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ORIGINAL ARTICLES
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.
  15 14,207 1,465
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.
  12 203,443 8,348
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.
  7 29,088 1,984
ORIGINAL ARTICLES
Diagnosis of malaria: A comparison between microscopy and rapid diagnostic test among under-five children at Gusau, Nigeria
Bilkisu Ilah Garba, Aminu Sakajiki Muhammad, Abdullahi Musa, Bassey Edem, Ibrahim Yusuf, Nura Kaura Bello, Akeem Oladiran Adeniji, Taofik Kolawole
April-June 2016, 3(2):96-101
DOI:10.4103/2384-5147.184371  
Background: Malaria remains a disease of public health concern in tropical countries. Diagnosis in such countries largely depends on clinical assessment, microscopy (as the gold standard) and recently by rapid diagnostic tests (RDTs). This study was conducted to document common presenting symptoms of malaria, compare microscopy and RDT in the diagnosis of malaria in children in Gusau, Nigeria. Materials and Methods: A cross-sectional, study of children under-five years with presumptive diagnosis of malaria that was managed at the pediatric outpatient department and emergency pediatric unit of Yariman Bakura Specialist Hospital, Gusau. All consecutive children that met the inclusion criteria were recruited over a 4 weeks period. Malaria thick film microscopy and RDTs were carried out on all children. Results: Of the 118 children enrolled, 61 (51.69%) were males while 57 (48.31%) were females. Fever and vomiting were the most common presenting complaints. Microscopy was positive in 55 (46.61%) while RDT was positive in 10 (8.47%) of the children. Only 5 (4.24%) were positive for both microscopy and RDT. Fifty-eight (49.15%) children had negative microscopy and RDT results. There was no significance when positivity of both tests were compared (χ2 = 0.050, P = 0.822). RDT had a sensitivity of 9.09%, a specificity of 92.06%, positive predictive value of 50.00%, and a negative predictive value of 53.70%. Conclusion: Our study observed higher positivity rate for microscopy than RDT. We recommend microscopy to be carried out on all patients suspected of having malaria where possible, even in the presence of negative RDT.
  6 9,986 752
Knowledge of contraception and contraceptive choices among human immunodeficiency virus-positive women attending antiretroviral clinics in Zaria, Nigeria
Adamu U Shehu, Istifanus Anekoson Joshua, Zuwaira Umar
April-June 2016, 3(2):84-90
DOI:10.4103/2384-5147.184355  
Introduction: Once human immunodeficiency virus (HIV)-positive women become aware of their status, many demonstrate a reduced desire for pregnancy, particularly because most of them know that there are risks involved in delivering an HIV-positive child. Others, on the other hand, want to have children despite their HIV-positive status. These women have reproductive needs that should be respected and attended to. This study assessed the knowledge of contraception and contraceptive choices among HIV-positive women of reproductive age (15-49 years) attending antiretroviral clinics in Zaria. Materials and Methods: A cross-sectional descriptive study was carried out on 340 HIV-seropositive women of reproductive age group in January 2015 using a simple random sampling technique. Data were collected via structured interviewer administered questionnaire. Data collected were analyzed using SPSS version 21.0 and results were presented in tables and charts. Statistical significance was at P = 0.005. Results: The modal age group of the respondents was 20-29 years (44.7%) with mean age of 24.5 ± 8.4 years, 45% were Hausa, 59.4% Muslim, and 57.4% married. The majority (32%) had secondary education and of different occupation. About 87% had knowledge of HIV transmission from infected mother to child and 73.8% had heard of contraception. Prevalence of past contraceptive usage among these women was 56.1%, of which male condom was the most commonly used contraceptive (60.4%), either alone or dual contraception. This was followed by injectables (52%) and oral pills (35%). However, the current contraceptive use among the respondents was 36.3%. There was statistical relationship between age and educational level of the respondents and contraceptive use. Conclusion: The study has demonstrated that majority of these HIV-positive women had good knowledge about contraception but they do not apply this knowledge they have toward using an appropriate family planning method. Hence, there is a need for proper counseling and education of these women and their spouses by the health workers as they attend the antiretroviral clinic to erase fear and misconceptions of modern contraception. Male involvement will also go a long way in promoting contraceptive utilization.
  5 4,830 403
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.
  5 13,051 554
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.
  4 4,832 499
Histopathological review of breast tumors in Kano, Northern Nigeria
Imam Mohammed Ibrahim, Yawale Iliyasu, Aminu Zakari Mohammed
January-March 2015, 2(1):47-51
DOI:10.4103/2384-5147.150471  
Context: Breast tumors are common worldwide, and various reports suggest an increasing incidence in Nigeria, which necessitates an urgent need to differentiate benign from malignant tumors. Aims: To classify, grade and to determine the changing pattern, frequency, age and sex distribution of breast tumors seen in a tertiary hospital. Materials and Methods: This was a 10-year retrospective study of all breast tumors diagnosed at the Pathology Department of a Teaching Hospital from 1 January 2001 to 31 December 2010. Results: A total of 1,566 breast tumors were diagnosed during the study period, of which 1035 (66.1%) were benign, and 531 (33.9%) were malignant. Fibroadenoma was the commonest benign breast tumor followed by fibrocystic change, and they accounted for 47.1% and 25.4% of benign breast tumors respectively. Out of the 531 malignant cases reviewed; 496 (93.4%) were females, and 35 (6.6%) were males with a female to male:ratio of 14.2:1.0. The age range of malignant cases was between 21 and 79 years with a mean age of 42.0 years. Invasive ductal carcinoma was the predominant histological type with 316 cases (59.5%). This was followed by medullary carcinoma with 61 (11.5%) cases, invasive lobular carcinoma and invasive papillary carcinoma each with 37 (6.9%) cases. Three hundred and ninety-eight cases satisfied the criteria for grading, out of which 237 (59.5%) cases were classified in Grade 1, 133 (33.4%) cases in Grade 2 and 28 (7.1%) cases in Grade 2. Conclusions: Breast tumors are quite common which are mostly benign and are seen in both sexes with a striking female preponderance. The findings are generally similar to most previous studies from Nigeria, Africa and western world with minimal variations.
  4 3,874 327
The prevalence of neural tube defects in live born neonates in Kano, North-Western Nigeria
Lofty-John Chukwuemeka Anyanwu, Barnabas Danborno, Wilson Oliver Hamman
July-September 2015, 2(3):105-109
DOI:10.4103/2384-5147.164417  
Background: Neural tube defects (NTDs) are congenital malformations of the cranium, spine, and nervous system. About 350,000 infants are born with NTDs yearly worldwide. This study aimed to determine the prevalence and spectrum of NTDs in live-born neonates in the Kano Metropolis of North-western Nigeria. Materials and Methods: This is a prospective study of all live-born neonates in three selected hospitals in the Kano metropolis between April 2013 and December 2013. A descriptive study design was employed. Neonates delivered at gestational ages 28 weeks or more were examined within 48 h of birth for external congenital anomalies. Detailed family history and clinical data were recorded for each child. Data were analyzed using SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: Of the 1456 neonates recruited into the study, there were 757 (52%) boys and 699 (48%) girls. Of these, 4 neonates (2 boys and 2 girls) had NTDs (male:female ratio = 1:1), giving a birth prevalence of NTDs (2 spina bifida cystic, 1 anencephaly, and 1 encephalocele) of 2.75/1000 live births. The mean gestational age for the neonates with NTDs was 38 weeks (standard deviation [SD] 2.16 weeks) while their mean birth weight was 2.93 kg (SD 0.51 kg). Only 5.03% of the mothers in this study began the use of folic acid-containing multivitamin supplement at least 1-month before or in the 1 st month of the index pregnancy. Conclusion: Given the high prevalence of NTDs in this study, public health measures aimed at the prevention of this anomaly should be encouraged.
  4 4,308 347
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.
  3 10,956 568
Hypospadias: 10 year review of outcome of treatment in pediatric urological practice
Ahmad Bello, Maitama Yusuf Hussaini, Mustapha Muhammed Kura, Ahmed Muhammed, Lawal Ahmad Tijjani
January-March 2015, 2(1):28-32
DOI:10.4103/2384-5147.151571  
Introduction: Hypospadias and its surgical correction is a challenging urologic discipline. Various surgical procedures for correction of this anomaly have evolved, in order to reduce complication rate and improve cosmetic outcome. The aim of this study is to review the complication rate and cosmetic outcome in patients who had hypospadias surgery at Ahmadu Bello University Teaching Hospital, Zaria. Patients and Methods: The case records and clinical appearance of 54 patients with hypospadias who had surgery between June1998 and June 2008 were reviewed. The effect of different variables on the overall complication rates were evaluated, including: the degree of chordee; the urethral meatal site after correction of any penile curvature; the age of the patient at surgery; the source of the neourethra; and tubularization of the flap. Result: The mean age of the patients was 1.97 (0.5-12) years. Most patients had their repair at 2 years of age. Twenty-six had distal hypospadias while twenty-eight were mid penile or proximal hypospadias. Distal hypospadias have a better outcome than proximal hypospadias. Onlay flaps have lower stricture and fistula compared with tubularized flaps. Repairs are done recently at earlier age with equal or better outcome. Conclusion: Skin flap procedures have had sufficiently extensive use to support the feasibility of a one-stage repair of different types of hypospadias. Snodgrass is gaining popularity in recent times, and more procedures are likely to evolve in order to improve cosmetic outcome.
  3 4,787 351
Hepatoprotective Effects of Aqueous Extract of Watermelon (Citrullus lanatus) Seeds on Ethanol-Induced Oxidative Damage in Wister Rats
Sebastine Anthony Bazabang, Nwankwo Monday, Sunday Samuel Adebisi, Wusa Makena, Ibrahim Abdullahi Iliya
October-December 2018, 5(4):129-137
DOI:10.4103/ssajm.ssajm_18_18  
Background: Watermelon (Citrullus lanatus) is a roundish or ovoid fruit rich in antioxidant supplements that prevent oxidative stress in hepatic tissues due to generation of reactive oxygen species following exposure to alcohol. The present study aimed to investigate the protective effects of watermelon seed on ethanol-induced oxidative damage in liver of Wister rats. Methods: Twenty-five adult Wister rats of both sexes were randomly divided into five groups of five rats each. Rats in group I were administered distilled water for 8 days. Group II were administered distilled water for 7 days followed by 20 mL/kg body weight of 40% ethanol per body weight on day 8. Groups III and IV were administered 200 and 400 mg/kg, respectively, of the extract for 7 days followed by 20 mL/kg of 40% ethanol on day 8. Group V received 100 mg/kg body weight of silymarin for 7 days followed by 20 mg/kg of 40% ethanol on day 8. Animals were sacrificed on day 8. Liver was excised and then processed for histopathological examination. Biochemical assay for the following hepatic marker enzymes was carried out: alanine amino-transferase (ALT), aspartate amino-transferase (AST), alkaline phosphates (ALP), and protein concentration. Results: The results showed that watermelon treatment leads to increase in body weight. Furthermore, pretreatment with watermelon seed extract lead to significant decrease (P < 0.05) in plasma AST, ALT, ALP, and protein concentration, compared to ethanol treatment group. Conclusion: Watermelon seed extract demonstrates hepatoprotective effect in ethanol-induced oxidation in the liver of Wister rats, which might be linked to various antioxidant phytochemical content present in the extract.
  3 1,874 179
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.
  2 28,624 1,008
Monolateral frame external fixators in the definitive management of open limb fractures in North-western Nigeria
Yau Zakari Lawal, Friday S Ejagwulu, Sunny O Salami, Salihu Mohammed
July-September 2016, 3(3):137-141
DOI:10.4103/2384-5147.190847  
Background: The use of external fixators became popular in the last ten years in our environment with the availability and expertise to apply them being popularised by the AO foundation. They have virtually supplanted the application of casts which had high levels of complications and unpredictable outcomes in patients with open fractures. This manuscript describes its use in trauma in our environment. Aims: The aim of this study is to demonstrate that monolateral frame external fixators are a means of definitively treating open limb fractures. Materials and Methods: For a period of nine years (2006-2014), we prospectively studied the use of monoframe external fixation in one hundred and six limbs in three hospitals in the northwest of Nigeria. Gustillo II and III A, B and C patients were included in the study. External fixators from different manufacturers were used. The adherence to the principles of application, duration of application, pin track infection, union and non-union rates were observed for both groups. Results: One hundred and six limbs in were studied. Ninety four males and eleven females in the study group with five of the males being children of less than twelve years. Ninety seven cases had open tibial fractures (one lady had bilateral open tibial fractures) and four cases involved the femur. Union rate of 60% was observed. Pin tack infection rate of 80%, average duration of stay of the patient was three month; fracture union rate of 60% and reoperation rate of 2%were observed. Conclusion: Monolateral external fixators can be used successfully in the management of open diaphyseal fractures of long bones with reasonably high success rates and few complications.
  2 3,382 262
Evaluation of lipid profile in cord blood of full-term Nigerian newborn infants
Lawal W Umar, Ibrahim S Aliyu, Shehu A Akuyam
January-March 2017, 4(1):9-14
DOI:10.4103/ssajm.ssajm_44_16  
Background: Blood lipid profiles are known to be under the influence of genetic and environmental factors, with considerable age variation. While lipid levels are generally lower in childhood and may predict future risk for atherosclerosis, normal ranges in cord blood have not been fully evaluated in developing countries. Objective: To evaluate the cord blood lipid profiles for full-term newborn infants. Materials and Methods: A descriptive cross-sectional study was performed at Ahmadu Bello University Teaching Hospital, Zaria, involving 71 term newborn infants. At delivery, cord blood was collected and serum separated by centrifugation. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured using Selectra XL AutoAnalyser (HUMAN Gesellschaft für Biochemica und Diagnostica mbH, Wiesbaden, Germany), while the atherogenic index of plasma (AIP) was calculated from the lipid fractions. Using a standardised pro forma, obstetric and demographic data, and cord blood lipid levels were collected. Data were analysed using the Statistical Package for Social Sciences version 20.0 software (SPSS Inc., Chicago, Illinois, USA), and results were presented in tables and charts. A P value of <0.05 was considered as significant. Results: There were 38 males and 33 females. The mean TC, TG, HDL-C and LDL-C were 1.87 ± 0.10, 0.57 ± 0.05, 0.70 ± 0.04 and 1.02 ± 0.07 mmol/L, respectively. The mean TG concentration is lower while the LDL-C is higher than the standard reference values. The AIP was −0.09. Neither gender nor anthropometric differences were observed. Conclusion: This study has defined the cord blood lipid profile and reference ranges for full-term newborn infants, with no sex or anthropometric differences. Further studies are recommended to determine values for pre- and post-term infants.
  2 2,460 207
Knowledge regarding co-trimoxazole preventive therapy among patients who are HIV positive in a tertiary health facility, northeastern Nigeria
Ballah Akawu Denue
April-June 2017, 4(2):31-36
DOI:10.4103/ssajm.ssajm_22_16  
Background: Co-trimoxazole (sulfamethoxazole and trimethoprim, CTX) is known to be effective against common opportunistic infections associated with severe immunosuppression such as AIDS. Its use among patients with defects in immunity and multiple infections is associated with significant reduction in morbidity and mortality. Objective: To determine and predict the level of knowledge regarding co-trimoxazole preventive therapy (CPT) among patients with HIV. Materials and Methods: This was a descriptive cross-sectional study conducted among 358 patients who were HIV positive. An expert-validated, interviewer-administered questionnaire with Cronbach alpha of 0.67 was used to assess patients’ knowledge regarding CPT. Results: Most respondents, 323 (90.2%) in total, reported not to have ever been counseled on CPT. The proportion of those counseled showed female preponderance, with 26 females (74.3%) compared with nine males (25.7%). Among those who responded to ever been counseled, only 19% had questionnaire-defined (≥50% score) adequate knowledge. The level of education and counseling regarding CPT were independent predictors of knowledge. Patients with secondary and tertiary education were three times [P = 0.021, odds ratio (OR) = 3.098, 95% confidence interval (CI) = 1.187–8.084] and 18.7 times (P < 0.001, OR = 18.764, CI = 6.862–51.313) likely to demonstrate having adequate knowledge than those without formal education. Similarly, adherence counseling was associated with 16 times greater chance for demonstrating adequate knowledge (P < 0.001, OR = 16.063, CI = 5.768–44.733). Conclusion: Knowledge on the use of CPT is poor in our setting; adherence counseling on its use is recommended at services delivery points.
  2 3,352 261
Prevalence and risk factors for hepatotoxicity among patients with HIV/AIDS on highly active antiretroviral therapy in North-Western Nigeria
Muhammad Hamza, Sama'ila Alhaji Adamu, Yakasai Ahmad Maifada, Babashani Musa, A'isha Muhammad Nalado, Muhammad Sani Mijinyawa, Borodo Musa Muhammad, Habib Abdulrazaq Garba
October-December 2014, 1(4):175-184
DOI:10.4103/2384-5147.144727  
Introduction: Highly active antiretroviral therapy (HAART) has become more accessible to human immunodeficiency virus (HIV)/AIDS patients in resource-poor countries, especially sub-Saharan Africa. However, its use is often complicated by the occurrence of drug-related toxicities and interactions limiting this benefit in a substantial proportion of individuals. Hepatotoxicity being one of the adverse effects of HAART has led to the interruption of therapy from sub-clinical and clinical hepatitis and sometimes led to death. This study, therefore, sets out to determine the prevalence and risk factors for hepatotoxicity among HIV/AIDS patients on HAART in our environment. Materials and Methods: This was a cross-sectional comparative study carried out at Aminu Kano Teaching Hospital, Kano, North-Western Nigeria. HIV positive patients aged 18 years and above who consented to take part in the study were recruited. The study subjects were made up of patients on HAART for at least 6 months who were compared with age-and sex-matched HAART naοve subjects. Data were collected using a pretested interviewer administered questionnaire. Sociodemographic information, clinical characteristics, possible risk factors, CD4 cell count, HAART regimen, etc., were extracted from the case notes of the subjects. Venous blood samples were collected for necessary investigations and analyzed at the hospital central laboratory. Results: Four hundred and forty subjects consisting of 220 HAART-experienced (group 1) as cases; while the other 220 (group 2) HAART-naοve served as controls. The prevalence of hepatotoxicity for the HAART-experienced group was 36.4%, with severe hepatotoxicity occurring in 3.2%. There was no statistically significant difference in the prevalence of hepatotoxicity between in the two groups (P = 0.738). Over 90% of liver enzyme elevations were asymptomatic. Independent risk factors for hepatotoxicity were concurrent use of antituberculosis drugs and HAART and low CD4 count. Conclusion: There is a need for pre-emptive regular monitoring of liver function tests in patients on HAART since cases of hepatotoxicity found in this study were predominantly asymptomatic. Careful selection of less hepatotoxic HAART regimens in patients with identifiable risk factors is an important strategy in preventing the hepatotoxicity.
  2 5,201 445
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.
  2 9,309 675
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.
  2 5,909 464
Glycemic control and radiographic manifestations of pulmonary tuberculosis in patients with type 2 diabetes mellitus
Sindhuri Avuthu, Vinay Mahishale, Bhagyashri Patil, Ajith Eti
January-March 2015, 2(1):5-9
DOI:10.4103/2384-5147.151564  
Background: Diabetes mellitus (DM) is a risk factor for tuberculosis (TB) and may modify its presenting features. Atypical radiologic images of pulmonary TB are common in DM. Many studies have compared the radiological manifestations of TB between patients with and without DM. Aim of the Study: To study the impact of poor glycemic control on radiographic manifestations of the newly diagnosed smear-positive pulmonary TB patients with type 2 DM. Materials and Methods: In a tertiary care hospital, 70 patients newly diagnosed with smear-positive pulmonary TB and with coexisting type 2 DM were enrolled. Glycemic control was assessed by glycosylated hemoglobin (HbA1 C ). A pretreatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader. Radiological lesions on chest radiograph were classified into minimal, moderately advanced and far advanced as per American Thoracic Society criteria. Results: Of 70 patients, 47 (67.1%) had their HbA1c level ΃7%. Patients with poor glycemic control (HbA1c ΃7%) were more likely to have lower lung field involvement (29.8% vs. 13.04%; P < 0.01), far advanced lesions (40% vs. 4%; P < 0.001) and cavitary disease on chest radiograph (76.6% vs. 43.4% P < 0.05). Conclusion: Poor glycemic control significantly influences radiographic manifestations of pulmonary TB in patients with DM. Uncontrolled diabetics seem to have multiple and large cavities. Also isolated lower lung field involvement is more common in uncontrolled diabetics than in optimal control patients. High index of suspicion is, therefore, required in uncontrolled diabetics when radiological patterns are atypical.
  2 3,435 436
Evaluation of pattern of tubo-peritoneal abnormalities potentially responsible for infertility in Zaria, Nigeria: hysterosalpingographic assessment
Reuben Omokafe Lawan, Philip Oluleke Ibinaiye, Polite Onwuhafua, Ahmed Hamidu
July-September 2015, 2(3):110-116
DOI:10.4103/2384-5147.164418  
Background: Structural abnormalities on hysterosalpingography (HSG) are among the important factors in the evaluation of female infertility. Aim and Objective: This study is mainly concerned with the pattern of tubal and peritoneal abnormalities and their effects on fertility outcome. Materials and Methods: A prospective study of 220 consecutive patients who underwent HSG between December, 2011 and May, 2013, at Department of Radiology, Ahmadu Bello University Teaching Hospital, Zaria. Clinical notes and radiological findings were analyzed for demographic data, tubal and peritoneal pathologies. Fertility outcome in patients with abnormal findings was compared with those with normal findings. Results: A total of 121 (55.0%) patients had normal tubes on HSG. Tube abnormalities were found in 99 (45.0%) patients; 37 (37%) patients with primary and 62 (63%) patients with secondary infertility. Totally, 203 (92.3%) patients had normal peritonea contrast medium spillage on HSG. Peritoneal cavity abnormality (pelvic adhesion) affected 17 (7.7%) patients; 8 (47%) patients with primary and 9 (53%) patients with secondary infertility. The fertility outcome showed that after 1-year of follow-up, 3 (2.6%) of the 116 patients with abnormal findings (tubal and peritoneal abnormalities) got pregnant, while 25 (34.7%) of the 72 patients with normal findings (tubal, peritoneum, cervical canal and endometrial cavity) got pregnant. The difference noted was statistically significant (P = 0.0000). Conclusion: Fertility outcome in patients with tubo-peritoneal abnormalities at HSG was low.
  2 7,148 315
Presbyopic correction coverage and barriers to the use of near vision spectacles in rural Abuja, Nigeria
Rilwan Chiroma Muhammad, Mustapha Abubakar Jamda
January-March 2016, 3(1):20-24
DOI:10.4103/2384-5147.176301  
Purpose: To determine the presbyopia correction coverage and the barriers to the use of near vision spectacles in rural Gwagwalada, Nigeria. Materials and Methods: Eligible subjects were refracted, with their distance correction in place, near vision was tested and corrected using World Health Organization guidelines. A pretested near vision-related questionnaire was administered to collect information on spectacle use, barriers to the use of near vision spectacles and willingness to pay for replacement spectacles. Presbyopic correction coverage, met, and unmet presbyopic spectacle needs were calculated. Results: The presbyopic correction coverage for the sample was 21%, the met need was 11.2%, and the "unmet presbyopic need" was 42.1%. Presbyopic correction coverage was significantly higher for males, skilled workers, and those with at least secondary education. Barriers to obtaining near vision spectacles included cost (51.3%) and spectacles not being a priority (19.7%). Skilled workers and those with at least secondary education were willing to pay up to one thousand naira ($5) for replacement spectacles. Conclusion: Presbyopic correction coverage is low with a large unmet need. A community-based approach to the provision of spectacles that are new, of good quality, accessible, and affordable is needed.
  2 2,991 238
Tropical diabetic hand syndrome among diabetic patients attending endocrine clinic of Ahmadu Bello University Teaching Hospital, Shika Zaria, North Central Nigeria
Innocent Onoja Okpe, Kenneth Ezenwa Amaefule, Ismail Lawal Dahiru, Yaqub Lawal, Ademola Odunayo Adeleye, Beatrice Bello-Ovosi
April-June 2016, 3(2):106-110
DOI:10.4103/2384-5147.184378  
Background: Tropical diabetic hand syndrome (TDHS) is a known complication affecting patients with diabetes mellitus in the tropics. However, there has been no previous report on the condition from the Northern Nigeria. This study assessed the prevalence of the syndrome among diabetic patients attending the endocrine clinic of Ahmadu Bello University Teaching Hospital (ABUTH), North Central Nigeria. Materials and Methods: A retrospective cohort study was employed for the study from January 2010 to May 2013. All patients with incomplete treatment records were excluded from the study. Data analysis was done with Statistical Packages for Social Sciences (SPSS) version 20.0 and presented as tables and charts. Results: Of the total 894 cases reviewed, the prevalence of diseases condition was 12 (1.3%), with female to male ratio of 2:1. Majority (75.0%) of the initiating events were minor trauma, followed by spontaneous blisters and subsequent rupture (16.7%) and the least (8.3%) was burns. The mean interval between onset of disease and presentation in the hospital was 22.9 days. Staphylococcus aureus was the main microbial isolates (75.0%) and majority (88.9%) were sensitive to ciprofloxacin. Mortality rate among the patients was 25.0% while amputation and healing with fixed flexion deformity of digits accounted for 33.3% and 58.3%, respectively. Conclusion: TDHS is a significant complication among diabetic patients in ABUTH, and the most common initiating risk factor was minor trauma. Mortality rate among the patients was also high. Hence, there is a need for intensive education of diabetic patients on the benefits of early diagnosis and treatment and avoidance of trauma.
  2 2,726 182
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.
  2 27,904 811
Epidemiology and Clinical Outcomes of Community Acquired Pneumococcal Infection in North-West Nigeria
Garba Iliyasu, Abdulrazaq G Habib, Aminu B Mohammed, Mohammad M Borodo
April-June 2015, 2(2):79-84
DOI:10.4103/2384-5147.157429  
Introduction: Pneumococcal infection is a leading cause of morbidity and mortality worldwide. There is a paucity of data on pneumococcal infection in Nigeria. We aimed to determine the epidemiology and clinical outcome of pneumococcal infection in a Tertiary Referral Center in Northwestern Nigeria. Materials and Methods: We conducted a prospective, hospital-based study on patients with community acquired pneumococcal infections. All studied subjects had clinical evaluation and relevant laboratory investigations. The outcome was defined as mortality. Analysis was carried out using descriptive statistics with differences and relationships determined using Student's t-test, Chi-squared and Fisher's exact tests as appropriate, with P < 0.05 regarded as significant. Result: Three hundred and two cases of bacteriologically proven community acquired pneumonia (241/302), bacteremia (38/302) and meningitis (23/302) were screened, out of which 125/241 (51.7%), 7/23 (30.4%) and 8/38 (21.1%) were pneumococcal pneumonia, pneumococcal meningitis and pneumococcal bacteremia, respectively. Most of the patients, 87/140 (69.3%) had comorbidity conditions. The overall mortality rate was 12.9%. Chronic heart disease (odds ratio [OR] = 1.143; 95% confidence interval [CI] = 0.032-0.638), human immunodeficiency virus infection (OR = 2.309; 95% CI = 1.258-4.241), age ≥65 years (OR = 6.397; 95% CI = 2.181-18.746), and infection with multi-drug resistant Pneumococcus (OR = 4.089; 95% CI = 1.274-13.125) were identified as independent risk factors for mortality. Conclusion: The Pneumococcus is a common cause of community acquired infections among adults in northwestern Nigeria, with associated high mortality.
  1 5,790 377
* Source: CrossRef
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