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The use of magnesium sulphate for the treatment of severe pre-eclampsia and eclampsia
Jamilu Tukur
April-June 2009, 8(2):76-80
DOI:10.4103/1596-3519.56232  PMID:19805935
Background : Pre-eclampsia and eclampsia are important causes of maternal and perinatal morbidity and mortality in the developing countries. There is need to provide the most effective management to pre-eclamptic and eclamptic patients. There is now evidence that magnesium sulphate is the most effective anticonvulsant. Method : In this article , a literature review was made on the contribution of pre-eclampsia and eclampsia to maternal mortality and how it can be curtailed by the use of magnesium sulphate. Results : The drug is administered by the Pritchard or Zuspan regimen, although modifications in the two protocols have been reported. Conclusion : A Nigerian national protocol has been developed on its use. There is need for further training of health workers on how to use this important drug.
  19,352 996 18
Peculiarities of genital ulcer diseases in HIV-infected patients: Report of four cases from Zaria, Nigeria
Dimie Ogoina, Haruna M Muktar, Reginald O Obiako
April-June 2011, 10(2):192-193
DOI:10.4103/1596-3519.82058  PMID:21691031
  19,609 5 -
The burden of non-communicable diseases in Nigeria; in the context of globalization
Musa Baba Maiyaki, Musa Abubakar Garbati
January-March 2014, 13(1):1-10
DOI:10.4103/1596-3519.126933  PMID:24521570
This paper highlights the tenets of globalization and how its elements have spread to sub-Saharan Africa, and Nigeria in particular. It assesses the growing burden of non-communicable diseases (NCDs) in Nigeria and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on NCDs in Nigeria. It assesses the Nigerian dimension of the relationship between the risk factors of NCDs and globalization. Appropriate recommendations on tackling the burden of NCDs in Nigeria based on cost-effective, culturally sensitive, and evidence-based interventions are highlighted.
  18,091 40 3
Detection of Salmonella typhi agglutinins in sera of patients with other febrile illnesses and healthy individuals
Ali M Somily, Mustafa H Adam, Mohamed O Gad El Rab, Muhammad G Morshed, Zahid Shakoor
January-March 2011, 10(1):41-44
DOI:10.4103/1596-3519.76584  PMID:21311155
Background and Purpose : Widal test is frequently applied for the detection of Salmonella agglutinins to diagnose Salmonella enterica serotype Typhi infection. There are however a number of controversies challenging the diagnostic utility of this test. This study was performed to determine the prevalence of Salmonella agglutinins in patients with other febrile illnesses and healthy blood donors. Materials and Methods : Sera from 50 healthy blood donors were compared for the presence of Salmonella agglutinins in various groups of patients with other febrile illnesses using Widal test in the division of Serology and Immunology at King Khalid University Hospital, Riyadh. The patient groups of other febrile illnesses included infections with Beta-hemolytic streptococcus (n = 50), Brucella (n = 46), Helicobacter pylori (n = 24), Treponema pallidum (n = 30), Toxoplasma (n = 44), and other parasites (n = 20). Results : Majority of the patients and normal individuals were tested positive for Widal test at dilution of less than 1 : 40 both for the O (62.5%) and H (64.6%) antigen. A decreasing trend in Widal reactivity was observed with increasing dilutions of the serum samples. At 1 : 160 titer, which is generally considered as a cut off point for positive Widal test, 6.4 and 11% individuals had positive Widal test for O and H Salmonella antigens, respectively. Conclusion : Detection of a significant number of positive Widal tests in conditions where it is expected to be nonreactive appears to be a serious problem in making a correct diagnosis of typhoid fever, thus challenging the diagnostic utility of the Widal test.
  14,105 32 2
Alzheimer's disease: A review of recent developments
Fatai K Salawu, Joel T Umar, Abdulfatai B Olokoba
April-June 2011, 10(2):73-79
DOI:10.4103/1596-3519.82057  PMID:21691010
Alzheimer's disease (AD) is the most common type of dementia in aging adults, and a substantial burden to patients, caregivers, and the healthcare system. It is an increasingly significant public health issue; with the number of people living with AD projected to increase dramatically over the next few decades, making the search for treatments and tools to measure disease progression increasingly urgent. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. The subject headings and keywords used were Alzheimer's disease, dementia, primary neuronal degeneration and senile plagues. Only the articles written in English were included. The diagnosis is still primarily made based on history and physical and neurologic examinations. Approved treatments are few and of limited efficacy, serving mostly to slow or delay progression and not to cure the disease, despite significant research by pharmaceutical industries. Cholinesterase inhibitors offer some help in treating cognitive and global functioning, as well as behavioral abnormalities in patients with mild-, moderate-, or severe-stage disease. The N-methyl-d-aspartate (NMDA) antagonist, memantine, is similarly effective alone or in combination with cholinesterase inhibitors in moderate to severe stages of the disease. Recent insights into the pathophysiology of AD have led to promising investigational therapies, including the development of γ- and β-secretase inhibitors as well as active and passive immunization against the amyloid β-protein.
  13,979 83 11
Prevalence of diarrhea disease and risk factors in Jos University Teaching Hospital, Nigeria
Christopher S Yilgwan, SN Okolo
October-December 2012, 11(4):217-221
DOI:10.4103/1596-3519.102852  PMID:23103920
Background: Diarrhea is widely recognized as a major cause of childhood morbidity and mortality in many developing countries, particularly in sub-Saharan Africa. According to World Health Organization (WHO) report in the African region, diarrheal diseases are still leading causes of mortality and morbidity in children under five years of age. This same report indicates that each child in the said region has five episodes of diarrhea per year and that 800,000 die each year from diarrhea and dehydration. Materials and Methods: This study examined diarrheal morbidity and associated risk factors in children under five years in Jos. A total of 340 children were seen in the Diarrhea Training Unit (DTU) of the Jos University Teaching Hospital (JUTH), Jos, over a period of 24 months (Jan 2008-Dec 2009). A semi-structured interviewer administered questionnaire was used to generate the data. All women whose children presented with diarrhea were interviewed and data generated analyzed using Epi info version 3.5.1 statistical software. Results: During the study period, 13,076 children were seen in our facility, of which 340 were suffering from diarrhea, thus giving a diarrhea prevalence of 2.7%. There were 183 (54%) male and 157 (40%) female children seen with diarrhea. The mean age was 11 ± 8.5 months. The mean duration of diarrhea was found to be 4 ± 3.6 days. A majority of children were aged less than 6 months, consisting of 235 infants, 95 toddlers, and 10 pre-schoolers. Of the number of women seen, 242 (61%) had at least primary education, while 98 (29%) had no formal education. Diarrheal episodes were found to have a bivariate association with mothers' educational status, family type, family size, breastfeeding, and sex of child. However, only mother's educational status, diarrhea in other sibling, and breast feeding were significantly associated with the occurrence of diarrhea. Although there were more male children with diarrhea, the odds of having diarrhea was not significantly related to sex. Conclusion: Our study demonstrated an important relationship between diarrheal morbidity and low maternal education, nonexclusively breastfed infant, and previous diarrheal episode in a sibling. It thus meant that diarrhea morbidity is still an important problem for infants in our environment. Moreover, maternal education and exclusive breastfeeding are still relevant viable measures in curbing diarrhea in infants.
  13,714 40 8
Knowledge, attitude and practice of school health programme among head teachers of primary schools in Egor local government area of Edo state, Nigeria
GE Ofovwe, AN Ofili
September 2007, 6(3):99-103
DOI:10.4103/1596-3519.55726  PMID:18240496
Background : School health program (SHP) is an important component of the overall health care delivery system of any country. In developing countries such as Nigeria where infant and early childhood mortality is high its importance cannot be overemphasized. For this reason and the recent action plan of the Federal Government of Nigeria concerning SHP, the knowledge, attitude and practice of SHP among head teachers of primary schools in a Local Government Area in Nigeria was evaluated. Methods : A pre-tested questionnaire designed to evaluate the knowledge attitude and practice of SHP by the researchers was administered by assistants to 133 head teachers of 104 private and 29 public primary schools in Egor Local Government Area of Edo State, Nigeria. The School premises were also inspected to check provision of pipe borne water, sick bay, toilet facilities and the adequacy of the school environments among other things. Results :None of the head teachers had adequate knowledge of SHP. 93.1% from private compared to 48.3% from public schools had poor knowledge of SHP (χ2 = 56.86, p < 0.05). A favorable attitude was demonstrated by all the teachers. Up to 40.4% of private compared to 31.0% of public schools have SHP. Overall 27.7% of the schools had no toilet facility, 33.3% had pit latrine while 40.0% had water closet. Only 25.6% had hand washing facilities. Regarding health services, 51.0% of private schools compared to 27.6% of public schools perform medical inspection of the pupils. Similarly 39.4% private compared to 3.4% public schools have sick bay (χ2 = 11.11; p < 0.05). A total of 16.5% of the schools undertake medical screening of food handlers/vendors, while 20.2% private compared to 3.4% public schools screen food handlers/vendors (χ2 = 4.47; p < 0.05). Conclusion : The poor status of SHP in Nigeria may be attributed to failure of policy enunciation, poor primary health care base and lack of supervision.
  12,771 111 6
Jaundice in typhoid patients: Differentiation from other common causes of fever and jaundice in the tropics
A Ahmed, B Ahmed
July-September 2010, 9(3):135-140
DOI:10.4103/1596-3519.68361  PMID:20710103
Background: While typhoid fever is common in our environment, presentation with jaundice is unusual. The aim of this study has been to determine the clinical and laboratory features that allow early diagnosis of typhoid fever in patients that present with jaundice and differentiate it from other common causes of fever and jaundice in the tropics. Materials and Methods: This prospective study was conducted between May 1997 and October 1998 at Center Hopitalier Regional de Hombo Anjuoan, Comoros Islands. Patients with clinical and laboratory evidence of typhoid fever were included. Viral or toxic hepatitis, chronic liver disease, sickle cell disease and other causes of jaundice were excluded by clinical examination and appropriate investigations. Serial evaluation of liver function test and abdominal ultrasound were done. Patients were resuscitated with fluids and electrolytes and treated with appropriate antibiotics. Liver involvement was determined using clinical and laboratory parameters. Results: Of the 254 patients with confirmed diagnosis of typhoid fever, 31 (12.2%) presented with jaundice. Their mean age was 24.6 ± 9.2SD years. Fever preceded the appearance of jaundice by 8-27 days. In 27 (87.1%) patients, there was hepatosplenomegaly. Serum bilirubin ranged 38 - 165 umol/l with mean of 117 ± 14SD. Conjugated bilirubin ranged 31-150 umol/l with mean of 95 ± 8SD. Serum aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase were raised with mean values of 180, 105 and 136 IU, respectively. Six (19.4%) patients died compared to 12.1% of non-icteric patients. Conclusion: Typhoid patients may present with varying degrees of jaundice and fever that may be confused with viral, malarial or amebic hepatitis, diseases that are common in the tropics. Physical examination and simple biochemical tests would identify the typhoid patients who should be treated with appropriate antibiotics even before the results of blood culture are available.
  11,256 86 9
Anemia in pregnancy at two levels of health care in Ibadan, south west Nigeria
Adesina Olubukola, Akinyemi Odunayo, Oladokun Adesina
October-December 2011, 10(4):272-277
DOI:10.4103/1596-3519.87042  PMID:22064252
Background: In Africa, anemia in pregnancy contributes to non-attainment of the MDG goals 4 and 5. This study examined the prevalence and some risk factors for anemia at two levels of health care in the Ibadan metropolis. Methods: This was a retrospective study of the booking records of pregnant women at the University College Hospital (UCH, a profit-making tertiary institution) and Adeoyo Maternity Hospital (AMH, a secondary level institution offering free services) in Ibadan, September 1, 2008 to December 31, 2008. Eligible women had singleton pregnancies and no known chronic illnesses. Anemia was defined as packed cell volume (PCV) <30%, and degrees of anemia as mild (PCV 27-29%), moderate (PCV 19-26%), and severe (PCV below 19%). Statistical analysis was done by the Chi-square test, Fisher exact test, and t-test. A P value of <0.05 was considered significant. Results: Data from 2702 women (384 and 2318 from UCH and AMH, respectively) were available for analysis. About 30% of the women were anemic. The patients in UCH had higher mean PCV (33.03± 4.32 vs. 31. 04 ± 4.09, P = 0.00). A higher proportion of anemia was seen in patients presenting in Adeoyo (32.4% vs. 16.7%, P = 0.00). Factors associated with anemia included young age (P = 0.00), low parity (P = 0.00), and hospital type (P = 0.00). Parity and hospital type remained significant on logistic regression. Conclusion: Lower prevalence of anemia at the tertiary hospital maybe attributed to the higher socioeconomic status of the clientele. Short-term early antenatal management of anemia and long-term economic/educational empowerment is advocated.
  10,674 16 3
Ophthalmologic abnormalities among deaf students in Kaduna, Northern Nigeria
ER Abah, KK Oladigbolu, E Samaila, H Merali, AO Ahmed, TH Abubakar
January-March 2011, 10(1):29-33
DOI:10.4103/1596-3519.76573  PMID:21311152
Background : The association between deafness and ocular problems is well established; however the nature and prevalence of these problems are diverse across the globe. Objective : The aim of this study is to determine the nature and prevalence of ophthalmologic abnormalities in deaf students and offer treatment to those with remediable conditions. Method : Six hundred and twenty deaf students aged between 5 and 38 years were examined in a school for the deaf. Results : One hundred and thirty (20.9%) had some form of ophthalmologic abnormality. Some had anterior segment abnormalities such as corneal opacities (0.5%) and allergic conjunctivitis (3.4%) while others had posterior segment abnormalities like optic atrophy (0.3%), Waardenburg syndrome (0.6%) and Ushers syndrome (0.6%). Refractive error was the most common (7.9%). Conclusion : Since these deaf students use their sight to compensate for the deafness, routine ophthalmologic examination should be carried out on them so that ophthalmologic abnormalities are detected early and treatment offered for remediable diseases.
  10,488 11 5
Awareness and uptake of cervical cancer screening in Owerri, South-Eastern Nigeria
BU Ezem
September 2007, 6(3):94-98
DOI:10.4103/1596-3519.55727  PMID:18240495
Background : Cancer of the cervix is the most common cancer of the female genital tract and accounts for about two hundred and fifty thousand deaths yearly most of which occur in the developing countries. It has assumed greater prominence with the decrease in deaths due to infective causes and the increase in the incidence of HIV/AIDS which is a predisposing factor. A significant drop in its incidence has been recorded in the developed countries as a result of intensive program of cervical screening. This study determines the level of awareness and uptake of cervical screening in Owerri, South Eastern part of Nigeria. Method : This is a cross sectional study in which self administered questionnaires returned by eight hundred and forty six respondents were analysed using simple percentages. Results : The level of awareness of cervical screening was 52.8 %( 447), while 7.1 %( 60) had ever done the test. The major sources of information about cervical smear were hospital /health facilities (31.3%) and friends (30.9%).The most common reasons given for not doing the test were lack of awareness 390(46.1%),no need for it 106( 12.5%) and fear of a bad result 98(11.6%). Conclusion : The level of awareness of cervical screening is low and worse still, is the level of uptake at the present level of uptake no significant impact will be made on the incidence of cervical cancer which needs to be reduced. A national cervical smear screening policy is advocated but in the interim, greater public education and the greater use of opportunistic screening by physicians should be vigorously pursued.
  10,381 116 25
Appendicitis: Trends in incidence, age, sex, and seasonal variations in South-Western Nigeria
AS Oguntola, ML Adeoti, TA Oyemolade
October-December 2010, 9(4):213-217
DOI:10.4103/1596-3519.70956  PMID:20935419
Background : Appendicitis is a common clinical condition worldwide. Differences in incidences, sex, age, and seasonal variations have been reported widely, with paucity of information from Nigeria. Aim : To assess the trends in incidence and pattern of variation with age, sex, and seasons of the year. Materials and Methods : A review of the records of all patients with confirmed appendicitis treated in both the LAUTECH Teaching Hospital (LTH) and the Abake Medical Center (AMC), both situated in Osogbo, Nigeria, between January 2003 and December 2008, was done. LTH was a 320-bed University Hospital (with 100 surgical beds), while AMC was a 20-bed surgical center. The age, sex, and month of admission of all the histologically proven cases of appendicitis were retrieved and treated. Analysis was done using simple percentages, Student t or Chi-square tests, where applicable. Results : A total of 299 out of 321 cases of appendicitis recorded during the observed period were confirmed histologically from both hospitals (69.56% from LTH). Fifty-two percent were males. It made up 0.94, 1.43, and 1.86% of the total hospital admissions in 2004, 2006, and 2008, respectively. There has been an increasing incidence in both sexes almost in a similar pattern. The overall mean age was 25.79 years (M 25.94 and F 25.43 years) with 6% below the age of ten and 1.3% above 60 years. The highest incidence in males and females occurred in the second and third decades, respectively. Incidences were higher during the rainy season (April to September) 68%, P < 0.05), with peaks from June to August, when 39.5% of all cases presented. Conclusion : The increasing incidence of appendicitis in both sexes in this region may be due to the change to a Western lifestyle. The age distribution has a similar pattern in both sexes and 87% are 40 years or less, although the incidence is marginally higher in males. Higher prevalence of infections and allergens from pollens in the rainy season could contribute to a higher incidence of appendicitis.
  10,107 28 10
Health needs assessment and determinants of health-seeking behaviour among elderly Nigerians: A house-hold survey
IS Abdulraheem
June 2007, 6(2):58-63
DOI:10.4103/1596-3519.55715  PMID:18240704
Background : In the last decade the number of elderly citizens in Nigeria has increased and their health needs are becoming popularly recognized. A number of factors have also been recognized to determine health care seeking behaviour in these elderly. Methods : The sample consisted of 756 households that had at least one resident who was aged 60 years and above (35% of 2160 households). Multistage and proportionate sampling techniques were employed to select the study subjects. Structured interview were conducted to elicit information on health needs and determinants of health care seeking behaviour of household members aged 60 years and above. Results : The most frequently reported illnesses were body pain (89.5%), joint pain (86.4%), generalized body weakness and fatigue (81.5%), poor sight (78.2%), fever (71.3%) %), irritability, anger, and nervous tension (70 %), %), listlessness, depression, and headaches (60 %),and decreased mobility (65.8%). More than two-thirds (68.8%) of respondents had never visited health facilities in the last one year even for ordinary medical check-up. Family care/Family consultation was the first choice (44. 6%) of treatment for the most frequently reported illnesses irrespective of age group and sex.Less than one-third (28.7%) of the subjects were aware of their health needs. Receiving treatment when sick was the health needs mentioned by the majority (89.4%) of the elderly. Poverty emerged as a major (50.3%) determinant of health care seeking behaviour followed by nature of illness (28.5%). The odds ratio that elderly from poor households will seek health care from unqualified health care practitioners was 0.7 (95% confidence interval (CI) = 0.38-0.67); while the odds ratio that elderly from poor households will seek health care from qualified health care practitionerswas 0.8 (95% CI = 0.57-0.89). Self treatment had odds ratio of 1.7 (95% CI= 0.38-0.67). After controlling the household's poverty status, there was still a significance difference (P<0.05) in age group and gender in terms of health care seeking behaviour. Conclusion : Socio-economic indicators and nature of illness were the most pervasive determinants of health care seeking behaviour among the elderly, overriding age and sex, and in terms of health-care expenditure, the nature of illness and quality of service provided ranked the major determinants.
  9,305 140 17
Preeclampsia: A review of the evidence
TA Jido, IA Yakasai
April-June 2013, 12(2):75-85
DOI:10.4103/1596-3519.112395  PMID:23713013
Preeclampsia is a common complication of pregnancy associated with high maternal and perinatal morbidity and mortality especially in developing countries. There is considerable progress in the understanding of the pathophysiology and the management of the diseases, although the aetiology and primary pathology remained elusive. Integration of current evidence in the clinical management of the condition has witnessed improved maternal and fetal outcomes in many societies. In developing countries variations in management often not based on current evidence accounts for comparatively higher morbidity and mortality. This article aims to provide an overview of our present understanding of preeclampsia help care providers and our managers focus practice and policy to reflect existing evidence.
  9,319 55 3
Factors influencing the pattern of self-medication in an adult Nigerian population
AO Afolabi
September 2008, 7(3):120-127
DOI:10.4103/1596-3519.55666  PMID:19253521
Background : Despite the growing research interest in self-medication, little information has been available about its major determinants especially in developing countries. This informed the conduct of this study to determine the major factors that influence the pattern of self medication in a population of market women in Ifako-Ijaiye area of Lagos, Nigeria. Methods : Interviewer administered pretested semistructured questionnaire was used to collect data from 205 market women selected by multistage sampling technique. Results : The patent medicine dealers were the commonest source of information on medications (31.4%) and where they were obtained (52.2%). The exceptions were the educated (62.5%) respondents who obtained theirs from hospitals and pharmacies. Trade and generic names (61.1%) were common means of drug recognition especially among the educated respondents (P<.05). Education of the respondents was the major factor influencing the practice of self-medication though the pattern was descriptively associated with the marital status and educational level of the respondents (P<.05). Benefits of the practice includes in the order: curing of ailments (58.0%), saving time and money (32.0%) and independence of care (7.0%). Conclusion : Literacy and public health education were the major factors influencing the pattern of self-medication among market women. Recommendations on the role of education of market women, patent medicine dealers and the importance of community pharmacy were suggested.
  8,948 128 21
Pattern of prescription drug use in Nigerian army hospitals
ET Adebayo, NA Hussain
July-September 2010, 9(3):152-158
DOI:10.4103/1596-3519.68366  PMID:20710106
Background: Most health expenditure of developing countries is on drugs and medical sundries but inappropriate use of such resources is common. To our knowledge, only few studies have been done in Africa on this issue , with inadequate consideration of the sociological context of the knowledge, attitude and practice of the prescribers especially doctors. This study presents the pooled data of the pattern of prescription drug use from three Nigerian Army hospitals using some WHO criteria, and the knowledge and attitude underlying doctors' prescribing practices in these hospitals. Methods: Retrospective cross-sectional survey of one year (March 2006-February 2007). Systematic random sample of general out patient case notes from three hospitals were collected using WHO criteria. The knowledge, attitude and practice survey of doctors at each study site towards the concept of rational drug use (RDU) were assessed using a self-administered questionnaire. Results: Data collected from 660 case notes showed that average number of drugs per encounter was 2.8 while 49.3% of drugs were prescribed in the generic form. An average of 28.1% of patients encountered antibiotics. From the knowledge, attitude and practice survey, it is evident that 90.5% of 74 prescribers were aware of the existence of national essential drugs list but 58.1% of them did not use it as basis of prescriptions. In describing types of medicines preferred, 56.7% of prescribers claimed they prescribed a mixture of generic and branded drugs. Only 12.1% of prescribers could accurately detail the 5 steps of rational prescribing. Conclusion: The pattern of prescription drug use in Nigerian Army hospitals is unsatisfactory. It is characterised by high number of drugs per prescription, high rate of antibiotic usage and unscientific prescription by doctors. There is a need for further education and research on rational drug use among prescribers in Nigerian military health facilities.
  8,967 89 14
Parasitic contamination of vegetables in Jos, Nigeria
JG Damen, EB Banwat, DZ Egah, JA Allanana
September 2007, 6(3):115-118
DOI:10.4103/1596-3519.55723  PMID:18240499
Background : Intestinal parasites are very common in developing countries including Nigeria. There are diverse ways of their transmission; the study attempts to determine the level of intestinal parasitic contamination on vegetables sold in Jos. Methods : Sample of 200 each of Tomatoes (Lycopersium sativus), Letus (Loctus satival) Carrot (Davcus carota L) Cabbage (Brassica Denceal) and Green leafy vegetables were analyzed using standardized Centrifugal-floatation technique methods. Results : Of the 1250 samples of vegetables examined, 450 (36.0%) were positive for intestinal parasites, cabbage recorded the highest prevalence of 64% while tomatoes had the least prevalence of 20%. Conclusion : Vegetables in Jos are heavily contaminated with intestinal parasites and there is need for public enlightenment campaign on the danger of consuming inadequately washed and prepared vegetables.
  8,787 104 25
Knowledge and practice of breast-self examination among female undergraduate students of Ahmadu Bello University Zaria, Northwestern Nigeria
U M.D Gwarzo, K Sabitu, SH Idris
January-March 2009, 8(1):55-58
DOI:10.4103/1596-3519.55766  PMID:19763009
Background : Carcinoma of the breast is an important public health problem in Nigeria and studies have reported low levels of awareness and practice of breast self examination as an important method of prevention. Breast self examination is a cost-effective method of early detection of cancer of the breast especially in resource poor countries. We assessed knowledge and practice of breast-self examination (BSE) among female undergraduate students of Ahmadu Bello University Zaria, Nigeria. Method : In this study, knowledge and practice of BSE were examined among 221 female students aged 16 - 28 years old studying at Ahmadu Bello University Zaria using self administered questionnaires. Results : It was found that despite nearly three quarter of the respondents (87.7%) had heard of BSE, only 19.0% of them were performing this examination monthly. Regarding the sources of information about BSE among respondents, media was found to be most common followed by health workers accounting for 45.5% and 32.2% respectively. Regular performance of BSE was significantly correlated with duration of stay in the University (X2 = 81.9, df = 3, P < .05) and family history of breast cancer (X2 = 17.4, df = 2, P < .05). Conclusion : We observed a disparity between high levels of knowledge of BSE compared to a low level of practice. Public health education using the media could significantly reduce the knowledge- practice gap and early detection of breast lump.
  8,625 186 20
Trends in maternal mortality in a tertiary institution in Northern Nigeria
Abubakar Ali Kullima, Mohammed Bello Kawuwa, Bala Mohammed Audu, Ado Danazumi Geidam, Abdulkarim G Mairiga
October-December 2009, 8(4):221-224
DOI:10.4103/1596-3519.59575  PMID:20139543
Objective: To look at the trends in maternal mortality in our institution over 5 years. Methods: Records of 112 maternal deaths were retrospectively reviewed to determine the trends and the likely direct cause of each death over the study period. Results: There were a total of 112 maternal deaths, while 3931 deliveries were conducted over the 5-year period. The maternal mortality ratio (MMR) was 2849/100,000 deliveries. The highest MMR of 6234/100,000 was observed in 2003, with remarkable decline to 1837/100,000 in 2007. Eclampsia consistently remained the leading cause, accounting for 46.4% of the maternal deaths, followed by sepsis and postpartum hemorrhage (PPH) contributing 17% and 14.3%, respectively. There were no statistically significant differences in the corresponding percentages of maternal deaths between various age groups (χ2=6.68; P =0.083). Grandmultiparas accounted for a significant proportion of maternal deaths as compared to low parity, with χ2=10.43; P =0.00054. Lack of seeking antenatal care (unbooked) and illiteracy were observed to be significant determinants of maternal mortality (χ2=64.69, P =0.00000; and χ2=18.52, P =0.0000168, respectively). Conclusion: In spite of decrease in the maternal mortality ratio over the years, it still remains high, with eclampsia persistently contributing most significantly. Community enlightenment on the need to avail of antenatal care and hospital delivery services, and improvement in the quality of skilled maternity care will, among other factors, drastically curtail these preventable causes of maternal death and reduce MMR.
  8,642 119 17
Doppler ultrasound in the assessment of suspected intra-uterine growth restriction
N AL Qahtani
October-December 2011, 10(4):266-271
DOI:10.4103/1596-3519.87041  PMID:22064251
Small fetuses constitute a large heterogenous group that includes healthy small fetuses, chromosomally abnormal fetuses and fetuses suffering from utero-placental insufficiency leading to restriction in fetal growth. This review outlines the diagnosis of intra-uterine growth restriction and describes how to differentiate this group from the group of healthy small fetuses. This is very crucial in the management of small fetuses in order to avoid unnecessary intervention in the healthy group, as well as avoid stillbirth and neonatal mortality and morbidity.
  8,510 21 4
Management of appendiceal mass
ES Garba, A Ahmed
December 2008, 7(4):200-204
DOI:10.4103/1596-3519.55652  PMID:19623924
Background: The management of appendiceal mass is surrounded with controversy. Traditional management has been conservative, with interval appendicectomy performed weeks after the mass had resolved. This remains the most common approach at many centers in the world. Recently, an increasing number of studies have challenged this approach. This article reviews some of the controversial issues in the management of appendix mass, assesses current practice and suggests an appropriate approach for the management of appendix mass. Methods:A Medline, Pubmed and Cochrane database search were used to find such key words and combinations of: appendix, appendiceal, appendicular, interval, appendectomy, appendicectomy, mass, abscess, phlegmon, and appendicitis. Results were saved and managed by Reference manager 11. All articles were cross-referenced by the authors. Results: A conservative management is still a highly acceptable approach for appendix mass. This should be followed with interval appendicectomy especially in patients with persistent right iliac fossa pain. Conclusion: We recommend initially conservative approach to the management of appendiceal mass especially in our environment.
  7,805 410 10
Epidemiology, etiology, and treatment of chronic leg ulcer: Experience with sixty patients
GA Rahman, IA Adigun, A Fadeyi
January-March 2010, 9(1):1-4
DOI:10.4103/1596-3519.62615  PMID:20418641
Background: Chronic leg ulcer (CLU) is reported to have an impact on virtually all aspects of life. Treatment is expensive and has large economic burden on many countries' health services. This presentation is to determine the impact, etiology, and presentation of CLU as well as the procedures for processing in a Nigeria tertiary care facility. Methods: All patients with CLU seen that were prospectively managed in our hospital between 2004 and 2006 have been included in the study. The data were analyzed by SPSS version 11.0 of software. Results: Sixty consecutive patients seen over a period of 3 years (2004-2006) were prospectively studied. There were two peak period of age presentation 30-39 and 50-69 years. The male female ratio was 1:1. Most of the patients (93.3%) had unilateral ulcers and it was as common on the right as on the left. Fifty percent of patients had medical disorders. The commonest cause of CLU was poorly managed traumatic wound. Conclusion: Most patients benefited from debridement with or without split thickness skin graft or flap.
  7,399 290 12
Adult large bowel obstruction: A review of clinical experience
AZ Sule, A Ajibade
January-March 2011, 10(1):45-50
DOI:10.4103/1596-3519.76586  PMID:21311156
Background : Adult large bowel obstruction is an infrequent cause of acute obstruction in Africa and India. The cause of obstruction varies between regions of the world. Current controversy concerns the surgical management of the acutely obstructed left colon. Materials and Methods : This is a prospective study of adult patients with acute large bowel obstruction over a 6-year period. The diagnosis of adult obstruction was made from a history of constipation, abdominal distension, abdominal pain, nausea, and radiographic features of large bowel obstruction. Laparotomy was performed on all patients after resuscitation. If the obstruction involved the right colon resection and primary ileo-colic anastomosis was performed, while for a lesion in the left colon a resection and primary colocolic anastomosis was performed after intraoperative antegrade colonic irrigation. If the obstructing lesions were thought to be malignant and too advanced to merit any excisional or the patient's general condition was too poor to withstand resection, a biopsy was taken and a decompressive bypass procedure given pending the confirmation of the diagnosis. The clinical course and postoperative outcome were carefully documented. Results : A total of 50 patients aged 20-80 years, with a median age of 49 years, presented with features consistent with large bowel obstruction. Of these, 32 had simple sigmoid volvulus and were offered sigmoid colectomy and primary colorectal anastomosis, while 3 further patients with compound sigmoid volvulus had double resection with primary ileo-ileal and colorectal anastomosis. A patient with sigmoid volvulus had a Hartmann's procedure. Twelve patients had colon cancer, four had left hemicolectomy and primary colocolic anastomosis; three, sigmoid colectomy and primary colorectal anastomosis; three, low anterior resection and primary colorectal anastomosis; one decompressive colostomy and one, a right hemicolectomy and primary ileocolic anastomosis. The two patients with functional obstruction (Ogilvie syndrome) had tube caecostomy. All resections and primary anastomosis involving the right colon were preceded by antegrade on-table colonic lavage. One clinical anastomotic leak occurred in a low rectal anastomosis and minor wound infection in 10 patients. Operative mortality occurred in three patients with sigmoid volvulus. Conclusion : Adult large bowel obstruction is infrequent in our community and is caused commonly by sigmoid volvulus. Resection and primary anastomosis of the acute left-sided large bowel obstruction seems safe after antegrade on-table colonic lavage, provided bowel gangrene with peritonitis or any additional risk factor for anastomotic breakdown is not present.
  7,487 33 2
Current knowledge and pattern of use of family planning methods among a severely ill female Nigerian psychiatric outpatients: Implication for existing service
Mosunmola F Tunde-Ayinmode
January-March 2013, 12(1):16-23
Background: Despite the acknowledged benefits accruable to the mentally ill from the use of contraceptives, research and dedicated reproductive health services for this group of people in Nigeria are still underdeveloped or non-existent in many cases. This study aims at identifying the current status of knowledge and pattern of use of modern contraceptives in a clinic population. Materials and Methods: A cross-sectional descriptive study of 100 women with severe mental illness attending psychiatric outpatient clinic in Ilorin, Nigeria, using a semi-structured questionnaire. Results: A majority (88%) of the women had good knowledge of family planning, many (61%) were interested in its use but at least half of them had not used any method and current use was just 27%. Attitude to family planning was generally positive as indicated by desired family size (71%) of less than 4 children with 6 out of 10 desiring future intention to use. The male condom was the most known and ever used method (68%, 37%), respectively. Most (81%) of these women desired that family planning information be provided at the psychiatric clinic but fewer of them discussed this with their partners. Conclusion: Considering discrepancies between knowledge, interest and use, the potential health benefits of fertility regulation, and the adverse effects of unregulated family, and contraceptive use is still relatively low. There is need for improvement which might only be possible if psychiatric focused programs are initiated. The large number of women who desired clinic-based family planning education suggests that the introduction of such program is feasible.
  7,145 13 -
Penile gangrene due to calcific uremic arteriopathy
Adamu Bappa, Fayaz Hakim, Mustafa Ahmad, Abdullahi Assirri
April-June 2011, 10(2):181-184
DOI:10.4103/1596-3519.82064  PMID:21691028
Calcific uremic arteriopathy (CUA) is a rare but potentially life-threatening complication of end-stage renal disease (ESRD) and secondary hyperparathyroidism. It typically presents with ischemic necrosis involving areas of adiposity in the body mainly the trunk, buttocks, or proximal extremity. Patients can also present with digital ischemia and more rarely penile gangrene. The pathogenesis of CUA is not yet clear but several putative factors, mainly hyperparathyroidism and related metabolic abnormalities are implicated. A number of conditions can mimic CUA clinically and should be differentiated from it. We present in the current study, a patient who presented with progressive penile gangrene and skin necrosis due to CUA. We review the current understanding of the pathogenesis, diagnosis/differential diagnosis, and management of this rare but potentially life-threatening complication of ESRD.
  6,934 12 5