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  Most popular articles (Since September 21, 2012)

 
 
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CASE REPORTS
Diaphragmatic eventration mimicking congenital diaphragmatic hernia: The value of chest radiograph and barium meal in diagnosis
Mohammed Kabir Saleh, Mohammad Abba Suwaid, Sule Kazaure Idris, Abdulkadir Musa Tabari, Kabiru Isyaku
January-June 2012, 9(1):36-39
DOI:10.4103/0331-8540.102114  
A 6-month-old boy was referred to the radiology department of the Aminu Kano Teaching Hospital for chest X-ray, from the Emergency Pediatric unit of the Hospital, on account of severe bronchopneumonia in association with diaphragmatic hernia to rule out pulmonary tuberculosis, but for which, chest X-ray and a complimentary urgent Barium meal studies showed a complete left-sided eventration of the hemidiaphragm. He had successful plication of the left hemidiaphragm and the bowel loops, and spleen were carefully freed and fixed back into the abdomen. The paper highlighted on the key role played by the chest X-ray and an immediate complimentary upper gastrointestinal barium studies in making the diagnosis of this life-threatening condition in a resource-poor environment. The relevant literature was also reviewed.
  12,178 784 -
ORIGINAL ARTICLES
Bacteriological evaluation of sampled sachet water sold in Samaru-Zaria, Kaduna-State, Nigeria
S Ugochukwu, FJ Giwa, A Giwa
January-June 2015, 12(1):6-12
DOI:10.4103/0331-8540.156663  
Background: The quality of drinking water is an important environmental determinant of health. Widespread production and consumption of inadequately processed or contaminated packaged drinking water can lead to waterborne disease outbreaks. To safeguard public health, it is important that available packaged water is duly registered and regularly analysed. Aim: This study was carried out to determine the bacteriological quality of ten selected brands of sachet water produced and sold in Samaru Zaria metropolis. Materials and Methods: From the brands of sachet water being sold in samaru, ten most popular brands were identified and selected based on patronage by consumers and distributors. A total of 20 samples, two from each of the ten brands of sachet water were bought from water vendors every fortnight for 1 month (may - june 2013). Results: The total coliform count ranged from 2-18+/100 ml. Isolates were identified to be Klebsiella spp., 0[40%] Proteus spp., [30%] Pseudomonas spp. [20%] and Chromobacterium violaceum [10%]. All were negative for thermotolerant coliforms, Salmonella, Shigella and Vibrio cholera. Conclusion: The results of this study showed contamination with micro-organisms found naturally in water, soil or vegetation which indicates a problem with the overall quality of water production but showed no contamination with sewage or animal waste. Microbiological assessment of drinking water quality should be done periodically with the regulatory body National agency for food and drug administration and control (NAFDAC) ensuring good quality assurance and maintenance of internationally defined drinking water standards.
  12,222 627 3
CASE REPORTS
Chronic non-puerperal uterine inversion: Case series
Zakari Muhammad, Saidu Adamu Ibrahim, Ibrahim Adamu Yakasai
July-December 2012, 9(2):87-90
DOI:10.4103/0331-8540.108473  
Inversion of the uterus is a rare clinical problem. Non-puerperal inversion usually results from a tumor arising from the fundus of the uterus. We report two cases of chronic non-puerperal uterine inversion in a 38-year-old and a 54-year-old postmenopausal woman. They both presented with vaginal bleeding, a mass protruding from the vagina and lower abdominal pain. Diagnosis was made based on these clinical features. At first, vaginal myomectomy was performed and after that, a Kustner procedure and vaginal hysterectomy was performed in both cases. Early diagnosis and appropriate surgical treatment of the inverted uterus are important to prevent further complications.
  12,486 314 -
REVIEW ARTICLE
Bedside teaching: An indispensable model of patient-centred teaching in undergraduate medical education
Mustafa Asani
July-December 2014, 11(2):57-61
DOI:10.4103/0331-8540.140305  
Bedside teaching remains the most effective way of imparting competency in clinical skills in undergraduate medical education but there has been a noticeable decline in the practice of bedside teaching worldwide. This paper aims to emphasise the importance of bedside teaching, highlights the possible barriers to effective bedside teaching and equip medical teachers with the effective ways of achieving the intended goals of bedside teaching by emphasising the techniques recommended by experts in the field of medical education. Developed countries have employed the use of clinical skill centres to cushion the effect of the decline in bedside teaching, but in resource-limited countries it remains the only viable option. The advantages of bedside teaching include; learning in context, impartation of clinical skills, nurturing and development of clinical reasoning. In addition, bedside teaching provides opportunity for role modelling, professional thinking, observation of communication skills, team work and integration of communication skills, clinical skills and ethical issues in the process of patient care. Several hindrances to effective bedside teaching have been identified. These include a large student: teacher ratio, crowded lectures, improper use of logbooks, lack of preparedness and interest, increasing administrative and research works among medical teachers. The strategies recommended by experts can be categorised into three; based on the timing as; before, during and after bedside teaching. These emphasise the need for adequate preparation, setting of clear objectives before teaching, active participation, gentle correction during teaching, feedback and discussion of sensitive issues away from the patient.
  5,777 2,891 2
Assessment methods in undergraduate medical schools
Mustafa Asani
July-December 2012, 9(2):53-60
DOI:10.4103/0331-8540.108463  
Assessment in medical education is very vital because of its far reaching implications not only for the students and their teachers but for the communities and world at large. This article attempts to review the assessment methods used in undergraduate medical schools, highlight their limitations while proffering solutions as recommended by experts in medical education. Assessment methods that are used in the undergraduate medical education can be broadly subdivided into two; assessment of knowledge and its application (Multiple choice questions, essay and viva voce) and assessment of clinical competence (long case, short case and objective structured clinical examination [OSCE]). There are five major criteria for determining the usefulness of a particular method of assessment: Reliability, Validity, Educational impact, Cost effectiveness and Acceptability. The major drawback of the long and short case examinations is the poor reliability or reproducibility due to case specificity, inter examiner and clinical case scenario variability. In 1975, Harden et al., introduced the OSCE to avoid the disadvantages of long case but acceptability may be an issue because of inadequate exposure to its principles and resistance to change by some teachers. Another objective version of the long case is the objective structured long examination records. Objective structured practical examination is also preferred to the traditional practical examinations in laboratory based courses. All assessment methods have their strengths and limitations. It is important that teachers in medical schools are aware of the limitations of the traditional assessment tools and embrace newer and more reliable methods of assessment.
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ORIGINAL ARTICLES
Sexual stimulants and their effects on women of reproductive age group in Kano, northern Nigeria
Hauwa Abdullahi, Jamilu Tukur
January-June 2013, 10(1):13-16
DOI:10.4103/0331-8540.117233  
Introduction: Sexual stimulants are preparations used for increasing pleasure during sexual intercourse. The study sought to determine the use and effect of such preparations on women of reproductive age group in Kano, northern Nigeria. Materials and Methods: A self administered questionnaire was used to obtain information from 500 women to determine if they use sexual stimulants and the effects of the drugs on them (if any). Results: There were 423 women that responded. Majority 228 (53.9%) of them use sexual stimulants. Most (47.4%) of them were between the ages of 21 and 30 years, married (85.5%), multiparous (46.9%), and attained tertiary education (58.3%). About 39.9% of the respondents benefited from increased sexual pleasure and satisfaction, 20.2% obtained extra favors from their husbands while 29.9% did not benefit anything from the preparations. About 37.3% developed complications, which included coital laceration (5.9%), copious vaginal discharge (16.5%), vulval itching and rashes (17.5%), lower abdominal pains (14.1%), painful intercourse (16.5%), vaginal dryness (13.0%), and irregular menses (5.9%). Conclusion: A large number of women use sexual stimulants mainly sold by traditional healers. There is need for setting up more orthodox care for sexual dysfunction. There is need for more community health education on female sexual dysfunction.
  7,165 416 3
Knowledge, attitude, and practice of breast self-examination among female nurses in Aminu Kano teaching hospital, Kano, Nigeria
AA Yakubu, MA Gadanya, AA Sheshe
July-December 2014, 11(2):85-88
DOI:10.4103/0331-8540.140344  
Background: The incidence of breast cancer is increasing and the presentation is often late in our environment with poor prognosis. Breast self-examination (BSE) remains an important diagnostic tool for the early detection of breast cancer in a resource-limited community. Nurses being in closer contact with patients should be in the forefront in educating the general public on BSE. Objectives: This study investigates the knowledge, attitude and practice of BSE among female nurses in Aminu Kano Teaching Hospital (AKTH) with regard to the number that practice, method and the frequency of BSE. Materials and Methods: The study is a descriptive cross-sectional study of female nurses employed in AKTH using self-administered questionnaire. Respondents were selected by simple random sampling methods from the register of nursing staff at AKTH. The data collected were on socio-demographic profile, knowledge, attitude and practice of BSE. The relationships between these factors were studied. Results: All the nurses studied are aware about BSE, with 91.2% practicing it. There is appallingly poor knowledge of its timing, frequency and method. Only 45 (41.2%) of the respondents practice BSE monthly, and none of the respondents can accurately describe the exact method of BSE. Conclusion: There is universal awareness of the BSE among nurses, with dismal awareness of its purpose, method, timing, and frequency among the female nursing staff studied. However, there is a lot of enthusiasm to encourage others to do it. Therefore, nurses need to be also further trained and educated about the procedure.
  6,126 432 1
REVIEW ARTICLE
Advances in clinical estimation of foetal weight before delivery
Emmanuel Ajuluchukwu Ugwa
July-December 2015, 12(2):67-73
DOI:10.4103/0331-8540.158888  
Accurate estimation of foetal weight is of paramount importance before delivery. Clinical estimation of foetal weight is an important and necessary skill in management of obstetrics patients because of its simplicity; and if it is found to be as accurate as sonographic measurement as some studies suggest, it may be considered for screening of foetal weight especially in low-resource settings where ultrasound is unavailable. The aim of this review is to search for various literatures where clinical methods of foetal weight estimation were used and to examine these methods critically for possible recommendation for their use among obstetrics residents and healthcare practitioners. Electronic search of Medline, Pub Med, Health Internetwork Access to Research Initiative (HINARI) and Google Scholar databases from 1953 to 10th December 2014 was conducted for studies which compared clinical and sonographic foetal weight estimation. Various formulae have been suggested by researchers over the years. The methods however depend on the clinical dexterity of clinicians' and not on specific measurements. No simple and easily applied formula has yet been suggested to transform an external maternal measurement into an estimated foetal weight. Researchers on estimation of foetal weight should work towards a consensus and reproducible formula for clinical foetal weight estimation. Symphysio fundal height (SFH) measurement with a tape-measure seems a simple clinical method because it is cheap, readily available, non-invasive and acceptable to patients. These skills should be practiced by senior obstetricians and taught to midwifes, house officers, medical officers and obstetrics residents. It is however subjected to various degrees of intra-observer and inter-observer errors and studies comparing the different formulae are lacking. Therefore, further researches are needed to improve reliability and reproducibility of these clinical methods. The reliability of other clinical methods other than Dare' method should also be explored.
  3,404 2,648 -
ORIGINAL ARTICLES
Prevalence of gingivitis and periodontitis in an adult male population in Nigeria
Agnes O Umoh, Clement C Azodo
July-December 2012, 9(2):65-69
DOI:10.4103/0331-8540.108465  
Objective: To determine the prevalence of gingivitis and periodontitis among an adult male population in Benin City, Nigeria. Materials and Methods: The drivers of a private motor transport company whose head office is in Benin City constituted the study participants. Data collection was through an interview-administered questionnaire and periodontal examination. Periodontal disease was assessed using community periodontal index while demographic characteristics, social habits and oral hygiene habits were elicited using interview-administered questionnaire. Results: The prevalence of gingivitis and periodontitis was 75.4% and 15.4% respectively. The prevalence of periodontitis was higher among older participants, those of lower educational attainment and longer driving experience, those that indulged in only once-daily teeth cleaning, tobacco users, regular alcohol and kolanut consumers. Conclusion: The prevalence of gingivitis and periodontitis in this study was similar to previous reports in Nigeria. The prevalence was higher in relation to the risk factors considered in this study thereby necessitating the need for an awareness campaign to enlighten the public about the harmful effects of tobacco, kolanut and alcohol on periodontal health. This study is also recommended among a larger number of people.
  5,390 592 1
Prevalence of hepatitis B and C virus infections among HIV-infected patients in a tertiary hospital in North-Western Nigeria
Muhammad Hamza, Adamu Alhaji Samaila, Ahmad Maifada Yakasai, Musa Babashani, Musa Muhammad Borodo, Abdulrazaq Garba Habib
July-December 2013, 10(2):76-81
DOI:10.4103/0331-8540.122765  
Introduction: Infections from HIV, Hepatitis B and to some extent Hepatitis C viruses constitute a major public health challenge in sub-Saharan Africa, and there are evidences to suggest that there is faster progression of HIV in those co-infected with either HBV or HCV. The aim of this study was to determine the prevalence of HBV and HCV infections among HIV-infected patients, and describe the socio-demographic features and correlates of HIV and HBV/HCV co-infected patients at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Materials and Methods: This was a cross-sectional study carried out among HIV-positive individuals seen at the adult HIV clinic of AKTH. Four Hundred and forty (440) consecutive HIV-positive adult patients who consented to the study were screened for markers of HBV and HCV using Enzyme-linked Immunosorbent Assay (ELISA) technique. CD 4 Count and serum ALT were also obtained from the recruited patients. Socio-demographic characteristics and Body Mass Index (BMI) were obtained. Differences and relationships between groups were determined using students t-test and Chi-square test where appropriate, and a P < 0.05 was regarded as significant. Results: Prevalence rates of Hepatitis B and C virus infections obtained were 12.3% and 1.6%, respectively. Individuals who were 40 years or younger were the most affected. HBV co-infection was more common among males than females (16.9% vs 9.2%, respectively, P = 0.0153). Mean serum ALT among participants with HIV alone was 31.6 International Units (IU), but was significantly higher (45.3 IU) for those with HIV/HBV co-infection, P = 0.048. Mean CD 4 count for HIV/HBV co-infected participants (259.7 c/mm 3 ) was significantly higher than that for participants with HIV alone (240.0 c/mm 3 ), P = 0.0170 whereas the mean BMI was not significantly different between participants with HIV alone (21.3 kg/m 2 ) versus HIV/HBV co-infected participants (22.2 kg/m 2 ), P = 0.1385. Conclusion: Co-infection with hepatitis B virus is common among HIV-infected patients in our setting and this further reaffirms the need for routine baseline screening for this marker, as it is a major consideration in the initiation and choice of highly active antiretroviral therapy. Furthermore, those found to be negative should be immunized with HBV vaccine to improve the prognosis of their HIV status.
  5,326 452 3
Maternal anthropometric characteristics as determinants of birth weight in North-West Nigeria: A prospective study
Emmanuel Ajuluchukwu Ugwa
January-June 2014, 11(1):8-12
DOI:10.4103/0331-8540.130151  
Background/Aim: Foetal weight cannot be measured directly in utero, but it can be estimated or predicted from foetal and maternal anatomical characteristics. This study was undertaken to examine the relationship between birth weights and certain maternal anthropometric measurements (weight, height and BMI). Context/Setting: This study was done in Aminu Kano Teaching Hospital (AKTH), North-West, Nigeria. Aminu Kano Teaching Hospital is a 500-bed tertiary hospital located in Kano, the most populous state in Nigeria. Materials and Methods: This was a prospective study. Interviewer-administered questionnaires were used to retrieve sociodemographic and obstetrics information. Two-hundred (88.9%) pregnant women responded completely. The weight, height and BMI of the women were measured. Unclothed newborns were weighed immediately after delivery. The data obtained was analysed using SPSS version 16.0 statistical software. The accuracy of maternal weight, height and body mass index in predicting birth weight was compared using Student's t-test, Chi-square test and Pearson's Coefficient of Correlation and P < 0.05 was considered statistically significant. Results: The mean maternal age was 28.2 ± 5.7 years. The mean parity was 3 ± 2. The mean gestational age at delivery was 38.5 ± 2 years. The mean actual birth weight was 3.27 ± 0.53 kg. The mean maternal weight was 72.03 ± 11 kg. Maternal weight showed a strong positive correlation with birth weight ( r = 0.48) and this was statistically significant ( P < 0.001). The mean maternal height was 1.64 ± 0.55 m. The mean maternal BMI was 27.9 ± 4.33. Maternal BMI showed a weak positive correlation with birth weight ( r = 0.28) and this was statistically significant ( P < 0.001). Maternal weight and BMI are better predictors of birth weight than maternal height. Conclusion: Maternal weight and BMI are good predictors of birth weight and can be recommended for use as screening test in poor resource setting.
  5,282 470 1
A prospective study of maternal risk factors for low birth weight babies in Maiduguri, North-Eastern Nigeria
Idris Usman Takai, Mohammed Bukar, Bala Mohammed Audu
July-December 2014, 11(2):89-98
DOI:10.4103/0331-8540.140353  
Background/Aim: Low birth weight (LBW) is associated with a higher risk of mortality and long term consequences for the survivors. This study determines the incidence and risk factors for LBW babies in Maiduguri. Context/Setting: This study was done in the Departments of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital and the State Specialist Hospital, Maiduguri. Materials and Methods: This was a prospective study involving 854 pregnant women and their babies between 2 nd February 2009 and 29 th July 2009. Socio-demographic, obstetric, medical factors, obstetrics interventions and foetal birth weights were obtained and recorded. Association between variables were examined using student's t-test and Chi-squared test and multivariate logistic regression analysis a P < 0.05 was considered significant. Results: The incidence of LBW was 16.9%. The risk factors for LBW were non-use of haematinics index pregnancy (OR = 13.04; 95% CI = 12-36; P value 0.000); previous history of stillbirth (OR = 8.11; 95% CI = 6-19; P value 0.000); hypertensive disorders of pregnancy (OR = 6.12; 95% CI = 5-14; P value 0.000); ante-partum haemorrhage (OR = 5.85; 95% CI = 4-9; P value 0.000); less than 4 ANC visitsn (OR = 4.94; 95% CI = 3-12; P value 0.000); previous history of premature delivery (OR = 4.39; 95% CI = 4-11; P value 0.000); previous history of LBW (OR = 3.65; 95% CI = 2-21; P value 0.000) and non-use of intermittent preventive therapy in the index pregnancy (OR = 3.24; 95% CI = 1-16; P value 0.001); and teenage mother (OR = 2.75; 95% CI = 2-27; P value 0.006). Conclusion: This study showed high incidence of LBW. Obstetric factors (problems and intervention of the current pregnancy) and previous obstetric performances played crucial role in the occurrence of LBW in our study. Qualitative antenatal care should be made available and provided to pregnant women at all levels of care.
  5,274 394 2
A review of twin deliveries in Aminu Kano Teaching Hospital, North-West Nigeria
Raphael Avidime Attah, Zakari Mohammed, Maimuna Gobir
January-June 2014, 11(1):3-7
DOI:10.4103/0331-8540.130148  
Background: Twin pregnancy remains a high risk one, and its incidence varies from one ethnic group to the other. Twin delivery is also associated with increased neonatal and maternal morbidity and mortality. Objective: To det ermine the current incidence and document the complication of twin pregnancy in Kano, northwest Nigeria. Materials and Methods: A retrospective analysis of 231 cases of twin deliveries between 1 st January 2007 to 31 st December 2009, in Aminu Kano Teaching Hospital (AKTH) Kano was carried out. Results: During this study period, there were 15,233 deliveries and 353 cases of twin deliveries, giving an incidence of 2.3% or 1 in 43 deliveries. The mean maternal age and parity were 29.0 years and 2.6 respectively. The mean gestational age at delivery was 36.9 weeks, with a mean birth weight of 2.4 kg and 2.3 kg for the first and second twin respectively. Male twins constituted 50.3% of twin births. The commonest presentation of twins was Cephalic-cephalic in 52.2%. This was followed by breech-cephalic in 29.6%, cephalic-breech in 12.6% and breech- breech in 5.2%. Mode of delivery was vaginal in 57.4% while 40.0% delivered by Caesarean section. The commonest indication for the Caesarean section was due to breech presentation in the leading twin (75.0%). Hypertensive disorder in pregnancy was the commonest maternal complication accounting for 63.16%, increasing maternal morbidity and mortality, while prematurity was the leading cause of perinatal mortality. Conclusion: This study has shown that the incidence of twin pregnancy is high in Aminu Kano Teaching Hospital, Kano, northwest of Nigeria. It has also shown that twin delivery is associated with prematurity, malpresentations and operative delivery, therefore increased perinatal and maternal morbidity. It is therefore recommended that twin pregnancy should be supervised in a tertiary centre under a specialist care and where facility for neonatal support is available to improve its outcome and reduce perinatal morbidity and mortality.
  5,262 390 -
Juvenile polyp in children in Kano Nigeria: Clinical presentation and management challenges
C Anyanwu Lofty-John, M Mohammad Aminu, U Ibrahim Mustapha, T Atanda Akinfenwa
January-June 2014, 11(1):20-23
DOI:10.4103/0331-8540.130162  
Background: Juvenile polyps are a common cause of low volume painless rectal bleeding in children. Most of these polyps are located within the sigmoid colon and the rectum. Objective: The aim of this study was to describe the clinical characteristics of children presenting with colorectal polyp in Kano, Nigeria and to document the challenges faced in their management. Materials and Methods: We undertook a retrospective review of the clinical records of all children aged 13 years or less who presented to our hospital with a colorectal polyp between January 2008 and December 2008, and also prospectively enrolled all those presenting between January 2009 and December 2010. Demographic, clinical and laboratory data were collected. Data were analysed using SPSS 15.0 (SPSS Inc, Chicago, IL). Results: There were 16 patients in all, with their ages ranging between 2.5 years and 9 years (mean 6.03 years). There were 8 boys and 8 girls (M: F = 1:1). Haematochezia was the most common presenting symptom, followed by a prolapsing rectal mass and rectal prolapse. In 13 of the patients, there was a solitary polyp, while 3 patients had 2 polyps each. All the polyps were located in the rectum within 7 cm of the anal verge. Only one patient had a sessile polyp, while all the others were pedunculated. Histopathology reported juvenile polyp without evidence of adenomatous change in all of them. Conclusion: A careful digital rectal examination is recommended for all children presenting with a bloody stool to rule out juvenile polyp.
  5,367 259 -
Liver function test profile of Nigerian children with sickle cell anaemia in steady state
Shehu A Akuyam, Peter O Anaja, Olufemi G Ogunrinde, Auwal Abubakar, Nasir Lawal, Sa'ad M Ya'uba, Abdullahi Musa, Fatima F Abdullah, Yusuf Garba, Yakubu Abubakar, Mustapha N Adebiyi
January-June 2014, 11(1):13-19
DOI:10.4103/0331-8540.130157  
Background and Objective: Several studies across the world have revealed that liver dysfunction is a common finding in children with sickle cell anaemia (SCA). The situation in hospitals in Nigeria is not known. The few studies carried out in Nigeria were on adult subjects. The overall objective of the study was to evaluate the liver function test (LFT) profile of children with SCA, aged 1-14 years, with a view to improve the routine investigation and management of this group of subjects. Materials and Methods: LFT profile of 60 SCA subjects and 60 age- and sex-matched apparently healthy subjects (controls) was evaluated in the present study in the departments of chemical pathology and paediatrics of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, northern region of Nigeria. Results: The results of serum LFTs of the SCA subjects and age- and sex-matched control subjects showed that the concentrations of serum total bilirubin (TB), conjugated bilirubin (CB), unconjugated bilirubin (UCB), alkaline phosphatase (ALP), and aspartate transaminase/alanine transaminase (AST/ALT) ratio were significantly higher (P < 0.001), while the levels of total protein (TP) were significantly lower (P < 0.001) in SCA subjects compared with the control subjects. Serum levels of ALT, AST and albumin (ALB) among SCA and control subjects were not statistically different (P > 0.05). The results of serum LFTs also showed that there were no significant age differences (P > 0.05) in both SCA subjects and control subjects. There were no correlations between all the LFT analytes and the frequency of crisis (FOC) among SCA subjects (P > 0.05). Conclusion: It could be concluded from the findings of the present study that there are mild LFT abnormalities in children with SCA even in steady state, and that the extent of some of the abnormalities decreases with advancing age of the subjects.
  5,113 327 -
HIV counseling and testing in a tertiary health facility in Lafia, Nigeria
Audu Esther Solomon, Madawa Absalom Amos, Mohaammed Hajara Laraba, Iyigulu Alice Alaska, Yakubu Ahmed Ashuku, Olaiya Olanrewaju Oluwadare, Bako Ishaku Ara
January-June 2012, 9(1):6-10
Objectives : This study was carried out with the aim of determining the seroprevalence of HIV among clients accessing human immunodeficiency virus (HIV) counseling and testing (HCT) services in Dalhatu Araf Specialist Hospital, Lafia, North Central Nigeria. The study also determined the personal profile of these clients and their reasons for accessing the HCT services. The findings of the research would be useful in assisting the state government and policy makers to plan for treatment, care, and prevention for those at risk. Materials and Methods : A retrospective review of records of clients who accessed services at the HCT unit of the Dalhatu Araf Specialist Hospital Lafia over a 2-year period was carried out. Results : A total of 4,292 (50.1%) out of the 8,554 who were tested for HIV were seropositive. 65.7% (2,818) of those who were HIV-seropositive were females while 44% (1,474) were males. Majority (84.7%) of those who were HIV-seropositive were between the ages of 16 to 35 years, and 64.9% of those who were positive were married. Those who came for HCT because of medical reasons had higher seroprevalence than those who came on their own to know their HIV status Conclusion: There is need to encourage activities that promote HCT and especially health provider initiated HCT in all health facilities. This will increase the diagnosis of new HIV cases, thus leading to an early commencement of treatment and initiation of strategies for prevention of transmission from the HIV-infected persons to their partners. Preventive strategies should be tailored towards high-risk groups including those who are married and the young adults to reduce new infections through heterosexual transmission.
  5,029 387 -
CASE REPORTS
Late presentation of advanced abdominal pregnancy with live baby: A case report and literature review
Hauwa Musa Abdullahi, Ibrahim Adamu Yakasai, Muhammed Zakari, Samaila Danjuma Shuaibu
January-June 2013, 10(1):25-28
DOI:10.4103/0331-8540.117242  
Abdominal pregnancy is a rare form of ectopic pregnancy. It is associated with an increase in maternal morbidity and mortality, as well as perinatal mortality rate of up to 85%-95%. A case of abdominal pregnancy in an unbooked primigravida who presented in the third trimester and was successfully managed is hereby described. She came with weight loss and jaundice. The fetus was alive and she was managed conservatively till a laparotomy was eventually performed. The outcome was good for mother and baby.
  5,176 205 -
ORIGINAL ARTICLES
ABO and rhesus blood groups among blood donors in Kano, North-Western Nigeria
Onwuka Kalu Chima, Tijjani Bashir Mohammed, Kuliya-Gwarzo Aisha, Samaila Adamu Alhaji, Borodo Musa Muhammad, Aminu Haruna Kwaru
January-June 2012, 9(1):11-13
DOI:10.4103/0331-8540.102105  
Background: The need for blood and blood products requires an efficient blood transfusion service. This study was undertaken to provide pro data on the distribution of ABO and Rhesus blood groups that would assist in planning and coordinating blood transfusion services for the cosmopolitan city of Kano. Materials and Methods: A total of 5000 consecutive blood donor samples were grouped for ABO and Rhesus 'D' antigen by tile and tube methods at Aminu Kano Teaching Hospital (AKTH) over a one-year period. Results: Blood group O had the highest prevalence of 2860 (57.2%) followed by blood group B of 1035 (20.7%), then A of 1025 (20.5%) and the lowest being AB of 80 (1.6%). A total of 4741 (94.8%) of the study group were Rhesus 'D' positive while 259 (5.2%) were Rhesus 'D' negative. Conclusion: The ABO blood group had blood group O as the most prevalent blood group in the study population while the lowest was AB. The Rhesus blood group positive was 94.8% while Rhesus negative blood group was 5.2%.
  4,863 476 4
Effect of caffeine on foetal morphometric parameters of embryonic Wistar rat (Rattus norvegicus)
Lukman Femi Owolabi, Mathew Temitayo Shokunbi
July-December 2016, 13(2):67-71
DOI:10.4103/0331-8540.187362  
Background: There is increasing body of evidence that maternal caffeine use during pregnancy predisposes the embryo and foetus to spontaneous abortion but data on its influence on foetal morphometry is scarce. Aim: This study aimed to evaluate experimentally the effects of caffeine on morphometric parameters of newborn of Wistar rats. Materials and Methods: Thirty, experimentally naive, adult female Wistar-albino rats weighing 100–150 g were mated. After confirming pregnancy by vaginal plug method, the pregnant rats were randomly assigned into four groups (Group A–D). The dams in Group A served a normal control. They had 0.2 ml/kg body weight of normal saline intraperitoneally from day 9 to 20. Experimental Group B rats had 25 mg/kg body weight of caffeine intraperitoneally. Group C had 50 mg/kg body weight of caffeine intraperitoneally and Group D dams had 100 mg/kg body weight of caffeine intraperitoneally. Dams in both experimental and control groups were sacrificed on day 20 after caffeine administration. The foetuses were weighed and their crown-rump lengths were measured. Their body mass index of the litters (foetuses) was calculated and their placentas were weighed. Results: The mean crown-rump length of the litters (Group A) was significantly more (5.61 ± 0.29) than the experimental which were 5.10 ± 0.22 cm, 4.72 ± 0.24 cm and 3.81 ± 0.16 cm for Group B, C and D litters, respectively (P < 0.0001). The mean foetal weight of Group A litters was significantly more (1.56 ± 0.38) than the experimental which were 1.25 ± 0.41 g, 1.15 ± 0.77 cm and 0.78 ± 0.34 cm for Group B, C and D litters, respectively (P < 0.0001). The mean placenta weight of the foetuses was significantly lower in the females from the experimental Group B, C and D compared to the control group (P < 0.0001). Conclusion: This study showed a significantly reduced foetal weight, crown-rump length and placenta weight in the offspring of experimental female rats treated with caffeine compared to the control.
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REVIEW ARTICLE
An overview of diabetic foot disease
Ismail Lawal Dahiru, Kenneth Ezenwa Amaefule, Innocent Onoja Okpe, Abdulrasheed Ibrahim, Salisu Babura Muazu
January-June 2016, 13(1):1-12
DOI:10.4103/0331-8540.176206  
The incidence of diabetes globally is reaching an epidemic proportion and with it carries the risk of complications and diabetic foot disease inclusive. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischaemia and abnormal foot structure and biomechanics. Early recognition of the aetiology of these lesions is important for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection and revascularisation of ischaemic limbs are the mainstays of treatment. Even with proper management, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents and negative pressure wound therapy. We reviewed current literature including original and review articles obtained through a search of PubMed database, Medline, Google scholar and hand searching of bibliographies of published articles using the keywords: Diabetes, diabetic foot, neuropathy, peripheral arterial disease and ulceration. The enormity of the challenges associated with the management of this important complication of diabetes, coupled with the various progresses being made in this area, and the need to streamline the principles of management, especially in our environment prompted us to review this subject matter.
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ORIGINAL ARTICLES
Feasibility of elective mass hernia repair in Kano State, Northwestern Nigeria
Abdurrahman Abba Sheshe
January-June 2014, 11(1):30-35
DOI:10.4103/0331-8540.130169  
Background: Hernia is a common surgical condition in our environment and constitutes a serious problem in male farmers in northern Nigeria. Complications are frequently seen, especially during the rainy season, due to increased physical activity as a result of farm work; many of these are Life threatening. Elective repair is often delayed due to long waiting time and the cost of operation is not readily affordable to many in the general public. Approach: The government of Kano State decided to embark upon a free campaign to electively treat 1000 patients with hernia across the state in order to decrease the morbidity and mortality associated with its complications and also to increase the capacity of the hospitals by retaining procured equipments used for the campaign for further use. Following public enlightenment, the campaign was carried out over a period of 3 weeks between 4 and 25 December 2006 in six selected hospitals using mobile surgical teams. A protocol and a questionnaire were designed for use during the campaign. Achievements: A total of 2824 patients with hernia and/or hydrocoele were screened during the campaign, out of which 1155 stable patients were successfully operated at no cost. Equipment, surgical outfits, patient drapes including remaining drugs and consumables were left for use in the centers. No untoward event was reported. Conclusion: It is feasible to conduct a mass hernia campaign to decrease the morbidity and mortality associated with its complications and emergency repair. Mass hernia campaigns require adequate organization, trained staff, necessary equipments and enough supply of consumables. The mass turnout of patients demands a regular/scheduled campaign to further alleviate this problem. There is need for participation of non-governmental organizations, professional associations and corporate bodies to be more involved in health care delivery in our society.
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Transabdominal ultrasonographic findings in children with sickle cell anemia in Sokoto, North-Western Nigeria
Sadisu M Ma'aji, NMA Muhammed Jiya, Sule A Saidu, Muhammad Danfulani, Garba H Yunusa, Usman M Sani, Baba Jibril, Abubakar Musa, Haruna I Gele, Mohammed S Baba, Samaila Bello
January-June 2012, 9(1):14-17
DOI:10.4103/0331-8540.102106  
Background: Sickle cell anemia (SCA) is an inherited disease caused by production of abnormal hemoglobin chains within the red blood cell. In Nigeria, West Africa, the incidence of SCA is 3%. The most common abdominal manifestations include abdominal pain (mesenteric crisis), hepatomegaly, splenomegaly, autosplenomegaly, and cholelithiasis. Objective: To evaluate the abnormal transabdominal ultrasonographic (TAUS) findings in children with sickle cell anemia in Sokoto, Northwestern Nigeria. Materials and Methods: Pediatric patients with SCA attending the sickle cell clinic at the Department of Pediatrics, Usmanu Danfodiyo University Teaching Hospital Sokoto were scanned at the Radiology Department of the Hospital by transabdominal ultrasonography (TAUS) using Apogee 800 plus Ultrasound scanner with a variable frequency probes at 5-12 MHz. The patients were in their steady states. They were also screened for viral hepatitis B and C. Results: The commonest TAUS findings in this study was hepatomegaly in 70 (98.6%) patients followed by splenomegaly in 15 (21.1%), autosplenomegaly in 3 (4.2%), and gallbladder sludge in 2 (2.8%) patients. Conclusion: Transabdominal ultrasonographic imaging of patients with sickle cell anemia revealed a high prevalence of abdominal abnormalities, especially of the liver, spleen, and gallbladder.
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EDITORIAL
Tackling the global burden of cancers
MM Borodo
July-December 2013, 10(2):49-50
DOI:10.4103/0331-8540.122752  
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ORIGINAL ARTICLES
Prevalence of hypertension and its relationship with indices of obesity in Maiduguri, Northeastern Nigeria
Ibrahim D Gezawa, Baba M Musa, Muhammad S Mijinyawa, Muhammad A Talle, Yusuf M Shehu, Andrew E Uloko, MM Watila, BM Musa
July-December 2014, 11(2):67-71
DOI:10.4103/0331-8540.140307  
Background: Hypertension is the greatest preventable cause of death one of the most important modifiable risk factors for cardiovascular diseases. There is paucity of studies on the relationship between obesity and hypertension in northern Nigeria. Objective: To determine the prevalence of hypertension and its relationship with indices of obesity in Maiduguri, northeastern Nigeria. Materials and Methods: We recruited 1700 consenting adults aged 15-70 years using a multistage random sampling technique. Data on socio-demographic characteristics were obtained using a pretested questionnaire. Physical measurements for anthropometric indices and blood pressure (BP) were carried out using standard procedures. Hypertension was defined as systolic BP ≥ 140mmHg and/or diastolic BP ≥ 90mmHg. Multiple logistic regressions were fitted and odds ratios with 95% confidence intervals were calculated to identify associated factors. Results: Of the 1700 subjects recruited, 1650 responde, d yielding a response rate of 97%. The overall prevalence of hypertension was 32.3%, with a higher prevalence among women than men (46.1% vs. 34.5%, P < 0.05). Obesity was found in 15.9% of the study subjects. The prevalence of obesity was higher among women (20.7%) than men (13.6%). All the obesity indices correlated significantly with both SBP and DBP. Age ≥ 40 years, BMI and waist circumference in men were significantly associated with hypertension. Conclusion: The prevalence of hypertension in our study is high, particularly among women. Increasing age (>40 years), BMI and WC were found to be independently associated with hypertension. There is need for further studies to determine the role of lifestyle modification in reducing the burden of hypertension in our environment.
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Prevalence of thinness among adolescents in Kano, Northwestern Nigeria
Muhammad S Mijinyawa, Shehu M Yusuf, Ibrahim D Gezawa, Baba M Musa, Andrew E Uloko
January-June 2014, 11(1):24-29
DOI:10.4103/0331-8540.130165  
Background: Thinness in older children has been associated with delayed pubertal maturation, reduced muscular strength and work capacity. There is paucity of studies on thinness among adolescents in Nigeria. Objectives: The aim of this study was to determine the prevalence of thinness among adolescents in Kano, Northwestern Nigeria . Materials and Methods: In this descriptive cross-sectional survey, we used a multi-staged random sampling technique to select 718 students from six secondary schools in Kano metropolis. A pretested questionnaire was used to collect socio-demographic data. Physical measurements for weight and height were carried out using standard procedures. Results: The overall prevalence of thinness was 60.6%, with a higher prevalence among boys (63.0%) compared with girls (58.7%). Grades-I, II and III thinness were found in 26.0%, 15.5% and 19.1% of the studied subjects respectively. The prevalence of grade III thinness was higher among boys (19.4%) compared with girls (18.8%). The rate of thinness was observed to increase with age up to 16 years after which it starts to fall. Older age was also found to be independently associated with thinness among our subjects. Conclusion: The prevalence of thinness among adolescents in Kano is high, with a slightly higher rate in boys than girls. There is need for concerted effort by policy makers to come up with programmes aimed at reducing the burden of undernutrition among school children in our setting.
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