West African Journal Of Medicine[JOURNAL]
Sun
200 papers
Chemotherapy-Induced Oral Changes in Cancer Patients: Prevalence, Types, and Risk Factors in a Nigerian Tertiary Health Facility.
Mogaji IK, Owotade FJ, Bolarinwa RA … +2 more , Oyetola EO, Adesina OM
West Afr J Med · 2024 Dec · PMID 40391813
BACKGROUND: Chemotherapy-induced oral changes are common complications after receiving chemotherapy. These complications are often not prioritized in clinical practice, particularly in resource-limited settings like Nige...
BACKGROUND: Chemotherapy-induced oral changes are common complications after receiving chemotherapy. These complications are often not prioritized in clinical practice, particularly in resource-limited settings like Nigeria. However, they impact patients' quality of life and overall treatment outcomes This study determined the prevalence and types of chemotherapy-induced oral changes, the relationship between chemotherapeutic agents and oral changes, and the associated risk factors. METHODS: An analytical cross-sectional study with a convenience sampling method was designed at the Department of Oral Medicine and Oral Pathology, Obafemi Awolowo University, Osun State, Nigeria. The oral cavity of 82 patients aged 6 years and above who received cancer chemotherapy at the Paediatric Medicine, Haematology, and Surgical Units of the hospital were examined for pathologies associated with chemotherapy. RESULTS: Dysgeusia was present in 60 (73.17%), oral pain in 47 (57.32%), and oral mucositis (OM) in 44 (53.66%). Forty-two (95.45%) of the total 44 (100%) persons with OM complained of oral pain (p < 0.001), 41 (93.18%) had dysgeusia (p < 0.001), and 31 (70.45%) had fungal infection (p = 0.002). Methotrexate based regimens (MBR) were the most involved in oral changes, with 11 (91.67%) out of 12 having dysgeusia (p ≤ 0.001), 11 (91.67%) had oral pain(p=0.073), and 10 (83.33%) had mucositis (p=0.012). Age was not associated with oral changes (p =0.755), likewise cancer duration (p=0.483) and type of cancer (p=0.353). Multivariate analysis identified mucotoxic drugs (OR 3.6, CI 1.37, 9.19, p=0.009) and solid tumours (OR 2.5, CI 1.04, 6.02, p=0.040) as risk factors for severe OM. CONCLUSION: Chemotherapy-induced oral changes are prevalent among patients with cancer. Mucotoxic agents and solid tumours are risk factors for severe mucositis. Early identification and prioritizing of oral care strategies are crucial to improving quality of life and treatment outcomes, particularly in resource-limited settings.
Beyond the Cure: Advancing Towards Holistic Oncology Care Through Multidisciplinary Interventions.
Erhabor GE
West Afr J Med · 2024 Dec · PMID 40391735
Abstract loading — click title to view on PubMed.
Forearm Auto-Transplantation of Adenomatous Parathyroid Tissue to Prevent Post-Surgical Hypoparathyroidism: A Case Report.
Jalalimehr R, Balasubramanian SP
West Afr J Med · 2024 Nov · PMID 40231899
BACKGROUND: Primary hyperparathyroidism (PHPT) is commonly treated surgically, though post-surgical hypoparathyroidism (PoSH) is a significant concern. Most studies focus on the auto-transplantation of healthy parathyroi...
BACKGROUND: Primary hyperparathyroidism (PHPT) is commonly treated surgically, though post-surgical hypoparathyroidism (PoSH) is a significant concern. Most studies focus on the auto-transplantation of healthy parathyroid glands, especially in multi-gland disease cases such as multiple endocrine neoplasia type 1 (MEN1) syndrome. However, limited data exist on auto-transplantation of pathological glands in single-gland disease due to concerns over recurrence. OBJECTIVES: This case report describes the successful management of persistent PHPT using the auto-transplantation of adenomatous parathyroid tissue, preventing long-term hypoparathyroidism. METHODS: A male patient in his 40s presented with persistent PHPT after previous surgery and inadvertent excision of three normal parathyroid glands. Re-operative exploration with excision of the last remaining parathyroid gland was performed, and the excised tissue was transplanted into the forearm. RESULTS: Six months post-surgery, the patient was weaned off active vitamin treatments as hypoparathyroidism resolved. Five years after surgery, calcium and parathyroid hormone (PTH) levels remained normal, with no recurrence of hypercalcaemia. CONCLUSIONS: This case illustrates that forearm auto-transplantation of pathological parathyroid tissue can restore parathyroid function, prevent long-term hypoparathyroidism and avoid recurrence over a five year period.
Dermatoglyphic Characteristics in Adults with Primary Hypertension in Southwestern Nigeria.
Adetona MO, Babawale DO, Michael OS … +2 more , Badejo JA, Adeoye AM
West Afr J Med · 2024 Nov · PMID 40231825
Dermatoglyphics is genetically determined and the traits remain unchanged until decomposition after death. These traits reflect prenatal developmental stability. Dermatoglyphics details are studied from level 1 to level...
Dermatoglyphics is genetically determined and the traits remain unchanged until decomposition after death. These traits reflect prenatal developmental stability. Dermatoglyphics details are studied from level 1 to level 3. Hypertension is a pathological condition influenced by genetics and environmental factors. The aim of this study is to investigate the use of dermatoglyphics as noninvasive screening tool to determine predisposition to hypertension. The participants were 384 (192 normotensive and 192 hypertensive), from University College Hospital Ibadan. Fingerprints were obtained using fingerprint scanner Dermalog LF10, Hamburg, Germany. GraphPad Prism 8.4.3 was used for T-test and ANOVA for association between the variables. Level 1 details did not reveal significant difference between hypertensive and normotensive. Level 2 details (minutiae) revealed significant difference (p<0.05) between hypertensives and normotensives. The level 2 details of dermatoglyphics may be a screening tool for predisposition to hypertension.
Adult Intussusception: A 10-year Institutional Review.
Aghahowa ME, Alu FE, Emuze O … +4 more , Atinko SI, Alada MA, Olofin KE, Gali BM
West Afr J Med · 2024 Nov · PMID 40231800
BACKGROUND: Intussusception occurs when a proximal bowel segment telescopes into the lumen of adjoining distal bowel. Adult intussusception (AI) is a rare cause of intestinal obstruction. The preoperative diagnosis remai...
BACKGROUND: Intussusception occurs when a proximal bowel segment telescopes into the lumen of adjoining distal bowel. Adult intussusception (AI) is a rare cause of intestinal obstruction. The preoperative diagnosis remains a challenge due to the nonspecific nature of presenting symptoms. OBJECTIVE: To present our institutional experience with the presentation and management of AI. PATIENTS AND METHODS: A retrospective analysis of 10 cases of AI managed between January 2015 and December 2024. Data were extracted from the patients' medical records and analysed using SPSS version 21. Results were presented in tables as frequency and simple percentages. RESULTS: During the study period, 10 cases of AI were managed, comprising of 5 males and 5 females, giving a male to female ratio of 1:1. The patients' ages ranged between 29 and 75 years with a mean age of 43.2 years. Most of the patients presented with symptoms of intestinal obstruction including nausea and vomiting. The symptoms' duration varied from 3 days to 180 days, with majority (60%) presenting with subacute symptoms. Ileocolic (40%) was the commonest variety. Lymphadenitis (30%) and idiopathic (20%) were the commonest lead points. Adenocarcinoma accounted for 10%. All 10 patients had surgical intervention that included right hemicolectomy (50%), segmental ileal resection (30%) and segmental ileal resection with subtotal colectomy (10%). There were two morbidities and one mortality. CONCLUSION: AI is rare in our facility occurring equally in both sexes. Surgery was the mainstay of treatment. A high index of suspicion, aided by appropriate imaging techniques, is critical to achieving good management outcome.
Comparative Effectiveness of Paracetamol, Ibuprofen, and their Combination in Managing Post-Endodontic Treatment Pain.
Otakhoigbogie U, Onyia NE, Omogbai EKI … +1 more , Sede MA
West Afr J Med · 2024 Nov · PMID 40231775
BACKGROUND: Although endodontic treatment is intended to eliminate long-term pain, pain after this treatment is commonly reported. Non-opioid analgesics like non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol...
BACKGROUND: Although endodontic treatment is intended to eliminate long-term pain, pain after this treatment is commonly reported. Non-opioid analgesics like non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol, have been used with great success in treating patients with endodontic pain. OBJECTIVES: This study seeks to compare the effectiveness of doses of paracetamol, ibuprofen; each drug used alone, and a combination of both drugs in the management of post endodontic treatment pain. METHOD: A randomized placebo-controlled single-blind comparative study involving 80 patients who had endodontic treatment (instrumentation) was conducted by putting the patients into four groups of 20 patients each: paracetamol group, ibuprofen group, paracetamol + ibuprofen group, and placebo group. Numerical rating scale (NRS) was used to measure pain intensity at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5 and 6 h after drug administration. Inferential statistics included the Friedman's Test with Kruskal-Wallis H post-hoc test. Level of significance was set at 95% (p-value < 0.05). RESULTS: Paracetamol was more effective compared to ibuprofen, the combination and placebo in the relief of post-endodontic pain within the first 2 h after administration of medications (p < 0.05). Ibuprofen + paracetamol combination showed a better relief of pain than ibuprofen alone within the first 2 h after administration but this was not statistically significant (p > 0.05). CONCLUSION: Paracetamol significantly reduced post-endodontic pain better than ibuprofen and its combination with paracetamol within the first two hours.
Comparative Study of Serum Malondialdehyde in Women with Cervical Cancer and Women with High-Risk Human Papillomavirus Infection at The Lagos State University Teaching Hospital, Lagos.
Owuye AJ, Adefemi AK, Olumodeji AM … +5 more , Adedeji MO, Rabiu KA, Akinola OI, Ugwu AO, Adenekan MA
West Afr J Med · 2024 Nov · PMID 40231722
BACKGROUND: Cervical cancer is a common cause of cancer-related morbidity and mortality among women in developing countries. HPV infection has been detected in more than 99% of cervical cancers throughout the world. Amon...
BACKGROUND: Cervical cancer is a common cause of cancer-related morbidity and mortality among women in developing countries. HPV infection has been detected in more than 99% of cervical cancers throughout the world. Among the effective factors in the progression of HPV infection is oxidative stress which can influence the host immune responses to viral proteins and viral genes expression. AIM: To determine the association between serum malondialdehyde concentration in women with cervical cancer and women with high-risk human papillomavirus infection at the Lagos State University Teaching Hospital, Lagos (LASUTH). METHODS: This was a comparative cross-sectional study where 90 women from the gynaecology and colposcopy as well as medical oncology clinics of LASUTH were recruited using convenience sampling method. This study comprised 30 women with histologically confirmed cervical cancer, 30 women with high-risk human papilloma virus infection and 30 apparently healthy women negative for high-risk human papilloma virus infection. Fasting blood samples of consenting women were obtained and serum malondialdehyde were measured using spectrophotometric method. Data was given as mean ± standard deviation (SD) and significant differences between means were assessed by Student's t-test. Analysis of data was carried out by using the statistical package for social sciences (SPSS) version 23 software. P-value of <0.05 was considered statistically significant. RESULTS: Results indicated that the mean serum malondialdehyde levels were significantly higher among women with cervical cancer (6.13 ± 4.1 nmol/l) and those with high-risk HPV infection (5.61±3.0nmol/l) compared to women negative for high-risk HPV infection (0.35±0.2nmol/l). A statistically significant association was observed between cervical cancer and negative high-risk HPV infection(p<0.001). However, no significant association was found between cervical cancer and positive high-risk HPV infection (p = 0.57). CONCLUSION: The study's conclusion highlighted significantly elevated serum malondialdehyde levels in women with cervical cancer and high-risk HPV infection compared to those without high- risk HPV infection, indicating increased oxidative stress. It also noted no significant disparity in serum malondialdehyde levels between women with cervical cancer and those with high-risk HPV infection. The findings underscored the importance of conducting serum antioxidant studies in these women to mitigate oxidative stress.
Family Planning Service Uptake in Hospitals in Rivers State, Nigeria.
Atata CT, Oguzor UC, Green PA … +1 more , Dienye PO
West Afr J Med · 2024 Nov · PMID 40231688
INTRODUCTION: Family planning refers to a couple's ability to have the number of children they want by spacing out their children appropriately or a person's ability to avoid unintended pregnancies by using various contr...
INTRODUCTION: Family planning refers to a couple's ability to have the number of children they want by spacing out their children appropriately or a person's ability to avoid unintended pregnancies by using various contraceptive methods and infertility treatment. All hospitals in Rivers State, Nigeria, that provide primary care and offer family planning services were included in the study. AIM: To describe the pattern of family planning service uptake in the hospitals in Rivers State. METHODOLOGY: An 8-year retrospective review of data collection from the District Health Information System 2 (DHIS 2) platform in the Health Management Information System in Rivers State was conducted from 2014 - 2021. Data from 387 health facilities was obtained from the DHIS 2 platform and reviewed. The inclusion criteria were all the family planning data in the platform from the various health facilities in the LGAs in the State, during the time of review while the exclusion criteria was the health facilities that didn't provide any family planning data. Data was represented as frequencies, percentages, and charts. RESULTS: During the period under review, the Family Planning clinics counselled a total of 931,774 individuals, of whom 421,785 (45.3%) accepted family planning services. Condoms (65.3%) were the most widely utilized contraceptive, whereas bilateral tubal ligation (0.1%) was the least utilized. Methods like injectables, implants, oral contraceptive pills, and intrauterine contraceptive devices accounted for 16.1%, 9.4%, 7.8%, and 1.3%, respectively. A significant increase was observed in the trend of the use of condoms, injectables, and oral contraceptive pills between 2014- 2021. CONCLUSION: There was an increasing trend in the utilization of family planning services among women of childbearing age in the State during this eight-year period. Condom being the most utilized indicated that it was the most accepted and approved by clients in family planning clinics in Rivers State. The knowledge of contraceptive utilization trends can be used to monitor and appraise the acceptance and approval of each method and family planning program over a period.
Trichoscopic Evaluation of Normative Values of Scalp Hair Density in an African Population from Nigeria: A Cross-Sectional Study.
Anaba EL, Sani H, Magaji D … +6 more , Oseze H, Otrofanowei E, Akinkugbe AO, Okoro EO, Tosti A, Ogunbiyi A
West Afr J Med · 2024 Nov · PMID 40231658
BACKGROUND: Reports of hair density (HD) on healthy scalp of Africans is rare. Our study aimed to document normative scalp HD values in an African population. METHODS: A cross-sectional study of the healthy scalp of 909...
BACKGROUND: Reports of hair density (HD) on healthy scalp of Africans is rare. Our study aimed to document normative scalp HD values in an African population. METHODS: A cross-sectional study of the healthy scalp of 909 individuals aged 5-45 years was conducted in 2023. Phototrichoscopic measurements were taken from four scalp sites (frontal, temporal, vertex and occipital). Hair parameters were compared between genders and across age groups. Data was analyzed using the IBM statistical package version 26.0. RESULTS: The mean age of the participants was 21.8 ± 11.02 years and they were 52.1% female. The number of hair strands (HS) from each pilosebaceous unit (PU) was 1 in 99.9% and 2 in 98% of the participants. HD ranged from 113 - 660/cm2 with a median (IQR) of 330.0 (301.0, 368.0) and was highest at the frontal scalp area. HD and total number of HS were significantly higher in all scalp sites in males (p=0.001) except for the frontal scalp site, p=0.283. HD and number of HS were highest in the fourth decade of life (median HD (IQR); 339 (301, 386), mean HS/PU; 37.09±6.96) and least in the first decade of life (median HD (IQR); 320 (292, 358), mean HS/PU; 35.18± 6.26) irrespective of the scalp site, P<0.001. CONCLUSIONS: The hair density of Africans is high. The number of HS from each PU and HD varies with the scalp site, age and gender. These findings from the African scalp are relevant in the management of Africans who have hair loss and in those who require restoratives surgeries.
Assessing the Safety of Ketamine as a Procedural Sedative in Paediatric Dentistry: A Comparative Study with Midazolam.
Oladokun OD, Oyeleke SO, Adebayo AA … +3 more , Shuaib NM, Omotuyole AS, Ajibare AO
West Afr J Med · 2024 Nov · PMID 40231543
Sedation has been employed to improve patient's cooperation. This has contributed to quality of treatments as well as improving the patients' and practitioners' experience during some procedures especially among children...
Sedation has been employed to improve patient's cooperation. This has contributed to quality of treatments as well as improving the patients' and practitioners' experience during some procedures especially among children. The price of some of the newer sedatives can hamper the use in resource-constraint environments, hence the need to explore other cost-effective options. We compared the safety of oral ketamine against oral midazolam among 100 ASA I and II children aged between 3 and 7 years requiring dental treatments in a tertiary hospital in Lagos, Nigeria. The patients were divided into 2 equal groups by balloting using the opaque envelope method. Group A received Ketamine (7.5 mg / kg) while group B received Midazolam (0.75 mg / kg). The intravenous formulation was mixed with apple juice and administered orally. The patient's vital signs were monitored and the behaviour during procedure was assessed using the Frankl behaviour rating scale. Time to respond to verbal stimulus was recorded. The demographic characteristics and ASA status were similar between the 2 groups (p>0.05). the behaviour of the patients was better among the children in the midazolam group (p=0.026). the ease of administration of local anaesthesia (p=0.012) and examination of the buccal cavity after the procedure (p=0.019) was better in the ketamine group but there was no significant difference in the overall assessment of adequacy of sedation (p= 0.196). The trend of vital signs was similar between the 2 groups (P>0.05). Recovery was longer in the ketamine group (p=0.001). Side effects like vomiting, nystagmus, hypersecretion and somnolence, were significantly higher among the ketamine group, p<0.05. there was no significant difference in the acceptability of both drugs to the dental surgeons and the guardians of the patients (p= 0.093 and 0.308, respectively). Both drugs provided adequate conditions for complete treatments in the study groups. Although the side effect profile was better in the midazolam group, both were acceptable to both dental practitioners and the guardians of the patients.
Association Between Anti-Chlamydial Antibodies and Tubal Factor Infertility in South Eastern Nigeria.
Akabueze JC, Agu PU, Ugwu EO … +8 more , Obi SN, Aniebue UU, Eleje GU, Ugwu AO, Anigbo CS, Ekwueme PC, Eze MI, Ekwuazi KE
West Afr J Med · 2024 Nov · PMID 40221906
BACKGROUND: Chlamydia Trachomatis infection often runs an asymptomatic course with long-term sequelae. It commonly affects the fallopian tubes and could result in tubal blockage. A study of antichlamydial antibodies, a m...
BACKGROUND: Chlamydia Trachomatis infection often runs an asymptomatic course with long-term sequelae. It commonly affects the fallopian tubes and could result in tubal blockage. A study of antichlamydial antibodies, a marker of the disease's presence, could help understand the disease burden in a given population. OBJECTIVE: To determine the prevalence of anti-chlamydial antibodies, and its association with tubal infertility among female partners of infertile couples in Enugu, South-eastern Nigeria. METHODOLOGY: It was a cross-sectional analytical study involving two groups of infertile women attending gynaecology clinics of two tertiary institutions in Enugu, south-eastern Nigeria. Group A (Study group) had tubal factor infertility (n = 143) while Group B (Control) had non-tubal factor infertility (n = 143). Data were obtained using a structured, interviewer-administered questionnaire. Peripheral blood samples were collected and analyzed for anti-chlamydial antibodies using Human chlamydial trachomatis ELISA kits. Statistical package for social science (SPSS) version 25.0 was used for analysis. P-value of <0.05 was statistically significant. RESULT: The overall prevalence of chlamydial seropositivity was 28.0%. Women with tubal factor infertility were almost twice more likely to have chlamydial seropositivity than those with non-tubal factor infertility (33.6% vs 22.4%; OR = 1.75; 95% C.I = 1.03 - 2.96; p = 0.036). Bilateral tubal occlusion (66.4%) was the commonest tubal pathology identified in the hysterosalpingogram. CONCLUSION: Anti-chlamydial antibodies were significantly associated with tubal factor infertility in Enugu, South-eastern Nigeria. It is recommended that serum anti-chlamydial antibody testing could be adopted as a screening test for tubal infertility in the study population.
Self-rated Competence and Role of Primary Health Care Workers in Mental Health Care Delivery in Oyo State, Nigeria.
Omobowale OC, Olatunji MB
West Afr J Med · 2024 Nov · PMID 40221902
BACKGROUND: The mental health treatment gap in Nigeria remains wide, with only 20% of individuals accessing appropriate care. Integrating mental health services into the Primary Health Care (PHC) system has been identifi...
BACKGROUND: The mental health treatment gap in Nigeria remains wide, with only 20% of individuals accessing appropriate care. Integrating mental health services into the Primary Health Care (PHC) system has been identified as a strategy to address this problem. The Oyo State PHC Board recently appointed mental health desk officers across its 33 Local Government Areas to provide services and facilitate referrals. OBJECTIVES: This study aimed to evaluate the roles and self-rated competence of PHC workers in mental health care delivery in Oyo State. METHODS: A cross-sectional study was conducted among 40 PHC workers including mental health desk officers across all the 33 Local Government Areas in Oyo State. Data on socio-demographic characteristics, self-rated competence, roles, training needs, and challenges were collected via a self-administered questionnaire. Data were subjected to bivariate and multivariate analysis using SPSS version 26 at p-value ≤0.05. RESULT: About 57.5% of the respondents rated their competence as good, with notable competence in diagnosing mental illnesses and developing treatment plans, yet 32.5% lacked confidence in psychosis management. Only 20% identified their roles in sensitisation and awareness creation on mental health-related activities. Challenges included insufficient resources, funding, and stigma associated with mental health conditions. While a significant association was found between years as mental health desk officers and self-rated competence (P=0.000), this was not significant in multivariate analysis. CONCLUSION: The study highlights the necessity for targeted interventions, training initiatives, and collaborative strategies to address gaps in competence and role identification among PHC workers, crucial for effectively addressing escalating mental health needs within communities.
Exploring Dermatoglyphic Screening for Hypertension, Strengthening Mental Health Care in Primary Health Settings, and Other Innovative Approaches to Improve Healthcare Outcomes.
Erhabor GE, Olajubu TO
West Afr J Med · 2024 Nov · PMID 40221895
Abstract loading — click title to view on PubMed.
Review of Obstructive Sleep Apnea and the Peri-Operative Management of Patients in a Resource-Limited Setting.
Ojo AK, Komolafe MA, Ojumu TA … +3 more , Raji AS, Aaron OI, Adetoye AO
West Afr J Med · 2024 Oct · PMID 40009868
Obstructive sleep apnea (OSA) patients suffer from recurrent asphyxia, airway obstruction, and hypoxia. Poor awareness among Africans precludes diagnosis and pre-surgery optimization. Vital diagnostic tools such as polys...
Obstructive sleep apnea (OSA) patients suffer from recurrent asphyxia, airway obstruction, and hypoxia. Poor awareness among Africans precludes diagnosis and pre-surgery optimization. Vital diagnostic tools such as polysomnography (PSG) are largely inaccessible to patients and anesthesia providers in low-resourced countries. In particular, Africans have genetic, inflammatory, and social-cultural factors predisposing them to sleep difficulty. The perioperative mortality risk in OSA patients has a linear relationship with the disease severity. Anesthesia considerations including difficult airway, desaturation, ventilatory failure, and inadvertent intensive care unit (ICU) admission, promote perioperative fatality. This article reviews the diagnosis, anesthesia concerns, optimization, and perioperative management of OSA in poorly resourced settings.
Fertility Desire of Women with Obstetric Fistula in Northwest Nigeria.
Adeoti H, Uchendu OC, Olabumuyi OO … +1 more , Oyewole EA
West Afr J Med · 2024 Oct · PMID 40009865
BACKGROUND: Obstetric fistulas are a high burden globally, especially in developing regions. Despite their experiences, many affected women have a high fertility desire. OBJECTIVES: This study aimed to assess fertility d...
BACKGROUND: Obstetric fistulas are a high burden globally, especially in developing regions. Despite their experiences, many affected women have a high fertility desire. OBJECTIVES: This study aimed to assess fertility desires and associated factors among women with obstetric fistulas in Northwest Nigeria and explore their experiences. METHODOLOGY: Using a cross-sectional mixed-method approach, quantitative data was gathered from 420 women of reproductive age via an interviewer-administered questionnaire, and qualitative data from 24 women using focus group discussions. Participants were selected from three hospitals using a two-stage sampling technique. The quantitative data was analyzed using SPSS version 21, employing descriptive and inferential statistics to identify predictors of fertility desire. Thematic analysis was used for the qualitative data. RESULTS: Respondents' mean age (± SD) was 26.4 (±8.4) years. The majority (88.8%) had only vesico-vaginal fistulas, while 3.3% had both vesico-vaginal and recto-vaginal fistulas. Although less than half (43.8%) had no surviving children, 74.3% desired more children. No protective association was found in the multivariable analysis. Age, number of surviving children, and family influence significantly predicted fertility desires. Qualitative findings highlighted cultural norms contrib uting to delayed treatment and poor home-based services, with social stigma, divorce, and lack of family and social support being common. However, some women received encouragement from their maternal family and community members. CONCLUSION: Obstetric fistulas not only significantly affect women's fertility desires but their social and personal lives. Integrating fertility counselling and community-based support into comprehensive fistula care is crucial for addressing these challenges effectively.
Safety Evaluation of NutriMeal Products using Animal Model.
Aina OO, Ajibaye O, Kareem OK … +4 more , Bamgbose DJ, Okoyenta CO, Akindele SK, Salako BL
West Afr J Med · 2024 Oct · PMID 40009851
INTRODUCTION: NutriMeal, a cassava-soya ready-to-use therapeutic food (RUTF), was developed to address severe acute malnutrition (SAM), a global health challenge. It offers a nutrientrich, low-fat alternative to peanut-b...
INTRODUCTION: NutriMeal, a cassava-soya ready-to-use therapeutic food (RUTF), was developed to address severe acute malnutrition (SAM), a global health challenge. It offers a nutrientrich, low-fat alternative to peanut-based RUTFs, which pose aflatoxin risks. This study evaluates NutriMeal's safety through acute and subacute toxicity tests in animal models. METHODOLOGY: Acute toxicity tests involved Swiss albino mice, while subacute tests used male and female Wistar rats. Animals were grouped into dosages (300, 1000, 3000, 5000 mg/kg) and a control. NutriMeal was administered orally once in the acute study, and the animals were observed for 14 days, while the product was administered orally daily for 28 days in the subacute study. Parameters assessed included weight gain, hematological and biochemical markers, organ histopathology, and cyanide levels via high-performance liquid chromatography (HPLC). RESULTS: NutriMeal caused consistent weight gain across groups, reflecting improved nutritional status with no adverse metabolic effects. Hematological and biochemical markers remained within normal ranges, indicating no significant liver or kidney toxicity. The histopathology assessments for the acute and sub-acute toxicity study showed varying responses based on dosage. Histopathology reports were generally normal for the 300mg/kg dose, eight times the recommended dose for children. Also, cyanide levels in NutriMeal and blood samples from treated animals were well below toxic thresholds. CONCLUSION: NutriMeal demonstrated a favorable safety profile in animal models, showing no significant adverse effects even at doses far exceeding human equivalents. These findings support its further evaluation in clinical trials to validate its efficacy and longterm safety in treating SAM.
Colonoscopy Experience in a Private Hospital in Nigeria.
Nwashilli NJ, Bamgboye EL, Dozie I … +1 more , Ojeola T
West Afr J Med · 2024 Oct · PMID 40009832
BACKGROUND: Colonoscopy remains the gold standard for examining and detecting lesions of the colon and can be used as a therapeutic procedure. AIM: To report our colonoscopy experience in a private hospital in Nigeria. P...
BACKGROUND: Colonoscopy remains the gold standard for examining and detecting lesions of the colon and can be used as a therapeutic procedure. AIM: To report our colonoscopy experience in a private hospital in Nigeria. PATIENTS AND METHODS: This was a retrospective review of all consecutive patients who underwent colonoscopy from September 2020 to January 2022 (17 months) at Saint Nicholas hospital, a private hospital in Lagos, Nigeria. Informed consents for colonoscopy were obtained from all the patients recruited. Ethical approval for the publication of this manuscript was obtained from the Hospital authority. Each patient had a 3-day bowel preparation before the procedure. Statistical analysis was carried out using IBM SPSS version 26. RESULTS: A total of one hundred and one patients were recruited into the study with no exclusion. There were 68 males and 33 females with a male to female ratio of 2:1. The mean age of the patients was 52.2± 1.4 years with age range of 23-93 years. The most common indication for colonoscopy was bleeding per rectum. Caecal intubation was achieved in 97% of the patients. Normal findings were recorded in 71% of the patients. CONCLUSION: The most common indication for colonoscopy was bleeding per rectum. Caecal intubation was achieved in the majority of the patients with the colon noted to be normal in over two-thirds of the patients.
Relationship Between Average Keratometric (AK) Readings and Axial Length (AL) Measurements in A Sub-Saharan African Population.
Oderinlo O, Bogunjoko T, Hassan A … +2 more , Olowolaiyemo M, Akinye A
West Afr J Med · 2024 Oct · PMID 40009825
AIM: To report the relationship between average keratometric (AK) readings and axial length (AL) measurements in left eyes of patients attending a cataract surgery camp in sub-Saharan Africa. METHODS: A prospective evalu...
AIM: To report the relationship between average keratometric (AK) readings and axial length (AL) measurements in left eyes of patients attending a cataract surgery camp in sub-Saharan Africa. METHODS: A prospective evaluation of 648 left eyes of consecutive patients who presented for a cataract surgery camp. The KOWA Autorefractor and Alcon ocuscan were used for measurements. Left eyes alone were evaluated to reduce duplication of data. The data obtained were statistically analyzed using Statistical Package for Social Sciences, version 20.0 (SPSS v20). RESULTS: A total of 648 eyes of 648 patients were analyzed. There were 306 (47.2%) males and 342 (52.8%) females with age range from 11 to 95 years, mean ± SD age of 65.70 ± 14.28 years. AL range was from 18.00 mm to 30.39 mm, mean ± SD of 23.21± 1.19. AK ranged from 38.50 D to 48.50 D with mean ± SD of 43.41±1.68. AK reading of patients' left eye increased as the patients age increased (p=0.007). AK readings also increased with a reduction in AL (p=<0.001). Hence smaller eyes had steeper corneas. AL of left eye and AK readings were linearly related by: AL = 33.29 - 0.232AK. CONCLUSION: Average keratometric readings in left eyes of our cohort of patients increased with age (p=0.007) and reducing axial length (p=<0.001). Axial length of left eye and Average-K readings are linearly related by: AL = 33.29 - 0.232AK. This formula can be utilized during cataract camps to estimate either value, used in intraocular lens calculations.
The Effects of Varying Doses of Magnesium-Sulphate on Succinylcholine-Induced Fasciculation and Postoperative Muscle Pain in A Nigerian Population.
Ojo AK, Ikokoh MO, Ojumu TA … +2 more , Ayegbusi OE, Owoniya TA
West Afr J Med · 2024 Oct · PMID 40009802
BACKGROUND: Magnesium has been shown to attenuate succinylcholine-induced fasciculation (SIF) and postoperative muscle pain (POMP); however, the optimal dose remains undetermined. This study explores the effects of varyi...
BACKGROUND: Magnesium has been shown to attenuate succinylcholine-induced fasciculation (SIF) and postoperative muscle pain (POMP); however, the optimal dose remains undetermined. This study explores the effects of varying low doses in a Nigerian population. METHODS: Ninety patients, aged 18 and 65 years, ASA I and II, who had succinylcholine-assisted airway management, under general anaesthesia, (with propofol-midazolam co-induction, isoflurane and pancuronium maintenance), were randomised into three groups. All patients received magnesium pretreatment before induction; group A received 7.5mg/kg, group B received 10 mg/kg, while group C received 20 mg/kg. RESULTS: Socio-demographic characteristics were comparable in all groups, p-value > 0.05. The overall incidence of SIF was similar between groups A (24, 80.0%) and B (22, 73.3%), and significantly higher than group C (12, 40.0%) (p = 0.001). Incidence of mild SIF were similar between groups A, (13, 43.3%) and B, (16, 53.3%), and statistically lesser than C, (12, 40.0%), p-value 0.001. The overall POMP incidence was similar between group A, (15, 50.0%) and B, (14, 46.7%), and statistically higher than C, (6, 20.0%), p-value 0.021. CONCLUSION: This study demonstrates that a 20 mg/kg magnesium pretreatment attenuates SIF and POMP more effectively than 7.5 mg/kg and 10 mg/kg doses in patients undergoing succinylcholine-assisted airway management for general anesthesia.
Clients' Satisfaction with Quality of Care among Health-Insured and Non-Insured Diabetic Patients in Kaduna State, Northwest Nigeria.
Babandi ZS, Suleiman AG, Saulawa FA … +5 more , Sufiyan MB, Jibril MB, Lawal A, Idris SH, Aliyu AT
West Afr J Med · 2024 Oct · PMID 40009780
BACKGROUND: Access to affordable and quality care is critical to reducing suffering and mortality from diabetes given the huge economic challenge it poses. Health insurance aims to, among other things, improve the qualit...
BACKGROUND: Access to affordable and quality care is critical to reducing suffering and mortality from diabetes given the huge economic challenge it poses. Health insurance aims to, among other things, improve the quality of health care services provided to patients. OBJECTIVES: To assess and compare client satisfaction with quality of care among health-insured and non-insured diabetic patients in Kaduna State. METHODS: A comparative cross-sectional study was conducted using a two-stage sampling technique and 500 respondents, comprising 250 (50%) insured and 250 (50%) uninsured patients. Data was collected with a pretested, semi-structured, interviewer-administered questionnaire. Data was analysed using IBM SPSS version 25. A p-value < 0.05 was considered statistically significant, and results were presented using tables. RESULTS: The mean satisfaction scores of the health-insured and noninsured patients were found to be 106.6 and 109.5 respectively. The noninsured patients were more satisfied with the Health workers' interpersonal approach (p = 0.022) and communication (p = 0.026), while the health-insured patients were more satisfied with the financial aspect of care (p = 0.040). However, there is no statistically significant difference in the composite satisfaction between the health-insured and non-insured patients. Religion, duration of diabetes and educational status were found to be predictors of client satisfaction. CONCLUSIONS: The study found that although there was no significant difference in total satisfaction with the quality of care, the noninsured patients were more satisfied with the Health workers' interpersonal approach and communication. It was recommended that the NHIA through accredited health facilities should improve interpersonal relationships and communication with health-insured diabetic patients.
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