Nigerian Medical Journal[JOURNAL]
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200 papers
Patient-Related and Health System Factors, and Experiences of Women with a History of Stillbirth in Port-Harcourt.
Awoyesuku PA, Ohaka C, Kua PL … +3 more , Okagua KE, Lebara LB, Ndii LD
Niger Med J · 2024 · PMID 39877501 · Full text
BACKGROUND: Nigeria makes a substantial contribution to the global burden of stillbirths. However, data on women's experiences and care received at the time of stillbirth are limited. This study aimed to investigate the...
BACKGROUND: Nigeria makes a substantial contribution to the global burden of stillbirths. However, data on women's experiences and care received at the time of stillbirth are limited. This study aimed to investigate the experiences and patient-related and health system factors in women who had a stillbirth in a previous pregnancy in the past 15 years. METHODOLOGY: This was a cross-sectional survey of 64 pregnant women, attending antenatal care in Port-Harcourt, who had stillbirth in a previous pregnancy. Consenting participants were interviewed using a predesigned and pretested questionnaire. Information on sociodemographic characteristics, pregnancy history including health-seeking behaviour in the stillbirth pregnancy, and women's experiences and appraisal of care provided by healthcare workers during the stillbirth event, were collected. Data was analysed using descriptive statistics and presented as numbers, Means and Percentages in tables. RESULTS: Most participants (92.2%) experienced one stillbirth. The majority (71.9%) had stillbirths at 9 months gestation. Almost all pregnancies (98.4%) were singleton, and most mothers (81.3%) reported attending antenatal care regularly. The majority of deliveries (89.1%) occurred in healthcare facilities. Post-stillbirth, 45.3% of the mothers stayed in an open postnatal ward, 56.3% saw their stillborn child, with 39.1% of them not seeing the baby at all, and only 4.69% saw and held their dead baby. Over half (56.3%) found healthcare workers supportive and satisfied with their role, but (45.3%) did not receive postnatal care or counselling. Concerning performing an autopsy, 60.9% would not have requested one. CONCLUSION: Most stillbirths were term pregnancies, occurred intrapartum, and were in-facility deliveries. Delays in reporting complications and receiving care at the hospital contributed to the stillbirths. A good proportion of the women were not shown and did not hold their babies and were admitted to a standard postnatal ward following delivery, factors which are predictive of increased psychological morbidity. However, most women were satisfied with the care and support they received from healthcare workers during the delivery.
Probable Case of Cutaneous Anthrax with Toxic Manifestations and Fatality seen in an adolescent in Sokoto, Nigeria: A postmortem review.
Isezuo KO, Sani UM, Waziri UM … +7 more , Zaiyanu SA, Folorunsho A, Shehu S, Akpelu HE, Amodu-Sanni M, Aliyu ND, Mohammed Y
Niger Med J · 2024 · PMID 39877500 · Full text
BACKGROUND: Anthrax is a life-threatening zoonotic disease caused by Gram-positive, spore-forming bacterium . It manifests as a cutaneous, gastrointestinal, and respiratory disease. The cutaneous form ranges from a self-...
BACKGROUND: Anthrax is a life-threatening zoonotic disease caused by Gram-positive, spore-forming bacterium . It manifests as a cutaneous, gastrointestinal, and respiratory disease. The cutaneous form ranges from a self-limiting lesion to severe edematous lesions with toxemic shock. Of recent, increasing cases of anthrax have been reported in Nigeria warranting heightened surveillance. A patient with skin lesions suggestive of cutaneous anthrax and toxic manifestations is reviewed to emphasize the need for a high index of suspicion. CASE REPORT: A 14-year-old boy presented with skin lesions of one month involving the hands, face, and legs, left lower limb swelling of two weeks, fever of 10 days, and fast breathing of five days duration. There was a positive history of contact with cattle carcasses at the abattoir. He was febrile (38.1c), mildly pale, and mildly dehydrated, oxygen saturation was 95%. He was tachypnoeic and tachycardic with a low-volume pulse. There was extensive left lower limb swelling, a raised necrotic ulcer with a black surface on the calf, measuring 9cmx5cm with serosanguinous discharge, and another confluent vesicular lesion on the anterolateral aspect of the left leg measuring 8cmx6cm. Differential diagnoses considered were cellulitis, osteomyelitis, leishmaniasis, and malignancy. RESULT TREATMENT & OUTCOME: His packed cell volume was 33%, retroviral screening, and hepatitis screening were nonreactive, and erythrocyte sedimentation rate was 3mm/hr. Leg X-ray was normal. Other investigations could not be done due to financial constraints and the patient's demise. He received intravenous (IV) fluid, IV ceftriaxone, IV metronidazole, tetanus toxoid, and antiseptic wound dressing. He succumbed to the illness 72 hours later. Anthrax was considered after the patient's demise due to the type of skin lesion and progression of the illness in line with the standard case definition. CONCLUSION: Cutaneous anthrax with systemic manifestations should be considered as a probable diagnosis in patients with typical skin lesions and toxic features.
A study to compare and correlate the effect of a yogic lifestyle on Framingham, Q RISK 3, and WHO risk scores among high-risk cardiovascular subjects.
Saboo N, Rao A, Kacker S
Niger Med J · 2024 · PMID 39877499 · Full text
BACKGROUND: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. Yoga is a low-cost, easily accessible lifestyle modification program that holds as an approach to decreasing cardiometab...
BACKGROUND: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. Yoga is a low-cost, easily accessible lifestyle modification program that holds as an approach to decreasing cardiometabolic risk factors and increasing exercise self-efficacy among high-risk subjects. This study aimed to assess the impact of the yogic lifestyle (including diet) on cardiovascular risk scores by using the Framingham (FRS), QRISK3 score, and World Health Organization (WHO) CVD risk prediction charts at baseline, three months, and six months. The present study compares and correlates FRS, QRISK3, and WHO cardiovascular risk scores. METHODOLOGY: The experimental interventional study was conducted among the high-risk population at RUHS College of Medical Sciences and Associated Group of Hospitals, Jaipur. Framingham risk Score, QRISK3 score, and WHO CVD risk prediction charts were used as a method of measurement for the outcome of interest at baseline, three months, and six months in the study and control group. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The statistical analysis was done using advanced SPSS-22 software at significant level tests as p≤0.05, ensuring the highest level of accuracy. Data were analyzed using a one-way variance ANOVA test analysis at baseline, three, and six months. Pearson correlation analysis was done to compare different risk scores. RESULTS: Participants had a mean age of 48.43 ± 6.4 years. Baseline values (mean±SD) of FRS, Qrisk3, WHO were 24.59±10.15,28.59±10.11,15.71±6.07. After six months of yogic lifestyle, these values decreased significantly to 15.1±7.05, 20.09±7.08, and 13.85±4.96. The decrease in cardiovascular scores was statistically significant (p<0.0001), providing strong evidence for the effectiveness of the yogic lifestyle. Pearson correlation analysis results depict that FRS and Q risk 3 (r=0.840, p<0.0001), FRS and WHO risk chart (r=0.768, p<0.0001), Q risk3 and WHO risk chart (r=0.778, p<0.0001) have a statistically significant strong positive correlation. CONCLUSION: This study's findings suggest that a 24-week yogic lifestyle intervention (including diet) significantly decreased FRS, Q RISK 3, and WHO CVD risk scores among high-risk subjects compared to the control group.
Haemolytic anemia in a patient of Chronic myeloid leukemia: an unrecognized side-effect of Hydroxyurea?
Jamal I, Smita S, Choudhary V
Niger Med J · 2024 · PMID 39877498 · Full text
Hydroxyurea (HU) is frequently used in the treatment of various myeloproliferative neoplasms (MPN) where it reduces cell proliferation by impairing DNA synthesis leading to decreased hematopoiesis. Herein we report a cas...
Hydroxyurea (HU) is frequently used in the treatment of various myeloproliferative neoplasms (MPN) where it reduces cell proliferation by impairing DNA synthesis leading to decreased hematopoiesis. Herein we report a case of a 65-year-old female who was diagnosed with Chronic myeloid leukemia and developed severe hemolytic anemia requiring multiple packed red blood cell (RBC) transfusions while being treated with hydroxyurea. The haemolysis persisted until discontinuation of the drug. Common side-effects of HU like macrocytic anemia, leucopenia, and thrombocytopenia are well known but hemolytic anemia is a rare side-effect, not well known with only a handful of cases being described in the scientific literature so far.
A Rare Case of Poorly Differentiated Neuroendocrine Carcinoma of the Descending Colon with Regional Lymph Node Involvement Presenting in a Young Adult Nigerian Male: A Case Report.
IfeanyiNwadiokwu J, Okebalama VC, Olayemi RA … +7 more , Omokore OA, Joe-Ikechebelu BB, Duru HO, Nwudele U, Okoawoh AI, Sunday O, Manzoor A
Niger Med J · 2024 · PMID 39877497 · Full text
Malignant colonic neuroendocrine tumours are rare. Even more uncommon is their occurrence in the left colon. They also infrequently occur in males and young adults. We describe a rare case of poorly differentiated neuroe...
Malignant colonic neuroendocrine tumours are rare. Even more uncommon is their occurrence in the left colon. They also infrequently occur in males and young adults. We describe a rare case of poorly differentiated neuroendocrine carcinoma of the descending colon in a 32-year-old male who presented with signs of intestinal obstruction. He later had exploratory laparotomy and tumour resection with 5 cm gross tumour margins and Hartman-type colostomy and completed six cycles of Etoposide and Carboplatin combination. He has been tumour- and symptom-free for 36 months. Even though rare, neuroendocrine tumours should be an important differential of all colonic tumours, irrespective of the patient's age and sex, and surgeons should have a high index of suspicion for them. Although they most commonly occur in the right colon (cecum), they can also be found in the descending colon, where they can present with intestinal obstruction. Tumour resection with 5 cm gross tumour margins and Hartman-type colostomy can be handy. Etoposide and Carboplatin combination can improve overall survival in complicated World Health Organization (WHO) stage 3 neuroendocrine carcinoma with regional lymph node involvement, and generally poor prognosis, but without evidence of distant metastasis, and relatively fair performance index. Younger patients with neuroendocrine carcinomas may benefit better from platinum-based chemotherapy.
Otorhinological disorders among pregnant women attending the obstetric clinic at Benjamin Mkapa Hospital, Tanzania.
Abraham ZS, Rweyemamu A, Kahinga AA
Niger Med J · 2024 · PMID 39877496 · Full text
BACKGROUND: Pregnancy leads to physiological changes primarily driven by hormones like oestrogen and progesterone. Such changes are multi-systemic in nature including involvement of the ear, nose and throat. Such changes...
BACKGROUND: Pregnancy leads to physiological changes primarily driven by hormones like oestrogen and progesterone. Such changes are multi-systemic in nature including involvement of the ear, nose and throat. Such changes impair the quality of the life of pregnant women and thus requires prompt intervention during pregnancy. This study aimed to determine otorhinological disorders among pregnant women attending obstetric clinic at Benjamin Mkapa Hospital. METHODOLOGY: A hospital-based descriptive cross-sectional study was conducted at Benjamin Mkapa Hospital from June to August 2023. A total of 246 pregnant women were recruited after consenting where data on their age, gestational age, and otological and rhinological disorders were obtained. Otoscopic and rhinoscopic examination were done and recorded in the data collection sheet. Data was analysed using a Statistical Package for Social Sciences (SPSS) version 23. A p-value<0.05 was statistically significant. RESULTS: This study recruited 246 pregnant women with majority 135(52.8%) in the 3 trimester. Pertaining otological disorders manifested by pregnant women, majority 39(15.9%) of them presented with hearing loss/reduced hearing ability, and conductive hearing loss was the most common type, 19(48.7%). Regarding rhinological disorders, 47(19.1%) pregnant women had allergic rhinitis and most of them presented with nasal obstruction 41(87.2%), nasal bleeding 12(25.5%) and pale pinkish inferior turbinate,3(6.4%). Eighty (32.7%) pregnant women had olfactory disturbance whereby most of them had reduced sense of smell 41(51.3%). The association between otorhinological disorders and gestational age was significant for only allergic rhinitis and olfactory disturbance (p-value<0.05). CONCLUSION: The study concludes that otorhinological disorders are common among pregnant women, with a significant number experiencing hearing loss, allergic rhinitis, and olfactory disturbances. Specifically, allergic rhinitis and olfactory disturbances are significantly associated with the trimesters of pregnancy, while other disorders like hearing loss, Bell's palsy, otitis externa, and sinusitis do not show a significant association with the pregnancy trimesters. This highlights the need for prompt intervention to manage these conditions and improve the quality of life for pregnant women.
The Hypertriglyceridemic Waist Phenotype is Associated with an Adverse Cardiometabolic Profile in this Cohort of Nigerians.
Okorafor UC, Okorafor CI, Amadi CE
Niger Med J · 2024 · PMID 39877495 · Full text
BACKGROUND: The hypertriglyceridemic waist (HTGW) phenotype was introduced as a means of identifying individuals at risk of developing metabolic syndrome as well as cardiovascular diseases and diabetes. However, studies...
BACKGROUND: The hypertriglyceridemic waist (HTGW) phenotype was introduced as a means of identifying individuals at risk of developing metabolic syndrome as well as cardiovascular diseases and diabetes. However, studies surrounding the prevalence of the phenotype and its relationship with established markers of cardiometabolic risk, especially in the Nigerian population, remain sparse. This study aimed to determine the prevalence of the HTGW phenotype and explore its relationship with cardiovascular risk markers, namely Castelli Risk Indices I and II (CRI-I and CRI-II), Atherogenic Index of Plasma (AIP) and serum triglyceride-HDL cholesterol ratio (TG/HDL). METHODOLOGY: In this retrospective cross-sectional study, the records of 206 patients presenting at a cardiac hospital from November 2022 to October 2023 were analysed. The HTGW phenotype was deemed present with a waist circumference of at least 94cm in men or 80cm in women and a serum triglyceride level of 150mg/dl or more in both sexes. RESULTS: At-risk waist circumference was more prevalent in women (92.7% vs 77.3%; p=0.002). The prevalence of the HTWG phenotype in the patient cohort was 29.6%, with more males than females (31.8% vs 27.1%) presenting with the phenotype (p=0.004). Patients with the phenotype also had higher systolic blood pressure, waist circumference, body mass index, triglycerides, AIP, and TG/HDL (all p<0.0005). The HTWG phenotype was also associated with a lower HDL and LDL cholesterol (p<0.0005) as well as a lower CRI-II (p=0.049). CONCLUSION: The HTWG phenotype correlates with an increased cardiometabolic risk among Nigerians. This finding warrants the implementation of routine anthropometric and serum triglyceride measurements in screening programmes and hospitals for the early detection of individuals at risk of developing cardiovascular diseases.
Factors Associated with the Place of Delivery among Women in Ogun East Senatorial District Nigeria: A Rural-Urban Comparative Cross-Sectional Study.
Adefala NO, Omotosho AY, Osinaike AO
Niger Med J · 2024 · PMID 39877494 · Full text
BACKGROUND: Choosing the appropriate place for delivery has a significant impact on the outcome of labour and childbirth. This study aimed to identify the factors associated with the place of delivery among women in Ogun...
BACKGROUND: Choosing the appropriate place for delivery has a significant impact on the outcome of labour and childbirth. This study aimed to identify the factors associated with the place of delivery among women in Ogun East senatorial district, Nigeria. METHODOLOGY: Using a multistage sampling technique, a comparative cross-sectional study was conducted among 375 women in Ogun East Senatorial District. An interviewer-administered, structured questionnaire was used. Data were analyzed using IBM SPSS version 22.0. Statistical significance was set at p<0.05. Relevant descriptive and inferential statistics were calculated. Results were presented in frequency tables. RESULTS: More urban respondents (n=296, 78.9%) utilized health facilities as a place of delivery during their last pregnancy than rural respondents (n=288, 76.8%). The factors associated with the place of delivery included marital status, educational status, cost of health service, and proximity to the health facility. CONCLUSION: The findings underscore the need for public health policies that improve rural access to affordable and nearby maternal health services, which could enhance facility-based deliveries and reduce maternal and neonatal risks.
Hypophosphatemia in pregnancy: A case report.
Dogra PM, Bhavna B, Kaundal A … +2 more , Malik N, Kaushal S
Niger Med J · 2024 · PMID 39877493 · Full text
Autosomal hypophosphatemic rickets though a rare genetic disorder can lead to significant discomfort to the patient resulting in clinical deterioration and a poor quality of life. We describe a case of a 33-year-old woma...
Autosomal hypophosphatemic rickets though a rare genetic disorder can lead to significant discomfort to the patient resulting in clinical deterioration and a poor quality of life. We describe a case of a 33-year-old woman G2P1001 at 6 weeks of gestation with complaints of myalgia and bony pains. Keeping her history of bony pains and fractures in mind, she was further evaluated. On evaluation, she was found to have low levels of phosphates 0.99 mg/dl (2.40-4.40) and high levels of fibroblast growth factor 23 (FGF 23) 231.70pg/ml (23.20-95.40). These biochemical parameters were suggestive of hypophosphatemic rickets and further on gene sequencing she was found to have autosomal dominant hypophosphatemic rickets (HR). During her follow-up visits, her checkup and antenatal investigations were normal. Pregnancy acts as a stressor and patients with asymptomatic ADHR may present during pregnancy for the first time with the symptoms of HR. So, a high index of suspicion is required for patients reporting musculoskeletal pains in pregnancy. Early diagnosis can help the mother have a better pregnancy experience. Phosphate and vitamin D supplementation during pregnancy can help these women reduce musculoskeletal pain symptoms. Unfortunately, this patient had a spontaneous abortion in the second trimester. The overall prevalence of ADHR is less than 1 per 1,00,000 live births. Data in pregnancy with ADHR is also minimal due to the condition's rarity. Hence, more and more studies are required in pregnancy with this disease to come to any conclusion and to find any association of ADHR with pregnancy outcomes. Genetic counselling and the need for testing in newborns if symptomatic is also an essential factor to remember when coming across such antenatal patients.
The variability in pattern, presentation, and outcomes in the management of congenital corrected transposition of the great artery (ccTGA): A Systematic Review and Meta-analysis.
Chinawa JM, Chinawa T AT, Uwaezuoke NA … +1 more , Igoche PD
Niger Med J · 2024 · PMID 39877492 · Full text
BACKGROUND: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease with varying regional reports in management approach. The meta-analysis is aimed to document various regio...
BACKGROUND: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease with varying regional reports in management approach. The meta-analysis is aimed to document various regional differences in the pattern, presentation, and outcomes in the management of congenitally corrected transposition of the great artery(ccTGA). METHODOLOGY: Search engines for published articles on ccTGA were used in the meta-analysis. This includes PubMed, Google Scholar, Web of Science, Medline, and Africa journal online. Articles published between 2001 and 2024 were recruited of which the last search was done in August 2024. Selected articles were highlighted and screened by means of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Statistical heterogeneity was assessed with the statistics. RESULTS: Fifty-one full articles were screened from the initial four hundred and eighty citations. A total of 37 studies were further excluded from the 51 studies after further screening for incomplete data, case reports, non-English language reportage, and studies from autopsy findings. The resultant 14 studies were presented in PRISMA. The statistical significance was observed as evidenced by the significance heterogeneity identified in the selected studies. CONCLUSION: The review had shown that children with ccTGA presented with varying features with some chromosomal correlates. Management options are directed towards a high index of suspicion, early intervention, and prompt surgical care to avert the numerous complications that follow the disease.
Validation of Siriraj Stroke Scoring System in the Clinical Differentiation of Stroke Sub-types in a resource-limited Setting.
Amin HH, Umar FK
Niger Med J · 2024 · PMID 39877491 · Full text
BACKGROUND: Stroke remains one of the major non-communicable public health disease conditions with resultant high morbidity and mortality. Neuroimaging in the form of Computed Tomography (CT) or Magnetic Resonance Imagin...
BACKGROUND: Stroke remains one of the major non-communicable public health disease conditions with resultant high morbidity and mortality. Neuroimaging in the form of Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) is adjudged to be the most reliable and efficient method of accurately diagnosing stroke and ruling out differentials. However, in view of cost implication and non-availability, a clinical scoring system known as the Siriraj Stroke Score (SSS) was developed to clinically differentiate stroke types, especially in resource-limited settings. This study sought to validate and determine the role of Siriraj stroke score in the clinical evaluation of patients presenting with acute stroke. METHODOLOGY: This is a descriptive prospective study that was conducted over a one-year period. The study populations were adult patients presenting with acute stroke in a tertiary health facility in North-Western Nigeria. Clinical details with neuroimaging in the form of a CT scan were obtained. Data obtained was analyzed using Stata 15. RESULTS: Fifty-four percent (54%) of patients enrolled were males and ischaemic stroke is the commonest stroke subtype present in 69% of patients studied. Altered levels of consciousness, headache and vomiting are important discriminatory variables of the scoring system. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy of Siriraj Stroke Score for haemorrhagic stroke is 92%, 72%, 62%, 95% and 62% respectively. CONCLUSION: Siriraj Stroke Score with sensitivity greater than 90% is reliable in differentiating the stroke sub-types; the patients in the 'grey zone' will however require neuroimaging.
Gestational Diabetes Mellitus and Feto-Maternal Outcomes in Federal Medical Centre, Yenagoa, Bayelsa State-A Comparative Study of Two Diagnostic Criteria.
Dambo ND, Jeremiah I, Omietimi JE … +3 more , Oyeyemi N, Kasia BE, Finomo FO
Niger Med J · 2024 · PMID 39877490 · Full text
BACKGROUND: The prevalence of gestational diabetes mellitus (GDM) is dependent on the diagnostic criteria used and there is no consensus on screening methods and diagnostic criteria. The International Association for Dia...
BACKGROUND: The prevalence of gestational diabetes mellitus (GDM) is dependent on the diagnostic criteria used and there is no consensus on screening methods and diagnostic criteria. The International Association for Diabetes in Pregnancy Study Group (IADPSG) recently put forward new diagnostic criteria and encourages its adoption worldwide. The aim of this study was to determine the incidence of GDM and to compare the foeto-maternal outcomes of women diagnosed with GDM in the Federal Medical Centre, Yenagoa using the WHO 1999 and IADPSG criteria. METHODOLOGY: This was a cohort study of 340 women who were booked for antenatal care at the Federal Medical Centre, Yenagoa. Women who gave consent to participate in this study took part in a 75-gram, 2-hour oral glucose tolerance test (OGTT). The diagnosis of GDM was sought in each participant using both the WHO 1999 and the IADPSG criteria. The incidence and the foeto-maternal outcomes in women diagnosed with GDM using different criteria were compared. RESULTS: The incidence of GDM was 5.3% in the IADPSG (case) group and 3.8% in the WHO (control) group. This difference was not statistically significant (p = 0.18). There was no significant difference between the groups for foetal and maternal outcomes that were assessed. Maternal outcomes were pre-eclampsia (p = 0.48), polyhydramnios (p = 0.31), insulin therapy (p = 0.35), caesarean section (p = 0.28), genital tract laceration (p = 0.18) and instrumental vaginal delivery (p = 0.34). Foetal outcomes were birth weight ≥ 4kg (p = 0.07), neonatal jaundice (p = 0.38), hypoglycaemia (p = 0.46), birth injuries (p = 0.42) and shoulder dystocia (p = 0.23). CONCLUSION: The application of the IADPSG criteria in our environment may lead to an increase in the number of women being managed for GDM without any appreciable improvement in foetal and maternal outcomes.
Factors Associated with Microalbuminuria among Children with Sickle Cell Disease in a Tertiary Centre in South-South Nigeria.
Briggs DC, Okechukwu C, Apollus J … +4 more , Amadi I, Omunakwe H, Dublin-Green LA, Okoh D
Niger Med J · 2024 · PMID 39877489 · Full text
BACKGROUND: Microalbuminuria, an early indicator of kidney damage in Sickle Cell Disease (SCD) patients, is linked to a heightened risk of chronic kidney disease (CKD) in adulthood. This study investigates the determinan...
BACKGROUND: Microalbuminuria, an early indicator of kidney damage in Sickle Cell Disease (SCD) patients, is linked to a heightened risk of chronic kidney disease (CKD) in adulthood. This study investigates the determinants of microalbuminuria in paediatric SCD patients in South-South Nigeria. METHODOLOGY: This cross-sectional study was conducted over six months at the Rivers State University Teaching Hospital, Nigeria, involving 60 children with [HbSS genotype, SCD] in a steady state. Data collection included demographics, past medical history, clinical measurements, and laboratory assessments of urine and blood samples. 'Steady state' was defined as SCD with a known 'steady state' haemoglobin level and stable clinical state for ≥ 3 months. Microalbuminuria was defined spot urine albumin-creatinine ratio of 30mg/g to <300 mg/g. RESULTS: Of the 60 children recruited, 31 children (51.7%) were males. The mean age was 9.6 ± 4.3 years. The prevalence of microalbuminuria was 16.7% (CI: 8.29 - 28.5%) and associated risk factors were hypertension (p = 0.017), use of Hydroxyurea (p = 0.008), and Ciklavit (p = 0.025), but not NSAIDs (p = 0.046). There was a significant negative correlation (ɼ = -0.28; p = 0.032) between haemoglobin level and microalbuminuria. CONCLUSION: This study provides insights into the factors associated with microalbuminuria in children with SCD in our setting and highlights the need for early screening for markers of CKD among children with SCD. Further research is needed to ascertain the potential benefits of addressing anaemia and reducing haemolysis in mitigating the occurrence of microalbuminuria among children with SCD.
Perception of Learning Environment Among Undergraduate Medical Students at University of Jos Using Johns Hopkins Learning Environment Scale.
Adamgbe MA, Okpanachi JA, Inalegwu AJ … +12 more , Firima E, Bakwa ND, Gani SA, Dung DS, Bature EY, Imade VI, Anuligo GI, Alapa GE, Dafong AA, Agbatse IJ, Ojile JI, Okoye CI
Niger Med J · 2024 · PMID 39877488 · Full text
BACKGROUND: The learning environment (LE) plays a crucial role in the performance and training of medical students. Different tools have been used to assess the LE with various conclusions. However, the John Hopkins Lear...
BACKGROUND: The learning environment (LE) plays a crucial role in the performance and training of medical students. Different tools have been used to assess the LE with various conclusions. However, the John Hopkins Learning Environment Scale (JHLES) which is a relatively newer scale is more specific, less cumbersome to administer, and has a wider scope. The study aims to assess the perception of the LE of undergraduate medical students in a Nigerian institution using the JHLES. METHODOLOGY: This was a cross-sectional study carried out on clinical medical students of the College of Health Sciences, University of Jos. A self-administered questionnaire containing socio-demographic data and the 28 JHLES questions was used. Data was analysed using SPSS version 25.0. The Overall mean JHLES Score was obtained by calculating the average of the JHLES scores attained by all participants. RESULTS: A total of 400 clinical medical students were enrolled and a mean JHLES Score of 77.90 (±14.03) was obtained. The males were found to have statistically significantly higher mean JHLES scores than the females, particularly in the domain of Faculty relationships, Academic climate, and Mentoring. The domain of "community of peers" had the highest ratings while "mentoring" and "meaningful engagement" recorded the least scores. CONCLUSION: The clinical medical students had a fair perception of their LE. The areas of strength should be encouraged while faculty may enact programs that will improve the domains with low scores to ultimately make better the learning environment and training of these future doctors.
Fallopian Tube Papilloma: A Systematic Review of Case Reports.
Kaundal A, Kaur G, Renjhen P … +2 more , Parsad S, Sharma S
Niger Med J · 2024 · PMID 39877487 · Full text
Fallopian tube papilloma (FTP) is one of the benign lesions of the oviduct and is a rare proliferative epithelial lesion. Low incidence and underreporting of the disease limit our knowledge of these lesions. These lesion...
Fallopian tube papilloma (FTP) is one of the benign lesions of the oviduct and is a rare proliferative epithelial lesion. Low incidence and underreporting of the disease limit our knowledge of these lesions. These lesions cause a diagnostic dilemma and need to be differentiated from several other conditions of the fallopian tubes both benign and malignant. Fallopian tube papilloma may lead to tubal obstruction and can be a cause of subfertility, ectopic gestation, or mass lesions in the fallopian tubes and hence should be considered as an important differential while managing these women. A high index of suspicion is required, and the final diagnosis can only be made after histopathological results. The reporting of such lesions is important to know the true prevalence of these tumors and to increase our knowledge about these benign neoplasms. This systematic review of case reports was done to enhance knowledge regarding the etiology, natural course, complication, and recurrence of FTP. An electronic search of Scopus, Pubmed, Embase, Web of Science, Google Scholar, and other databases was conducted for case reports and case series published in English from inception till January 2024.
Prevalence and Pattern of Obstructive Sleep Apnea among Undergraduate Students in Tertiary Institutions, Kwara State, Nigeria.
WuraolaAlatishe-Muhammad B, Ige ET, Fatoye J … +7 more , Shittu R, Adefila BC, Oyekunle O, Akanji MA, Lawal A, Bakare ZA, Bolarinwa OA
Niger Med J · 2024 · PMID 39877486 · Full text
BACKGROUND: Sleep is a very important physiologic process which is necessary to maintain a state of well-being. Obstructive Sleep Apnea (OSA) is prevalent among all age groups with variations in presentation and severity...
BACKGROUND: Sleep is a very important physiologic process which is necessary to maintain a state of well-being. Obstructive Sleep Apnea (OSA) is prevalent among all age groups with variations in presentation and severity. It is often underreported, especially among young people in the Low- and Middle-Income Countries LMICs. This study assessed the prevalence and pattern of OSA among undergraduates enrolled at tertiary Institutions in Kwara State, Nigeria using both Epworth and Stop Bang tools. METHODOLOGY: A campus-based study conducted among undergraduate students in Kwara state. Respondents were selected from three tertiary institutions. A total of 1,048 eligible students were selected using a multistage sampling technique. Epworth Sleepiness Scale (ESS) and Stop Bang Questionnaire (SBQ) were adapted and administered. Both descriptive and inferential analyses were conducted. The level of significance was set at a p-value of <0.05 at 95% confidence interval. Ethical approval was obtained. RESULTS: The mean age of respondents was 21± 2.69. More than half 634 (60.5%) of the 1048 respondents were females, with 20 (1.9%) were married. Abnormal sleepiness was reported in 151 (14.41%) while 897 (85.59%) had normal sleepiness using ESS. With the SBQ, 998 (95.2%) had a low risk while 46 (4.3%) had a moderate to high risk of OSA. Religion, increasing levels of study, and presence of chronic disease, were significantly associated with abnormal sleepiness using ESS, whereas female gender, religion, presence of chronic disease, smoking, use of sedatives and caffeine were significantly associated with OSA using SBQ. CONCLUSION: The prevalence and pattern of sleep disorder among the undergraduates showed a moderate prevalence of sleep disorder and associated risks of OSA using the sleep disorder tools. There is a tendency to become a big burden with an increase in age, therefore health promotion interventions are recommended early to students to create awareness of OSA risks.
Demographic and Clinical Characteristics of Benign Laryngeal Lesions: Insights from a Decade of Experience in a Tertiary Hospital.
Shofoluwe NA, Lawal J, Quadri OR … +6 more , Hamza MA, Abdullahi AM, Yahaya ST, Sanni R, Zubair S, Jimoh ML
Niger Med J · 2024 · PMID 39877485 · Full text
BACKGROUND: Benign laryngeal lesions, characterized by non-cancerous growths in the larynx, significantly impact voice quality and respiratory function. These lesions, which include vocal cord polyps, nodules, papillomas...
BACKGROUND: Benign laryngeal lesions, characterized by non-cancerous growths in the larynx, significantly impact voice quality and respiratory function. These lesions, which include vocal cord polyps, nodules, papillomas, and cysts, often result from factors such as vocal abuse, viral infections, and chronic inflammation. While studies on benign laryngeal lesions are well-documented globally, data specific to Northern Nigeria remains sparse. This study aims to analyze the demographics, clinical features, treatment modalities, and outcomes of benign laryngeal lesions over a decade in a tertiary otolaryngology center in Northern Nigeria. METHODOLOGY: A retrospective review of 176 cases of benign laryngeal lesions was conducted over 10-years (2011-2020). Data were collected on patient demographics, clinical presentation, risk factors, lesion characteristics, and treatment outcomes. All patients underwent flexible laryngoscopy, with a subset receiving CT scans and histopathological examination. The study excluded malignant lesions. RESULTS: The study population comprised 123 males (69.9%) and 53 females (30.1%), with a male-to-female ratio of 2.3:1. The age range of patients was from 1.5 to 69 years, with a mean age of 34.74 years (±16.64). The most common presenting symptom was hoarseness (94.8%), and most lesions were vocal cord polyps (52.3%), followed by vocal cord nodules (34.7%) and juvenile-onset respiratory papilloma (6.8%). The glottic region was the most frequent site of lesion occurrence (94.9%). Treatment primarily involved voice rest (43.2%), direct laryngoscopy with excision (22.2%), and microlaryngeal surgery (8.0%). Treatment outcomes showed a cure rate of 40.9%, with a recurrence rate of 29.0%. CONCLUSION: This study provides valuable insights into the demographic and clinical profiles of patients with benign laryngeal lesions in Northern Nigeria. The findings indicate a predominance of vocal cord polyps, significant gender disparity, and the effectiveness of surgical interventions. These results align with regional and international data but highlight the need for more localized studies to better understand the epidemiology and management of these lesions in Northern Nigeria. Further research should explore specific risk factors and the longterm outcomes of different treatment modalities.
Geospatial Distribution, Accessibility and Utilization of Basic Emergency Obstetric and New-born Care in Jigawa State, Northwest Nigeria.
Babandi ZS, Usman S, Abubakar BG … +5 more , Umar AA, Suleiman AG, Aliyu AT, Isa MF, Dahiru T
Niger Med J · 2024 · PMID 39877484 · Full text
BACKGROUND: High maternal mortality has remained a problem, especially in developing countries. Ensuring availability and utilization of Basic Emergency Obstetric and Newborn Care services (BEmONC) reduce maternal morbid...
BACKGROUND: High maternal mortality has remained a problem, especially in developing countries. Ensuring availability and utilization of Basic Emergency Obstetric and Newborn Care services (BEmONC) reduce maternal morbidity and mortality. The study aimed to determine the geospatial distribution, accessibility and utilization of BEmONC services in Jigawa State. METHODOLOGY: A cross-sectional study was conducted using the WHO "30 by 7" cluster sampling technique and two-stage sampling to select 630 women and 15 Primary Health Care facilities (PHCFs) respectively. The Geo coordinates of the PHCFs and households of respondents were taken using the global positioning system (GPS) on Android devices. Data were analysed using IBM SPSS version 25 and Arc GIS version 10.6. RESULTS: A dispersed distribution was observed for the BEmONC facilities in two LGAs and majority of the respondents (71.9%) fall within 5 Km radius to a BEmONC facility. Only 27% of the respondents utilized BEmONC services for obstetric complications. Predictors of utilization of BEmONC were living within 5 Km to the nearest BEmONC (aOR=3.3; 95% CI=1.565 - 6.822), use of bicycle (aOR=1.930; 95% CI=1.012 - 3.679), cars (aOR=1.838; 95% CI=1.127 - 2.998), and tricycles (aOR=1.833; 95% CI=1.017 - 3.309) as means of transportation to PHCs. CONCLUSIONS: A dispersed distribution and good physical accessibility to BEmONC facilities were found, however, utilization was poor. Distance and mode of transportation were predictors of utilization of BEmONC services. Jigawa State Government should intensify awareness campaigns to improve the utilization of BEmONC services and provide emergency transport schemes for women with obstetric complications.
Analysis of HAM-D Scores on Cognitive Functions and Heart Rate Variability in Patients with Major Depressive Disorder.
Sharma S, Kacker S, Saboo N
Niger Med J · 2024 · PMID 39877483 · Full text
BACKGROUND: Previous research has shown that Major Depressive Disorder (MDD) is accompanied by severe impairments in cognitive and autonomic processes, which may linger even when mood symptoms recover. This study aimed t...
BACKGROUND: Previous research has shown that Major Depressive Disorder (MDD) is accompanied by severe impairments in cognitive and autonomic processes, which may linger even when mood symptoms recover. This study aimed to analyse the relationship between depression severity, as measured by the Hamilton Depression Rating Scale (HAM-D), and how it affects heart rate variability (HRV) and cognitive function in patients with Major Depressive Disorder (MDD). METHODOLOGY: The cross-sectional study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, from July 2022 to January 2023 on 90 subjects having major depressive disorder (MDD) of either sex in the 20-40 age group using the Hamilton score for depression (HAM D), Heart Rate Variability (HRV) measurements, and a battery of cognitive tests. Regression analyses were conducted to examine the associations between HAM-D scores with both HRV parameters and cognitive functions. RESULTS: Results indicated a significant negative correlation between HAM-D scores and HRV measures with p<0.001, suggesting that increased depression severity is associated with reduced HRV. Additionally, higher HAM-D scores predicted poorer performance on cognitive tasks, particularly in the domains of executive function and working memory. The coefficient of determination r2=0.724 suggests that approximately 72.4% of the variance in the dependent variable (Hamilton rating score for depression) could be explained by the combined cognitive function and heart rate variability parameters. CONCLUSION: These findings highlight the potential utility of, emphasizing the importance of comprehensive assessment and treatment approaches that address both the affective and cognitive aspects of depression.
Genetic Modifiers in Sickle Cell Disease Leg Ulcers: Unveiling the Pathways associated with the development and, or progression of Leg Ulcers - A Scoping Review Protocol.
Dogara LG, Awwalu S, Awodele D
Niger Med J · 2024 · PMID 39877482 · Full text
This scoping review aims to assess the literature on genetic modifiers of leg ulcers in sickle cell disease, evaluating available evidence, methodologies, and research gaps. A major morbidity in sickle cell disease is th...
This scoping review aims to assess the literature on genetic modifiers of leg ulcers in sickle cell disease, evaluating available evidence, methodologies, and research gaps. A major morbidity in sickle cell disease is the development of leg ulcers. This clinical syndrome of SCD leg ulcers (SLU) has continued to be an enigma due to its multifactorial evolution, dearth of promising guidelines on treatment, and generally unsatisfactory response to treatment. Underlying genetic susceptibilities for SLU may impact counselling, prognostication, risk of development, severity as well as response to interventions. Hence the need for this scoping review. This scoping review will collate and assess studies in English on genetic markers of SLU among all SCD age groups, genders, races, and regions. Genetic or molecular markers to be assessed among patients with sickle cell leg ulcers included, genetic markers of Inflammation, vasculopathy, tissue damage, oxidative stress, coagulopathy as well as genetic predispositions that have been studied in relation to SLUs across all countries. This includes most common biomarkers that promote development of SLU, the single nucleotide polymorphic markers (SNPs) that work through the MAPK and SMAD signaling pathway. A PubMed search of all fields for literature published in English using the strategy (sickle cell) AND (leg ulcer), and (sickle cell) AND (leg ulcer genetics) from 1998 to 2023 (last 25 years) will be undertaken. This will be modified, according to the inclusion criteria, as appropriate across other databases. The other databases will include Google Scholar, web of Knowledge, Scopus, New Zealand Science, Silver chair, Taylor and Francis+NEJM, and journals.lww.com.
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