Nigerian Quarterly Journal Of Hospital Medicine[JOURNAL]
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200 papers
Perinatal mortality in Lagos University Teaching Hospital: a five year review.
Olamijulo JA, Olaleye O
Nig Q J Hosp Med · 2011 · PMID 23175887
BACKGROUND: An overwhelming proportion of the annual global perinatal deaths occur in developing countries. However few data on perinatal mortality are available from these countries. Reducing perinatal deaths requires a...
BACKGROUND: An overwhelming proportion of the annual global perinatal deaths occur in developing countries. However few data on perinatal mortality are available from these countries. Reducing perinatal deaths requires adequate data that can be used to develop appropriate strategies. OBJECTIVES: To determine the perinatal mortality rate at the Lagos University Teaching Hospital (LUTH), the associated risk factors and the causes of perinatal deaths; and make recommendations to help reduce perinatal mortality. METHODS: A retrospective study of all deliveries in LUTH in the period between January 2002 and December 2006 was done. Data were collected on all stillbirths and early neonatal deaths. Analysis included such variables as booking status, maternal age, parity, gestational age, fetal weight and cause of perinatal death. RESULTS: The perinatal mortality rate was 70.6/1000 total births. The rate was higher among unbooked patients and those with multiple pregnancies. It increased with parity after the 2nd delivery and was highest at the extremes of reproductive age groups. The commonest causes of death were antepartum haemorrhage, pre-eclampsia/eclampsia, mechanical causes, intrapartum asphyxia and prematurity. CONCLUSIONS: The perinatal mortality rate in our institution is high. The causes of perinatal death are largely preventable. Urgent clinical and political actions are required to make any progress towards attaining the fourth millennium development goal (MDG4).
Hydrocephalus and the eyes: a teaching hospital experience.
Akinsola FB, Yusuf GF, Bankole OB … +3 more , Kanu OO, Onakoya AO, Aribaba OT
Nig Q J Hosp Med · 2011 · PMID 23175886
BACKGROUND: The eye developes from prosencephalon, the primitive forebrain and hence share similar embryonic origin with brain. This gives insight into primary or secondary involvement of eyes in intra-cranial pathology....
BACKGROUND: The eye developes from prosencephalon, the primitive forebrain and hence share similar embryonic origin with brain. This gives insight into primary or secondary involvement of eyes in intra-cranial pathology. OBJECTIVE: The study was done to describe ocular findings in hydrocephalus patients and effect of intervention on the complications. METHODS: Forty one consecutive hydrocephalus patients were examined pre and post ventriculo-peritoneal shunts. Comprehensive ocular examinations included dilated fundoscopy in all cases. RESULTS: A total of 41 patients were examined with the age range of between 4 hours to 108 months and a mean age of 21 months. Onset of the hydrocephalus varies from 4hours to 108 months, with a mean of 4.1 weeks. Twenty two patients (51.2%) presented after 2 months of onset of hydrocephalus. Most common presenting complaint was enlarged head seeing in 29 patients (70.7%). CONCLUSION: A total of 12 (30%) out of 41 patients with hydrocephalus had optic atrophy. Another 10 patients had sun-setting phenomenon, 3 of these sun-setting phenomena resolved a week after ventriculo-peritoneal shunts. The ocular morbidity is high among hydrocephalus patients.
Implementing the new WHO guidelines for the early detection of sensorineural hearing loss in newborns and infants in Nigeria.
Olusanya BO, Okhakhu AL, Somefun AO
Nig Q J Hosp Med · 2012 · PMID 23175885
This brief educational update examines the key recommendations in the new report of the World Health Organisation on newborn and infant hearing screening within the Nigerian context. While acknowledging the goal of unive...
This brief educational update examines the key recommendations in the new report of the World Health Organisation on newborn and infant hearing screening within the Nigerian context. While acknowledging the goal of universal newborn hearing screening as desirable, the authors highlight the need for all tertiary hospitals in the country to be appropriately equipped to provide at the minimum early hearing detection services for all high-risk newborns including those delivered by consanguineous parents, those with maternal hypertensive disorders, nonelective caesarean section and unskilled birth attendants. In addition to conventional risk factors for infant hearing loss, microcephalic and undernourished infants should be tested based on evidence from local pilot studies. Primary and secondary-level hospitals should maintain an active referral system to the tertiary centres within a multidisciplinary framework to assure the best of care for the affected infants.
Principles of chest tube insertion.
Ogunleye EO
Nig Q J Hosp Med · 2012 · PMID 23175884
Chest tube insertion is often times a life saving procedure which is well within the scope of a trained physician. It is a simple therapeutic manoevre but prone to complications if the principles of thoracic drainage are...
Chest tube insertion is often times a life saving procedure which is well within the scope of a trained physician. It is a simple therapeutic manoevre but prone to complications if the principles of thoracic drainage are not complied with strictly. This article aims to highlight the indications and contraindications associated with chest tube insertion and also the technique of thoracostomy tube drainage and its associated complications.
Diverticulosis of the colon: a report of two cases.
Olokoba AB, Obateru OA, Bojuwoye MO … +1 more , Olatoke SA
Nig Q J Hosp Med · 2012 · PMID 23175883
BACKGROUND: Diverticula are bulging pouch-like herniations in the wall of the hollow organ anywhere in the gastrointestinal tract from the oesophagus to the colon. Diverticula are thought to occur more commonly in the co...
BACKGROUND: Diverticula are bulging pouch-like herniations in the wall of the hollow organ anywhere in the gastrointestinal tract from the oesophagus to the colon. Diverticula are thought to occur more commonly in the colon than in any other segment of the gastrointestinal tract. It may be asymptomatic or complicated by diverticulitis (diverticular inflammation), bleeding, or perforation with peritonitis. It could be potentially life threatening. It was thought to be rare in this part of the world, but is increasingly diagnosed with the advent of modern imaging techniques and colonoscopy. Two cases of colonic diverticula discovered during colonoscopy were highlighted. CASE REPORTS: Case 1--This patient was a 79-year old traditional ruler who presented with 2 months history of progressive left- sided abdominal pain, dull in nature and sometimes colicky but non-radiating. There was no known aggravating or relieving factors. There was associated history of chronic constipation dating back to over 15 years relieved with use of laxatives. There was no diarrhoea, vomiting or haematochezia. He had no history of previous surgeries. Physical examination showed mild tenderness at the left iliac fossa. Digital rectal examination was normal. Plain abdominal x-ray and abdomino-pelvic ultrasound scan showed no abnormalities. Colonoscopy revealed multiple diverticula with diverticulitis at the descending and sigmoid colon 40 cm-60 cm from the anal verge. Case 2--This patient is a 64-year old retired military officer who presented with constipation of 5 years and rectal bleeding of 10 months. Pre-morbid bowel habit was 1-2 bowel motions per day but now once in 2 days. Constipation was characterized by recurrent passage of hard pellet-like stools. This became associated with passage of fresh blood in the stool 10 months ago, and anal pain. Volume of blood was about 5 mls per episode, and this occurred only when stool was hard. The anal pain was sometimes severe enough to prevent the patient from sitting comfortably on both buttocks. There was no weight loss or constipation alternating with diarrhoea. He had no history of any chronic medical illness. Colonoscopy revealed anal fissure, internal haemorrhoids, and multiple diverticula in the sigmoid and descending colon. Both patients are being managed conservatively with dietary advice and antibiotics, and still being followed up in the clinic. CONCLUSION: Reports of colonic diverticula with diverticulitis in this part of the world are few. This is the first report of colonic diverticulosis from Ilorin.
Spectrum of endoscopic findings in Nigerians with dyspepsia.
Olokoba AB, Salawu FK, Danburam A … +1 more , Aderibigbe SA
Nig Q J Hosp Med · 2012 · PMID 23175882
BACKGROUND: Dyspepsia is a common gastrointestinal disorder originating from the gastroduodenal region, and is the most common indication for upper gastrointestinal tract endoscopy. There are differing information on the...
BACKGROUND: Dyspepsia is a common gastrointestinal disorder originating from the gastroduodenal region, and is the most common indication for upper gastrointestinal tract endoscopy. There are differing information on the commonest endoscopic findings in patients with dyspepsia from Nigeria. OBJECTIVE: The aim of this study was to determine the spectrum of endoscopic findings in patients with dyspepsia. PATIENTS AND METHODS: This is a hospital-based prospective study carried out at the Endoscopy Unit of Federal Medical Centre, Yola from November, 2006 to May, 2010. Patients with clinical features of dyspepsia who underwent upper gastrointestinal tract endoscopy as part of their workup were recruited. Their biodata, history and duration of dyspepsia were noted on a proforma. The spectrum of endoscopic findings was also noted. RESULTS: A total of 259 patients with dyspepsia had upper gastrointestinal tract endoscopy. Ninety-nine (38.2%) were males while 160 (61.8%) were females, giving a male to female ratio of 1:1.6. Clinically significant endoscopic findings were seen in 241 (93.1%) patients while gastroduodenitis was the commonest finding. One hundred and two (39.4%) patients had two endoscopic findings, and 7 (2.7%) had three findings. CONCLUSION: Majority of patients with dyspepsia had clinically significant endoscopic findings. Gastroduodenitis was the commonest endoscopic finding.
Ocular findings in acquired immunodeficiency syndrome patients in Lagos, Nigeria.
Onakoya AO, Odeyemi MG, Aribaba OT … +1 more , Akinsola FB
Nig Q J Hosp Med · 2012 · PMID 23175881
BACKGROUND: There is paucity of studies on the prevalence and pattern of ocular complication in HIV patients in developing countries where 90% of all HIV sufferers live. Most studies were carried out in industrialized co...
BACKGROUND: There is paucity of studies on the prevalence and pattern of ocular complication in HIV patients in developing countries where 90% of all HIV sufferers live. Most studies were carried out in industrialized countries and are not representative of the spectrum of ocular complication of HIV and it's prevalence in developing countries. OBJECTIVE: To determine the prevalence of ocular disorders in adult (> 15 years ) AIDS patients at PEPFAR clinic in Lagos, Nigeria. MATERIAL AND METHODS: All consecutive adult Seropositive HIV/AIDS patients of PEPFAR Clinic at the Lagos University Teaching Hospital between February 1st-March 15th 2008 were enrolled into the study Cross sectional and non randomized, convenient study was used. Biodata and medical history were recorded on interviewer administered questionnaire. Participants were examined according to standard protocol comprising visual acuity, intraocular pressure, anterior segment examination with slit lamp biomicroscopy, dilated fundoscopy and fundus photograph where necessary. PCV, CD4+ count, viral load at diagnosis, stage of HIV disease were extracted from patients' records. Details of drug were regimen also recorded. Data analysis was performed with EPI-lnfo 6.04 version; Chi square and student t test used to describe statistical association. RESULTS: A total of 400 patients were studied. Male:female ratio was 1.7 and mean age was 40 years (S.D. + 9.12). Ocular disorders seen in 78.5% of patients; HIV related ocular disorders occurred in 45 (11.3) patients. Conjunctival microvasculopathy 166 patients (41.5%), pingueculum in 114 (28.5%), pterygium in 76 (19.0%), refractive error in 93 (23.3%), cataract in 12 (3.0%), and 22 (5.5%) Glaucoma suspects. HIV retinopathy and allergic eye disease in one patient each (0.3%). Presumed Cytomegalovirus retinitis 7 (1.8%), 14 (3.5%) Toxoplasmosis, 8 (2.0%) HZO, and 15 (3.8%) Presumed Squamous cell carcinoma. Eighty six (21.5%) of the patients had no abnormality. 91.4% of eyes examined had visual acuity with best correction of > 6/18. CD4+ in 79.3% of the patients was > 200 cells/ul and < 5% had counts < 50 cells with an overall mean of 406 cell/ul. 375 (93.8%) patients were on Highly Active Antiretroviral therapy (HAART), and 25 (6.2%) were not. CONCLUSION: Study revealed low prevalence of HIV related ocular disorders. This could be due to few patients at low level of immunosuppresion where the infections occur.
A classification system for recurrent ameloblastoma of the jaws--review of 30 cases in Nigerians.
Arotiba GT, Effiom AO, Ayodele AS … +9 more , Ogundana MO, Gbotolorun MO, Olasoji HO, James O, Ladeinde AL, Ugboko VI, Ndukwe KC, Ikem IC, Braimah RO
Nig Q J Hosp Med · 2012 · PMID 23175880
This paper reviewed the clinicopathologic presentation of recurrent ameloblastoma in 30 Nigerian patients at three tertiary referral centers with the sole objective of developing a classification system. Most recurrences...
This paper reviewed the clinicopathologic presentation of recurrent ameloblastoma in 30 Nigerian patients at three tertiary referral centers with the sole objective of developing a classification system. Most recurrences occurred in patients in their 3rd decade of life (20-29years) and males were more frequently affected than females (1.5 to 1). Though enucleation resulted in the highest rate of recurrences (30%), hemi-mandibulectomy also resulted in a 20% recurrence rate. Majority of the recurrences occurred within 5 to 9 years after primary surgery. Most primary jaw sites of the lesion corresponded with the primary jaw sites of the recurrent tumor which in itself may be a reflection of inadequate primary treatment. The most frequent anatomic site of primary tumors that recurred was c4 (highest level of ramus involvement). The most frequent anatomic classification of the recurrent tumors was recurrence at one bone margin (Bla) and recurrence at intervening /adjacent soft tissues between the resected bone edges (Blc). Mandible to maxilla recurrence increases the likelihood of extension to the skull and brain.
Pattern of conjunctival masses seen at Guinness Eye Centre Luth Idi-Araba.
Akinsola FB, Mbadugha CA, Onakoya AO … +3 more , Adefule-Ositelu AO, Aribaba OT, Rotimi-Samuel A
Nig Q J Hosp Med · 2012 · PMID 23175879
BACKGROUND: Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations. OBJECTIVE: To determine the pattern of presentation of conjunctival masses at the Guinn...
BACKGROUND: Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations. OBJECTIVE: To determine the pattern of presentation of conjunctival masses at the Guinness Eye Centre (GEC), Lagos University Teaching Hospital (LUTH) Idi-Araba over a 13 year period (Jan 1995-Dec 2007). METHOD: A retrospective review of the clinical notes of all patients that presented to GEC with conjunctival masses during the study period was carried out. The bio-data, clinical features, stage, laterality and associated features of the masses were noted. The diagnosis, treatment and complications of treatment were also recorded. RESULTS: Case notes of 612 eyes of 393 patients were included in the study. There were 219 (55.7%) males, 174 (44.3%) females with ages ranging from 4-85 years with a male to female ratio of 1.26: 1. Three hundred and eighty-eight patients (98.7%) presented as elective cases to the outpatient department while 5 (1.3%) presented as emergencies on account of associated ocular inflammation. There were 220 (56%) bilateral masses while 44% were uniocular. Pterygium was the leading conjunctival mass affecting 548 eyes (89.5%) of 329 patients. Pingueculae occurred in 53 eyes (8.7%), conjunctival cysts in 5 (0.8%) eyes, neoplastic growths in 3 (0.5%) eyes, conjunctival granulomas in 2 (0.3%) eyes and limbal teratoma in 1 (0.2%) eye. Most of these patients defaulted from surgery as only 141 eyes (23%) of 121 patients had surgery. Post-operative complications occurred in 33 eyes (5.4%) of 30 patients. The commonest postoperative complication was pterygium recurrence which occurred in 18 eyes of 15 patients. CONCLUSION: Pterygium was the commonest conjunctival mass and preventive strategies need to be advocated. Prevention of recurrence remains a challenge in the management of pterygium as recurrence after surgical excision occurred in 13.2% of eyes. Our study however did not confirm outdoor occupations as a risk factor for pterygium.
The relationship between microalbuminuria, cardiovascular risk factors and disease management in type 2 diabetes.
Udenze IC, Azinge EC, Ebuehi OA … +4 more , Awolola NA, Adekola OO, Menkiti I, Irurhe NK
Nig Q J Hosp Med · 2012 · PMID 23175878
BACKGROUND: In patients with type 2 diabetes, microalbuminuria is an early clinical sign suggestive of vascular damage to the glomerulus. Microalbuminuria has also been currently reported as an important risk factor for...
BACKGROUND: In patients with type 2 diabetes, microalbuminuria is an early clinical sign suggestive of vascular damage to the glomerulus. Microalbuminuria has also been currently reported as an important risk factor for cardiovascular disease and becomes relevant in the management of type 2 diabetes. OBJECTIVES: This study is to determine the prevalence of microalbuminuria, identify the risk factors associated with microalbuminuria in type 2 diabetes, and to asses the achievement of treatment goals for cardiovascular risk reduction in type 2 diabetics. SUBJECTS AND METHODS: Seventy- two subjects with microalbuminuria were recruited from three hundred consecutively screened type 2 diabetics attending the Diabetic Clinic at the Lagos University Teaching Hospital. Clinical data were obtained by interviewing the participants. Anthropometric measurements were made and blood specimens were collected for analysis. RESULTS: The prevalence of microalbuminuria was twenty-four percent (24%) in type 2 diabetes. Multiple logistic regression identified duration of diabetes (odds ratio 1.3 (95% CI; 0.03-1.58), hypertension(odds ratio 5.2 (95% Cl; 1.24-18.62), Body mass index (BMI) (odds ratio 1.27 (95% CI; 1.0-1.6), waist/hip ratio (WHR) (odds ratio 1.9 (95% Cl; 1.3-3.5), andHbA,c (odds ratio 6.6 (95% Cl; 1.02-27) as independent risk factors associated with microalbuminuria in type 2 diabetics. Optimum blood pressure, glycemic and weight control were achieved in eighty five percent (85%), fifty eight percent (58%) and nineteen percent (19%) of the type 2 diabetes respectively. CONCLUSION: This study showed that microalbuminuria is common among patients with type 2 diabetes. It also showed improvement in glycemic control and modifiable cardiovascular risk factor control when compared with previous studies.
The antidiarrhoeal activity of the aqueous root extract of Aristolochia ringens (Vahl.) Aristolochiaceae.
Adeyemi OO, Aigbe FR, Badru OA
Nig Q J Hosp Med · 2012 · PMID 23175877
BACKGROUND: Aristolochia ringens, an ornamental plant native to tropical America that now grows in a number of African countries has been reported to be used in African traditional medicine for the management of snake bi...
BACKGROUND: Aristolochia ringens, an ornamental plant native to tropical America that now grows in a number of African countries has been reported to be used in African traditional medicine for the management of snake bite venom, gastrointestinal disturbances, rheumatoicd arthritis and insomnia among others. OBJECTIVE: Based on its use in traditional African medicine, the antidiarrhoeal activity of the aqueous root extract of Aristolochia ringens (AR) was evaluated to determine the pharmacological basis of its use in the management of diarrhoea. METHODS: Normal and castor oil (CO) induced intestinal transit, castor oil induced diarrhoea, gastric emptying and enteropooling models were carried out in mice and rats. Preliminary phytochemical screening and acute toxicity tests were also carried out. RESULTS: AR (100-400 mg/kg, p.o.) produced a dose-dependent and significant decrease in normal and castor oil-induced intestinal transit compared to the vehicle group. This effect was significantly (p < 0.001) inhibited by pilocarpine (10 mg/kg, s.c.), phentolamine and propranolol (1 mg/kg, i.p.) respectively but neither significantly inhibited by yohimbine (1 mg/kg, s.c.) nor significantly enhanced by isosorbide dinitrate (150 mg/kg, p.o.). AR produced a dose-dependent and significant increase in the latency of diarrhoeal onset. AR also reduced the diarrhoeal score, number and weight of wet stools. The in vivo antidarrhoeal index (ADI(in vivo)) of 81.79 produced by AR (400 mg/kg) is comparable to the 86.85 ADI(in vivo). produced by morphine (10 mg/kg, s.c.). AR also reduced the gastric enteropooling and emptying effects of castor oil. Preliminary screening showed the presence of tannins, saponins and alkaloids. In the acute toxicity study, no mortality was observed with AR administered orally up to 10,000 mg/kg, but an LD50 of 407.38 mg/kg was obtained with the intraperitoneal route of administration in mice. CONCLUSION: Results show that the aqueous root extract of Aristolochia ringens possesses antidiarrhoeal activity possibly mediated by its non selective action on adrenoceptors in the GIT and physiological antagonism of the parasympathetic nervous system.
Circulating adipokine levels in type 2 diabetes mellitus in Lagos, Nigeria.
Oshodi T, Ebuehi OA, Ojewunmi O … +2 more , Udenze I, Soriyan T
Nig Q J Hosp Med · 2012 · PMID 23175876
BACKGROUND: Type 2 diabetes remains a global concern with its numerical increase occurring in developing countries which include Nigeria. Adipose tissue-secreted factors called "adipokines" are involved in energy homeost...
BACKGROUND: Type 2 diabetes remains a global concern with its numerical increase occurring in developing countries which include Nigeria. Adipose tissue-secreted factors called "adipokines" are involved in energy homeostasis and regulation of glucose and lipid metabolism. OBJECTIVE: This study was undertaken with the aim of investigating adipokine levels in the Type 2 Diabetes Mellitus. METHODS: This is a cross sectional study conducted in Lagos University Teaching Hospital (LUTH), a-700 bed tertiary hospital centre in Lagos, Nigeria. 53 diabetic subjects and 27 non-diabetic controls with mean age (56.72 +/- 10.44) and (38.67 +/- 9.63) years respectively, were recruited into the study. Fasting blood glucose, HbA1 C, leptin and resistin levels and body mass index (BMI) were assayed. RESULTS: Mean BMI was higher but not statistically significant in diabetics than in non diabetics (diabetics 28.77 +/- 5.35; non diabetics 27.38 +/- 6.04; p > 0.05). Resistin level was significantly higher in diabetics (31.26 +/- 2.5) as compared with non diabetics (16.61 +/- 2.16) compared to non-diabetics. Leptin correlated very strongly with BMI (r = 0.620, p < 0.0001) and was significantly higher in females than males (female 9.72 +/- 1.70; male 1.79 +/- 0.54; p < 0.0001). CONCLUSION: The circulating adipokines have variable effect on the glucose and fat metabolism. BMI and resistin level were higher in diabetics. Leptin was found in this study to correlate very strongly with BMI (adiposity). There was also a strong gender dependence observed as leptin level was signficantly higher in females than males.
Spinal neural tube defects in Lagos University Teaching Hospital, Nigeria.
Bankole OB, Arigbabu SO, Kanu OO
Nig Q J Hosp Med · 2012 · PMID 23175875
BACKGROUND: The incidence of neural tube defects is known to vary among regions. Very little has been reported about the incidence in Sub-Saharan Africa except for the general impression that the prevalent rates are low....
BACKGROUND: The incidence of neural tube defects is known to vary among regions. Very little has been reported about the incidence in Sub-Saharan Africa except for the general impression that the prevalent rates are low. OBJECTIVE: To determine the profile of patients presenting with neural tube defects in Lagos, Nigeria METHODS: We studied all patients with congenital midline back swellings presenting to one of two neurosurgical services in the state over a 5-year period to establish the incidence of spina bifida and develop demographic data. Data collected included the age at presentation, maternal age, education and parity, presence of co-existing anomalies and the social status of the parents. RESULTS: One hundred and eight patients with congenital midline swellings of the back were studied. Meningomyelocele accounted for 96% of the cases seen. Half the patients presented within the first two weeks of life and although fifty percent of mothers had ultrasound scans done during pregnancy none of the patients were diagnosed prenatally. Seventy-three percent of mothers of affected children were from a low socio-economic class. The commonest co-existing congenital anomaly was lower limb deformity (Talipes equino-varus). CONCLUSION: Spina bifida is the commonest indication for neurosurgical clinic referral with the exception of trauma in our environment. The prevalence is higher among women in the lower socio-economic groups. Improved perinatal care is required to ensure that children with such birth defects get prompt medical attention and thereby prevent worsening of an already complex problem.
Knowledge of health insurance among primary health-care managers in Shongom LGA, Gombe State, Nigeria.
Karatu DL, Olufunlayo TF, Onigbogi OO
Nig Q J Hosp Med · 2012 · PMID 23175874
BACKGROUND: The National Health Insurance Scheme (NHIS) was formally launched in Nigeria in 2005 as an option to help bridge the evident gaps in health care financing, with the expectation of it leading to significant im...
BACKGROUND: The National Health Insurance Scheme (NHIS) was formally launched in Nigeria in 2005 as an option to help bridge the evident gaps in health care financing, with the expectation of it leading to significant improvement in the country's dismal health status indices. Primary Health Care (PHC) is the nation's adopted strategy for health service delivery and its managers are central to the success of any health-related programme. There is paucity of specific data about what this critical group of people know about health insurance. OBJECTIVE: The objective of the study was to assess the level of knowledge of managers of the Shongom PHC system about health insurance. METHODS: The study was of a descriptive cross-sectional design carried out among twenty-eight PHC managers of government-provided and community-owned health facilities/units in Shongom LGA, Gombe State, northeastern Nigeria. RESULTS: Among the respondents, 17.9% had good knowledge about health insurance while 35.7% and 46.4% had fair and poor scores respectively. Respondents in government-provided facilities/units had 6.3%, 37.5% and 56.3% for good, fair and poor scores respectively, while their counterparts in community-owned facilities had 33.3% for each of the score grades. CONCLUSION: The research showed that knowledge about health insurance among managers in this rural PHC system was below average.
Clinical and proctosigmoidoscopic findings in patients with anorectal sepsis in a private health facility in Lagos, Nigeria.
Jeje EA, Mofikoya BO, Osunkoya SA … +2 more , Olajide TG, Osinowo AO
Nig Q J Hosp Med · 2012 · PMID 23175873
BACKGROUND: Anorectal sepsis is a distressing condition which is sometimes inadequatelytreated. OBJECTIVES: To determine the clinical and prostosigmoidoscopic findings in patients with anorectal sepsis seen by the author...
BACKGROUND: Anorectal sepsis is a distressing condition which is sometimes inadequatelytreated. OBJECTIVES: To determine the clinical and prostosigmoidoscopic findings in patients with anorectal sepsis seen by the authors over a 5 year period as well as identifying the commonly performed procedures. METHOD: A review of all the records of patients seen by the authors over a 5 year period was carried out. The demographic pattern was determined including the age, sex, mode of presentation, and associated co-morbidities. The detailed perianal and protosigmoidoscopic findings were also noted RESULTS: 45 males and 10 females were seen during the study period. The mean age incidence was 43.4 years. The commonest mode of presentation was perianal discharge and pain in over 85% of the patients seen. The low anal fistula was the commonest pathology on proctosigmoidoscopy while abscesses and external haemorrhoids were the other commonly occurring lesions found . Fistulotomy was the most commonly perfomed procedure while diabetes was the most common comorbidity. CONCLUSION: Anorectal sepsis most commonly affects males in the fifth decade of life. Thorough evaluation and adequate operative treatment appear to result in satisfactory early outcome.
Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review.
Umeizudike KA, Ayanbadejo PO, Savage KO … +1 more , Taiwo OA
Nig Q J Hosp Med · 2012 · PMID 23175872
BACKGROUND: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service. OBJECTIVE: To a...
BACKGROUND: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service. OBJECTIVE: To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. METHODS: This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software. RESULTS: A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments. CONCLUSION: This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.
Distribution and characteristics of non carious cervical lesions in an adult Nigerian population.
Afolabi AO, Shaba OP, Adegbulugbe IC
Nig Q J Hosp Med · 2012 · PMID 23175871
BACKGROUND: Controversies rages in the literature as to the characteristics of non carious cervical lesions (NCCLs) in terms of the location and its severity. OBJECTIVE: The study is to investigate the characteristics of...
BACKGROUND: Controversies rages in the literature as to the characteristics of non carious cervical lesions (NCCLs) in terms of the location and its severity. OBJECTIVE: The study is to investigate the characteristics of NCCLs in adult patients who had a high incidence in them and to see if there are any association with the findings. Methods : The author examined 356 teeth with NCCLs in 34 subjects (male and female aged 22-75 years). The characteristics were based on the location of the lesion and the size (shape, extensiveness and depth). RESULTS: In terms of the location, 61.2% were located on the posterior teeth, and 55.9% on the maxillary teeth. The first premolars (25.8%) and canines (19.4%) were affected most often, followed by the first molars (16.9%) and second premolars (13.8%). There was slight right side preponderance (50.3%) and more lesions in the male subjects (67.4%). Patients tended to be older, with 76.4% in the 40 years and older age group. In terms of the size of the lesion, 75.0% of the lesion had angular shape of < 135 (wedge), 70.2% had axial depth of 1-2 mm, and 51.7% had occlusogingival width (extensiveness) of 2-3.9mm (small). There was association between gender and the severity (extensiveness) of the lesion. The severity (shape and extensiveness) of NCCL was associated with age. There was strong association between the severity of NCCL and site of the lesion (jaws). CONCLUSION: The authors found that NCCLs were significantly related to age. The posterior maxillary teeth especially the first premolars followed by the canines were the teeth commonly involved. No great difference in incidence was found between the right and left sides as a result of right or left hand dexterity. Awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient. In addition, these characteristics help identify which teeth and patients that are more susceptible.
Incidence of impacted mandibular canine and associated pathologies in an orthodontic patient population in Lagos, Nigeria.
Sanu OO, Adeyemi TA, Isiekwe MC
Nig Q J Hosp Med · 2012 · PMID 24596969
BACKGROUND: Mandibular canine impaction is less frequent in our environment with various factors implicated in the aetiology and with several associated pathologies, the advent of the technique of panoramic radiography h...
BACKGROUND: Mandibular canine impaction is less frequent in our environment with various factors implicated in the aetiology and with several associated pathologies, the advent of the technique of panoramic radiography has helped with the diagnosis of this condition. OBJECTIVE: The aim of the study was to investigate the incidence of impacted mandibular canines and the classification of associated pathology. METHODS: A retrospective cohort study of 1250 panoramic radiographs taken of patients who presented to the Orthodontic Unit of Lagos University Teaching Hospital, Lagos, Nigeria between January, 2001 and September, 2008. The clinical data and panoramic radiographs were reviewed and observations on the status of missing permanent mandibular canine, symptoms as well as treatment methods employed were made. RESULTS: The incidence of mandibular canine impaction was found to be 1.36% in the studied demand population. A total of 17 patients (10 females and 7 males) had impacted mandibular canines. In this study 5 (27.8%) impacted canines were extracted, seven canines (38.9%) were attached to bonded brackets after surgical exposure and traction was applied while six (33.3%) impacted mandibular canines were left in place for periodic observation. CONCLUSION: The incidence of impacted mandibular canines was found to be high in the subpopulation studied. However, this may not be unrelated with the fact that this is a demand population.
Repair of defective composite resin restoration: current trend among conservative dentists in Nigeria.
Abiodun OA, Ayamma UU, Olabisi HO
Nig Q J Hosp Med · 2012 · PMID 24568067
BACKGROUND: Repair of defective composite resins restorations is being increasingly recognized as a viable alternative to replacement. there is however no consensus yet on the treatment protocol. OBJECTIVE: To determine...
BACKGROUND: Repair of defective composite resins restorations is being increasingly recognized as a viable alternative to replacement. there is however no consensus yet on the treatment protocol. OBJECTIVE: To determine the views and practice of specialists in Conservative Dentistry in Nigeria as regard to repair procedure of defective composite resin restorations. METHODS: A cross sectional study was conducted among conservative dentists in Nigeria using anonymous structured and open-ended questionnaire as instrument for data collection, the data collected were: socio demographic variables; views and practice of the respondents as regards the indications, benefits and longevity of composite resins repair treatment option and type of surface preparation usually employed, summary statistics was performed. RESULTS: The respondents comprise 9 (37.5%) males and 15 (62.5%) females. Marginal defect (91.7%) was the strongest indication and preservation of tooth structure (95.8%) was regarded as the topmost benefit, majority of the respondents (75.0%) considered repair procedure as a definitive treatment and etching with phosphoric acid was the most utilized surface preparation (87.5%). CONCLUSION: The views and practice of the respondents is in the literature.
C-reactive protein in healthy adult Nigerians.
Baba MM, Kolawole BA, Balogun MO … +7 more , Akintomide AO, Ikem RT, Arogundade FA, Gezawa ID, Yusuph H, Talle A, Abdul H
Nig Q J Hosp Med · 2012 · PMID 24568066
BACKGROUND: C-reactive protein (CRP) is an acute phase reactant produced in the liver in response to tissue injury or systemic inflammation, its release is stimulated by cytokines (interleukin-6 and tumour necrosis facto...
BACKGROUND: C-reactive protein (CRP) is an acute phase reactant produced in the liver in response to tissue injury or systemic inflammation, its release is stimulated by cytokines (interleukin-6 and tumour necrosis factor-alpha). Elevated CRP levels have been linked to an increased risk of later development of diabetes mellitus and systemic hypertension. Baseline level of C-reactive protein in apparently healthy men and women predict long-term risk of a first myocardial infarction. METHOD: The study design was cross-sectional conducted among apparently healthy adult relative of patients and hospital staff of the Obafemi Awolowo University Teaching Hospitals complex (OAUTHC) Ile Ife, Osun State south western Nigeria. Serum lipids and fasting blood glucose were measured, while C-reactive protein measurement was based on the principle of solid phase enzyme-linked immunosorbent assay (ELISA). RESULTS: Atotal of 50 apparently healthy consecutive adult subjects were recruited into the study comprising 19 male and 31 female. There was no significant difference in mean Fasting blood glucose and serum lipids between the male and female study subjects. However, C-reactive protein was found to be higher in female compared to male, but the difference was not statistically significant. CONCLUSION: This study showed that apparently healthy adult female Nigerians have higher level of C-reactive protein compared to male, but with no significant difference.
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