Showing papers in "Nigerian Medical Journal in 2016"
TL;DR: It is incumbent on health giver to incorporate MetS assessment as a part of treatment and management plan in patients receiving HAART as indicated by dyslipidemia, high blood pressure, and abnormal body fat.
Abstract: Background: Prevalence of metabolic syndrome (MetS) in HIV-infected patients is very limited in the Ghanaian setting and may vary across the globe by the different study populations and criteria used. Aim: We investigated the prevalence of MetS among HIV-infected patients receiving highly active antiretroviral therapy (HAART) at the St. Dominic Hospital, Akwatia, Ghana. Patients and Methods: This cross-sectional study recruited 433 HIV-infected patients (294 on HAART and 139 HAART-naIve) from the period of February 2013 to December 2013. Information on the demographic, clinical, anthropometric characteristics were obtained and lipid profile for each patient was assessed. MetS was assessed based on the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), World Health Organization (WHO) and International Diabetes Federation (IDF) criteria. Results: The prevalence of MetS was 24.5% according to WHO criteria, 48.3% by NCEP-ATP III criteria, and 42.3% by IDF criteria. In general, participants on HAART were significantly associated with higher prevalence of MetS compared to those without HAART (P < 0.05) irrespective of the criteria used. Prevalence of clustering components of MetS was significantly higher among those on HAART when risk scores of 2 and above were used compared with those not on HAART (P < 0.05). Conclusion: HAART recipient developed MetS as indicated by dyslipidemia, high blood pressure, and abnormal body fat. It is incumbent on health giver to incorporate MetS assessment as a part of treatment and management plan in patients receiving HAART.
30 citations
TL;DR: Results of the present study showed that nephrotoxicity and ototoxicity are minimized in single-dose administration compared to multiples doses.
Abstract: Background: Aminoglycosides and mainly gentamicin are the most important antimicrobial agents. Two different methods of administration exist: Single and multiple doses. There has always been a controversy about the less harmful administration method, to minimize adverse effects of gentamicin - deafness and renal insufficiency. In this study, it was aimed to compare two different methods of administration to figure out the least harmful treatment method. Materials and Methods: In a clinical study, eighty patients aged 12-55 years who were admitted with sepsis syndrome were included in the study; they were divided into two groups: The first group received single-dose treatment (5 mg/kg) whereas the second group was treated with multiple doses (1.7 mg/kg three times a day) of gentamicin. Results: The results show that blood urea nitrogen (BUN) and creatinine (CR) levels were decreased in the first group. Both blood urea nitrogen and creatinine and also mean glomerular filtration rate was increased in the same group. In the second group, mean BUN and CR levels were increased while the GFR was decreased in the same group. There was also a gradual increase in GFR in the first group. GFR <80 was decreased from 20% to 5.1% in the first group while increased from 5% to 27.5% in the second group. Results of audiometric studies show 6.1% hearing problem in the first group and 12.8% in the second one. Conclusions: Results of the present study showed that nephrotoxicity and ototoxicity are minimized in single-dose administration compared to multiples doses.
20 citations
TL;DR: The analysis of the environmental factors present during the pregnancy of children with oral clefts revealed a significant association between parity (second onward), maternal smoking, and paternal smoking and the occurrence of CL and/or palate in this population.
Abstract: Background: A cross-sectional study was conducted at the Craniofacial Rehabilitation Center in the General Hospital of the University of Cuiabα, Cuiabα city, Mato Grosso, Brazil. Materials and Methods: Poisson regression model was used to analyze the relationship between antenatal factors and the occurrence of oral clefts in 116 patients. Results: Oral clefts were more common in males (64.66%) and White race (46.02%). The mean age of the children was 21.91 months. The most common type of cleft was cleft lip and palate (CLP, 55.17%). Maternal and paternal smoking in the first trimester of pregnancy and parity were significantly associated with the occurrence of CLP. Parent's age, educational level, and occupation did not interfere in the occurrence of oral clefts. There was also no significant association between maternal illness, medication use, alcohol consumption, and maternal exposure to chemicals in the first trimester of pregnancy and the occurrence of clefts in this population. Conclusion: The analysis of the environmental factors present during the pregnancy of children with oral clefts revealed a significant association between parity (second onward), maternal smoking, and paternal smoking and the occurrence of CL and/or palate in this population.
18 citations
TL;DR: Late stage disease presentation and initial wrong diagnosis contributed to the poor management outcome, and squamous cell carcinoma is the most common histologic variant.
Abstract: Background: Malignant laryngeal tumors are uncommon. Late presentation of the disease may worsen management outcomes. We described the epidemiologic, clinicopathologic profile, and management outcomes of laryngeal tumors in a tertiary health institution in Nigeria. Materials and Methods: An 11-year retrospective review of medical records of patients managed for malignant laryngeal tumor at the University College Hospital, Ibadan, Nigeria, was performed. Results: There were 97 patients comprising 74 (76.3%) males and 23 (23.7%) females with a mean age of 60.48 ± 12.15 years. The mean duration of illness was 7.3 ± 3.8 months. History of cigarette smoking and alcohol consumption was in 2.1% and 14.4% patients, respectively. The most common clinical presentations were hoarseness, cough, and dyspnea. Transglottis (91.8%) was the most common anatomic tumor location and 92.8% patients presented in advanced disease stage. Four histologic types were identified with squamous cell carcinoma accounting for 96.9%. About 92% patients had emergency tracheostomy and 56 (57.7%) patients had total laryngectomy. The postoperative complications were pharyngocutaneous fistula (5.2%) and peristomal recurrence (3.1%). The 5-year survival rate was 52.5%. Conclusions: Malignant laryngeal tumors are uncommon, but more females are getting the disease. Squamous cell carcinoma is the most common histologic variant. Late stage disease presentation and initial wrong diagnosis contributed to the poor management outcome.
16 citations
TL;DR: Methylation of the SFRP2 promoter in fecal DNA is associated with the presence of colorectal tumors, and the detection of aberrantly methylated DNA in feces samples may present a promising, noninvasive screening method for CRC.
Abstract: Background: The early detection of colorectal cancer (CRC) with high sensitivity screening is essential for the reduction of cancer-specific mortality. Abnormally methylated genes that are responsible for the pathogenesis of cancers can be used as biomarkers for the detection of CRC. The methylation status of the secreted frizzled-related protein 2 (SFRP2) gene was evaluated for their use as a marker in the noninvasive detection of CRC. Materials and Methods: Methylation-specific polymerase chain reaction was performed to analyze the promoter CpG methylation of SFRP2 in the fecal DNA of 25 patients with CRC and 25 individuals exhibiting normal colonoscopy results. Results: Promoter methylation levels of SFRP2 in CRC patients and in healthy controls were 60% and 8%, respectively. Methylation of the SFRP2 promoter in fecal DNA is associated with the presence of colorectal tumors. Conclusion: Hence, the detection of aberrantly methylated DNA in fecal samples may present a promising, noninvasive screening method for CRC.
14 citations
TL;DR: Comparisons of dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria show that urban children generally have a better nutritional status than their rural counterparts, but prevalence levels of underweight and stunted children were significantly higher in rural communities.
Abstract: Background: Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. Objective: The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. Methods: This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother-child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. Results: The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively). Conclusions: Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities.
10 citations
TL;DR: The prevalence of unintended pregnancy among women attending antenatal clinic is high, possibly due to low contraceptive usage, and adequate information, education, and communication materials should be provided during antenatal health talks.
Abstract: Background: Unintended pregnancy is a pregnancy that is either unwanted or mistimed. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinic at the University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. Materials and Methods: This was a descriptive, cross-sectional study of 300 women attending the antenatal clinic of the Teaching Hospital. Information on sociodemographic characteristics, desirability of the current pregnancy at the time of conception, and knowledge and practice of contraceptive methods were collected using a pretested questionnaire. The data obtained were analyzed using SPSS version 20. Chi-square test was used for tests of associations with the level of significance set at P < 0.05. Results: The average age of the respondents was 30.0 ± 4.7 years. Overall, 33.3% and 58.3% of the respondents attained secondary and tertiary levels of education, respectively. The prevalence rate of unintended pregnancy was 16%. Contraceptive awareness was quite high (259, 86.3%). However, contraceptive usage was low as 192 (61.9%) had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unwanted pregnancy (χ[2] = 68.56, P < 0.001), as well as between parity and unwanted pregnancy (χ[2] = 39.92, P < 0.001). Conclusion: The prevalence of unintended pregnancy among women attending antenatal clinic is high, possibly due to low contraceptive usage. Adequate information, education, and communication materials should be provided during antenatal health talks. Advocacy visits for community sensitization should also be increased.
7 citations
TL;DR: Intussusception in adults is uncommon but carries a high morbidity and mortality which can be reduced with a good clinical assessment, appropriate imaging, and early laparotomy.
Abstract: Background: Intussusception is a rare cause of intestinal obstruction in adults. Its diagnosis could be elusive based solely on clinical features because of protean presentation. Supplementary imaging allows for preoperative diagnosis, early institution of definitive management, and a better clinical outcome. Patients and Methods: Records of adults managed for intestinal obstruction by laparotomy in a surgical unit of a tertiary health facility were retrospectively examined. The subgroup having an intraoperative diagnosis of intussusception was extracted and analyzed. Data obtained included age, sex, and primary symptom at presentation. Presence of intestinal perforation, the histology of the lead point of resected tissues, and the final disposition of the patients were documented. Results: Four hundred and three patients underwent surgical management of intestinal obstruction. Eight patients (2%) had an intraoperative diagnosis of intussusception at laparotomy; four males and four females (male: female = 1:1). Abdominal pain was the presentation in 7 (87.5%) and anal protrusion in 1 (12.5%). Four patients (50%) had bowel perforation with peritonitis. Seven of the resected intestines had lead points which were benign. Two patients (25%) died from sepsis. Resection and anastomosis were done for all the patients. Conclusion: Intussusception in adults is uncommon but carries a high morbidity and mortality which can be reduced with a good clinical assessment, appropriate imaging, and early laparotomy.
6 citations
TL;DR: There was no significant difference in overall MQOL HIV score between HIV and HIV/HCV patients, but future studies will need to explore the impact of HCV on HIV infected individuals' QOL.
Abstract: Background: The aim of this study was to compare the quality of life (QOL) of people infected with both hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The study design was a cross sectional descriptive survey, using self administered questionnaires. Materials and Methods: A convenience sample of 242 patients (131 of them HIV/HCV), Iranian adults (aged 18–57) living with HIV/AIDS, was recruited from outpatient referring to Imam Khomeini Hospital behavioral counseling center in Tehran city, Iran. The instruments included the Multidimensional QOL HIV (MQoL HIV) and a demographic section. Results: The majority of the samples were male and single. The mean age was 36.52 years (standard deviation = 8.5). HIV mono infected patients reported higher scores in social support and physical functioning, but lower scores in physical health compared with HIV/HCV co infected individuals. There was no significant difference in overall MQOL HIV score between HIV and HIV/HCV patients. Conclusion: Future studies will need to explore the impact of HCV on HIV infected individuals' QOL.
6 citations
TL;DR: Although AEs of ribavirin may not be uncommon, they are rarely serious enough to cause treatment interruption, and more emphasis should be on supporting persons looking after LF cases adopt measures that minimize the risks of exposure.
Abstract: Background: Secondary transmission of Lassa fever (LF) occurs in the community and in health-care facilities, and is associated with high fatality in Nigeria. We investigated the role of oral ribavirin postexposure prophylaxis (orPEP) in preventing LF among the primary contacts of confirmed cases from December 2015 to March 2016. Materials and Methods: Epidemiological and clinical data of LF contacts were prospectively collected. However, information regarding ribavirin adverse effects (AEs) were collected retrospectively through a telephone interview. High-risk contacts were clinically monitored orPEP. Results: Thirty-five (94.6%) out of the 37 individuals enrolled in the study were contacts of confirmed LF cases, and friends and family members (54%) constituted the largest group. However, only 29 (83%) individuals were classified as high-risk contacts. Twenty-one (60%) of contacts were prescribed ribavirin with 6 (28.6%) of them reporting AEs. Body weakness (33%) was the most frequent AE, but there was no incidence of treatment discontinuation due to AE. Furthermore, there were no reported cases of LF among all respondents (0%), whether they had orPEP or not. Conclusion: Secondary transmission of LF seems uncommon and the benefit of orPEP is uncertain. Although AEs of ribavirin may not be uncommon, they are rarely serious enough to cause treatment interruption. More emphasis should be on supporting persons looking after LF cases adopt measures that minimize the risks of exposure.
4 citations
TL;DR: The use of toe length alone may not be effective for sex differentiation; however, it can serve as an adjunct in forensic investigation involving sex identification.
Abstract: Background: Sex determination is an important and one of the foremost criteria in establishing the identity of an individual, and this is achieved by investigating various anatomical structures to establish sex discriminatory features. The present study conducted baseline data for the toe with a view of finding discriminatory sex characteristics. Materials and Methods: A total of 420 subjects were studied by direct linear measurements of the toe length (big toe [1T] to the fifth toes [5T]) of both feet using a digital Vernier caliper with accuracy of 0.01 mm. Statistical Package for Social Sciences (IBM, version 23, Armonk, New York, USA), Levene's ANOVA outcome informed the use of t-tests to compare mean differences. Discriminant function analysis (DFA) was used to evaluate the possibility of sex categorization. The significance level was set at 95%. Results: The mean ± standard deviation values of the right (R) toes for the males were 49.63 ± 4.43 mm (1T), 36.92 ± 5.14 mm (2T), 30.35 ± 4.95 mm (3T), 25.55 ± 3.97 mm (4T) and 22.21 ± 2.94 mm (5T), whereas the female values were 45.73 ± 4.07 mm (1T), 33.31 ± 4.66 mm (2T), 26.63 ± 4.02 mm (3T), 22.89 ± 3.43 mm (4T), and 19.77 ± 2.70 mm (5T). The left male values were 49.16 ± 4.32 mm (1T), 36.82 ± 5.16 mm (2T), 30.88 ± 4.91 mm (3T), 26.13 ± 3.99 mm (4T), and 22.46 ± 3.24 mm (5T), whereas the female values were 45.33 ± 4.05 mm (1T), 33.05 ± 4.70 mm (2T), 27.27 ± 4.29 mm (3T), 23.10 ± 3.36 mm (4T), 19.81 ± 2.59 mm (5T). From the results, males displayed significantly higher mean values than females in all measured parameters (t = 2.405, P = 0.018) with no asymmetry (P > 0.05); although T3 and T4 were larger on the left foot. The DFA model when tested with the present data derived a significant F likelihood ratio test (P < 0.001), a Wilks' lambda predictability value of 0.759 having a model accuracy of 69.5% with a better prediction for female (70%) than males (69%). Conclusion: The use of toe length alone may not be effective for sex differentiation; however, it can serve as an adjunct in forensic investigation involving sex identification.
TL;DR: In patients with CHD, serum levels of TNF-α increased but IL-6 not changed when compared to control and this increase in necrosis tumoral factor-α would be related with hypoxia and remarkable left to right shunt and caused growth retardation in these patients.
Abstract: Background: The objective of the study is to assess the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in patients with congenital heart diseases (CHDs) and control. Patients and Methods: In this case-control study, sixty patients with CHD with ages of 1 month to 15 years and thirty healthy subjects were assessed. All objects measured in height, weight, age, sex, and body mass index (BMI). Patients diagnosed by echocardiography and patients' blood samples were 3 ml and taken in the catheterization laboratory through catheter and kept for 60 min at a room with normal temperature and separated serum has been held. All samples in compliance with the cold chain carried out to biochemistry laboratory and finally the levels of serum TNF-α and IL-6 were measured by Elisa Kit. Data were analyzed with Statistical Package for Social Sciences version 20. Nonparametric tests by considering 95% confidence interval were applied. Results: The mean of age in cyanotic patients was 4.28 3.44 years, a cyanotic was 3.12 3.87 years and for the control group was 3.30 3.61 years. Comparison of TNF-α (Mann-Whitney U-test = 56.62, P P P P = 0.015), and BMI (Mann-Whitney U-test = 214.5, P P P P P = 00.052), oxygen saturation (Chi-square = 74.70, P P Conclusion: The findings of this study showed that in patients with CHD, serum levels of TNF-α increased but IL-6 not changed when compared to control and this increase in necrosis tumoral factor-α would be related with hypoxia and remarkable left to right shunt and caused growth retardation in these patients.
TL;DR: It seems that controlling of clinical or subclinical hypothyroidism may have a role in slowing of dementia progression and also have a preventive role.
Abstract: Background: Cognitive disorders and dementia are common problems, and Alzheimer's disease is one of the major leading causes of death worldwide. Thyroid hormone disorders as a common problem effect on hippocampus size which as a prognostic factor in dementia. The aim of the present study was to investigate the relationship between serum thyroid-stimulating hormone (TSH) level and the size of hippocampus in patients with mild cognitive disorders. Materials and Methods: In a descriptive-analytical study, 41 patients with symptoms of mild cognitive disorders whom referred to take the brain magnetic resonance image (MRI) in a radiology center under the direction of Tabriz University of Medical Sciences (Tabriz, Iran) were evaluated. The right and left hippocampal and brain volume was calculated by MRI at coronal T1-weighted. Serum TSH level was also measured in these patients. Correlation between serum TSH level and hippocampal volume size was evaluated. Results: Male to female ratio was 1.05:1 with mean age of 54.09 ± 3.11 years. Mean serum TSH level of patients was 1.55 ± 1.45 uU/ml. The right and left hippocampal volumes were 1.61 ± 0.42 and 1.62 ± 0.39 ml, respectively. There were slight negative correlations between the right and left hippocampal volumes with TSH level (r = −0.133 and r = −0.092, respectively). Correlations between the right and left hippocampal volumes with TSH level were not statistically significant (P = 0.406, P = 0.566, respectively). Conclusion: Based on findings of the present study, there was a weak negative correlation between serum level of TSH with the right and left hippocampal and brain volume ratio, but the correlation was not statistically significant. It seems that controlling of clinical or subclinical hypothyroidism may have a role in slowing of dementia progression and also have a preventive role.
TL;DR: An innovative method for DNA extraction (heat alkaline plus mineral oil) achieved high DNA purity and concentration, and the best result in quantitative PCR was in proteinase K method that had the lowest cycle threshold averages among the other extraction methods.
Abstract: Background: Nowadays, definitive diagnosis of numerous diseases is based on the genetic and molecular findings. Therefore, preparation of fundamental materials for these evaluations is necessary. Deoxyribonucleic acid (DNA) is the first material for the molecular pathology and genetic analysis, and better results need more pure DNA. Furthermore, higher concentration of achieved DNA causes better results and higher amplifying ability for subsequent steps. We aim to evaluate five DNA extraction methods to compare DNA intimacy including purity, concentration, and amplifying ability with each other. Materials and Methods: The lymphoid tissue DNA was extracted from formalin-fixed, paraffin embedded (FFPE) tissue through five different methods including phenol-chloroform as the reference method, DNA isolation kit (QIAamp DNA FFPE Tissue Kit, Qiagen, Germany), proteinase K and xylol extraction and heat alkaline plus mineral oil extraction as authorship innovative method. Finally, polymerase chain reaction (PCR) and real-time PCR method were assessed to compare each following method consider to DNA purity and its concentration. Results: Among five different applied methods, the highest mean of DNA purity was related to heat alkaline method. Moreover, the highest mean of DNA concentration was related to heat alkaline plus mineral oil. Furthermore, the best result in quantitative PCR was in proteinase K method that had the lowest cycle threshold averages among the other extraction methods. Conclusion: We concluded that our innovative method for DNA extraction (heat alkaline plus mineral oil) achieved high DNA purity and concentration.