The Nigerian Postgraduate Medical Journal[JOURNAL]
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200 papers
Monoclonal Gammopathy of Renal Significance.
Manne SC, Mohammed Z, Madhavan K … +2 more , Varadharajan J, Kumar JS
Niger Postgrad Med J · 2026 May · PMID 42085062 · Publisher ↗
Monoclonal gammopathy of renal significance (MGRS) refers to a spectrum of kidney disorders caused by monoclonal immunoglobulins produced by small, often clinically silent clones of B-cells or plasma cells that do not me...
Monoclonal gammopathy of renal significance (MGRS) refers to a spectrum of kidney disorders caused by monoclonal immunoglobulins produced by small, often clinically silent clones of B-cells or plasma cells that do not meet the diagnostic criteria for overt haematological malignancy. These entities are frequently overlooked, as their clinical presentation often mimics more common renal diseases and typical markers of monoclonal protein may be absent. We describe the case of a 49-year-old woman with type 2 diabetes and hypertension who presented with nephrotic-range proteinuria. Despite unremarkable findings on serum and urine protein electrophoresis and a normal bone marrow biopsy, serum free light chain analysis revealed significantly elevated kappa chains. Renal biopsy demonstrated classic features of both kappa light chain cast nephropathy and light chain deposition disease. This case highlights the role of renal biopsy and serum free light chain assays in the diagnosis of MGRS, especially when traditional paraprotein studies are inconclusive.
Abdominal Pregnancy at Advanced Gestational Age in Lagos, Nigeria.
Oseni NA, Ofoegbu OU
Niger Postgrad Med J · 2026 May · PMID 42085061 · Publisher ↗
Abdominal ectopic pregnancy is an uncommon form of ectopic pregnancy with few cases reported in Nigeria. We present a case report of abdominal ectopic pregnancy with haemoperitoneum in an unbooked multipara at advanced g...
Abdominal ectopic pregnancy is an uncommon form of ectopic pregnancy with few cases reported in Nigeria. We present a case report of abdominal ectopic pregnancy with haemoperitoneum in an unbooked multipara at advanced gestational age. She subsequently had an emergency exploratory laparotomy and right salpingectomy. Diagnosis of this condition can be challenging due to non-specific clinical symptoms, while definitive management can also pose a challenge due to the site of placental attachment.
Efficacy of an Instructional Module on Awareness of the Side Effects of Cosmetic Products among Teenage Girls.
Munjewar PK, Sharma RP, Pohekar SB … +2 more , Wankhede P, Jawade SD
Niger Postgrad Med J · 2026 May · PMID 42085060 · Publisher ↗
BACKGROUND: Cosmetic product is widely used by teenage girls as part of their daily routine. However, certain ingredients in these products may cause adverse effects such as acne, dermatitis, allergic reactions and even...
BACKGROUND: Cosmetic product is widely used by teenage girls as part of their daily routine. However, certain ingredients in these products may cause adverse effects such as acne, dermatitis, allergic reactions and even long-term health risks. Awareness regarding these side effects remains limited among adolescents. AIMS: To assess the efficacy of an instructional module in enhancing the knowledge of teenage girls about the side effects of cosmetic products and to identify the association between demographic variables and knowledge scores. MATERIALS AND METHODS: This cross-sectional study aimed to evaluate the efficacy of an instructional module on improving the knowledge of teenage girls regarding the side effects of cosmetic products. The demographic variable of the study participants was also analysed to determine their association with knowledge scores. The study included 100 teenage girls aged 12-19 from central rural India. RESULTS: The results of the study showed that 48% of the participants had poor knowledge before the intervention, and 52% had average knowledge regarding the side effects of cosmetic products. However, after the intervention, the knowledge scores significantly improved, with 60% of the participants having good knowledge and 30% having very good knowledge. CONCLUSIONS: The instruction module effectively enhances knowledge regarding cosmetic side effects among teenage girls. Educational intervention should be integrated into school health programs to promote safer cosmetic use and informed decision-making.
Relatedness of Drug-resistant Tuberculosis amongst Prison Inmates in South-South Nigeria.
Agwu I, Ekuma AE, Nweke IC … +3 more , Amagwu C, Onwuezobe I, Obunge O
Niger Postgrad Med J · 2026 May · PMID 42085059 · Publisher ↗
BACKGROUND: Tuberculosis (TB) is a major cause of morbidity and mortality in many developing countries and a significant public health problem worldwide. Prison systems worldwide are known to be focal points for the conc...
BACKGROUND: Tuberculosis (TB) is a major cause of morbidity and mortality in many developing countries and a significant public health problem worldwide. Prison systems worldwide are known to be focal points for the concentration and dissemination of TB amongst inmates and prison staff. AIM: The aim of the present study was to determine the drug resistance and relatedness of Mycobacterium tuberculosis (MTB) isolates obtained from prison inmates in Akwa Ibom State. MATERIALS AND METHODS: All inmates in the four federal prisons in Akwa Ibom State, South-South Nigeria, who had a cough for 2 or more weeks were included in the study. All the participants were interviewed and requested to provide a sputum sample, which was analysed for MTB by molecular techniques after obtaining consent. 16s rRNA gene sequencing and phylogenetic analysis of multidrug-resistant (MDR) isolates were carried out. RESULTS: Eight isolates were resistant to rifampicin (RIF), nine to isoniazid (INH), four to fluoroquinolones and two to aminoglycosides. Seven isolates were resistant to both RIF and INH and two to RIF, INH and fluoroquinolone each. The eight MDR-TB isolates were divided into four lineages, with Lineage 1 and 2 having one isolate each, Lineage 2 with three isolates and Lineage 4 with five isolates. CONCLUSION: There is a significant transmission of MDR-TB strains amongst inmates in Uyo prison.
Ethnic and Sex Differences in Salt Sensitivity amongst Normotensive Young Adult Nigerians: Implications for Hypertension Prevention.
Oloyo AK, Adejare AA, Odukoya OO … +3 more , Elias SO, Kushimo OA, Sofola OA
Niger Postgrad Med J · 2026 May · PMID 42085058 · Publisher ↗
BACKGROUND: High dietary salt intake is a well-established modifiable risk factor for hypertension and cardiovascular disease. Salt sensitivity - a blood pressure (BP) phenotype defined by exaggerated BP response to salt...
BACKGROUND: High dietary salt intake is a well-established modifiable risk factor for hypertension and cardiovascular disease. Salt sensitivity - a blood pressure (BP) phenotype defined by exaggerated BP response to salt loading, remains underrecognised in normotensive populations despite its strong link to adverse cardiovascular outcomes. The burden and determinants of salt sensitivity amongst young Nigerians remain poorly understood. AIMS: This study aimed to identify demographic and behavioural risk factors associated with salt sensitivity, explore potential ethnic and sex-related differences and determine the independent predictors of salt-sensitive (SS) BP response amongst normotensive young adult Nigerians. SUBJECTS AND METHODS: An interviewer-administered questionnaire was used to collect demographic and behavioural data. Participants underwent a 5-day salt-loading protocol. BP, serum and urinary electrolytes were assessed before and after salt-loading. Data were analysed using appropriate statistical tools and P values set at P < 0.05. RESULTS: Among the participants, 24% were SS. The prevalence of salt sensitivity was higher in Igbos (47.8%) compared to Yorubas (20.5%). SS individuals had significantly lower baseline systolic, diastolic and MA P values and reduced urinary sodium concentrations pre-salt loading, particularly among females. There were no statistically significant associations between salt sensitivity and body mass index, sleep duration or residential location ( P > 0.05). CONCLUSIONS: Salt sensitivity is common amongst normotensive young adult Nigerians, with clear ethnic and sex-related differences. The observed subclinical BP alterations and reduced sodium excretion suggest early renal or vascular dysregulation in SS individuals. These findings underscore the need for early identification and targeted prevention strategies to reduce future hypertension risk in this population.
Predictive Utility of Atherogenic Index of Plasma in Carcinoma Breast Cases in Correlation with Oxidative Stress, Immuno-biomarkers and Body Mass Index.
Pant A, Anjankar A
Niger Postgrad Med J · 2026 May · PMID 42085057 · Publisher ↗
BACKGROUND: Breast cancer remains the most prevalent malignancy among women worldwide, contributing significantly to global cancer-related morbidity and mortality. It is responsible for nearly 15% of all female cancer fa...
BACKGROUND: Breast cancer remains the most prevalent malignancy among women worldwide, contributing significantly to global cancer-related morbidity and mortality. It is responsible for nearly 15% of all female cancer fatalities. It has a higher prevalence in developed nations. AIMS: The present study aimed to assess the predictive utility of Atherogenic index of plasma (AIP) in carcinoma breast cases in correlation with oxidative stress, immuno-biomarkers and body mass index (BMI). SUBJECTS AND METHODS: Prospective interventional study. The Prospective Interventional Study was conducted in the Department of Biochemistry, Jawaharlal Nehru Medical College and the Histopathology and Radiology division of the Department of Pathology, JNMC, in collaboration with the Department of Surgery, JNMC and Acharya Vinoba Bhave Rural Hospital, Wardha, for the duration of 3 years. Total 81 samples were recruited for the study. The patient's history was taken, and a proper medical examination was carried out. The SPSS program for Windows, version 26.0 (SPSS, Chicago, Illinois, USA), was employed to conduct the statistical analysis. Categorical variables were analysed using either the Chi-square test or Fisher's exact test, while continuous variables were compared using the unpaired t -testing method. P ≤0.05 was deemed to be statistically significant. RESULTS: A significant positive correlations between AIP and various parameters, including BMI ( r = 0.591, P < 0.001), superoxide dismutase ( r = 0.407, P < 0.001), high-sensitivity C-reactive protein ( r = 0.507, P < 0.001), Interleukin-10 (IL-10) ( r = 0.706, P < 0.001) and IL-18 ( r = 0.652, P < 0.001). Furthermore, a strong positive correlation with lipid profile was observed. CONCLUSIONS: AIP could serve as a useful surrogate marker to assess not only lipid imbalance but also broader systemic changes that accompany breast cancer.
Gender-specific Causal Relationship between Sex Hormones and Carpal Tunnel Syndrome: A Mendelian Randomisation Study.
Zeng X, Li Z, Luo B … +3 more , Zheng R, Wei D, Lao S
Niger Postgrad Med J · 2026 May · PMID 42085056 · Publisher ↗
BACKGROUND: Observational studies have shown a correlation between sex hormones and the risk of developing carpal tunnel syndrome (CTS), but it remains unclear whether these associations are causal. AIMS: We aimed to inv...
BACKGROUND: Observational studies have shown a correlation between sex hormones and the risk of developing carpal tunnel syndrome (CTS), but it remains unclear whether these associations are causal. AIMS: We aimed to investigate the potential causal relationships between a range of sex hormones and the risk of CTS using a Mendelian randomisation (MR) approach. METHODS: We selected exposure-related genetic instruments from genome-wide association studies summary data using significance thresholds. The CTS summary data were obtained from two sources: the UK Biobank (UKB) (12,887 cases and 443,461 controls) and the FinnGen consortium (17,198 cases and 273,097 controls). The random-effects inverse variance-weighted method was used as the primary approach for causal analysis, along with complementary weighted median, MR-Egger and MR-PRESSO tests for sensitivity analysis. Fixed-effect model was used to meta-analyse the results from the UKB and FinnGen. RESULTS: The meta-analysis of the MR results from FinnGen and UKB identified potential risk factors that may increase the risk of CTS. These factors include lower sex hormone-binding globulin (SHBG) levels (both: odds ratio [OR] =0.628, P < 0.0001; female: OR = 0.601, P < 0.0001; male: OR = 0.717, P < 0.0001) and lower body mass index-adjusted SHBG levels (both: OR = 0.748, P < 0.0001; female: OR = 0.718, P < 0.0001; male: OR = 0.753, P < 0.0001). In males, higher total testosterone (TT) levels (OR = 0.912, P = 0.0052) may decrease the risk of CTS, whereas higher bioavailable testosterone (BAT) levels (OR = 1.370, P < 0.0001) may increase the risk of CTS in females. Oestradiol (E2), progesterone, the ratio of testosterone to oestradiol, androstendione, aldosterone and 17-hydroxyprogesterone showed no significant causal relationship with CTS risk. CONCLUSION: This MR study provides insights into the potential role of SHBG, TT and BAT in the development of CTS, highlighting the importance of conducting gender-specific genetic analyses.
Biomechanical Evaluation of Implant Size and Osseointegration Using Three-dimensional Finite Element Analysis.
Kamble PS, Kalghatgi S, Karade P … +3 more , Nair AS, Chatterjee A, Chopade RV
Niger Postgrad Med J · 2026 May · PMID 42085055 · Publisher ↗
BACKGROUND: Finite element analysis (FEA) is a technique for obtaining a solution to a complex mechanical problem by dividing the problem domain into a collection of much smaller and simpler domains (elements) in which t...
BACKGROUND: Finite element analysis (FEA) is a technique for obtaining a solution to a complex mechanical problem by dividing the problem domain into a collection of much smaller and simpler domains (elements) in which the field variables can be interpolated with the use of shape functions. Load transfer from implants to surrounding bone depends on the type of loading, the bone-implant interface, the length and diameter of the implants, the shape and characteristics of the implant surface, the prosthesis type and the quantity and quality of the surrounding bone. FEA allows researchers to predict stress distribution in the contact area of the implants with the cortical bone and around the apex of the implants in trabecular bone. AIMS: This study aimed to compare the stress and strain on a single implant and its surrounding bone for various implant lengths and diameters, both before and after osseointegration. MATERIALS AND METHODS: An initial model of a single implant substituting a second premolar was developed with reference to a posterior cross-sectional area of both cortical and cancellous bone on a personal computer using ANSYS software. The length and diameter of the implant were assumed to be L = 11.5 mm and D = 4 mm. The loading condition was performed by the application of the static vertical force of 118.2 N to the node of the implant. RESULTS: Increased implant length results in stress reduction on the implant in both immediate and delayed implant loading. In the present study, the Von Miss Stress are reduced. Furthermore, increased implant diameter results in stress reduction on the implant in both immediate and delayed implant loading. CONCLUSION: The present study indicates that implant length prior to and after osseointegration is not the sole factor affecting stress/strain distribution pattern. There are other influencing factors like type of loading, the bone-implant interface, the length and diameter of the implants, the shape and characteristics of the implant surface, the prosthesis type and the quantity and quality of the surrounding bone.
Comparative Analysis of Coconut Husk and Coconut Shell Ash Powder for Latent Fingerprint Development.
Shetty A, Joseph A, Gupta C … +1 more , Palimar V
Niger Postgrad Med J · 2026 May · PMID 42085054 · Publisher ↗
BACKGROUND: Conventional powder agents are compounds of chemicals that have a high potential for causing harm to the user and are also expensive for developing latent fingerprints from crime scenes. AIMS: The present stu...
BACKGROUND: Conventional powder agents are compounds of chemicals that have a high potential for causing harm to the user and are also expensive for developing latent fingerprints from crime scenes. AIMS: The present study aimed to show the effectiveness of coconut ash-based powders as potential latent fingerprint development powders, determine the optimal particle size for effective visualisation, and assess the visibility of sweat pores after powder application. METHODS: The dried coconut shell and coconut husk were burnt, and its ash was ground into fine particles. The latent thumbprints of 269 participants were collected on the glass surface. The developed powders were applied to the deposited latent fingerprints. The developed prints were scored as per the 'Fingerprint Quality Assessment scale'. The powder-developed prints were then photographed using a mobile phone for documentation purposes. RESULTS: It was observed that coconut shell ash powder developed high-quality fingerprints, especially at 200 mesh size, with clear visualisation of sweat pores from the developed prints as compared to coconut husk. CONCLUSION: Thus, coconut shell ash powder proved to be the better powder for the development of clear latent fingerprint visualisation along with sweat pores at 200 mesh size from the glass surface.
Comparison of Serum Prolactin Level with Child-Pugh Scoring System in Predicting the Complications of Cirrhosis of Liver: A Cross-sectional Study.
Kishor AR, Sandeep MLN, Reddy K … +2 more , Kumar JS, Sethupathi SP
Niger Postgrad Med J · 2026 May · PMID 42085053 · Publisher ↗
BACKGROUND: Cirrhosis of the liver is a chronic condition characterised by scar tissue replacing healthy liver tissue, leading to impaired liver function and endocrine disturbances. Hyperprolactinemia in cirrhosis result...
BACKGROUND: Cirrhosis of the liver is a chronic condition characterised by scar tissue replacing healthy liver tissue, leading to impaired liver function and endocrine disturbances. Hyperprolactinemia in cirrhosis results from reduced dopamine inhibition due to elevated circulating oestrogens. AIMS: This study assessed the relationship between serum prolactin levels and the Child-Pugh scoring system in predicting complications in liver cirrhosis. MATERIALS AND METHODS: A cross-sectional study was conducted on 70 cirrhotic patients over 12 months at a tertiary care center. Inclusion criteria included patients aged ≥18 years with diagnosed cirrhosis. Serum prolactin levels were measured using radioimmunoassay. Disease severity was evaluated using the Child-Pugh scoring system. Statistical analysis was performed to assess correlations between prolactin levels, Child-Pugh scores and clinical complications. RESULTS: Serum prolactin levels showed a strong positive correlation with the Child-Pugh score ( r = 0.641, P < 0.001). Elevated prolactin levels were associated with complications such as ascites, portal hypertension, hepatic encephalopathy and oesophageal varices ( P < 0.001). Patients with higher prolactin levels demonstrated significantly increased 6-month mortality ( P < 0.0001). Receiver operating characteristic curve analysis (area under the curve = 0.98) highlighted prolactin's predictive value for mortality. CONCLUSION: Serum prolactin is a reliable biomarker for assessing cirrhosis severity and predicting complications. It complements the Child-Pugh scoring system and may guide early interventions in high-risk patients.
Effects of Functional Rehabilitation on Muscle Strength, Dynamic Balance and Functional Performance 1 Year after Anterior Cruciate Ligament Reconstruction: A Randomised Controlled Trial.
Feng H, Kahar JBA, Malek IZBA … +1 more , Saleh MZB
Niger Postgrad Med J · 2026 May · PMID 42085052 · Publisher ↗
BACKGROUND: Return to sport (RTS) success rates remain suboptimal for high sports demand individuals (HSDs) following anterior cruciate ligament reconstruction (ACLR). Traditional rehabilitation model (TRM) primarily foc...
BACKGROUND: Return to sport (RTS) success rates remain suboptimal for high sports demand individuals (HSDs) following anterior cruciate ligament reconstruction (ACLR). Traditional rehabilitation model (TRM) primarily focuses on strength recovery and range of motion but demonstrates deficiencies in neuromuscular control and sport-specific conditioning. AIMS: This study aimed to compare the effects of functional rehabilitation model (FRM) versus Traditional rehabilitation model (TRM) on post-operative functional recovery and RTS outcomes in HSDs. METHODS: A prospective single-blind randomised controlled trial was conducted including 64 HSDs who underwent ACLR (exercise ≥3 times per week, Tegner score >5), randomly allocated to the FRM group ( n = 32) and TRM group ( n = 32). The FRM group received a performance-based progressive 24-week rehabilitation protocol incorporating multimodal sensory training, closed-chain exercises, unstable surface proprioceptive training and sport-specific skill integration. The TRM group received a standard time-oriented 24-week rehabilitation protocol. The primary outcomes included 48-week RTS rate and functional recovery trajectory. The secondary outcomes included isokinetic strength, single-leg hop tests, modified star excursion balance test, proprioception and patient-reported outcomes (International Knee Documentation Committee [IKDC], Lysholm and Anterior Cruciate Ligament-Return to Sport after Injury [ACL-RSI]). Assessment time points included pre-operative baseline, 24 weeks and 48 weeks postoperatively. Repeated measures analysis of variance was used to evaluate longitudinal changes. RESULTS: Fifty-seven patients completed follow-up (retention rate: 89.1%). The FRM group demonstrated significantly higher 48-week successful RTS rate compared to the TRM group (89.3% vs. 62.1%, P = 0.038), with relative risk 1.44 (95% confidence interval: 1.05-1.97) and number needed to treat 3.7. Repeated measures analysis revealed that the FRM group significantly outperformed the TRM group in quadriceps peak torque (48 weeks: 124.17 ± 7.25 vs. 98.42 ± 8.73 Nm, P < 0.001) and limb symmetry index (89.15% ± 3.85% vs. 69.45% ± 5.15%, P < 0.001). In single-leg hop tests, the FRM group demonstrated superior performance in lateral hop time (5.54 ± 2.25 vs. 7.84 ± 3.37 s, P = 0.004) and box hop symmetry index (97.50% ± 29.60% vs. 76.20% ± 31.40%, P = 0.011). Proprioceptive testing showed that the FRM group had smaller position sense errors at 30° (2.83° ± 1.63° vs. 4.25° ± 1.85°, P = 0.002) and 45° knee flexion angles (6.37° ± 1.69° vs. 7.57° ± 1.73°, P = 0.008). Patient-reported outcomes demonstrated the FRM group superiority in IKDC (89.45 ± 9.72 vs. 83.45 ± 12.73, P = 0.028), Lysholm (88.71 ± 5.78 vs. 76.12 ± 12.38, P < 0.001) and ACL-RSI scores (79.52 ± 8.17 vs. 70.35 ± 10.24, P < 0.001). The FRM group exhibited sustained linear improvement patterns, while the TRM group showed a recovery plateau after 24 weeks. CONCLUSION: Compared to TRM, FRM significantly improved functional recovery trajectories and RTS outcomes in HSDs through enhanced neuromuscular control, improved dynamic performance and increased psychological readiness.
Association between Bone Mineral Density and Insulin Resistance in Polycystic Ovarian Syndrome - A Case-control Observational Study.
Sridharan A, Guddeti A, Kumar S … +5 more , Aleem S, Vasamsetti SR, Mashetty S, Alekya LAV, Kumar KVSH
Niger Postgrad Med J · 2026 May · PMID 42085051 · Publisher ↗
BACKGROUND: Polycystic ovarian syndrome (PCOS) has bidirectional effects on the skeleton due to hormonal dysfunction and insulin resistance (IR). AIMS: We examined bone mineral density (BMD) and its relationship with IR...
BACKGROUND: Polycystic ovarian syndrome (PCOS) has bidirectional effects on the skeleton due to hormonal dysfunction and insulin resistance (IR). AIMS: We examined bone mineral density (BMD) and its relationship with IR using the homeostasis model of assessment (HOMA) in patients with PCOS and matched controls. MATERIALS AND METHODS: In this case-control observational study, we included 74 patients newly diagnosed with PCOS and a similar number of age-and weight-matched healthy women as controls. Haematological, biochemical and hormonal parameters were measured in a fasting blood sample during the follicular phase, and the BMD Z score was calculated using dual energy X-ray absorptiometry. The results were analysed using relevant statistical methods, and P < 0.05 was considered significant. RESULTS: The study participants ( n = 148) had a mean age of 23.6 ± 3.7 years and a body mass index (BMI) of 25.2 ± 3.2 kg/m 2 . Among the PCOS patients, 25 (34%) had a normal BMI and 49 (66%) were obese. The BMD at the femoral neck ( P = 0.4313) and lumbar spine ( P = 0.1410) was comparable between the PCOS and control groups. Correlation analysis showed a positive correlation of BMD with testosterone and 17-hydroxy progesterone (17OHP) ( P < 0.001). None of the BMD parameters correlated with HOMA in either group. CONCLUSION: BMD at the lumbar spine and femoral neck was similar between patients with PCOS and controls. Further studies with a larger sample size, longer follow-up periods and fracture data are needed to confirm our findings.
Barriers to Timely Care Associated with Complications of Snakebite Envenomation amongst Farmers in Northeastern Nigeria.
Isaac OO, Kwaku AA, Jalo RI … +7 more , Tsiga-Ahmed FI, Ibrahim UM, Sunusi SM, Amole TG, Yushau SS, Abdullahi HM, Abubakar IS
Niger Postgrad Med J · 2026 May · PMID 42085050 · Publisher ↗
BACKGROUND: Delays in seeking medical care after snakebites are common in rural areas and worsen the risks of complications, disability and death. In North-eastern Nigeria, subsistence farmers struggle to access prompt t...
BACKGROUND: Delays in seeking medical care after snakebites are common in rural areas and worsen the risks of complications, disability and death. In North-eastern Nigeria, subsistence farmers struggle to access prompt treatment due to financial, geographic and cultural barriers, posing a public health issue. AIM: We assessed the barriers to timely care associated with the complications of snakebite envenomation amongst farmers in Northeastern Nigeria. SETTINGS AND DESIGN: A community-based, sequential explanatory mixed-methods study was conducted in Kaltungo Local Government Area, a recognised hotspot for carpet viper bites. MATERIALS AND METHODS: Farmers aged 15+ years were surveyed with an interviewer-administered semi-structured questionnaire. Six focus group discussions (FGDs) explored experiences, care-seeking behaviours and barriers to treatment. Statistical analysis included descriptive statistics to summarise the sociodemographic data and bite patterns. Relationships between barriers to care and complications were examined using the Chi-square or Fisher's exact test, followed by multivariable logistic regression to control for confounding factors and determine the independent associations. P < 0.05 was deemed statistically significant. RESULTS: Snakebite prevalence was 42.3% ( n = 160), with 95% reporting symptoms and 91.9% having prolonged complications. Barriers included financial issues (75.5%), transportation (80.9%) and low danger perception (65.5%), all linked to complications ( P < 0.05). FGDs cited hospital cost fears, distance, traditional healer reliance and seasonal exposure as key delay factors. CONCLUSIONS: Snakebite envenoming remains a health threat for rural farmers, worsened by financial, transportation and sociocultural barriers. Improving health insurance, decentralising antivenom and enhancing health education are crucial for better outcomes.
A Study Assessing Patch Test Results in Hand and Foot Eczema Patients at a Tertiary Care Hospital.
Balakumaran C, Sukanya G, Kumar NA … +3 more , Megalai AS, Sankeerthana MP, Rajeev K
Niger Postgrad Med J · 2026 Mar · PMID 41766280 · Publisher ↗
BACKGROUND: Eczema of hand and foot is one of the most common dermatological conditions encountered in the outpatient clinic. Both endogenous and exogenous factors can cause eczema identification and elimination of the t...
BACKGROUND: Eczema of hand and foot is one of the most common dermatological conditions encountered in the outpatient clinic. Both endogenous and exogenous factors can cause eczema identification and elimination of the triggering factor becomes essential. AIMS AND OBJECTIVES: The primary objective of the study was to assess the diagnostic outcomes of patch testing in hand and foot eczema and to study the distribution of clinical patterns and aetiologies causing hand and foot eczema. MATERIALS AND METHODS: Thirty patients diagnosed with hand and foot eczema had a patch test using Indian standard battery series. This prospective observational study was carried out over 18 months at a tertiary care hospital in Chromepet, Chennai, Tamil Nadu, India. Data entry was done on Microsoft Excel and data analysis was done using SPSS 22 version. P < 0.005 was considered to be significant throughout the study. Patients diagnosed with hand and foot eczema had patch test done using indian standard battery series. The patients were followed up at 48 and 72 h, respectively, and the results were interpreted using international contact dermatitis research group (ICDRG) grading. RESULTS: The study population comprised predominantly of 18 (60%) males and 12 (40%) females with 16 (53.3%) of the entire study population being 41-60 years. Hand eczema was the most common presentation: 19 (63.3%) patients, with itching reported in 29 (96.75%) patients and dryness in 24 (80%) patients, bilateral involvement was observed in 25 (83.3%) cases. The most common exposure was to gloves in 15 (50%) patients followed by detergents in 9 (30%) patients. Hyperkeratotic hand and foot eczema was the most frequent morphological finding documented in 6 patients (20%). Of the 30 patients who had patch testing done, 9 patients (30%) had one positive antigen, 3 had (10%) had three positive antigens, 1 patient (3.3%) had two positive antigens and 17 (56.7%) patients had no positive antigens. The most common antigen was potassium dichromate (25%). CONCLUSION: Hand and foot eczema remains a challenging dermatological condition due to its chronicity and multifactorial aetiology. Hand eczema is more prevalent than foot eczema and comprises a major part of occupational dermatoses. Patch test being a non-invasive tool helps in ascertaining the causative allergen and plays a significant role in the management of eczema, as avoidance of the allergen forms the cornerstone in the treatment of eczema.
Acute Kidney Injury in Pregnancy among Kidney Transplant Recipients.
Okwuonu CG, Chimezie OJ, Oviasu E
Niger Postgrad Med J · 2026 Mar · PMID 41766279 · Publisher ↗
Acute kidney injury (AKI) in pregnancy among women with kidney transplants is rarely addressed in the literature. There is no consensus definition of AKI among this population, and limited data exist on the different aet...
Acute kidney injury (AKI) in pregnancy among women with kidney transplants is rarely addressed in the literature. There is no consensus definition of AKI among this population, and limited data exist on the different aetiologies and outcomes, thereby creating a significant knowledge gap. Pregnancy among patients with a kidney transplant is considered high risk due to the possibility of foetal and maternal risks, AKI and graft loss during pregnancy. This is a case series report of two post-kidney transplant patients who developed multiple episodes of AKI in the course of pregnancy. There was no identifiable pre-renal, intrinsic renal, post-renal or transplant-specific cause for the AKI. There was a failure of the first-trimester dip in serum creatinine in both patients. In addition, the serum creatinine stabilised between 6 and 12 months post-delivery, albeit at a higher level. The renal biopsy done was negative for rejection or polyoma virus nephropathy. Failure of the first trimester dip in serum creatinine may be a risk factor for AKI in pregnant transplant patient which may in turn have deleterious short term and long term outcomes on kidney function.
Poikilodermatous Change of Skin: Diagnostic Insights from Clinical and Histopathological Examination.
Biswas AG
Niger Postgrad Med J · 2026 Mar · PMID 41766278 · Publisher ↗
Poikilodermatous skin changes represent a diagnostic challenge due to their non-specific clinical features and broad differential diagnoses. This report presents the case of a 29-year-old female with symmetrical, variabl...
Poikilodermatous skin changes represent a diagnostic challenge due to their non-specific clinical features and broad differential diagnoses. This report presents the case of a 29-year-old female with symmetrical, variably pigmented macules and patches over sun-exposed areas, including the neck and upper limbs. Histopathological examination revealed epidermal atrophy, pigment incontinence, basal layer pigmentation, dermal telangiectasia and a mild lymphocytic infiltrate - findings consistent with poikilodermatous change. No features suggestive of interface dermatitis, atypical lymphoid cells or basal vacuolar alteration were observed, effectively ruling out conditions such as cutaneous T-cell lymphoma, connective tissue disease and lichen planus pigmentosus. In the absence of systemic symptoms or alarming histological features, a diagnosis of benign acquired poikiloderma, likely actinic in origin, was favoured. This case underscores the critical role of histopathological correlation in accurately diagnosing poikilodermatous lesions and guiding appropriate clinical management.
Detection of Previously Undiagnosed Glaucoma and Suspects through Annual Screening of Hospital Staff in a Nigerian Tertiary Hospital.
Sarimiye TF, Adebusoye SO, Ugalahi MO … +1 more , Onebunne EO
Niger Postgrad Med J · 2026 Mar · PMID 41766277 · Publisher ↗
BACKGROUND: Glaucoma, a leading cause of irreversible blindness globally, disproportionately affects the persons of African descent. In Nigeria, delayed diagnosis and advanced disease presentation are common. AIMS: This...
BACKGROUND: Glaucoma, a leading cause of irreversible blindness globally, disproportionately affects the persons of African descent. In Nigeria, delayed diagnosis and advanced disease presentation are common. AIMS: This study evaluated the uptake and screening outcomes of targeted glaucoma screening among hospital staff at a tertiary hospital in Nigeria. SUBJECTS AND METHODS: This cross-sectional study recruited staff who participated in a 1-day workplace screening. Data collected included prior screening experience, medical and family history and comprehensive eye examinations. Glaucoma and suspects were identified using the International Society of Geographical and Epidemiological Ophthalmology Criteria. RESULTS: Ninety-six staff were screened. The median age was 44.0 years (interquartile range: 39.0-52.0), with 67.7% (n = 65) younger than 50 years. Glaucoma was identified in 5.2% (2.3%-11.6%; n = 5) and 14.6% (8.8%-22.9%; n = 14) were glaucoma suspects. Over half (58.3%, n = 56) had never undergone previous eye screening. Participants with a family history were more likely to have had previous screening (odds ratio [OR] = 12.7 [2.9-55.8]). Participants with glaucoma/suspect status were modestly older (median 48 vs. 44 years), supported by a Mann-Whitney probability OR of 3.41 (1.45-13.93), showing increased probability of elderly amongst the affected group. Family history was associated with glaucoma/suspect classification (OR = 5.03 [1.54-16.45]). CONCLUSIONS: The high proportion of undiagnosed glaucoma and glaucoma suspects, even amongst a relatively young population, underscores the value of targeted, opportunistic workplace screening. Early detection is vital to prevent irreversible vision loss. Promoting family-based discussions and glaucoma disclosure and enhancing targeted awareness campaigns may improve screening participation and public health outcomes.
Evaluation of Mean Platelet Volume and Platelet Distribution Width as an Early Marker of Neonatal Sepsis: A Case-Control Study.
Aglave NR, Rokade RS, Nagrale PB
Niger Postgrad Med J · 2026 Mar · PMID 41766276 · Publisher ↗
BACKGROUND: Neonatal sepsis (NS) is one of the greatest concerns in developing countries and the leading cause of mortality in the neonatal intensive care unit. Due to non-specific and overlapping signs, it poses a diffi...
BACKGROUND: Neonatal sepsis (NS) is one of the greatest concerns in developing countries and the leading cause of mortality in the neonatal intensive care unit. Due to non-specific and overlapping signs, it poses a difficulty for early diagnosis of sepsis. Blood culture, though the gold standard for diagnosis of sepsis, takes at least 72 h to show positive growth. Early indicators are the need of the hour to predict NS, so that early empirical antibiotics could be initiated. AIM OF THE STUDY: To evaluate Mean platelet volume (MPV) and Platelet distribution width (PDW) as early diagnostic marker of neonatal sepsis and to compare their values between septic and non septic neonates. SUBJECTS AND METHODS: This was a prospective case-control study conducted in a tertiary care centre over a period of 1 year from January 2022 to December 2022. Fifty-three neonates who met the inclusion criteria according to the operational definition of NS were included as cases, while another 53 neonates served as controls. Blood culture, sepsis screen and platelet indices, mean platelet volume (MPV) and platelet distribution width (PDW), were performed on all these babies. Relationship between various factors like gestational age, gender, onset of sepsis, blood culture and outcome, with MPV and PDW in cases and control were analysed. RESULTS: During the study period, 53 neonates were included in the case group and 53 neonates in the control group. Early-onset sepsis (EOS) was more frequent in this study, with 32 (60.38%) neonates being diagnosed with EOS. Blood culture was positive in 26 out of 53 (49.06%) of cases, with the most frequent isolate being Burkholderia cepasia followed by Klebsiella pneumoniae. Gram-negative organisms were the most common organisms seen in 17 (65.38%) of cases with positive blood culture. Mean value of MPV and PDW in cases were 11.3 ± 2.26 and 57.20 ± 18.91, respectively, while that in the control group were 9.13 ± 1.30 and 47.73 ± 20.02, respectively, with P = 0.00001, which was statistically significant (P < 0.05). Receiver operating curve for MPV and PDW, considering blood culture as the gold standard, showed the area under the curve for MPV and PDW were 0.831 and 0.644, respectively. CONCLUSIONS: MPV and PDW are increased in neonates with sepsis, both in term and preterm. MPV is a better predictor of sepsis compared to PDW. So, both MPV and PDW can be used as a surrogate marker of NS and as a predictor of mortality.
Prevalence and Biomechanical Analysis of Knee Valgus and Knee Flexion Angle during Hop Test and Step-down Test among Badminton Players.
Gaikwad SS, Pradhan DK, Mohankumar P … +6 more , Pandith SN, Chaudhary MA, Dastikop CS, Prajwal H, Pati SK, Mishra A
Niger Postgrad Med J · 2026 Mar · PMID 41766275 · Publisher ↗
BACKGROUND: The knee joint plays a crucial role in various badminton-related functional movements for both stability and mobility. Specifically, an optimal flexion and valgus angle upon landing tasks ensures less injury...
BACKGROUND: The knee joint plays a crucial role in various badminton-related functional movements for both stability and mobility. Specifically, an optimal flexion and valgus angle upon landing tasks ensures less injury risk. AIMS: Thus, the study aimed to investigate the prevalence and biomechanical analysis of knee joint flexion and valgus angle among badminton athletes. METHODS: Sixty players were included in this study. The study conducted a two-dimensional biomechanical analysis using the Kinovea software to measure the knee flexion and valgus angle while hop and step-down tests, respectively. RESULTS: The study found that for the 13-17 age group, the mean knee flexion angle is 109.8° ± 8.0° (right) and 112.9° ± 8.7° (left), whereas for the 18-25-year age group, it is 110.4° ± 10.1° (right) and 111.7° ± 9.6° (left). The knee valgus angle for 13-17 years is 11.0° ± 5.5° (right) and 11.1° ± 5.7° (left), and for 18-25 years, it is 12.6° ± 6.1° (right) and 11.9° ± 4.0° (left). The difference in knee flexion and valgus angle between legs or the age groups did not find statistically different (P > 0.05). CONCLUSION: The findings conclude that there was a high prevalence of increased valgus angle among badminton players. However, the flexion angle was found to be optimal. There was no meaningful differences in the knee joint alignments neither between both the legs and the age groups. The study findings can underscore the potential mechanisms and necessary training modifications by emphasising certain neuromuscular control trainings and optimal landing mechanics to ensure a safe and effective badminton-related mechanics, thereby reducing injury risks.
Nutritional Status as a Predictor for Length of Stay of Patients with Respiratory Ailments in the Paediatric Intensive Care Unit.
Maheshwari S, Khwaja H, Rajan AR … +2 more , Joshi D, Chordia P
Niger Postgrad Med J · 2026 Mar · PMID 41766274 · Publisher ↗
BACKGROUND: Malnutrition is a major public health problem in India. Approximately 80% of the world's undernourished children are concentrated in 20 countries. In India, nearly 60 million children are underweight. Childre...
BACKGROUND: Malnutrition is a major public health problem in India. Approximately 80% of the world's undernourished children are concentrated in 20 countries. In India, nearly 60 million children are underweight. Children with malnutrition contribute more to paediatric intensive care unit (PICU) admissions, and their outcomes may be affected by the degree of malnutrition. Malnutrition is also a risk factor for both, increase in length of stay in the PICU and higher Paediatric Respiratory Severity Score (PRESS) scores, thus increasing the need for respiratory support. AIM: To assess the impact of the nutritional status of children admitted with respiratory illnesses on the duration of stay at the PICU in a tertiary care hospital catering to suburban population. MATERIALS AND METHODS: A prospective descriptive study carried out over a period of 6 months analysed 49 children admitted with respiratory illness to PICU in a tertiary care hospital. All Data collected was entered in Excel sheet. All data analyses were performed using IBM Corp. IBM SPSS Statistics for Windows [computer software]. Version 21. Armonk, NY: IBM Corp.; 2012. RESULTS: During the study period, a total of 134 children were admitted to the PICU. Among them, 49 children (36.5%) were admitted due to respiratory tract infections, forming our study group. Based on the IAP weight-for-age growth charts, it was found that 30 (61.2%) of these children exhibited some degree of malnutrition. In our study, 63.3% of the study population were infants. The male gender was predominant (59.2%) in the demographic pattern. The mean hospital stay for all patients was 8.3 days. Mean hospital stay in malnourished patients was 10.85 days, whereas in normally nourished children, it was 4.33 days. The average duration of PICU stay was 4.46 days overall. For malnourished patients, the average stay in PICU was 5.82 days, compared to 2.29 days for patients with normal weight. A significant positive correlation (P < 0.05) was found between malnutrition and prolonged PICU stay, hospital stay and severity of PRESS score. CONCLUSION: The grade of malnutrition was associated with greater severity of respiratory illness and a longer length of stay in PICU and Hospital. The assessment of grades of malnutrition at the time of admission can predict the impact on the length of stay in PICU and hospital.
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