Nigerian Medical Journal[JOURNAL]
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200 papers
Establishing a Consensus Algorithm for H. Pylori Screening, Diagnosis, Initial Management, and Referral Protocols for Primary Care Physicians.
Abere S, Sixtus O, Koko-James N
Niger Med J · 2025 · PMID 41523880 · Full text
BACKGROUND: Helicobacter pylori (H. pylori) infection is a significant public health concern, contributing to various gastrointestinal disorders, including peptic ulcers and gastric cancer. The infection is highly preval...
BACKGROUND: Helicobacter pylori (H. pylori) infection is a significant public health concern, contributing to various gastrointestinal disorders, including peptic ulcers and gastric cancer. The infection is highly prevalent in Africa, but still diagnostic and treatment challenges persist in primary care settings. Effective treatment regimens are therefore crucial for eradicating this infection and preventing complications. This study aimed to develop a consensus-based algorithm for H. pylori management optimized for Primary care settings utilizing data from primary care physicians, patient screening, and treatments. METHODOLOGY: A cross-sectional study was conducted among forty-four primary care physicians involved in diagnosing and treating H. pylori infection. They were provided with a data Collection Form (DCF) and an H. pylori rapid antibody test kit. All the questionnaire responses and the result of rapid antibody test were recorded and analyzed. A panel of experts involving senior family medicine doctors, and a gastroenterologist via a modified Delphi process of discussions on the DCF responses, and test results from the 44 physicians arrived at a consensus-based treatment algorithm developed to guide clinical decision-making for H. pylori management. RESULTS: This study comprised 245 patients with a female preponderance and mean age of 35.0±11.5 years. The most common symptoms from the DCF were epigastric pain, nausea/vomiting and bloating in 74.5%, 52.7% and 35% respectively while the mean duration of symptoms was 3weeks. Constipation and irritability were the least common symptoms with heartburn reported less frequently in the H. Pylori positive cases. 79.9% of the 245 patients were H. Pylori treatment naïve with a higher likelihood (57.1%) of having a positive antibody test. It was recommended that both treatment experienced and naïve patients with epigastric or abdominal pain, nausea vomiting and/or bloating with symptom duration > 2weeks be tested and eradicated while those with alarm symptoms be referred to the specialist. CONCLUSION: The proposed algorithm provides a comprehensive guide for Physicians at the primary and secondary care level in selecting the most effective treatment regimen for H. pylori infection. H. Pylori antibody testing is a primary screening tool for patients with persistent symptoms or those lasting greater than 2weeks and where positive confirmatory test is recommended.
Prevalence of Adverse Drug Reactions among People Living with HIV in Lagos State University Teaching Hospital, Lagos, Nigeria.
Olaniyi CA, Akinbami AA, Uche EI … +4 more , Odubona AO, Jinadu SS, Akinbami OT, Dawodu RA
Niger Med J · 2025 · PMID 41509682 · Full text
BACKGROUND: Human Immunodeficiency Virus (HIV) remains a major public health concern in Nigeria, which has been rated as having a high HIV burden globally. Antiretroviral therapy (ART) has significantly improved life exp...
BACKGROUND: Human Immunodeficiency Virus (HIV) remains a major public health concern in Nigeria, which has been rated as having a high HIV burden globally. Antiretroviral therapy (ART) has significantly improved life expectancy and reduced HIV-related morbidity and mortality. However, ART is associated with adverse drug reactions (ADRs), which can lead to treatment failure, regimen changes, and non-adherence, ultimately affecting patient outcomes. METHODOLOGY: This was a retrospective cohort study of newly initiated people living with HIV (PLHIV) accessing care at the Lagos State University Teaching Hospital (LASUTH), Ikeja. All newly initiated HIV patients receiving antiretroviral therapy (ART) at LASUTH between March 2023 and March 2025 were included. Data collected during the study period were abstracted, and individuals who experienced an adverse drug reaction (ADR) were recorded. Data was analysed using the Statistical Package for the Social Sciences (SPSS) version 27.0. Statistical significance was established at p ≤ 0.5. RESULTS: Overall, 533 newly initiated into treatment in the study period. Out of the newly initiated (533), a total of 65 reported adverse reactions to the drugs of treatment, which constituted 12.1% prevalence of ADR in the newly initiated. The mean age of all participants was 40.50 ± 11.76 years. All the newly initiated (100%) were on Tenofovir, Lamivudine, and Dolutegravir (TLD) combination. Pruritus is the commonest symptom in both females and males. CONCLUSION: The ADR prevalence among the newly enrolled PLHIV is 12% and pruritus is the commonest ADR seen among the newly enrolled.
Assessment of the Secondary Metabolites of the Aerial Extract of Ocimum Tenuiflorumfor Anti-Diabetic Potential.
Ololade ZS, Salemcity AJ, Akinawo CA … +2 more , Salemcity OG, Balogun SP
Niger Med J · 2025 · PMID 41509681 · Full text
BACKGROUND: is an important plant in Africa with diverse medicinal properties. This study investigates the anti-diabetic effects of methanol-ethyl acetate (2:1) extract (OTE) on alloxan-induced diabetic rats. METHODOLOG...
BACKGROUND: is an important plant in Africa with diverse medicinal properties. This study investigates the anti-diabetic effects of methanol-ethyl acetate (2:1) extract (OTE) on alloxan-induced diabetic rats. METHODOLOGY: Thirty rats (90-100g) acclimatized for one week were grouped into 5 (n=6). Group 1 (Normal control) received distilled water. The other groups were administered a single dose of 100 mg/kg alloxan intraperitoneally and treated as follows: Group 2 (olive oil), Groups 3 and 4 (200mg/kg and 400mg/kg OTE, respectively), and Group 5 received 5mg/kg glibenclamide. After twenty-one days of treatment, the rats were fasted overnight and sacrificed. Blood and liver samples were collected for analysis. Blood glucose status was measured using a glucometer. Serum insulin concentration was measured using an Enzyme-linked immunosorbent assay. Antioxidant assays were assessed via spectrophotometry. P<0.05 was considered statistically significant. RESULTS: Blood glucose level increased while insulin concentration reduced in diabetic controls relative to normal rats. Conversely, a dose-dependent reduction was observed in the glucose level, while insulin concentration returned to near normal with increasing doses of OTE compared to the normal control. It was observed that GSH level, CAT, and GST activities decreased significantly in diabetic control relative to normal control. Meanwhile, treatment with doses of OTE caused a dose-related increase in these antioxidant parameters, significantly compared to the normal control. MDA showed a significant increase in the untreated group relative to the normal control. However, MDA concentration declined drastically (P<0.01) in a dose-dependent manner upon treatment with OTE relative to normal rats. CONCLUSION: It could be inferred from the results above that OTE may exhibit its anti-diabetic potential via enhancing the synthesis of insulin and scavenging of free radicals. This study showed that the extract can be used in the treatment of diabetes and can be formulated into a novel drug or supplement.
Current Concepts in the Management of Achilles Tendon Injuries.
Diamond TE, Achor MT
Niger Med J · 2025 · PMID 41509680 · Full text
Achilles tendon injuries are commonly encountered in orthopaedic practice. The Achilles tendon is prone to rupture, and this negatively imparts ambulation. The diagnosis is clinical. Treatment options have evolved from c...
Achilles tendon injuries are commonly encountered in orthopaedic practice. The Achilles tendon is prone to rupture, and this negatively imparts ambulation. The diagnosis is clinical. Treatment options have evolved from conservative to surgeries, however there is no consensus on the most superior option of treatment. This narrative review aims to highlight the evolution in clinical diagnosis and treatment of Achilles tendon ruptures and discuss the current evidence in the treatment with emphasis on outcome measures of each treatment modality. Relevant studies on Achilles tendon ruptures with emphasis on treatment options, their strengths and weaknesses were reviewed. The treatment of Achilles tendon rupture has evolved from conservative options to surgeries. The surgical options include open repair, percutaneous repair, endoscopic repair, and ultrasound-guided repair. However, there is still no consensus on the most superior option for treating Achilles tendon injuries. Each method has its pros and cons. Conservative treatment has the appeal of the absence of scars, low cost and shorter duration of hospital stay. However, ankle stiffness, and late return to work are important drawbacks. Open surgery has the advantage of early return to function and low re-intervention rates. Surgical scars, likelihood of infection and cost are major disadvantages. Appropriate patient selection guided by the severity of the injury, the age of the patient, pre-injury status, work demand for the patient, experience of the surgeon, available resources, local soft tissue condition, and the patient's preferences are key to successful outcome.
Discovery of New Bat Coronavirus (HKU5-CoV-2): Can it be Another Public Health Threat?
Aggarwal R, Kaur K, Nirola A … +3 more , Singh R, Gupta D, Gambhir RS
Niger Med J · 2025 · PMID 41472995 · Full text
The deadly COVID-19 outbreak which started in Wuhan city of China in December 2019, created a dangerous Public Health Disaster the world has ever witnessed. Bats have been widely recognised as natural reservoir hosts of...
The deadly COVID-19 outbreak which started in Wuhan city of China in December 2019, created a dangerous Public Health Disaster the world has ever witnessed. Bats have been widely recognised as natural reservoir hosts of several zoonotic diseases, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) caused by coronaviruses. A new bat coronavirus similar to the virus resembling COVID-19, has been discovered recently by researchers at the Wuhan Institute of Virology in China. The new virus named as 'HKU5-CoV-2, carries the risk of animal-to-human transmission. This paper shares the most recent information on the virus and views of other eminent scientists regarding its potential to start another pandemic.
Socio-economic Characteristics of Orthodontic Patients in Lagos, Nigeria: A Cross-sectional Study.
Simon Etim S, Umeh OD
Niger Med J · 2025 · PMID 41472994 · Full text
BACKGROUND: Orthodontic treatment for malocclusion is one of the costly dental treatments globally, leading to the general belief that it is mostly accessible to individuals in the high socioeconomic category (SEC) in Ni...
BACKGROUND: Orthodontic treatment for malocclusion is one of the costly dental treatments globally, leading to the general belief that it is mostly accessible to individuals in the high socioeconomic category (SEC) in Nigeria. This study aims to assess the socio-economic characteristics of Nigerian orthodontic patients. METHODOLOGY: This was a descriptive cross-sectional study, conducted in Lagos State, Nigeria, from March to August2025. The study sites were Lagos University Teaching Hospital and Hilton Dental Services, a major private orthodontic clinic in Lagos. Data was collected using a 15-item structured interviewer questionnaire, analyzed with SPSS version 26 statistical software using descriptive (frequency and percentage) and inferential (Fisher's exact test) statistics. The level of significance was set at p > 0.05. RESULT: A total of 309 respondents participated; 220 females and 89 males, with a mean age of 24.8 ± 10 years. Most, 217 (70.2%), were at the tertiary education level. The majority (197, 63.8%) fell into the high SE category, and rented apartments were the most common type of housing. Respondents from the high SEC agreed that SE status serves as a barrier to accessing orthodontic treatment. However, it was not a factor in choosing the treatment facility. Out-of-pocket payment was the most common method used for paying for orthodontic treatment. CONCLUSION: Socioeconomic status has a significant impact on access to orthodontic treatment, and most orthodontic patients belong to the higher socioeconomic category. Recommendation is the main reason for choosing a treatment facility.
Assessment of Peripheral Arterial Disease among Type 2 Diabetes Patients in Calabar, Nigeria.
Enang OE, Araga AN, Okpa HO … +1 more , Essien OE
Niger Med J · 2025 · PMID 41472993 · Full text
BACKGROUND: Peripheral Arterial Disease (PAD) is a significant complication among patients with Type 2 Diabetes Mellitus (T2DM), characterized by atherosclerosis that leads to reduced blood flow to the extremities. This...
BACKGROUND: Peripheral Arterial Disease (PAD) is a significant complication among patients with Type 2 Diabetes Mellitus (T2DM), characterized by atherosclerosis that leads to reduced blood flow to the extremities. This article assesses the traditional risk factors for PAD and the predictive value of the new inflammatory biomarkers like fibrinogen and C-reactive protein (CRP), and the implications of PAD in T2DM patients, drawing from recent studies and findings. The presence of PAD in T2DM patients poses serious health risks, including increased risk of foot ulcers, limb amputation, and cardiovascular events, necessitating comprehensive cardiovascular risk management. The study aims to assess the effectiveness of various diagnostic tests for PAD, particularly the Ankle-Brachial Index (ABI), in detecting PAD and stratifying cardiovascular risk in T2DM patients. METHODOLOGY: The study population comprises the recruitment of 112 Type 2 DM patients and an equal number and sex matched healthy participants as controls from three centres in Calabar, making a total of 224 participants. Socio-demographic information was collected. After physical examination and anthropometric measurements, the ABI was performed using a Doppler ultrasound device. Descriptive statistics were used to summarize clinical and demographic characteristics, and comparative analysis was done using chi-square for categorical variables and t-test for continuous variables. Logistic regression was used for independent risk factors associated with PAD. RESULTS: The median ages for the Type 2 DM patients and the controls were 58 years (IQR 10) and 58 years (IQR 11), respectively. The prevalence of PAD using ABI<0.9 in this study was 37.5% in people living with type 2 diabetes and 14.3% in controls. The prevalence of PAD for Type 2 DM patients and controls using symptoms of palpation of pedal pulsations and intermittent claudication was 17.0% vs 3.6% and 11.6% vs 2.7% respectively. There was a statistically significant relationship between advanced age, hypertension, duration of diabetes, glycaemic control, fibrinogen, as well as CRP, and PAD among people living with Type 2 diabetes. After multiple regression analysis, the predictors of PAD in this study were age, duration of Diabetes, and elevated serum CRP. There was no correlation between smoking, obesity, and lipid profiles with PAD. CONCLUSION: There is a high prevalence of peripheral artery disease among people with T2DM in Calabar. The use of ABI is of great value in the detection of PAD, as evidenced by a more objective assessment of PAD compared to intermittent claudication and reduced/absent pedal pulses. Routine screening of PLWDM for PAD using ABI would enhance early diagnosis and intervention.
Epidemiological Profile of Haemoglobinopathies in Different Districts of West Bengal: A Retrospective Study.
Dhar O, Sharma A, Bhaumik S … +1 more , Das AK
Niger Med J · 2025 · PMID 41472992 · Full text
BACKGROUND: Haemoglobinopathies are autosomal recessive inherited disorders affecting haemoglobin structure or production. Over 1,000 haemoglobin variants have been identified, with carriers often asymptomatic or exhibit...
BACKGROUND: Haemoglobinopathies are autosomal recessive inherited disorders affecting haemoglobin structure or production. Over 1,000 haemoglobin variants have been identified, with carriers often asymptomatic or exhibiting mild anaemia. When both parents are carriers, there is a 25% risk per pregnancy of having a child with a severe form of the disease. Our study aims to (i) describe the epidemiological profile of different haemoglobinopathies, (ii) evaluate the variety of haemoglobinopathies and carriers, and(iii) estimate the prevalence of haemoglobinopathies and carriers. METHODOLOGY: This retrospective cross-sectional study included 5,000 cases obtained from multiple screening camps organized by Ma Sarada Charitable Dispensary & Pathology Centre. All available high-performance liquid chromatography (HPLC) reports with corresponding patient clinical histories and complete blood count results were reviewed. Patients with a history of blood transfusion were excluded from the study to prevent alteration of hemoglobin profiles. Data was extracted and analysed to determine the prevalence and types of haemoglobinopathies in the study population. RESULT: Beta thalassemia carrier is the most common haemoglobinopathy (6.36%) detected in West Bengal, followed by HbE carrier. HbE disease, Hb E beta thalassemia, Hb S carrier, Hb S disease, and HPHF trait are the other haemoglobinopathies, also found in this study. Most of the patients are male (11.27%). Among the districts, Beta thalassemia carrier is mostly found in North 24 Parganas, and Hb E carrier is mostly found in South 24 Parganas. Other haemoglobinopathies are also mostly found in North 24 Parganas. CONCLUSION: This study highlights a significant prevalence of beta thalassemia and other hemoglobinopathies in the screened population, underscoring the urgent need for widespread screening programs to identify asymptomatic carriers. Early detection through high-performance liquid chromatography (HPLC) can facilitate timely genetic counseling and intervention, thereby helping to prevent disease transmission. Although HPLC interpretation demands specialized training, it remains a reliable and practical screening tool when performed promptly after blood collection to minimize diagnostic errors.
Metachronous Testicular Loss Following Testicular Torsion; A Pathology requiring a time dependent intervention: A Case Report and Review of the Literature.
Ozah E, Obasuyi JO
Niger Med J · 2025 · PMID 41472991 · Full text
Bilateral metachronous testicular torsion is rare, few cases are reported in the literature. A high clinical index of suspicion is required to avoid a delay in diagnosis and intervention on the part of the managing physi...
Bilateral metachronous testicular torsion is rare, few cases are reported in the literature. A high clinical index of suspicion is required to avoid a delay in diagnosis and intervention on the part of the managing physician and if necessary avoid delayed referral. It is also important to educate patients on the possibility of this condition and the need for timeous presentation at the hospital to avoid testicular loss. We present a case of a 24-year-old who presented 48 hours after sudden onset of left testicular pains after an initial delay of 24 hours at a private hospital, where he had analgesics and antibiotics. He previously had right orchidectomy 10 years ago for right testicular torsion and left orchidopexy, after an initial delay in presentation. Examination findings revealed an oedematous left hemiscrotum, tender with hard, indurated knotted mass and absent testis in right hemiscrotum. He immediately had scrotal exploration with findings of a gangrenous left testis with 540 degrees anticlockwise twist, he subsequently had orchidectomy. Post-operative recovery was uneventful. Hormonal parameters revealed hypergonadotrpic hypogonadism, 2weeks after surgery, he was placed on testosterone replacement therapy and counselled for immediate sperm banking. Bilateral testicular torsion is rare, it is important to emphasize to the patients that it can occur, despite orchidopexy, therefore the need to present early to avoid testicular loss and the challenges of hypogonadism and infertility. In the literature it is documented that use of non-absorbable sutures and more than two-point fixation may reduce risk of recurrent testicular torsion.
Glycemic control among People living with HIV and diabetes in Eastern Uganda: A cross-sectional study.
Okia D
Niger Med J · 2025 · PMID 41472990 · Full text
BACKGROUND: Poor glycemic control remains a significant Public Health problem among people living with HIV(PLWH) and diabetes in Africa and Uganda specifically. Dual diagnosis of HIV and diabetes is associated with high...
BACKGROUND: Poor glycemic control remains a significant Public Health problem among people living with HIV(PLWH) and diabetes in Africa and Uganda specifically. Dual diagnosis of HIV and diabetes is associated with high costs of management and poor prognosis. This study aimed to determine the baseline glycemic control of PLWH and diabetes and associated factors in Eastern Uganda. METHODOLOGY: This study employed quantitative methods along with a cross-sectional analytical study design. A total of 257 participants (ten didn't participate) from Mbale and Soroti Regional Referral Hospitals participated in this study from May 1 to July 30th, 2024. The sample size was determined using the modified Cochrane formula, and participants were selected using simple random sampling. An electronic questionnaire was used to collect socio-demographic and clinical data. An automated Finecare HbA1c analyser was used to determine the HbA1c levels of participants. The data was analysed using Stata version 15. Multivariable logistic regression analyses were conducted to identify associated factors. At p<0.05, statistical significance was established. RESULTS: The median age was 51(44, 60). The female participants comprised 152 (59.1%), and 52 (20.2%) of the total participants had a tertiary education. More than half, 136 (52.9%), had HbA1c above 7%. The age group above 50 years, having more than three children, and tertiary education were positively associated; however, only the tertiary level of education was statistically significant after adjusting for confounders, aPOR 3.9(95% CI:1.1-14.2), p=0.037. CONCLUSION: The prevalence of poor glycemic control among people living with HIV and diabetes at Mbale and Soroti Hospitals in Uganda is high at 52.90%. The age group above 50 years, having children and tertiary education were positively associated with poor glycemic control. Routine HbA1c testing and immediate evidence-based management by health workers are encouraged among clients over 50, those with children, and those with tertiary education.
Treatment Outcome of Patellar Fractures Across Two Tertiary Centers: A Five-Year Retrospective Study.
Diamond TE, Achor MT
Niger Med J · 2025 · PMID 41472989 · Full text
BACKGROUND: Fractures of the patella, though not so common, are prone to complications. Injuries to the patella often disrupts the extensor mechanism of the knee and increases the likelihood of patella-femoral joint inco...
BACKGROUND: Fractures of the patella, though not so common, are prone to complications. Injuries to the patella often disrupts the extensor mechanism of the knee and increases the likelihood of patella-femoral joint incongruence. The aim of this study was to determine the outcome of treatment of patella fracture in two tertiary health institutions in South-south Nigeria. METHODOLOGY: A retrospective descriptive study was conducted among patients who had patella fractures over a five-year period, using hospital records. The data obtained were analyzed and formed into tables, charts and figures. RESULTS: Thirty-nine patients were recruited into the study. Patella fractures were most predominant in the age bracket 31-40 years (30.8%), while the least was noted in the age group 61-70 years (5.1%). Road traffic accidents were the most common etiological factor (53.8%). Majority of the patients had transverse fractures (61.5%), while severely committed fractures constituted the least (2.6%). Four patients (10.3%) had open fractures. Majority of the patients had surgical treatment with tension band wiring (25 patients). The outcomes were good within the period of follow-up. CONCLUSION: The result showed that patella fractures are common in young population. Patients receive optimum care with good outcome in the two centers involved in this study.
Factors Leading to Delay in Surgical Treatment of Paediatric Congenital Heart Diseases in Rural Western India - A Hospital-Based Study.
Shah A, Bhalodiya P, Patel P … +3 more , Trivedi B, Tandon K, Bhende V
Niger Med J · 2025 · PMID 41472988 · Full text
BACKGROUND: Congenital heart diseases (CHD) account for 28% of birth defects in India. Treatment options and long-term outcomes have significantly improved over the past six decades. However, there is a notable delay in...
BACKGROUND: Congenital heart diseases (CHD) account for 28% of birth defects in India. Treatment options and long-term outcomes have significantly improved over the past six decades. However, there is a notable delay in diagnosing CHD and initiating treatment for diagnosed patients. This study seeks to identify factors influencing the treatment timing of CHDs in paediatric patients residing in rural areas of India. METHODOLOGY: Cross-sectional survey. The study uses descriptive statistics and chi-square tests for comparing categorical data between groups to identify factors contributing to delays. RESULTS: A total of 115 patients were enrolled. Ventricular septal defect was the most prevalent diagnosis (40 patients), followed by Tetralogy of Fallot (23 patients). 47 % of patients experienced delayed diagnosis, while 69% experienced delayed treatment. Notably, the severity of delayed treatment was more pronounced in acyanotic heart diseases compared to cyanotic heart diseases. Financial constraints were cited as the primary reason for delayed treatment in 27.8% of cases, while social factors were the most common reason for delayed treatment despite diagnosis in the remaining 72.2%. CONCLUSION: Despite substantial government financial support for treatment and diagnosis, further delays in treatment remain significant. Social factors, other than economic factors, appear to be the primary contributors to these delays. Sample size and in-hospital study limitations are acknowledged.
Immediate, 6-hours and 24-hours urethral catheter removal on urinary morbidity following elective caesarean delivery under spinal anaesthesia: A randomized comparative study.
Iheagwam RB, Awoyesuku PA, Amachree PT … +3 more , John DH, Jumbo AI, Orazulike NC
Niger Med J · 2025 · PMID 41472987 · Full text
BACKGROUND: Urethral catheterization is a common practice during caesarean delivery. Prolonged use may lead to urinarytract infection, the duration of catheterization being critical to its development. The optimal time f...
BACKGROUND: Urethral catheterization is a common practice during caesarean delivery. Prolonged use may lead to urinarytract infection, the duration of catheterization being critical to its development. The optimal time for its removal after caesarean delivery remains undecided. This study compared the effect of immediate, 6-hours and 24-hours removal postelective caesarean delivery on significant bacteriuria, re-catheterisation, interval to first micturition and maternal discomfort. METHODOLOGY: The study was conducted at a tertiary hospital in Port Harcourt, Nigeria. A total of 150 women who had elective caesarean delivery were randomised into 3 groups using computer-generated random sequence numbers. Group A - had the urethral catheter removed immediately, Group B - after 6 hours, and Group C - after 24 hours post-operation. The women were assessed for significant bacteriuria and need for re-catheterisation as the primary outcomes; interval to first micturition and maternal discomfort as the secondary outcomes. Data was analysed using IBM SPSS version 23. RESULTS: Overall incidence of significant bacteriuria was 12%. The difference in incidence was 0(0%), 6(12%), and 12(24%) for the Immediate, 6-hours and 24-hours groups respectively,(>0.001).Urinary retention requiring re-catheterization was also significant, highest in the Immediate group 8(14%), 2(4%) in the 6-hours group and none in the 24-hours group. The mean interval to first micturition was highest in the 6-hour group, least in the 24-hour group and intermediate in the Immediate group (9.52±6.26, 5.16±3.80, and 6.92±3.36, respectively<0.001). Most participants had mild discomfort, and the difference between groups was insignificant (=0.445). CONCLUSION: Immediate catheter removal had a lower risk of significant bacteriuria but increased urinary retention, while the 24-hour removal had reduced urinary retention but was fraught with significant bacteriuria. The 6-hour removal had a modest risk for both significant bacteriuria and urinary retention. The 6-hours removal offers a balance and should be a safer option.
'Publish or Perish!': perception and self-appraisal of Indian physicians on academic publications: A cross-sectional study.
Nath S, Mudgal SK, Narasimha VL … +1 more , Varshney S
Niger Med J · 2025 · PMID 41472986 · Full text
BACKGROUND: Research and academic publications are crucial for Indian physicians' professional growth, evidence generation, and academic advancement. It often contributes to the "publish or perish" culture. This study ai...
BACKGROUND: Research and academic publications are crucial for Indian physicians' professional growth, evidence generation, and academic advancement. It often contributes to the "publish or perish" culture. This study aims to assess Indian physicians' perceptions and self-appraisal on academic publications, for those practicing evidence-based medicine (EBM). METHODOLOGY: A cross-sectional online survey with proper consent was conducted over two months, targeting Indian physicians practicing EBM to evaluate their views on research and publications. RESULTS: A total of 320 physicians participated (mean age 41.15 ± 8.94 years; 68.8% male). Most held post-graduate degrees (73.4%) and worked in government-run institutions (56.6%). A large proportion (88.7%) had prior publications, with a preference for PubMed/Medline-indexed journals (40.0%). Sixty-five percent balanced clinical and academic roles. Physicians were motivated by career advancement (31.6%) and professional recognition (34.7%). Behavioral patterns showed "addiction-like" tendencies, with many frequently checking publication metrics and tracking manuscript progress. Physicians with post-graduate qualifications, particularly in medicine, were more engaged in these behaviors. Those in central government teaching institutions showed even greater engagement. CONCLUSION: This study reveals the complex dynamics of academic publishing among Indian physicians, highlighting the pressures of the "publish or perish" culture. Institutions should focus on fostering quality over quantity in publishing, providing mentorship, and promoting ethical practices to mitigate these pressures.
Assessment of Uptake of Cervical Pre-Cancer Screening among Women of Reproductive Age in Ogun State, Nigeria.
Adenaya OR, Odelola OI, Aderinwale OA … +5 more , Ewuoso BO, Badmus OM, Okusanya O, Ojo OO, Igbafa LO
Niger Med J · 2025 · PMID 41472985 · Full text
BACKGROUND: Cervical cancer is the second most common cancer in women in Nigeria and is largely preventable. However, in Nigeria, the absence of universal screening means individual awareness and knowledge significantly...
BACKGROUND: Cervical cancer is the second most common cancer in women in Nigeria and is largely preventable. However, in Nigeria, the absence of universal screening means individual awareness and knowledge significantly impact screening uptake. Previous studies have reported mixed results regarding awareness and screening rates.The study assessed cervical screening uptake rate among women of reproductive age. METHODOLOGY: It was a descriptive cross-sectional study among women of reproductive age across the three senatorial districts in Ogun State, Nigeria, using interviewer-administered questionnaires following ethical approval. Data analysis was performed using IBM SPSS version 25. The outcome variables included the level of awareness and knowledge of cervical cancer and its pre-malignant screening, as well as the level of uptake of cervical cancer. RESULTS: A total of 1310 women were interviewed, with 1233 responses analyzed. The mean age of the respondents was 32.33 ± 6.25 years. Of the respondents, 592 (48.0%) were aware of cervical cancer, 281 (22.8%) were aware of cervical screening, and 141 (11.4%) had good knowledge of cervical cancer. Eighty (6.49%) participants had been screened at least once, and only nine had been screened at least twice. The majority of the women, despite the poor awareness and knowledge levels, were willing to be screened in the future. There was a statistically significant association between cervical cancer awareness and uptake of screening (X = 9.282, df =1, P-value = 0.002). CONCLUSION: Awareness, knowledge, and screening uptake remain low among women in Ogun State. However, awareness of cervical cancer positively influences screening participation. Therefore, extensive awareness campaigns are recommended to improve screening rates and reduce cervical cancer prevalence.
A Diagnostic Conundrum: Amelanotic Vulvar Malignant Melanoma in a Postmenopausal Patient.
Bhankhodia V, Singh G, Patel T … +1 more , Goswami P
Niger Med J · 2025 · PMID 41472984 · Full text
Amelanotic vulvar malignant melanoma is an exceedingly rare and aggressive malignancy, accounting for only 2% of vulvar melanomas and presenting unique diagnostic challenges due to its lack of pigmentation. This report d...
Amelanotic vulvar malignant melanoma is an exceedingly rare and aggressive malignancy, accounting for only 2% of vulvar melanomas and presenting unique diagnostic challenges due to its lack of pigmentation. This report discusses the case of a 57-year-old postmenopausal woman who presented with a 2x2 cm greyish-white growth on the labia majora, accompanied by itching and burning for three months. Clinical examinations and routine investigations were inconclusive, necessitating a biopsy for definitive diagnosis. Histopathological analysis revealed nests of atypical cells exhibiting high-grade features, including a high nuclear-to-cytoplasmic ratio, vesicular chromatin, prominent eosinophilic nucleoli, and mitotic activity. The absence of melanin pigment complicated the diagnosis, requiring immunohistochemical confirmation with markers such as S100, Melan-A, and HMB45. Differential diagnoses, including poorly differentiated squamous cell carcinoma, neuroendocrine tumor, and adenocarcinoma, were meticulously excluded through morphological and immunohistochemical evaluation. This case underscores the critical importance of histopathological examination and immunohistochemistry in accurately diagnosing vulvar lesions, particularly in amelanotic variants, where clinical presentation can mimic other malignancies. Given the high metastatic potential and poor prognosis of vulvar melanoma, early recognition, accurate diagnosis, and prompt surgical intervention, including wide local excision and lymphatic dissection, are essential. This case highlights the need for heightened clinical suspicion and a multidisciplinary approach in managing rare vulvar malignancies to optimize patient outcomes.
Knowledge and Attitude of Pregnant Women on ABO and Rhesus Blood Grouping Towards Preventing Neonatal Hemolytic Disease at Rasheed Shekoni Federal University Teaching Hospital, Dutse, Jigawa State, Nigeria.
Sulaiman A, Abdullahi M
Niger Med J · 2025 · PMID 41472983 · Full text
BACKGROUND: Hemolytic Disease of the Fetus and Newborn (HDFN) is a significant neonatal condition resulting from ABO and Rhesus (Rh) blood group incompatibility between mother and fetus. Adequate knowledge and positive a...
BACKGROUND: Hemolytic Disease of the Fetus and Newborn (HDFN) is a significant neonatal condition resulting from ABO and Rhesus (Rh) blood group incompatibility between mother and fetus. Adequate knowledge and positive attitudes among pregnant women toward blood grouping can help prevent complications. This study assessed the Knowledge and Attitude of Pregnant Women on ABO and Rhesus Grouping towards Preventing Neonatal Hemolytic Disease at Rasheed Shekoni Federal University Teaching Hospital, Dutse, Jigawa state. METHODOLOGY: A descriptive cross-sectional study was conducted among 316 pregnant women receiving antenatal care at the hospital. A structured questionnaire was used to collect data on socio-demographic characteristics, knowledge of ABO and Rh blood grouping, and attitude toward their importance in preventing HDFN. Data were analyzed using descriptive and inferential statistics. RESULTS: The majorities of respondents (46.2%) were aged 26-30 years and most had at least a secondary education (57.2%). Awareness of ABO and Rh blood groups was high, with 70.3% of respondents knowing their blood group and Rh status. However, only 16.5% demonstrated good knowledge of HDFN, while 33.2% had poor knowledge. Awareness of preventive measures, including the anti-D immunoglobulin, was low (17.4%). Despite knowledge gaps, attitudes were positive, with 87.7% recognizing the importance of blood grouping in pregnancy, and 98.4% supporting public health campaigns on the topic. Age (p = 0.001), educational level (p = 0.001), occupation (p = 0.001), family income (p = 0.001) and number of pregnancies (p = 0.003) were significantly associated with knowledge levels. Attitude was also significantly associated with age (p = 0.003), educational level (p = 0.003) and family income (p = 0.024). CONCLUSION: While awareness of blood grouping was high, knowledge of HDFN and its preventive measures remained limited. Strengthening antenatal education and implementing targeted awareness programs are essential to improve understanding and ensure the effective prevention of HDFN.
Rare Presentations of Embryonal Rhabdomyosarcoma in the Middle Ear of a 3-Year-Old Boy and Girl.
Usman A, Shuaibu L, Dahiru A … +1 more , Adam S
Niger Med J · 2025 · PMID 41472982 · Full text
Embryonal rhabdomyosarcoma is a distinct subtype of rhabdomyosarcoma commonly seen in children less than 5 years of age, but it can appear at any age. It's frequently seen at the head and neck region, but rare sites incl...
Embryonal rhabdomyosarcoma is a distinct subtype of rhabdomyosarcoma commonly seen in children less than 5 years of age, but it can appear at any age. It's frequently seen at the head and neck region, but rare sites include the ear. It often presents with facial nerve palsy. We present two extraordinary cases of embryonal rhabdomyosarcoma in the middle ear in a 3-year-old boy and girl.
A complex presentation of complicated secondary syphilis with ulcerated lesion progression.
Ibrahim EA, Abbas H, Oisakede EO … +1 more , Walker N
Niger Med J · 2025 · PMID 41472981 · Full text
Secondary syphilis is commonly associated with well-known cutaneous and mucosal manifestations, including maculopapular rashes and condylomata lata. However, clinical presentation can vary significantly, often resembling...
Secondary syphilis is commonly associated with well-known cutaneous and mucosal manifestations, including maculopapular rashes and condylomata lata. However, clinical presentation can vary significantly, often resembling other dermatological or infectious conditions, which can lead to diagnostic delays and challenges, particularly in immunocompetent individuals. We report the case of a 26-year-old heterosexual Asian man working as a baggage handler at a busy international airport, who presented with a rapidly progressive, painful rash. Initially treated with flucloxacillin, his condition worsened, spreading to his face, trunk, and mucous membranes, accompanied by fever, tachycardia, and difficulty swallowing. Physical examination revealed widespread umbilicated vesicles, haemorrhagic blisters on his right lower leg, and ulcers in the oral cavity. Despite negative results for common viral infections (HSV, VZV, HIV) and autoimmune disorders, serological testing for syphilis revealed a positive rapid plasma regain test, confirmed by a positive treponemal antibody EIA test and subsequent clinical improvement with appropriate antibiotic therapy. Following the diagnosis of secondary syphilis, the patient was treated with benzathine penicillin and supportive care. He experienced a mild Jarisch-Herxheimer reaction, which resolved with monitoring. A subsequent infection of a fungating lesion (bacteria superimposition) on the right shin was managed with amoxicillin/clavulanic acid. By the patient's follow-up visit, the skin lesions had markedly improved, and he was discharged with ongoing care and penicillin treatment. This case highlights the importance of considering syphilis in the differential diagnosis of atypical cutaneous and mucosal lesions, especially when presenting with systemic symptoms. The diagnosis of secondary syphilis can be challenging due to its diverse clinical manifestations, which may mimic other infectious or autoimmune conditions. A careful diagnostic approach, including serological and polymerase chain reaction testing, is essential for accurate diagnosis and effective treatment. This case also emphasizes the need for timely public health intervention and education in high-risk populations.
Misconceptions about Ebola Virus Disease among Residents of Calabar, Cross River State, Nigeria: A Mixed-Method Approach.
Bisong EM, Ayuk AE, Asibong IU … +3 more , Asibong UE, Okokon IB, Monjok E
Niger Med J · 2025 · PMID 41472980 · Full text
BACKGROUND: The Ebola Virus Disease (EVD) has a high risk of death killing an average of about 50% of those infected. Several outbreaks have occurred intermittently since the disease was first described. The 2014 outbrea...
BACKGROUND: The Ebola Virus Disease (EVD) has a high risk of death killing an average of about 50% of those infected. Several outbreaks have occurred intermittently since the disease was first described. The 2014 outbreak was the largest and most complex in recorded history. Rumours were rife especially through social media that a salt ritual amongst other unverified claims could prevent or cure EVD. This study aimed to determine the knowledge, perception and practices to prevent EVD in Calabar and to highlight the role of social media in health seeking behaviours. METHODOLOGY: This was a mixed method study, a combination of cross-sectional design and Focused Group Discussion conducted between November 2016 and June 2017. RESULTS: Ninety-three percent (93%) of the respondents had heard about EVD with the radio (82%) being the dominant source of information. Virus as the causative agent and contact with body fluids as the most common mode of transmission were correctly identified by 72%. Fever ranked as the most common symptom by 75% and washing of hands (60%) was perceived as the most common way to prevent EVD. Sixty-three percent (63%) responded that salt is used to cure EVD,57% participated in the salt ritual and 85% of those who partook in the salt ritual later realized it did not cure or prevent EVD. CONCLUSION: People should be encouraged to seek health related information from the appropriate sources. Effective and sustained communication strategies are advocated to mitigate rumour mongering and misinformation to curb unhealthy practices.
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