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   2010| October-December  | Volume 13 | Issue 4  
    Online since January 5, 2011

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Pregnancy outcome in eclamptics at the University of Abuja Teaching Hospital, Gwagwalada, Abuja: A 3 year review
ET Agida, BI Adeka, KA Jibril
October-December 2010, 13(4):394-398
Background : Eclampsia remains one of the major causes of maternal morbidity and mortality especially in the developing countries. In Nigeria, it is the 3 rd commonest cause of maternal mortality. The high maternal morbidity and mortality due to eclampsia in the developing countries has been ascribed to late referral, delay in hospitalization, lack of transport, unbooked status of patients and multiple seizures prior to admission. Objective: To review the presentation and management of eclampsia at the University of Teaching Hospital (UATH), the factors associated with it, the maternal and perinatal outcome and make recommendations on how to reduce maternal and perinatal morbidity and mortality from eclampsia. Methodology: The case notes of all the patients that had eclampsia between 1 st May 2005 and 30 th April 2008 were retrieved and analyzed. The informations sought for include age of the patients, parity, booking status, type of eclampsia and blood pressure at presentation. Other informations include level of proteinuria, anticonvulsants used, mode of delivery, maternal complications and perinatal outcome. Results : There were 4471 total deliveries within the period, out of which 59 had eclampsia, giving an incidence of 13 per 1000 deliveries. There were 5 maternal deaths, giving a case fatality rate of 8.5%. Eclampsia was commonest amongst the age group of 20-24 years (34.8%). Primigravidae constituted 60.9% of the cases. Majority of the patients (89.1 %) were unbooked. Antepartum eclampsia (73.9%) was more than intra-partum (19.6%) and postpartum (2.2%) combined. Thirty two patients had severe hypertension on admission (diastolic BP= 110 mmHg) while 11 (23.9%) had mild hypertension (diastolic BP 90-< 110mmHg). Twenty patients (47.8%) were managed with diazepam alone while 19 patients (41.3%) were managed with magnesium sulphate alone. Five patients were managed with both. Thirty nine (84.8%) were delivered through caesarean section while 5 (10.8%) were delivered vaginally. Maternal complications include 6 cases of acute renal failure and one case of visual impairment. Thirty seven babies were delivered live while 8 stillbirths were recorded. Six babies (13.0%) had very low birth weight, 14 (30.4%) had low birth weight and 16 (34.8%) had normal birth weight. Conclusion: Eclampsia still remains a major cause of maternal morbidity and mortality in Nigeria. More awareness and enabling factors should be created for more women to access antenatal facilities. Information about danger signs of pre-eclampsia/eclampsia should be made available to antenatal clients. Government should be committed to providing emergency obstetric case facilities in our hospitals for effective management of eclampsia.
  6 5,798 1,507
Smokeless tobacco use in adult Nigerian population
OO Desalu, KR Iseh, AB Olokoba, FK Salawu, A Danburam
October-December 2010, 13(4):382-387
Objectives: The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Methods: Across-sectional survey of 1776 adults in Yola, North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and data collection. Results: Out of 1776 interviewed respondents, 133 (7.49%) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8%). Fifteen (0.9%) chewed tobacco while only 2(0.1%) both chewed and snuffed tobacco. Social acceptance (21.8%) was the major reason for using smokeless tobacco. Males, 5 th and 6 th decades of life, poor education, lower socioeconomic class, Margi, Hausa and Fulani tribes were the determinants of smokeless tobacco use. About 89.5% of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. Conclusion : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking.
  4 4,450 579
Day case surgery and developing countries - A review
EO Ojo
October-December 2010, 13(4):459-466
Background: Day case surgery (DCS) is increasingly practiced all over the world but with a lag between the developed and developing continents. While it has witnessed a boom in the continents of America and Europe culminating in the establishment of Freestanding and autonomous units, the developing countries still largely practice hospital based day cases with relatively limited scope and utilization. Objective: This article reviews the evolution, scope, safety, organisation including the standard necessary for establishing and practicing day case surgery and examines the practice in the developing world. Design: Electronic literature search combined with review of both local journals and relevant texts. Outcome: There is increasing need, applicability, potentials and relevance of day case surgery in the developing world with potential huge economic and social benefits. Conclusion: As modern day case surgery practice requires dedicated services with meticulous attention equal to that given to in-patients, efforts should be focused on providing efficient services, in well structured centres, ploughing back resources to improve infrastructural/organisational deficiencies and acquiring relevant technology with skills in the developing world.
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Incidence of delivery of low birthweight infants in twin gestations
AN Onyiriuka
October-December 2010, 13(4):365-370
Background: Twin gestations are commonly associated with delivery of low birthweight infants. Despite the fact that Nigeria has the highest incidence of twinning in the world, there is paucity of information on the characteristics of LBW twin infants in Nigeria. Objective: To determine the incidence and document some of the characteristics of low birth weight (LBW) twin infants. Method: A descriptive analysis of data on 119 LBW twin infants delivered between 1st January, 2000 and 31st December, 2003 in a Nigerian mission hospital in Benin City was carried out. The characteristics of the LBW twin infants was studied in relation to perinatal mortality. Results: The overall incidence of LBW twin infants was 51.7% with a female preponderance. Of the 107 live-born LBW twins, 74 (69.2%) compared to 33 (30.8%) were preterm and term small-for-gestational age (SGA) infants respectively (p<0.001). Twenty six (35.1%) of the 74 preterms were very preterm (<32 weeks gestation), corresponding to 24.3% of all LBW twin infants. The associated perinatal mortality for the two categories of LBW infants were 21.6% for preterm and 9.1% for term SGA infants (p>0.05). Of the 119 LBW twin infants, 7.6% were extremely LBW, 10.1% very LBW while 57.1% were in 2000 2499g category. Fifty one (42.9%) of LBW twin infants weighed less than 2000g. The risk of delivery of LBW twin infants was significantly higher in primiparous women (p<0.001), as well as in mothers who were unbooked (p<0.001) or lacked formal education (p<0.01). Out of 9 growth discordant LBW twins, 6 (66.7%) had birthweight difference ≥30%. Conclusion: In twin gestations, preterm delivery is a more important contributor to LBW than term SGA delivery with majority of these preterm infants delivered by primiparous mothers.
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Burden of obesity in essential hypertension: Pattern and prevalence
AA Akintunde, PO Akinwusi, RA Adebayo, S Ogunyemi, OG Opadijo
October-December 2010, 13(4):399-402
Obesity continues to be an epidemic worldwide. There also continues to be a relationship between obesity and hypertension both causal and consequentially. The study aims at determining the prevalence and pattern of overweight and obesity among our patients being managed for essential hypertension. Material and Methods: The study was a cross sectional study. Consecutive patients diagnosed with essential hypertension were recruited from two university teaching hospitals in the South West of Nigeria. Demographic data such as age, gender, weight and height were obtained from patients at recruitment. Patients with congestive heart failure, secondary hypertension, chronic kidney disease, and other chronic diseases were excluded. Pregnant women were also excluded. Obesity was defined according to WHO classification. Statistical analysis was done by the Statistical Package for Social Sciences version 11.0. Results: One thousand one hundred and two (1102) consecutive hypertensive patients were recruited. Two hundred and eighty six (286) were dropped due to evidence of overt heart failure (98) and chronic kidney disease and others (188). There were (420) males (51.5%) and 396 females (48.5%), mean age 54.97 (΁13.14) years. (Range 10-91). 7.6% (62) were underweight (36 males, 26 Females): 260 (31.9%) were overweight, consisting of 148 males and 112 females: 135 (16.5%) had mild obesity consisting of 48 males and 87 females: 43(5.3%) had moderate obesity with 15 males and 28 females while 30(3.7%) had severe obesity (consisting of 22 females). Conclusion: About two thirds of the hypertensive patients seen in two teaching hospitals in the South West of Nigeria in this study were either overweight or obese. Therefore lifestyle modification geared toward weight reduction should be emphasized in these patients.
  2 3,816 824
Effects of position and phonation on oropharyngeal view and correlation with laryngoscpic view
FE Amadasun, OP Adudu, A Sadiq
October-December 2010, 13(4):417-420
Objective: To evaluate the effects of phonation and various head and body positions on oropharyngeal view (Mallampati score), and the correlation of these with laryngoscopic view, using the Cormack and Lehane score. Methodology: Four hundred (390) consecutive patients were evaluated in the wards during preoperative anaesthetic review. During airway assessment, the patients were placed in various head and body positions to determine oropharyngeal structures visualized, with and without phonation, according to the Mallampati test score. In the operating theatre, laryngoscopic view scores (according to Cormack and Lehane) were recorded, and the various scores analyzed. Results: Phonation consistently improved the Mallampati scores in all the head and body positions. The scores were better in the supine position compared to the sitting position. The best correlation of the Mallampati score with the Cormack and Lehane score was in the sitting, head maximally extended position, without phonation. Extention of the head improved the score in the sitting position, but not in the supine position. Phonation reduced the correlation of the scores in all the positions. Conclusion: We conclude that the best position to conduct the Mallampati test is sitting, head maximally extended, without phonation. This correlated best with laryngoscopic view score in our study.
  2 3,222 527
Knowledge and attitude of civil servants in Osun state, Southwestern Nigeria towards the national health insurance
AI Olugbenga-Bello, WO Adebimpe
October-December 2010, 13(4):421-426
Introduction: In Nigeria, inequity and poor accessibility to quality health care has been a persistent problem. This study aimed to determine knowledge and attitude of civil servants in Osun state towards the National Health Insurance Scheme (NHIS). Methodology: This is a descriptive, cross sectional study of 380 civil servants in the employment of Osun state government, using multi stage sampling method. The research instruments was pre-coded, semi structured, self administered questionnaires. Results: About 60% were aware of out of pocket as the most prevalent form of health care financing, while 40% were aware of NHIS, television and billboards were their main sources of awareness, However, none had good knowledge of the components of NHIS, 26.7% knew about its objectives, and 30% knew about who ideally should benefit from the scheme. Personal spending still accounts for a high as 74.7% of health care spending among respondents but respondents believed that this does not cover all their health needs. Only 0.3% have so far benefited from NHIS while 199 (52.5%) of respondents agreed to participate in the scheme. A significant association exists between willingness to participate in the NHIS scheme and awareness of methods of options of health care financing and awareness of NHIS (P<0.05) Conclusion: Poor knowledge of the objectives and mechanism of operation of the NHIS scheme characterised the civil servants under study. The poor knowledge of the components and fair attitude towards joining the scheme observed in this study could be improved upon, if stakeholders in the scheme could carry out adequate awareness seminars targeted at the civil servants.
  2 8,554 1,179
Massive haemoperitoneum from endometriosis masquerading as ruptured ectopic pregnancy: Case report
JT Mutihir, DD Nyango
October-December 2010, 13(4):477-479
  1 3,104 418
The contribution of alcohol to chronic liver disease in patients from South-west Nigeria
DA Ndububa, OS Ojo, VA Adetiloye, AO Aladegbaiye, RA Adebayo, O Adekanle
October-December 2010, 13(4):360-364
Objective: This study aimed at determining the level and type of alcohol consumed by patients diagnosed with chronic liver disease (CLD) and, hence, the extent to which alcohol may have contributed to the development of the condition. Study Design: Patients with diagnosis of CLD were consecutively recruited and a structured questionnaire was administered on each of them. Diagnosis of CLD was made based on liver histology and/or typical clinical and laboratory features. Alcohol consumption was considered significant if a patient took >50g/day for > 10 years. Results: A total of 145 patients were studied consisting of 102 males and 43 females. Their ages ranged from 20- 80 years with a mean of 46.8 ± 15.7 years. Fifty-one (35.2%) patients, all males, drank significant alcohol while consumption was not significant in 43 (29.6%) patients. Alcohol was not consumed at all by 51 (35.2%) patients made up of 18 males (35.3%) and 33 females (64.7%). Beer was the commonest form of alcohol consumed (70.2%) followed by palm wine (50%) and locally-brewed gin (20.2%). The diagnoses made were liver cirrhosis [LC] (60, 41.38%), chronic hepatitis [CH] (54, 37.20%), hepatocellular carcinoma [HCC] (23, 15.86%), alcoholic liver disease [ALD] (6, 4.14%) and non-alcoholic fatty liver disease [NAFLD] (2, 1.38%). The liver disease spectrum did not differ between the patients who drank significant alcohol and those who did not. However, the proportion of LC/HCC cases increased relative to CH with increasing age and consumption of alcohol. Conclusions: The proportion of CLD directly attributable to alcohol (i.e. ALD) is low among the patients studied. However, the burden of LC and HCC is directly related to age and the amount of alcohol consumed and the determinants of alcohol abuse are gender and affluence.
  1 5,855 821
Neuromusculoskeletal disorders in patients with type 2 diabetes mellitus: Outcome of a twelve-week therapeutic exercise programme
AF Adeniyi, AA Fasanmade, AO Sanya, M Borodo
October-December 2010, 13(4):403-408
Background and Objectives: Usual line of management of diabetes patients is drug and diet with their physical needs usually receiving minimal attention. Among the physical needs, requiring attention is their neuromusculoskeletal disorders. This study was designed to investigate the effect of a twelve-week therapeutic exercise on neuromusculoskeletal disorders of Type 2 Diabetes (T2D) patients. Methods: Forty-three participants from the Diabetes Specialty Clinic of Aminu Kano Teaching Hospital, Kano completed the study. Selected neuromusculoskeletal disorders including pain, dermatological foot grades, disorders of ranges of motion and strength of selected joints and muscles were assessed before and after a period of twelve weeks of therapeutic exercises. Participants were followed up for another twelve weeks without therapeutic exercises. Results: Baseline assessment revealed poor neuromusculoskeletal status. Significant improvements (P<0.05) were obtained for pain, Severity of Dermatological Foot Grading, Muscle strength (One Repetition Maximum) and Range of Motions at the end of the exercises except that of right wrist extension (P>0.05). Conclusions: T2D patients presented with neuromusculoskeletal disorders at baseline. Therapeutic exercises however assisted in the improvement of these disorders but relapsed when exercises were suspended. Engagement in therapeutic exercises enhanced neuromusculoskeletal health, while withdrawal from the exercise contributed to a decline. T2D patients should be encouraged to participate in therapeutic exercises in order to promote their health and function.
  1 3,626 772
The prevalence and bacteriology of asymptomatic bacteriuria among antenatal patients in Nnamdi Azikiwe University Teaching Hospital Nnewi; South Eastern Nigeria
AN Oli, CI Okafor, EC Ibezim, CN Akujiobi, MC Onwunzo
October-December 2010, 13(4):409-412
Background: Urinary tract infection in pregnancy leads to poor pregnancy outcome. Diagnosis and treatment of asymptomatic bacteriuria markedly improves pregnancy outcome as well as reduce the incidence of acute pyelonephritis. Objective: To determine the prevalence and bacteriology of asymptomatic bacteriuria among Antenatal patients in our centre, and to know if routine screening will be justifiable. Materials and Methods: This was a prospective study carried out between April and August 2008. Sample size was statistically determined. Women who consented were interviewed and mid stream urine samples were collected and processed in the microbiology laboratory, using standard microbiological methods. Results: Out of 357 women studied, 65(18.21%) had significant bacteriuria. Escherichia coli was the commonest isolate (25.6%), while proteus mirabilis was the least frequent isolate (3.66%). Women in third trimester had the highest prevalence (25.68%) while those in the first trimester had the least (15.79%). Women that had only primary education had the highest prevalence (27.50%) while those that had tertiary education had the least prevalence (21.10%). Conclusion: The prevalence of significant asymptomatic bacteriuria among the women studied was high. Screening of all the pregnant women and treatment will reduce the incidence and complications of overt urinary tract infection in pregnancy among these women.
  1 4,924 814
Review of childhood measles admissions at the National Hospital, Abuja
PA Ahmed, IB Babaniyi, AT Otuneye
October-December 2010, 13(4):413-416
Background: The global disease burden from measles as a vaccine preventable disease remains high despite decades of interventions by various organs and agencies. Objectives: To determine the prevalence and outcome of childhood cases of measles admitted into the children's emergency ward of the National hospital and highlight the possible contributing factors. Design: Retrospective. Subjects : A total number of 43 children with measles presenting at the National Hospital Abuja, seen over a 40 months period; January 2002 and April 2005. Methods: Cases-folders of patients seen at the Emergency Paediatric Unit (EPU) of the National Hospital Abuja during the period under review with the clinical diagnosis of measles were reviewed. Results: The children were aged between seven to 12months, with 25 (58.1%) age 24months and below. Twenty three (53.5%) of the subjects had received prior measles vaccination. History of contact with cases of acute measles was present in 26 (60.5%). Associated protein energy malnutrition (PEM) was found in 30 (69.8%) with 28 (65.1 %) parents of these children being of lower social economic classes (III, IV &V). Recorded complications included gastroenteritis, bronchopneumonia, laryngo-tracheo-bronchitis as part of croup syndrome, tuberculosis, and otitis media. Three fatalities (7.0%) were record in this review, all in association with bronchopneumonia. Conclusion : Measles with its complications still present as a fatal illness even among vaccinated children.
  1 3,572 553
Patients' satisfaction with services obtained from Aminu Kano Teaching Hospital, Kano, Northern Nigeria
Z Iliyasu, IS Abubakar, S Abubakar, UM Lawan, AU Gajida
October-December 2010, 13(4):371-378
Objective : Periodic patient satisfaction surveys provide feedback to hospital management and staff regarding the quality of services rendered. These surveys have become routine as part of total quality management in developed countries. We assessed patient satisfaction with services provided in a teaching hospital in northern Nigeria. Method : Structured questionnaires were administered on a cross-section of 201 patients and two focus group discussions were held with patient relatives at Aminu Kano Teaching Hospital. Results : Overall, 83% of the patients were satisfied with the services received from Aminu Kano Teaching Hospital, while the remaining 17% were dissatisfied. Specifically, 88%, 88%, 87% and 84% of the patients were satisfied with patient provider relationship, in-patient services, hospital facilities and access to care. However, 30% and 27% of the patients were dissatisfied with waiting time and cost of treatment respectively. Patients and their relatives complained about delayed appointments, missing folders, missing laboratory results and long appointments for ultrasound and other radiological investigations. Conclusion : The high patient satisfaction notwithstanding, health workers need to consider patients as customers by being friendly and reducing waiting time for consultation and investigations. Widespread implementation of the National Health Insurance Scheme will also reduce the cost of services and drugs to patients.
  1 19,782 2,274
Early onset pregnancy-induced hypertension/eclampsia in Benin City, Nigeria
PN Ebeigbe, ME Aziken
October-December 2010, 13(4):388-393
Context: Pregnancy - induced hypertension/eclampsia is a major cause of maternal and perinatal morbidity and mortality in Nigeria. There have been very few studies focused on early onset pregnancy induced hypertension/eclampsia in Nigerian women Objectives: To determine the incidence, clinical features and outcome of cases of early onset pregnancy-induced hypertension /eclampsia in a Nigerian tertiary hospital, and compare maternofetal outcome in early and late onset disease. Methods : A retrospective study of all cases of early onset pregnancy induced hypertension/eclampsia seen over a five-year period in a tertiary hospital. Main outcome measures : Severity of disease, rates of induction of labour, caesarean section rate, maternal mortality, abruptio placenta, still births, severe birth asphyxia and early neonatal deaths. Results : Early onset pregnancy induced hypertension/eclampsia contributed 6.3% of all cases of hypertensive disorders in pregnancy with an incidence of 1:141 deliveries. Most cases presented at between 28-32 weeks gestation (78.3%) The disease was severe at presentation or rapidly progressive in 39 cases (84.8%) leading to delivery within 72 hours of presentation. Caesarean section was the mode of delivery in 58.7% of cases. The perinatal survival rate was 34.0%. Early onset pregnancy induced hypertension was associated with significantly higher risk of presenting with eclampsia, having induction of labour and worse perinatal outcome than late onset disease. Conclusion : Most cases of early onset pregnancy induced hypertension in the study population presented with severe and rapidly progressive disease and were associated with significantly higher risk of obstetric intervention and worse perinatal outcome than late onset disease.
  1 8,221 1,131
Takayasu's disease in a young black boy
SA Oguntona
October-December 2010, 13(4):467-469
Background: Takayusu's disease is a rare disease affecting women predominantly during the child- bearing age. It is a primary vasculitis condition of large-vessels that responds well to steroid therapy. Immunosuppressives and vascular reconstruction may be needed as necessary. Procedure: Reference was made to the case note of this young boy who was being co-managed by cardiology and vascular clinics. The diagnosis of Takayasu's disease was confirmed by the rheumatology unit and appropriate literature search was done. Result: Takayusu's disease responds well to steroid therapy as exemplified by this patient. There was no relapse of the active inflammation after six months of steroid therapy. Conclusion: A high index of suspicion must be exercise in diagnosing Takayasu's disease. It could be difficult to have a clue early in the disease process because of non-specific presentations. Appropriate referral should however be made to Rheumatologist when the diagnosis is suspected. This will go a long way in delaying the morbidity that is associated with this rare disease.
  - 2,173 317
Intussusception and volvulus secondary to jejunal adenocarcinoma in an adult Nigerian male; A case report
CA Okolo, AO Afolabi, SM Sahabi
October-December 2010, 13(4):470-472
A 31 year-old Nigerian man with jejuno-jejunal intussusception with the lead point being an adenocarcinoma complicated by small intestinal volvulus is presented. The subtle clinical features of an underlying small bowel malignancy were masked by the overwhelming clinical and radiological features of intussusception. rare case is reported to remind clinicians to have an increased index of suspicion of malignancy in patients who present with the usual features of chronic anemia, weight loss and loss of appetite with an intra-abdominal mass. The presentation of acute intestinal obstruction, with mesenteric vein thrombosis probably due to intussusception or volvulus should not however lower the suspicion. Histological evaluation of surgical biopsies is of immense importance.
  - 3,627 378
Crohn's disease presenting as a recurrent perianal fistula: A case report
AO Ajayi, TSC Chandrasekar, AH Hammed
October-December 2010, 13(4):473-476
Crohn's disease (CD) is a multifactorial polygenic disease characterized by chronic inflammation of the gastrointestinal tract (GIT), often complicated by the development of intestinal strictures and/or formation of fistulas. Several diagnostic criteria have been proposed, usually relying on clinical, endoscopic, radiological or histological features. report a case of Crohn's disease of the entire colon with rectal sparing presenting with recurrent perianal fistula that had earlier on been misdiagnosed and treated for other things. The patient was treated successfully with corticosteroids and aminosalicylates and had since remained stable.
  - 3,956 557
Prediction of functional capacity during six-minute walk among patients with chronic heart failure
RA Adedoyin, SA Adeyanju, MO Balogun, RA Adebayo, AO Akintomide, PO Akinwusi
October-December 2010, 13(4):379-381
Background: Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. Aims: The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 2 ) in Chronic Heart Failure Patients (CHF) during exercise. Methods: Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated. Results: The result showed that the distance covered was highly correlated with the VO2 (0.65, p< 0.01). The regression analysis revealed that a linear equation model developed was a good predictor of V0 2 for the group. Conclusion: The study concluded that in situation where sophisticated equipments are lacking, this equation might be useful during exercise supervision for patients with CHF. [VO2 (mlkg-1 min-1) = 0.0105 x distance (m) + 0.0238 age (yr) - 0.03085 weight (kg) + 5.598].
  - 4,866 921
Comparative study of intradermal smear microscopy in the diagnosis of malaria in symptomatic pregnant women
BO Okusanya, JO Eigbefoh, EE Okpere, O Ohiosimuan, NJ Inyang
October-December 2010, 13(4):427-430
Objectives: A comparative study of intradermal smear in the diagnosis of malaria in symptomatic pregnant women. Venous blood served as the control. Patients and methods : Fifty consecutive symptomatic pregnant women were recruited. Thick films of both venous and intradermal blood were examined. Questionnaires were used to determine patients' preference for the two techniques. Tests of statistical significance were done with Fisher exact and Yates correlation coefficient at 95% confidence interval. Sensitivity specificity and accuracy rates were used to assess the validity of intradermal smear. Results: Intradermal smear more frequently diagnosed malaria parasitaemia than peripheral venous blood (66% vs 56%). This was statistically significant (P value: 0.0065). The sensitivity of intradermal smear was 85.7% while the positive predictive value was 77.4%. The accuracy rate was 76.7%. The technique of intradermal blood collection was preferred by 28% of women. Conclusion: Intradermal smear is useful in malaria diagnosis in pregnancy and may be an additional evaluation tool for persistent fever in pregnancy.
  - 2,427 333
Evaluation of the mechanical and physical properties of a posterior resin composite in posterior adult teeth
LO Agbaje, OP Shaba, IC Adegbulugbe
October-December 2010, 13(4):431-435
Objective: To evaluate the mechanical and physical properties of a micro-hybrid resin composite used in adult posterior restorations Materials and Methods: A micro-hybrid, light curing resin composite Unolux BCS Composite Restorative, (UnoDent, England) was used to restore 74 carious classes I and II cavities on posterior teeth of 62 adult patients. The restorations were evaluated immediately following placement (Baseline), at 1 week, 3months, 6months and 12months using the United States Public Health Service Criteria/Modified Ryge criteria for direct evaluation. Color matching, marginal stains and adaptation, wear and surface texture were evaluated. Ranging from best to the worst, the ratings were, Alfa, Bravo and Charlie. Results: 58 restorations were available for review at the 12 th month evaluation, 15 patients bearing 21.6% of the restorations were lost to recall. Colour match scores were 89.6% Alpha at baseline and 74.1% at 12-month review. Marginal staining were 100% Alpha at baseline and 98.3% Alpha at the end of the evaluation period. Marginal adaptation at baseline was 100% Alpha this value dropped to 94.8% by the 12th month. Anatomical wear scores were 100% Alpha at baseline and scores dropped to 93.1 % at the 12-month evaluation. At baseline, Alpha scores for Surface texture were 100%. A drop in Alpha scores to 93.1 % at the first week review was maintained till the 12 month. Conclusion: Carefully controlled placement of micro-hybrid resin composite using the total etch and type 2 (one-bottle) adhesive can produce satisfactory posterior restorations on permanent teeth.
  - 3,054 634
Osseous union in cases of non-union in long bones treated by osteosynthesis
IC Nwagbara
October-December 2010, 13(4):436-440
Objective: To determine the incidence of osseous union in cases of nonunion of long bones managed by open reduction and compression plating. Patients and methods: Between November, 2003 and June, 2005, 53 patients with nonunion of long bones were treated by open reduction and internal fixation and followed up. The follow up period for each case was 6 months. Immediate post- operative x-ray was done in each case. Patients were seen in the post- operative period at 4 weeks, 6 weeks, 12 weeks, and 6 months. At each visit, clinical and radiological assessments were done. Result: The male to female ratio was 3:2, and the average age at presentation was 39.7 years (range: 19-64years). The average time from injury to presentation was 19.98 months (range: 6-132months). The commonest bone involved was the humerus (18), followed by the femur (17), the Tibia (11), the ulna (5), and the radius (2). Osseous union was achieved in 44 patients (83%). There was no significant difference in incidence of osseous union among the various bones. It was observed that previous infection at the fracture site adversely affected osseous union. Conclusion : The management of nonunion in long bones by compression plating was found to be satisfactory.
  - 4,731 532
Evaluation of post-operative sensitivity and secondary caries in posterior composite restorations: A 12 month study
LO Agbaje, OP Shaba, IC Adegbulugbe
October-December 2010, 13(4):441-444
Objective: To evaluate post-operative sensitivity and secondary caries associated with posterior composite restoration. Materials and Methods: The study involved restoration of occlusal and proximo-occlusal caries on premolars and molars of 62 patients seen at the out-patient clinic of the restorative department of the Lagos University Teaching Hospital. The restorations were completed with a micro-hybrid light curing resin composite (Unolux BCS, UnoDent, England). Following total etch procedure and use of a type 2 (5th generation/one-bottle) adhesive. The USPHSC or modified Ryge criteria was employed for direct evaluation of the restorations over the 12 month period. Results: Post-operative sensitivity was 3.5% Bravo at baseline and 1.7% Bravo at 12 months. No significant change in result was recorded for post-operative sensitivity at the end of the evaluation period. 100% was recorded for the absence of secondary caries throughout the evaluation period up till the 6 th month when a failed restoration scored 1.7% Bravo. At 12 months Alpha scores for secondary caries was 98.3%. Conclusion: Post-operative sensitivity was kept to a minimum and there were no occurrences of secondary caries.
  - 4,079 925
Clinico-pathological pattern of nasopharyngeal carcinoma in Ilorin, Nigeria
BS Alabi, KB Badmos, OA Afolabi, MO Buhari, S Segun-Busari
October-December 2010, 13(4):445-448
Background: Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high. Aim: The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria. Materials and Methods: This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1 st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991 WHO classification. Results: A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable risk factors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by well-differentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%). Conclusion: Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease.
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Outcome of training on yellow fever surveillance in a South-Western state, Nigeria: Implications for improved field implementation
AA Fatiregun, AO Sangowawa, OA Abubakar
October-December 2010, 13(4):449-452
Background : Nigeria is in the process of strengthening yellow fever case-based surveillance with the collection of serum samples among suspected case patients. Objective: A training conducted for surveillance officers in the local government areas (LGAs) of Osun State on yellow fever case-based surveillance was assessed to determine its immediate impact on the knowledge of participants. Methods: The training focused mainly on how to detect and report a suspected case of yellow fever to the national authorities and the reference laboratory. Training materials included the World Health Organization district guidelines for yellow fever surveillance. A pre and post test was used to evaluate the immediate impact of the training on knowledge among participants. Results: A total of 31 officers participated. The mean scores for pre and post tests were 7.1 (SD 3.6) and 20.7 (SD 3.4) out of a total of 30 points respectively. More than 80% of participants rated the training as excellent in overall organization. Conclusion: All participants indicated that they were very confident to fully implement yellow fever surveillance in their LGAs.
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A comparative study of HIV/AIDS knowledge and attitudes of hearing-impaired and non-hearing-impaired secondary school students in Ibadan
AO Sangowawa, ET Owoaje, B Faseru, IP Ebong, BT Alagh
October-December 2010, 13(4):453-458
Objective: This study was conducted to compare HIV/AIDS knowledge and attitudes of hearing-impaired and non-hearing-impaired secondary school students in Ibadan, South-Western Nigeria. Method: A cross-sectional survey of all the hearing impaired students and an equal number of non-hearing-impaired students enrolled in a half way school in Ibadan was conducted. Four non-hearing-impaired students did not complete the survey and their responses were excluded from the final analysis. Data was analysed using the Statistical Package for the Social Sciences (version 11.0). Results: Seventy-eight hearing-impaired and non 74 non-hearing impaired students completed the survey. Thirty (38.5%) hearing-impaired and 67 (90.5%) and non-hearing-impaired students knew that HIV could be transmitted via semen, vaginal fluid and blood, (p<0.001). HIV/AIDS knowledge scores were calculated giving minimum and maximum scores of 0 and 15 respectively. Mean knowledge score for hearing-impaired students was 4.7(±2.1) compared with 8.7(±2.3) among non-hearing-impaired students (t-test=11.307, p<0.001). Generally, the students' attitudes to HIV/AIDS prevention and PLWHA were not favorable with only hearing-impaired and 44 (59.5%) non-hearing-impaired students agreeing that it would be alright for them to be in the same class with someone who had AIDS. Conclusions : The study showed that the hearing-impaired students had poorer knowledge and attitudes to HIV/AIDS compared with their non-hearing-impaired counterparts. There is a pressing need for development of HIV/AIDS education programmes specially designed to meet the needs of hearing impaired students.
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