Nigerian Medical Journal[JOURNAL]
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200 papers
Increased thromboembolic risk in non-neoplastic pancreatic diseases: A review focusing on acute pancreatitis.
Odusanya KE, Ukoha CB, Olomojobi VO … +4 more , Okpanachi PA, Adabiri JO, Okeugo OT, Quadri IO
Niger Med J · 2025 · PMID 41472979 · Full text
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of preventable morbidity and mortality in hospitalized patients. While VTE is well-established in pancreati...
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of preventable morbidity and mortality in hospitalized patients. While VTE is well-established in pancreatic malignancy, its association with non-neoplastic pancreatic conditions, particularly acute pancreatitis (AP), is less clearly defined and frequently underrecognized in clinical practice. This narrative review aims to explore and synthesize existing literature on the thromboembolic complications associated with AP, highlighting the underlying pathophysiological mechanisms, clinical implications, and current gaps in prophylactic and therapeutic strategies. We reviewed published studies from major databases up to June 2025, focusing on epidemiological trends, pathological mechanisms related to inflammation-induced thrombosis, and clinical outcomes in patients with AP complicated by VTE. The review discusses pathogenesis, epidemiology, clinical features and diagnostic challenges due to symptom overlap, current pharmacologic and non-pharmacologic management strategies, and the limited but growing real-world evidence on anticoagulation in this setting.
Association of Anaemia and Depression: A Systematic Review and Meta-analysis.
Gupta B, Goel R, Satodiya V … +2 more , Gupta K, Mittal A
Niger Med J · 2025 · PMID 41472978 · Full text
BACKGROUND: This research aims to find out the prevalence of depression in all types of anaemia patients of all age groups and genders by conducting a comprehensive meta-analysis of observational epidemiological studies....
BACKGROUND: This research aims to find out the prevalence of depression in all types of anaemia patients of all age groups and genders by conducting a comprehensive meta-analysis of observational epidemiological studies. METHODOLOGY: The relevant peer-reviewed literature describing primary data analysis was thoroughly evaluated using the PRISMA checklist as a reference. We searched databases, including PubMed, Scopus, Embase, and Google Scholar, to identify research publications published between 2003 and 2024. R software version 4.3.0 was utilised to perform the meta-analysis, and the JBI score was employed for quality appraisal. Heterogeneity was assessed using the Q and I2 statistics. To pool estimates, a random-effects model was employed. Publication bias was assessed using a funnel plot and Egger's regression test. RESULTS: After combining the results of the papers, the prevalence of depression was estimated at 36 % (CI = 95: 28-45 %) based on a random effects model. Sub-group analysis showed that the prevalence of depression was higher in patients with sickle cell anaemia (42%) followed by Thalassemia (35%) and Iron deficiency anaemia (20%). Sub-group analysis also found a higher prevalence (almost double) of depression in anaemic patients of Asia (40%) and the African continent (37%,) which is almost double as compared to America (28%) and Europe (20%). The declining trend of meta-regression analysis demonstrates that depression prevalence is higher among young anaemia patients (Children and adolescents) as compared to older ones. CONCLUSION: Routine screening for depression may be required during regular follow-ups of anaemic patients, especially in resource-limited settings.
Disparities Impacts Psychiatry Competency Assessments among Students in a Nigerian Medical School.
Buhari OIN, Salihu MO, Ogunmodede AJ … +1 more , Ajiboye PO
Niger Med J · 2025 · PMID 41472977 · Full text
BACKGROUND: Assessments in medical education must reliably evaluate competencies while addressing potential gender disparities. This study examines the reliability of psychiatry competency assessments among final-year me...
BACKGROUND: Assessments in medical education must reliably evaluate competencies while addressing potential gender disparities. This study examines the reliability of psychiatry competency assessments among final-year medical students at the University of Ilorin, Nigeria, and explores gender differences in performance. The aim was to evaluate the internal consistency of formative (progressive assessment) and summative (final MBBS) examinations, analyse correlations between assessment components, and compare gender-based performance. METHODOLOGY: A retrospective analysis of all 137 (77 male, 60 female) final year medical students' psychiatry competence assessments was conducted. Reliability was measured using Cronbach's alpha, correlations between exam components were assessed via Pearson's correlation, and gender differences were analysed using t-tests and Cohen's d. RESULTS: The combined assessments showed high reliability (α = 0.857), though lower for females (α = 0.553 vs. males: α = 0.618). Progressive assessment correlated moderately with theory components (Multiple Choice Questions: r = 0.507) but weakly with clinical tools (picture test: r = 0.158). Females outperformed males in both theory (mean difference: +1.71, p = 0.001) and clinical exams (mean difference: +1.08, p = 0.019), with moderate effect sizes (Cohen's d = 0.63 and 0.42, respectively). CONCLUSION: While the assessment system demonstrates strong overall reliability, gendered disparities suggest a need for more equitable evaluation methods. Females consistently outperformed males, but lower reliability in their combined scores calls for refined formative tools. Integrating more multimodal assessments may enhance fairness and validity.
Evaluation of the Prevalence and Factors Affecting the Mental Health of Undergraduate Medical Students in a Nigerian University: A Cross-Sectional Study.
Okwudishu O, Okebalama VC, Bamidele EF … +9 more , Osinaike A, Adefala NO, Olabiyi HO, Nwudele U, Chinatu-Nwankwo O, Fide-Nwoko FU, Opadotun OA, Chigozie UC, Quadri IO
Niger Med J · 2025 · PMID 41472976 · Full text
BACKGROUND: Medical education is known to be demanding and stressful, often leading to mental health challenges such as stress, anxiety, and depression among students. Understanding the prevalence and factors contributin...
BACKGROUND: Medical education is known to be demanding and stressful, often leading to mental health challenges such as stress, anxiety, and depression among students. Understanding the prevalence and factors contributing to these issues is crucial for effective intervention and support. METHODOLOGY: A descriptive cross-sectional study was conducted among 400 medical students at the College of Health and Medical Sciences at Babcock University. Data was collected using a standardised questionnaire comprising sections on sociodemographic characteristics, depression (PHQ-9), anxiety (GAD-7), stress (PSQ), and health-seeking behaviour. Statistical analysis was performed using SPSS version 22, with descriptive statistics and chi-square tests applied. The value for p was <0.05, which is statistically significant. RESULTS: The prevalence of depression was 53.5% with 186(45.3%) having mild depression, more than half of the respondents had minimal anxiety, 202(50.5%), and a high level of stress, 214(53.5%), respectively. Factors affecting mental health included lack of institutional support 170 (42.5%), poor awareness of available services 125 (31.3%), and poor utilization of mental health services 310, (77.5%). Age was found to be statistically significant (x2=15.792, P=0.015) in terms of anxiety level. Additionally, significant associations were observed between stress and depression (x2=37.497, P<0.001), as well as between stress and anxiety (x2=44.286, P<0.001). CONCLUSION: This study shows that the levels of depression, anxiety, and stress are moderately high among the medical students, underscoring the urgent need for intervention and support mechanisms. Enhancing institutional support, integrating mental health education into the curriculum, and conducting regular screenings will go a long way in creating a supportive environment conducive to the mental well-being and academic success of its medical students.
Statin-Induced Toxic Myopathy Masquerading as Recurrent Falls and De-Conditioning in an Older Adult.
Asuka E, Odion J
Niger Med J · 2025 · PMID 41472975 · Full text
Statins, widely prescribed for their efficacy in reducing low-density lipoprotein cholesterol (LDL-C) and preventing atherosclerotic cardiovascular disease, are generally well tolerated. However, muscle-related adverse e...
Statins, widely prescribed for their efficacy in reducing low-density lipoprotein cholesterol (LDL-C) and preventing atherosclerotic cardiovascular disease, are generally well tolerated. However, muscle-related adverse effects, particularly statin-associated myopathy, can significantly impact patient function and adherence. This case report describes an 83-year-old man who developed progressive proximal muscle weakness, fatigue, and recurrent falls following initiation of high-dose atorvastatin after a ST-elevation myocardial infarction. Clinical and laboratory evaluation, along with the temporal association and improvement after drug withdrawal, supported a diagnosis of self-limited toxic statin myopathy. Extensive differential diagnosis excluded other neuromuscular, endocrine, and vascular causes. Prompt discontinuation of atorvastatin, supportive care, and physiotherapy led to marked functional recovery. This case highlights the spectrum of statin-induced muscle toxicity, emphasises diagnostic vigilance in older adults, and underscores the importance of personalised therapy and early intervention to mitigate adverse outcomes.
Evaluating the Knowledge and Awareness of Professional Indemnity Insurance among Medical Doctors in Nigeria.
Alao AK, Taiwo AO, Fasanu AO … +3 more , Owolabi AO, Balogun SA, Anjous-Alao RM
Niger Med J · 2025 · PMID 41472974 · Full text
BACKGROUND: Professional Indemnity Insurance (PII) is an important cover for health professionals against the risks of legal and financial consequences of medical malpractice lawsuits. Nigerian medical doctors are still...
BACKGROUND: Professional Indemnity Insurance (PII) is an important cover for health professionals against the risks of legal and financial consequences of medical malpractice lawsuits. Nigerian medical doctors are still not adequately informed about it. This cross-sectional study evaluated PII knowledge and awareness among 300 registered physicians across different settings in Nigeria, including urban tertiary hospitals, rural clinics, and private practice. METHODOLOGY: A self-validated questionnaire collected socio-demographic data, medical specialties, and the extent of PII knowle1dge. Descriptive and inferential statistics were used to analyse the data. Outcomes revealed that merely 32% of participants possessed sufficient knowledge about the purpose and scope of PII. Knowledge was significantly correlated with years of experience (p=0.03), with senior physicians exhibiting higher awareness, as well as practice setting (p=0.04), with doctors working in urban tertiary institutions performing better than those practising in rural clinics. RESULTS: In particular, 45% of urban tertiary hospital physicians expressed familiarity with PII, compared with 22% of rural clinic physicians, presumably due to greater access to professional resources. These disparities indicate a large gap in PII awareness, particularly in the countryside. CONCLUSIONS: To address this, the integration of medico-legal modules into medical training, as implemented in South Africa, would enhance knowledge among newly qualified doctors. Targeted education interventions, such as workshops and continuing medical education courses in diverse practice settings, would be required to bridge the gap. This would empower Nigerian doctors with the knowledge needed to access PII and hence better protect themselves and patients.
Digital Technology-Enhanced Remote Health Services: Antenatal Clients' Perception, Acceptance and Readiness at a Nigerian Tertiary Hospital.
Deekae LR, Denebari DL, Dick HC … +1 more , Ogaji DS
Niger Med J · 2025 · PMID 41472973 · Full text
BACKGROUND: Digital technology offers promising solutions for monitoring pregnant women but client's readiness for its adoption in Nigeria remains underexplored. This study assessed antenatal clients' perceptions and rea...
BACKGROUND: Digital technology offers promising solutions for monitoring pregnant women but client's readiness for its adoption in Nigeria remains underexplored. This study assessed antenatal clients' perceptions and readiness for digital health adoption. METHODOLOGY: This cross-sectional survey involved 228 antenatal clients recruited through systematic sampling. Participants completed the 16-item Technology Readiness Index (TRI 2.0) and supplementary perception scales on 5-point response scales. Respondents were categorised as explorers, pioneers, skeptics, paranoids, or laggards based on their TRI scores. The range of Cronbach's alpha for scales was: 0.80-0.92. Data were analysed using SPSS version 29, applying descriptive and generalised linear regression analyses, with statistical significance set at p ≤ 0.05. RESULTS: The response rate was 100% and most participants were aged 25-34 (43.9%), married (51.8%), and held tertiary education (38.6%). Ownership of digital devices was smartwatches (6.1%), smartphones (25.9%), and computers (26.3%). Clients prioritised e-prescription (3.09±1.11) and access to personal health information (3.08±1.13) as top benefits of remote services. TRI Scores were overall TRI (3.00±0.31), optimism (3.12), innovativeness (3.22), discomfort (3.12), and insecurity (3.19). Majority (90.4%) were classified as skeptics. Unemployed clients showed lower acceptance of devices for remote maternal monitoring (B = -0.13, 95% CI: -0.24, -0.01, p = 0.033). CONCLUSION: Despite the global momentum toward digital maternal health solutions, antenatal clients in Nigeria demonstrate low digital engagement and are predominantly skeptics. Targeted interventions including digital literacy campaigns, improved trust through data privacy protections, and broader infrastructural investments are critical for promoting equitable adoption of remote digital maternal health solutions.
Outcome of intra-operative Purulent Peritoneal Fluid Aspirate Culture Results during Appendicectomy in Patients' Management.
Kalu UA, Walshaw J, Ravi V … +3 more , Yassin S, Eltom M, Jayawardane G
Niger Med J · 2025 · PMID 41472972 · Full text
BACKGROUND: Intra-operative purulent peritoneal fluid aspirate for microscopy, culture, and sensitivity during appendicectomy is practiced by some surgeons to help in the post-operative management of patients if the pati...
BACKGROUND: Intra-operative purulent peritoneal fluid aspirate for microscopy, culture, and sensitivity during appendicectomy is practiced by some surgeons to help in the post-operative management of patients if the patients get unwell, requiring a change of the prescribed pre-operative antibiotics. This study aimed to evaluate if there are benefits from purulent peritoneal fluid aspirate culture results during appendicectomy. METHODOLOGY: This was a retrospective review of medical records and operation notes of all the patients who had an appendicectomy with purulent peritoneal fluid that was aspirated for microscopy culture and sensitivity in the last 3 years (May 2019 to April 2022). RESULTS: A total of 73 patients had purulent peritoneal fluid culture results and received perioperative intravenous antibiotics. There were 52 (71%) bacteriological positive culture results from the purulent peritoneal fluid aspirates and 21 (29%) negative peritoneal pus culture results. The most common antibiotics administered were a combination of co-amoxiclav and metronidazole 45 (61.6%). One-quarter of the preoperative antibiotics were changed due to the positive microbiology culture results from the peritoneal pus aspirates. The main reasons for the change in antibiotics were intra-abdominal collections and wound infection in 21 (28.8%) of the patients, and Streptoccocus anginosus was the most common organism isolated. A re-operation and/or ultrasound-guided drainage of intra-abdominal collections were avoided in 13 out of 17 patients due to the change of the pre-operative antibiotics following the results from the purulent peritoneal fluid. CONCLUSION: The intra-operative purulent peritoneal fluid culture results during appendicectomy contributed positively towards the post-operative management of patients.
Heart-Brain Interactions in Depression: Insights from HRV and Neurocognitive Correlates.
Ardahanh N, Örsel ES, Ardahanh İ
Niger Med J · 2025 · PMID 41472971 · Full text
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The Cost of Care of Childhood Epilepsy in Southern Nigeria: Experience from a Tertiary Hospital in Port Harcourt.
Wobo KN, Gabriel-Job N
Niger Med J · 2025 · PMID 41472970 · Full text
BACKGROUND: The financial burden of caring for a child living with epilepsy and its effect on the family's financial status and quality of life are understudied. This study aimed to determine the cost of care for childre...
BACKGROUND: The financial burden of caring for a child living with epilepsy and its effect on the family's financial status and quality of life are understudied. This study aimed to determine the cost of care for children with Epilepsy in Port Harcourt. METHODOLOGY: A purposive sampling method was employed. Participants were 37 children with epilepsy and their parents/caregivers. An interviewer-administered semi-structured questionnaire was used to obtain information on the socio-demographic, estimates of the financial costs of epilepsy care, the effect of caregiving on caregiver productivity and income. RESULTS: The average monthly income per family is $332.80 ± $116.82. The majority, 32(86.5%), financed epilepsy care via out-of-pocket payments. The average cost of epilepsy care is $66 per month ($792 per annum), accounting for 20% of the average family income. There was a negative correlation between hours spent on caregiving and household income (rho =-0.288; value = 0.084). Over two-thirds (67.6%) of the caregivers consider their overall well-being negatively affected by having a child with epilepsy. CONCLUSION: The cost of care of childhood epilepsy in southern Nigeria is high and takes up a significant proportion of household income. Concerted efforts need to be made to encourage subscription to health insurance to alleviate the financial burdens on families.
Hematological Profile and Blood-Borne Virus Prevalence in Pregnant Women at a Tertiary Military Hospital, Lagos, Nigeria.
Omisakin SI, Ogoh GS, Ayeni SA … +16 more , Ugwu AO, Odo C, Okorafor UC, Garba SR, Otokiti OE, Harrison N, Awoniyi AW, Ohagwu IC, Ige S, Ezeoke DC, Akpan M, Okoro AC, Asini AO, Adefemi KA, Oriji PC, Okunade KS
Niger Med J · 2025 · PMID 41472969 · Full text
BACKGROUND: Maternal haematological status and concurrent blood-borne viral infections play a crucial role in determining pregnancy outcomes. This study assessed haematological profiles and the prevalence of blood-borne...
BACKGROUND: Maternal haematological status and concurrent blood-borne viral infections play a crucial role in determining pregnancy outcomes. This study assessed haematological profiles and the prevalence of blood-borne viruses among pregnant women attending a tertiary military hospital over a four-year period. METHODOLOGY: A retrospective cohort analysis was conducted using clinical records of 499 pregnant women who attended antenatal care at the 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Data on demographics, complete blood count, and serology for blood-borne viruses were extracted into a structured proforma. It was analysed using statistical package of social sciences (SPSS) version 29. Descriptive statistics were presented using tables and charts. Associations were tested, with statistical significance set at <0.05. RESULTS: Participants had a mean age of 36 ± 2.3 years. Blood group O was most common 245(49.7%), with the least being AB blood group which accounted for 48(9.6%). Haematocrit was lowest in the third trimester (31.21 ± 4.1%, <0.001), while 1 and 2 trimester haematocrits were 33.49±3.4 and 31.73±3.1 respectively. Anaemia was significantly associated with primiparity (=0.04), HIV infection (=0.03), and the Hb AS genotype (=0.01). HIV prevalence was 30 (6.0%) higher than that of hepatitis B 27(5.4%) and Hepatitis C 7(1.4%). CONCLUSION: HIV prevalence (6.0%) was higher than hepatitis B and C, and primiparous women showed significant anaemia with low haematocrit values. These findings call for targeted nutritional support and strengthened antenatal screening for blood-borne viruses to improve maternal and fetal outcomes.
Serum Galectin-3 as a Prognostic Biomarker in Acute Ischemic Stroke: A Comparative Cross-Sectional Study.
Bakare AK, Adebisi OO, Adebisi OI … +4 more , Omoyele-Abdulssalam HO, Vaughan TA, Okunola OO, Wahab WK
Niger Med J · 2025 · PMID 41472968 · Full text
BACKGROUND: Stroke is a major cause of morbidity and mortality globally, with a particularly high burden in low- and middle-income countries such as Nigeria. Early identification of biomarkers, such as serum Galectin-3,...
BACKGROUND: Stroke is a major cause of morbidity and mortality globally, with a particularly high burden in low- and middle-income countries such as Nigeria. Early identification of biomarkers, such as serum Galectin-3, which plays a role in inflammation and tissue remodeling, may improve diagnostic accuracy and patient outcomes in acute ischemic stroke. This study aimed to compare serum Galectin-3 levels between patients with acute ischemic stroke and age- and sex-matched stroke-free controls. METHODOLOGY: A prospective comparative cross-sectional study was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 100 first-ever acute ischemic stroke patients and 100 apparently healthy controls were recruited. Serum Galectin-3 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed to compare Galectin-3 levels between groups using the Statistical Package for the Social Sciences (SPSS), version 24.0. RESULTS: The median serum Galectin-3 level was significantly higher in stroke patients compared to controls [60 (55.00-63.00) vs 56 (49.00-62.00), p = 0.003]. The two groups were comparable in age and sex distribution, but hypertension and diabetes were significantly more prevalent among stroke patients. Elevated serum Galectin-3 levels were positively associated with stroke diagnosis. CONCLUSION: Serum Galectin-3 is significantly elevated in acute ischemic stroke patients compared to stroke-free individuals. Galectin-3 could serve as an important biomarker for acute ischemic stroke, aiding in timely diagnosis and management.
A Comparative Study of Clinical and Electroencephalographic Findings of the Children with Epilepsy with or without Cerebral palsy in a Tertiary Health Facility in Nigeria.
Jangebe MA, Ahmed H, Ahmad MM … +7 more , Jiya NM, Jiya FB, Ahmed HK, Isezuo KO, Abubakar FI, Amodu-Sanni M, Surajo I
Niger Med J · 2025 · PMID 41472967 · Full text
BACKGROUND: Epilepsy, whether occurring alone or with cerebral palsy (CP), is among the most common neurological disorders seen in paediatric neurology clinics in Nigeria. Management requires accurate diagnosis and class...
BACKGROUND: Epilepsy, whether occurring alone or with cerebral palsy (CP), is among the most common neurological disorders seen in paediatric neurology clinics in Nigeria. Management requires accurate diagnosis and classification, which becomes more challenging when epilepsy coexists with CP. Electroencephalography (EEG) is a valuable tool for confirming and characterising epileptic activity. This study aimed to compare the clinical and EEG characteristics of children with CP and epilepsy (Group 1) and those with epilepsy without CP (Group 2) in a Nigerian tertiary institution. METHODOLOGY: This prospective, cross-sectional, comparative study was conducted from March 2022 to February 2023. A total of 121 children with epilepsy and CP (Group 1) and 124 with epilepsy only (Group 2), aged 6 months to 15 years, were consecutively recruited. Clinical profiles and EEG findings were compared. Data were analysed with SPSS version 25.0, with p < 0.05 considered significant. RESULTS: The median age at epilepsy onset was 12 months (IQR: 9.5) in Group 1 and 49 months (IQR: 58.7) in Group 2, showing a significant difference (p < 0.001). Uncontrolled epilepsy was more common in Group 1, occurring in 50 of 72 (69.4%) on antiepileptic drugs, compared to 12 of 69 (17.4%) in Group 2 (p < 0.001). Generalized-onset epilepsy was most frequent in both groups (59.5% vs. 54.8%, p = 0.844). West and Lennox-Gastaut syndromes appeared only in Group 1, while Doose syndrome occurred only in Group 2. CONCLUSION: A disparity was observed between clinical and electroencephalographic (EEG) classifications, particularly among children with epilepsy and cerebral palsy. EEG evaluation is therefore recommended as an essential component of epilepsy management in this population.
Comparison of Blood Glucose Levels in Caesarean and Vaginally Delivered Newborns at Lagos University Teaching Hospital, Nigeria.
Ajogun EO, Oyenusi EE, Oduwole AO … +1 more , Ibekwe MU
Niger Med J · 2025 · PMID 41472966 · Full text
BACKGROUND: Normal blood glucose supply and metabolism are of utmost importance for growth and normal brain development in the foetus and newborn. Disorders in glucose supply or metabolism can result in hypoglycaemia or...
BACKGROUND: Normal blood glucose supply and metabolism are of utmost importance for growth and normal brain development in the foetus and newborn. Disorders in glucose supply or metabolism can result in hypoglycaemia or hyperglycaemia. Considering the increasing trend of caesarean section (CS) worldwide, including Nigeria, it is important to determine the incidence and type of dysglycaemia in neonates delivered by CS. The study objective was to compare the blood glucose (BG) levels of newborns delivered by CS with those by vaginal delivery (VD). METHODOLOGY: This was a prospective observational study of 164 neonates, of which 85 were delivered through CS and 79 through VD. A pretested questionnaire was used to obtain information on sociodemographic variables, gestational age, feeding time of the new-born and maternal fasting time, while BG was determined using Accu-chek Multiclix. Every tenth sample was also tested in the laboratory for quality control. RESULTS: The mean (SD) cord blood glucose level was lower in the CS (68.7(10.1) mg/dl) than VD neonates (80.9(11.5) mg/dl, p = <0.001). The mean (SD) blood glucose level at 2 hours of life was also lower in CS (62.5(10.0) mg/dl) than VD neonates (71.2(10.9) mg/dl, p = <0.001). Factors that were significantly associated with cord BG levels were gestational age, maternal fasting time and mode of delivery. At two hours of life, cord blood, neonatal feeding time, gestational age and birth weight were significantly associated with neonatal BG levels. CONCLUSION: Cord and neonatal BG were significantly lower in neonates who were delivered via CS compared to those delivered vaginally.
What is the relationship between the Number of Significant rib fractures and Haemothorax in adults with blunt chest trauma?
Okonta KE
Niger Med J · 2025 · PMID 41472965 · Full text
BACKGROUND: The study aimed to determine the correlation between the number of significant rib fractures in patients with blunt chest trauma (BCT) and the amount of haemothorax as recorded by Closed Thoracostomy Tube Dra...
BACKGROUND: The study aimed to determine the correlation between the number of significant rib fractures in patients with blunt chest trauma (BCT) and the amount of haemothorax as recorded by Closed Thoracostomy Tube Drainage (CTTD). METHODOLOGY: This was a cross-sectional study of all patients with significant rib fractures following BCT over a period of two years. "Significant rib fractures" was defined as the fracture of 3 or more ribs with 50% or more displacement of each fractured rib edge. Patients with massive haemothorax, patients with severe neurological, or patients who required emergency thoracotomy were excluded.The diagnosis of rib fracture was made by standard chest radiograph or Chest Tomography Scan.Descriptive analyses were reported as mean and standard deviation (SD) for the variables. Pearson correlation test was conducted to test the relationship between the numbers of fractured ribs with the amount of haemothorax as recorded by CTTD with P-value significant at<0.001. RESULT: Sixteen patients who met the criteria were analysed with a mean age of 46.5years±(SD16.47), the mean number of fractured ribs was 4.5±1.37, the mean amount of drained blood was 605.3ml±(SD244.3) and the mean amount of drained blood per the number of each fractured rib was 134.5ml±54.29.The Pearson Correlation test was strongly positive at,r=0.80 with (< 0.001). CONCLUSION: In any patient with BCT, and with fractured of 3 or more ribs, there may be the need to institute a CTTD irrespective of whether the chest radiograph or chest computerized scan shows immediate evidence of significant haemothorax.
Efficacy and Safety of Steroids in Acute Heart Failure: A Systematic Review and Meta-analysis.
Gothwal M, Solanki H, Gupta P … +6 more , Chaudhary S, Agrawal NK, Kothari N, Patel N, Aggarwal P, Singh S
Niger Med J · 2025 · PMID 41472964 · Full text
BACKGROUND: Persistent congestion in acute heart failure (AHF) is associated with worse clinical outcomes. The use of steroids may provide therapeutic benefits by alleviating congestion, overcoming diuretic resistance, a...
BACKGROUND: Persistent congestion in acute heart failure (AHF) is associated with worse clinical outcomes. The use of steroids may provide therapeutic benefits by alleviating congestion, overcoming diuretic resistance, and mitigating the harmful effects of neurohormonal activation. This approach could potentially improve hemodynamic status and support better management of AHF, ultimately leading to enhanced patient recovery and reduced complications. OBJECTIVE: To evaluate the efficacy and safety of steroids in acute heart failure (AHF) as compared to the standard of care (SOC). SEARCH STRATEGY: We used PubMed, Scopus, Google Scholar, and a manual search to identify Randomized controlled trials published up to October 15, 2024.The protocol was registered in PROSPERO (CRD42024601261). SELECTION CRITERIA: All full-text randomized control trials (RCTs) that investigated steroids in heart failure were included. Results were pooled, where appropriate, using a random-effects model. RESULTS: Three RCTs with 563 participants [282 Steroid, 281 (SOC)] were identified. No statistically significant difference is seen in mortality as well as NT-proBNP levels between the steroid plus SOC and control group (RR=0.59, 95% CI=0.06-6.13, p=0.66, (I⊃2;=51%, p=0.15) and (MD=0.14, 95% CI=-0.62 to 0.90, p=0.71, I⊃2;=91%, p<0.0006), respectively. CONCLUSION: Steroids have no significant effect on all-cause mortality or NT-proBNP levels in patients with AHF.
Point-of-Care Ultrasound in Paediatric Cardiac Tamponade: A Case Report of Rapid Diagnosis and Guided Pericardiocentesis in a Resource-Limited Setting.
Usman NH, Sufyan I, Iduze A … +4 more , Abdullahi FL, Hassan L, Musa A, Abdulkadir I
Niger Med J · 2025 · PMID 41472963 · Full text
The case report demonstrates the utility of point-of-care ultrasound (POCUS) for both diagnosis and ultrasound-guided intervention in managing cardiac tamponade in a paediatric patient. A 10-year-old child presented with...
The case report demonstrates the utility of point-of-care ultrasound (POCUS) for both diagnosis and ultrasound-guided intervention in managing cardiac tamponade in a paediatric patient. A 10-year-old child presented with a six-week history of cough, weight loss, and a two-week history of respiratory difficulty, orthopnoea, and generalized body swelling, starting in the legs. He had progressive easy fatigability over the last three months. An external chest X-ray indicated a globular heart, suggestive of pericardial effusion to rule out cardiomyopathy. Cardiac POCUS revealed a massive pericardial effusion with tamponade physiology. Immediate ultrasound-guided pericardiocentesis was performed, draining 800 ml of purulent fluid, followed by an additional 200 ml with an underwater seal setup. Post-procedure, serial POCUS examinations were conducted to monitor for adequate drainage and to detect any possible re-accumulation of pericardial fluid. The symptoms resolved, and a 2-week follow-up showed sustained improvement. This case underscores the vital role of POCUS in both the prompt diagnosis and safe, accurate ultrasound-guided pericardiocentesis in emergent cardiac care for paediatric patients.
Descriptive study of free Emergency Trauma Services and Outcomes in a Tertiary Teaching Hospital, North-Western Nigeria.
Nuradeen AA, Ajiboye LO, Sabir AA … +1 more , Bello AG
Niger Med J · 2025 · PMID 41472962 · Full text
BACKGROUND: Waiting time at a trauma centre (TC) before injured patients receive treatment is critical to treatment outcomes. The study aims to find the impact of the government's free emergency services on the waiting t...
BACKGROUND: Waiting time at a trauma centre (TC) before injured patients receive treatment is critical to treatment outcomes. The study aims to find the impact of the government's free emergency services on the waiting time before treatment is initiated. METHODOLOGY: This was a retrospective study of the admitted emergency patients at the Trauma Centre, of Usmanu Dan fodio University Teaching Hospital (UDUTH), Sokoto, Nigeria, from November 2024 to March 2025. Patients' presentation time was classified as less than 6 hours or more than 6 hours before admission and waiting time as less than 15 minutes or greater than 15 minutes. The outcome was either satisfactory or unsatisfactory. Chi-Square was used to analyse categorical data. The level of significance was set at P<0.05. RESULTS: There were 366 patients included in the study. The average waiting time before intervention (in minutes) was 10.5±0.242. Most patients (42/11.5%) had a waiting time of 7 minutes. The male-to-female ratio was 2.1 to 1. The mean age of patients was 35.87±17.20. Cases seen were fractures & dislocations (122/33.3%), gunshot wounds (62/16.9%), head injuries (43/11.7%), burns (38/10.4%), spinal cord injuries (33/9.0%), abdominal injuries (26/7.1%), urologic injuries (21/5.7%) and others (21/5.7%) include chest injuries, soft tissues, limbs gangrene etc. There were 252 (58.9%) patients who presented less than 6 hours post-injury, while 114 (31.1%) presented after 6 hours. Patients who started receiving treatment on admission <16 minutes were 298 (81.4%), and those at >15 minutes were 68 (18.6%). Associating injury duration (<6 hours vs. >6 hours) and treatment outcomes, p-value=0.0001, OR=4.90, 95% CI=2.39-10.04. At the same time, associating waiting time before treatment and treatment outcomes, the p-value=0.0001, OR=5.29, 95% CI=10.77. Following the paired sample t-test of the 2 groups between the median (10.0), the p-value was 0.0001. CONCLUSION: There was an improvement in the waiting time for the initiation of treatment. This was largely influenced by the presence of free ambulance services, available free medications and surgical interventions.
Comparative evaluation of intracanal medicaments on sealing ability of MTA and Hydroxyapatite apical plug in simulated immature teeth - An in vitro study.
Verma KG, Kasat S, Solanki SKS … +3 more , Das A, Khan N, Tirale DK
Niger Med J · 2025 · PMID 41472961 · Full text
BACKGROUND: Immature teeth must be managed by apexification as there is no definite apical stop. Use of intracanal medicaments prior to apexification affect the sealing ability of apical plug. Present study was done to c...
BACKGROUND: Immature teeth must be managed by apexification as there is no definite apical stop. Use of intracanal medicaments prior to apexification affect the sealing ability of apical plug. Present study was done to compare the effect of various intracanal medicaments: Metapex, Chlorhexidine digluconate, Curcuma longa, and Triple antibiotic paste (TAP) on the sealing ability of MTA and Hydroxyapatite as an apical plug. METHODOLOGY: 130 single-rooted teeth were divided into two experimental groups (n=60 each) [Group I: MTA; Group II: Hydroxyapatite], and two control groups (n=5 each) [Group IIIA: MTA; Group IIIB: Hydroxyapatite] based on the apical plug used. Experimental groups were subdivided, based on intracanal medicaments [Group IA and IIA - Metapex; Group IB and IIB - 2% Chlorhexidine digluconate, Group IC and IIC - Curcuma longa, Group ID and IID - TAP]. After biomechanical preparation, simulation of immature apex was done using peeso-reamer. Intracanal medicaments were placed, and study samples were incubated for 7 days. Then all medicaments were removed using H-files, followed by retrograde apical placement, obturation, and restoration. Samples were subjected to dye penetration test, followed by clearing procedure. Apical microleakage was assessed using stereomicroscope at 40X. Data collected was subjected to statistical analysis using SPSS version 20.0 (p=0.05). RESULTS: Apical dye penetration was minimum in control group, followed by Group IB (0.17±.46) < IIB (0.53±.57) < IIC (0.90±.96) < IID (0.93±.59) < IC (1.83±.83) < ID (1.91±.81) < IIA (2.13±.81) < IA (2.31±.73).Intragroup comparison for apical microleakage was statistically significant (p<0.001), whereas intergroup comparisons were statistically significant except for group IA v/s IIA, IB v/s IIB, IC v/s IIA, ID v/s IIA. CONCLUSION: Hydroxyapatite showed better sealing ability than MTA with all intracanal medicaments. Sealing ability was minimal with Metapex, followed by Turmeric, TAP, and 2% Chlorhexidine.
The immunological and virological correlates of Cervical Precancerous Lesions among HIV-Infected Women on ART in Faith Alive Hospital, Jos, Nigeria.
Onyeji J, Ogunsola OO, Osayi E … +4 more , Ajayi OA, Isichei MW, Isichei CO, Christopher PC
Niger Med J · 2025 · PMID 41189566 · Full text
BACKGROUND: Immuno-suppression in women living with HIV (WLHIV) increases the persistence of high-risk human papillomavirus (HPV) and reduces the ability to clear cervical precancerous lesions; as such, WLHIV are more pr...
BACKGROUND: Immuno-suppression in women living with HIV (WLHIV) increases the persistence of high-risk human papillomavirus (HPV) and reduces the ability to clear cervical precancerous lesions; as such, WLHIV are more predisposed to cervical cancer. Widespread use of antiretroviral therapy (ART) among WLHIV enhances immune reconstitution, controlling HIV replication and reversing the weakened immune system. This impedes HPV persistence and the development of precancerous lesions. The immune status of WLHIV is related to their CD4 count and viral load. These factors are impacted by the duration of effective ART. This study aimedto determine the association between cervical precancerous lesions with viral load, CD4 count, and duration on ART among WLHIV. METHODOLOGY: A retrospective study on 1113 WLHIV aged 16 -55 years screened for cervical cancer using visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) within a 16-month period in Faith Alive Hospital, Jos, Nigeria. Sociodemographic characteristics of study participants, CD4 count, viral load, duration on ART, and screening results were documented. The data were analysed using IBM-SPSS 26, and logistic regression was performed to determine factors associated with pre-cancerous lesions. RESULTS: The prevalence of cervical precancerous lesions was 9.1%, the prevalence of suspected cancer was 1.6% and the mean age of clients with pre-cancerous lesions was 41.32±9.89 years. Unsuppressed baseline viral load (≥1000 copies/ml) and <6 months of exposure to ART were found to be strongly associated with cervical precancerous lesions. CONCLUSION: This study demonstrated a higher burden of cervical precancerous lesions in viral unsuppressed women on ART initiation and in women with <6 months of exposure to antiretroviral therapy. Early commencement and prolonged use of ART on WLHIV to ensure early and sustained viral suppression to reduce the risk of cervical cancer is recommended.
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