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REVIEW ARTICLES
Laboratory perspective of gram staining and its significance in investigations of infectious diseases
Yunusa Thairu, Idris Abdullahi Nasir, Yahaya Usman
October-December 2014, 1(4):168-174
DOI:10.4103/2384-5147.144725  
Clinical microbiology laboratory plays several important roles in the management of bacterial infections. Isolation, identification of pathogenic microorganisms in cultures and subsequent antimicrobial susceptibility testing always assists in selecting appropriate antimicrobial agent and prevention of unnecessary complications. The most important and primary test to perform directly on some special samples such as cerebrospinal fluid and positive cultures is Gram staining which serves as the most rapid and simplest test to characterize microorganisms. It is therefore highly likely that the information provided by the Gram staining will help to assess the adequacy of preliminary diagnosis and antimicrobial therapy selected after collecting culture specimens and before final identification of the microorganism. In recent reports, the impact of Gram staining results on patient mortality has been documented. On the other hand, there remains the possibility that Gram staining results do not match with the final identification of microorganisms. This would carry a risk leading to inadequate antimicrobial therapy and potentially affecting patients' clinical course and mortality. The aim of this mini review is to analyze and discuss the clinical significance and limitations of reporting Gram staining results for sample meant for bacteriological investigations.
  51,639 2,942 3
ORIGINAL ARTICLES
Accuracy of ultrasound in fetal birth weight estimation and sex determination in singleton term pregnancies from two tertiary institutions of northwestern Nigeria
Sadisu Mohammed Ma`aji, Daniel Dirioha Odunko
January-March 2015, 2(1):14-18
DOI:10.4103/2384-5147.151568  
Background: Ultrasonographic assessment of fetal growth for the estimation of fetal weight (EFW) is a common obstetrics practice and provides valuable information for planning the mode of delivery. The aim of this study is to determine the accuracy of fetal birth weight estimation and sex determination using ultrasonography from two tertiary institutions of Northwestern Nigeria. Materials and Methods: This was a prospective study involving 109 singleton uncomplicated pregnancies from January 2013 to January 2014. All the patients are booked at the antenatal clinic of two tertiary institutions (Usmanu Danfodiyo University Teaching Hospital [UDUTH] Sokoto and Federal Medical Center Birnin Kebbi). Inclusion criteria in the study were term pregnancy (36-42 weeks), reliable date of last menstrual period, regular menstrual cycle, a close correlation between menstrual age and clinical gestational age measurements. Results: The mean maternal age was 29.01 ΁ standard deviation 4.81 (range: 18-40 years). One hundred and nine term live-born singleton infants delivered at UDUTH and Federal Medical Center Birnin Kebbi during the study period had undergone ultrasound EFW <7 days preceding birth. Twenty-one (19.3%) fetuses were identified as male while 38 (34.9%) was identified as female during the ultrasound examinations. In about 40 (36.7%) of the fetuses, the gender was not seen. Conclusion: There was a significant error while estimating fetal weight by ultrasound and underestimation has the highest percentage. Determination of fetal sex with ultrasound show some degree of accuracy in our study because 21 (19.3%) fetuses were identified as male, while 38 (34.9%) was identified as female during the ultrasound examinations. Hence, it should be recommended only if the mother requested for the gender during the scanning taking into account the social implications.
  12,854 374 -
REVIEW ARTICLES
HIV-Associated tuberculosis: A sub-saharan african perspective
Mukhtar A Adeiza, Abdullah A Abba, Juliana U Okpapi
January-March 2014, 1(1):1-14
The sub-Saharan Africa bears the brunt of being the region with the highest burden of both Human Immunodefiency Virus (HIV) infection and of tuberculosis (TB). While only 10% of immunocompetent individuals infected with M.tuberculosis go on to develop active disease in their lifetime, 50% of those co-infected with HIV develop active TB. Qualitative and quantitative defects of CD4+ T-lymphocytes explain the inability of HIV-infected individuals to contain mycobacterial proliferation. Similarly, TB also accelerates the progression of HIV infection. The clinical and radiological presentation of TB in patients infected with the HIV virus may be different and atypical posing significant diagnostic challenges. This is compounded by the dearth of diagnostic facilities in sub-Saharan Africa. The initiation of antiretroviral therapy (ART) during anti-TB therapy (ATT) significantly improves survival of TB/HIV co-infected persons. There are challenges in treatment of HIV associated TB because of overlapping drug toxicities, pill burden and suboptimal adherence, drug-drug interactions between ART and ATT as well as timing of ART. Of particular importance are the immune reconstitution inflammatory syndrome (IRIS) and the emergence of multi-drug resistant (MD-R) and extensively drug resistant (X-DR) TB. Centre's for tuberculosis diagnosis and treatment and for HIV care and treatment need to be integrated. This has not been so successful in sub-Saharan Africa. In spite of sustained support by donor organizations, a substantial number of HIV-TB co-infected individuals remain undiagnosed and are poorly managed. This review focuses on the epidemiology and pathogenesis of HIV-TB co-infection and the special areas of difficulty in the diagnosis and treatment of the dual infection. Emphasis is placed on the peculiarities of management in sub-Saharan Africa, the region with the highest burden of both infections.
  11,722 555 -
Acute chest syndrome
Bello Jamoh Yusuf, Abdullah A Abba, Mohammed Tasiu
July-September 2014, 1(3):111-118
DOI:10.4103/2384-5147.138930  
Sickle cell anaemia - the disease that combines molecular biology, clinical features, biochemistry, pathology, natural selection, population genetics, gene expression and genomics - is the world's most common life threatening monogenic disorder. Acute chest syndrome is a common complication of SCA and it has been identified as the most common cause of mortality in adult patients with SCA. In addition to elaboration of pro-inflammatory cytokines and up-regulation of cellular adhesion molecules, interplay among red cell sequestration, fat embolism and pulmonary infection, which are the pertinent pathophysiological phenomena that operate in a vicious cycle, lead to the clinical features of ACS. Chest infection, usually caused by atypical organisms, is a more common trigger in children, while fat embolism is considered as a more common trigger in adults. More common clinical features are cough, fever and chest pain, although the pattern of these symptoms varies between children and adults cohorts. The operational definition of ACS appears to be a bit loose, making it difficult to categorically distinguish from other differential diagnoses like pneumonia, especially in resource-poor areas. However, when ACS is diagnosed, treatment should be aggressive, addressing analgesia, hydration, the use of broad-spectrum antibiotics, inhaled bronchodilators, anticoagulation and blood transfusion if required. Randomized trials on efficacy of novel agents like statins, glycoprotein IIa/IIIb inhibitors and phospholipase inhibitors are still on-going.
  11,157 415 1
ORIGINAL ARTICLES
Third and Fourth Cerebral Ventricular Sizes among Normal Adults in Zaria-Nigeria
Ahmed Umdagas Hamidu, Solomon Ekott David, Sefiya Adebanke Olarinoye-Akorede, Barnabas Danborno, Abdullahi Jimoh, Olaniyan Fatai
April-June 2015, 2(2):89-92
DOI:10.4103/2384-5147.157432  
Introduction: The cerebrospinal fluid within the ventricles could be in excess or markedly reduced, and these could be the only sign of an intracranial or intraventricular disease. The linear dimensions of the 3 rd and 4 th cerebral ventricles are key to some of these findings. The practice of using the reviewer's experience or observing a change in the shape of the ventricles can be very subjective, hence the need for normal values. Objective: To establish linear dimensions of the 3 rd and 4 th cerebral ventricles among normal adults in Zaria using computer tomography. Materials and Methods: Axial computerized tomographic brain scans of the 488 normal subjects reviewed were acquired during a 3 year period (2009-2012) using a multi-slice GE Sigma excite scanner in our department, and the images were reviewed retrospectively. We obtained the widest linear dimensions of the 3 rd and 4 th cerebral ventricles using the in-built linear calipers of the computer tomography (CT) scan machine for each patient. Statistical analysis was performed using Sigmastat 2.0 for Windows (Statsoft, San Rafael, CA). The following statistical tests employed: students t-test and analysis of variance, and a probability level of <0.001 taken as statistically significant. Results: The 488 brain CT scans analyzed for this study comprised of 319 (65.36%) males and 169 (34.63%) females. The ages ranged from 18 to 84 years with a mean age of 37.26 years. The age difference between males and females were statistically significant. The mean 3 rd ventricular widths were 4.23 ± 1.25 and 3.81 ± 0.87 in males and females respectively, whereas the mean 4 th ventricular widths were, 7.87 ± 1.30 and 7.54 ± 1.33, in males and females, respectively. Conclusion: In this study, we have established normal linear values for the 3 rd and 4 th cerebral ventricles in Zaria using computed tomography. These values could serve as a quick reference for radiologists and neurosurgeons, obviating the need for advanced software packages, which may not be readily available.
  10,898 468 2
Prevalence and Risk Factors for Perinatal Asphyxia as Seen at a Specialist Hospital in Gusau, Nigeria
Bilkisu Garba Ilah, Muhammad Sakajiki Aminu, Abdullahi Musa, Muyideen Bimbo Adelakun, Akeem Oladiran Adeniji, Taofik Kolawole
April-June 2015, 2(2):64-69
DOI:10.4103/2384-5147.157421  
Introduction: Perinatal asphyxia is a global neonatal problem which significantly contributes to both morbidity and mortality. It is the fifth largest cause of under-five mortality. This study was aimed to determine the prevalence, risk factors and outcome of perinatal asphyxia in newborns seen in the Special Care Baby Unit. Materials and Methods: A retrospective study of newborns managed for perinatal asphyxia over a 1-year period. All inborn babies with Apgar scores <6 at 5 min and out born babies with no Apgar score but with features of asphyxia were studied. Case files of the patients were retrieved and relevant information was obtained. Results: Of the 223 neonates admitted during the study period, 67 (30.1%) newborns had perinatal asphyxia from our record; but only 47 (70.1%) case files with complete data were retrieved, giving a prevalence of 21.1%. Twenty five (53.2%) of the mothers were primiparous, 31 (66.0%) had no antenatal care and 25 (53.2%) presented with prolonged obstructed labor. Twenty-eight (59.6%) of the newborns were females; 41 (87.2%) were term, 27 (57.4%) of normal birth weight, 42 (89.4%) delivered in the hospital and mostly through an emergency caesarean section. Thirty (63.9%) of the newborns were discharged; while 12 newborns died, giving a case fatality rate of 25.5%. Conclusion: Perinatal asphyxia is a significant cause of morbidity and mortality in Gusau. Health education of pregnant mothers on antenatal care for early detection of high-risk pregnancy is highly recommended in order to reduce the high incidence of this preventable condition.
  8,012 884 3
Normative ultrasonographic values for testicular volumes in Nigerian boys aged 0-15 years
Suleiman Lawal, Hafsatu Wasagu Idris, Philip Ibinaiye, Ahmed Umdagas Hamidu, Musa Abdulkadir Tabari, Bello Usman, Ahmad Tijjani Lawal
April-June 2016, 3(2):71-78
DOI:10.4103/2384-5147.184353  
Background: Pediatric testicular volume is an important index in determining the start of puberty, its progress, and/or any subsequent disorder of puberty. It is also important in detecting and monitoring local testicular pathologies. This study is aimed at obtaining reference values for testicular volume measured by ultrasound in normal pediatric age group 0-15 years. Materials and Methods: This cross-sectional study was conducted at the Radiology Department of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Boys numbering 450 without any evidence of testicular pathology were recruited for this study. The testicular volume was measured by ultrasound (Aloka SSD 3500) utilizing the testicular length, width, and thickness of the ultrasound images. All measurements were analyzed using Statistical Package for Social Sciences (SPSS 17). A P ≤ 0.05 was considered statistically significant. Results: The testicular volume shows no significant increase before the age of 9 years with an average volume of 0.74 ml and then increased to 1.1 ml at 9 years. Afterward, it shows marked increase in volume to reach a value of 8.99 ml at 15 years. Strong correlations were established between the right and left testicular parameters, except for the anteroposterior diameter. However, no statistically significant difference was observed between them, except for length (P = 0.000). Conclusion: The study provides contemporary reference values for testicular volume of the pediatric age group.
  7,716 326 -
REVIEW ARTICLE
A review of population-based studies on diabetes mellitus in Nigeria
Tukur Dahiru, Alhaji A Aliyu, AU Shehu
April-June 2016, 3(2):59-64
DOI:10.4103/2384-5147.184351  
Diabetes is a major cause of morbidity and mortality both in developing and developed countries. The incidence is rising rapidly with sub-Saharan Africa experiencing the largest percentage increase between 2013 and 2035. Nigeria has the largest number of people with the disease, yet information on the diabetes mellitus for policy and programming is fragmentary. Therefore, the purpose of this study to systematically identify population-based studies on diabetes in Nigeria and to determine the prevalence and sex differential. A literature search of the PubMed database was conducted of published research between 1990 and 2013 using the medical subject headings "diabetes mellitus" and "Nigeria." The search was done at the end of 2013 which returned 741 hits. A manual search for additional studies was performed using references cited in the original articles. Some authors were contacted whose full-text publications were not available on the PubMed database or freely on the internet. Twenty population-based studies that had been conducted on the prevalence of diabetes in Nigeria between 1990 and December 2013 that satisfied the inclusion criteria were identified. The prevalence of diabetes ranged from 0.8% to 11% involving both urban and rural populations, with varying sampling schemes, one study reported a traditional population with very low prevalence of diabetes and highly specific populations as well. The review revealed a generally low prevalence (<10%) of diabetes in Nigeria. It also found that there is dearth of literature on diabetes. There is the need to undertake a nationally-representative survey to assess the burden of diabetes in general population.
  6,968 647 2
REVIEW ARTICLES
Approaches to tackling the menace of street begging by visually disabled persons in Northern Nigeria
Aliyu H Balarabe, Abdulraheem O Mahmoud
October-December 2014, 1(4):161-167
DOI:10.4103/2384-5147.144721  
Street begging is a social challenge that is more rampant in Northern Nigeria than elsewhere in the country. Some poor individuals resort to street begging to sustain their families. Street begging is found more among people living with physical challenges, particularly the blind persons. We reviewed the literature on the causes of blindness and challenges to accessing curative and rehabilitation support services. This is with a view to draw the attention of policy formulators on the appropriate rehabilitation of the visually disabled persons in order to tackle the menace of street begging in Northern Nigeria. A review of the literature was done electronically as well as manually. For electronic search, various scientific journals and web-based search engines were used. The search terms were blind street beggars, visual disability among beggars, avoidable blindness, blindness in northern Nigeria, socioeconomic impact of blindness, psychosocial impact of blindness, challenges of rehabilitation in Nigeria, visual disability in Northern Nigeria, destitution in Nigeria. Cross references of relevant articles were also retrieved. Majority had blindness from avoidable causes (over 75%) and had difficulty in accessing curative and rehabilitation support services. In the light of the avoidable nature of the majority of the causes of blindness among blind beggars in Northern Nigeria, coupled with the existing inadequate modalities for rehabilitating incurably blind, it is recommended that, a comprehensive eye care program on preventive, curative and rehabilitative services with a strong public health education campaign on the avoidable causes of blindness and discouraging street begging should be put in place by relevant stakeholders.
  4,792 2,137 -
ORIGINAL ARTICLES
Relationship of ultrasound renal echogenicity, serum creatinine level and CD4 cell counts in patients with human immunodeficiency virus-associated nephropathy
Philip Oluleke Ibinaiye, Sani Suleiman Garko, Ahidjo Ahmed, Sa'ad Suleiman Tanimu, Nasiru Musa Tahir
October-December 2014, 1(4):191-197
DOI:10.4103/2384-5147.144733  
Background: There is a paucity of information on the relationship of renal ultrasound echogenicity and serum creatinine levels to CD4 cell counts in patients with human immunodeficiency virus-associated nephropathy (HIVAN) in our local environment. This necessitated the conduct of this study. Aims and objectives: To establish a relationship between renal ultrasound echogenicity and serum creatinine levels and CD4 cell counts in adult patients with HIVAN. Settings and Design: A cross-sectional study of 100 consecutively confirmed HIV-seropositive patients aged between 19 and 65 years (mean ± standard deviation: 35 ± 10.79) comprising 32 males and 68 females with clinical and laboratory features of HIVAN was conducted at the infectious disease clinic of the University of Maiduguri Teaching Hospital, between April 2011 and September 2012. Materials and Methods: The subjects underwent renal ultrasound scan, and the degree of parenchymal echogenicity was recorded. Serum creatinine levels and CD4 lymphocyte counts were also obtained for all the patients. Statistical Analysis: The data obtained were recorded on Data sheet and analyzed using SPSS for windows version 16. Results: Of the 100 cases studied (i.e., 200 kidneys), ultrasound showed abnormal echogenicity in 192 kidneys (96%) with a grade I echogenicity in 4 patients (4%), grade II echogenicity in 36 patients (36%) and grade III echogenicity in 56 patients (56%). Four patients (4%) had a normal renal echogenicity. Majority of the patients had grade III renal echogenicity. The lower the CD4 count, the higher the degree of the renal echogenicity. Although, the higher the serum creatinine levels, the higher the degree of the renal echogenicity. Conclusion: The degree of the renal echogenicity was found to be inversely proportional to the CD4 cell counts. Prognosis also worsens with higher serum creatinine and lower CD4 cell counts.
  6,559 339 3
Ultrasound Determination of Portal Vein Diameter in Adult Patients with Chronic Liver Disease in North-Eastern Nigeria
Aminu Umar Usman, Philip Ibinaiye, Ahmed Ahidjo, Abdurrahman Tahir, Sulaiman Tanimu Sa'ad, Zainab Mustapha, Nasiru Tahir, Sani Garko
April-June 2015, 2(2):57-63
DOI:10.4103/2384-5147.157419  
Background: Despite the safety, affordability and widespread use of ultrasound; there is a paucity of literature on ultrasonographic assessment of the portal vein (PV) diameter in adult patients in our local environment. Aims and Objective: The aim of this study was to determine the mean and range of PV diameter in chronic liver disease (CLD) patients in our local environment. Materials and Methods: This cross-sectional prospective study was carried out at the University of Maiduguri Teaching Hospital between January and June, 2013. Two hundred and fifty adult male and female CLD patients and equal number of age and sex matched controls aged 18 years and above had abdominal ultrasonography for measurement of their main, right and left PV diameter in both inspiration and expiration. Transverse and longitudinal measurements were obtained, and the averages of the two measurements were used to determine their final diameter. Results: There were 187 (74.8%) male and 63 (25.2%) female CLD patients aged between 19 and 77 years (mean ± standard deviation [SD], 43.78 ± 12.97 years). The mean diameter of the main PV (±SD) in CLD was 18.68 ± 2.59 mm which is higher than that of the control (10.87 ± 0.81 mm). The mean diameter of the right and left PVs in CLD were 9.04 ± 1.26 mm and 8.58 ± 1.23 mm respectively, which were higher than the respective values of 4.35 ± 0.52 mm and 4.12 ± 0.52 mm in the control. The PV diameter correlated with age and respiratory phases in both CLD and the control group (P < 0.05). There was statistically significant difference in PV diameter between males and females (P < 0.05) with values higher in females. Conclusion: The mean value and range of PV diameter in CLD patients in this environment were statistically and significantly higher than controls. The diameter correlated with age and showed significant difference between the two sexes and respiratory phases.
  5,330 290 -
Anemia and iron deficiency in pregnant women in Zaria, Nigeria
Abdul-Aziz Hassan, Aisha Indo Mamman, Sunday Adaji, Bolanle Musa, Simon Kene
January-March 2014, 1(1):36-39
Introduction: Anemia is common in pregnancy and iron deficiency is a major cause of anemia in pregnant women in Africa. This is due to increased demands of the fetus, growing uterus, placenta, and poor nutritional habits. Objectives: To determine the prevalence of anemia and the role of iron deficiency in causation of anemia in pregnant women attending the antenatal clinic of the Ahmadu Bello University teaching hospital (ABUTH) in Zaria, Nigeria. Materials and Methods: Ninety (90) consenting pregnant women were entered for this study with an equal number of controls. A structured questionnaire was administered to participants. Full blood count, serum ferritin, urine and stool microscopy for parasites were carried out. Results: The mean hematocrit in the pregnant and non-pregnant subjects was 35% (SD ± 3.8; 95 CI = 34.2-35.8) and 39% L/L (SD ± 3.2; 95% CI = 37.3-38.7) with P < 0.001. In the pregnant subjects 11(12.2%) had anemia while none of the controls was anemic. Mean serum ferritin among the pregnant and non-pregnant subjects was 26.0 μg/L (SD ± 35.2; 95% CI = 18.6-33.4) and 70.3 μg/L (SD ± 106.1; 95% CI 48.1-92.5), respectively, with P-value of <0.001. Even though iron deficiency was observed in 68/90 (75.6%) of pregnant women, it was latent in 61/68(89.7%) of the women while it was frank in 7/68 (10.3%). In the non-pregnant subjects, 23/90 (25.6%) had iron deficiency despite a normal hematocrit. Of the 11/90 (12.2%) of pregnant subjects that had anemia 7/11(63.6%) had frank iron deficiency anemia while 4/11 (36.4) had anemia due to other causes. 2/90 (2.2%) of the pregnant subjects had ova of hookworm in their stool samples and both had iron deficiency anemia. Conclusion: Iron deficiency underlies many cases of anemia in pregnancy, thus justifying the use of iron supplementation in pregnancy as is currently practiced. Latent iron deficiency among non-pregnant controls suggests that iron supplementation may benefit non-pregnant women within the reproductive age group could help to improve their iron stores before the contemplation of pregnancy, thereby, reducing the prevalence of pregnancy related anemia in this environment.
  5,101 432 -
Correlation between wayne's score and laboratory evidence of thyrotoxicosis in Nigeria
Anas Ahmad Sabir, Sandra Omozehio Iwuala, Olufemi Adetola Fasanmade, Sani Atta Abubakar, Garba Yunusa Haruna, Augustine Efedaye Ohwovoriole
July-September 2014, 1(3):142-144
DOI:10.4103/2384-5147.138944  
Background: The diagnosis of thyrotoxicosis is based on clinical suspicion and confirmed by thyroid function test. In Nigeria, measurements of thyroid function tests are not readily available therefore the need for clinical assessment remains paramount in the diagnosis and management of thyrotoxicosis. Objective: The objective was to determine the relationship between Wayne's score and biochemical indices of thyroid function in Nigerians. Materials and Methods: A total of 30 newly diagnosed patients with thyrotoxicosis referred to the Endocrinology Clinic were recruited for participation in this study. All patients had detailed history taken and thorough physical examinations performed. They were also assessed using the Wayne's score. The patients also had the biochemical evaluation of their thyroid function. The relationship between the Wayne's score values and the biochemical indices were then correlated using the Pearson's correlation coefficient. Results: All the patients with elevated thyroid hormones had elevated Wayne's score. The correlation coefficient between T3 and Wayne's score was 0.79, whereas between T4 and Wayne's score was 0.81. The average Wayne's score was 31.6. There was negative correlation between age and Wayne's score (r = 0.86). Conclusion: The Wayne's score can be used as a screening tool for thyrotoxicosis in our environment.
  5,081 284 -
Epidemiology of appendicitis in Northern Nigeria: A 10-year review
Saad Aliyu Ahmed, Jerry G Makama, Umar Mohammed, Robert B Sanda, Sani Mohammed Shehu, Emmanuel A Ameh
October-December 2014, 1(4):185-190
DOI:10.4103/2384-5147.144729  
Background: The true incidence rate of appendicitis in Nigeria and the magnitude of appendicular fecaliths as a specific causal factor in appendicitis are unknown. Materials and Methods: A retrospective clinicopathologic study was conducted using the medical database of the Ahmadu Bello University teaching hospital, Zaria, northern Nigeria for the decade from 2001 to 2010. The National Population Census in Nigeria 2006 was used to estimate the standardized annual incidence of appendicitis in the locality. Pathologically confirmed specimens of appendicitis were analyzed against demographic data of the patient. Results: During the decade, there were a total of 382 cases with intraoperative diagnosis of appendicitis of which the diagnosis was confirmed pathologically in 373 cases. With a local population whose disease or specimens would most probably end up in this hospital pathology department estimated at 1,423,469 the standardized incidence rate of appendicitis was 2.6 per 100,000 per annum. In 354 (93%) out of the 382 specimens, fecaliths were identified and thought to be causally related to the disease in the individual case. Conclusion: Appendicitis is very uncommon in northern Nigeria and when it occurs, it is almost always caused by fecaliths.
  4,529 353 -
An application of Kaplan-Meier survival analysis using breast cancer data
M Usman, HG Dikko, S Bala, SU Gulumbe
July-September 2014, 1(3):132-137
DOI:10.4103/2384-5147.138940  
Aim: Kaplan-Meier estimator provides better estimates to determine the median of the distribution of breast cancer patient's survival times following their recruitment into the study. Materials and Methods: Age, sex, occupation, stage of the disease and results of the treatment of 312 breast cancer patients were the variables used in the study. The mean age of breast cancer patients was found to be 43.39 with a standard deviation of 11.74; the overall median survival time was 10 months. This indicates that 50% of breast cancer patients survived longer than 10 months after being diagnosed with the disease. Results and Discussion: Log-rank test was used to test the significant difference between the survival experiences of the patients. Age group, stage of the breast cancer and results of the treatment, indicated a significant difference, while occupations have not shown any significant difference in the survival of the breast cancer patients.
  4,206 384 1
Community-integrated management of childhood Illnesses (C-IMCI) and key household practices in Kano, Northwest Nigeria
Abubakar Mohammed Jibo, Zubairu Iliyasu, Isa Sadeeq Abubakar, Lawan Muhammad Umar, Aliyu Muktar Hassan
April-June 2014, 1(2):70-76
DOI:10.4103/2384-5147.136810  
Introduction: Integrated management of childhood illnesses (IMCI) is a holistic approach to reducing under-5 morbidity and mortality, and improving growth and development of children. This study compared key household and community practices in IMCI implementing and non-implementing communities in two local government areas (LGAs) of Kano State, Nigeria. Materials and Methods: A cross-sectional study was employed with multistage cluster sampling selection of caregivers of children 0-59 months of age and their index children (n = 400). The study was conducted from February 2009 through January 2010. Data analysis was performed using EpiInfo TM v6.0 and Minitab TM software. Results: The adoption of IMCI key household and community practices was generally better in IMCI-implementing communities than in non-IMCI communities. Exclusive breastfeeding (EBF) rate among children under 6 months was higher in IMCI communities than in non-IMCI communities (P = 0.05). Non-IMCI communities also had a greater proportion of low weight-for-age children (42.5%) than IMCI communities. Mothers from IMCI communities (30.5%) were more likely to have antenatal care (ANC) during the first trimester than those from non-IMCI communities (P < 0.05). There was no difference between the study communities with regard to use of insecticide-treated nets (ITN) during pregnancy (P = 0.09), and having skilled attendance during last childbirth (P = 0.23). Conclusion: Mothers in communities implementing IMCI are more likely to adopt EBF and to attend ANC services than their counterparts in communities not implementing IMCI. Expanding IMCI activities to other LGAs in northwest Nigeria will have a positive impact on reducing morbidity from common childhood diseases.
  4,153 329 -
Magnetic Resonance Imaging Findings in Cervical Spondylosis and Cervical Spondylotic Myelopathy in Zaria, Northern Nigeria
Sefiya Adebanke Olarinoye-Akorede, Phillip Oluleke Ibinaiye, Aliu Akano, Ahmed Umdagas Hamidu, Gbenga Abimbola Kajogbola
April-June 2015, 2(2):74-78
DOI:10.4103/2384-5147.157424  
Background: Cervical spondylosis (CS) has received little attention in the Nigerian medical literature even in the present era of magnetic resonance imaging (MRI). Unfortunately, cervical spondylotic myelopathy (CSM) is the most common form of functional debility from spinal cord disease in older adults. Objective: We sought to describe the clinico radiologic findings in CS and CSM with the hope of familiarizing clinicians with this prevalent and potentially devastating disorder. Materials and Methods: This study was a retrospective analysis of 76 patients who underwent cervical MRI examination on account of CS, associated with either radiculopathy, myelopathy, or myelo radiculopathy. The patients comprised of 54 (71.1%) males and 22 (28.9%) females, their ages ranged from 26 to 78 years. Each patient was also scored clinically using the Nurick's classification for cervical myelopathy and scores compared with their MRI examination findings. Results: The condition was commoner in males than females (M:F = 2.5:1). Multi-level disease was seen in almost all patients and the commonest disc levels affected in spondylosis were C4/5, followed by C5/6; while for spondylotic myelopathy, it was C3-4 level. The prevalence of CSM in this study was 42.10%. The patients' clinical scores compared well with their MRI findings. Conclusion: CS should not be dismissed as a mere consequence of aging 'but a disease with possible debilitating outcome and early prevalence due to an interplay of environmental and genetic factors'. On the strength of this, we have presented the MRI and clinical findings in CS and spondylotic myelopathy; and also reviewed previous reports in the light of the current findings in the literature.
  3,931 260 -
Determinants and outcome of teenage pregnancy in a rural community in Jos, Plateau State, Nigeria
Esther A Envuladu, Hadiza A Agbo, Victor A Ohize, Ayuba I Zoakah
January-March 2014, 1(1):48-52
Background: In Nigeria, the rate of teenage mothers was reported in 2008 to be 22.9% and the poor socio-demographic status of the pregnant teens play a major role in the poor maternal and child health indices and contribute to the slow pace of attainment of the related Millennium Development Goals (MDGs). This study was designed to determine the proportion of teenagers who have been pregnant, the outcome of the pregnancy and the socio-demographic determinants of the affected teens in the community. Materials and Methods: It was a community-based cross-sectional study in which an interviewer administered questionnaires was administered to 192 respondents aged 13-19 years. Results: the proportion of those who have ever been married was 25.5%, with significant association found between the age of the teenagers and being pregnant (P < 0.001). Most of the teenagers were single (75.6%) and a significant association was found between TP and teenage marriage (P < 0.001). Although 72.9% were still in school, TP was significantly associated with teenagers that were out of school (P = 0.001). TP was observed to be higher among teens with lower level of parental education though not statistically significant. (Father- none-33% and primary-36.4%; Mother: Primary-30.4%). TP was also found to be higher among teens of unskilled parent (30.4%), from polygamous family setting (42.3%) and teens in tertiary level of education (40.7%), though no statistical significant association was observed. Conclusion: Teenage pregnancy still remains a major issue in our environment and the socio-demographic characteristics of both the parents and the teenagers were found to be determinants of teenage pregnancy.
  3,595 348 -
REVIEW ARTICLES
Pneumococcal Infection in Nigeria: Preparing for the vaccine
Garba Iliyasu, Abdulrazaq G Habib, Musa Mohammad Borodo, Musa Babashani, Mohammad Ahmed
January-March 2014, 1(1):15-19
Background: The Pneumococcus is the most common cause of community-acquired pneumonia (CAP), sporadic bacterial meningitis, and bacteremia worldwide. It is an important public health concern throughout the world with global burden in causing disease and deaths comparable to that of human immunodeficiency virus (HIV), malaria, and tuberculosis. Nigeria accounts for 5% of the total global burden. Many of these morbidity and mortality could be averted with the use of pneumococcal vaccine, which is shown to be highly effective. This review is set out to highlight the burden of pneumococcal infection (PI) in Nigeria, its attendant mortality, antibiotic resistance, and the rational for the need to introduce routine pneumococcal vaccination. Materials and Methods: Relevant literatures were reviewed from medical journals, library search, and internet source. Other relevant websites like Global Alliance for Vaccines and Immunisation (GAVI), WHO were also visited as source for information. The key words employed were: pneumococcal infection, Nigeria, and vaccine. Results: Several studies have shown high burden of PI and high prevalence of antibiotic resistant Pneumococcus in Nigeria. Mortality rate has also been shown to be high and the need for effective implementation of pneumococcal vaccine into routine childhood vaccination program has been underscored. Conclusion: Prevention of pneumococcal disease and death is achievable only if efforts to deliver and implement prevention in regions with the greatest burden of disease are successful. National Primary Healthcare Development Agency (NPHCDA) should introduce either pneumococcal conjugate vaccine (PCV)-13 or PCV-10 through GAVI support to eligible children and at risk adult all over the country. As these new vaccines are introduced, it is imperative that we conduct surveillance to document changes, positive or negative, which occur in disease epidemiology. This entails continuing surveillance pre- and post-vaccine introduction, assessing resistance, changes in invasive PI (IPI), serotypes, and any replacement.
  3,500 288 -
REVIEW ARTICLE
The importance of detecting delays in the development of visual functioning and signs of disorders of the eyes during the 1 st year of life: An African perspective
Adedayo Omobolanle Adio, Olubunmi Temitope Bodunde, Lea Hyvärinen
October-December 2015, 2(4):149-153
DOI:10.4103/2384-5147.172432  
Normal visual functioning is related to cognitive, motor, and emotional development since typical children learn to use visual communication, to move, to talk, and to develop many activities they observe others using. Early detection of atypical visual functioning, particularly in the 1 st year of life can help avoid potentially life-threatening conditions and delays in development which may follow. This article discusses five visual developmental milestones during the 1 st year of life in a typical healthy infant. It also advocates using these milestones in a multidisciplinary approach to early intervention, which includes training of pediatricians and other stakeholders in contact with infants at every level. In addition to this, the development of a cadre of ophthalmic counselors to improve compliance and follow-up may be a cost-effective strategy for pediatric vision care in the developing countries today.
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ORIGINAL ARTICLES
Lipid profile of HIV/AIDS patients attending antiretroviral clinic in Zaria, North-Western Nigeria
Rasheed Yusuf, Aliyu Ibrahim Sambo, Muktar Haruna Mohammed, Hassan Abdulaziz
January-March 2014, 1(1):31-35
Introduction: Nigeria, the tenth most populous country in the world and the most populous country in sub-Saharan Africa, has the second highest population of people living with HIV, after South Africa. A variety of endocrinologic, metabolic and nutritional disturbances are common during the course of HIV infection. Most HIV/AIDS patients develop multiple metabolic abnormalities including insulin resistance, lipodystrophy and dyslipidemia leading to increased risk of cardiovascular disease (CVD). Objective: To assess the lipid profile of HIV/AIDS patients attending antiretroviral (ARV) clinic in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. Materials and Methods: Fifty HIV-seropositive patients on ARV therapy, 50 ARV-naοve HIV patients and also 50 HIV-negative controls were assessed for lipid profile status and CD4 count. BMI of all participants was calculated. Data obtained were analysed using SPSS 15.0. A P- value ≤ 0.05 was considered as statistically significant. Results: The mean values of lipid profile showed a significantly higher total cholesterol (P < 0.01) and HDL-cholesterol (P < 0.001) in HIV-positive patients on ARV therapy compared with ARV-naïve patients and controls. There was a positive significant correlation between CD4 count and total cholesterol as well as between CD4 count and LDL-cholesterol in patients on ARV therapy. A negative significant correlation was found between CD4 count and triglyceride in ARV-naïve patients. Atherogenic index was significantly lower (P < 0.01) in HIV-positive patients on ARV therapy. Conclusion: HIV infection leads to dyslipidemia which is probably worsened by ARV therapy; however, these dyslipidemia did not constitute CVD risk.
  3,343 323 -
Hepatoprotective effect of methanolic leaf extract of Anacardium occidentale (cashew) on carbon-tetrachloride-induced liver toxicity in wistar rats
Daniel Ikyembe, Coston Pwavodi, Abel Nosereme Agbon
July-September 2014, 1(3):124-131
DOI:10.4103/2384-5147.138938  
Context: Anacardium occidentale (cashew) leaf is used medicinally to treat various kinds of diseases such as diabetes, fever, bronchitis, and cetera, in different parts of the world, including Nigeria. Liver diseases are a worldwide problem. Medicinal plants are being increasingly utilized to treat a wide variety of diseases, liver disorder inclusive. Aim: This study investigated the hepatoprotective activity of pre-treatment with methanolic leaf extract of A. occidentale (MLAO) against carbon-tetrachloride (CCl 4 )-induced hepatotoxicity in Wistar rats. Materials and Methods: A total of 20 Wistar rats were divided into five groups I-V of four rats each. Group I was the control, while groups II-V were treatment groups. Groups V and IV were administered MLAO (500 mg/kg and 1000 mg/kg, oral, respectively); III administered silymarin (100 mg/kg, oral) as the reference drug and group II administered CCl 4 only. Treatment lasted a week. Twelve hours after the last treatment, hepatotoxicity was induced in the treatment group animals by administering a single dose of CCl 4 (1 ml; 1:1 solution:oil, oral). Hepatoprotective effect was studied by histological and serum marker enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and alkaline phosphatase [ALP]) analysis. MLAO showed significant (P < 0.05) hepatoprotective effect by lowering the levels serum liver enzymes: AST, ALT, and ALP, which were in turn confirmed by histopathological examinations of liver sections and are comparable with the reference drug. Statistical Analysis Used: One-way analysis of variance. Results: Histological and biochemical examinations of the liver showed CCl 4 -induced hepatotoxicity. Pretreatment with MLAO, especially at dose 500 mg/kg, revealed hepatoprotective effect against chemically induced acute liver toxicity by preserving the histoarchitecture of the liver and significantly (P < 0.05) reducing of the serum marker enzymes. Conclusion: MLAO possesses significant hepatoprotective activity.
  3,395 270 1
Uptake of family planning services among women of reproductive age in Edo North senatorial District, Edo State, Nigeria
Innocent Osi Alenoghena, Essy Clementina Isah, Alphonsus Rukewe Isara, Soter Sunday Ameh, Vincent Yakubu Adam
October-December 2015, 2(4):154-159
DOI:10.4103/2384-5147.172433  
Introduction: Inadequate provision of family planning and contraceptive services contributes immensely to the worldwide burden of maternal and child morbidity and mortality. Objectives: To assess the uptake of family planning services and its determinants among women of reproductive age group in Edo North Senatorial District, Edo State. Methodology: A descriptive cross-sectional study was carried out. Respondents were selected using multi-stage sampling technique. Questionnaires and observational checklists were used for data collection. Data were analyzed using SPSS version 17. Results: A total of 340 respondents and 15 primary health care facilities were assessed in this study. Sixty percent of the respondents had at least secondary education. The choices of contraceptives were as oral contraceptive pills (OCP) (77.0%), condoms (75.8%), and injectables (56.2%). The predictors of uptake of contraceptives were as marital status (odds ratio [OR] =0.283, 95% confidence interval [CI]: 0.108, 0.746), monthly income (OR = 0.628, 95% CI: 0.491, 0.802), and respondents residence (OR = 0.504, 95% CI: 0.296, 0.859). Conclusion: Uptake of family planning services was higher than both the national and Edo State average values. The determinants of uptake of these services were, marital status, monthly income, and respondents' residence. The state and local government should increase the availability of family planning services in all the communities and create awareness among the single and unmarried women for improved uptake.
  2,370 976 -
Impact of PowerPoint Presentation on the Academic Performance of Medical Students of Ahmadu Bello University Zaria
Abdul-Aziz Hassan, Isa A Usman, Sani Awwalu, Livingstone G Dogara, Lucky Okpetu, Garba Yahaya, Ismaila N Ibrahim
April-June 2014, 1(2):91-94
DOI:10.4103/2384-5147.136820  
Context: Teaching of medical students in Ahmadu Bello University (ABU) has been by conventional lecture methods. However, in other parts of the world, there has been a shift toward the use of PowerPoint and other computer-aided instructions (CAI). The conventional lecture method is said to encourage rote learning, whereas CAI is considered to improve students' performance as information is presented in the form of "reality." This study was conducted to determine the effect of PowerPoint presentation of lectures on the academic performance of students at ABU Zaria. Aims: The aim of this study is to determine the effect of PowerPoint presentation of lectures on the academic performance of 400 level medical students of ABU Zaria. Materials and Methods: It was a quasi-experimental technique, divided students into control (67) and experimental (67) groups. Pre- and post-test were conducted on the complications of blood transfusion. The experimental group was taught with PowerPoint using pictures, diagrams and algorithms, while the control group was taught with white board and marker. The mean pre- and post-test scores were compared using the t-test of significance (P < 0.05). Statistical Analysis Used: Student's t-test. Results: The mean pre- and post-test scores of the control (conventional) and experimental (CAI) groups were 54.3 versus 53.6 (P > 0.05) and 74.0 versus 80.5 (P < 0.05), respectively. Conclusion: PowerPoint presentation significantly improves the academic performance of medical students more than conventional lecture method. It is recommended that medical tutors should be encouraged to use PowerPoint in delivering lectures to students.
  2,984 224 1
Preliminary histological and histochemical studies on the neuroprotective effect of aqueous fruit extract of phoenix dactylifera L. (Date Palm) on atesunate - induced cerebellar damage in wistar rats
Abel Nosereme Agbon, Sechivir Damilola Ingbian, Ahmadu Usman Dahiru
October-December 2014, 1(4):204-209
DOI:10.4103/2384-5147.144744  
Context: The cerebellum is vulnerable to damage from a variety of sources such as degenerative diseases, infectious processes and toxins, like antimalarial drugs. Various parts of Phoenix dactylifera (date palm) are used in traditional medicine to treat various disorders such as memory disturbances, loss of consciousness, nervous disorders, etc., in different parts of the world. Aim: The neuroprotective effect of aqueous fruit extract of P. dactylifera (AFPD) was assessed against artesunate (AS) (antimalarial drug) - induced cerebellar damage in Wistar rats. Materials and Methods: Twenty Wistar rats (male and female) were divided into five groups (A-E) of four rats each. Group A was the control whereas Groups B-E were treatment groups. Cerebellar toxicity was experimentally induced in Wistar rats by administering AS. Group B was administered AS (300 mg/kg, oral). Groups C, D, and E were administered AFPD (500 mg/kg, 1000 mg/kg and 1500 mg/kg, oral, respectively) followed by AS (300 mg/kg, oral) for a period of 7 days. Neuroprotective activity was studied by histopathological examination of brain sections applying routine (Haematoxylin and Eosin) and histochemical (Cresly Fast Violet) staining techniques. Statistical Analysis Used: One-way analysis of variance. Results: Histopathological examination of brain sections revealed neuronal degeneration of cerebellar cells, such as, vacuolations and degeneration of Purkinje cells, and alteration in the general histoarchitecture of cerebellum was observed in AS-intoxicated group. The administration of AFPD remarkably inhibited AS-induced neuronal damage in Wistar rats with maximum neuroprotective effect at 500 mg/kg and 1500 mg/kg doses when compared with tissue sections of AS-intoxicated group. Conclusion: Result suggests that the effectiveness of AFPD in neuroprotection is probably due to its constituent antioxidant properties.
  2,745 313 3
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