Nigerian Medical Journal[JOURNAL]
Sun
200 papers
Experience with Anaesthesia for Cleft Surgery in a Smile Train Partner Hospital in a Low- and Middle-Income Country.
Alagbe-Briggs OT, Onajin-Obembe BO
Niger Med J · 2025 · PMID 40703909 · Full text
BACKGROUND: Patients with cleft lips and palate (CLP) pose a high perioperative risk. Specialized anaesthesia is therefore required to improve outcomes. The experience with anaesthesia for patients scheduled for cleft su...
BACKGROUND: Patients with cleft lips and palate (CLP) pose a high perioperative risk. Specialized anaesthesia is therefore required to improve outcomes. The experience with anaesthesia for patients scheduled for cleft surgeries at the University of Port Harcourt Teaching Hospital, a Smile Train partner hospital in Nigeria-West Africa (a low- and middle-income country-LMIC), from January 2020 to June 2023 is hereby presented. METHODOLOGY: Data on demography, clinical and perioperative characteristics of patients billed for CLP surgery from January 2020 to June 2023 were collected, using records from patient's folders, anaesthetic and theatre registers. SPSS v.22 was used for analysis and results presented as frequencies and percentages. RESULTS: A total of 94 patients were anaesthesized during the study period, including 10(10.6%) preoperative cancellations that were optimized. The mean age was 54.7±73.8 months, M:F ratio was 1:1.2, paediatric patients were 90(95.7%) and general anaesthesia (GA) with controlled ventilation was 93(98.9%). Surgeries were CP-49(52.1%), CL-42(44.7), and palatal fistula repair-3(3.2%). Preoperatively, 4 (4.3%) each had anaemia and upper respiratory tract infection which were treated. Mandatory monitoring included non-invasive blood pressure 94(100%), pulse oximetry 94(100%), ECG 94(100%) and end tidal CO2 93(98.9%). Intraoperatively, difficult intubation 6(6.4) and hypoxaemia 4(4.3%) were encountered; and postoperatively there was respiratory obstruction in 4(4.3%). All complications were successfully managed with full recovery. CONCLUSION: With specialised perioperative care, anaesthesia for cleft surgeries can be associated with good outcomes in low- and middle-income countries (LMIC).
Human Hearts, Machine Minds: How Artificial Intelligence Can Transform Paediatric Care in Nigeria.
Abdu-Raheem F, Musa S
Niger Med J · 2025 · PMID 40703908 · Full text
Due to its ubiquitous use in diverse sectors, artificial intelligence (AI) has been hailed as the fourth industrial revolution. AI's potential has not been fully realised in Nigeria's medical space, notably in paediatric...
Due to its ubiquitous use in diverse sectors, artificial intelligence (AI) has been hailed as the fourth industrial revolution. AI's potential has not been fully realised in Nigeria's medical space, notably in paediatric care. We discuss how AI can improve paediatric care in Nigeria, focusing on early diagnosis, precision medicine, and remote monitoring. AI must overcome several obstacles to be appropriately integrated into paediatric care. The disparity between training data and healthcare settings can cause algorithmic bias, diagnostic errors, and flawed treatment recommendations. More substantial patient privacy rights and transparent AI algorithms are needed to build healthcare workers and patient trust in AI and ease AI adoption. This paper contends that medical curricula must include training in AI and related fields to equip future Nigerian paediatricians with the skills to maximise AI's potential. Meanwhile, Nigerian paediatricians and AI specialists must join forces to adapt AI technologies to Nigeria's particular needs.
Giant Cystic Mucinous Borderline Tumour of the Ovary in a Young Female: A Rare Case Report.
Gupta N, Myes D, Avd K … +1 more , Sharma S
Niger Med J · 2025 · PMID 40703907 · Full text
Giant mucinous borderline tumours of the ovary are an unusual finding and pose a diagnostic challenge. We present a case of a 20-year-old unmarried, nulliparous female who presented with left quadrant pain and a progress...
Giant mucinous borderline tumours of the ovary are an unusual finding and pose a diagnostic challenge. We present a case of a 20-year-old unmarried, nulliparous female who presented with left quadrant pain and a progressively increasing abdomino-pelvic mass. Based on clinical and radiological investigations, a provisional diagnosis of mass arising from the ovary was made. The histopathological evaluation revealed it to be a mucinous borderline ovarian tumour.
Type 2 Cardiorenal Syndrome: Prevalence and Correlates in Nigerian Heart Failure Patients.
Uchendu DG, Okeahialam BN, Imoh LC … +2 more , Esala AE, Zunman GM
Niger Med J · 2025 · PMID 40703906 · Full text
BACKGROUND: Type 2 cardiorenal syndrome (Type 2 CRS) describes a relationship in which chronic congestive heart failure causes a progressive and permanent chronic kidney disease. Heart failure (HF) and chronic kidney dis...
BACKGROUND: Type 2 cardiorenal syndrome (Type 2 CRS) describes a relationship in which chronic congestive heart failure causes a progressive and permanent chronic kidney disease. Heart failure (HF) and chronic kidney disease (CKD) share similar cardiovascular risk factors and have a bi-directional relationship. A comprehensive approach including early screening of HF patients for CKD as well as management involving the nephrologist and cardiologist will most definitely reduce morbidity and mortality. The aim of this study was to determine the prevalence of and correlates for Type 2 CRS among HF patients in JUTH, Jos-Nigeria. METHODOLOGY: A hospital-based cross-sectional descriptive study carried out in JUTH involving 120 patients with chronic HF recruited consecutively. History, physical examination and laboratory investigations including urinalysis using albustix were performed on all subjects. CKD was determined using estimated glomerular function rate (eGFR) and persistent albuminuria. The data were analyzed using Epi Info (CDC, Atlanta GA) and p-values <0.05 were considered statistically significant. RESULTS: The mean age of the participants was 52.00 ± 11.44 years, majority of whom were females consisting of 58.3%. The prevalence of CRS was 37.5%. Majoity (66.7%) of the patients had mild CRS, while 26.7% had moderate CRS, and only 6.7% had the severe CRS. The predictors of CRS were diabetes (OR=6.230; CI=2.094-19.093), New York heart Association (NYHA) grading I (OR=0.017; CI=0.002-0.142) and II (OR=0.089; CI=0.016-0.483), raised jugular venous pressure (JVP) (OR=7.099; CI=2.671-18.865), loud pulmonary component of the second heart sound (P2) (OR=3.769; CI=1.726-8.232), systolic dysfunction (EF<45%) (OR=3.316; CI=1.487-7.395), anaemia (OR=5.091; CI=1.657-15.640), albuminuria (OR:0.014, CI=0.004-0.052), rural/suburban dwelling (OR=2.875; CI=1.335-6.192) and increased cardiothoracic ratio (CTR) (OR=3.237; CI=1.019-10.278). CONCLUSION: The frequency of Type 2 CRS among CHF patients in JUTH was high. The predictors of chronic CRS include diabetes mellitus, NYHA grade, raised JVP, loud P2, systolic dysfunction, anaemia, albuminuria, rural/suburban dwelling and increased CTR. These findings highlight the urgent need to incorporate screening for CKD among stable heart failure patients at regular intervals, and early referral to the nephrologist to prevent further deterioration to ESRD.
Neuroimaging Findings and Their Prognostic Value in Acute Ischaemic Stroke Patients at University of Maiduguri Teaching Hospital (UMTH), Borno State, Nigeria.
Musa I, Joseph M, Musa Z … +13 more , Kehinde VV, Tunwagun DA, Igweike RC, Kawai CU, Yaga JM, Ja'afar IK, Olokpo MA, Paul GM, Chukwu IL, Kanhu PU, Amanum IO, Yakub Y, Onyemaechi Mogbolu W
Niger Med J · 2025 · PMID 40703905 · Full text
BACKGROUND: Accurate prediction of stroke outcomes in resource-limited settings remains challenging. This study assessed the utility of neuroimaging findings in predicting mortality among acute ischaemic stroke patients...
BACKGROUND: Accurate prediction of stroke outcomes in resource-limited settings remains challenging. This study assessed the utility of neuroimaging findings in predicting mortality among acute ischaemic stroke patients at the University of Maiduguri Teaching Hospital, Nigeria. METHODOLOGY: This prospective study enrolled 171 consecutive adults with acute ischaemic stroke between January and December 2023. All patients underwent non-contrast brain CT scanning, with infarct volume calculated using standardized measurements. The primary outcome was 30-day mortality. Multivariate logistic regression analysis identified independent predictors of mortality, which were used to develop a risk stratification system. RESULTS: Large infarct volume (>100,000 mm) emerged as the strongest independent predictor of mortality (aOR 6.82, 95% CI 2.0522.68, p=0.002), followed by multiple territory involvement (aOR 3.42, 95% CI 1.43-8.17, p=0.006). The developed risk score demonstrated good discriminative ability (AUC 0.775, 95% CI 0.689-0.860) and stratified patients into three risk categories with mortality rates of 8.2% (low), 11.8% (intermediate), and 42.0% (high) (p<0.001). CONCLUSION: Specific neuroimaging parameters can effectively predict early mortality in acute ischaemic stroke. The developed risk stratification tool could improve patient care in resource-limited settings.
Low-Pressure Versus Normal-Pressure Laparoscopic Cholecystectomy and its Effect on Intra-Operative Parameters and Post-Operative Pain: An Observational Study.
Sanjay T, Agarwal K, Rathod PA
Niger Med J · 2025 · PMID 40703904 · Full text
BACKGROUND: Pneumoperitoneum, created by insufflating carbon dioxide (CO), is essential for surgical visualization, but conventional intra-abdominal pressures (12-15 mmHg) can negatively impact cardiac and respiratory fu...
BACKGROUND: Pneumoperitoneum, created by insufflating carbon dioxide (CO), is essential for surgical visualization, but conventional intra-abdominal pressures (12-15 mmHg) can negatively impact cardiac and respiratory functions. To mitigate these effects, low-pressure pneumoperitoneum (7-10 mmHg) has been suggested. The present study aimed to compare the outcomes of laparoscopic cholecystectomy at low intra-abdominal pressure with conventional standard pressure laparoscopic cholecystectomy. METHODOLOGY: A prospective observational study was conducted in a tertiary care hospital in Eastern India over a period of one year, involving 100 patients undergoing elective LC for symptomatic uncomplicated cholelithiasis. Participants were divided into two groups: low-pressure pneumoperitoneum (LPP) (7-10 mmHg) and standard-pressure pneumoperitoneum (SPP) (12-15 mmHg). Key parameters such as operative time, hemodynamic changes, CO consumption, postoperative pain, and hospital stay were recorded. Statistical analysis was performed using SPSS version 16.0, with p<0.05 considered significant. RESULTS: The study found no significant difference in operative duration between LPP and SPP groups. However, CO consumption was significantly lower in the LPP group (p=0.040). Postoperative shoulder tip pain was more frequent in the SPP group (p=0.041). Additionally, patients in the LPP group had a significantly shorter hospital stay (p=0.042). Hemodynamic changes, particularly in heart rate and systolic blood pressure, were less pronounced in the LPP group compared to the SPP group. CONCLUSION: Low-pressure pneumoperitoneum in laparoscopic cholecystectomy is associated with reduced CO consumption, less postoperative pain, better preservation of hemodynamics, and shorter hospital stays compared to standard-pressure pneumoperitoneum. Despite potential challenges for surgeons, LPP appears to be a safe and feasible alternative for uncomplicated gallstone surgery in the hands of skilled professionals.
Catastrophic Outcomes: Rapid Multi-Organ Failure from Paraquat Poisoning- A Case Report.
Mehta PP, Annam RS, Hadiyel IN
Niger Med J · 2025 · PMID 40703903 · Full text
Paraquat dichloride, a potent herbicide widely used in agriculture, poses a severe health risk due to its high toxicity. Ingesting even small amounts can cause fatal multi-organ failure. We report a case of a 19-year-old...
Paraquat dichloride, a potent herbicide widely used in agriculture, poses a severe health risk due to its high toxicity. Ingesting even small amounts can cause fatal multi-organ failure. We report a case of a 19-year-old male who ingested approximately 5 ml of 24% paraquat dichloride. He presented with stable vital signs, but initial laboratory results showed elevated urea (26mg/dL), creatinine (0.97 mg/dL), and hypokalemia (3.2 mEq/L). Despite interventions including gastric lavage, N-Acetyl cysteine, methylprednisolone, and supportive care, he developed severe metabolic acidosis (HCO- 22.8 to 16.3 mEq/L), acute renal failure (creatinine 0.97 to 4.62 mg/dL, urea 26 to 99 mg/dL, serum potassium 3.2 to 2.62 mEq/L), and multi-organ dysfunction. The unavailability of hemoperfusion has impacted the outcome. The patient's rapid deterioration highlights paraquat's aggressive nature and underscores the necessity for better therapeutic strategies and regulatory measures to prevent such poisoning.
Tiny Lungs, Big Challenges: Navigating Fetal Pleural Effusion Outcomes, Long Term Follow-up and Implications for Future Pregnancies.
Sharma C, Das S, Dubey K … +5 more , Shekhawat DS, Gothwal M, Shekhar S, Singh P, Singh K
Niger Med J · 2025 · PMID 40703902 · Full text
Fetal pleural effusion is a rare condition involving fluid accumulation in the pleural cavity of the fetus. Invasive procedures are required to exclude chromosomal anomalies and infections, as treatment delays can lead t...
Fetal pleural effusion is a rare condition involving fluid accumulation in the pleural cavity of the fetus. Invasive procedures are required to exclude chromosomal anomalies and infections, as treatment delays can lead to severe fetal complications. We discuss a case where a 30-year-old primigravida presented at 20 weeks gestation with fetal bilateral pleural effusion and mild ascites. At 23 weeks of gestation, thoracocentesis was performed which revealed chylothorax. The pleural effusion resolved spontaneously by 28 weeks. At 36 weeks, severe oligohydramnios prompted an emergency caesarean section. Postnatal genetic testing found two variants of uncertain significance. The baby improved and was discharged on day six, with no complications over 3.5 years of follow-up. The couple's subsequent pregnancy was uncomplicated. We propose a stepwise management protocol emphasising early diagnosis through ultrasound and cytological analysis, followed by thoracocentesis in severe cases. Regular follow-up is essential to monitor fluid dynamics and adjust management as needed.
Clinical Profile of Seborrhoeic Dermatitis Patients Seen in a Tertiary Hospital in Lagos, Nigeria - A Case-Control Study.
Cole-Adeife OM, Anaba EL, Akinkugbe AO … +2 more , Ajose FO, Onayemi EO
Niger Med J · 2025 · PMID 40703901 · Full text
BACKGROUND: Seborrhoeic dermatitis (SD) is a common dermatosis worldwide and ranks among the ten most prevalent skin conditions in Nigeria and Africa. However, studies on SD in African populations are sparse. This study...
BACKGROUND: Seborrhoeic dermatitis (SD) is a common dermatosis worldwide and ranks among the ten most prevalent skin conditions in Nigeria and Africa. However, studies on SD in African populations are sparse. This study aimed to document the demographic and clinical characteristics of adult SD patients in Lagos, Nigeria. METHODOLOGY: A prospective, hospital-based case-control study was conducted at a tertiary dermatology clinic between January and July 2019. It included 80 newly diagnosed SD patients and 80 age- and sex-matched healthy controls. Demographic and clinical data were collected using structured questionnaires, detailed skin examinations,10% KOH microscopy of lesional scrapings, and blood tests for random blood sugar and HIV serology. Severity was classified using a modified SD severity scoring system. Data analysis was performed using Epi Info version 7.2 and SPSS version 22. RESULTS: The mean patient age was 32 years, and 52.5% were female. Most patients had recurrent, scaly, and pruritic lesions on the face, scalp, and trunk, with 81% reporting recurrences. Aggravating factors included hot and humid weather, stress, and inappropriate skincare. Family history of SD and medicated soap use were common (66.3%). Embarrassment due to lesions was reported in 93.8% of cases. Self-medication with triple-action creams, antihistamines, and herbal remedies was found in 91.3%. Moderate severity was most frequent, and hypo- and hyperpigmentation were more common than erythema. HIV infection and abnormal glycemic levels occurred in 2.5%. CONCLUSION: Seborrhoeic dermatitis is a recurrent inflammatory dermatitis occurring predominantly among young adults in Lagos. It is often moderately severe, aggravated by exogenous factors, and causes patient embarrassment. Further research on SD is needed to develop more effective treatment modalities.
Perception of Autopsy among Selected Healthcare Workers at a Tertiary Hospital in Freetown, Sierra Leone- A Cross-Sectional Study.
Duduyemi BM, Momoh MT, Ngongou FR … +3 more , Kalawa A, Sandy SFF, Onyishi NT
Niger Med J · 2025 · PMID 40703900 · Full text
BACKGROUND: Autopsy is a specialized surgical procedure that thoroughly examines a dead body to determine the cause and manner of death and assess any pre-existing conditions. Studies show its practice has significantly...
BACKGROUND: Autopsy is a specialized surgical procedure that thoroughly examines a dead body to determine the cause and manner of death and assess any pre-existing conditions. Studies show its practice has significantly declined in recent years. In Sierra Leone, some deaths are attributed to traditional and religious beliefs due to the lack of scientific explanations. Even within the medical community, many deaths remain undiagnosed despite advanced diagnostic tools like CT scans and MRIs. Clinicians often overlook autopsy as a tool for solving such mysteries. This study aimed to evaluate the perception of autopsy among doctors and nurses at a tertiary hospital in Freetown, Sierra Leone. METHODOLOGY: A cross-sectional study design enrolled 215 doctors and nurses using probability proportionate to size, followed by random sampling. Data was collected through a semi-structured questionnaire, and SPSS Version 26.0 was used for analysis. Descriptive statistics, Chi-square, and logistic regression analyses were performed. RESULTS: The mean age of participants was 32.8 ±7.42 years. Nurses accounted for 73.5% of the study participants. 48.4% and 38.1% of the participants had fair and good knowledge regarding autopsy respectively, and 81.9% displayed a positive attitude. However, only 53.5% had a positive perception, with doctors showing a higher proportion. Only 36.7% were open to organ donation, and most (71.6%) were unaware of policies guiding autopsy practice at the study site. Profession did not predict participant's knowledge (p-value > 0.05); but it significantly predicted their perception, with doctors 4.62 times more likely to have a positive perception (AOR= 4.62, p value< 0.001). The T-test analysis showed that doctors showed higher knowledge and perception than nurses. CONCLUSION: Although many participants had fair to good knowledge and a positive attitude, more awareness is still needed about the medical benefits of autopsy.
Ending Nuclear Weapons, Before They End Us.
Abbasi K, Ali P, Barbour V … +20 more , Birch M, Blum I, Doherty P, Haines A, Helfand I, Horton R, Juva K, Lapena JF, Mash R, Mironova O, Mitra A, Monteiro C, Naumova EN, Onazi D, Ruff T, Sahni P, Tumwine J, Umaña C, Yonga P, Zielinski C
Niger Med J · 2025 · PMID 40703899 · Full text
The World Health Assembly (WHA) will vote on re-establishing a mandate for the World Health Organization (WHO) to address the health consequences of nuclear weapons and war during the WHA in May 2025. This mandate is imp...
The World Health Assembly (WHA) will vote on re-establishing a mandate for the World Health Organization (WHO) to address the health consequences of nuclear weapons and war during the WHA in May 2025. This mandate is important as the world has witnessed a reduction in the commitment to nuclear arms reduction from the world's nuclear states indicating thata worldwide nuclear arms race is underway. The Marshall Islands, Samoa and Vanuatu, supported by seven co-sponsoring states and the International Physicians for the Prevention of Nuclear War (IPPNW), are working to renew WHO's mandateon nuclear weapons and health which lapsed in 2020. They are seeking wide support for a resolution on the health effects of nuclear weapons/war at this year's WHA in Geneva on 19-27 May 2025, that would enable the WHO to re-establish a programme of work on this most critical threat to health and be able to lead strongly in providing the best health evidence to the UN panel. It is in furtherance of the advocacy to support this mandate that this editorial is published to promote support for this cause that will provide vital authoritative and up-to-date evidence for health and public education to advance global health and reduce the health risk associated with nuclear weapons and war.
Sport injury prevention strategies and sporting behaviors of male professional footballers - A cross-sectional study.
Oghumu SN, Ekom EA, Nicholas RO … +4 more , Awhen PA, Okhuahesuyi E, Oke KI, Mbada CE
Niger Med J · 2025 · PMID 40703898 · Full text
BACKGROUND: Identifying how playing positions (PP) and playing years (PY) influence injury prevention strategies (IPS) and sporting behaviors (SB) of footballers may guide health professionals in developing targeted inte...
BACKGROUND: Identifying how playing positions (PP) and playing years (PY) influence injury prevention strategies (IPS) and sporting behaviors (SB) of footballers may guide health professionals in developing targeted interventions to prevent sports injuries and enhance players' fitness. This study assessed the association of PP and PY with IPS and SB of male professional footballers. METHODOLOGY: A cross-sectional survey of 130 male footballers aged 18 to 35 years, from six professional teams in Calabar, Cross River, Nigeria. Data was collected on PP, PY, IPS, and SB using adapted questionnaires on IPS and SB. Data was summarised using frequencies and percentages. The Chi-square test was used to analyse the associations among variables at p < 0.05. RESULTS: Respondents were 31.5% defenders, 32.3% midfielders, 31.5% forwards, and 4.6% goalkeepers. Among these respondents, 54.6% played for 1-5 years, 42.3% for 6-10 years, and 3.1% for 11-15 years. Injury prevention was important to 57.7%, 86.9% had used IPS, 26.9% had used FIFA 11+, and 23.8% had used general warm-up programmes. In SB, 40.0% of respondents looked forward to matches and training, and over 50% felt energetic, found sporting meaningful, behaved aggressively towards opponents, exhibited fair play, acted strong and rigorous, were oblivious of surroundings, felt inspired, and were happy when engrossed in sport. Significant associations (p<0.05) were found between SB and each of PP and PY. PP and PY were not significantly associated (p>0.05) with IPS. CONCLUSION: Although PP and PY influenced the SB of male professional footballers, they do not impact IPS. Usage of IPS was higher in FIFA 11+ than in other IPS. Defenders and forwards have a higher propensity of exhibiting aggressive behaviours towards opponents when liable to injury than midfielders, while the burden of a team having good results was highest among defenders and midfielders than in forwards and goalkeepers.
Speech Disorders in Children with Congenital Heart Disease Attending a Tertiary Institution in South East Nigeria.
Chinawa AT, Onyia JT, Chime PU … +6 more , Agu G, Nwankwo OO, Ogbuka FN, Ossai EN, Adiele DK, Chinawa JM
Niger Med J · 2025 · PMID 40703897 · Full text
BACKGROUND: Speech problems are neurodevelopmental disorders rarely reported in children with congenital heart defects (CHD). This study aimed to elicit various speech disorders in children with CHD compared to controls....
BACKGROUND: Speech problems are neurodevelopmental disorders rarely reported in children with congenital heart defects (CHD). This study aimed to elicit various speech disorders in children with CHD compared to controls. METHODOLOGY: This cross-sectional study involved 50 children with CHD and 50 children without CHD (control group). RESULTS: Children with heart defects had a higher mean score (1.02±0.16) for speech problems than the control (0.22±0.14), with a statistically significant p-value of <0.0001. Difficulty in understanding a child's speech was also more pronounced in children with heart defects (1.00±0.16) than in control (0.27±0.19), p=0.006. Understanding speech over the phone was significantly harder for children with heart defects (1.22±0.18) compared to control (1.93±1.83), p=0.003. The belief that a child might have a stutter was significantly higher in children with heart defects (0.65±0.14) versus (0.29±0.2), p=0.0001. Tourette's syndrome was reported more frequently in those with heart defects (1.14±0.18) than in those with heart defects (0.1±0.07; p=0.0001). Family history of speech or language disorder shows significant differences, with children with heart defects scoring 0.65±0.15 versus 0.01±0.001, p= 0.001. The prevalence of speech disorders was significantly higher in 36% of children with heart defects, which was significantly higher than 4% seen in controls. χ=14.18; p=0.0001, Regarding the age of the child, 36.8% of children under five years of age had a speech disorder compared to 33.3% of those aged five years and older. p= 0.825, OR= 1.1 (95% CI: 0.2 - 4.5). CONCLUSION: Children with CHD presented with a higher prevalence of speech disorders compared with control. The prevalence of speech disorders among children with CHD was higher in children who were less than five years old. Furthermore, children with CHD had a significant family history of speech or language disorders than control.
Maternal and Fetal Outcomes in Idiopathic Oligohydramnios vs. Normal Amniotic Fluid Index After 34 Weeks: A Case-Control Study in Eastern India.
Dutta I, Suman S, Pan T
Niger Med J · 2025 · PMID 40703896 · Full text
BACKGROUND: Oligohydramnios, traditionally associated with adverse perinatal outcomes, often prompt early delivery via caesarean section, even in otherwise uncomplicated pregnancies. However, emerging research suggests t...
BACKGROUND: Oligohydramnios, traditionally associated with adverse perinatal outcomes, often prompt early delivery via caesarean section, even in otherwise uncomplicated pregnancies. However, emerging research suggests that isolated oligohydramnios may not significantly impact neonatal outcomes, warranting re-evaluation of current management strategies. This study aimed to assess maternal and fetal outcomes in patients with idiopathic oligohydramnios diagnosed between 34-40 weeks of gestation, compared to low-risk pregnancies with normal amniotic fluid volume. METHODOLOGY: A prospective case-control study was conducted in a tertiary care hospital in Eastern India over a period of one year. The study enrolled 100 pregnant women divided into cases: women with idiopathic oligohydramnios (amniotic fluid index [AFI] ≤5 without any identifiable maternal, fetal, or placental cause) and controls: gestational age-matched women with normal AFI (5-25 cm). Maternal characteristics, labor course, mode of delivery, and neonatal outcomes were analyzed. Statistical analysis was performed using SPSS, with p<0.05 considered significant. RESULTS: The rate of labor induction was significantly higher in cases compared to controls (50% vs. 20%, p=0.001). Meconium-stained liquor (44%) and non-reactive cardiotocography (NRCTG) (60%) were more common in the oligohydramnios group. Caesarean section rates were markedly higher among cases (78% vs. 32%, p<0.001), primarily due to fetal distress (71.8%). Newborns of cases had a higher incidence of small-for-gestational-age (SGA) status (56%). APGAR scores <7 at 1 and 5 minutes were more frequent in cases, with significantly higher neonatal intensive care unit (NICU) admissions (60% vs. 16%, p<0.001). CONCLUSION: Isolated oligohydramnios is associated with increased obstetric interventions, higher caesarean rates, and adverse neonatal outcomes, including SGA and higher NICU admissions, despite reassuring antenatal fetal surveillance. These findings suggest the need for individualized care and close fetal monitoring rather than automatic early delivery in isolated oligohydramnios cases.
Barriers and Facilitators Influencing Nurses in Genetic Services Provision: A Systematic Review.
Latha T, Soniya C, Dem Dukpa R … +2 more , Singh J, Mudgal SK
Niger Med J · 2025 · PMID 40703895 · Full text
BACKGROUND: Nurses play a crucial role in the provision of genetic services, yet their capacity to deliver these services is often constrained by various barriers. Understanding these barriers and identifying facilitator...
BACKGROUND: Nurses play a crucial role in the provision of genetic services, yet their capacity to deliver these services is often constrained by various barriers. Understanding these barriers and identifying facilitators is essential for optimizing genetic services delivery in nursing practice. This systematic review aimed to explore the barriers and facilitators influencing nurses' roles in providing genetic services, including genetic counseling, testing, and patient management. METHODOLOGY: A comprehensive search across multiple databases yielded 1,275 articles. After de-duplication and screening, 12 studies published between 2001 and 2024 were included. These studies, conducted in nine countries, utilized qualitative and quantitative approaches. Data was synthesized narratively, focusing on key themes related to barriers and facilitators. RESULTS: Barriers were identified across six domains: gaps in educational preparedness, insufficient knowledge, administrative hurdles, negative attitudes, logistical difficulties, and environmental limitations. Common challenges included knowledge deficits, role ambiguity, time constraints, and cultural variations. Facilitators were grouped into five domains: educational support, role expansion, integration across specialties, positive attitudes, and policy/institutional support. Key enablers included genomic education programs, multidisciplinary teamwork, and structured institutional policies. CONCLUSION: Barriers and facilitators to nurses' provision of genetic services are multifaceted, spanning individual, institutional, and systemic factors. Addressing these challenges through targeted interventions, such as enhancing genomic education and fostering interdisciplinary collaboration, can significantly improve genetic services delivery in nursing practice.
An unusual survival for 6.5 years with end-stage hepatitis C related advanced liver cirrhosis following sustained virologic response with direct antiviral agents - A case report from A low-resource setting.
Stephen RI, Reyes JA, Dunga JA … +2 more , Awang SK, Zawaya KP
Niger Med J · 2025 · PMID 40703894 · Full text
Advanced chronic liver disease is frequently complicated by hepatic encephalopathy (HE), hepatorenal syndrome, and spontaneous bacterial peritonitis; predictors of poor prognosis that significantly reduce survival. While...
Advanced chronic liver disease is frequently complicated by hepatic encephalopathy (HE), hepatorenal syndrome, and spontaneous bacterial peritonitis; predictors of poor prognosis that significantly reduce survival. While orthotopic liver transplantation (OLT) remains the definitive treatment, it is often inaccessible in resource-limited settings. We present the case of a 70-year-old retired hospital attendant with hypertension who developed decompensated liver cirrhosis secondary to chronic hepatitis C virus HCV infection. She presented with portal hypertension, grade 4 HE, hepatorenal syndrome, and spontaneous bacterial peritonitis. She remained in grade 3 to 4 HE for approximately three months and in grade 2-3 HE for an additional two months. Despite profound hepatic decompensation and a high Model for End-Stage Liver Disease-Sodium (MELD-Na) score of 48 (indicating a 71% three-month mortality) and a Child-Pugh score of 15 (Class C), she responded remarkably to intensive conservative management. After six months of inpatient care, which included direct-acting antiviral therapy, anti-failure therapy, and seizure management, she recovered from hepatic coma. She received a six-month course of direct-acting antivirals (DAAs)daclatasvir and sofosbuvir and achieved sustained virologic response. Over six and a half years later, she remains in good health with preserved cognition and normal blood pressure and has been under annual surveillance for hepatocellular carcinoma. This case underscores the transformative potential of DAAs in improving survival even among severely decompensated HCV-related cirrhotic patients. It highlights the need for expanded access and subsidization of DAAs in low-resource settings, where liver transplantation is not feasible, and emphasizes the role of aggressive, supportive management in bridging the treatment gap.
Immunohistochemical profiling of Bcl-2 and EGFR proteins in cervical carcinoma at a tertiary hospital in Ghana.
Duduyemi BM, Addae EK, Opoku F … +1 more , Bedu-Addo K
Niger Med J · 2025 · PMID 40703893 · Full text
BACKGROUND: Using Immunohistochemistry (IHC) to assess the expression of EGFR and Bcl-2, and their correlations with clinicopathological features in a cohort of cervical cancer cases. METHODOLOGY: A retrospective and des...
BACKGROUND: Using Immunohistochemistry (IHC) to assess the expression of EGFR and Bcl-2, and their correlations with clinicopathological features in a cohort of cervical cancer cases. METHODOLOGY: A retrospective and descriptive study in Komfo Anokye Teaching Hospital (KATH) Kumasi, Ghana. Patients were women diagnosed with cervical cancer at KATH from January 2015 to December 2016. For inclusion, suitable archived formalin fixed paraffin-embedded (FFPE) cases with adequately preserved tissue blocks and available clinicopathological data were selected for Tissue Microarray (TMA), otherwise, the cases were excluded. One hundred and thirty-five out of 230 cervical cases met the inclusion criteria. IHC assesses EGFR and Bcl-2 expressions, correlating with clinicopathological features in cervical cancer cases, enhancing molecular-clinical insights in the Ghanaian context. RESULTS: The mean age of the cases was 58.9 (SD ± 17.88). Predominantly, 96.3% of the cases were of the squamous cell carcinoma (SCC) subtype. The majority of the cases (49.63%) were grade III. EGFR and Bcl-2 were expressed in 35.2% and 25.7% of the cases, respectively. Neither EGFR nor Bcl-2 showed any significant correlation with age, subtype, and histological grade. Significant inverse correlation was, however, observed between EGFR and Bcl-2 expression (P<0.001). CONCLUSION: The age stratification shown in this study confirms earlier reports of late age at diagnosis, mostly observed in our setting, and therefore emphasizes the need for effective and population-wide screening programs to ensure early diagnosis. The significant inverse correlation between EGFR and Bcl-2, suggestively leans towards a possible role played by EGFR in downregulating Bcl-2.
Pattern of Root Fracture among Adult Patients with Traumatic Dental Injuries to Anterior Teeth.
Enabulele J, Omokhua H, Ibhawoh L
Niger Med J · 2025 · PMID 40703892 · Full text
BACKGROUND: Dental trauma is a major public health issue, with the prevalence of traumatic dental injuries varying by country, geographic location, and age group. The study aimed to assess the pattern of root fractures i...
BACKGROUND: Dental trauma is a major public health issue, with the prevalence of traumatic dental injuries varying by country, geographic location, and age group. The study aimed to assess the pattern of root fractures in adult patients with traumatic dental injuries. Do traumatic dental injuries influence the pattern of root fractures? METHODOLOGY: This was a descriptive cross-sectional study of patients presenting with dental traumatic injuries. Data was collected via an interviewer-administered questionnaire. The data collated were analyzed using IBM SPSS version 26.0. The data was subjected to analysis using descriptive statistics. The chi-square test was used to determine associations between categorical variables with a p-value set at 0.05. RESULTS: Eighty patients with radiographically confirmed root fractures of the anterior teeth were recruited to undertake this study. The participants were aged between 23 years and 69 years. The most prevalent presenting complaint was pain (53.8%). The main etiological factor of the traumatic incident was interpersonal violence (42.4%). The arch most involved was the maxillary arch (75.0%) with the central incisor being the most affected teeth (75.0%). The fracture of the apical third was the most recorded (67.5%). There was a statistically significant association between the gender of the patient and the location of the root fracture with 90.0% of males presenting with apical root fracture and 40.0% of females presenting with coronal third root fracture. CONCLUSION: The study concluded that traumatic dental injuries are common and different patterns of fractures were reported. Apical third fracture was reported as the most common pattern of root fracture in this study to be the most common in terms of pattern. The clinical relevance is to improve the high index of suspicion of apical root fracture in traumatic dental injuries.
Coarctation of the Aorta Presenting as Haemorrhagic Stroke in a 3-Year-Old Boy- A Case Report.
Abolodje E, Campbell FC, Etumudor SN … +2 more , Ejumudo FO, Ovili C
Niger Med J · 2025 · PMID 40703891 · Full text
Coarctation of the aorta is an obstructive form of congenital heart defects that presents with upper limb hypertension. If untreated, Coarctation of the aorta can lead to left ventricular dysfunction and cerebral vasculo...
Coarctation of the aorta is an obstructive form of congenital heart defects that presents with upper limb hypertension. If untreated, Coarctation of the aorta can lead to left ventricular dysfunction and cerebral vasculopathy. Missed diagnosis due to its subtle presentation is common with attendant complications. This is a case report of an apparently healthy 3-year-old boy who lapsed into a coma after a trivial fall. He had upper limb hypertension and the pulses in the lower limbs were barely palpable. Brain computed tomography (CT) revealed non-traumatic haemorrhagic stroke and echocardiography showed severe left ventricular hypertrophy and severe coarctation of the aorta. Coarctation of the aorta can manifest as chronic upper limb hypertension in children with complicated non-traumatic haemorrhagic stroke. Routine blood pressure measurement in young children can serve as a screening tool for early diagnosis of the condition.
Pattern of Depression among Secondary School Adolescents in Ilesa, South West, Nigeria.
Oke OJ, Ibigbami OI, Mapayi BM … +1 more , Akinsulore A
Niger Med J · 2025 · PMID 40703890 · Full text
BACKGROUND: Depression in adolescents could be highly distressing and may exert a huge burden on the growing individuals transiting to adulthood. Adolescents are confronted with high expectations and societal demands whi...
BACKGROUND: Depression in adolescents could be highly distressing and may exert a huge burden on the growing individuals transiting to adulthood. Adolescents are confronted with high expectations and societal demands which may place serious burdens on them and lead to depression. This study intended to study the pattern of depression among adolescents in Ilesa with a view to providing information that could serve as an empirical basis for strategic interventions for the affected adolescents. METHODOLOGY: A descriptive cross-sectional study was conducted among 302 secondary school adolescents in Ilesa East LGA. These subjects were selected using a multistage sampling method. Adolescents' socio-demographics were assessed with a socio-demographics questionnaire. The PHQ-9 was used to assess depression among adolescents. Data was entered and analyzed using Statistical Package for the Social Sciences version 21 (SPSS 21) and analyzed. The test of associations between the outcome variable and categorical variables was done with Chi- square and p<0.05 was taken as the level of significance. RESULTS: The results showed that seventy-nine out of the 302 adolescents screened with PHQ 9 had depression with prevalence of 26.2%. The prevalence of depression was significantly higher in adolescent girls than in boys (χ2=9.782,p=0.002); and significantly pronounced in early adolescents compared to the middle and late adolescents (χ2=14.205, p=0.001). CONCLUSION: The Prevalence of depression was high among the adolescents in Ilesa and commoner among the early and females' adolescents.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe