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   Table of Contents - Current issue
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October-December 2017
Volume 4 | Issue 4
Page Nos. 91-115

Online since Wednesday, April 11, 2018

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REVIEW ARTICLE  

Medical therapy for primary expulsion of urinary calculi: A review p. 91
Mushabab A Al-Ghamdi, Abubakar Abdulkadir
DOI:10.4103/ssajm.ssajm_33_17  
Urinary calculi are relatively common worldwide. Open surgical removal and minimally invasive surgery are effective in treating calculi but are associated with a cost and significant complications. In addition, extracorporeal shock waves lithotripsy and minimally invasive surgery are not widely available in resource-limited countries. Medical treatments for expulsion of urinary calculi provide noninvasive, relatively cheaper and safer alternatives to open surgery as well as to minimally invasive surgery for small stones. However, these modes of therapy are not widely used despite mounting evidence of their efficacy. The aim of this review is to appraise the existing literature on medical therapies for primary expulsion of urinary calculi. We searched Medline, EMBASE, CINAHL, AJOL and Cochrane database, for randomized controlled trials on urinary calculi using the search terms “urinary calculi” (MESH for Medline) AND “expulsion” OR medical treatment. We also searched reference list of relevant articles. The literature was appraised and summarized in this review. Twenty-seven randomized controlled trials on medical therapies for expulsion of urinary stones were found from various databases and hand-search of references of articles. We also retrieved some basic science, epidemiologic, and meta-analytic research related to urinary calculi. Medical expulsive therapies, especially alpha-blockers and calcium channel blockers have been shown to be effective in many trials as well as meta-analysis of clinical trials. We conclude that medical therapies for primary expulsion of small size urinary calculi should be considered in suitable patients, especially in resource-limited settings where facilities for shockwave lithotripsy (SWL) and minimally invasive surgeries are not readily available.
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ORIGINAL ARTICLES Top

Prevalence and antimicrobial susceptibility of Shigella species isolates from diarrheal stool of patients in a tertiary health facility in northeastern Nigeria p. 96
Ibrahim Y Ngoshe, Ballah A Denue, Hauwa S Bello, Cecilia B Akawu, Wadzani Gashau
DOI:10.4103/ssajm.ssajm_7_17  
Background: Shigella is a frequent cause of bacterial diarrhea especially in sub Saharan Africa region. Antimicrobial chemotherapy is recommended for diarrheal disease due to Shigella species, but the options are limited by emerging resistance. Aim: To determine the prevalence and antimicrobial susceptibility of shigella species isolated from diarrheal stool of patients in a tertiary health facility in northeastern Nigeria. Patients and methods: This prospective cross sectional study was conducted in University of Maiduguri Teaching Hospital from 2nd January to 29th December 2013. Diarrheal stool samples were consecutively collected from all consenting patients from Emergency pediatric unit, General out patients and Medical clinics. Shigella species were detected by biochemical and serological tests. Antibiotic sensitivity pattern of these isolates was studied by disk diffusion Method. Results: A total of 400 diarrheal stool samples were considered, shigella species isolation rate was 32(8%). It consisted of shigella flexneri 15(46.9%), shigella dysenteriae 12(37.5%), shigella sonnei 5(15.6%), no shigella boydii specie was identified. The shigella species were sensitive to Ciprofloxacin, Ofloxacin and Cefuroxime. Resistance to these antimicrobial were as follows: Gentamycin (28.1%), Tetracycline (31.2%) and Amoxycyllin (75%). At least 4 out of every 5 isolates were resistant to Chloromphenicol, Ampicillin and Norfloxacin. The highest resistance of 93.8% was exhibited against Cotrimoxazole. Conclusion: Shigellosis is a recognized cause of bacterial diarrhea in our setting. In this study, Shigella flexneri was the most commonest isolated species followed by S. dysentriae. There was no resistance against Ciprofloxacin, Ofloxacin, Norfloxacin and Cefuroxime. At least 4 out of every 5 isolates were resistant to Chloromphenicol, Ampicillin and Nitrofurantoin. Cotrimoxazole showed highest resistance pattern.
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Sex-related differences in clinical, electrocardiographic, and echocardiographic indices among normotensive offspring of black parents with hypertension p. 102
Philip M Kolo, Emmanuel O Sanya, Ayodele B Omotoso, Ayodele Soladoye, James A Ogunmodede
DOI:10.4103/ssajm.ssajm_18_17  
Context: Blood pressure tracking has suggested that the difference in blood pressure between women and men begins to manifest during the adolescent period. It is therefore postulated that sex-related cardiac structural and functional differences that could predict future events may exist in the heart of offspring of parents with hypertension. Aims: This study aimed at evaluating the effects of sex difference on the heart of offspring of parents with hypertension. Settings and Design: Cross-sectional study. Participants and Methods: A group of offspring of parents with hypertension aged between 15 and 25 years were recruited for the study if they had normal blood pressure and gave consent. They had clinical, electrocardiography, and echocardiographic assessments. Results: Sixty-five participants consisting of 47 males and 18 females participated in the study. Mean systolic blood pressure was higher (P = 0.001) in the males compared with the females but the diastolic blood pressure was similar between them. Electrocardiogram (ECG) parameters (heart rate, QRS axis and QTc) were similar between the males and the females but the summation of ECG voltage (SV2 + RV6) was higher in the former than the latter. Left ventricular (LV) posterior wall (P = 0.001), aortic root diameter (P = 0.014), LV mass (P = 0.001), LV mass index (P = 0.001), and relative wall thickness (P = 0.003) were higher in the male compared with the female participants, respectively. However, more females (72.2%) had normal LV geometry compared with the males, P = 0.03. Conclusion: There are subtle clinical, electrocardiographic, and echocardiographic differences between the heart of male and female offspring of parents with hypertension with the former having more precursors of future cardiovascular events.
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Outcome of treatment in patients with thyroglossal duct cyst in Zaria: Our experience p. 108
Tunde T Sholadoye, Dotiro Chitumu, Iliyasu Y Shuaibu, Oluseyi O Ogunsua, Ibrahim B Mohammed
DOI:10.4103/ssajm.ssajm_32_17  
Introduction: Thyroglossal duct cyst (TGDC) is the most common congenital midline neck mass that most commonly present as gradually enlarging painless mass that moves with swallowing and protrusion of tongue, usually noticed in the first decade or in young adult. The aim of this study is to review the treatment outcome of patients with TGDC who presented to Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Materials and Methods: The record of patients managed for TGDC at the Division of Paediatric Surgery and Otorhinolaryngology of Department of Surgery Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria over a 10-year period between January 2007 and December 2016 was reviewed. The information obtained included demographic characteristic and complete clinical information. The data were analyzed using a Statistical Package for Social Sciences version 21.0 software. Results: A total of 19 patients were managed for TGDC within the years under review. The age range of the patients was 2–12 years with mean age and standard deviation of 6.6 and 3.5 years, respectively. Eleven patients (57.9%) presented within 6 months to 3 years of the disease onset. The location of the TGDC in majority of our patients 15 (78.9%) was infrahyoid. Most of the patients 17 (89.5%) had uncomplicated TGDC. Fifteen (79%) of the patients had Sistrunk operation, and no case of recurrence was observed after 2 years. Conclusion: The outcome of treatment of TGDC is good, when early diagnosis and complete surgical excision of the cyst is achieved. Complete excision of the cyst without the removal of the hyoid bone may be adequate for suprahyoid cyst.
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CASE REPORT Top

Widespread heterotopic ossification in a patient with anoxic brain injury: Case report and review of literature p. 112
Mamuda A Abdulrahman, Mamuda Atiku, Magaji G Taura, Lawan H Adamu
DOI:10.4103/ssajm.ssajm_34_17  
Heterotopic ossification (HO) is the formation of bone in the soft tissue, which exhibits no properties of ossification. Widespread HO is an uncommon condition. We present the findings in an 18-year-old young female who presented with benign bilateral fibroadenoma of the breast. However, she suffered an anoxic brain injury following cardiac arrest and had mechanical ventilation for some weeks. Thereafter, she developed widespread HOs, which were subsequently managed conservatively but required surgery for the ossification around the right hip. The report highlighted the multiplicity of risk factors vis-à-vis the challenges of management. A plan for the future care of this patient in relation to some of the currently available literature has also been highlighted.
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