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   Table of Contents - Current issue
Coverpage
January-March 2015
Volume 10 | Issue 1
Page Nos. 1-32

Online since Wednesday, November 4, 2015

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ORIGINAL ARTICLES  

Organ toxicity of monosodium glutamate in adult albino Wistar rats p. 1
OE Ogbuagu, IN Nweke, PC Unekwe
DOI:10.4103/9783-1230.169056  
Objectives: To determine the LD50 and organ toxicity of monosodium glutamate (MSG). Materials and Methods: A total of 30 adult albino Wistar rats of both sexes were used in this study. Fifteen of them were used for acute toxicity test. The second stage of the experiment was performed with 15 rats which received 500 mg/kg, 750 mg/kg, 1000 mg/kg, and 1250 mg/kg of MSG thoroughly mixed with the feeds, respectively, with unlimited supply of drinking water on daily basis for 8 weeks. Group E, which was the control, received an equal amount of feeds without MSG. The animals' weights were measured weekly, constantly observed daily for systemic effects and later sacrificed at the end of 8 weeks in a desiccator under anesthesia with ether following an overnight fast. Blood was obtained by left ventricular cardiac puncture for biochemical analysis. The kidneys, heart, lungs, spleen, liver, and testis were dissected and fixed in 10% formal saline for histological examination using hematoxylin and eosin (Hand E) methods. Results: There was a significant increase in the mean weight of the animals and controls (P < 0.05). There was a significant decrease in the mean serum cholesterol levels, a significant increase in the mean fasting plasma glucose, and plasma alanine transferase levels of the experimental animals when compared with the controls (P < 0.05). The histological finding revealed a reduction in spermatocytes in testes of animals fed with 1000 mg/kg MSG plus necrosis and scanty seminiferous tubules. There was massive necrosis on the liver and lungs, fatty change in the spleen and degenerative changes of heart muscle cells. There were also irregular spaces of various shapes and sizes and necrosis in the kidney. Conclusion: The study demonstrated that consumption of MSG has deleterious effects in virtually all organs which will apparently affect their functions.
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Hand washing practices and techniques among health professionals in a tertiary hospital in Kano p. 8
Mohammed Abdulsalam, Aliyu Ibrahim, Godpower Michael, Abubakar Mijinyawa
DOI:10.4103/9783-1230.169058  
Background: The simple act of hand washing has been proven to reduce the risk of acquiring hospital infection, especially with the current concern of Ebola viral disease. Hospital acquired infections have contributed significantly to overall mortality and morbidity and health care cost. They report that hand washing remains at an unacceptable low level in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients. Transmission of health-care-associated infections often occurs via the contaminated hands of health care workers. Materials and Methods: It was a descriptive cross-sectional study carried out among randomly selected doctors and nurses in Aminu Kano Teaching Hospital, Kano. The questionnaires were administered to the respondents during their ward rounds or clinic sessions. Results: One hundred and forty health professionals comprising 98 nurses and 42 doctors were studied. About 64.4% of them were aware of the World Health Organization (WHO) global hand washing day but only 15% stated the date correctly. About 99.3% of them believed that if hand washing is done correctly it can reduce the risk of infection. All (100%) of the health professionals use water and soap or hand rubs as agents of hand washing. About 93.6% were taught hand washing technique and 47% were aware of the five moments in hand washing but only 17% of them could list the five moments in hand washing. Only 25.7% health professionals knew the correct steps of hand washing (χ2 = 2.444, df = 2, P = 0.295). Ninety-one percent of the health professionals had seen posters on hand washing. Majority (72.1%) adhered to principles of hand washing (χ2 = 0.015, df = 1, P = 0.902) while 82.1% wash their hands before touching patients (χ2 = 2.841, df = 1, P = 0.092). However, most of them (95%) washed their hands after touching patients and 97% washed their hands after handling body fluids or secretions from patients. On the other hand, only 39% health professionals washed hands before wearing hand gloves (χ2 = 0.321, df = 1, P = 0.571) but 95% washed hands after removing the hand gloves. Ninety-nine percent washed their hands after visiting or using the restroom. Conclusion: This study underscores the need for continuous information and education of health professionals on the importance WHO global hand washing day. As doctors and nurses are important in the health care team, it is important to provide the appropriate knowledge and training regarding preventive practices of infectious diseases. Training and retraining of health professionals on correct steps of hand washing will encourage and remind them on the importance of washing hands before wearing gloves and before touching patients to reduce the risk of infection and cross infection.
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Increased levels of pancreatic enzymes in sickle cell anemia and the effect of proteinuria p. 13
Mathias Abiodun Emokpae, Idahosa Ehioghae
DOI:10.4103/9783-1230.169054  
Background/Objective: Sickle cell disease (SCD) is the most common hemoglobinopathy in Nigeria, and the condition can affect any part of the body including the pancreas. The study seeks to evaluate the levels of pancreatic enzymes in blood and urine of SCD patients in steady clinical state, and the effect of proteinuria on the enzyme levels as proteinuria was previously reported in SCD subjects. Materials and Methods: Urine and plasma amylase, serum lipase, and proteinuria were determined in 150 subjects comprising 100 SCD patients and 50 age/sex matched apparently healthy subjects with normal hemoglobin using commercially available reagent test kits. Results: Urine amylase (P = 0.029), serum amylase (P < 0.001), lipase (P = 0.008), and proteinuria (P < 0.001) were significantly higher in steady state SCD patients compared with controls. Significant decreases were observed in urine amylase (P = 0.022), serum amylase (P < 0.001), lipase (P < 0.001), and proteinuria (P < 0.001) in SCD patients without proteinuria compared with SCD patients with proteinuria. Conclusion: Pancreatic enzymes levels were increased in SCD patients which indicate that these patients may be predisposed to pancreatitis and the levels of these enzymes were further increased in those with proteinuria.
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Critically ill obstetric admissions into a tertiary hospital's intensive care unit p. 16
AA Fawole, BO Bolaji, OO Oyedepo, AS Adeniran
DOI:10.4103/9783-1230.169060  
Background: Intensive Care Unit (ICU) management is a critical care and may be lifesaving in critically ill obstetric patients, but mortality remains high in low-resource countries. Objective: To review obstetric admissions into a tertiary hospital ICU. Design: Retrospective descriptive study. Setting: The ICU of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Subjects: Women admitted to the ICU during pregnancy or within 42 days of the end of the pregnancy. Materials and Methods: A list of all eligible participants was compiled, the case files were retrieved and relevant data extracted; the results were presented in tables and percentages. Results: Obstetric patients constituted 12.3% of the total ICU admissions and 0.84% of all deliveries with 45.6% mortality; the mean age was 29.2 ± 5.4 years (range 18–42 years), mean parity was 2.0 ± 1.5 (range 0–6), 15 (28.8%) had no formal education, 39 (75.0%) were of low social class, 22 (42.3%) had no antenatal care, 41 (78.9%) were admitted for obstetric reason, and postpartum hemorrhage was the most common indication for admission (19 [36.5%]). In all, 44 (84.6%) were admitted postpartum, 45 (86.5%) had organ dysfunction at ICU admission, 36 (69.2%) had mechanical ventilation while the most common drug administered were antibiotics. Conclusion: Obstetric patients are important intensive care users, but maternal mortality remains high among them in low-resource countries despite the care received.
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Prevalence of extended spectrum beta-lactamase-producing Klebsiella species at the University of Ilorin Teaching Hospital p. 20
BU Faari, AA Akanbi, A Fadeyi, KW Wahab, C Nwabuisi
DOI:10.4103/9783-1230.169059  
Background: Persistent blind antibiotic treatment of patients, in resource poor nations like Nigeria, makes the prevalence of antibiotic resistance to increase sporadically. Extended spectrum beta-lactamase (ESBL) production is one of the ways by which bacteria become resistant to antibiotics. For this reason, isolation, identification, sensitivity and screening for possible resistance genes is very important before prescription, if the affected patients must receive qualitative care particularly when their condition is chronic. Materials and Methods: Four hundred suspected isolates of Klebsiella belonging to various species obtained from routine specimens such as swabs, urine, blood, and sputum from May to October 2009 were studied. The identity of all isolates obtained was biochemically analyzed. The isolates were subjected to antibiotic susceptibility testing using modified Kirby–Bauer method and ESBL production was phenotypically determined using double disc synergy test for laboratory detection and reporting of bacteria by CLSI method. Results: Ninety-eight (24.5%) isolates expressed ESBL. Majority of the ESBL producing isolates were from swab specimens 59 (14.75%) followed by blood culture 16 (4.0%), urine 13 (3.25%), and sputum 10 (2.5%). Sensitivity patterns of ESBL producing Klebsiella spp. revealed that all ware resistant to augmentin (AUG), ceftazidime (CAZ), cefotaxime (CTX), cefuroxime (CRO), cefpodoxime (CPD), and none resistant to imipenem (IMP).Conclusion: ESBL producing Klebsiella spp., were present in University of Ilorin Teaching Hospital. They are resistant to augmentin (AUG), CAZ, CTX, and CPD. Presence of ESBL in any Klebsiella spp. has made cephalosporins which are first line antibiotics usually given non-effective, thereby reducing the treatment options. We, therefore, suggest screening and confirmation for ESBL, in other to prevent treatment failure.
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REVIEW ARTICLE Top

Keloids: A review p. 24
E Onyenyirionwu, A Agu
DOI:10.4103/9783-1230.169057  
The management of keloids remains a difficult clinical problem. This article is a review of the current methods available for the treatment of keloids. Online search was made on review articles and other publications on keloids mainly from PubMed (search results from National Center for Biotechnology Information at the US National Library of Medicine [NLM]) and African Journals Online. A review of the selected articles was carried out. The various methods of treatment available suggest that there is still no one method that is completely satisfactory. Currently, combination therapy using surgical excision followed by intralesional steroid or other adjuvant therapy appears to yield the best results for keloidal management.
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CASE REPORT Top

Cystolithiasis with coexisting nephrolithiasis: A radiodiagnostic discovery in an adult Nigerian male with lower urinary tract symptoms p. 30
Olufunso Simisola Aduayi, Olusola Comfort Famurewa
DOI:10.4103/9783-1230.169055  
Urolithiasis is a broad term for the presence of calculi or stones along the urinary tract and these may be found in the kidneys (nephrolithiasis), ureters (ureterolithiasis), bladder (cystolithiasis) or urethra (urethrolithiasis). A 50-year-old man presented with lower urinary tract symptoms which had progressively worsened over a period of 10 years. He had radiological, and laboratory investigations done. Imaging findings revealed the presence of calculi in the bladder and right kidney. The role of radiological imaging in the management of the patient is discussed.
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