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   2010| January-March  | Volume 13 | Issue 1  
    Online since November 27, 2010

 
 
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ORIGINAL ARTICLES
Determination of antibacterial activity of Carica papaya (paw­-paw) extracts
CN Akujobi, CN Ofodeme, CA Enweani
January-March 2010, 13(1):55-57
Objective: The quest for suitable and affordable alternatives in the face of increasing antimicrobial drug resistance has led researchers into exploring the use of plant extracts in the treatment of infections. Method: Antibacterial activity of extracts of carica papaya (paw-paw) fruit was investigated using isolates from wound culture. These include: Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa and proteus species. These organisms were challenged with extracts from the seed, endocarp and epicarp. Result: The extracts demonstrated antibacterial activity as shown by their zones of inhibition and this was more pronounced with alcohol extracts than that of water. Staphylococcus aureus was the most susceptible with a minimum inhibition concentration (MIC) of 1:64 while Enterococcus faecalis was the least sensitive. The extracts were also heat stable. Conclusion: The demonstration of antibacterial activity against both gram positive and gram negative bacteria demonstrates that the paw-paw plant is a potential source for the production of antimicrobial drugs. Researchers should be encouraged towards utilizing this plant as well as others with such potential in other to curb the menace of antimicrobial drug resistance in the near future.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  2,880 551 2
Pattern of health seeking behaviour of mothers for common childhood illnesses in Enugu metropolis south east zone Nigeria
UE Ezeoke, EA Nwobi, OC Ekwueme, B Tagbo, E Aronu, S Uwaezuoke
January-March 2010, 13(1):37-40
Objective: The Objective of the study is to assess the Health Seeking Behaviour of mothers when their children present with the common aliments and their preferred treatment options. Materials And Methods: A cross sectional survey of 300 women that brought their children for routine immunization and growth monitoring to three health institutions in Enugu metropolis was carried out using an interviewer administered structured questionnaire. Result: Majority of the mothers, 208(69.3%) used self treatment for their children at home when they presented with common illnesses. A total of 146(48.7%) made use of government health institutions, 117(39. 0%) attended private health institutions while 21(7.0%) consulted an elder woman and 9 (.0%) patronized prayer house. Only 3(1%) respondents sought the help of traditional healers. Conclusion: In this study, the greater percentage of mothers used self medication for treatment of common childhood illnesses. The implication of this is that the majority of the mothers may not know the right treatment to institute at any point in time. This situation could lead to more complications of the illnesses or even loss of life. As a result, mothers should be educated on how best to take care of their sick children at home and be able to recognize when to seek appropriate help.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  1,102 338 1
Patients' knowledge of glaucoma and treatment options
SNN Nwosu
January-March 2010, 13(1):74-77
Aims: To determine among glaucoma patients their knowledge of the disease; consequences; available treatment and their preferred treatment options Materials and Methods: Interviewer- administered pre-tested questionnaire was administered to consecutive glaucoma patients at the Guinness Eye Center Onitsha in June and July 2004. Results: Fifty- two patients aged 16 - 85 years who had glaucoma and had been on treatment for 6 months - 8 years were interviewed. 43 (82.7%) patients had primary school or higher education. Ten (19.2%) patients did not have any knowledge of glaucoma; only 41 (78.9%) patients were aware that glaucoma leads to irreversible blindness. There was no significant association between disease knowledge and (1) age (OR 0.8; 95%CI: 0.24, -0.20; p>0.05); (2) gender (OR 0.3; 95%CI: 0.42, -0.02; p>0.05); (3) disease duration (OR 0.35; 95%CI: 0.51, -0.07; p>0.05). Patients with at least primary school education were more likely to have knowledge of the disease than those without formal education (OR 6.3; 95%CI: 0.05, 0.75; p<0.05). But there was no significant difference in disease knowledge between patients with post primary or higher education and those with primary school or less formal education (OR 0.3; 95%CI: 0, 0.4; p>0.05). While 32 (61.5%) patients knew of surgery and or drug treatment, 31 (59.6%) would preferred drug treatment and 12 (23.1%) would accept any treatment option the doctor considered most effective. Religious belief and cultural practice would affect the choice of treatment in 5 (9.6%) and 7 (13.5%) patients respectively. Conclusions: The level of disease knowledge among glaucoma patients is low. This has negative implication for compliance with treatment of glaucoma. Persons without formal education are at the greatest risk. With 23.1% of the patients surrendering the choice of treatment to the doctor, ophthalmologists are challenged to always educate the patients on the nature and consequences of glaucoma while prescribing the most effective mode of therapy.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  1,094 344 2
CASE REPORTS
Dextrocardia with situs viscerum inversus totalis in a 65 year old man: A case report
SA Isezuo, SM Ma'aji, U Isah, A Makusidi
January-March 2010, 13(1):98-100
We report a 65 year old hypertensive and type 2 diabetic low income male observed during physical examination to have right sided cardiac apex and heart sounds. Radiologic, electrocardiography, echocardiography and computed tomogram scan studies confirmed dextrocardia with situs viscerum inversus totalis. There was neither coexisting congenital cardiac anomaly nor disconcordant atrio-ventricular connection. In spite of being diabetic and hypertensive, he had no evidence of ischaemic heart disease. The blood pressure and blood glucose were adequately controlled using appropriate agents. This case, to our knowledge, may be the documented oldest Nigerian with situs inversus dextrocardia, and shows that individuals with this rare thoracic-abdominal organ developmental anomaly may have normal life expectancy similar to the general population.
[ABSTRACT]   Full text not available  [PDF]
  1,145 192 -
ORIGINAL ARTICLES
Epistaxis in Sagamu
OA Sogebi, EA Oyewole, OA Adebajo
January-March 2010, 13(1):32-36
Background: Epistaxis is a common nasal complaint with varied aetiologies. Physicians need to know the characteristics of epistaxis in their area of practice in order to give the best amongst the various treatment options.The aim of this study was to analyze the causes, management and outcome of epistaxis in Sagamu Materials and Methods: This is an analysis of the patients who had epistaxis and were managed in the Ear, Nose and Throat department of Olabisi Onabanjo University Teaching Hospital in Sagamu, Ogun state between July 2003 and June 2007. Results: There were seventy-nine patients, M:F ratio was 1.3:1. There were two peak age groups between 1­10 and 31-40, with a mean age of 34.8 years. Anterior epistaxis was present in 60.8%, 11.4% had posterior, 5.1% had combined anterior and posterior, while the location of the bleeding could not be ascertained in 22.8% of the patients. The leading causes noted were idiopathic 29.1%%, road traffic accidents 24.1%, sinonasal and nasopharyngeal malignancies 22.8%. 77.3% of the patients had their epistaxis controlled with nasal packs, with 72.2% of the nasal bleeds being well controlled without complications. 2.5% of the patients had recurrent epistaxis and 1.3% died. Conclusion: The trend of epistaxis in our study is in agreement with that found in previous studies. Nasal packings were effective methods of treatment.
[ABSTRACT]   Full text not available  [PDF]
  1,089 222 -
Role of hysterosalpingography as a simple tool in the diagnosis of uterotubal causes of infertility in a developing country setting
BM Audu, ST Sa'ad, N Tahir
January-March 2010, 13(1):7-12
Objective: The objective of the study was to evaluate the role of hysterosalpingography in the diagnosis of utero-tubal causes of infertility. Material and Method: All hysterosalpingograms taken for infertility from July 2000 to June 2001 at the Federal Medical Centre Gombe were analysed for utero-tubal and pelvic pathologies as seen on radiological examination. Result: One hundred and forty one hysterosalpingograms were reviewed for cervical, uterine, tubal and pelvic pathologies. In 100 (70.9%), the HSG was able to detect some abnormality. The abnormalities were usually multiple. Synaechiae accounted for 28.4% and 19.9% of cervical and uterine pathologies respectively, followed by uterine fibroids in 9.2% of cases. In 38.3% of cases, the tubes were blocked with the cornua being the commonest site of blockage. There was a 4:1 ratio between right-sided and left-sided distal tubal block, with equal cornual involvement on both sides. There were 10 (7.1%) cases of hydrosalpinges. Twenty patients (14.2%) had dye loculation in the pelvis, suggestive of pelvic adhesions, mainly perifimbrial. There were statistically significant associations between cervical and uterine synaechiae, and between uterine synaechiae, uterine fibroids and tubal block. Conclusion: Hysterosalpingography remains an important and invaluable tool in defining utero-tubal causes of infertility. Hysteroscopy and laparoscopy are recommended to complement HSG in further evaluating uterine synaechiae and pelvic adhesions respectively, considering their high prevalence.
[ABSTRACT]   Full text not available  [PDF]
  1,077 212 -
Prevalence of hepatitis C virus in HIV infected persons in a tertiary hospital in Nigeria
EU Eze, AN Ofili, AN Onunu
January-March 2010, 13(1):41-46
Objectives: To assess the prevalence of hepatitis C virus (HCV) infection among HIV/AIDS patients in a tertiary hospital in Nigeria. Methods: All infected persons confirmed by Elisa and aged 15 years and above seen at the University of Benin Teaching Hospital were included in the study. The subjects were recruited over a period of one year. All patients with sickle cell anemia and other immuno compromising diseases were excluded from the study. Age and sex matched controls were pooled from patients attending the outpatient clinics of the hospital who were HIV negatives. A medical history and complete physical examination under bright light was carried out on all the subjects. Assays done for each of the patients were HIV screening by Elisa techniques and confirmed by double Elisa and hepatitis C virus screening. Results: A total of 370 subjects were involved in the study of which 204 were cases (HIV positive patients) while 166 were HIV negative controls. Comparing the patients who were widowed with other marital groups, more of the widows were HIV positive than other marital groups. This difference was found to be statistically significant (X 2 =12.807, df = 1: P = 0.000). Nine (4.4%) HIV positive patients were found to be Hepatitis C seropositive while 4 (2.4%) HIV negative controls were hepatitis C seropositive. There was no statistical difference between the prevalence of Hepatitis C virus infection among HIV positive patients and the controls (HIV negative patients) Conclusion: This study has shown that there is no statistical significant difference between the prevalence of hepatitis C virus infection in HIV positive and HIV negative patients. This is in agreement with findings in other developing countries, in the South/South (Niger Delta) of Nigeria and other regions of Nigeria.
[ABSTRACT]   Full text not available  [PDF]
  965 278 -
Haematological profile of cytomegalovirus antibody positive blood donors in Jos, Nigeria
OO Alao, DE Joseph, EB Banwat
January-March 2010, 13(1):47-50
Background: Various kinds of Haematological abnormalities and alterations have been known to occur in a number of viral infections. These alterations define the pathology of the infection, serve as tools for diagnosis, and assist in treatment and prognostication. But much more importantly, such alterations may constitute a hazard and make an individual unfit for blood donation. Given the high frequency of haematological alterations and complications associated with many viral infections and coupled with the observation that cytomegalovirus antibody positive persons are accepted for routine blood donation in many countries, this paper aims to evaluate the haematological profile of cytomegalovirus antibody positive prospective donors in Jos. This is with a view to recognizing and characterizing any associated abnormal haematological changes. It is also hoped that such data will assist in ascertaining the safety and fitness of seropositive persons for blood donation. Methods: A total of 200 prospective blood donors were recruited into the study. Screening for CMV antibodies was done using ELISA kit, manufactured by DIALAB, Austria. ( www.dialab.at). Complete blood count (PCV: Packed cell volume, WBC: White cell count-total and differential counts, and platelet counts) was done on all donors using automated coulter machine. Results: Although the mean PCV value was higher in the CMV positive (38.04) than in the CMV negative donors (37.25), there was no significant statistical difference between the two groups (p>0.05).Among the CMV negative donors the mean Total WBC, Granulocyte, lymphocyte, middle cells (basophils, eosinophils and monocytes), and platelet counts were higher than those of CMV positive donors, but there was also no statistical difference between the two groups (p>0.05). Conclusion: There were no abnormal alterations in the full blood count profile of cytomegalovirus antibody positive prospective blood donors in Jos. Seropositive individuals can safely donate blood, provided there are no other contraindications.
[ABSTRACT]   Full text not available  [PDF]
  980 205 -
Fear of prostate biopsy: A limitation in the management of prostate cancer
A Akhator, DF Essiet
January-March 2010, 13(1):64-66
Background: The incidence of prostate cancer is increasing in the country and now constitutes 11% of all male cancers. For diagnosis of prostate cancer, a histological diagnosis is necessary and this requires that a prostate biopsy be performed but patients may not readily accept this invasive procedure. Methods: A 2-year retrospective study was carried out in Baptist Medical Centre, Eku, Delta State from JanuaryV2004 2004 to December 31 st 2005; data were collected from case notes of patients who had serum prostate specific antigen (PSA) done to review the response of patients to the offer of prostate biopsy after an elevated serum prostate specific antigen result. Results: There were 65 patients aged between 48years to 97years, mean age was 71years. 45 patients were offered prostate biopsy based on elevated serum prostate specific antigen (PSA) and/or findings on digital rectal examination (DRE). Only 12 (26.67%) accepted and of these, 4 (33.33%) had a histological diagnosis of adenocarcinoma of the prostrate. Conclusion: Our study has shown that majority of symptomatic prostate cancer patients refuse biopsy regardless of adequate counseling.
[ABSTRACT]   Full text not available  [PDF]
  1,002 176 -
One-year experience with Implanon sub-dermal implants in Jos, Nigeria
JT Mutihir, DD Nyango
January-March 2010, 13(1):28-31
Objective: To determine Implanon acceptance, the group of women accepting it, complications, indications for discontinuation; and report an initial experience with the method. Methodology: This was a retrospective observational study of Implanon®, a single rod, long acting, reversible subdermal contraceptive implant system, containing the progestin etonogestrel, which was introduced in Jos, Nigeria, in May 2006. Results: Implanon capsules were accepted by 404 clients constituting 13.4% of acceptors of all contraceptive methods. The average age, parity and number of living children to the acceptors were 32.1 years, 3.6 and 3.3 respectively. About three-quarters (76.0%) of the women had secondary and tertiary education. Seventy-three (18.1%) of the women were taking a modern contraceptive method for the first time. There were 7 removals giving a high continuation rate of 98.3% in the first year. Menstrual disturbance was the commonest (57.1%) indication for removal. Conclusion: Implanon is an acceptable method of contraception among our women population.
[ABSTRACT]   Full text not available  [PDF]
  932 231 -
RESEARCH LETTER
Age at menarche and menstrual pattern in secondary schoolgirls in Sagamu
PO Adefuye, OL Odusoga, BO Adefuye, RA Akindele
January-March 2010, 13(1):109-113
Background: Menarche is the first menstruation in the life of a woman. Menstrual pattern involves the length of bleeding, the length of the cycle and other associated events such as pain (dysmenorrhoea). Dysmenorrhoea has been identified as a reason for school absenteeism in girls. Objective: To determine the mean age at menarche and pattern of menstruation in the sub-urban district of Southwestern Nigeria and to demonstrate the influence of pre-menarcheal education on the attitude of the respondents. Method: Students in senior secondary classes were randomly selected from seven Secondary Schools in the town. The tool was a self administered simple questionnaire and analysis was done using SPSS 11.0 statistical package. Result: The mean age at menarche was 13.8 (±1.3) and the range were 10 to 18 years. The mean length of the cycle was 26.9 (±3.7) and the range was from 14 days to 32 days. The duration of flow ranged from 1 day to 13 days with a mean of 4.6 (± 1.2) days. Fifty three point four percent of the respondents had varying severity of dysmenorrhoea. There is a better perception of dysmenorrhoea in girls who had pre-menarcheal education (p=0.000). Conclusion: Mean menarcheal age of 13.8 (±1.3) days compared favourably with findings in recent studies and also agree with declining trends over the past decades. Pre-menarcheal education will improve perception of dysmenorrhoea and thus reduce school absenteeism resulting from it.
[ABSTRACT]   Full text not available  [PDF]
  929 203 -
COMMENTARY
Bridging the gap between outputs of clinical research and utilisation towards improved healthcare outcome in Nigerian hospitals
OP Arewa
January-March 2010, 13(1):114-117
Worldwide clinical research efforts do not necessarily translate to improved outcomes in clinical practice. However, with the rising challenge facing clinicians in the midst of an environment of increasing health care choices, rising expectations and limited resources, the awareness of this lag is rising globally and health authorities in collaboration with the clinicians in many countries are taking specific measures to address this issue. While certain contributory factors to this problem could be universal and possible solutions generalized, some other issues are specific to socio-political and economic circumstances. This article examines two critical issues of attitudinal barriers and institutional defects contributing to this gap in the Nigeria situation and suggests possible measures for improvement. "Much knowledge if out of proportion to the disposition of forces, is invalid, however formally correct it may be". TheodorAdorno (German philosopher & sociologist 1903 -1969). "I am dying with the help of too many physicians". Alexander the Great (356 BC - 323 BC)
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  812 318 2
ORIGINAL ARTICLES
Morbidity pattern in paediatric outpatient unit of the university of Abuja Teaching Hospital, Gwagwalada, Nigeria
AA Okechukwu
January-March 2010, 13(1):1-6
Objective: The study was aimed at identifying the common presenting complain, and diagnosis among paediatric patients, who attended outpatient unit of department, at the University of Abuja Teaching Hospital (UATH), Gwagwalada. Patients and Method: Information was retrieved from the case records of all children from the ages of one day to 15 years, who presented for treatment at the Paediatric Out Patient Unit (POPD) of UATH, from January 2005 to December 2006. Result: During the study period of two years, a total of 3,669 paediatric patients were seen, with a mean age of 4.1 ± 1.7 years. There were 1,948 males and 1,721 females given a male to female ratio of 1.1 :1. Under five years constituted 74.9% of paediatirc outpatient visit, with 52.7% being children less than 2 years, and 33.1% being those less than one year. The three commonest presenting complain were fever (48.4%), cough/catarrah (18.4%) and diarrhoea (7.9%) . Malaria was the commonest diagnosis made (39.0%), this was and followed acute respiratory tract infection (ARTI) in (22.0%) of case, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in 11.9%. Measles was least diagnosed (0.5%), with gastroenteritis being recorded in (5.2%), and skin infection in 5.8% of cases. Infectious diseases with HIV/AIDS inclusive constituted 82.8% reason for outpatient paediatric visit in UATH. Conclusion: Infectious diseases still remain major reason for paediatric outpatient visit at the UATH. Though measles and diarrhoea were on a downward trend, every effort must be made to bring malaria, ARTI and most recently HIV/AIDS under control.
[ABSTRACT]   Full text not available  [PDF]
  928 186 -
Impact of dog bite in Kano city a retrospective study
SI Adeleke
January-March 2010, 13(1):67-69
Background: Rabies is an acute encephalomyelitis. It is zoonotic disease occurring in a variety of warm blooded animals including man. Objectives: The study is to review the impact of dog bite and rabies in Kano City. A review of cases seen in Paediatric Unit of Aminu Kano Teaching Hospital, Kano over a ten year period. (January 1996 December 2005). Results: There were 44 cases of dog bites of which five (11.4%) cases developed rabies. The age range of children with dog bite was 4 to 9years. The most common sites of bite were on the legs (45.5%), gluteal region (36.4%) while the least affected sites were the upper arm (6.8%) and the face (4.5%). There were 28 (63.7%) of the dogs were stray dogs while 12(27.3%) were domestic dogs, only 31.8% of the domestic dogs were vaccinated. All those with rabies died; All the five patients presented with furious rabies. Conclusion: Children with dog bites in which the current certificate of vaccination in the dog cannot be produced, should be given antirabies vaccine. There should be public enlightenment talks aimed at informing the public of the need to report all cases of dog bite to health facilities.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  917 196 1
Awareness and practice of emergency contraception among university students in Abakaliki, Southeast Nigeria
PC Ibekwe, JA Obuna
January-March 2010, 13(1):20-23
Background: Unprotected sexual exposure leading to unwanted pregnancy and unsafe abortion contributes significantly to reproductive ill health, especially in developing countries. Promotion of emergency contraception (EC) has been advocated as a way of reducing these problems. Our youth, the most vulnerable group, should therefore be the target for this form of contraception. Objective: To evaluate the awareness and practice of emergency contraception among University students. Methods: A semi- structured self-administered questionnaire was developed and distributed to 500 randomly selected students of Ebonyi State University, Abakaliki, Nigeria. Information regarding their awareness and practice were sought. The response rate was 100%. Result: Fifty-six percent of the respondents were aware of EC. Of these, only 10.5% had used it. However, 41.2% agreed to use EC if they are exposed to unprotected intercourse. For those who knew about EC, 26.4% were aware it could be started within stipulated time of unprotected sexual exposure. Most students (46.8%) cited peer groups as their source of information while 6.0% knew about it from their parents. 86% of the respondents were sexually active. Conclusion: There is limited knowledge and poor practice of EC among the students of Ebonyi State University. There is an urgent need to improve knowledge and practice of EC through reliable and accessible contraceptive information. This will help to reduce the gap between knowledge and practice.
[ABSTRACT]   Full text not available  [PDF]
  906 206 -
Early experience with endourology at Ladoke Akintola University of Technology Teaching Hospital, Osogbo
AK Eziyi, JAE Eziyi, AA Salako, AOA Aderounmu
January-March 2010, 13(1):24-27
Background: Endourological practice has revolutionized the diagnosis and the management of patients with various urologic abnormalities. But the level of practice in developing countries is unusually low, basically due to lack of necessary equipment and experienced trained manpower. Objectives: To present our initial experience with endourological procedures in a tertiary hospital in Nigeria with emphasis on the indications, complications and challenges encountered. Setting: The endourological section of our urology unit is new with some facilities for lower urinary tract endoscopes. A lot of the patients with various urological disorders who had endourological procedures were used in this study. Materials and Methods: Aprospective analysis of records of all patients who had diagnostic and therapeutic endourological procedures in our practice from September 2004 to December 2006 was carried out. Indications for the procedure, type of anesthesia, type of irrigation fluid used and complications and challenges encountered during the procedure were noted. Results: 201 medical notes were available for review. Atotal of 204 procedures were carried out, representing twenty five percent of the total urological procedures done by the unit during the study period. The commonest indication for an endourological procedure was bladder outlet obstruction with benign prostate hyperplasia responsible in 108.0 (53.7%) of cases followed by cancer of the prostate in 36.0 (17.9%) and urethral stricture in 18 (9%) of cases. The commonest form of endourologoical procedure performed was urethrocystoscopy which constituted 89.6% while the second most common procedure was urethroscopy alone (9.0%) mainly for patients with urethral stricture. There were three complications, acute urinary retention, epididymo-orchitis, and heamaturia, following the procedure. Conclusion: Endourological procedures have refined and improved the management outcome of diverse urological procedures with minimal complications.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  949 161 1
Effect of bacterial isolates on the seminal indices of men investigated for infertility in Gombe
BM Audu, AA Massa, M Bukar, GS Melah, A Kudi
January-March 2010, 13(1):16-19
Context: The significant contribution of the male partner to infertility is no longer in doubt. There is however little disagreement regarding the frustrating experience with medical management of male infertility. The effect of infection as a contributor to abnormalities in semen parameters has been reviewed. Objectives: The study was aimed at identifying male factor contribution to infertility and the influence of bacterial infection on seminal parameters. Study-design, setting and subjects: All 202 patients were spouses of infertile women who presented to the Gynaecological clinic of the Federal Medical Centre Gombe over a one-year period, from January to December 2001 inclusive. Results: The density of spermatozoa ranged from 0-844x10 6 /ml with a mean of 44.588.5 x10 6 /ml. Only 94 (46.5%) of the patients had the reference lower limit normal density of 20 million spermatozoa/ml or more. However, 111 (55%) were normozoospermic for total count with 64 (31.7%) being oligozoospermic. There were bacterial isolates from the seminal fluid of 134 (66.3%) patients that was predominantly accounted for by S. aureus 67.2% (90/134). The seminal fluid produced was 1-8mls, with a mean of 3.11.7mls of which 45 (22.3%) were oligospermic. The mean pH was 7.10.3, in 16 (7.9%) patients the seminal fluid pH was 8-9.There were 27 (13.4%) azoospermic men, in 163 (80.7%) the spermatozoa had normal morphology of 70% or more while 12 (5.9%) men had abnormal morphology of 30% or more i.e. were teratozoospermic. All cases with no abnormal (or normal) morphology were actually azoospermic. There was a significant association between the presence of bacterial isolate in the seminal fluid and oligozoospermia. However the motility, morphology or the count do not seem to be affected by the presence of infection. Conclusion: Bacterial presence contribute significantly to poor semen quality in our environment. Primary prevention and prompt treatment of urogenital infections could reduce the infectious contribution to male infertility.
[ABSTRACT]   Full text not available  [PDF]
  907 197 -
True corrected seminal fructose in male infertility in Nigerians a preliminary study
JC Orakwe, FO Chukwuezi, GU Ebuh
January-March 2010, 13(1):84-86
Background: The function of the seminal vesicle is important for fertility. Low level of true corrected seminal fructose has been observed in hypofunction of the seminal vesicles and has been related to male infertility. In Nigeria, published studies on seminal fluid analyses have so far excluded information on seminal fructose. Objective: To prospectively determine the true corrected seminal fructose values in Nigerians as it may serve as a cheaper and available alternative for assessing seminal vesicle function, and for overall evaluation, in male infertility in Nigeria. Materials and Method: The subjects included patients and volunteers. Seminal fluid collection and analysis were done using the WHO standards. Serum testosterone was also measured in all subjects. Correlation was tested with the student "t" test and the level significance was p<0.05. Result: 317 subjects were studied, 20 were azoospermic, 237 were oligospermic, and 60 were normospermic (normal control). Their ages ranged 24-60 years with a mean of 41.55±7.63 years. Mean values of seminal fructose were 154.35±29.52mg/dl in azoospermics, 487.03±87.45mg/dl in oligospermics, and 338.03±86.14mg/dl in normospermics. The normal range of seminal fructose was determined to be 163.13-512.93mg/dl. Mean serum testosterone level of the subjects was 2.47±0.63ng/ml, range '1.3-4.1ng/ml. There was a correlation between true corrected seminal fructose with motile density in normospermics (r=0.32), and it was strongly so with oligospermics (r=0.734). Serum testosterone was strongly correlated with seminal fructose in all groups (r=>0.67). Conclusion: In our environment, true corrected seminal fructose may be of value in the evaluation of infertility as a biological marker for androgen activity in the reproductive tract, and of seminal vesicular function.
[ABSTRACT]   Full text not available  [PDF]
  921 174 -
Incidence of pulmonary mycoses in patients with acquired immunedeficiency diseases
HAS Aluyi, FD Otajevwo, O Iweriebor
January-March 2010, 13(1):78-83
Background: Fungal infections are common complications of AIDS and pulmonary complications remain a major cause of both morbidity and mortality in immune compromised patients. Such complications can also result in life threatening meningitis and discomforting if not debilitating thrush. The impact of the Acquired Immunodeficiency Syndrome (AIDS) on the incidence of mycoses is difficult to predict but is likely to be substantial. Retrospective studies in Africa and USA have indicated that 58% to 81% of patients with AIDS develop a mycosis. Objectives: The objectives of the study were to determine the prevalence of pulmonary mycosis in AIDS patients with complications of cough, determine if there is any relationship between AIDS and pulmonary mycoses and determine if there is any difference in the prevalence of pulmonary mycoses in AIDS patients on anti retroviral drugs and those not on drugs. Methods: A total of 195 sputum samples were obtained from patients diagnosed with full blown Acquired Immune Deficiency Syndrome (AIDS) who had been sick between 6 months to 3 yrs with CD4 count less than 200/mm 3 presenting with cough at the University of Benin Teaching Hospital (UBTH) Edo State. 55 (28.2%) of population studied had been on anti-retroviral medication, with the remainder on none during the study period. Forty other sputum samples were obtained from apparently healthy (HIV Seronegative) persons also based in Benin City as controls. All subjects were grouped into <20 (3.1%), 20-30 (32.3%), 31-40 (30.3%), 41-50 (17.4%), ≥51(2.1%) age groups. Test and control samples were cultured on Sabouraud Dextrose Agar and Potato Dextrose Agar and incubated at 37° C and room temperatures respectively with daily observation for growth for 2 weeks. Cultural and morphological characteristics, KOH mount and Lactophenol Cotton Blue staining were used to identify opportunistic fungal pathogens. Results: One hundred and forty (71.8%) of test samples yielded fungal pathogens while 55(28.2%) yielded no growth. 3(7.5%) of control samples yielded fungal growth. Fungal organisms isolated were: Candida albicans (19.0%), Candida stellatoidea (9.7%), Cryptococcus neoformans (9.7%), Candida parapsilosis (9.7%), Torulopsis glabrata (5.6%),Mucor spp (7.2%), Penicillium marneffei (4.1%), Rhodotorula rubra (3.6%) and Fusarium spp (3.1%) in that order. All (9) organisms were isolated from patients within 21-30 and 31-40 age groups; 8 organisms from 41-50 age group and 3 organisms each from ≤ 20 and ≥50 age brackets. Candida albicans and Cryptococcus neoformans occurred in all age groups. Conclusion: Findings suggest that routine management (treatment) of pulmonary opportunistic mycoses in AIDS patients should include treatment for Candidiasis and Cryptococcosis for all age groups as well as additional antifungal agents if patients fall within 21-45 age group.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  887 204 2
CASE REPORTS
Fresh non-preserved human amniotic membrane transplantation in the treatment of deep corneal ulcers in a developing country (Nigeria): Case reports on initial experience
JM Waziri-Erameh, AE Omoti, AU Uduose
January-March 2010, 13(1):94-97
Aim: To demonstrate the use of Fresh non-preserved human amniotic membrane in treating deep corneal ulcers. Methods: Three patients who had deep corneal ulcers following traditional medicine instillation had amniotic membrane transplantation at the University of Benin Teaching Hospital, Benin City. Appropriately cut pieces of amniotic membrane were layered in the centre of the of the corneal ulcers, epithelial surface up and the top one or two pieces were anchored with sutures. Results: There was dramatic improvement in all the cases with the ulcers healing within 3 weeks. Conclusion: Fresh non-preserved amniotic membrane is very useful in the management of severe deep corneal ulcers in the absence of preserved amniotic membrane. This will be of value in developing countries.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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ORIGINAL ARTICLES
Evaluation of hydronephrosis, during pregnancy in Nigerian women
OI Oyinloye, AA Okoyomo
January-March 2010, 13(1):51-54
Objective: Hydronephrosis is common during pregnancy. However, pattern of dilatation and effect of urinary tract problems are still largely controversial. The study aims to determine, the pattern of dilatation of the collecting system during pregnancy, effect of urinary tract problems and parity on the degree of dilatation, in our environment. Materials and Methods: Subjects were 135 women with singleton pregnancy (Gestational age of 12-40 weeks) and 43 non- pregnant women of child bearing age, referred to the ultrasound unit of Federal Medical centre Lokoja,Nigeria, for routine obstetrics sonography. Duration was, from January 2004 to may 2004. The pelvicalyceal diameters were measured and classified into mild, moderate or severe dilatation. Result: Hydronephrosis of pregnancy was found to have an incidence of 93.4% on the right side and 84.4% on the left side. A linear relationship was established between gestational age and mean pelvicalyceal diameters for both kidneys. Mean pelvicalyceal diameter was higher in women with urinary tract problems than those without, and this was statistically significant for the right kidney.(p>0.05).No association was however found with parity. Conclusion: Hydronephrosis is common in pregnancy with a right sided predominance.Pelvicalyceal diameter increases gradually throughout pregnancy with advancing gestational age. Urinary tract problems seem to cause increase in pelvicalyceal diameter while parity has no influence.
[ABSTRACT]   Full text not available  [PDF]
  896 179 -
Drug-resistance in chronic tuberculosis cases in Southern Nigeria
MN Aghaji, BAN Nwakoby
January-March 2010, 13(1):58-63
Objective: Nigeria has a high burden of tuberculosis but the drug resistant situation was previously unknown. This report evaluates the first line drug resistance and associated factors among chronic tuberculosis cases from the tuberculosis control programme in South south and South east zones of Nigeria. Methods: Descriptive study of chronic tuberculosis patients consecutively referred from March 2003 to December 2005. Information collected by indepth interview of patients and tuberculosis microscopy, culture and sensitivity of patients sputum. Results: Of 82 patients infected with M. tuberculosis strains, 57(64.0%) were males while their mean age was 38.0 13.2 years. Fifty nine (72.0%) patients had multidrug-resistance tuberculosis with 35(42.7%) resistant to rifampicin, isoniazid, ethambutol, streptomycin while 14(17.1%) had poly-drug resistance and one patient had monoresistance to isoniazid. Within and outside the national control programme, drug therapy was inappropriate (69.5-81.7%) and treatment poorly supervised (26.8-39.0%). Factors associated with multidrug resistance were a male age less than 45years and Category 1 treatment in a private health facility. Conclusion: The multidrug resistance burden in chronic tuberculosis cases is very high in southern Nigeria and should be urgently and adequately controlled in the interest of public health.
[ABSTRACT]   Full text not available  [PDF]
  857 166 -
CASE REPORTS
Penetrating head trauma following gunshot in a non­ neurosurgical trauma centre: A case report
II Onah, A Imo
January-March 2010, 13(1):106-108
With the dearth of trained neurosurgeons in sub-Saharan Africa and increasing civilian violence, penetrating head trauma occasionally present to other clinicians for management. The National Orthopaedic Hospital, Enugu is a non-neurologic trauma centre having the south-east, south-south geopolitical zones, and parts of Benue and Kogi states as the catchments area. A retrospective report from the case note of a patient with infratentorial brain injury from a gunshot is presented. He was treated conservatively and had a satisfactory outcome. The follow up is for four years. Adequate resuscitation and monitoring is crucial in successfully managing head injuries.
[ABSTRACT]   Full text not available  [PDF]
  819 182 -
ORIGINAL ARTICLES
Attitude of Nigerian surgeons to intraoperative deaths
PE Iribhogbe
January-March 2010, 13(1):13-15
Objectives: To assess the attitude of Nigerian surgeons to intra operative deaths. Method: A scenario based questionnaire on the subject was distributed to 100 participants at a National meeting of surgeons in Benin City in 2004. Results: Sixty-three questionnaires were returned (Response rate of 63%). One questionnaire was disregarded having been completed by a histopathologist. Respondents included 50 consultant surgeons, 2 consultant anaesthetists, 8 senior registrars and 2 registrars from surgery. 21 (33.9%) respondents opined that the rest of the list be cancelled following an intra operative death while 41 (66.1%) felt the list should continue. Of the 62 respondents 31 (50%) had experienced death of a patient on elective list. Forty four (71%) respondents felt that the surgeons and anaesthetists involved in the intra operative death of a patient would benefit from psychotherapy. Conclusion: This study revealed that surgeons of varied subspecialty interests would want the rest of the elective list to continue following the intra operative death of a patient but that some form of psychotherapy is given to the surgeons and anaesthetists involved.
[ABSTRACT]   Full text not available  [PDF]
  839 162 -
REVIEW
Blindness in Southern Nigeria: A review of available data
CN Pedro-Egbe, S Babatunde
January-March 2010, 13(1):87-93
Purpose: To bring up to date, existing knowledge on the prevalence and common causes of blindness in Southern Nigeria. Source of data: Available publications on blindness in national and international journals, some dissertations of the National Postgraduate Medical College and the internet using MEDLINE. Data extraction: Data relating to the prevalence and common causes of blindness in southern Nigeria over a 20-year period (1973-2003) was reviewed. All relevant articles, full length and abstracts, were sorted by categories i.e. into global, continental (Africa), Nigeria and then southern and northern Nigeria groupings. Recent information was also obtained on the internet using MEDLINE and the key words "Blindness in Nigeria". Results: Reviewed information shows that blindness is as much a problem in Southern Nigeria as it is in the rest of the less developed and poor countries of the world; and that the commonest causes of blinding diseases are largely preventable and treatable. Conclusion: An appreciable depth of data exists on blindness in southern Nigeria. Reviewed information indicate that blindness is as much a problem in southern Nigeria as it is in the rest of the less developed and poor countries of the world, but regrettably, the commonest causes of blinding diseases in this region are largely preventable and treatable.
[ABSTRACT]   Full text not available  [PDF]
  837 149 -
CASE REPORTS
Ano-rectal tuberculous granuloma presenting with faecal incontinence
PO Okokhere, EF Alufohai, CE Iyamu, J Kpolugbo, HO Omeife, A Dongo
January-March 2010, 13(1):101-102
Tuberculosis is a common condition world-wide but more so in developing countries where it accounts for 95% of all cases. It primarily affects the respiratory system, but other systems including the gastro-intestinal tract can also be affected. When it does, it has predilection for the ileo-caecal region, where half of the cases occur. Ano-rectal tuberculosis is not very common and when it occurs, it could present as a mass, making it difficult to differentiate from malignancy and other granulomatous lesions. We therefore, present a case of a 68-year old man with a huge mass in the ano-rectum with faecal incontinence, which was clinically diagnosed as an advanced carcinoma of the ano-rectum for which the biopsy was reported as tuberculosis. He improved with anti-tuberculosis treatment.
[ABSTRACT]   Full text not available  [PDF]
  834 146 -
Black water fever (BWF)? A case report from the semi-arid Northeastern Nigeria
S Oguche, Y Mava, IM Watila, NB Molta
January-March 2010, 13(1):103-105
Black Water Fever is an uncommon complication of P. falciparum malaria in our environment. The overall incidence in Nigeria is unknown but the frequency may be more than is reported. It is commonly associated with administration of suboptimal doses of quinine and development of acute renal failure. We present a case of BWF having occurred after the administration of quinine, which we treated successfully with artemether.
[ABSTRACT]   Full text not available  [PDF]
  812 157 -
ORIGINAL ARTICLES
Opinions of Nigerian dental consultants on ideal content current quality and attitudes to referrals
AO Arigbede, OO Dosumu
January-March 2010, 13(1):70-73
Aim: The current study was designed to ascertain the opinion of a cross-section of Nigerian dental consultants on: current quality of referral sent to dental specialists; what should constitute the ideal content of referral letters and to ascertain their opinion on attitudes of colleagues to referrals. Materials and Methods: The study was conducted using a structure questionnaire hand delivered to a cross­-section of Nigerian dental consultants. Information requested includes: demographic variables; current quality; constituents of a quality referrals and current attitudes to referrals. The respondents were asked to rate their responses to the questionnaire items on a 3-point and 5-point Likert scale respectively. Results: Only 6.23% (SD ± 7.66) referrals was perceived as excellent, while most of them, 42.63% (SD± 31.51) was reported as adequate. The result shows that response to referral is not always prompt while feedback to referral is hardly provided. Undergraduate students are hardly taught the art of referral writing. The consultants agreed that date of referrals, patient's name and address, accurate description of complaints, history of patient's complaint and steps taken by the practitioner so far, should be included in a quality referral. Conclusion: The quality of referral sent to dental specialties at the moment was considered unsatisfactory. The consultants agreed that date of referral, patient's name and address, accurate description of complaints and steps taken by the practitioner so far, should be included in a quality referral.
[ABSTRACT]   Full text not available  [PDF]
  800 151 -
LETTER
Severe idiosyncratic drug reaction (Lyell's syndrome) after ingesting dihydroartemesinin: Alternative interpretations
KA Oshikoya
January-March 2010, 13(1):118-119
Full text not available  [PDF] [CITATIONS]
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