Nigerian Journal Of Medicine[JOURNAL]
Sun
200 papers
Role of pathology in improving health care in poor resource environments.
Barnabas M, Ngbea JA, Innocent E … +1 more , Malu KN
Niger J Med · 2014 · PMID 25185385
BACKGROUND: The task of a Pathologist is to provide an accurate specific and sufficiently comprehensive diagnosis to enable the clinician to develop an optimal plan for patient treatment and to a large extent possible, e...
BACKGROUND: The task of a Pathologist is to provide an accurate specific and sufficiently comprehensive diagnosis to enable the clinician to develop an optimal plan for patient treatment and to a large extent possible, estimate prognosis. Modern Pathology practice is closely linked with all clinical departments and it serves as a bridge between the beginning of disease and how the disease ends. It is obvious that Pathology practice is central to patient care and it is the science behind the cure. However the paucity of pathologist in resource poor countries has posed a challenge to effective health care delivery. METHODOLOGY: This is a review article aimed at reviewing the challenges of Pathology practice in poor resource environment. The author reviewed literature in Medline and other journal on challenges facing health care in developing countries of sub-Saharan region of Africa. Solutions to some of these challenges were also provided and the way forward for the practice of Pathology in Africa. RESULT: Literature review showed that there were negative factors that affected the effective practice of pathology. These factors are:-Lack of political will of most Governments to appropriately provide resources, according to United Nation standard. Absence of National Health Insurance Policy, population control, and infrastructural support. Poor funding, training and, lack of motivation which is prevalent in most resource poor countries. CONCLUSION: Private Partnership with public health institution, donor agencies and non-government agencies is believed to be the only solution to good clinical practice including pathology practice.
The influence of environmental sanitation on prevalence of malaria in a rural town in south-western Nigeria.
Amoran OE, Onwumbe OO, Salami OM … +1 more , Mautin GB
Niger J Med · 2014 · PMID 25185384
INTRODUCTION: The single most significant cause of morbidity and mortality in sub-Saharan Africa and other third world countries is the poor standard of environmental sanitation.This factor plays a major role in disease...
INTRODUCTION: The single most significant cause of morbidity and mortality in sub-Saharan Africa and other third world countries is the poor standard of environmental sanitation.This factor plays a major role in disease transmission especially for endemic diseases such as malaria. This study was therefore designed to assess the influence of environmental sanitation on prevalence of Malaria in a rural town in South-Western Nigeria. METHODS: This was an analytical cross-sectional study. A multi stage cluster sampling technique was used to select the participants into the study. One participant per each household was selected into the study. A semistructured questionnaire was used to collect relevant information. RESULT: A total of 300 households were recruited into the study. Only 14 [4.7%] were regularly involved in daily cleaning of the environment outside their houses and 286 [95.3%] were aware that dirty environment increases the risk of contracting malaria. Majority 178 [62.2%] believe that bushes around the house are major facilitators of malaria. 32 [11.2%] mentioned presence of stagnant water while 76 [26.6%] mentioned unclean drainage system. The prevalence of Malaria attack in the last 6 months among respondents was 192 (64.0 %). Regular cleaning of respondent's environment outside their houses was statistically significant associated with prevalence of Malaria in the households studied [OR = 1.88, CI = 2.61-54.13] while the knowledge of environmental impact on malaria [OR = 1.37, Cl = 0.92-2.05] and malaria transmission [OR = 0.70, CI = 0.43-1.12] were not statistically significandy associated with prevalence of malaria. CONCLUSION: The study concludes that regular cleaning of house surroundings was associated with prevalence of malaria infection in rural areas in Nigeria. Sustainable control and elimination of malaria cannot occur in isolation from other sector of the society most especially the environmental health and engineering services.
Prevalence of antenatal hepatitis B infection in tertiary and non-tertiary health facilities in Ibadan, Nigeria.
Adeyemi AB, Enabor OO, Ugwu IA … +3 more , Abraham OA, Bello FA, Olayemi O
Niger J Med · 2014 · PMID 25185383
BACKGROUND: Hepatitis B infection remains a significant source of morbidity among women and infants at different levels of care particularly in developing countries. AIM: To determine the prevalence of hepatitis B infect...
BACKGROUND: Hepatitis B infection remains a significant source of morbidity among women and infants at different levels of care particularly in developing countries. AIM: To determine the prevalence of hepatitis B infection among pregnant women in tertiary and non-tertiary health facilities. MATERIALS & METHODS: Women receiving antenatal care in a tertiary centre and 2 non-tertiary centres in Ibadan. Nigeria were consecutively screened for Hepatitis B surface antigen by the ELISA method following written informed consent. The results were entered with socio-demographic and obstetric data into a proforma and significant associations determined by chi-square test and logistic regression (p < 0.05). RESULTS: A total of 658 women were recruited; 389 were from the tertiary hospital while 259 were from nontertiary health facilities. The mean age of the whole population was 30.17 +/- 5.24 years while the median gestational age was 27 weeks. Majority of the participants (64.5%) were between 26 and 35 years. The total prevalence of Hepatitis B infection was 16.3%. Prevalence of hepatitis B infection was 30.9% in the non-tertiary health facilities and 6.4% in the tertiary health facility (p = 0.000).The only significant positive predictor variable for hepatitis B infection was being in a non-tertiary health facility (OR: 0.086 CI: 0.037-0.199, p = 0.004). CONCLUSION: The burden ofAntenatal hepatitis B infection in Ibadan may be significantly greater in nontertiary health facilities. Health policy, particularly in these centres, should be directed towards education, screening and vaccination programmes.
Influence of religious beliefs on health workers, a pilot study.
Bellgam IH, Buowari YO
Niger J Med · 2014 · PMID 25185382
BACKGROUND: Religious beliefs amongst health care providers have been noted to influence some advice given to patients by hospital workers. There are instances when patients have been told to go and seek help from elsewh...
BACKGROUND: Religious beliefs amongst health care providers have been noted to influence some advice given to patients by hospital workers. There are instances when patients have been told to go and seek help from elsewhere as this ailment is not for their type of medicine (orthodox medicine). That patient should go to a spiritualist for help. The authors wanted to find out if this was rarity or common practice. METHOD: An observational study carried out at health facility using a 15 item structured questionnaire. RESULTS: Seventy questionnaires were self-administeredto clinical healthcare workers and retrieved. 58 (82.9%) have heard that a practitioners religious belief can affect client/patient's management. 48 (68.6%) believe that a practitioners religion can influence client/patients management. Several reasons were given howbelief can affect the management CONCLUSION: Physicians religious bias can affect practice. This should be discouraged and effort made to stop this attitude and practice.
Effect of x-ray exposure (mAs) on peroxide and acid values of honey.
Inyang SO, Egbe NO, Inyang IS … +3 more , Azogor WE, Ekpo E, Eduwem DU
Niger J Med · 2014 · PMID 25185381
Honey is used in most places as food sweetener and antibacterial agent for wounds. The antibacterial property of honey depends mainly on its peroxide value and acidity. This study investigated the possible effect that ma...
Honey is used in most places as food sweetener and antibacterial agent for wounds. The antibacterial property of honey depends mainly on its peroxide value and acidity. This study investigated the possible effect that may be observed on the peroxide value and acidity if honey is exposed to x-ray at varying tube current values (mAs) in order to infer the possible implications of referring patients undergoing honey therapy for diagnostic x-ray examination. The acid and peroxide values were found to vary with changes in the exposure (mAs) value. It is therefore recommended that patients undergoing honey therapy should be referred for diagnostic x-ray examination with caution while radiotherapy should be avoided.
Head injury: correlation of brain morphology on cranial CT with head injury severity using a new (computed tomography-head injury severity assessment) grading scale--a pilot study.
Malomo AO, Uche EO, Shokunbi MT … +2 more , Adeolu AA, Agunloye AM
Niger J Med · 2014 · PMID 25185380
Eighty two (82) consecutive patients who presented with mechanical brain injury to the Accident and Emergency department of our hospital and were assessed with cranial Computerized Tomographic Scan between November 2005...
Eighty two (82) consecutive patients who presented with mechanical brain injury to the Accident and Emergency department of our hospital and were assessed with cranial Computerized Tomographic Scan between November 2005 and April 2006 were included in the study. Demographic data were obtained at admission. Clinical severity of head injury was assessed by the Glasgow Coma Scale Score just before cranial CT while morphologic severity was assessed using features on the same post-resuscitation cranial CTwith which theTCDB (Traumatic Coma Databank) grade and CT-HISAS (computerizedTomographic-Head injury Severity Assessment Scale) score were assessed. Both the TCDB and CT-HISAS scores were correlated with short-term outcomes using the Glasgow outcome score. Pearson's correlation coefficient, ANOVA and regression models were used as appropriate for statistical tests of significance.The age range of Patients was between 3 months and 86 years with a mean of 26.8 years and median of 25.9 years +/- 1.9 years (95% CL). There were more males (74.4%) than females (25.6%). There was a negative correlation between Post resuscitation GCS and CT-HISA score (p = -0.0141). However, although patients with non-functional outcome based on Glasgow Outcome score had higher CT-HISA scores, this relationship was not statistically significant. From our study, brain morphology on cranial CT using the CT-HISA Scale predicts clinical severity and outcome.We believe this study that CT-HISA may find useful application in assessment of teleradiologically transferred CT images of patients as well as research in mechanical brain trauma.
Elderly primigravidae versus young primigravidae: a review of pregnancy outcome in a low resource setting.
Eleje GU, lgwegbe AO, Okonkwo JE … +2 more , Udigwe GO, Eke AC
Niger J Med · 2014 · PMID 25185379
BACKGROUND: The elderly primigravida is defined as a woman who goes into pregnancy for the first time at the age of 35 years or older. Progressively, this has become more common in our contemporary society and traditiona...
BACKGROUND: The elderly primigravida is defined as a woman who goes into pregnancy for the first time at the age of 35 years or older. Progressively, this has become more common in our contemporary society and traditionally such pregnancy is regarded as high risk. OBJECTIVE: This was to determine and compare the pregnancy outcomes in elderly primigravidae aged 35 years and above with those of young primigravidae aged 20-25 years METHODS: The pregnancy outcomes of 82 elderly primigravidae (study group) with a singleton gestation, who delivered in the Teaching Hospital from 1st July, 2005 to 30th June, 2010 were compared with those of 131 young primigravidae (control group) who delivered during the same period in the same hospital. RESULTS: During the study period, there were 3,189 deliveries, given an incidence of elderly primigravidity as 2.6% or 1 in 39 deliveries. The mean age of the study group and control group were 36.4 +/- 0.9 years and 23.1 +/- 1.6 years respectively. The incidence of anaemia, antepartum haemorrhage, hyperemesis gravidarum, malpresentation, intrauterine growth restriction, diabetes mellitus and fibroid were statistically higher in the elderly primigravidae than in the control (p < 0.05). Cephalopelvic disproportion, prolonged second stage, fetal distress and primary post partum haemorrhage were also statistically higher (p < 0.05) including the caesarean section (53.7%) and episiotomy rates (94.6%). CONCLUSION: Elderly primigravida remains a high risk pregnancy and the incidence is high. They were significantly associated with adverse pregnancy outcomes and operative obstetric interventions. Early booking and more obstetric vigilance shall improve their pregnancy outcomes.
Risk factors for diabetes mellitus among rural adults in Nigeria.
Etukumana EA, Puepet FH, Obadofin MO
Niger J Med · 2014 · PMID 25185378
BACKGROUND: Diabetes mellitus remains a high burden for individuals all over the world. Identification of adults at risk for diabetes mellitus provides potential opportunities for early diagnosis and prevention of diabet...
BACKGROUND: Diabetes mellitus remains a high burden for individuals all over the world. Identification of adults at risk for diabetes mellitus provides potential opportunities for early diagnosis and prevention of diabetes mellitus. This study sought to determine the risk factors for diabetes mellitus among adults in a rural Nigerian community. METHOD: A cross sectional descriptive study of 750 subjects age > or = 15 years using a systematic sampling technique. Data were collected with a structured questionnaire. Subjects were examined for weight, height, waist circumference and hip circumference; body mass index and waist-hip ratio were calculated. Blood samples were collected from subjects for estimation of plasma glucose concentration using the glucose oxidase method of Trinder. Diabetes mellitus was diagnosed according to standard WHO/IDF criteria. RESULTS: Subjects consisted of 385 (51.3%) males and 365 (48.7%) females (male: female 1.05:1) with mean age of 39.42 +/- 16.17 years. Physical inactivity and body mass index were not identified as risk factors for diabetes mellitus. In multiple logistic regression, the prevalence of diabetes mellitus was independently associated with age (OR 1.03, 95% CI 1.00-1.05, p = 0.03), alcohol intake (OR 9.04, 95% CI 1.68-48.8l, p = 0.1), parental history of diabetes mellitus (OR 57.02, 95% CI 7.88-432.9, p < 0.001) and waist-hip ratio (OR 22175.12.95% CI 19.38-253736.1, p < 0.001). CONCLUSION: We established that advancing age, alcohol intake, parental history of DM and increasing waist-hip ratio were risk factors for diabetes mellitus among rural adults in Nigeria. Identification of these risk factors in rural adults would be an important step in prevention and early diagnosis of diabetes mellitus in the rural population.
A five year review of ectopic pregnancy at Federal Medical Centre, Owerri, South East, Nigeria.
Cornelius AC, Onyegbule A, Onyema … +2 more , Uchenna ET, Duke OA
Niger J Med · 2014 · PMID 25185377
BACKGROUND: Ectopic pregnancy remains a leading cause of maternal morbidity and mortality in the first trimester of pregnancy in developing countries. OBJECTIVES: To determine the incidence, pattern of presentation and m...
BACKGROUND: Ectopic pregnancy remains a leading cause of maternal morbidity and mortality in the first trimester of pregnancy in developing countries. OBJECTIVES: To determine the incidence, pattern of presentation and management of ectopic pregnancies at Federal Medical Centre (FMC) Owerri. METHODS: This was a retrospective descriptive study of all cases of ectopic gestations managed at FMC Owerri between 1st January 2009 and 31st December, 2013. The case notes were retrieved from the hospital's Records Department and information on socio-demographic characteristics, age, and parity, clinical presentation, findings at laparotomy, estimated blood loss and the need for blood transfusion were obtained. Data were entered into SPSS 17.0 and analysed descriptively. RESULTS: There were 382 cases of ectopic gestations out of the total 9880 total deliveries within the study period. The incidence of ectopic pregnancy was 38.66 per 1,000 live births or I in 26 deliveries. Nulliparous women were 132 (34.5%). At presentation, 99.47% of patients had rupture with haemoperitoneum, with the commonest site being the ampulla of the fallopian tube as seen in 338 (88.4%). Salpingectomy was done in majority of cases, accounting for 355 (93%), while 248 (65%) had blood transfusion. Five (1.3%) maternal deaths occurred during period of study. CONCLUSION: Ectopic pregnancy presents a major public health challenge among women of reproductive age groups in Nigeria. Efforts should be directed to public awareness on sex education, contraception, prevention and treatment of common risk factors for ectopic pregnancy.
Determining the minimum inhibitory concentration of Tetraclean against Candida albicans.
Qyasian A, Mohammadi Z, Giardino L … +4 more , Palazzi F, Shalavi S, Sabbaghi S, Khoshbin E
Niger J Med · 2014 · PMID 25185376
The purpose of the present study was to determine the minimum inhibitory concentrations of Tetraclean, chlorhexidine, hydrogen peroxide, and sodium hypochlorite against Candida albicans.Amphotericin B was used as positiv...
The purpose of the present study was to determine the minimum inhibitory concentrations of Tetraclean, chlorhexidine, hydrogen peroxide, and sodium hypochlorite against Candida albicans.Amphotericin B was used as positive control and RPMI plus 1 ml Candida suspension was used as negative control. Serial dilution method was used to determine MIC of the irrigants. Findings showed that all positive controls demonstrated complete inhibition of C. albicans at concentration of 0.78 microg mL(-1). On the other hand, all negative controls were positive for fungal growth which confirms the methodology of the study. Findings showed that the MIC of CHX was significantly lesser than other tested irrigants (p < 0.05). The MICs of other groups in an ascending order were as follows: Tetraclean, NaOCl, and H2O2. However, the difference betweenTetraclean and NaOCI was not significant (p > 0.05). It can be concluded that MIC of CHX was significantly lower than other irrigations solutions which confirms its strong antifungal activity.
HIV screening in blood donors: rapid diagnostic test versus enhanced ELISA.
Orkuma JA, Egesie JO, Banwat EB … +3 more , Ejele AO, Orkuma JH, Bako IA
Niger J Med · 2014 · PMID 25185375
OBJECTIVE: To compare the laboratory performance of a HIV antibody Rapid Diagnostic Test (RDT) [Determine HIV-1/2] with an Enhanced ELISA [GENSCREEN PLUS HIV Ag-Ab] used for HIV screening among blood donors in a hospital...
OBJECTIVE: To compare the laboratory performance of a HIV antibody Rapid Diagnostic Test (RDT) [Determine HIV-1/2] with an Enhanced ELISA [GENSCREEN PLUS HIV Ag-Ab] used for HIV screening among blood donors in a hospital-based transfusion centre in North Central Nigeria. METHODS: The serum of four hundred and forty (440) blood donors of both sexes aged between 18 and 55 years, who fulfilled the conditions to donate blood, were serially tested for HIV using both methods. RESULT: DetermineTM HIV-1/2 detected 16 (3.6%) while GENSCREEN PLUS HIV Ag-Ab ELISA detected 41 (9.3%) blood donors who were HIV sero-positive. The DetermineTM HIV-1/2 missed 25 (61%) blood donors who were positive with the GENSCREENPLUS HIV Ag-Ab ELISA. The calculated sensitivity and specificity of Determine HIV-1/2 were 39.0% and 100% respectively while the positive predictive value and negative predictive values of Determine HIV-1/2 were 100% and 94.1% respectively. CONCLUSION: The HIV Antibody RDT (Determine HIV-1/2) has a very low sensitivity and therefore, inadequate in preventing transfusion transmissible HIV (TT-HIV) in a hospital-based blood transfusion service. The National Blood Transfusion Service (NBTS) in Nigeria should be equipped and supported to provide blood products screened with Enhanced ELISA as well as to embark on regular evaluation of all HIV screening assays used in the country in order to prevent counterfeit and sub standard assays and invariably reduce the risk of TT-HIV infection in the country.
Continuous spinal anaesthesia for caesarean section in a parturient with peripartum cardiomyopathy.
Fyneface-Ogan S, Ojule JD
Niger J Med · 2014 · PMID 24956694
Peripartum cardiomyopathy is a potentially fatal form of heart failure associated with pregnancy. A 27-year-old Nigerian woman, gravida 1, para 0, presented at 31 weeks' gestation with no previous history of hypertension...
Peripartum cardiomyopathy is a potentially fatal form of heart failure associated with pregnancy. A 27-year-old Nigerian woman, gravida 1, para 0, presented at 31 weeks' gestation with no previous history of hypertension heart disease, but morbidly obese (body mass index of 42 kg/m2), with uncontrolled and hypertension, severe pulmonary oedema who required an urgent Caesarean section is presented. The patient was admitted into the hospital's ICU for stabilisation. She was placed on oxygen by non-rebreathing face mask while receiving intravenous labetalol and frusemide. Following a worsening clinical state, an urgent Caesarean section was conducted under continuous spinal anaesthesia using 7.5 mg intrathecal 0.5% isobaric bupivacaine and was delivered of a 1.8 Kg live female baby with good Apgar scores. At the end of the surgery, mother and baby were transferred to the ICU and SCBU respectively. After a 7-day intensive treatment she was discharged. Since then she remained symptom-free and her baby was doing well during the period of admission and discharge. This case report illustrated the recognition of peripartum cardiomyopathy and the use of a more haemodynamic stable anaesthetic technique. It also described the need for collaboration of multiple medical specialists before, during delivery and after delivery to provide the best possible outcome for both mother and infant.
An unusual presentation of non-Hodgkins lymphoma: a case report.
Ujunwa FA, Chinawa JM, Enemuo A … +1 more , Ikefuna AN
Niger J Med · 2014 · PMID 24956693
BACKGROUND: Breast lymphoma is an uncommon disease with poor clinical outcome. The rarity of the disease is related to relatively small amount of lymphoid tissues in the breast. The prognosis usually depends on the stage...
BACKGROUND: Breast lymphoma is an uncommon disease with poor clinical outcome. The rarity of the disease is related to relatively small amount of lymphoid tissues in the breast. The prognosis usually depends on the stage at presentation. OBJECTIVE: To highlight an uncommon presentation of Non-Hodgkin's Lymphoma. CONCLUSION: Non-Hodgkin's lymphoma can affect the breast. A high index of suspicion and prompt histological diagnosis are needed for effective management.
Emergency peripartum hysterectomy in a low resource setting: a 5-year analysis.
Bassey G, Akani CI
Niger J Med · 2014 · PMID 24956692
BACKGROUND: Emergency peripartum hysterectomy (EPH) is an important life saving surgical procedure often necessitated by life threatening obstetric haemorrhage. The indications for peripartum hysterectomy differs between...
BACKGROUND: Emergency peripartum hysterectomy (EPH) is an important life saving surgical procedure often necessitated by life threatening obstetric haemorrhage. The indications for peripartum hysterectomy differs between develop and developing countries and may reflect the level of obstetric practice in a region. PATIENTS AND METHODS: This was a 5-year retrospective study. The medical records of patients who had emergency peripartum hysterectomy at the University of Port Harcourt Teaching Hospital were reviewed and relevant data were retrieved and analyzed. RESULTS: Sixty two cases of peripartum hysterectomy were performed giving a prevalence rate of 0.38% out of 16,113 total deliveries. Being unbooked was significantly associated with peripartum hysterectomy (x2 = 85.29, p = 0.0000). Peripartum hysterectomy was performed for 20.3% of nulliparous women. Subtotal hysterectomy accounted for 55.9% while total hysterectomy was performed for 44.1% of cases. The commonest indication for peripartum hysterectomy was uterine rupture (57.6%). There was no case of ureteric injury Unbooked mothers were 28 times more likely to die than booked mothers. Unbooked status was significantly associated with maternal mortality (p = 0.00008) and perinatal mortality (p = 0.00000). CONCLUSION: Emergency peripartum hysterectomy still remains indispensible in obstetric practice in low resource setting. Labour and delivery when well supervised will reduce the need for emergency peripartum hysterectomy. Training of specialist in the skill of internal iliac artery ligation is recommended.
The profile of chest injuries in a southeastern Nigeria teaching hospital, a 10-year experience.
Nwafor IA, Eze JC, Ezemba N … +3 more , Onyekwulu OC, Brown A, Anyanwu CH
Niger J Med · 2014 · PMID 24956691
BACKGROUND: Globally, major chest injuries have both high morbidity and mortality. A detailed study of chest injuries in south-eastern Nigeria is here presented. AIMS: To determine the incidence, the predisposing factors...
BACKGROUND: Globally, major chest injuries have both high morbidity and mortality. A detailed study of chest injuries in south-eastern Nigeria is here presented. AIMS: To determine the incidence, the predisposing factors, the pattern of presentation and the outcome of management of chest injuries. MATERIALS AND METHODS: This is a retrospective study spanning a period of 10 years (2002-2011). The medical records of all patients with documented chest injuries that presented to our hospital within the period under review, were retrieved and analysed, by simple arithmetic percentages. RESULT: A total of 402 patients (average of 40/year) with the age ranges in the spectrum of 0-10 and 81-90 years, with a mean of 2.2 were found. Gender-wise, 301 males (74.9%) and 101 females (25.1%) were affected. The aetiological or the predisposing factors were blunt chest injuries (61.2%) and penetrating chest injuries (38.8%). In the pattern of presentation, haemothorax (20.9%), haemopneumothorax (16.2%), pneumothorax (17.4%) including simple, open and tension types as well as multiple ribs fractures (7.7%) constituted the majority. In the management strategies, conservative methods were mainly used. The outcome ranged from very good to fair. CONCLUSION: The management of chest injuries in our sub-region like any other developing countries is very much challenging. Concerted efforts are needed to overcome the burden it imposes.
Traditional bone setting in the Niger Delta region of Nigeria.
Odatuwa-Omagbemi DO, Enemudo RE, Enamine SE … +1 more , Esezobor EE
Niger J Med · 2014 · PMID 24956690
BACKGROUND: Traditional bone setting is an age long practice in African societies. It has flourished in spite of the advent of orthodox fracture management in Nigeria and many other African countries. However, complicati...
BACKGROUND: Traditional bone setting is an age long practice in African societies. It has flourished in spite of the advent of orthodox fracture management in Nigeria and many other African countries. However, complications emanating from their practice have led to suggestions on the need for intervention and control of their activities. OBJECTIVE: We aim to document the current practice of the traditional bone setting in the Niger-Delta region of Nigeria. METHODOLOGY: A structured interview of two traditional bone setters in the surrounding villages of the Delta State University Teaching Hospital, Oghara, Delta State, Nigeria was carried out. In addition we visited their 'clinics' to make on the spot assessment of their practice. RESULTS/FINDINGS: The two practitioners ('A' and 'B') interviewed were both males who inherited the trade from their parents. Practitioner 'A' has both out-patient and in-patient practices while 'B' only treat outpatients in addition to home visits. Basically, both practitioners have similar method of injury treatment which consists of; massaging/manipulation to reduce fractures/dislocations after which the area may be scarified before application of an herbal mixture (Igbudia) followed with bandaging and splinting. CONCLUSION: From this study, it is obvious that the current practice of traditional bone setters in the Niger-Delta region of Nigeria is still crude and far from ideal. There is thus need for a review of their practice with reorientation of their psyche, training, standardisation, certification/licencing, legislative control and eventual integration atthe primary health care level.
Perinatal autopsies in a tertiary health facility in Southwestern Nigeria: a retrospective evaluation of 14 consecutive cases.
Omoniyi-Esan GO, Omonisi AE, Bakare B … +2 more , Kuti O, Adejuyigbe E
Niger J Med · 2014 · PMID 24956689
BACKGROUND: Perinatal autopsy remains a valuable tool in perinatal medicine. It provides an insight into the genetic implications of subsequent pregnancies and also helps reduce parental events such as maternal illness o...
BACKGROUND: Perinatal autopsy remains a valuable tool in perinatal medicine. It provides an insight into the genetic implications of subsequent pregnancies and also helps reduce parental events such as maternal illness or maternal use of medications. The practice is not popularly acceptable in our environment for socio-cultural reasons. The scarcity of pathologists who are interested in this aspect of pathology is also an issue. No wonder, the literature is scanty on the cases of perinatal autopsy reported in our environment. MATERIAL AND METHODS: This was a retrospective review of patients' medical and autopsy records to measure the perinatal autopsy rate at a tertiary health institution and identify the trends over the last 12 months (January 1, 2010 and December 31, 2010). This study also aim examining any discordance between antemortem diagnoses and postmortem diagnoses. RESULTS: Of 263 perinatal deaths, autopsies were requested and performed in 14 of the cases representing a perinatal autopsy rate of 5.3%. New information was obtained in 64.3% of the cases. The birth weights of the infants ranged from 500g to 3600g with their gestational ages ranged from 22 weeks to 41 weeks. CONCLUSIONS: This study is a preliminary report that serves principally to provide base line data for the ongoing study.
Pattern of placenta histopathology in low birth weight babies seen in a tertiary health centre in South-Western Nigeria.
Omoniyi-Esan GO, Olaofe OO, Omonisi AE … +1 more , Kuti O
Niger J Med · 2014 · PMID 24956688
BACKGROUND: Pre-term delivery is usually associated with low birth weight and is a known obstectrics problem in our setting. Few Histopathologists are interested in placental pathology, and this is particularly so becaus...
BACKGROUND: Pre-term delivery is usually associated with low birth weight and is a known obstectrics problem in our setting. Few Histopathologists are interested in placental pathology, and this is particularly so because consent is often difficult to get from the relatives making few specimens available for study in our environment. OBJECTIVE: Our objective was to evaluate the placental histopathology in low birth weight infants (LBW, birth weight < 2500 g) and to determine if placental histopathological findings are associated with low birth weight and preterm deliveries. METHODS: The placenta of thirty-eight consecutive cases of LBW deliveries at the Obafemi Awolowo University Teaching Hospital, Wesley Guild Hospital, (lesa were histologically examined. RESULTS: A total of thirty-eight LBW placentas were examined. The Male: Female ratio was 1.8:1. The maternal age range 19 - 38 years (mean age = 28.7 yrs +/- 5.37SD). The parity ranged from 0 to 5. The birth weight ranged 0.75 - 2.4kg (mean 1.84kg +/- 0.39SD). The gestational age at delivery range was 25 - 38 weeks (mean 32.85 weeks +/- 3.7SD). Histological examination of the placentae showed that 17 cases (44.7%) had evidence of placenta malaria (PM), 17 cases (44.7%) had chorioamnionitis (CA), 9 cases (23.7%) had villitis, 2 cases (5.3%) had vasculitis and 4 cases (10.5%) had no abnormality. Four sets of twins (8 cases) were among the 38 cases seen. A case of abruptio placenta was delivered by caesarean section, with histological diagnosis of active- chronic malaria. Out of the cases with CA11 (64.7%) had mild CA, 4 (23.6%) moderate while 2 (11.8) had severe infection. Placenta malaria co-infection was also found in 7 (41%) of the CA. Nine (23:7%) had villitis, only 2 cases had umbilical cord vasculitis. Of the cases with PM, 10 (58.8) had active-chronic infection while 7 (41.2%) had evidence of past infection. CONCLUSION: The main placenta findings histologically in LBW babies include chorioamnionitis and placenta malaria infection. These are known contributory factors to preterm labour. Improved maternity care, health education of pregnant women to reduce ascending infection and use of intermittent preventive treatment for malaria in pregnancy will go a long way in improving outcome of pregnancy.
Knowledge, attitude and practice of perioperative antibiotic prophylaxis among nurse-anaesthetists in Nigeria.
Ajibade A, Olaitan PB
Niger J Med · 2014 · PMID 24956687
BACKGROUND: In Nigeria, nurse-anaesthetists are responsible for administering perioperative prophylactic antibiotics in a large number of operations but this practice is poorly studied. AIMS: The aim of this study was to...
BACKGROUND: In Nigeria, nurse-anaesthetists are responsible for administering perioperative prophylactic antibiotics in a large number of operations but this practice is poorly studied. AIMS: The aim of this study was to evaluate the knowledge, attitude and practice of perioperative antibiotic prophylaxis among nurse-anaesthetists in Nigeria. METHODS: A cross-sectional study was conducted among nurse-anaesthetists at an Annual General Meeting/Scientific Conference of Nigeria Association of Nurse-Anaesthetists, using a pre-tested questionnaire. RESULTS: Of 70 questionnaires. 67 were returned. Antibiotic administration at induction of anaesthesia was considered inappropriate by 79.1% (n = 67) and safe by 42.6% (n = 61). There was poor knowledge of indications for intraoperative administration. There was agreement by 81.9% of respondents that anaesthetists should administer prophylactic antibiotics (n = 66) but 72.2% would want the surgeon to indicate the time of administration (n = 60). About 69.3% and 77.2% of respondents administered prophylactic antibiotics before tourniquet application (n = 62) and skin incision (n = 66) respectively in their practice but the latter finding was not corroborated by internal validity check. Availability of a hospital perioperative antibiotic prophylaxis protocol (p = 0.048) and practice for 10 or more years (p = 0.009) were associated with higher knowledge score. CONCLUSION: Inclusion of lectures on perioperative antibiotic prophylaxis in nurse-anaesthesia training curriculum, having hospital perioperative antibiotic prophylaxis protocol, stating in the protocols that surgeons give instructions on timing of antibiotic administration and ensuring adherence to the protocols may improve knowledge and practice of perioperative antibiotic prophylaxis among nurse-anaesthetists.
Factors influencing herpes simplex virus type 2 infection among females in Enugu, Enugu State, Nigeria.
Ojinmah UR, Ozoh GA, Onyekonwu CL
Niger J Med · 2014 · PMID 24956686
BACKGROUND: Herpes Simplex Virus infection is a chronic infection of the sensory ganglia with variable levels of epithelial expression. An important feature of HSV infection is the recurrence of disease as a result of pe...
BACKGROUND: Herpes Simplex Virus infection is a chronic infection of the sensory ganglia with variable levels of epithelial expression. An important feature of HSV infection is the recurrence of disease as a result of periodic or sporadic activation of viral replication. In addition, asymptomatic shedding of herpes viruses may play a significant role in transmission from person to person. This infection being lifelong manifests only in a small proportion of those infected. It has presented public health concern because of its progressively increasing prevalence which some reports say is of epidemic proportion in developing countries and also for its synergistic effect with HIV infection. OBJECTIVES: Determination of antibody prevalence to HSV-2/co-infection with HIV among females attending skin and ANC clinics in UNTH and ESUTH. MATERIALS AND METHODS: One hundred and eighty suitably qualified subjects were appropriately recruited over a period of six months into this study. Essential information was collected using a questionnaire. Venous blood was also obtained for HSV 2 serology, HIV screening, and confirmation, if positive. RESULTS: The antibody prevalence of HSV 2 was found to be 77.8% (n = 137) and 14.6% (n = 20) had clinical diagnosis. The HIV and HSV-2 co-infection rate was 5.11% (n = 9). The risk factors for groups 1 [HSV2 Infection] and 2 [HSV2 & HIV co-infection] were similar with few differences, thus buttressing the fact that their modes of transmission are similar. CONCLUSION: Factors influencing Herpes simplex virus type 2 infection among females in Enugu included among other things older age and increasing number of lifetime sexual partners.
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