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   2015| January-June  | Volume 17 | Issue 1  
    Online since January 7, 2015

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Spontaneous abortions (miscarriages): Analysis of cases at a tertiary center in North Central Nigeria
Abiodun S Adeniran, Adegboyega A Fawole, Ishaq F Abdul, Kikelomo T Adesina
January-June 2015, 17(1):22-26
Background: Spontaneous abortion (miscarriage) is a source of pregnancy loss globally. Its management, especially in low resource countries remains hampered by inadequate facilities for evaluation. Objectives: To assess the clinical presentation, diagnosis, and treatment of cases of spontaneous abortion at a tertiary hospital in Ilorin, Nigeria. Methodology: A descriptive study of all spontaneous abortions (miscarriages) managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between January 1, 2007 and December 31, 2011. The records were retrieved from the medical records department and necessary information retrieved. Results: There were 603 miscarriages with a prevalence of 4.2%; incomplete miscarriage was the most common 254 (42.1%), 356 (59.0%) had no identifiable risk factor; 434 (72%) of the women were <35 years; 361 (59.9%) had first trimester miscarriages, 272 (45.1%) were of low parity (Para 0-1) and 223 (37%) were having a repeat miscarriage. Of the 141 managed for threatened miscarriage, pregnancy was salvaged in 90 (63.8%), 244 (40.5%) had surgical evacuation with 100% success rate while 218 (36.2%) had medical management with 90.8% success rate. The mean duration of admission was shortest with surgical management (2.03 ΁ 1.1 days) and post-abortion infection rate was 11 (2.6%). Histology confirmed product of conception in 98% and molar gestation in 2% of the samples; no mortality was recorded in this study. Conclusion: More than half of women with miscarriages had no identifiable risk factors mainly due to limitation in facilities for evaluation; there is a need to improve facilities for investigating women with spontaneous abortions in developing countries to identify the causes of the losses.
  16,070 1,476 3
How relevant is pre-gastrointestinal endoscopy screening for HBV and HIV infections?
Adegboyega Akere, Jesse A Otegbayo, Samuel O Ola
January-June 2015, 17(1):1-3
Aim: To determine the prevalence of HBV and HIV infections among patients referred for gastrointestinal (GI) endoscopy and evaluate the need for prescreening of patients prior to this procedure. Settings and Design: Retrospective study carried out in a teaching hospital. Methodology: The data of 772 patients referred for GI endoscopy were retrospectively reviewed, but the screening results of only 711 patients were available for review. Statistical Analysis Used: SPSS version 7. Results: The 772 patients, consisted of 420 (54.4%) males and 352 (45.6%) females with a mean age of 50.4 ± 16.5 years (range 10-100). Of the 711 patients with screening results, 574 (80.7%) had UGI endoscopy, while 137 (19.3%) had Colonoscopy. It showed that 82 (11.5%) had HBV and 26 (3.7%) had HIV, while 8 (1.1%) patients had co-infection. Conclusion: The high prevalence of HBV and HIV infections observed calls for high level precaution to prevent transmission of these infections to other patients and health care personnel.
  9,168 535 -
Effect of primary health care workers training on the knowledge and utilization of intermittent preventive therapy for malaria in pregnancy in Zaria, Nigeria
Adegboyega M Oyefabi, Mohammed N Sambo, Kabir Sabitu
January-June 2015, 17(1):4-11
Introduction: Malaria in pregnancy (MIP) is one of the leading causes of maternal deaths and adverse pregnancy outcomes in Nigeria. All pregnant women in the country are at risk of MIP. Since 2001, intermittent preventive therapy (IPTp) using pyrimethamine sulfadoxinewas recommended by the World Health Organization as a strategy for prevention of MIP. Nigeria adopted this policy in 2005. This study was carried out to determine the effects of training primary health care workers on the utilization of IPTp among pregnant women who attend antenatal clinics in Sabon-Gari local government area (LGA) of Kaduna State, Nigeria. Methodology: Using quasi-experimental pre and post study design. Two LGAs were sampled, SabonGari the intervention LGA and Zaria LGA as the control. One hundred and seventy clients each from the 6 Primary Health Care Centers (PHCs) in Sabon-Gari, the study and 5 PHCs in Zaria LGA, the control were selected. Semi-structured, Pre-tested questionnaires and focused group discussion (FGD) guides were used as an instrument of data collection from the clients' pre- and post-intervention. Data were analyzed with SPSS 17 and STATA 12SE. Relationships between variables were tested using χ2 at P < 0.05 level of significance. Results: Majority of the clients aged 20-24 years, were married, Hausa Muslims Intermittent preventive therapy had mainly primary education, and earn < 5000/month. During the baseline assessment at the PHCs in Sabon-Gari LGAs, only 20 (11.8%) of the clients had good knowledge of the IPTp. This however increased significantly to 144 (87.4%) clients post intervention (mks 11.12 ± 1.99 P < 0.001). A significant majority of the clients in Zaria still had poor knowledge of the IPTp post study (mean knowledge score = 3.86 ± 2.50, P < 0.001). The poor practice in Zaria also persisted even after the study period, but with a significant decrease from 160 (94.12%) to 142 clients (83.53%), with the mean practice score in Zaria being 2.62 ± 1.72, P < 0.001). More clients (68%) use IPTp - sulfadoxine pyrimethamine at the study LGA postintervention. Conclusion: This research has demonstrated significant improvement in the knowledge and utilization of the IPTp by the clients in the study LGA when the health care workers were trained compared with where such training was not conducted, in the control LGA.
  8,645 623 3
A survey of commercial drivers' perception on the causes of road traffic accidents in Nigeria
Nwashindi Arthur
January-June 2015, 17(1):12-15
Background: Road traffic accident is a multifactorial phenomenon that affects victims to different degrees depending on the type of accident. The aim of this study was to study commercial driver's attitude and their perceived causes of accidents on Nigerian roads. Methodology: A cross-sectional study of commercial drivers from various motor parks in a Nigerian urban city was carried out using questionnaires. Every volunteer was asked to complete a questionnaire that revealed patient demographics, age, education level, time of accident and perceived cause(s) of the accident. All participants were males and licensed drivers. Results : Drivers in the age range of 38 - 47 years (n = 174; 46.77%) were mostly involved in road traffic accidents. Road accidents were much more prevalent on rural roads than on urban roads. Majority of the drivers (n = 198; 53%) had secondary level of education, while 112 drivers (30%) had primary level of education. One hundred and eight drivers (29.03%) believed the accidents were as a result of the road. 21.24% (79) stated that the time of the day, which could be in the daylight, dusk or at night, could influence road traffic accidents. Conclusions : The drivers perceived that the nature of the road, time and weather are some of the major contributory factors to road accidents. However, it was deduced from the study  that behavioral patterns on the road, violation of traffic rules and driving under the influence of alcohol were the major contributory factors in commercial drivers' involvement in vehicular accidents.
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Socio-demographic determinants of birth registration among mothers in an urban community in southern Nigeria
Alphonsus R Isara, Antony O Atimati
January-June 2015, 17(1):16-21
Background: Birth registration is both a fundamental human right and an essential means of protecting a child's right to identity. Objective: The aim was to assess the awareness, knowledge and practice of birth registration by mothers and the socio-demographic determinants of birth registration in an urban community in southern Nigeria. Methodology: A community-based descriptive cross-sectional study was carried out among mothers in an urban community in Ovia North East local government area of Edo State, Nigeria. A structured interviewer administered questionnaire was used for data collection. Data were analyzed using SPSS version 20. Results: Awareness of birth registration was high (69.6%) with mass media as the major source of information (60.5%), but the composite knowledge of it was poor. Awareness of the agency responsible for birth registration was poor. Only 44.2% of the respondents registered the births of their children, two-thirds of those who registered births possess a birth certificate. Marital status and level of education were significantly associated with the knowledge of birth registration. Age, level of education, marital status, occupation, and place of delivery were the determinants of the practice of birth registration. Conclusion: There is a need for a change of strategy in the campaign for birth registration so that awareness can translate into better knowledge and practice. We advocate the establishment of community-based birth registration centers to improve accessibility and practice of birth registration.
  8,091 905 12
Utilization of appropriate technology in public health in developing countries
Saurabh R Shrivastava, Prateek S Shrivastava, Ramasamy Jegadeesh
January-June 2015, 17(1):47-48
  6,056 404 1
Primary orbital rhabdomyosarcoma in an 11-year-old boy: A management challenge in a resource limited environment
Keziah N Malu, Joseph A Ngbea, Hameed Mohammand
January-June 2015, 17(1):37-41
Rhabdomyosarcoma (RMS) is a very rare cancer, with only about 250-350 cases of children below 21 years of age seen in USA every year. Nigerian hospital studies have shown about 1-4 cases a year. Primary orbital RMS occurs mainly in children, with 90% below the age of 16 and a mean age of 5-7 years. It arises from the orbit and eyelid in up to 10% of all cases. The superonasal part of the orbit is the most favored position, giving rise to proptosis with lateral displacement of the eyeball. Orbital RMS enjoys a relatively good prognosis as a result of improved radiological imaging with computed tomography and magnetic resonance imaging, and adequate chemotherapy or radiation in advanced nations. In developing societies with limited resources, it still carries a poor prognosis. We present a case report of an 11-year-old boy with rapidly progressing tumor, which was confirmed histologically to be orbital RMS. The case report illustrates challenges faced in the management of orbital RMS in a resource limited environment.
  4,982 401 1
Common indications for major cardiothoracic surgeries in Aminu Kano Teaching Hospital, Kano, Nigeria: A 2-year review
Ibrahim Aliyu, Ismail M Inuwa
January-June 2015, 17(1):27-29
Background : Although cardiothoracic surgery has made significant progress in Nigeria, more has to be done in the field of open heart surgery to mitigate the currently experienced need for surgery abroad. This communication highlights the common indications for major cardiothoracic surgeries performed over a 2-year period from November 2011 to October 2013 in Aminu Kano Teaching Hospital, Kano. Highlighted are common cardiothoracic problems often encountered in this region and their outcome. This will therefore form the basis for comparison with what is obtainable in other cardiothoracic centers in the country. Objectives: To determine the common indications for major cardiothoracic surgeries and their outcome over a 2-year period in the Aminu Kano Teaching Hospital, Kano. Methodology: Data were retrieved from the operation theater register of our institution and relevant information such as age, sex, indication for surgery, surgical procedure performed and outcome were extracted. Results : A total of 89 major surgeries were performed during the study period. The subjects comprised of 66 males and 23 females, with a male to female ratio of 3:1. Trauma-related chest injuries constituted the major indication (21.4%), with nine cases being arrow-related chest injury, which was the most common. A single case of pericardectomy was performed. All surgeries were carried out successfully and patients were discharged except for one mortality recorded following intervention of a case of arrow-related chest injury (5.3%). Conclusion : Trauma-related events were the most common indication for major cardiothoracic surgery in our series. Arrow-related injuries were the most common, and these were seen mostly in males.
  4,597 382 1
Cherubism: Case report and review of literature
Akhiwu B Idemudia, Amole I Olushola, Efunkoya Akinwale, Atanda Akinfenwa Taoheed, Lawal H Sikiru, Omeje Kevin
January-June 2015, 17(1):42-45
Cherubism is a rare autosomal dominant genetic defect of bone remodeling which characteristically affects the mandible alone or both the mandible and the maxilla and does not occur in any other bone of the body. Nasal obstruction may occur in patients with cherubism as a result of involvement of the middle concha. Cherubism like any other genetic disease is incurable. Treatment, therefore, is based on the natural and clinical course of the disease.
  4,072 343 -
Gossypiboma: A cause of iatrogenic fecal entero-cutaneous fistula
Olabode P Oluwole, Akinbola Michael F Akinnagbe, Edmund Joseph C Nwana, Idoko Pius Ogolekwu, Monday G Yilkudi
January-June 2015, 17(1):34-36
Gossypiboma or textiloma is used to describe a retained surgical swab in the body after an operation. Inadvertent retention of a foreign body in the abdomen often requires another surgery. Foreign bodies forgotten in the abdomen include towels, artery forceps, pieces of broken instruments or irrigation sets, and rubber tubes. The most common surgically retained foreign body is the laparotomy sponge. Such materials cause foreign body reaction in the surrounding tissue. The complications caused by these foreign bodies are well known, but cases are rarely published because of medico-legal implications. We report a case of 36-year-old teacher who was admitted with 1-week complaints of colicky abdominal pain, postprandial vomiting and entero-cutaneous fistula following caesarean section performed 6 months prior to her referral to our hospital. Clinicians and Pathologists must have a high index of suspicion of this entity and its proper reporting, as the cases are liable to go to court.
  4,087 289 1
Neuroimaging in optic neuropathy: Role of computed tomography
Ehimwenma Ogbeide, Akhigbe O Theophilus
January-June 2015, 17(1):30-33
Background: There are many different conditions that can lead to optic neuropathy. The purpose of this article is to evaluate retrospective data on computed tomographic findings in patients presenting with optic neuropathy at a southern Nigerian teaching hospital. Methodology: A retrospective review of patients with clinical examination finding of optic atrophy who presented for cranial Computed Tomography (CT) scan at the University of Benin Teaching Hospital, Benin City, Nigeria from July 2009 to June 2012 was undertaken. SPSS version 16 software was used for data analysis. Results: The request forms and CT reports of 13 patients which comprised of 7 males and 6 females were reviewed. The mean age of the patients was 37.2 ΁ 13.5 years (age range 16 to 55 years). There was bilateral presentation in 12 (92.3%) of cases while the only unilateral case was left sided. Computed tomography finding of tumor was the most common finding in five cases. In one patient the only finding of note was an atrophic left optic nerve. Conclusion: Computed tomography is a useful tool in the management of patients with optic neuropathy providing information regarding etiology.
  3,903 326 -
Formulating a comprehensive public health strategy for the prevention and control of stomach cancer
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
January-June 2015, 17(1):46-47
  2,811 327 1