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   2016| July-December  | Volume 13 | Issue 2  
    Online since August 1, 2016

 
 
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ORIGINAL ARTICLES
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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Pattern of presentation of Type 1 diabetic patients in Kano, Nigeria
Umar Isa Umar
July-December 2016, 13(2):85-88
DOI:10.4103/0331-8540.187361  
Background: Type 1 diabetes is the most common form of diabetes in children; its symptoms may be subtle and frequently misinterpreted. Presentation with diabetic ketoacidosis (DKA) may be associated with significant morbidity and mortality in the paediatric population. Objective: To examine the prevalence of Type 1 diabetes in children at the Aminu Kano Teaching Hospital, Kano. Design: Retrospective study of case files of children with diagnosis of Type 1 diabetes mellitus (T1DM). Patients and Methods: It was a retrospective review of case files of children younger than 18 years with diagnosis of T1DM over 4 years (January 1, 2012,–December 31, 2015). Results: A total of 7929 patients were seen during the study period, out of which 18 were diagnosed with T1DM, giving a case prevalence rate of 2.3/1000. Sixteen (89%) of the 18 patients were first presented with DKA. The mean age at presentation was 8 years, and there were more females 13/18 than males 5/18 among the subjects. The most prevalent presenting symptoms were dehydration 16 (89%), fever 14 (77.8), abdominal pain 12 (66.6%), polyuria and polydipsia 12 (66.6%). Two of the sixteen patients with DKA died with cerebral oedema during admission. Conclusion: DKA is the most common pattern of presentation of T1DM in our environment. This highlights the need for intensified efforts in education of health workers and the populace at large for quick presentation and prompt diagnosis and optimal management of childhood diabetes.
  5,147 397 3
Extending otology services to the rural community: Use of smartphone for hearing screening
Abubakar Danjuma Salisu
July-December 2016, 13(2):72-77
DOI:10.4103/0331-8540.187359  
Background: Hearing screening services scarcely extend to rural communities due to limited resources. Active intervention to prevent hearing loss may, therefore, be ineffective. Hearing screening with the smartphone may extend screening services to rural communities. This paper aims to assess the reliability of using the smartphone for hearing screening by comparing results obtained with those of a standard calibrated audiometer. Methodology: A hospital-based cross-sectional study of 60 participants consisting of 36 males and 24 females, age ranged from 16 years to 68 years (mean = 33.4, standard deviation = 12.7). Using the Android application 'Hearing Test Pro™' installed on Samsung Galaxy Note 3 smartphone, hearing threshold across 250 Hz–8000 Hz frequencies of participants was determined in a quiet clinic room. This was repeated using a calibrated Welch/Allyn TM 262 auto tympanometer/audiometer. Hearing thresholds at low, high and speech range frequencies were summarised with threshold >40 dB considered as 'Failed screening'. The results obtained from the two methods were compared. Results: There was complete agreement between the hearing threshold results obtained by the two methods at high frequencies with smartphone sensitivity 96% and specificity 100%. There was a moderate agreement between the two methods at speech range frequencies with smartphone sensitivity 86% and specificity 99%. The least agreement between the two methods was in the low frequencies. Conclusion: The smartphone application 'Hearing test Pro' is quite accurate, especially in detecting high frequency hearing loss and can be used effectively in hearing screening.
  3,695 1,561 1
B-mode ultrasonographic measurement of inferior vena cava diameter among healthy adults in Kano, Nigeria
Abdu Hamisu Dambatta
July-December 2016, 13(2):94-98
DOI:10.4103/0331-8540.181232  
Background: The inferior vena cava (IVC) is thin-walled compliant vessel that adjust the body volume status by changing its diameter depending on the total body fluid volume. sonographic measurement of IVC diameter has been reported as an alternative, rapid and non-invasive method of volume assessment of body fluids. The aim of this study is to determine the normal IVC diameter among healthy adults in Kano, Nigeria. Materials and Methods: Sonographic measurement of IVC of healthy adults with age ranging between 15 and 65 years was done with the subject in the supine position. The intrahepatic portion of its diameter was measured at about 2 cm proximal to the hepatic veins in a longitudinal plane in both inspiratory and expiratory phases of respiration. Three repeated measurements were done to reduce intra-observer variability in this prospective cross-sectional study. Results: A total of 400 adults comprising 173 (43.3%) males and 227 (56.8%) females were recruited using Fisher's statistical formula for sample size determination. The mean age of the subjects was 32.4 ± standard deviation 10.9 years. The mean inspiratory diameter was 10.1 ± 2.7 mm (ranging from 4.8 mm to 18.8 mm). The overall mean IVC expiratory (IVCexp) diameter in this study was 16.7 ± 2.7 mm (range = 10.9–25.4 mm). The mean IVCexp diameter was slightly higher for males than for females (males: 17.1 ± 2.8 mm; females: 16.3 ± 2.7 mm). This difference was statistically significant (P = 0.0022). There was a gradual decrease in IVC diameter with advancing age. Conclusion: This study was able to generate normal IVC diameter in a sample of Nigerians which may serve as a reference for normal values in Black Africans.
  4,417 235 -
Scrotal doppler ultrasound evaluation in Zaria, Nigeria
Muhammad Zaria Ibrahim, Abdulkadir Musa Tabari, Joseph Bako Igashi, Suleiman Lawal, Mohammed Ahmed
July-December 2016, 13(2):89-93
DOI:10.4103/0331-8540.187356  
Introduction: The superficial location of the scrotal contents makes them ideally suited for sonographic examination. The development of high-frequency, real-time greyscale scanners along with Doppler facility has enhanced the diagnostic accuracy of scrotal sonographic examinations. Objectives: To determine the pattern and utility of Doppler ultrasound in the assessment of patients with scrotal pathologies in Zaria, Nigeria. Methodology: This retrospective study was carried out over a period of 36 months (February 2012 to January 2015) at the Radiology Department of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, on patients who presented for scrotal sonography on account of scrotal pathology. After a brief examination, colour Doppler ultrasound scan (CDUS) was performed. The clinical diagnosis and final ultrasound diagnosis were compared to determine the sensitivity and specificity of the later. Results: A total of 115 patients were scanned. Nearly 55.6% presented on account of primary infertility. Varicocele (45), hydrocele (31), epididymo-orchitis (8), epididymal cyst (6), microlithiasis (6) and others (6) were frequent Doppler findings. Only 12 cases were normal scan. Overall sensitivity of CDUS in diagnosing varicocele and hydrocele was 100% each, respectively. Conclusion: Doppler ultrasonography is an excellent, safe and reliable method for evaluating patients with scrotal diseases. It is especially important in conditions such as varicocele and hydrocele where accurate diagnosis is required in the management of infertility.
  4,301 294 -
Lobular capillary haemangioma of the gingiva: Clinical management and a review of the literature
Babatunde Olamide Bamgbose, Muhammad Abubakar Kaura, Akinfenwa T Atanda, Oluseyi Folake Ajayi
July-December 2016, 13(2):107-113
DOI:10.4103/0331-8540.181031  
Introduction: Lobular capillary hemangioma, otherwise called pyogenic granuloma represents an exuberant connective tissue proliferation to a known stimulus or injury. The aim of this paper is to present a case in our clinical practice, discuss the differential diagnosis and review the literature. Materials and Methods: A narrative review of the literature was performed to evaluate recent information as regards etiopathogenesis, clinical presentation as well as management of pyogenic granuloma. A search of the literature was performed on PubMed using the following keys terms: lobular capillary hemangioma, pyogenic granuloma, etiopathognenesis, clinical features and management. The search criteria were filtered to include articles on human studies, which were published in English Language. Results: We present a clinical case of pyogenic granuloma demonstrating positivity for estrogen receptor and a narrative review of the English Literature and management of a large case of lobular capillary hemangioma of the gingiva. Conclusion: The conventional deep scaling and polishing and root plaining, in addition to surgical excision of the lesion is still the acceptable treatment option of lobular capillary hemangioma of the gingiva. However, there is need to consider other less aggressive and less morbid methods of treatment such as cryosurgery and laser therapy.
  4,268 216 -
Perceived role of therapeutic footwear in the prevention of diabetic foot ulcers: A survey of patients with diabetes mellitus in Kaduna State
Tagang I Jerry, Pei Eujin, Chen Robert, Higgett Nick, Dahiru L Ismail, Abdulrasheed Ibrahim
July-December 2016, 13(2):78-84
DOI:10.4103/0331-8540.187357  
Background: There is a paucity of literature about the status of therapeutic footwear and their role in prevention of diabetic foot ulcers in Nigeria. The purpose of this study is thus 2-fold. (1) To determine the perceived role of therapeutic footwear in the prevention of foot ulcers among patients with diabetes mellitus, (2) to establish strategies that will encourage the use of therapeutic footwear in the prevention of diabetic foot ulcers. Materials and Methods: This cross-sectional study was carried out among patients with diabetes mellitus in Kaduna state, between December 2012 and March 2013. All the participants in this study had a history of foot ulceration. Exclusion criteria were patients with amputations and non-ambulatory status. Pre-tested questionnaires were used to collect data. The questionnaire was divided into four sections. The first section illustrates the demographics of the respondents. The second section explores the anatomic location of diabetic foot ulcers. The third section evaluates the type of regular footwear worn and experience of participants. The fourth section explores the awareness of respondents regarding therapeutic footwear features. Simple descriptive statistics were used; frequency with percentage distribution for categorised variables. Results: The anatomic subunit in the plantar surface with the highest number of ulcer was the phalanges 23% in males and 26% in females. In the dorsolateral surface, the phalanges 22% and 17% were the most common location in males and females, respectively. Slippers were regularly worn by 71% of respondents, whereas only 1% of respondents were reported to wear therapeutic footwear. More than 75% of respondents were willing to use footwear, as well as buy therapeutic footwear. Conclusion: Majority of the patients are reported to have foot ulcers located on the phalanges and these are related to the wearing of inappropriate footwear. However, they are willing to use therapeutic footwear if recommended by a physician.
  3,930 283 -
Otorhinolaryngological health of women attending antenatal care clinic in a tertiary hospital: The Aminu Kano Teaching Hospital experience
Abdurrazak Ajiya, Rabiu Ayyuba, Abdullahi Hamisu, Sulaiman Muhammad Daneji
July-December 2016, 13(2):119-124
DOI:10.4103/0331-8540.187358  
Background: Physiological changes of pregnancy have a profound effect on the head and neck region; pregnant women often present with otorhinolaryngological health challenges to the obstetricians. Objective: The objective of this study is to find out the otorhinolaryngological health complaints of pregnant women at Aminu Kano Teaching Hospital (AKTH). Materials and Methods: It was a cross-sectional study conducted among consenting pregnant women at AKTH. Ethical approval was obtained from the hospital ethical committee. The questionnaire was administered among consenting pregnant women. Data obtained were analysed using the Statistical Packages for Social Sciences version 18. Qualitative data were summarised using frequencies and percentages. Fischer's exact test was used for categorical data, and the P ≤ 0.05 was considered statistically significant. Results: A total of 146 pregnant women were recruited during the study. The mean age ± standard deviation was 28.57 years ± 5.796. Only 4 (2.7%) of the pregnant women were in the first trimester, while the rest were in second 47 (32.2%) and third trimester 95 (65.1%) respectively. Furthermore, few pregnant women 10 (6.8%) presented with mild hypertension, while in 136 (93.2%) of the pregnant women, the blood pressure measurements were normal. Ear itching 35 (24.0%), headache 42 (28.8%) and heartburn 55 (37.7%) were the most frequent complaints. High blood pressure was found to be statistically associated with tinnitus (P = 0.035), and high parity was also found to be associated with aural fullness (P = 0.028). Conclusion: The common otorhinolaryngological manifestations among pregnant women in this study were otomycosis, rhinitis and gastroesophageal reflux disease.
  3,224 151 -
A 15-year pathologic review of testicular and para-testicular tumours in Kano, Northern Nigeria
Sule Alfa Alhaji, Abubakar Abdulkadir, Haruna Muhammad Sanusi
July-December 2016, 13(2):114-118
DOI:10.4103/0331-8540.187360  
Background: Testicular and para-testicular tumours are envisaged as being rare in our setting. However, there is no published report on their statistics from Kano, Northern Nigeria despite the reported gradual increase over the past decades in many communities. Aim: The purpose of this study, therefore, is to determine the prevalence among other tumours, the frequency and the morphological patterns of testicular and para-testicular tumours in Kano, Northern Nigeria. Materials and Methods: This was a 15-year retrospective study of all cases of testicular and para-testicular tumours histologically diagnosed at Aminu Kano Teaching Hospital, from January 2001 to December 2015. Where necessary, new tissue sections were reprocessed from the formalin-fixed, paraffin-embedded blocks. Results: There were a total of 31 cases of testicular and para-testicular tumours recorded during the study period with an average incidence of 2 cases per year; 41.9% of these were testicular tumours and 58.1% para-testicular tumours. The youngest patient was 3 years old, whereas the oldest was 49 years. Among the para-testicular tumours, 27.8% were adenomatoid tumours mostly presenting in the fourth decade of life; followed by the embryonal rhabdomyosarcomas in 16.7% of cases all in children. Conclusion: This study attested to the low prevalence of testicular and para-testicular tumours in our environment and the findings conforms with studies from other African, the Caribbean and Asia communities but shows divergence to the western societies where a much higher prevalence was reported.
  3,032 152 1
Health workers' opinion about catatonia in a Nigerian tertiary health facility
Aghukwa Nkeremadu Chikaodiri, Musa Gambo Takai
July-December 2016, 13(2):99-104
DOI:10.4103/0331-8540.181230  
Background: Catatonia is a clinical syndrome that appears in many psychiatric and medical illnesses, yet most clinicians globally tend to view it as a purely psychiatric disorder. Aim: The aim of the present study was to determine the clinicians' ability and to identify patients with catatonia. Setting: This study was conducted in Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: The study was a descriptive and cross-sectional study that interviewed randomly selected 252 clinical staff comprising of doctors, nurses and physiotherapists. A pilot tested, researcher designed self-administered questionnaire was used to elicit the participants' sociodemographic information as well as their ability to identify catatonia. Results: Of 252 respondents, 120 (47.6%) were males and 132 (52.4%) were females. The mean age of the respondents was 35.9 ± 7.61 years. The majority of the respondents 172 (68%) had at least 5 years of working experience. Large proportion 215 (85%) of health professionals in this study identified catatonia as a type of mental illness. About one-third of the participants, i.e., 87 (35%) were able to identify the condition as catatonia whereas majority, i.e., 155 (62%) identified the condition as schizophrenia. A large proportion 168 (67%) of the health workers despite their years of professional experience thought catatonia was a disorder for only psychiatrists. Conclusions: The study shows that majority of health professionals with prime role in patients' care had difficulty detecting catatonia. Most of them viewed catatonia as a mental illness that should be treated by a psychiatrist. This underscores the need to plan an enlightenment program on identification and management of patients with catatonia among clinicians in Nigeria.
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CASE REPORT
Massive pleural empyema in infancy
Abubakar Ahmad, Yahuza Mansur Adamu, AH Dambatta, B Lawan
July-December 2016, 13(2):125-127
DOI:10.4103/0331-8540.181231  
Pleural empyema is an emergency clinical condition characterised by presence of purulent organisms within the pleural fluid. It is associated with significant morbidity and consumption of scarce resources. It is a rare clinical condition but constitute a serious thoracic emergency despite advances in management. Imaging plays an important role in the diagnosis and management of pleural empyema. We present an 11 month old infant with a month history of fever, cough, shortness of breath and weight loss. Clinical diagnosis of bronchopneumonia with pleural effusion was made. Chest radiograph revealed right opaque hemithorax with central mediastinum. Computed tomography (CT) of the chest showed extensive right pleural effusion with compression of viable lung tissue. Ultrasound guided thoracocentesis drained about one litre of pus. Intravenous antibiotics were also administered. Repeat chest radiograph a week after the drainage showed marked reduction in the size of the previously noted opaque right hemithorax with remarkable improvement of the clinical condition.
  2,454 147 -
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