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  Citation statistics : Table of Contents
   2015| July-December  | Volume 12 | Issue 2  
    Online since November 10, 2015

 
 
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ORIGINAL ARTICLES
Psychological distress due to academic stress among clinical students in a Nigerian tertiary institution: Comparison between medical and physiotherapy students
Tajudeen Abiola, Isa Lawal, Zaharadeen Garba Habib
July-December 2015, 12(2):81-85
DOI:10.4103/0331-8540.169298  
Introduction: Studies of psychological distress among university students identified academic stress as highest in medical students followed by allied-health students and least in those not in any of these two disciplines. The immediate antecedents include poor academic performance, substance abuse, and subsequent drop out. Future impacts as burnouts and poor services delivery can be exorbitant. This study therefore aimed to document the prevalence of psychological distress among two groups of clinical students of College of Medicine, Bayero University Kano. And also report influence of demographics, resilience and social support on the observed prevalence. Methodology: The participants were 122 clinical students from two departments of clinical sciences that is, medicine and physiotherapy. All gave consent before administration of the study instruments consisting of sociodemograhic questionnaire, Hospital Anxiety Depression Scale (HADS), Resilience Scale (RS) and Oslo Social Support Scale (OSS-3). Results: Overall, 63.1% of participants were males while 57.4% were females. The mean age of medical versus physiotherapy students are respectively 22.47 years and 22.17 years. Psychological distress as measured by HADS is higher in medical students (depression [57.4%] and anxiety [61.6%]) compared to physiotherapy students (depression [42.6%] and anxiety [38.4%]). Physiotherapy students had higher resilience and lower social support compared to medical students. The participants' mean scores on HADS, RS, and OSS-3 is only statistically significant for the RS. Conclusion: It was noted that psychological distress due to academic stress is more among Medical students compared to physiotherapy students. Interventions strengthening social support and improving resilience should be included as part of students' training.
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Knowledge, attitude and practice of contraceptives among grand multiparous women attending antenatal clinic in a specialist hospital, Kano, Nigeria
Garba Ibrahim, Ayyuba Rabiu, Idris Sulaiman Abubakar
July-December 2015, 12(2):90-94
DOI:10.4103/0331-8540.169277  
Background: Nigeria is the most populous country in Africa. Worldwide the country has the second highest maternal mortality ratio. The fertility rate is 5.38 children per woman. Grand multiparity with its associated risks contributes to the high maternal mortality ratio. This study was conducted to find out the knowledge, attitude and practice of contraception among grand multiparous women attending the antenatal clinic in a specialist hospital, Kano. Methods: It was a descriptive cross-sectional study conducted among grand multiparous women attending antenatal care clinic at Murtala Muhammed Specialist Hospital, Kano from 1st September to 31st December 2013. All consenting grand multiparous women were recruited within the study period. Data were collected on a predesigned questionnaire and analysed using SPSS version 17 (SPSS Inc., IL, Chicago, USA). The descriptive statistics was used for categorical variables and Chi-square was used for test of significance. A P ≤0.05 was considered statistically significant for inference. Results: Three hundred and thirty four grand multiparas were recruited. The mean age was 37.23 ± 3.17 years. Majority of them (80.20%) got their contraceptive knowledge from the nurses and/or midwives. Up to 88.60% agreed have used contraceptives. The most popular and used contraceptive among the grand multiparous women was oral contraceptive pills (OCP) (89.80%). The major cause of the non-use of contraceptives was the fear of side effects (77.20%). Conclusion: Grand multiparous women mainly obtain their contraceptive knowledge from the nurses/midwives. OCP was the most used methods. Major causes of non-use of contraceptives were the fear of side effects and desire for more children.
  3 7,117 512
A comparison of betamethasone gel and lidocaine jelly as prophylaxis against intubation-associated throat complications
Adamu Muhammad Sarki, Alhassan Datti Mohammed
July-December 2015, 12(2):105-110
DOI:10.4103/0331-8540.169294  
Background: Sore throat, cough and hoarseness of voice are common postoperative throat complications that follow general anaesthesia with tracheal intubation. Objective: This prospective study was designed to compare the efficacies of lidocaine jelly and betamethasone gel in the prevention of postoperative sore throat, cough and hoarseness after general anaesthesia with tracheal intubation. Materials andn Methods: Ninety ASA I and II consenting patients aged 18–65 years were recruited and randomly allocated into three groups of 30 each. The outer surface of the tracheal tube used in intubating patient was lubricated with one of three agents (2% lidocaine jelly, 0.05% betamethasone gel or KY jelly) from the distal tip of the tube to the 15 cm mark. The incidence and severity of sore throat, cough and hoarseness were then assessed by a blinded interviewer at the 6th, 24th and 48th h postoperative. Results: The highest incidence of throat complaints was recorded during the first evaluation at the 6th h postoperative. The incidence of sore throat was 36.7%, 66.7% and 80%; cough was 13.3%, 26.7% and 43.3%; and hoarseness was 23.3%, 30% and 46.7%, for the betamethasone, lidocaine and KY jelly groups, respectively. Betamethasone gel demonstrated significant superiority over lidocaine and KY jellies in the prevention of sore throat (P = 0.002), cough (P = 0.03) and hoarseness (P = 0.03) throughout the study. Duration of tracheal intubation longer than 2 h was associated with significant increase in the incidence of throat complaints (P < 0.001). Conclusion: Application of betamethasone gel on endotracheal tube effectively reduces incidence of postoperative sore throat, cough and hoarseness after tracheal intubation compared to lidocaine jelly.
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CASE REPORTS
A case report of a rare location solitary osteochondroma: Scapula
Rajesh K Ambulgekar, Nitin Jaiswal, Prajyot G Kandolkar, Rohit D Thakkar, Berlia Rahul
July-December 2015, 12(2):126-128
DOI:10.4103/0331-8540.169290  
Osteochondromas are most common benign malignancy of skeletal and most common site being metaphysis. It arises from cartilage forming bone. As per literature search very few cases are reported of scapular osteochondroma. We are presenting one of such case in a 25 year female from remote place in Nanded district which was treated by excision.
  1 1,919 140
ORIGINAL ARTICLES
Screening mammography in Ibadan: Our experience
MO Obajimi, AT Adeniji-Sofoluwe, AO Oluwasola, BO Adedokun, OA Mosuro, AO Adeoye, NT Ntekim, TO Soyemi, OO Osofundiya, OS Bassey
July-December 2015, 12(2):74-80
DOI:10.4103/0331-8540.169297  
Background: Early detection is an essential step in decreasing the mortality and morbidity of breast cancer. Mammography is a proven effective tool for early breast cancer detection. It has high sensitivity and specificity and remains the gold standard for breast cancer screening. This study aims at describing the findings at screening mammography in women in Ibadan, South-West Nigeria. Materials and Methods: A prospective descriptive single centre study of 568 asymptomatic women who had screening mammography over a 5 year period (2006–2011) in the Department of Radiology, University College Hospital, Ibadan, Nigeria. Two views; the cranio-caudal and the medio-lateral oblique views were obtained. Mammographic findings were reported using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) lexicon and assigned a final BI-RADS category according to overall findings. Data was analysed using Statistical Package for the Social Science SPSS Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago USA: SPSS Inc. Results: A total of 568 women participated in the study with age range from 22 to 82 years (mean 47.8 years). About a third (35.6%) of the women were post-menopausal; and a positive family history of breast cancer was reported in 28 (6.2%) women. The most frequent mammographic breast pattern was BI-RADS I (fatty replaced) in 181 (36.5%) women. Two hundred and twenty women had final BI-RADS category of two (benign), with 49% being fibroadenomas. Over 70% of 164 women called back for diagnostic work up absconded for various socioeconomic and religious factors. Nine women with suspicious breast masses were detected and had treatment constituted immediately. Conclusion: Mammography is just gaining ground in Nigeria; future increased patronage by women is anticipated with intense advocacy and widespread breast cancer awareness.
  1 5,630 1,885
Umbilical artery Doppler velocimetry study on prediction of adverse pregnancy outcomes among pregnant women with hypertensive disorders in Kano, Nigeria
Rabiu Ayyuba, Idris Sulaiman Abubakar, Ibrahim Adamu Yakasai
July-December 2015, 12(2):95-104
DOI:10.4103/0331-8540.169296  
Background: Doppler velocimetry studies have been widely used to predict adverse pregnancy outcomes in hypertensive disorders of pregnancies. Objective: To identify the pregnant women with hypertensive disorders for umbilical artery Doppler velocimetry to predict adverse pregnancy outcomes. Methods: This was a prospective study among 264 pregnant women with hypertensive disorders. The umbilical artery Doppler velocimetry study was conducted using 3.5 m Hz convex of the Mindry Digital Ultrasound Imaging System (Model DP-8800Plus; Shenzen Mindray Biomed Electronics, China). Results: A total of 264 pregnant women within the age of 18–40 years with a mean ± standard deviation of 31.33 ± 5.92 were studied. One hundred and twenty-four (29.90%) presented with pregnancy-induced hypertension (PIH), 72 (58.06%) had abnormal resistive indices (RIs) of at least 0.58 of which 4 had diastolic notches. The remaining 52 (41.94%) had normal RIs with no diastolic notch. Twenty (4.80%) presented with preeclampsia, 12 (60.00%) had abnormal RI of which four had diastolic notches. One hundred and twenty (28.90%) women presented with chronic hypertension, 72 (60.00%) had abnormal RI of which 16 had diastolic notches. Abnormal RI was associated with low Apgar scores and early neonatal death among the patients with PIH, low Apgar scores among patients with preeclampsia and low birth weight among chronic hypertensive pregnant women. Conclusion: We found abnormal umbilical artery Doppler velocimetry RI to be associated with adverse pregnancy outcomes. However, diverse nature of the hypertensive disorders and adverse pregnancy outcomes revealed different optimum cut-off points for various hypertensive disorders following ROC analysis.
  1 3,890 296
CASE REPORTS
Mediastinal traversing fatal oesophageal injury from an unusual trajectory: A case report and review of literature
Jameel Ismail Ahmad, Ismail Mohammed Inuwa, Mahmud Atiku, Adamu Atiku
July-December 2015, 12(2):121-125
DOI:10.4103/0331-8540.169288  
Oesophageal perforation is a potentially lethal clinical condition. Penetrating thoracic oesophageal injury is associated with increased morbidity and mortality, especially if the interval between the injury and commencement of treatment is delayed beyond 24 h. We present a 20-year-old man with a 2 weeks history of mediastinal traversing thoracic oesophageal injury and secondary right empyema following assault. The injury was a stab using a long knife with an entry point at the upper left arm which took an unusual trajectory to traverse the left hemithorax and the mediastinum to penetrate the oesophagus in the right hemithorax. He was resuscitated and thoracotomy was done where the perforation was repaired and the lung decorticated, but he sustained cardiac arrest and could not be resuscitated. Delayed time interval between the time of oesophageal injury and the commencement of treatment is a key determinant of patients' outcome. Prompt diagnosis and institution of treatment significantly reduce the morbidity and mortality associated with oesophageal perforation.
  - 2,442 140
ORIGINAL ARTICLES
Preference and views on lecture delivery methods of clinical students in Bayero University Medical School
MO Asani, I Peter
July-December 2015, 12(2):86-89
DOI:10.4103/0331-8540.169291  
Background: Lectures are essential parts of undergraduate medical education for the transfer of information to students. The traditional method of lecture delivery is widely practiced while some lecturers prefer the use of multimedia powerpoint. Objectives: This study intends to find out the preference and views on lecture delivery methods among the clinical students of Bayero University Medical School. Materials and Methods: This is a descriptive cross-sectional study involving the 400, 500 and 600 levels students. Self-administered pretested questionnaires were administered. Data were analysed by the use of frequencies and percentages. The difference between the various classes was analysed using one-way ANOVA with a P < 0.05 considered to be significant. Results: The age range is between 20 and 41 years with a mean age of 24.9 ± 2.91. There are 171 males and 90 females with a male: female ratio of 1.9:1. The predominant method of lecture delivery by teachers is the use of multimedia powerpoint, 215 (82.4%). Most of the students, 185 (70.9%) prefer a combination of the traditional and powerpoint methods, whereas 13 (12.6%) prefer the use of powerpoint while a minority 33 (5%), the traditional method. Majority, 181 (69.3%) are of the view that the duration of lectures should not exceed 1 h. Conclusion: A combination of the traditional method and multimedia powerpoint is the preferred lecture delivery method of Bayero University clinical students and they opined that lectures should not exceed an hour.
  - 3,065 201
Therapy-related lipid profile changes among patients' on highly active antiretroviral treatment in Kano, North-Western Nigeria
Idris Y Mohammed, Isah A Yahaya
July-December 2015, 12(2):111-115
DOI:10.4103/0331-8540.169289  
Context: Highly active antiretroviral therapy (HAART), an effective treatment for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) results in significant reduction in viral load, increased CD4 cell count and improved quality of life of people living with HIV/AIDS. HAART being a life-long treatment increases the propensity for manifesting long-term complications like changes in lipid profile. Aims: This study set out to assess therapy induced lipid profile changes among patients on HAART in Kano North-Western Nigeria. Design: Cross-sectional. Settings: This study was conducted at the HIV clinic of the Aminu Kano Teaching Hospital, Nigeria. Subjects and Methods: The study group consist of 120 patients on HAART (Group I) and 120 HAART naïve patients (Group II). Results: The mean values of cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDLC) and high-density lipoprotein cholesterol (HDLC) were 4.15 mmol/L ± 1.03, 1.79 mmol/L ± 0.67, 2.79 mmol/L ± 0.98 and 0.99 mmol/L ± 0.28 in Group I, respectively and were statistically significantly higher than 3.50 mmol/L ± 0.94, 1.21 mmol/L ± 0.55, 1.13 mmol/L ± 0.45 and 0.91 mmol/L ± 0.30 in Group II (P < 0.05). The prevalence of dyslipidaemia was high total cholesterol in Group I (25%) Group II (7.5%): high TG in Group I (30%) > Group II (7.5%): High LDLC in Group I (30%) > Group II (17.5%) low HDLC in Group II (40%) >xb Group I (35%). The prevalence of hypertriglyceridemia was 43% in the protease inhibitor (PI) based and 16.7% in 'the non-PI based groups respectively. Conclusions: This study confirms the existence of artherogenic lipid profile in patients on HAART (especially those on PI-based regimen) and further underscores the importance of close monitoring to prevent cardiovascular complications.
  - 2,275 150
Baseline lung function of patients with allergic rhinosinusitis in Kano
Abdulrazak Ajiya, Emmanuel Sara Kolo, Onyekwere George B Nwaorgu
July-December 2015, 12(2):116-120
DOI:10.4103/0331-8540.169293  
Background: Allergic rhinosinusitis is a global health problem both economically and socially with significant impact on the quality of life of the afflicted. This is worsened when bronchial asthma, a comorbidity, is present. Aim and Objective: This study aimed to determine the baseline lung function status of patients with allergic rhinosinusitis. Participants and Methods: All adult patients seen in the Otolaryngology Out-patient Clinic of the study centre with clinically diagnosed allergic rhinosinusitis were prospectively entered in the study. The participants' biodata, symptoms and signs were obtained using a specially designed interviewer-administered questionnaire. The baseline lung function values of the patients were determined using spirometry as a measuring tool. The data were collated and analysed using SPSS version 15 statistical software. Results: There were 300 patients and 300 control participants. Sixty-one percentage were females and 39% as males with a male: female ratio of 1:1.6. The age ranged between 18 and 49 years (mean = 29.3). Seventy percentage had positive family history of allergy, while 19% were obese. Allergic rhinosinusitis was the most common amongst students (38%). In the study group, the lung volumes were below 90% and above 90% in the control group; which was statistically significant (P = 0.05). Older age group (odds ratio, 13.0), female gender (odds ratio, 10.9) and negative family history of allergy (odds ratio, 7.7) were found to be associated with abnormal spirometry results in patients with allergic rhinosinusitis. Conclusion: There is impairment in baseline lung function of patients with allergic rhinosinusitis, even in the absence of asthma.
  - 2,560 127
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.
  - 12,877 4,374
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