Nigerian Journal Of Medicine[JOURNAL]
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200 papers
Anxiety and Depressive Symptoms among Discharged COVID-19 Patients from Isolation Centers in North-Central, Nigeria: A Cross-sectional Study.
Tungchama FP, Gomerep SS, Maigari YT … +6 more , Akogun M, Bako AE, Nwoga CN, Ajuma EC, Amupitan ET, Shehu NY
Niger J Med · 2023 · PMID 40785815 · Full text
INTRODUCTION: The COVID-19 pandemic brought about an unprecedented number of people to be isolated and this negatively impacted on manifestations of various anxiety and depressive symptoms. Our study determined the preva...
INTRODUCTION: The COVID-19 pandemic brought about an unprecedented number of people to be isolated and this negatively impacted on manifestations of various anxiety and depressive symptoms. Our study determined the prevalence of anxiety and depressive symptoms and the associated sociodemographic and clinical factors among discharged COVID-19 patients in North-Central, Nigeria. METHODS: One hundred and sixteen discharged COVID-19 patients were assessed in a cross-sectional study during the early phase of the COVID-19 outbreak in Jos, North-Central, Nigeria. The age, gender, educational level, length of stay in isolation, and presence of symptoms of COVID-19 were assessed with a semi-structured questionnaire designed by the authors. The Hopkins Symptom Checklist-25 was used to assess for the symptoms of anxiety and depression among participants. RESULTS: The mean age was 38.7 ± 14.6 years. More men (59%) were assessed with 67.2% of the participants "ever married," and 43% had tertiary education. Voluntary admission was 62% and about 14% had symptoms of COVID-19. Forty-three percent had stayed for more than 10 days. The prevalence of symptoms of anxiety and depression was 17.2% and 9.5%, respectively, with 10.3% having combined symptoms. No significant association between the various sociodemographic and clinical factors, with symptoms of anxiety, except for the female gender which was significantly associated with depressive symptoms ( = 0.026). CONCLUSION: Isolation and COVID-19 impact on the manifestation of anxiety and depressive symptoms. Screening for anxiety and depressive symptoms should be integrated into the comprehensive psychological management of patients, especially for epidemic-prone diseases like COVID-19 that are associated with stigma.
COVID-19 Subclinical Infection and Immunity: A Review.
Bartekwa JW, Abene EE, Luka PD … +2 more , Yilgwan CS, Shehu NY
Niger J Med · 2021 · PMID 37908370 · Full text
The aetiologic agent of COVID-19 is a novel coronavirus, SARS-CoV-2. Like other coronaviruses, it generally induces enteric and respiratory diseases in animals and humans. COVID-19 may be subclinical, and symptomatic, ra...
The aetiologic agent of COVID-19 is a novel coronavirus, SARS-CoV-2. Like other coronaviruses, it generally induces enteric and respiratory diseases in animals and humans. COVID-19 may be subclinical, and symptomatic, ranging from mild-to-severe disease. The spectrum of presentation is the result of several factors ranging from the inoculum size, inherent host susceptibility, possible cross-reacting circulating antibodies. Subclinical viral infections are associated with widespread community transmission and in some cases like Polio, herd immunity. An understanding of the biology and immune behavior in subclinical coronavirus disease 2019 (COVID-19) might be useful in the quest for vaccine development as well as the current control efforts against the COVID-19 pandemic. We carried out a narrative review of the available literature on the biology, etiopathogenesis, clinical manifestation of SARS-CoV-2 viral infection, focusing on our current understanding of the disease mechanisms and its clinical manifestation, and the host immune response to the infection. We also highlighted some of the research gaps regarding subclinical infection in COVID-19 and its potential application for vaccine development and other preventive efforts toward containing the current COVID-19 pandemic.
FOREIGN BODY IN THE NASOPHARYNX; MASQUERADING AS PHARYNGOTONSILLITIS.
Enyuma CO, Offiong M, Adekanye A … +3 more , Akpan U, Ezeanyagu N, Uffiah O
Niger J Med · 2015 · PMID 27487618
Foreign body (FB) in the aerodigestive tracts has been commonly reported but findings of impacted foreign bodies in the nasopharynx following inhalation/ingestion are very rare. Most of the FB gets lodged as a result of...
Foreign body (FB) in the aerodigestive tracts has been commonly reported but findings of impacted foreign bodies in the nasopharynx following inhalation/ingestion are very rare. Most of the FB gets lodged as a result of forceful vomiting, coughing,and digital manoeuvres for removal of FB in the oropharynx. Several objects have been identified lodged in the nasopharynx. No age group is spared although most victims are children under 10 years of age. Foreign bodies in the nasopharynx can be uneventful or potentially dangerous depending on type, size and location as it may cause sudden airway obstruction, or local pressure necrosis of alimentary or respiratory tract or both. Presentation in children is usually with a history of swallowed FB which may not be witnessed in children, choking, cough, bluish discolouration, breathlessness, drooling of saliva, halitosis, rhinorrhoea, snoring, stridor, dysphagia, vomiting and dysphonia. A foreign body in the nasopharynx is a challenge to patient, parents, the physician and the ENT surgeon, as it may be miss-diagnosed, in the index case, as Pharyngotonsilitis. The index patient, a 14 month child,was presented with a two days history of fever, drooling of saliva, mouth breathing, and digital manipulation. Lateral imaging of the post nasal space following initial treatment with antibiotics, aided the diagnosis of a periwinkle shell in the nasopharyngx that was removed during a nasopharyngoscopy under general anaesthesia without complication and subsequently discharged home. This emphasizes a high index of suspicion for FB in the nasopharynx in children with history of missing foreign body, digital manipulation, drooling of saliva and mouth breathing. Lateral X-ray of the postnasal space, neck, chest and abdomen should be the minimum investigation required.
TMJ ANKYLOSIS: MANAGEMENT WITH RECONSTRUCTION AND INTERPOSITIONAL ARTHROPLASTY.
Madhumati S, Shruthi R, Mitul S … +2 more , Karan A, Aziz A
Niger J Med · 2015 · PMID 27487617
Temporomandibular joint (TMJ) ankylosis is a very desolating structural condition that involves fusion of the mandibular condyle to the base of the skull. It causes difficulty in mastication and breathing. Trauma and Inf...
Temporomandibular joint (TMJ) ankylosis is a very desolating structural condition that involves fusion of the mandibular condyle to the base of the skull. It causes difficulty in mastication and breathing. Trauma and Infections are usually responsible. If trauma occurs in young age, it leads to disturbance in growth & facial asymmetry. Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic block (arthroplasty) or interpositional arthroplasty using autogenous or alloplastic materials. Early mobilization, physiotherapy & strict follow up are essential to prevent postop adhesions. In our cases fascia lata was used as an interpositional grafting material. One case was treated by gap arthroplasty, second case by costochondral graft & third case was managed with titanium condylar prosthesis.
DISTAL ILEAL STENOSING SUBSEROSAL LIPOMA: A CASE REPORT.
Innocent E, Vandhi KB, Olanrewaju A … +4 more , Ojile AP, Misauno MA, NabasuLemech E, DikkolNendangtokDakup
Niger J Med · 2015 · PMID 27487616
Lipoma is the commonest soft tissue tumour and ubiquitous in distribution. The gastrointestinal tract is a rare site for this neoplasm. This 38 years old patient presented to the surgical emergency unit of the Jos Univer...
Lipoma is the commonest soft tissue tumour and ubiquitous in distribution. The gastrointestinal tract is a rare site for this neoplasm. This 38 years old patient presented to the surgical emergency unit of the Jos University Teaching Hospital with features of intestinal obstruction which was confirmed by plain abdominal X-ray. Patient was resuscitated and had exploratory laparotomy. At surgery, a dilated, oedematous, and pale segment of ileum was seen measuring 56 cm in length and 10 cm short of the ileo-caecal junction, where an obstruction had occurred.The distal segment was collapsed. A limited right hemi-colectomy was done with ileocolic anastomosis. Specimen received atthe Histopathology Laboratory consisted of 45 cm of the ileum, the caecum, appendix, and proximal 25 cm of the colon in continuity. There was stenosis affecting the distal 30 cm of the ileum. The wall of the stenosed part of ileum had intramural fat at the sub-serosal locale. Histology confirmed the presence of sheets of matured adipocytes between the muscularispropria and serosa. Patient condition improved and was discharged seven days after surgery. This case is reported five months after surgery. We recommend that lipoma be at all times considered in the differential diagnosis of intestinal obstruction.
CURRENT MANAGEMENT OF PERIPARTUM CARDIOMYOPATHY: A REVIEW.
Dodiyi-Manuel ST, Ezennaka RC
Niger J Med · 2015 · PMID 27487615
BACKGROUND: Demarkis et al in 1971 described 27 patients who presented during pueperium with cardiomegaly, abnormal electrocardiographic findings, congestive heart failure and named the syndrome "peripartum cardiomyopath...
BACKGROUND: Demarkis et al in 1971 described 27 patients who presented during pueperium with cardiomegaly, abnormal electrocardiographic findings, congestive heart failure and named the syndrome "peripartum cardiomyopathy". The aim of this review is to document the current concepts in the management of peripartum cardiomyopathy. MATERIALSAND METHODS: A search of the literature was done using PubMed, Goggle scholar and books from authors' collections. RESULTS: The cause of the disease might be environmental and genetic factors. Diagnostic echocardiographic criteria include left ventricular ejection fraction of less than 45% or a combination of M-mode fractional shortening of less than 30% and end diastolic dimension of greater than 2.7 cm/m². Electrocardiogram, magnetic resonance imaging, endomyocardial biopsy and cardiac catheterization aid in the diagnosis and management of peripartum cardiomyopathy. Treatment includes both conventional pharcomological heart failure and peripartum cardiomyopathy targeted therapies.Therapeutic decisions are influenced by drug safety profiles during pregnancy and lactation. Mechanical support and transplantation might be necessary in severe cases. CONCLUSION: Peripartum cardiomyopathy is an uncommon but life threatening cardiac failure of unknown aetiology encountered in late pregnancy or postpartum period. Management aims at improving heart failure symptoms through conventional therapies and then at administering targeted therapies.The risk of recurrence in future pregnancies should always be considered.
TOBACCO ABUSE AND ITS HEALTH EFFECT.
Dunga JA, Adamu Y, Kida IM … +6 more , Alasiya D, Jibrin Y, Sabo U, Ukoli C, Chuhwak CH, Musa JJ
Niger J Med · 2015 · PMID 27487614
Tobacco smoking is still one of the most important risk factor for Respiratory and cardiovascular diseases and an estimated 90% of causes of lung cancer are attributable toTobacco smocking and equally 90% of peripheral v...
Tobacco smoking is still one of the most important risk factor for Respiratory and cardiovascular diseases and an estimated 90% of causes of lung cancer are attributable toTobacco smocking and equally 90% of peripheral vascular disease in non-diabetic population is attributable to Tobacco smoking, despite the health effect there is disturbing figures of people who take up smoking habit daily and increase level of failed quit smoking attempts. Environment and genetics still plays major role, and various forms of tobacco is used worldwide and its health consequence has been highlighted. Monitoring tobacco use and prevention policies through effective tax laws is paramount to reduction of the tobacco health effects in our environments.
PERCEPTION OF QUALITY CONTROL BY PERSONNEL IN DIAGNOSTIC RADIOLOGY FACILITIES IN AKWA IBOM STATE, NIGERIA.
Inyang SO, Essien IE, Egbe NO
Niger J Med · 2015 · PMID 27487613
BACKGROUND: The perception of quality control (QC) implementation by personnel in diagnostic radiology facilities can affect service delivery and deprive the facilities of the benefits associated with QC implementation....
BACKGROUND: The perception of quality control (QC) implementation by personnel in diagnostic radiology facilities can affect service delivery and deprive the facilities of the benefits associated with QC implementation. The responses by personnel working in diagnostic radiology facilities in Akwa Ibom State, Nigeria, concerning the implementation of quality control in diagnostic radiology has been assessed in order to ascertain their perception of QC implementation. METHOD: A total of thirty eight (38) radiology personnel from twenty radiology facilities took part in the study that was conducted using a twenty item questionnaire that was initially tested for reliability. RESULT: Responses from the surveyed personnel showed a positive perception for some QC items and a seeming lack of interest in some other items. This situation may be due to the perceived lack of interest and lack of cooperation from management of their facilities. The personnel also felt that they did not have sufficient training to implement QC and that QC results were difficult to analyse.
CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.
Inyang SO, Egbe NO, Ekpo E
Niger J Med · 2015 · PMID 27487612
BACKGROUND: The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipmen...
BACKGROUND: The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. METHOD: Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. RESULTS: Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.
CLINICOPATHOLOGICAL PRESENTATION AND MANAGEMENT OUTCOME OF APPENDICITIS IN GOMBE, NORTH-EAST NIGERIA: A 7-YEAR RETROSPECTIVE AUDIT.
Adejumo AA, Mshelia NM, Saleh YM
Niger J Med · 2015 · PMID 27487611
BACKGROUND: Acute appendicitis is a common cause of acute abdomen and right iliac fossa pain in the study centre with attendant negative appendicectomies. AIM: To study the demographic pattern, aetiology, clinical presen...
BACKGROUND: Acute appendicitis is a common cause of acute abdomen and right iliac fossa pain in the study centre with attendant negative appendicectomies. AIM: To study the demographic pattern, aetiology, clinical presentation and management outcome of appendicitis. METHODS: This is a retrospective study carried out on patients, who had appendicectomies between January 2007 and December 2014. A total of two hundred and thirteen (213) cases were operated during the study period. Only one hundred and forty one (141) folders retrieved. Relevant clinical information were entered in to a proforma designed for the study. Statistical analysis was done using Epi info (version 3.5.1). Quantitative data were presented in frequencies and percentages,mean and standard deviations were calculated. RESULT: Out of the 141 patients, 55 (39.0%) were males while 86 (61.0%) were females giving a M:F = 1:1.6. Their ages range from 8 to 65 years. The peak age group was 21-30 years. Acute inflammation was seen in 69 (48.9%) patients, lymphoid hyperplasia in 39 (27.7%) patients while parasitic appendicitis was seen in one (0.7%) patient. Post-operative complications observed include surgical site infection in 7 (5.0%) patients, delayed wound healing in 11(7.8%) patients and enterocutaneous fistula in one (0.7%) patient. CONCLUSION: The diagnosis of appendicitis still rests on the pillars of thorough clinical evaluation. The judicious use of modern diagnostic equipment will reduce the rate of negative appendicectomies.
PREVALENCE, PATTERN AND RISK FACTORS FOR RETINAL VASCULAR OCCLUSIONS IN A TERTIARY HOSPITAL IN JOS, NIGERIA.
Adenuga OO, Ramyil AV, Odugbo OP … +1 more , Oyediji FJ
Niger J Med · 2015 · PMID 27487610
INTRODUCTION: Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. They are associated with several systemic and ocular pathologies and are significant causes o...
INTRODUCTION: Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. They are associated with several systemic and ocular pathologies and are significant causes of visual loss. OBJECTIVE: This study aims to determine the prevalence, pattern and risk factors for retinal vascular occlusions in a tertiary hospital in Jos, Nigeria. METHODOLOGY: A retrospective review of all cases of retinal vascular occlusions seen in the eye clinic from January 2011 to December 2014 was carried out. The patients were identified from the clinic register and their case folders retrieved. The following data were then extracted from the files; patients' age, sex, presenting visual acuity, presence of any systemic disorders and type of retinal vascular occlusion. Data analysis was done using Epi Info 7. RESULTS: Three thousand eight hundred and twenty one new patients were seen during the study period and there were 52 (1.36%) cases of retinal vascular occlusions. Only the case files of 44 (84.6%) patients were available and were analysed. These were made up of 17 (39%) males and 27 (61%) females. These had a total of 46 retinal vascular occlusions made up of 37 (80.4%) retinal vein occlusions, 8 (17.4%) central retinal artery occlusions and a case (2.2%) of combined central retinal artery and vein occlusion. Hypertension and diabetes were the most common systemic risk factors while glaucoma was the most common ocular association. CONCLUSION: Retinal vascular occlusions are uncommon in our centre but lead to severe visual loss and are associated with significant systemic pathologies.
PREVALENCE OF METABOLIC SYNDROME AMONG APPARENTLY HEALTHY ADULTS IN A RURAL COMMUNITY, IN NORTH-WESTERN NIGERIA.
Nalado AM, Musa BM, Gezawa ID … +3 more , Muhammad H, Ibrahim DA, Uloko AE
Niger J Med · 2015 · PMID 27487609
BACKGROUND: Metabolic syndrome (MetS) is a cluster of multiple metabolic abnormalities that increases the risk of cardiovascular morbidity and mortality, and a resultant severe economic implication. This study assessed t...
BACKGROUND: Metabolic syndrome (MetS) is a cluster of multiple metabolic abnormalities that increases the risk of cardiovascular morbidity and mortality, and a resultant severe economic implication. This study assessed the burden of MetS in a Nigerian rural community setting. METHOD: This was a cross-sectional, community based study on apparently healthy subjects. A multi stage cluster sampling technique was employed to recruit the study subjects. A standardized pre-tested questionnaire was used to obtain data, and blood samples from subjects were analysed using standard laboratory techniques. MetS was defined using the NCEP-ATP3 criteria. Data were analysed using STATA version II, and a p value of < 0.05 was considered statistically significant. RESULTS: A total of 450 subjects completed the study, with 38% being males, and a mean age of 40.27 ± 16.41 years. MetS was found in 116 (25.78%) of the subjects. Of these, systemic hypertension was found in 91(78.45%), while all (116) had elevated cholesterol and triglycerides. Abdominal adiposity was found in 45 (38.79%) subjects and 44 (37.93%) had Type 2 diabetes mellitus. CONCLUSION: The prevalence of MetS and its components in our studied population was high; hence the need for further large population based studies to determine its predictors in our environment.
CHALLENGES IN THE MANAGEMENT OF GLAUCOMA IN A DEVELOPING COUNTRY; A QUALITATIVE STUDY OF PROVIDERS' PERSPECTIVES.
Adekoya BJ, Adepoju FG, Moshood KF … +1 more , Balarabe AH
Niger J Med · 2015 · PMID 27487608
BACKGROUND: Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. METHODS: In-depth interviews...
BACKGROUND: Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. METHODS: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services. The discussions were recorded with the aid of a micro-cassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified. Quotes that reflect the themes and sub-themes were then identified in the data. RESULTS: In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burden constituting about 35% of outpatient visits. Identified patient related challenges include; late presentation, lack of glaucoma awareness, delay in referral from optometrists, and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting of drugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant. Some respondents considered the current number of glaucoma surgeries as adequate, while some think otherwise. Reasons put forward for reluctance to offer glaucoma surgery include; late presentation, lack of patient satisfaction, complications of surgery, and negative publicity. CONCLUSION: Even though the challenges in the management of glaucoma in developing countries are many, they are not insurmountable. There is need for concerted and integrated efforts involving all cadres of eye care practitioners, patients, institutions and governments to address this important eye disease. Improved awareness, provision of adequate equipment, availability and affordability of medications, need for training and retraining of eye care providers are all important measures that can lead to better management of the glaucoma patient.
BODY MASS INDEX IS A POOR PREDICTOR OF MALNUTRITION IN HOSPITALIZED PATIENTS.
Baccaro F, Sanchez A
Niger J Med · 2015 · PMID 27487607
OBJECTIVE: Comparison between Subjective Global Assessment and Body Mass Index to determine the nutritional status in patients admitted in an Internal Medicine Service. METHODS: Prospective, longitudinal, observational s...
OBJECTIVE: Comparison between Subjective Global Assessment and Body Mass Index to determine the nutritional status in patients admitted in an Internal Medicine Service. METHODS: Prospective, longitudinal, observational study of a population of 152 patients, using the Subjective Global Assessment and Body Mass Index. Plasma levels of albumin, functional capacity weight and income conditions were determined. Statistics: methods of chi-square test for univariate analysis, non-parametric tests and logistic regression were used. RESULTS: 152 patients, of which 48.70% had malnutrition, moderate malnutrition 34.2% (group B) and 14.5% severe malnutrition (group C) were included. No association between Subjective Global Assessment and Body Mass Index was shown to determine nutritional status. MalnutrItion was associated with age over 60 years, male sex, and diagnosis of oncologic andinfectious diseases, as well as the level of functional ability. CONCLUSIONS: Body Mass Index is not a suitable method to assess the impact of malnutrition in hospitalized patients compared with the Subjective Global Assessment.
STROKE: CRITICAL APPRAISSAL OF INTENSIVE CARE MANAGEMENT.
Olajumoke TO, Afolayan JO, Ojo KO
Niger J Med · 2015 · PMID 27487606
BACKGROUND: Stroke is a common medical condition in the medical units. Stroke patients are usually managed on the medical wards while some that needs organ support are admitted into the intensive care unit. However there...
BACKGROUND: Stroke is a common medical condition in the medical units. Stroke patients are usually managed on the medical wards while some that needs organ support are admitted into the intensive care unit. However there is conflicting data on the benefits or otherwise of admitting stroke patients into the intensive care unit. This necessitated this study to know how much benefit is derived from admitting stroke patients into the intensive care unit. AIM AND OBJECTIVE: The study aims at the benefits of admitting stroke patients into the intensive care unit. The objective included studying the prognostic factors that determines the outcome of stroke patients admitted into the intensive care unit. METHODOLOGY: The case files of all patients admitted and managed in the intensive care unit of LAUTECH teaching hospital between 2002 and 2014 were retrieved and were analysed. The factors used in analyzing included the type of stroke, the age of the patients, the Glasgow Coma scale at admission, the need for intubation and mechanical ventilation as well as the percentage mortality in each subsets. RESULTS: A total of 48 patients were admitted over the study period of which 19 were males and 29 were females. The percentage mortality in females was 78.95 while mortality in males was 62.5%. The higher the age the worse the prognosis, the higher the GCS the better the prognosis. Patients that were intubated and ventilated had percentage mortality of 68.8% and better than non ventilated patients. The hemorrhagic strokes also carries worse prognosis. CONCLUSION: The admission of stroke patients to the intensive care unit should be individualized considering the above mentioned prognostic factors. However patients that are likely to benefit from intensive care unit should be admitted early for them to derive the maximum benefits.
MATERNAL MORTALITY AUDIT IN A TERTIARY HEALTH INSTITUTION IN NIGERIA: LESSONS FROM DIRECT CAUSES AND ITS DRIVERS.
Bello FA, Adesina OA, Morhason-Bello IO … +1 more , Adekunle AO
Niger J Med · 2015 · PMID 27487605
INTRODUCTION: Nigeria has the second highest number of maternal deaths in the world.The study aimed at determining the causes of and non-obstetric contributors to maternal mortality at a tertiary referral hospital. MATER...
INTRODUCTION: Nigeria has the second highest number of maternal deaths in the world.The study aimed at determining the causes of and non-obstetric contributors to maternal mortality at a tertiary referral hospital. MATERIALS AND METHODS: It was a prospective audit of all consecutive maternal deaths in the hospital over a three-year period. Immediately after the death, information wvas retrieved via a data collection form. Data were analysed with SPSS-20. RESULTS: Seventy deaths were examined over the study period. Maternal mortality ratio was 1,265/100,000 live births. The annual ratio decreased steadily over the study period. Most of the deaths were of multiparous women who had not received any antenatal care, and were mostly postpartum,within 24 hours of delivery. Most of them were critically ill on admission to the hospital. Major causes of death were haemorrhage (36%), sepsis (17%) and hypertensive disorders (16%).Delays were identified in 34.3% of cases; most (70.1%) were Phase III delays. DISCUSSION: Direct causes of maternal mortality are consistent with those found in literature. Steps which the centre has been taken to counter direct and non-obstetric causes are discussed. Possible strategies to improve health financing and referral system are proffered.
REFERENCE VALUES OF FETAL PEAK SYSTOLIC BLOOD FLOW VELOCITY IN THE MIDDLE CEREBRAL ARTERY AT 12-41 WEEKS OF GESTATION IN JOS, NORTH CENTRAL NIGERIA.
Ulu UO, Udoh BE, Agwu KK
Niger J Med · 2015 · PMID 27487604
OBJECTIVES: The objectives of this prospective cross sectional study are (i) to establish new reference values of peak systolic blood flow velocity measurement in the fetal middle cerebral artery (MCA-PSV) following vali...
OBJECTIVES: The objectives of this prospective cross sectional study are (i) to establish new reference values of peak systolic blood flow velocity measurement in the fetal middle cerebral artery (MCA-PSV) following validated methodological guidelines (ii) to correlat peak systolic velocity with gestational age and (iii) to establish regression prediction model of MCA-PSV for our population. PATIENTS AND METHODS: Cross-sectional data were obtained from 480 low risk pregnant women and cross validated by 120 high risk pregnant women between 12 and 41 weeks' gestation. Reference ranges for MCA-PSV were constructed and for each measurement linear regression models were fitted separately to the mean and standard deviations (SD) as a function of gestational age. A comparison was made between the reference ranges produced in our study and those of Caucasians. RESULTS: Tables of mean values of peak systolic velocity and percentile with regression equations of MCA-PSV are resented, with suggested limits of 2.5th as lower borderline and 97.5th values representing the upper borderline of normal. Foetal middle cerebral artery peak systolic velocity demonstrated simple continues increase and strong positive correlation with gestational age. Calculated values of z were higher than critical values for PSV of subjects and Caucasian values; p < 0.05 CONCLUSIONS: We have constructed reference ranges for MCA-PSV of gestation 1,241 week period and because the methodological flaws of published study have been eliminated, cross validated by a control group including larger sample size drawn from our population we therefore consider this to be useful for clinical practice.
REVIEW OF CONTROL OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN NIGERIA.
Dami N, Shehu NY, Dami S … +1 more , Iroezindu MO
Niger J Med · 2015 · PMID 27487603
The global scourge of human immunodeficiency virus (HIV) infection is inundating, especially in sub-Saharan Africa and in particular Nigeria which is home to 10% of the world's HIV-infected persons. The target of the mil...
The global scourge of human immunodeficiency virus (HIV) infection is inundating, especially in sub-Saharan Africa and in particular Nigeria which is home to 10% of the world's HIV-infected persons. The target of the millennium development goal 6 is to halt and reverse the spread of HIV/AIDS by 2015. HIV control in Nigeria was initially shrouded in denial and apathy. Subsequently, a more pragmatic approach was launched during the tenure of President Olusegun Obasanjo. Several policies were formulated. The national prevalence of HIV witnessed some progressive decline and is currently 4.1%. There is now improvement in both HIV awareness and counselling and testing. Greater access to antiretroviral therapy and other support services have also been witnessed with over 300,000 persons currently on drugs. Notable achievements have been recorded in prevention of mother to child transmission (PMTC). However, with increased access to antiretroviral therapy, antiretroviral drug resistance has become inevitable. Acquired drug resistance is high-82% and transmitted drug resistance ranges between 0.7 and 4.5%. The achievements were largely facilitated by international partnerships which have become more streamlined in recent years. A sustained shift to indigenously sourced financial and manpower resource has become imperative. It is also important to integrate HIV facilities with other existing health care facilities for sustainability and cost-effectiveness. In an attempt to strengthen the national response, President Goodluck Ebele Jonathan launched the President's Comprehensive Response Plan for HIV/AIDS in Nigeria. It is hoped that this well-articulated policy would be well implemented to significantly reverse the epidemic.
RECURRENT PLEOMORPHIC ADENOMA OF THE UPPER LIP: CASE REPORT AND REVIEW OF THE LITERATURE.
Fomete B, Adeosun OO, Awelimobor DI … +1 more , Olayemie L
Niger J Med · 2015 · PMID 27487602
INTRODUCTION: Pleomorphic adenoma or mixed tumour is a benign salivary gland tumour, presenting usually in the parotid or submandibular glands. This tumour contains elements of both epithelial and mesenchymal origin. The...
INTRODUCTION: Pleomorphic adenoma or mixed tumour is a benign salivary gland tumour, presenting usually in the parotid or submandibular glands. This tumour contains elements of both epithelial and mesenchymal origin. They are the most common tumours (50%), (60-65%) of the major and minor salivary glands. The palate is considered as the most common intraoral site (42.8-68.8%), followed by the upper lip (10.1%) and cheek (5.5%). CASE REPORT: A 37 year old female Nigerian house wife was seen with a four year history of painless slowly progressive upper lip swelling. Prior to her presentation, she had surgery for same swelling in a peripheral hospital. All other histories were not significant. CONCLUSION: PA remains the commonest benign minor salivary gland neoplasm and excision with safe margins the treatment of choice.
TRANSMIGRATION OF INTRA-UTERINE DEVICE, EXPLORATORY LAPAROTOMY, RETRIEVAL AND REPAIR OF PERFORATED UTERUS.
Eli SF, Olisa E, Abam DS … +1 more , Enyindah CE
Niger J Med · 2015 · PMID 27487601
BACKGROUND: Perforation of the uterus following transmigration of Intra-uterine devise (IUD) is an uncommon finding of insertion of IUD. There is associated increased risk of accidental pregnancy,morbidity and mortality....
BACKGROUND: Perforation of the uterus following transmigration of Intra-uterine devise (IUD) is an uncommon finding of insertion of IUD. There is associated increased risk of accidental pregnancy,morbidity and mortality. AIM: To report a rare clinical condition in which there was uterine perforation following migration of IUD and to increase awareness of this condition in our environment. CASE REPORT: A 37 year old para 6⁺⁰ woman (all alive) who presented with a ten day history of lower abdominal pains following IUD insertion. Examination revealed tenderness in the suprapubic region and non-visualization of IUD thread per vaginam. Pelvic USS showed an empty uterine cavity while an abdominopelvic x-ray following tracer IUD insertion showed the IUD to be outside the uterine cavity. She had an exploratory laparotomy for retrieval of transmigrated IUD and repair of perforated uterus. CONCLUSION: Transmigrated IUD with uterine perforation is distressing uncommmon clinical condition, and it is reported with the hope of increasing the awareness and possibly prevent this avoidable uncommon complication.
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