Nigerian Medical Journal[JOURNAL]
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200 papers
Knowledge, Attitudes and Practices Regarding the use of Traditional and Complementary Medical Practices by Patients with Ischemic Heart Disease in Oman.
Al-Maskari A, Al-Maamari Q, Al-Riyami H … +1 more , Nadar SK
Niger Med J · 2025 · PMID 41189565 · Full text
BACKGROUND: The use of traditional and complementary medicine is increasing worldwide. This study aims to assess the knowledge, attitudes and practices regarding the use of traditional medicine (TM) by patients with isch...
BACKGROUND: The use of traditional and complementary medicine is increasing worldwide. This study aims to assess the knowledge, attitudes and practices regarding the use of traditional medicine (TM) by patients with ischemic heart disease (IHD) in Oman. METHODOLOGY: This was a cross-sectional study based on a previously validated questionnaire conducted among patients attending a Cardiology outpatients' clinic. RESULT: There were 103(mean age 45.1+13.4 years; 85 or 82.5% male) responses to the questionnaire of which 70(67.9%) had previously used at least one form of TM. Those who had used TM were older (48.1+13.4yrs vs 41.2+10.9 years; p=0.01). However, there was no difference between the gender, educational status or occupation between the two groups. Cupping was the most common (58 out of 70 or 82.8%) followed by herbal medications (52 or 74.2%) and branding (47 or 67.1%), TM was used mainly for non-cardiac indications such as headache (47 or 67.1%), back pain (42 or 60%), abdominal pain (41 or 58.5%) and only 30 (42.8%) using it for chest pains. Majority of those who had used (65 out of 70 or 92.8%) said that they felt it was effective and 58 (82.8%) said that they would try it again. However, only 21.4% said that they would recommend it to others. CONCLUSION: Our study demonstrates that there is widespread use of TM practices among patients with IHD in Oman and their use should be monitored due to the potential for interactions with regular medications and side effects.
Effectiveness of Rectal Versus Oral Diclofenac for Perineal Pain Relief following Episiotomy Repair at a Tertiary Hospital in Port Harcourt, Nigeria: A randomized controlled study.
Amachree PT, Awoyesuku PA, Omietimi JE … +3 more , Iheagwam RB, Jumbo AI, George MD
Niger Med J · 2025 · PMID 41169854 · Full text
BACKGROUND: Perineal pain following episiotomy repair is a common complaint after vaginal delivery and may be severe, requiring the use of strong analgesics. Diclofenac is a non-steroidal anti-inflammatory drug commonly...
BACKGROUND: Perineal pain following episiotomy repair is a common complaint after vaginal delivery and may be severe, requiring the use of strong analgesics. Diclofenac is a non-steroidal anti-inflammatory drug commonly used for pain relief. This study aimed to compare the effectiveness of rectal versus oral Diclofenac in the management of pain post-episiotomy repair. METHODOLOGY: A prospective double-blind randomized controlled study was carried out involving 132 booked mothers who had episiotomy repair after vaginal delivery at a tertiary hospital in Port Harcourt, Nigeria. They were randomized into two groups and received either rectal diclofenac 100mg and oral placebo 12 hourly (Group A), or oral diclofenac 100mg and rectal placebo 12 hourly (Group B), for 48 hours following the repair. Perineal pain was measured using Visual Analogue Scale (VAS). Both groups were monitored for 48 hours (pain relief assessed at 6, 12, 18, 24, 36 and 48) and the analgesic effectiveness compared. The data obtained was analysed using IBM SPSS version 24. The recruitment spanned from 1st September 2023 to 30th January 2024. RESULTS: Both groups were similar in their baseline socio-demographic characteristics. The overall mean pain score was significantly lower in the rectal diclofenac group than the oral diclofenac group (4.14±0.42 vs. 4.30±0.44, t=2.01, p=0.048). Majority of the participants in the rectal route expressed more satisfaction (66.7% vs. 37.1%, χ2=23.08, p<0.01). The mean time interval (hours) between drug administration and the first urine void was similar in both groups (3.19±3.13 vs. 3.29±3.11, t=0.29, p=0.74), and there was no difference in the requirement for additional analgesia (12.1% vs. 9.1%, χ2=0.32, p=0.57). CONCLUSION: Diclofenac suppository was more effective in management of perineal pain following episiotomy repair and the participants in the rectal route group expressed more satisfaction than their counterparts who received the oral drug.
Exploring diversity in Non-Alcoholic Fatty Liver Disease (NAFLD) among lean, overweight, and obese patients: A Multicenter study from India.
Sahoo PP, Yadav DP, Singh M … +5 more , Praharaj D, Singh A, Uthansingh K, Sahu MK, Pati GK
Niger Med J · 2025 · PMID 41169853 · Full text
BACKGROUND: One common chronic liver illness is non-alcoholic fatty liver disease (NAFLD) affecting individuals across various body weights. Traditionally associated with obesity, NAFLD is now increasingly observed in ov...
BACKGROUND: One common chronic liver illness is non-alcoholic fatty liver disease (NAFLD) affecting individuals across various body weights. Traditionally associated with obesity, NAFLD is now increasingly observed in overweight and lean individuals as well. This research investigates the clinical, metabolic, dietary pattern, and socio-demographic differences of NAFLD in lean, overweight, and obese individuals across various centers in two Indian states. METHODOLOGY: Conducted as a cross-sectional observational study with 154 NAFLD patients aged 18-65 years across four centers [Odisha (OD) -3; Uttar Pradesh (UP) -1], the research utilized a self-administered questionnaire to gather socio-economic, biochemical, and clinical data. Data analysis involved Chi-square tests at a 0.05 significance level. Trail Registration: CTRI/2024/04/065699. RESULT: The majority of NAFLD cases were found in obese patients (37.01% in Odisha and 35.06% in UP). Overweight NAFLD was more common in UP (10.39%), while lean NAFLD was more prevalent in Odisha (7.14%). Obesity was significantly associated with diabetes in both states (p=0.020). Constipation was notable in overweight and obese groups (p=0.001 and p=0.027), and bloating was more frequent in overweight individuals (p=0.064). Loss of appetite was significant among lean NAFLD patients. Biochemical parameters and food consumption across ten food groups showed no significant variation. CONCLUSION: Overall, NAFLD was more common among obese patients, highlighting the need for tailored dietary interventions based on body type.
Clinico-hematological Portrait of Bone Marrow Infections: Unusual Visitors Unveiled.
Shuchismita, Jamal I, Raman RB … +3 more , Choudhary MK, Sharan S, Choudhary V
Niger Med J · 2025 · PMID 41169852 · Full text
BACKGROUND: Bone marrow examination is a crucial diagnostic tool for both hematological and non-hematological disorders, ranging from benign to malignant ones. It is a relatively simple and easy procedure for evaluating...
BACKGROUND: Bone marrow examination is a crucial diagnostic tool for both hematological and non-hematological disorders, ranging from benign to malignant ones. It is a relatively simple and easy procedure for evaluating pyrexia of unknown origin, as it often leads to an etiological diagnosis. The study aims to evaluate the clinico-hematological profile in various infections infiltrating bone marrow and study the spectrum of morphologic alterations in bone marrow aspirate in various infections. METHODOLOGY: This retrospective observational study was conducted at a tertiary care center in Bihar, India, over a 4.5-year period (June 2019-December 2023). All patients referred to the haematology section for bone marrow aspiration and/or biopsy based on strong clinical and morphological suspicion of infection were included. Cases with inadequate marrow samples or lacking corroborative infection evidence were excluded. RESULT: The study included a total of 52casesdemonstratingthe presence of bone marrow infections. Out of 52 cases, bone marrow aspirations were done in all cases, whereas bone marrow biopsy was done in 23(44.2%) cases only. There were 39 (75%) cases of adults and 13 (25%) of children; and the mean age of presentation was 35.3 years (range, 1-72 years).On clinical examination, anemia was the most common symptom (82.6%), followed by splenomegaly (78.8%). On bone marrow examination, an increase in plasma cells was the most striking finding, accounting for 67.3% (n=35), followed by erythroid hyperplasia and an increased number of macrophages showing features of hemophagocytosis in 50% and 32.6% of cases, respectively. A total of 41 cases showed the presence of Leishmania Donovani (LD) bodies. Granulomas were seen in 09 cases (17.3%), out of which 05(9.6%) cases showed AFB positivity. CONCLUSION: Bone marrow examination plays a pivotal role in diagnosing various infectious diseases, particularly in patients presenting with pyrexia of unknown origin, cytopenias, or unexplained hematological abnormalities. Morphological analysis, along with specialized staining techniques, allows the identification of a broad spectrum of infectious agents, spanning from parasites and bacteria to fungi.
Awareness and Determinants of Analgesic Abuse Among Undergraduate Students of University of Port Harcourt, Rivers State, Nigeria: A Descriptive Cross-sectional Study.
Enuagwuna FC, Dappa FA, Bethel TC … +1 more , Wilcox SA
Niger Med J · 2025 · PMID 41169851 · Full text
BACKGROUND: Rising incidents of deaths due to analgesic abuse are public health concerns globally. A good level of awareness and understanding of the determinants of analgesic abuse can reduce mortalities associated with...
BACKGROUND: Rising incidents of deaths due to analgesic abuse are public health concerns globally. A good level of awareness and understanding of the determinants of analgesic abuse can reduce mortalities associated with the condition. This study assessed the awareness and determinants of analgesic abuse among undergraduate students of the University of Port Harcourt. METHODOLOGY: A descriptive cross-sectional study design with multi-stage sampling was employed. An online self-administered questionnaire was used to collect information from 362 undergraduate students at the University of Port Harcourt. The data was analyzed using IBM Statistical Product and Service Solutions (SPSS) version 27. Data were summarized using means, frequency, proportions, Chi-square, and regression analysis; a p-value of <0.05 was considered significant. RESULTS: The awareness of risks associated with analgesic abuse was low in 47.4% and high in 10.9% of the respondents. Pharmacy students and females had higher levels of awareness. Peer pressure, availability of analgesics on campus/local stores, offer of analgesics by peer(s), and knowledge of someone who has experienced the adverse effects of analgesic abuse were significant determinants; however, only availability of analgesics on campus/local stores and offer of analgesics by peer were significant determinants of analgesic abuse from the bivariate logistic regression. CONCLUSION: The result showed that the majority of the respondents had low levels of awareness of risks associated with analgesic abuse, with females and pharmacy students showing higher levels of awareness. Peer pressure, availability of analgesics on campus/local stores, offer of analgesics by peers, and knowledge of someone who has experienced the adverse effects of analgesic abuse were significant determinants of analgesic abuse. Comprehensive educational/awareness programmes that cut across all departments and genders addressing analgesic abuse and policies to regulate the availability of analgesics on campus should be established in the institution.
Quality of Life among Women Living with Gynecological Malignancies in Zaria, Nigeria.
Yahya A, Babandi Z, Mustapha A … +6 more , Gumbi HS, Lawal BK, Zubairu IH, Umar SS, Kolawole AO, Oguntayo AO
Niger Med J · 2025 · PMID 41169850 · Full text
BACKGROUND: Cancer can have an impact on Quality of Life (QoL), which can be influenced by an individual's culture and value system. METHODOLOGY: The study was a cross-sectional descriptive study involving all women with...
BACKGROUND: Cancer can have an impact on Quality of Life (QoL), which can be influenced by an individual's culture and value system. METHODOLOGY: The study was a cross-sectional descriptive study involving all women with gynecological malignancies accessing care at Ahmadu Bello University Teaching Hospital, Zaria. The sample size constituted all women diagnosed with any gynecological malignancy who accessed care in Ahmadu Bello University Teaching Hospital within six months from the start of data collection. This period was from October 1st, 2023, to March 31st, 2024. A total of 176 cases were identified. The WHOQOL BREF was used to assess QoL. Scores greater than one standard deviation above the mean were considered good, scores less than one standard deviation below the mean were regarded as poor, while scores that fell between them were deemed fair. RESULTS: The mean age of respondents was 49.4 ± SD15.0 years. The mean overall quality of life and overall health were 3.18 ± SD 1.1 and 3.10 ± SD 1.1, respectively. The overall quality of life was poor in 19 (26%) of respondents, and only 7 (9.6%) of respondents had a good quality of life. The majority had a fair overall QoL. The overall QoL was significantly affected by the stage of disease (p=0.04) and treatment status (p=0.02). CONCLUSIONS: QoL concerns need to be addressed while offering care for women with gynecological malignancies.
Tuberous sclerosis with recurrent seizure, dermatological lesions, renal cysts, and hypothyroidism in a female patient in Awka, Nigeria.
Anyabolu EN, Ufoaroh CU, Okoli OI … +1 more , Izuu-Umeike AO
Niger Med J · 2025 · PMID 41169849 · Full text
The incidence of tuberous sclerosis seems to be rising in Nigeria. Tuberous sclerosis with cerebral, renal, thyroid, and dermatological manifestations have not been completely identified. This case report documents a rar...
The incidence of tuberous sclerosis seems to be rising in Nigeria. Tuberous sclerosis with cerebral, renal, thyroid, and dermatological manifestations have not been completely identified. This case report documents a rare case of tuberous sclerosis with cerebral and dermatological lesions, renal cysts, and hypothyroid state. A 28-year-old female patient who presented in our clinic with a history of recurrent seizures for 19 years, a shagreen patch on the right lumbar area, scarring alopecia, and puckering facial angiofibroma. No member of her family had a similar illness. Computerized tomography scan showed multiple echoic cysts in the two kidneys. Her thyroid function tests revealed a hypothyroid state. Brain computerized tomography showed subependymal calcified nodules of the lateral ventricles and prominence of the cerebral sulci, more at the vertex. Electroencephalogram findings were normal. She was placed on oral Carbamazepine 400mg BD and has remained seizure-free for two years. Tuberous sclerosis with concomitant renal, cerebral, and dermatological lesions and hypothyroidism, though rare, was presented. The patient had tuberous sclerosis with renal cysts, subependymal nodules, and prominence of the cerebral sulci, with recurrent seizures, ash leaf/shagreen patches, scarring scalp alopecia, and a hypothyroid state.
Acute Shoulder Injury Following Tdap Vaccination: A Case Report on SIRVA and the Importance of Proper Injection Technique.
Obayagbona KI, Zhao W, Arowona AM … +2 more , Odeyemi JO, Mirza L
Niger Med J · 2025 · PMID 41169848 · Full text
Shoulder Injury Related to Vaccine Administration (SIRVA) is a preventable iatrogenic condition caused by improper injection technique into the deltoid region. It can result in significant pain, inflammation, and impaire...
Shoulder Injury Related to Vaccine Administration (SIRVA) is a preventable iatrogenic condition caused by improper injection technique into the deltoid region. It can result in significant pain, inflammation, and impaired function. We report a case of a healthy adult female who developed acute shoulder pain and fatigue within hours of receiving an intramuscular tetanus toxoid vaccine. With no prior history of shoulder pathology, clinical evaluation supported a diagnosis of SIRVA. Conservative treatment with NSAIDs and physical therapy led to partial symptom relief, though some pain persisted a month later. This case highlights the importance of correct vaccination techniques and early recognition of SIRVA to mitigate its impact.
Clinical Challenges with Neovascular Glaucoma-Patient Tailored Strategies and Outcomes.
Rao A, Padhi TR, M SK
Niger Med J · 2025 · PMID 41169847 · Full text
BACKGROUND: To report the outcomes of patient-tailored concurrent combined surgery for retinal ischemia and intraocular pressure (IOP) control in neovascular glaucoma (NVG) with or without cataract. Methodology: Ninety-s...
BACKGROUND: To report the outcomes of patient-tailored concurrent combined surgery for retinal ischemia and intraocular pressure (IOP) control in neovascular glaucoma (NVG) with or without cataract. Methodology: Ninety-seven (97) eyes with NVG seen between January 2022-September 2023 at a tertiary eye care centre, 6 eyes (4 proliferative diabetic retinopathy and 2 retinal vein occlusion) that underwent concurrent retinal and glaucoma procedures with or without cataract surgery, were recruited. Outcomes after surgery were based on the World Glaucoma Association guidelines on the reporting of glaucoma surgical trials that comprise functional and surgical parameters. RESULTS: The IOP reduced by>50% from baseline in all 6 eyes, with one eye developing shallow AC by overstraining and 3 eyes developing transient self-resolving hyphema. Two eyes received additional bevacizumab (n=1) or ranibizumab (n=1) injections for persistent DME at 4 and 5 months after surgery. The final IOP was reduced in all eyes at the final follow-up of 6±1.2 months, with one eye requiring 2 medications for IOP control. CONCLUSION: The outcomes after concurrent retinal and glaucoma filtering surgery in NVG may provide favourable outcomes comparable to the traditional stepwise approach to management provided these are offered on a case-case basis.
Opioids in Cancer Pain Management: A Double-Edged Sword of Relief and Risk.
Omokore OA, Quadri IO, Kingdom PJ … +16 more , Ogbuiyi-Chima IC, Meribole SE, Olayinka TO, Ogunnoiki S, Precious SO, Olaitan A, Chima-Ogbuiyi N, Ifeanyichukwu OC, Ikpegbu RC, Adelakun FG, Aderinboye PO, Okpanachi P, Oladeji O, Baah H, Edochie P, Tsegah D
Niger Med J · 2025 · PMID 41169846 · Full text
Opioids are indispensable for managing cancer-related pain but carry risks such as immunosuppression, increased susceptibility to infections, and potential tumour progression. Balancing effective pain relief with these r...
Opioids are indispensable for managing cancer-related pain but carry risks such as immunosuppression, increased susceptibility to infections, and potential tumour progression. Balancing effective pain relief with these risks remains a critical challenge. This review examines the dual role of opioids in cancer pain management, highlighting their benefits, risks, and ethical implications while exploring strategies to mitigate adverse effects. Through a comprehensive literature review, we analysed mechanisms of opioid-induced immunosuppression, infection risks, tumour progression, and ethical prescribing practices. Additionally, strategies such as multimodal analgesia, opioid rotation, and personalised medicine were evaluated. Findings indicate that while opioids effectively alleviate cancer pain, they may suppress immune function, elevate infection risks, and potentially promote tumour progression. Mitigation strategies, including multimodal approaches, immunomodulatory interventions, and adherence to ethical principles (beneficence, non-maleficence, autonomy, and justice), are essential for safe opioid use. In conclusion, opioids remain vital for cancer pain management but require judicious application to minimise risks. Future research should prioritise non-opioid alternatives and immunomodulatory therapies to enhance patient outcomes.
Epidemiology and Pattern of Mental Health (Psychiatric) Disorders in Sierra Leone: A Retrospective Cross-Sectional Study of 4020 Cases.
Eze GO, Onyishi NT, Nnaji FC … +1 more , Kromba K
Niger Med J · 2025 · PMID 41169845 · Full text
BACKGROUND: The organization of mental health services and management of mental health disorders are driven by the availability of information on patterns and prevalence of such conditions. To the best of our knowledge,...
BACKGROUND: The organization of mental health services and management of mental health disorders are driven by the availability of information on patterns and prevalence of such conditions. To the best of our knowledge, no study has presented the pattern of mental illness in Sierra Leone disaggregated by ICD (International Classification of Diseases) categorization. This study aims to establish the socio-demographic profile and ICD11 diagnostic categorization of mental health patients in Sierra Leone. METHODOLOGY: All patients registered at SLPTH Kissy from 1st January 2021 to 31st July 2023 were eligible for the study. Data were retrospectively collected from the digital register of patients. Abstracted variables included patients' age, sex, marital status, district of residence, and diagnosis. Each of the diagnoses was further classified into one of the broad ICD-11 mental health diagnostic categories. Statistical analysis was done in Microsoft Excel and SPSS software. RESULT: There were 4020 individual patients, translating to an average of 130 new registrations monthly. The age range of patients was 4 to 96 years, with a median (IQR) age of 30(23 -40) years. About 87% of all patients were below 50 years of age. Of the 4020 patients, 2591 (64.5%) were males while 1429(35.5%) were females (P<.001). Disorders due to substance abuse accounted for 38.9% of all presentations, followed by schizophrenic and mood disorders at 25.1% and 19.0% respectively. Disorders of substance use, and Schizophrenia/primary psychotic disorders were significantly more prevalent in males, while Mood disorders were significantly more prevalent in females. CONCLUSION: Mental Health disorders in Sierra Leone showed comparable socio-demographic patterns with findings in regional studies. There are significant gender differences in the frequency of some ICD categories of mental disorders. Substance use is a foremost cause of severe mental illness; thus, campaign of demand reduction will improve the mental health situation of the country.
Determinants of Discharge against Medical Advice among Paediatric Patients in a Tertiary Hospital in Nigeria: A Retrospective Observational Study.
Adeyemi EO, Oladele AG, Anidobe C … +3 more , Ojulowo OB, Atoyebi OE, Adaje AO
Niger Med J · 2025 · PMID 41169844 · Full text
BACKGROUND: Discharge Against Medical Advice (DAMA) among children represents a significant public health issue in low-and middle-income countries. DAMA occurs when a patient leaves the hospital contrary to the physician...
BACKGROUND: Discharge Against Medical Advice (DAMA) among children represents a significant public health issue in low-and middle-income countries. DAMA occurs when a patient leaves the hospital contrary to the physician's recommendation. This action can hinder effective healthcare delivery and may lead to increased rates of morbidity and mortality. The aim of this study was to assess the prevalence and underlying reasons for DAMA among paediatric patients at a tertiary healthcare facility in Nigeria. METHODOLOGY: A descriptive retrospective study was carried out from October 1, 2020, to September 30, 2022, at the Department of Pediatrics, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Data such as age, gender, diagnosis, duration of hospital stay, insurance status, and the highest educational attainment and occupation of both parents were retrieved from the admission record book. These data were analyzed using proportions and Pearson's chi-square (χ) test. A p-value of less than 0.05 was considered statistically significant. RESULTS: The prevalence of DAMA was 3.4%, with 30 cases recorded out of 875 admissions. A higher proportion of those discharged were females (18 out of 30; 60.0%), and the majority (27 out of 30; 90.0%) belonged to the lower socioeconomic class. Sepsis, malignancy, malaria, and sickle cell anaemia collectively accounted for 80.2% of the diagnoses. The most common reason for DAMA was financial constraint, cited in 15 out of 30 cases (50.0%). Notably, none of the patients had health insurance. CONCLUSION: Financial constraints were identified as a leading cause of paediatric DAMA in our environment. Given that none of the affected patients were enrolled in any health insurance scheme, there is a need to raise public awareness about the benefits of health insurance.
Adult intussusception: A case report and review of literature of a patient seen at university of Abuja teaching hospital, Gwagwalada, Abuja, Nigeria.
Richard SK, Sani SA, OnuIllah G … +2 more , Kabang HA, Terna YK
Niger Med J · 2025 · PMID 41169843 · Full text
Intussusception is a recognized cause of bowel obstruction and is significantly more common in paediatric patients. Adult intussusception is rare and usually results from a predisposing factor in most patients. These fac...
Intussusception is a recognized cause of bowel obstruction and is significantly more common in paediatric patients. Adult intussusception is rare and usually results from a predisposing factor in most patients. These factors may include benign lesions, malignant lesions, or bowel wall abnormalities such as inflammatory bowel disease. We report on a case of a patient who presented with recurrent colicky central abdominal pain, anorexia, vomiting with occasional constipation and diarrhoea for six months. She was assessed and investigated with abdominal USS and Computer Tomography (CT) Scan, which showed features of intussusception, with telescoping of the jejunum with proximal bowel distension suggesting bowel obstruction. The patient underwent emergency laparotomy and surgical resection, and histopathology confirmed the lead point as intraluminal lipoma. We present a case of jejuno-jejunal intussusception in an adult, which is not commonly seen. The history of recurrent colicky abdominal pain and CT abdomen, together with an abdominal ultrasound scan (USS), was important in establishing a preoperative diagnosis, and histology confirmed lipoma as a lead point. Despite the conservative approach described in the literature, surgery continues to be the only option in patients who are unstable with persistent colicky abdominal pain, vomiting, abdominal distension, and constipation; Surgery is advocated for all adult patients. Adult intussusception is not a common condition and can be difficult to diagnose, posing a diagnostic conundrum. Patients with intussusception may report a relatively long period of recurrent colicky abdominal pain that might worsen acutely following complete obstruction. Abdominal CT scan is a very useful investigation in the preoperative diagnosis of intussusception, with histopathological confirmation of lipoma as a lead point.
Histopathological and Immunohistochemical Patterns of Malignant Peripheral Nerve Sheath Tumours in a Tertiary Institution of Northern Nigeria.
Adamu ZA, Buhari MO, Mohammed A
Niger Med J · 2025 · PMID 41169842 · Full text
BACKGROUND: Malignant peripheral nerve sheath tumours (MPNSTs)are uncommon, aggressive sarcomas arising from a peripheral nerve or extra neural soft tissue and show evidence of nerve sheath differentiation. These tumours...
BACKGROUND: Malignant peripheral nerve sheath tumours (MPNSTs)are uncommon, aggressive sarcomas arising from a peripheral nerve or extra neural soft tissue and show evidence of nerve sheath differentiation. These tumours exhibit variability in grade and can either occur as familial or sporadic tumours. Immunohistochemistry is a paramount tool in the evaluation of these tumours. This study aimed at analyzing the histopathological and immunohistochemical patterns of these tumours and determining the frequency, demographic and anatomical site distribution. METHODOLOGY: This was a 10-year retrospective hospital-based study. Formalin fixed paraffin embedded tissue blocks were sectioned and the slides werereviewed and interpreted. Morphological features were noted and immunohistochemical analysis was performed using four primary antibodies. Descriptive statistical analysis was used to collate and analyse data, and statistical test was used where necessary. The results were presented on statistical charts and tables. RESULT: In this series, 20 cases of MPNSTs were seen with a male predilection. The 3 and 4 decades were the most frequent decades of occurrence, and most tumours occurred in the gluteal region (eight cases) constituting 40% of all anatomical site's distribution. Borderline/intermediate grade tumours (Grade 2) were the most frequent grade. S100 (25%) and SOX10 (35%) showed low positive immunoexpression. Most of the tumours had low proliferative index or labelling hot spots with Ki67 antibody. CONCLUSION: Malignant peripheral nerve sheath tumours are uncommon and tend to be sporadic in our region. Most of these tumours are borderline/intermediate grade tumours (Grade 2) showing low immunoexpression to antibodies employed with varying intensities.
A Composite Risk Scoring Model for Predicting Adverse Perinatal Outcomes in Patients with Pre-Eclampsia- A Pilot Study.
Gothwal M, Babu A, Singh P … +3 more , Yadav G, Asati S, Gupta A
Niger Med J · 2025 · PMID 41169841 · Full text
BACKGROUND: Accurate early identification of pregnancies at high risk for adverse fetal outcomes (small-for-gestational-age [SGA], preterm birth, stillbirth) enables targeted interventions. The study aims to pilot the de...
BACKGROUND: Accurate early identification of pregnancies at high risk for adverse fetal outcomes (small-for-gestational-age [SGA], preterm birth, stillbirth) enables targeted interventions. The study aims to pilot the development and internal validation of a point-based Fetal Risk Score (rFRS₅) incorporating ten routine maternal parameters, and to compare its performance against a simpler four-item score (FRS red). METHODOLOGY: In this single-centre, retrospective cohort study of 118 pregnant women, we assigned points based on clinically meaningful ranges for age, parity, BMI, blood pressure, 24-hour proteinuria, haemoglobin, platelets, ALT, AST, and LDH. We computed rFRS₅ (0-19 points) and FRS_red (0-6 points). Discrimination was assessed using the ROC AUC (5-fold cross-validation), and calibration was evaluated using the Brier score and calibration curves. Optimal thresholds were determined by sensitivity/specificity trade-offs. Variables for score development were selected a priori based on clinical relevance and published evidence. Internal validation was performed using five-fold cross-validation and calibration methods. RESULT: rFRS₅ achieved ROC AUC 0.80 and Brier score 0.219; FRS red achieved ROC AUC 0.82 and Brier score 0.220. For rule-out (sensitivity 100 %), rFRS₅ < 2 and FRS red < 2 both provided NPV 100 %. For rule-in, FRS red ≥ 6 yielded specificity 94 % and PPV 50 %, outperforming rFRS₅ (specificity 68 %, PPV 40 %). CONCLUSION: In this pilot study, both scores effectively stratify fetal risk, with the simpler FRS red offering superior rule-in performance in resource-limited settings. Larger, prospective studies are warranted to confirm these findings.
Cervicovaginal fetal Fibronectin in Predicting Success of Induced Labour among Nulliparous Women.
Archibong MS, Sangolana MO, Olomola OV … +7 more , Amuda M, Ugwu OT, Adetunji LN, Ojo OD, Ubom AE, Ayegbusi EO, Orji EO
Niger Med J · 2025 · PMID 41169840 · Full text
BACKGROUND: Induction of labour is a routine and common obstetric intervention which aims at achieving successful vaginal delivery. Over the years, attempts have been made to find a pre-induction test that can predict th...
BACKGROUND: Induction of labour is a routine and common obstetric intervention which aims at achieving successful vaginal delivery. Over the years, attempts have been made to find a pre-induction test that can predict the success of induced labour, which may also serve as a selection criterion for determining which women should undergo labour induction. The study aims to determine whether the presence of fetal fibronectin in the cervicovaginal secretion can predict the success of induced labour. METHODOLOGY: This was a cohort study involving 137 nulliparous women at term undergoing induction of labour. The presence of fetal fibronectin in the cervicovaginal secretion was determined using a fetal fibronectin rapid immunoassay kit. Induction of labour was done using misoprostol. RESULTS: Data obtained were analysed using statistical product and service solutions (IBM-SPSS) version 20.0. Data obtained were tested for normality of distribution and compared by Chi square, Students' t-test, or Mann-Whitney U as appropriate. A p-value of less than 0.05 was regarded as significant. The rate of vaginal delivery was not significantly different between fetal fibronectin positive and negative women (65% vs. 66.7%, p value- 0.839). Women who were positive for fibronectin had a significantly shorter mean duration of induction (22.8+6.1 hours versus 30.1 + 11.1 hours, P value of 0.015), had higher bishop's scores, and required fewer doses of misoprostol. Regression analysis did not find fetal fibronectin to be predictive of vaginal delivery. CONCLUSION: The Presence of fetal fibronectin was not predictive of successful labour induction. Its presence may possibly be associated with a relatively shorter duration of induction.
Screening for Psychological distress and their Determinants among Clinical nurses in Tertiary Care Teaching Institution, India: A cross-sectional Survey.
Chelladurai S, Chellamuthu V, S S … +1 more , Kalyani VC
Niger Med J · 2025 · PMID 41169839 · Full text
BACKGROUND: Nurses are continually subjected to physical and mental stress because of their employment. Estimating the prevalence of and its association with psychological distress among nurses is critical for developing...
BACKGROUND: Nurses are continually subjected to physical and mental stress because of their employment. Estimating the prevalence of and its association with psychological distress among nurses is critical for developing health promotion initiatives. We conducted this study to investigate the incidence of psychological distress and related characteristics among nurses working in a teaching institute in Jharkhand. METHODOLOGY: We conducted cross-sectional research involving 452 clinical nurses between December 2024 and February 2025. We examined psychological distress using a self-administered general health questionnaire-12 (GHQ-12). Participants with a GHQ-12 score > three were classified as having psychological distress. The chi-squared test and multiple logistic regression analysis were performed to identify the components related to psychological distress. RESULT: More than one-fourth of nurses, 25.2% (95% CI: 21.3 - 29.5), had psychological distress. Psychological distress was significantly higher among age group of 26-30 years ( aPR=3.1, 95% Cl: 1.3 - 7.3) those who were not doing any physical activity (aPR=2.2, 95% Cl: 1.3 -3.6), those with poor sleep quality (aPR=2.0, 95% Cl: 1.0 -3.), and those having online screen time >3 hours (aPR=3.1, 95% Cl: 1.3 - 7.3). CONCLUSION: We report a high prevalence of psychological distress among nurses, especially among the age group of 26-30 years, those having poor sleep quality, and those not doing physical activity and having online screen time of more than 3 hours. We highlight that reducing workplace stress and improving sleep hygiene can be vital in improving mental health status.
Robotic Surgery in Africa: History, Contemporary, and Thereafter.
Okebalama VC, Omokore OA, Dike-Isreal VC … +11 more , Asaolu IO, Owolabi HA, Idowu MJ, Evwierhoma EZ, Perelade KJ, Olabiyi HO, Chima-Ogbuyi N, Olayemia RA, Abaenowa CC, Akudinobi OK, Okoronkwo CE
Niger Med J · 2025 · PMID 41169838 · Full text
BACKGROUND: Since its introduction in the late 1980s, robotic surgery has become a less invasive procedure, offering advantages such as increased dexterity, mobility, 3D visualization, and reduced fatigue for surgeons. A...
BACKGROUND: Since its introduction in the late 1980s, robotic surgery has become a less invasive procedure, offering advantages such as increased dexterity, mobility, 3D visualization, and reduced fatigue for surgeons. Although the procedure is still not widely used in Africa, it is fast growing and can potentially minimize surgical inequities in low- and middle-income nations. This narrative review aims to explore the advantages of robotic surgery, its history in Africa, the current level of application of this surgical technique in the continent, the limitations, and how the healthcare system in the region stands to benefit from its use in the future. METHODOLOGY: In this narrative review, extensive literature research was conducted using the Google search engine and databases: 'Google Scholar', 'Cochrane Library', 'PubMed', 'ScienceDirect', and African Journals Online (AJOL), spanning 6 months. The search phrases used included: robotic surgery, robotic surgery in Africa, history of robotic surgery in Africa, robotic surgery in low- and middle-income countries, potential advantages of robotic surgery, robotic surgery limitations, benefits of robotic surgery, demerits of robotic surgery, artificial Intelligence in surgical care, and the future of robotic surgery.A total of 405 articles were found. An advanced search that limited the search to titles revealed only 20 results. Two discussed the possibility of embracing robotic surgery in low- and middle-income countries, one talked about the potential benefits, challenges, and scope of robotic surgery in the future. Also, one talked about the origin of robotic surgery, one delved into artificial Intelligence and its role in surgical care, then discussed the roles of robotic surgery in surgical care, and the rest discussed the few recorded applications of robotic surgery in surgical care in Africa. RESULTS: Even though the concept of robotics in surgery dates back more than fifty years, its practical application began in the late 1980s. Its enormous potential notwithstanding, the application of robotic surgery on the African continent is still highly underwhelming. Admittedly the utilization of robotic surgery in Africa faces many challenges such as the high cost of its acquisition, maintenance, and training needed to use the machine, the upskilling of surgeons to specialize in robotic surgery in each field of expertise, the need to alter the size and layout of pre-existing operating rooms to accommodate the components of the robots and to also increase patient load for the use of the robot to make it effective for the cost price, it can potentially reduce cost of healthcare, nosocomial infections, antibiotics abuse and surgical inequalities in the Mother Continent. CONCLUSION: Our research showed that robotic surgery, despite offering multiple benefits and having the capability to lessen surgical inequalities in resource-poor nations, is still underutilized in the African continent. The study also showed that even though the utilization of robotic surgery faces challenges in middle and low-income parts of the world, like Africa, due to high costs, limited facilities, patient burden, and the need for specialized training. It, however, holds enormous potential in the continent, such as reductions of infections, antibiotic resistance, and hospital stays, and even possibly reduce the costs of healthcare.
Pre-cancerous cervical lesions among women in Bauchi: A crosssectional study.
Aminu MB, Suleiman DE, Makama L … +7 more , Muhammad A, Misau YA, Yusuf AB, Gabi UI, Gumau SA, Albuhari AG, Audu BM
Niger Med J · 2025 · PMID 41169837 · Full text
BACKGROUND: Cervical cancer is an important contributor to morbidity and mortality in low Human Development Index (HDI) countries where organized cervical cancer screening is often lacking. There is a paucity of data on...
BACKGROUND: Cervical cancer is an important contributor to morbidity and mortality in low Human Development Index (HDI) countries where organized cervical cancer screening is often lacking. There is a paucity of data on the prevalence of cervical precancerous lesions in Bauchi, Nigeria. METHODOLOGY: This cross-sectional study was carried out in selected hospitals in the 3 senatorial zones of Bauchi State. Sociodemographic and reproductive data were collected using a data collection tool, and cervical smears were collected and stained using a manual liquid-based cytology (LBC) method. RESULTS: Out of 458 women who underwent screening, 410 (89.5%) of the participants had a negative smear. Low-grade squamous intraepithelial lesions (LSIL) and Atypical squamous cells of undetermined significance (ASC-US) were the most common diagnostic categories of abnormal smears, together accounting for 78.9% of abnormal pap smear results. The chances of developing cervical precancerous lesions were higher in women <35 years (p<0.05). There was no statistically significant association between precancerous lesions and age at sexual debut or marital status (p>0.05). CONCLUSION: There is a need to implement organized state-wide screening programmes within the state to improve detection rates of cervical pre-cancerous lesions and eventually a reduction in cervical cancer mortality and morbidity statistics in the country.
Clinical Characteristics and Outcome of Children with Non-Traumatic Coma: Experience from a Tertiary Hospital in Rivers State, Nigeria.
Gabriel-Job N, Wobo KN
Niger Med J · 2025 · PMID 41169836 · Full text
BACKGROUND: Non-traumatic coma (NTC) is a common neurological emergency associated with high morbidity and mortality. This study investigates the clinical features and outcomes in children at the University of Port Harco...
BACKGROUND: Non-traumatic coma (NTC) is a common neurological emergency associated with high morbidity and mortality. This study investigates the clinical features and outcomes in children at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State. METHODOLOGY: A prospective study was conducted from 2021-2023 involving 406 patients who presented with NTC in the children's emergency ward and were consecutively recruited into the study. Consent was obtained from parents/caregivers. Data on age, sex, and clinical history were collected. The aetiology of NTC was determined based on history, clinical examination, and laboratory investigations. The degree of encephalopathy was assessed at presentation using Glasgow's coma score. All patients were followed up until discharge to evaluate the outcome. RESULT: A total of 5120 patients aged 1 month to less than 18 years were admitted, with 406 cases of NTC, indicating a prevalence (406/5120) of 7.9%. Of the 406 patients, 194 (47.8%) were males. Their ages ranged from 3 months to 17 years (mean age, 6.13±5.10 years). The prevalence of NTC was higher among under five years old. Fever (76.1%), convulsions (63.8%), and vomiting (53.2%) were the common complaints presented. Two hundred and forty-one (59.4%) patients presented with mild encephalopathy. The primary causes of NTC were CNS infection in 280 (69.0%), metabolic or toxic causes in 44 (10.8%), and epileptic causes in 27 (6.6%). Seventy-one (17.5%) patients died, while 319 (78.6%) were discharged. Among those discharged, 10.0% had mild disability, 3.4% severe disability, and 1.3% remained in a permanent vegetative state. The outcomes were influenced by sex, level of encephalopathy at presentation, age, and the need for ICU care. CONCLUSION: NTC is common in children, CNS infections, particularly cerebral malaria and meningitis, were the predominant causes. Implementing measures to prevent these infections is important in our setting, where resources are limited for adequate management.
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