common amongst women of reproductive age group and constitute a significant problem in the community. Abortion, particularly in the hands of quacks was a major option to handling an unwanted pregnancy. Almost all agreed that their culture and religion abhors abortion, yet widely practiced because of the odium associated with an unwanted pregnancy in the community. The knowledge of the Nigeria National abortion law even amongst the health workers and teachers was generally poor. The participants agreed that there were problems and complications (often severe) including death associated with abortion in the community. It was largely agreed that contraceptive knowledge and usage was poor. The reasons adduced for this include lack of knowledge, lack of spousal consent, socio-cultural taboos and misconceptions, as well as economic reasons. It was suggested that imbibing positive family values by parents in their wards and government leveraging the socio-economic status of the community will go a long way to stemming the tide. CONCLUSION: Unwanted pregnancy, unsafe abortion and abortion complications are reported to be common amongst women of reproductive age group in Amukpe community, whilst contraceptive awareness and usage is poor.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  593 0 1
Comparison of superficial surgical site infection following use of diathermy and scalpel for making skin incision in inguinal hernioplasty
Q Ali, K Siddique, S Mirza, Asif Zafar Malik
December 2009, 12(4):371-374
BACKGROUND: The method of making surgical incision remains a complex problem. Although controversial, the use of diathermy instead of scalpel for skin incision and underlying tissue dissection is gradually gaining wide acceptance. This is due to the observation that no change in wound complication rate or postoperative pain is reported with the use ofDiathermy. However, the fear ofexcessive scarring and poor wound healing has curtailed its widespread use for skin incision. OBJECTIVE: The objective of the study is to compare superficial surgical site infection (SSSI) in diathermy and scalpel skin incision in inguinal hernioplasty. STUDY DESIGN: Quasi experimental study. Place and Duration of Study: Study was conducted at Surgical Unit II, Holy Family Hospital. Rawalpindi from 1st Jan. 2008 to 30th September 2008. PATIENTS AND METHODS: A total of 80 patients who presented with inguinal hernias were included in the study. Patients were divided in two groups. Group1: In 40 patients skin incision was made with Diathermy, Group 2: The other 40 had skin incision with scalpel. RESULTS: The mean age of patients in the intervention group (Group 1) was 50 years while in the control group (Group 2) it was 46 years. 48% patients in Group 1 and 55% in the Group 2 had indirect inguinal hernias. SSSI was noted in 12.5% cases in Group 1 whereas in Group 2 it was 17.5% but this difference was not found to be statistically significant (p value=0.378). CONCLUSION: The use of diathermy for making skin incisions is as safe as scalpel and there is no significant difference amongst both regarding wound infection.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  590 0 1
Exclusive breastfeeding--the relationship between maternal perception and practice
UO Uchendu, AN Ikefuna, IJ Emodi
December 2009, 12(4):403-406
BACKGROUND: The behaviour adopted by individuals is moulded by their perception of various issues. In spite of well established benefits of exclusive breastfeeding (EBF) to babies, mothers and society, the EBF practice rate (EBFPr) in our environment has remained low. OBJECTIVE: To evaluate mother's perception of exclusive breastfeeding and determine the relationship between such view and their practices. SUBJECTS AND METHODS: Two hundred mothers were interviewed to elicit their perception of the merit and demerits of exclusive breastfeeding. The pattern of perception was related to actual practice in order to seek for possible associations. RESULTS: Of the 184 respondents, 39 (21.2%) practiced EBF for all their babies, while 95 (51.6%) never did so for any of their babies. Knowledge of EBF was excellent (94.0% and 90.8%) of the study group gave accurate definition and duration respectively. Most mothers felt that EBF babies look healthier (85.1%), have less disease (84.5%), are more intelligent (59.1%) but their mothers eat a lot (79.3%). Those who agree to the positive benefits of EBF generally had higher overall complete EBFPr than those who disagreed, as they looked healthier (p = 0.0001), had less disease (p = 0.041) and more intelligent (p= 0.0001). In addition to this, mothers who did EBF for all babies ( ie those with an EBFPr of 100%) had more positive perception on the benefits ofEBF. CONCLUSION: There is a fairly good relationship between pattern of maternal perception of the benefits of EBF and actual practice. Efforts need to be intensified to educate and encourage mothers to see the merits of EBF both for themselves and their babies.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  584 0 1
Knowledge and practice of universal precautions against blood borne pathogens amongst house officers and nurses in tertiary health institutions in Southeast Nigeria
ED Adinma, C Ezeama, JI Adinma, MC Asuzu
December 2009, 12(4):398-402
PURPOSE: To examine the knowledge and practice, as well as factors influencing universal precautions practices amongst Nigerian House officers and Nurses. METHODS: A Cross-sectional descriptive study. Sample selection was by stratified random sampling. Information was elicited using pretested, structured, self-administered questionnaire. Data were analyzed using EPI-info. RESULTS: Most Doctors, 66.6%, were aged 26-30 years while the Nurses, 41.1%, were aged 40 years. 57.6% of the Doctors were males, while 85.7% of the nurses were females. Knowledge of universal precautions measures was high for both categories of respondents--97.0% for doctors and 92.0% for nurses, although practice was better for the nurses, 75.0%, compared to the doctors, 15.2%, p < 0.05. The most important factor influencing universal precautions practice is the lack of provision of adequate protective equipments. Other factors, all of which show significant difference between the doctors and nurses (p < 0.05), include carelessness; lack of display of universal precautions guidelines; emergency nature of the procedure; insufficient water supply; patient perceived to be at low risk of blood borne pathogens; pressure of time; and universal precautions equipments interfering with technical skills. CONCLUSIONS: Although knowledge of universal precautions is high for both house officers and nurses, practice is however better amongst the latter than the former. The effective knowledge and practice of universal precautions amongst hospital workers are of absolute necessity to prevent infections from blood and body fluid pathogens.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  571 0 1
The role of blood transfusion on the prevalence of hepatitis C virus antibodies in children with sickle cell anaemia in Enugu, South East Nigeria
OS Ejiofor, BC Ibe, IJ Emodi, AN Ikefuna, GC Ilechukwu, G Emechebe, C Ilechukwu
December 2009, 12(4):355-358
BACKGROUND: The hepatitis C Virus (HCV) has become an important cause of chronic liver disease and liver cancer worldwide. Blood transfusion is one of the important modes of transmission. There is need to study the prevalence among those at risk such as sickle cell anaemia (SCA) patients. Such information will broaden knowledge of the problem among SCA patients transfused with blood in this part of the country. OBJECTIVE: To determine the prevalence of HCV antibodies among children with SCA transfused with blood in Enugu, compared with their non transfused counterparts as well as the roles of blood transfusion and traditional surgery in the prevalence ofHCV infection. METHODOLOGY: The study was conducted among 269 children with SCA attending the paediatrics sickle cell clinic at University of Nigeria Teaching Hospital (UNTH) Enugu, with 136 transfused SCA patients as subjects and 133 age and sex matched non-transfused SCA who served as controls. RESULTS: The results showed an HCV antibody prevalence of 6.6% among the transfused and 5.3% among the non-transfused (controls) SCA patients (P = 0.610). There was positive association between number of transfusions and HCV seropositiviy, such that those who had received 4 or more units ofblood had a prevalence rate of more than 50% (P = 0.001). The influence of scarifications on the prevalence of antibodies to HCV (antiHCV) for the non transfused (controls) was statistically significant (P = 0.001). CONCLUSION: HCV infection is not uncommon in children with SCA. The prevalence of HCV infection in transfused SCA patients is not significantly higher than their age/sex matched controls.
[ABSTRACT]   Full text not available     [PubMed]
  539 0 -
Pitfalls in diagnosis of hepatitis B virus infection among adults Nigerians
SO Ola, JA Otegbayo, A Yakubu, AO Aje, GN Odaibo, W Shokunbi
December 2009, 12(4):350-354
OBJECTIVE: Hepatitis B virus infection is common in Nigerians and its diagnosis is necessary for effective treatment and eradication. This study is aimed at highlighting the serological factors jeopardizing the diagnosis and treatment of the infection among Nigerians adults. PATIENTS AND METHODS: Three studies were carried out. The first study involved 56 Nigerian adults and it compared the assay of HBsAg by Haemagulation Method (HMA) with Enzyme linked immunoassay (ELISA). The second study was a comparison of Glaxo Welcome HB rapid test(GWHB) with ELISA in sero-assay of HBsAg and HBeAg among 25 Nigerian subjects while the third study was on the assay of the sera of HBsAg positive patients for HBeAg and anti-HBe in forty two Nigerian patients by ELISA. RESULTS: The sero - prevalence rates of HBsAg were 41.8% and 61.8% by HM and ELISA respectively with false HBsAg sero-positives and sero-negatives by HM of 5.4% and 25.5% respectively. Similarly, there was sero-detection of HBsAg in 84% and 80% by ELISA and GWHB respectively in 25 Nigerian adults. In addition, 19% and 64% of the 42 patients with HBsAg sero-positivity were also positive for HBeAg and anti-HBe respectively, while 31% of the patients were both HBeAg and anti-HBe sero-negative. CONCLUSION: Sero-diagnosis of HBsAg and other serological markers of infectivity in patients with HBV should be carried out by ELISA rather than HMA among adult Nigerians. Furthermore, high infectivity of the virus abounds among Nigerian with HBV infection.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  538 0 2
Physicians management of sore throat in children in Benin City, Nigeria
WE Sadoh, AM Akinsete
December 2009, 12(4):407-411
INTRODUCTION: Sorethroat is a common reason for presentation in primary paediatric care. Because only a minority of cases of pharyngitis is caused by bacteria, physicians have been guided by various recommendations on the judicious use of antibiotics to avoid overprescription. In the absence of guidelines, the treatment approaches between physicians may differ. The management of children with sorethroat by physicians in Benin City, Mid-Western Nigeria was evaluated. SUBJECTS AND METHODS: The experience and practice of 25 paediatricians and 30 non paediatricians who routinely attend to children with sorethroat in Benin metropolis, Nigeria were evaluated with the aid of a self administered questionnaire. Information sought for included biodata, empirical antibiotic prescription. The choice of antibiotic and complications ofpharyngitis encountered in practice. RESULTS: Majority of respondents 31(56.4 %) considered viruses as the commonest cause of pharyngitis. Despite this an equal proportion 31(56.4 %) treated children with sorethroat empirically with antibiotics. Of these, significantly more paediatricians 19(61.3 %) than non paediatricians 12(38.7 %) considered viruses the commonest cause of pharyngitis, P = 0.013. CI (0.10 0.63). Almost three quarter (72.7 %) of respondents examine the throat of the children while only 18.2 % obtained throat swab for microbiological analysis. The 24 doctors who did not treat empirically would prescribe antibiotic if the patient has purulent pharyngeal exudates, fever and adenitis. Augmentin and cefuroxime were the most prescribed antibiotics. CONCLUSION: A lot of children served by these doctors receive antibiotic needlessly from empirical antibiotic treatment ofpharyngitis. National guidelines on appropriate antibiotic use is needed to promote rational use of antibiotics and reduce antibiotic overuse.
[ABSTRACT]   Full text not available     [PubMed]
  535 0 -
The usefulness of total cholesterol and high density lipoprotein--cholesterol ratio in interpreting lipid profile results of diabetes mellitus patients
DS Mshelia, MA Garbati, AA Ndahi, YP Mamza, HA Sheikh
December 2009, 12(4):345-349
OBJECTIVE: To determine the usefulness of total cholesterol/high-density lipoprotein cholesterol and/or high-density lipoprotein cholesterol/total cholesterol ratios in the interpretation of lipid profile result in clinical practice. METHODS: This is a prospective case-control study involving 109 diabetics, 98 diabetic hypertensives, 102 hypertensives and 120 control subjects. Serum lipid profile and plasma glucose were determined using appropriate methods. RESULTS: The mean ages of the different study groups were similar. Body mass indices of diabetics with or without hypertension were significantly higher than that of the controls. The difference in the mean total cholesterol of each group was not statistically significant when compared with the controls. A significant difference existed in the mean LDL when the different study groups were compared with the controls. There was a significant difference in the mean TG of DM and DM/hypertension patients compared with that of controls. However, the mean TG of hypertensive patients was not statistically different with that of the controls. The mean HDL was lower in each group of patients compared to that of the controls however the difference was not statistically significant. The mean TC/HDL ratios were significantly higher in all groups of patients when compared to that of the controls while HDL/TC ratios were significantly lower in all categories of patients when compared to that of the controls. CONCLUSION: The ratios identified more dyslipidaemia than either of the lipid profile components. Therefore, the use of TC/HDL and or HDL/ TC ratios should be encouraged in screening for dyslipidaemia in diabetic patients with or without hypertension in clinical practice.
[ABSTRACT]   Full text not available     [PubMed]
  520 0 -
One year clinical audit of the use of blood and blood components at a tertiary hospital in Nigeria
OP Arewa
December 2009, 12(4):429-433
BACKGROUND: The appropriate use of blood and blood components remains a formidable challenge faced by clinicians particularly in a developing country like Nigeria. The inadequate supply of safe blood implies that measures aimed at ensuring judicious use of the available supply should be continually identified and explored. STUDY DESIGN: Aprospective study to evaluate all blood and blood component transfusions over a period of one year from January to December 2004 was done. The appropriateness of the transfusion with respect to the clinical state and the transfusion needs of the recipient was assessed by a Haematologist. RESULTS: A total of 682 transfusion episodes were reviewed and analyzed. The commonest indication for use blood/blood component was severe anaemia in 38% of cases. Twenty nine percent of transfusions for moderate anemia, and 36% of fresh frozen plasma transfusions were found to be unnecessary. Inappropriate transfusion is most marked in the setting ofplatelet transfusion with 81% of platelet transfusion being inappropriate. CONCLUSION: Enhanced capacity for component preparation, regular auditing of transfusion practices as well as improved communication between the clinicians and laboratory physicians will lead to more judicious use of blood component therapy. The need for the development of guidelines for blood component use in hospitals in line with the national blood transfusion policy is highlighted.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  514 0 2
Metabolic dysfunctions in non-antiretroviral treated HIV/AIDS patients
SA Isezuo, MA Makusidi
December 2009, 12(4):375-378
BACKGROUND: AIDS related metabolic and morphologic disorders have been attributed to protease inhibitor based antiretroviral therapy. HIV/AIDS is however a multi-systemic disease with potential for alteration of metabolic and endocrine functions. OBJECTIVE: To determine if metabolic disorders occur in non-antiretroviral treated HIV/AIDS patients. METHODS: Case control study of prospectively recruited 48 HIV seropositive patients, and randomly selected age and sex-matched controls. Main outcome measures included plasma lipid concentrations and intravenous glucose tolerance measured using glucose assimilation coefficient, K. A K-value less than 1.2 constituted an impaired glucose tolerance. RESULTS: Compared to the controls, HIV/AIDS patients had significantly lower glucose assimilation coefficient (1.5 +/- 0.5 versus 2.7 +/- 0.9; p < 0.001); higher proportion of individuals with impaired glucose tolerance (35.4% versus 7.5%; P = 0.01); and higher plasma triglyceride concentration (166.5 +/-20.7 mg/dL versus 148.9 +/- 13.5 mg/dL; p = 0.04). The proportion of patients with hypertriglyceridaemia was also significantly higher among patients than controls (56.3% versus 17.5%; p = 0.04). CONCLUSIONS: Metabolic dysfunctions occur in HIV/AIDS independent of antiretroviral therapy. Routine monitor of plasma lipids and glucose is therefore advocated in HIV/AIDS patients.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  497 0 2
Sexual practices of people living with HIV in South Eastern Nigeria
J Ikechebelu, SU Mbamara, NN Joe-Ikechebebelu, AO Ezenwabachili
December 2009, 12(4):416-420
BACKGROUND: Couples could be in serodiscordant or seroconcordant sexual relationship. The seroconcordant could be seroconcrdant positive or negative in a heterosexual or homosexual or bisexual relationship. The various sexual practices include vaginal sex; anal sex fisting; oral sex fellatio, cunnilingus; masturbation mutual or exclusive and a host of others. These sexual practices outside safer sex guidelines will lead to HIV transmission among couples. The study is set to determine the sexual practices of people living with HIV (PLWHA) in Southeast Nigeria. METHOD: This is an analytical epidemiological study. A total of 300 subjects were studied using interviewer administered questionnaires. Data is presented in tables and figures. Analysis was done using SPSS 11.0 statistical package. RESULTS: Most respondents were in heterosexual relationship (97%). The married couples in serodiscordant relationship were 25.3% while the singles in serodiscordant relationship were 20%. About 56% do not use condom for the adopted sexual practice although 65% believe that condom use would protect against HIV transmission. CONCLUSION: Couples in seroconcordant seronegative relationship have it as a challenge to remain so. This study suggests that the PLWHA are very important in the spread of HIV infection as they are still sexually active, in non-cohabiting conjugal unstable relationship, and they do not use the condom consistently. There is an urgent need to target this population with effective behavioural change communications that will translate to safer sexual behaviour. The practice of safer sex should be taught in every health care center, in schools and in village gatherings by qualified health care workers. This will help curb the transmission of HIV.
[ABSTRACT]   Full text not available     [PubMed]
  495 0 -
Clinical observations on the use of honcrivine in the chemical debridement of wounds
SE Efem
December 2009, 12(4):412-425
BACKGROUND: Chronic and non healing wounds, necrotic wounds and contused and devitalized wounds require debridement to rid the wounds of all these impediments that encourage bacterial growth and multiplications with consequent impairment of wound healing. Whereas there are several methods of wound debridement with their peculiar indications, merits and demerits, the ideal method of debridement is yet to be discovered. AIM: The aim of this study is to investigate clinically the ability of honcrivine (honey plus acriflavine 0.1%) to chemically debride various wounds in routine clinical practice. PATIENTS AND METHOD: One hundred and eighty nine consecutive patients managed by the author between June 1995 and June 2005 were included in this study. They were 125 males and 64 females and their ages ranged between 6 and 78 years. Initially swab was taken for bacterial culture from each wound before being cleaned with normal saline, then dressed daily with gauze soaked in honcrivine. Bacterial culture was repeated fortnightly. Antibiotics were administered as dictated by culture and sensitivity report. RESULTS: Wound debridement progressed rapidly and impressively with necrotic and devitalized tissues as well as tenacious pus and fibrin deposits being replaced with healthy granulation tissue. Patients age, sex and bacterial burden did not influence the rate of debridement, rather wound age and necrotic burden were inversely proportional to the debridement rate. Honcrivine did not provoke any inflammatory response nor was any allergic reaction observed. CONCLUSION: It is one of the oldest remedies known to mankind and is still useful and versatile today as it was 2000 years ago. It is a very effective chemical wound debridant.
[ABSTRACT]   Full text not available     [PubMed]
  489 0 -
Obstetric performance recall accuracy (OPERA) among a low literacy population in Southeast Nigeria
OU Umeora, VE Egwuatu
December 2009, 12(4):362-366
CONTEXT: Accurate obstetric history is of utmost importance in prenatal care to ensure optimal maternal and fetal outcomes. AIMS AND OBJECTIVES: To determine the accuracy of recalled obstetric history among rural Igbo women of Southeast Nigeria. STUDY DESIGN: Primiparous and multiparous women, who accessed antenatal care in a rural Mission Hospital over a two-year period, had their past obstetric histories recorded in a pro forma by trained research assistants. The information so obtained was compared with the previous obstetric data documented in the patients' hospital case files to evaluate their correctness. Univariate analysis was performed for statistical evaluation using the epi info package version 3.3.2 of 2005. RESULTS: Two hundred and thirty-five antenatal clinic attendees aged between 18 and 41 years were recruited for the study. Low literacy level is prevalent in rural communities of Southeast Nigeria. The ability of the women to accurately recall past obstetric events, including major pregnancy risk factors, was considerably limited. The recall accuracy for details of the immediate past pregnancy was 43.6% and 41.3% for the penultimate pregnancy. Patient's educational attainment, but not her age or parity, had significant influence on the recall ability. CONCLUSION: The introduction of the Obstetric performance card for use in the busy antenatal clinics in low literacy rural communities of the developing countries such as Nigeria, will corroborate the information obtained from patients and greatly enhance the management and positive outcomes of the index pregnancy.
[ABSTRACT]   Full text not available     [PubMed]
  489 0 -
Seroprevalence of antibody to HDV in Nigerians with hepatitis B virus-related liver diseases
SC Nwokediuko, U Ijeoma
December 2009, 12(4):439-442
OBEJECTIVE: Hepatitis D Virus (HDV) infection has been reported to be declining in some geographical areas. In order to ascertain the current status of HDV infection in Nigeria, a study of patients with hepatitis B virus (HBV)-related liver diseases was undertaken to determine the sero-prevalence ofanti-HDV. METHOD: This was a prospective, cross-sectional study in which all consecutive patients with liver disease who tested positive for Hepatitis B surface antigen (HBsAg) were also tested for antibody to HDV. RESULT: Ninety six patients with various forms of HBV-related liver diseases participated in the study (acute hepatitis 8.3%, asymptomatic infection 15.6%, chronic hepatitis 3.1%, liver cirrhosis 21.9% and primary liver cell carcinoma 51.0%). Anti-HDV was demonstrated in 12 patients (12.5%). In patients with acute hepatitis and asymptomatic infection the prevalence was 4.3% while in patients with chronic hepatitis, liver cirrhosis and primary liver cell carcinoma, the prevalence was 15%. CONCLUSION: HDV still contributes to significant morbidity and mortality in HBV-related liver diseases in Nigeria. There is urgent need for larger studies on a national scale to accurately appraise the public health importance of this infection.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  474 0 6
Nasopharyngeal cancer in North--Eastern Nigeria : Clinical trends
HI Garandawa, BM Ahmad, HA Nggada
December 2009, 12(4):379-382
BACKGROUND: Nasopharyngeal cancer is the malignancy of the posterior aspect of the nose called Nasopharynx. It is one of the most difficult diseases to diagnose at an early stage. AIM: To determine prevalence, clinical trends and histopathological types of Nasopharyngeal cancer in Maiduguri, North Eastern Nigeria. PATIENTS AND METHOD: Fifteen year retrospective evaluation of patient's case notes and cancer registry records of 40 patients with histologically confirmed nasopharyngeal cancer between 1991-2005. RESULTS: Nasopharyngeal cancers constituted 35.1% of all malignancies of ear, nose, throat during the study period. The M:F was 2.1-1, the mean age was 39(+/- 16.5) years and a peak age group and its occurrence of 40-49 years. The commonest symptom at presentation were cervical lymphadenopathy (72.5%), rhinorrhoea (55%), epistaxis(45%). The commonest histological type was squamous cell carcinoma(92.5%). Patients who received chemotherapy in addition to radiotherapy and higher symptom free period. CONCLUSION: Cancer is a difficult disease to diagnose at an stage. A meticulous ear, nose and throat examination and thorough evaluation of nasal symptoms with associated cervical lymphadenopathy may lead to an early diagnosis of nasopharyngeal cancer's.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  471 0 1
Bone cement in the management of cystic tumour defects of bone at National Orthopaedic Hospital, Igbobi, Lagos
SU Eyesan, OA Ugwoegbulem, DC Obalum
December 2009, 12(4):367-370
BACKGROUND: Cystic bony defects are characteristics of bone tumours especially benign ones e.g. Giant cell tumours of bone [GCT] and some metastatic tumours to bone. These patients present late with significant cystic cavities at a time the cost and availability of prosthetic implants to replace these defects sometimes precludes resection. The objective of this study is to evaluate the outcome of filling these defects with bone cement augmented with plate and screw for stability. METHOD: A seven year prospective study was carried out in patients presenting with large cystic bony defects secondary to bone tumours at the oncology unit of the National Orthopaedic Hospital, Igbobi, Lagos. Data such as age, sex, anatomic location of lesions, histological type of tumours, x-ray findings, operation performed with the number of packets of bone cement used to fill the resultant bony defects were retrieved from prepared proforma. The average follow-up was 36 months. RESULT: The proximal tibia and distal femur accounted for 42.9% and 28.6% respectively of the 14 patients studied. Giant cell tumour was the most common histological diagnosis 78.6%. Bone cement was effective in meeting the local requirements of limb salvage, early functional recovery and as a temporising measure until the patients can avail themselves of better options. The complication encountered was that of anaphylactic reaction in 2 scrub nurses. CONCLUSION: Bone cement augmented with appropriate implants has proven valuable as a stop gap in filling large cystic bony defects resulting from tumours.
[ABSTRACT]   Full text not available     [PubMed]
  467 0 -
Situation analysis of the existing infant feeding pattern at the commencement of the prevention of mother to child transmission (PMTCT) of HIV programme in Ibadan
BJ Brown, RE Oladokun, K Osinusi
December 2009, 12(4):421-428
OBJECTIVES: To evaluate breastfeeding and weaning practices associated socio-demographic factors and knowledge about mother-to-child transmission of HIV among mothers in Ibadan. METHODS: A cross sectional survey was conducted among 513 mothers of children aged 6- 24 months, attending infant welfare clinics. Data collection was by a structured questionnaire, which was supplemented by focus group discussions to further explore some of the issues covered in the survey. RESULTS: Breast-feeding rate was 99.4%, the duration of which ranged from 1-22 months with a median of 14 months among those who had stopped breastfeeding. Only 145 (28.3%) mothers breastfed their babies exclusively for six months and 259(50.8%) initiated breastfeeding within one hour of birth; both were associated with at least secondary level of education. The main obstacle to exclusive breastfeeding was the belief that water is required to quench thirst in babies. Expression of breast milk was not favoured by majority of the mothers (68%) most of whom felt that the milk would get contaminated. Wet nursing was rarely practiced (0.4%). Most of the mothers, 436 (85%) were aware that HIV could be transmitted through breast milk but the attitude towards a mother who did not breast feed was negative in 96.8% ofrespondents. CONCLUSIONS: Adherence to recommended infant feeding options for HIV-exposed infants are likely to be faced with challenges in a culture where breastfeeding is the norm and exclusive breastfeeding rate is low. There is need for counseling and health education on prevention of mother-to-child transmission of HIV.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  451 0 1
Subjective assessment of childhood fever by mothers utilizing primary health care facilities in Osogbo, Osun State, Nigeria
EO Asekun-Olarinmoye, BE Egbewale, FO Olajide
December 2009, 12(4):434-438
OBJECTIVE: To assess the accuracy of tactile examination by mothers as a method of fever determination in their children and thus determine the reliability of mothers' history about the presence or absence of fever in their children. METHODOLOGY: A descriptive cross-sectional study conducted in four health centers randomly selected in Osogbo metropolis. Three hundred mothers were studied, a semi-structured questionnaire was utilized. RESULTS: The study found the sensitivity and specificity of tactile examination for mothers as a means of detecting fever in their children to be 82.3% and 54.1% respectively. Mother's socio-demographic characteristics and the age of child did not affect mother's subjective assessment of childhood fever (p>0.05). CONCLUSION: Mothers are able to provide accurate information about the presence or absence of fever in their children by palpation without the use of a thermometer. Tactile examination was found to be adequate for mothers as a means of detecting fever in their children. Physicians should accept as reliable mothers' history of fever and give prompt management.
[ABSTRACT]   Full text not available     [PubMed]
  441 0 -
Protective clothing in the sun
R Tamas
December 2009, 12(4):464-464
Sun protecting clothing is clothing designed for sun protection and is producted from the fabric rated for its level ultraviolet (UV) protection. Some textiles and fabrics emloyed in the use of sun protective clothing may be pre-treated with UV inhibiting ingredients during manufacture to enhance their UV blocking capacitiy.
[ABSTRACT]   Full text not available     [PubMed]
  438 0 -
Autopsy as a tool in the prevention of maternal mortality
AO Daramola, AA Banjo
December 2009, 12(4):457-460
Maternal mortality rates are an index of the state of a nation's health system. Maternal autopsies help to determine these rates, provide information on avoidable/unavoidable causes of mortality, consequently leading to the development of strategies for treatment and prevention of maternal mortality and morbidity. The lesson from post-mortem examinations, using the vehicle of confidential enquiries into maternal deaths, can save the lives of many; causing reduction in both maternal and perinatal mortality as well as reductions in morbidity. However for autopsies to fulfil this role they must be of a very high standard and must be subjected to quality control measures.
[ABSTRACT]   Full text not available     [PubMed]
  438 0 -
Aortic arch diameter and its significance in the clinical evaluation of cardiac and aortic enlargements
GE Anyanwu, KK Agwuna
December 2009, 12(4):453-456
OBJECTIVE OF THE STUDY: To determine the relevance of the transverse aortic arch diameter in the evaluation of early aortic and cardiac enlargements. SUBJECT AND METHOD: A total of 1818 chest radiographs of male and female normotensive and hypertensive Nigerians of age range 4-80 and 10-80 years respectively were used for this study. Ages of subjects were obtained and transverse aortic arch, chest and heart diameters were determined. RESULTS: Mean aortic arch diameter for the normotensive groups were noted to be 5.0 +/- 0.5cm, 4.5 +/- 0.4cm and 4.7 +/- 0.5cm for males, females and both sexes respectively while 5.9 +/- 0.9cm, 5.4 +/- 0.6cm and 5.6 +/- 0.8cm for males, females and both sexes respectively were noted in the hypertensive group. Mean values were also generated for the chest and heart diameters. The study reports a mean difference in the aortic arch, heart and cardiothoracic ratio of 15% between the two groups. CONCLUSION: Relationship between aortic arch and heart diameter was established and aortic arch diameter was noted to be significant (p< 0.05) in evaluating aortic and cardiac enlargements.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  425 0 3
Disorders presenting with headache as the sole symptom
PO Eghwrudjakpor, AA Essien
December 2009, 12(4):461-462
Headache is one of the commonest medical complaints, and ranks high among the reasons why people consult neurologists and general practitioners. Most headache patients are, however, managed suboptimally; and indeed, many neurologists find outpatient headache management one of the least engaging parts of their job. Headache may present as part of a symptom complex or it may present alone. When it is part of a complex, the total presentation of the patient serves as pointer to any underlying disease. When it is the sole symptom however, identifying the specific cause can be more difficult. Even though the diagnosis and management of most cases of headache probably do not require sophisticated neurological skills or investigations, failure to recognise an underlying disorder or an attitude of total neglect can be fatal. In this paper, we briefly review some of the disorders reported to have presented with headache as the sole symptom with the aim of drawing attention to the need for proper attitude to every headache complaint even when it initially appears to be trivial. Two groups of headache are recognised - primary and secondary. More than 90% of headaches seen in practice are of the primary type, which includes migraine, tension and cluster headaches. Secondary headache results from a wide range of disorders which may be intracranial, extracranial or systemic. Intracranial causes of headache include tumours, haematomas, infections, idiopathic intracranial hypertension and vascular disorders. Some of the more common extracranial and systemic causes are shown in Tables 1 and 2 respectively. Recognition of these conditions requires a standardised diagnostic approach to history and examination, wherein the patient's history alerts the physician while the physical examination provides support for the diagnosis.
[ABSTRACT]   Full text not available     [PubMed]
  420 0 -
Instrumentation : penile retractor for urethroplasty in children (omega retractor)
PE Okoro
December 2009, 12(4):463-463
Full text not available     [PubMed]
  261 0 -