Showing papers in "Nigerian Journal of Basic and Clinical Sciences in 2013"
TL;DR: Co-infection with hepatitis B virus is common among HIV-infected patients in this setting and this further reaffirms the need for routine baseline screening for this marker, as it is a major consideration in the initiation and choice of highly active antiretroviral therapy.
Abstract: Introduction: Infections from HIV, Hepatitis B and to some extent Hepatitis C viruses constitute a major public health challenge in sub-Saharan Africa, and there are evidences to suggest that there is faster progression of HIV in those co-infected with either HBV or HCV. The aim of this study was to determine the prevalence of HBV and HCV infections among HIV-infected patients, and describe the socio-demographic features and correlates of HIV and HBV/HCV co-infected patients at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Materials and Methods: This was a cross-sectional study carried out among HIV-positive individuals seen at the adult HIV clinic of AKTH. Four Hundred and forty (440) consecutive HIV-positive adult patients who consented to the study were screened for markers of HBV and HCV using Enzyme-linked Immunosorbent Assay (ELISA) technique. CD 4 Count and serum ALT were also obtained from the recruited patients. Socio-demographic characteristics and Body Mass Index (BMI) were obtained. Differences and relationships between groups were determined using students t-test and Chi-square test where appropriate, and a P < 0.05 was regarded as significant. Results: Prevalence rates of Hepatitis B and C virus infections obtained were 12.3% and 1.6%, respectively. Individuals who were 40 years or younger were the most affected. HBV co-infection was more common among males than females (16.9% vs 9.2%, respectively, P = 0.0153). Mean serum ALT among participants with HIV alone was 31.6 International Units (IU), but was significantly higher (45.3 IU) for those with HIV/HBV co-infection, P = 0.048. Mean CD 4 count for HIV/HBV co-infected participants (259.7 c/mm 3 ) was significantly higher than that for participants with HIV alone (240.0 c/mm 3 ), P = 0.0170 whereas the mean BMI was not significantly different between participants with HIV alone (21.3 kg/m 2 ) versus HIV/HBV co-infected participants (22.2 kg/m 2 ), P = 0.1385. Conclusion: Co-infection with hepatitis B virus is common among HIV-infected patients in our setting and this further reaffirms the need for routine baseline screening for this marker, as it is a major consideration in the initiation and choice of highly active antiretroviral therapy. Furthermore, those found to be negative should be immunized with HBV vaccine to improve the prognosis of their HIV status.
24 citations
TL;DR: A large number of women use sexual stimulants mainly sold by traditional healers in Kano, northern Nigeria, and there is need for setting up more orthodox care for sexual dysfunction.
Abstract: Introduction: Sexual stimulants are preparations used for increasing pleasure during sexual intercourse. The study sought to determine the use and effect of such preparations on women of reproductive age group in Kano, northern Nigeria. Materials and Methods: A self administered questionnaire was used to obtain information from 500 women to determine if they use sexual stimulants and the effects of the drugs on them (if any). Results: There were 423 women that responded. Majority 228 (53.9%) of them use sexual stimulants. Most (47.4%) of them were between the ages of 21 and 30 years, married (85.5%), multiparous (46.9%), and attained tertiary education (58.3%). About 39.9% of the respondents benefited from increased sexual pleasure and satisfaction, 20.2% obtained extra favors from their husbands while 29.9% did not benefit anything from the preparations. About 37.3% developed complications, which included coital laceration (5.9%), copious vaginal discharge (16.5%), vulval itching and rashes (17.5%), lower abdominal pains (14.1%), painful intercourse (16.5%), vaginal dryness (13.0%), and irregular menses (5.9%). Conclusion: A large number of women use sexual stimulants mainly sold by traditional healers. There is need for setting up more orthodox care for sexual dysfunction. There is need for more community health education on female sexual dysfunction.
11 citations
TL;DR: Despite the low level of correlation of NC with other adiposity indices compared to the BMI, the NC may serve as an important tool for the assessment of upper body adiposity.
Abstract: Context: Obesity is one of the most significant contributors to ill health competing with under-nutrition and infectious diseases. Aims: The aims of the study were to determine the presence and level of sexual dimorphism in adiposity indices, correlation of neck circumference (NC) and body mass index (BMI) with other adiposity indices such as waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) and also to encourage the uses of neck circumferences as valuable tool in assessing upper body central adiposity index. Settings and Design: The study population included 71 undergraduate participants (41 Males and 30 Females) with mean age of 22.68 4.23 years. Subjects and Methods: Anthropometric measurements of height, weight, NC, WC and HC were obtained following standard protocols. Statistical Analysis Used: Independent t-test and Pearson's correlation were employed to compare and find the relationship between the variables, using SPSS version 17. Significance level was considered at P ≤ 0.05. Results: The result shows that there was statistically significant (P < 0.05) sexual dimorphism in mean WC, WHR and NC between the sexes. BMI showed strongest correlation with WHtR (r = 0.8, P < 0.001) followed by HC (r = 0.7, P < 0.001), WC (r = 0.7, P < 0.001). On the other hand the NC shows a significant correlation (P < 0.05) with all the variables. Conclusions: Despite the low level of correlation of NC with other adiposity indices compared to the BMI, the NC may serve as an important tool for the assessment of upper body adiposity.
9 citations
TL;DR: Early referral and screening of all babies born with the clinical phenotype of DS should be encouraged due to the high prevalence of CHD, which is the most common CHD among children with DS.
Abstract: Background: The association between Down syndrome (DS) and congenital heart disease (CHD) was first recognised by Garrod in 1894. Several studies have reported about 40-60% prevalence of CHD in DS and a predominance of left to right shunts like atrioventricular septal defects (AVSDs), ventricular septal defect, patent ductus arteriosus and atrial septal defect. Objectives: This study was carried out to find out the prevalence and types of CHD among children with DS. Materials and Methods: This was a retrospective study of the echocardiographic data collected over a 24-month period, between October 2009 and September 2011. The echocardiographic diagnosis of all children with DS referred was reviewed. Results: A total of 35 cases of DS were seen. The age ranged from 0.5-30 months. About 60% of the children with DS were aged 6 months and below. There were 19 males and 8 females giving a M: F ratio of about 2:1. A total of 77.1% of the children with DS had CHD. The most common CHD is AVSD (40%), followed by atrial septal defect (22.25%). A total of 22.25% had normal echocardiographic study. Conclusion: Early referral and screening of all babies born with the clinical phenotype of DS should be encouraged due to the high prevalence of CHD.
9 citations
TL;DR: The non-opioid analgesics specifically paracetamol was the most commonly prescribed by the respondents and the choice of analgesics was influenced by variety of factors.
Abstract: Introduction: Alleviation of pain is considered high priority care and service in dental and medical practice worldwide. The study was conducted to evaluate analgesics prescription among dentists in Nigeria. Materials and Methods: This descriptive cross-sectional study was conducted among dentists attending continuing education courses in Nigeria organized by the Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria and Regional Centre for Oral Health Research and Training Initiatives for Africa. Results: Out of the 150 questionnaires distributed, 138 questionnaires were returned giving a 92.0% response rate. Males constituted 88 (63.8%) while the remaining 50 (36.2%) were females. The most common prescribed analgesic among the respondents was paracetamol 54 (39.1%). Factors that influenced the choice of prescribed analgesics among the respondents in descending order were severity of pain or intended pain, patient medical condition, type of procedure, age of the patient, delayed treatment, economic status, uncertainty of diagnosis and patient request Conclusion: The non-opioid analgesics specifically paracetamol was the most commonly prescribed by the respondents and the choice of analgesics was influenced by variety of factors .
9 citations
TL;DR: Soft tissue sarcomas accounted for 8.8% of malignant tumours seen over the review period and Kaposi sarcoma was the predominant histological subtype commonly affecting young adults in the authors' centre.
Abstract: Background and Objective: Malignant soft tissue tumours account for less than 1% of overall human burden of malignant tumours. Increasing incidences of these tumours have been noted worldwide. This study aims to determine the pattern of soft tissue sarcomas seen in a teaching hospital. Materials and Methods: The study comprised of all cases of soft tissue sarcoma diagnosed over a 10-year review from 1 January 1999-31 December 2008. Results: A total of 264 cases of soft tissue sarcomas were reviewed; 162 males and 102 females with a male to female ratio of 1.6:1. The age range was between 3 months and 89 years with a mean age of 39.0 years. Kaposi sarcoma was the predominant histological type with 56 cases (21.2%). This was followed by rhabdomyosarcoma with 54 (20.5%) cases, dermatofibrosarcoma with 52 (19.7%) cases and liposarcoma with 32 (12.0%) cases. The most common site of affectation was the lower limb with 73 (27.7%) cases, followed by the trunk with 66 (25.0%) cases, head and neck with 45 (17.0%) cases and upper limb with 35 (13.3%) cases. Two hundred and eight cases satisfied the criteria for grading, out of which 34.1% were classified in grade I, 32.2% in grade II and 33.7% in grade III. Conclusion: Soft tissue sarcomas accounted for 8.8% of malignant tumours seen over the review period and Kaposi sarcoma was the predominant histological subtype commonly affecting young adults in our centre.
6 citations
TL;DR: The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans, and A. lumbricoides was the most prevalent parasitic agent recovered in this study.
Abstract: Context: Human intestinal parasites have always been a major health problem in the developing countries. This study was aimed at determining the prevalence of intestinal parasitic infections among artisans and establishes a relationship between the prevalence of intestinal parasitic infections and risk-factors. Materials and Methods: A total of 353 participants which consisted of 272 males and 81 females were recruited for this study with age ranging from 18 to 65 years. Stool specimens were collected from the participants and analysed using the standard technique. The data obtained were analysed using Chi-square (χ2 ) to compare the frequency data while the odd ratio was calculated for potential risk factors. Results: Out of 353 subjects, 118 (33.4%) subjects had intestinal parasitic infections. Age, gender, marital status, occupation, educational status and source of food did not significantly affect (P = 0.219, P = 0.920, P = 0.276, P = 0.087, P = 0.074 and P = 0.442, respectively) the prevalence of intestinal parasitic infections. The use of well/rain water (odds ratio [OR] =2.721; 95% confidence interval [CI] = 1.452, 5.100; P = 0.002) and presence of diarrhoea (OR = 6.169; 95% CI = 3.665, 10.474; P < 0.0001) were significantly associated with intestinal parasitic infections among artisans. Defecating in nearby bushes resulted in a significantly increased prevalence of intestinal parasitic infections among artisans (P < 0.0001). The intestinal parasites recovered were Ascaris lumbricoides, hookworm, Trichuris trichiura and Entamoeba histolytica. A. lumbricoides had the highest prevalence (77.8%). The male gender had the highest prevalence in all the four intestinal parasites recovered in this study. Conclusion: Overall prevalence of 34.4% of intestinal parasitic infections was observed among artisans in Benin City. The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans. A. lumbricoides was the most prevalent parasitic agent recovered in this study.
6 citations
TL;DR: A case of abdominal pregnancy in an unbooked primigravida who presented in the third trimester and was successfully managed is described, with weight loss and jaundice.
Abstract: Abdominal pregnancy is a rare form of ectopic pregnancy. It is associated with an increase in maternal morbidity and mortality, as well as perinatal mortality rate of up to 85%-95%. A case of abdominal pregnancy in an unbooked primigravida who presented in the third trimester and was successfully managed is hereby described. She came with weight loss and jaundice. The fetus was alive and she was managed conservatively till a laparotomy was eventually performed. The outcome was good for mother and baby.
5 citations
TL;DR: There is a great challenge for spread of HIV infection and risk of drug resistance in HIV care and management, and stakeholders at various levels should intensify efforts and support research towards behavioural modification in addressing the existing lacunae in HIV control.
Abstract: Background: Condom use during intercourse is perceived as unnecessary in sexual encounters involving a regular partner. The non-use of condom among HIV-positive people has been found to increase the risk of resistance to anti-retroviral therapy. The objective of this study was to determine the pattern of condom use among HIV sero-concordant couples attending a secondary health facility in North-Central Nigeria. Materials and Methods: This is a cross-sectional survey that was carried out among people living with HIV and AIDS (PLWHA) who have been enrolled into care and treatment at General Hospital Abejukolo in Kogi State, Nigeria. The data instrument used was self-/interviewer-administered questionnaire. The data obtained were analysed using EPI-INFO version 3.4.1 software package. Chi-square test was used and P < 0.05 was considered significant for the study. Results: Assessment of knowledge of the respondents on the correct use of condom showed that two-thirds (60; 65.9%) had good knowledge and 70 (79.6%) of them demonstrated positive attitude towards the use of condom during sexual intercourse. About one-third of the respondents (32; 35.2%) would oblige the spouse sexual intercourse without condom mainly because they are both positive, to fulfil marital obligations and to avoid problems in marital relationship. Less than two-thirds (59.3%) of sero-concordant spouse used condom during sexual intercourse for reasons of preventing re-infection and pregnancy. Conclusion: With one-third of respondents not using condom during sexual intercourse, there is a great challenge for spread of HIV infection and risk of drug resistance in HIV care and management. Therefore, stakeholders at various levels should intensify efforts and support research towards behavioural modification in addressing the existing lacunae in HIV control.
5 citations
TL;DR: JSY is an ambitious scheme serving as a safe motherhood intervention under the National Rural Health Mission, but the discrepancy in payment of funds was found in home deliveries as well as institutional deliveries.
Abstract: Context: Janani Suraksha Yojna (JSY), a conditional cash transfer scheme aims to encourage women to deliver their babies in medical facilities. Aims: To study the utilization of financial assistance under JSY. Settings: Rural areas of Haryana. Study Design: Cross-sectional study. Participants: Mothers who delivered within last 12 months (January to December 2010) and were entitled for benefits under JSY. Subjects and Methods: This cross-sectional study was conducted in two districts of Haryana. One district each was selected randomly from amongst high and low performing districts, depending upon rate of institutional deliveries. A total of 48 sub-centers were selected by multistage random sampling. Out of the 1476 enlisted JSY beneficiaries, 1386 mothers were interviewed by house-to-house visits, after getting informed consent. Data were collected on a pre-designed, pre-tested, semi-structured questionnaire, and analyzed using the SPSS (version 17.0). Results: About 14% ( n = 189) mothers had not received the financial assistance until the time of interview. Only 7.6% mothers got the financial assistance within 1 month after delivery. In nearly half (48.8%) study subjects, financial assistance was delayed beyond 3 months after delivery. More than half (52.7%) got the JSY assistance in cash and 34.8% by check. The incentive was not properly utilized as it was given to the family pool (70.2%) or put in savings account (5%). Only in about one-fifth of mothers, it was used for mother's care (I7.8%) and child care (5.8%). Conclusion: JSY is an ambitious scheme serving as a safe motherhood intervention under the National Rural Health Mission. It has been reasonably successful in promoting institutional deliveries, but the discrepancy in payment of funds was found in home deliveries as well as institutional deliveries. Therefore, the program managers should make the monitoring system for disbursement of funds more effective.
4 citations
TL;DR: A male patient of 56 years, who was diagnosed to have EOS arising from small bowel mesentery, is described, which has a very poor prognosis and a promising therapeutic regimen does not exist.
Abstract: Extraskeletal osteosarcoma (EOS) is a rare malignant soft tissue tumor. It predominantly occurs in the extremities, and is highly aggressive and rarely involves the visceral organs. Only five cases of mesenteric EOS have been reported in English literature. We describe a male patient of 56 years, who was diagnosed to have EOS arising from small bowel mesentery. Literature search and review was made. This patient presented with lower gastrointestinal bleeding. Resection of the tumor with adjacent small bowel was performed. Histopathology was performed and it revealed an osteosarcoma of mesentery. Given the rarity of cases of mesenteric EOS, its biologic behavior at this location remains to be determined. There should be high index of suspicion because of the possible fatal outcome related to the tumor. EOS has a very poor prognosis and a promising therapeutic regimen does not exist.
TL;DR: Low level of maternal education, lack of antenatal care attendance, prolonged rupture of amniotic membranes and low socioeconomic status were significantly associated with isolate positive neonatal conjunctivitis.
Abstract: Background: Neonatal conjunctivitis remains a major cause of preventable childhood blindness in developing countries. There are maternal risk factors, which if identified can assist in its prevention. Objective: This study attempts to determine the maternal risk factors for the development of neonatal conjunctivitis among babies seen in a tertiary health facility in Kano, Nigeria. Materials and Methods: This was a cross-sectional study. Neonates from special care baby unit, postnatal ward, paediatric out-patient unit and labour room who had bilateral or unilateral eye discharge were enrolled in the study. Those neonates whose parents refused consent were excluded from the study. The questionnaire sorted for information including patients' biodata, place and mode of delivery, age at onset of eye discharge, mothers' biodata, antenatal care attendance, educational and socioeconomic status and obstetrics history. Samples were collected and Gram staining was conducted using standard technique. Chlamydial antigens were detected using a rapid immunochromatographic technique (ICT). The data were analysed using EPI INFO version 3.5.1 2002. Proportions were compared using Chi-square test of significance. A probability ( P - value) of less than 0.05 was considered statistically significant. Results: A total of 175 neonates were studied. The mean age was 5.7 ± 4.6 days with a male:female ratio of 1.1:1. Low level of maternal education, lack of antenatal care attendance, prolonged rupture of amniotic membranes and low socioeconomic status were significantly associated with isolate positive neonatal conjunctivitis. Conclusion: Maternal factors including lack of antenatal care attendance and poor socioeconomic conditions are significantly associated with isolate positive neonatal conjunctivitis.
TL;DR: A 27-year-old Hausa/Fulani housewife who developed slowly progressive and unremitting hoarseness and foreign body sensation in the throat is presented who had indirect laryngoscopy at presentation and subsequent examination under anesthesia revealed a soft ovoid pinkish swelling arising from the posterior pharyngeal wall in the hypopharynx.
Abstract: Schwannomas are benign tumors of nerve cells and are particularly quite rare in the hypopharynx. To our knowledge only nine cases have been reported world-wide. We present a 27-year-old Hausa/Fulani housewife who developed slowly progressive and unremitting hoarseness and foreign body sensation in the throat. She had indirect laryngoscopy at presentation with subsequent examination under anesthesia, which revealed a soft ovoid pinkish swelling arising from the posterior pharyngeal wall in the hypopharynx. After a preliminary tracheotomy, the mass was mobilized and delivered trans-orally. She made an uneventful recovery and was discharged home. This uncommon presentation further emphasizes the dilemma of access and approach posed by hypopharyngeal masses.
TL;DR: It was concluded that moderate intensity interval training program is an effective means of lowering myocardial oxygen consumption and an adjunct non-pharmacological management of essential hypertension.
Abstract: Background: Rate-pressure product is a determinant of cardiovascular risk in patient with hypertension and one of the major predictors of myocardial oxygen consumption. Aim: The primary purpose of the present study was to investigate the effect of interval training program on rate-pressure product in subjects with hypertension. Materials and Methods: Two hundred and forty-five male patients of essential hypertension with mild to moderate systolic blood pressure between 140 and 179 mmHg and diastolic blood pressure between 90 and 109 mmHg were age-matched and grouped into interval group ( n = 140) and control group ( n = 105). The interval (work:rest ratio of 1:1) group was involved in an 8-week interval training program of between 45 and 60 min at intensities of 60-79% of the maximum heart rate, while the control group remained sedentary during this period. Blood pressure, maximum volume of oxygen consumed (VO 2 max), and rate-pressure product were assessed. Results: Findings of the study revealed significant effect of exercise training program on rate-pressure product and VO 2 max. The correlation of rate-pressure product with systolic blood pressure was much stronger (87% variance) at P Conclusion: It was concluded that moderate intensity interval training program is an effective means of lowering myocardial oxygen consumption and an adjunct non-pharmacological management of essential hypertension.
TL;DR: There was a statistically significant relationship between the RTS and outcome from the study, and the R TS could be used as a standard physiological trauma scoring system in prediction of outcome in the trauma population in Nigeria.
Abstract: Background: Current trauma management advocates inclusion of a measure of severity of the injury during evaluation. Aims: To evaluate the validity of the Revised Trauma Score (RTS) in assessment of trauma patients in accident and emergency unit of a tertiary hospital in Nigeria. Materials and Methods: Two hundred and fifty-two consecutive patients 18 years and above with injuries were recruited for the study. Written informed consent was obtained from each of the patients or their relations if unconscious. Each patient was registered according to the guidelines of International Categorization of External Causes of Injuries. The severity of injury was calculated using the RTS and the patients were followed-up, and their condition at discharge was documented. Results: Two hundred and fifty-two patients above the age of 18 years were studied. Mean age of patients' was 32.9 years with the oldest being 72 years. There were 192 male and 60 female with a male to female ratio of 3.2:1. Most of the injuries were following road traffic accidents. Among the patients with minor injuries from the RTS, 71% made full recovery, 25% were handicapped, and 4% died, while 22% of the patients with severe injuries made full recovery, 11% were handicapped, and 67% died. Conclusion: There was a statistically significant relationship between the RTS and outcome ( P < 0.05) from the study, and the RTS could be used as a standard physiological trauma scoring system in prediction of outcome in our trauma population.
TL;DR: In this paper, a case of a young Nigerian male, abusing codeine containing cough syrup with a clinical picture complicated by seizures, as well as review of relevant and available literature, including a discussion of its implication for clinical care.
Abstract: Cough remedies are available in Nigeria as narcotic and nonnarcotic over-the-counter preparations. The narcotic antitussive usually contains codeine, which has a high abuse potential. We report a case of a young Nigerian male, abusing codeine containing cough syrup with a clinical picture complicated by seizures, as well as review of relevant and available literature, including a discussion of its implication for clinical care. Clinicians should be aware of abuse and dependent potential of codeine containing cough syrup with seizures as one of the possible feature of toxicity. This case report buttresses the need for codeine containing cough syrups to be made available only on prescription.