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REVIEW ARTICLE
Bioequivalence comparison of generic drug DuLocap and brand drug Cymbalta
M Mudaliar
April-June 2014, 9(2):79-84
DOI:10.4103/9783-1230.139169  
Abbreviated new drug application is required to submit to United States Food and Drug Administration for approval of the generic version of an innovator drug. This application is for (DuLocap) ® duloxetine hydrochloride delayed release (DR) capsules 60 mg manufactured by alpha pharmaceuticals. This application is an abridged application claiming essential similarity to the brand product that is, Cymbalta ® (duloxetine HCL DR capsules) 60 mg, mfg by Lily S.A, Spain and marketed by Eli Lilly, This is application is filed on the basis of para III (patent expires on June 11, 2013).
  9,630 326 -
ORIGINAL ARTICLES
Organ toxicity of monosodium glutamate in adult albino Wistar rats
OE Ogbuagu, IN Nweke, PC Unekwe
January-March 2015, 10(1):1-7
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.
  3,405 3,254 -
Hand washing practices and techniques among health professionals in a tertiary hospital in Kano
Mohammed Abdulsalam, Aliyu Ibrahim, Godpower Michael, Abubakar Mijinyawa
January-March 2015, 10(1):8-12
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.
  3,744 924 -
Breastfeeding and weaning practices among Nigerian women
I Aliyu, C Duru, TO Lawal, A Mohammed
October-December 2014, 9(4):140-143
DOI:10.4103/9783-1230.157054  
Background: Infant feeding is an important determinant of child well-being. The practice of exclusive breastfeeding over the years is declining despite efforts at all levels to improve it; and with globalization there is concern of possible drift in the traditional weaning practices among Nigerian women. This study, therefore, seeks to determine the breastfeeding and weaning patterns among mothers attending two health facilities in the northern and southern parts of Nigerian. Materials and Methods: This was prospective cross-sectional study involving mothers seen in Paediatrics Outpatient and Child Immunization Clinics. This study involved two hospitals in northern and southern Nigeria respectively. Results: Two hundred breastfeeding mothers were recruited into this study. 75% of the mothers were in 25-40 years group and the majority of them (40.0%) commenced breastfeeding after 60 min of delivery. 83% of the mothers were aware of exclusive breastfeeding, but only 40.5% practiced it; their main reasons were that: Breastfeeding was not enough for the growth and development of the child (26.1%) and that breast-milk did not contain enough water; however most mothers' breasts fed for >12 months. About 44.5% of the mothers introduced complementary feeds between 4 and 6 months, and most complimentary meals (53.5%) were maize-based. 61½% of the mothers abruptly stopped breastfeeding, and the practice of separating the child from the home during weaning was reported in only 16% of the mothers. Conclusion: Exclusive breastfeeding is still unacceptably low among Nigerian women despite an increased level of awareness.
  4,104 405 -
REVIEW ARTICLE
Keloids: A review
E Onyenyirionwu, A Agu
January-March 2015, 10(1):24-29
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.
  3,653 395 -
ORIGINAL ARTICLES
Increased levels of pancreatic enzymes in sickle cell anemia and the effect of proteinuria
Mathias Abiodun Emokpae, Idahosa Ehioghae
January-March 2015, 10(1):13-15
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.
  2,731 461 -
Cardiopulmonary efficiency in gutkha chewers: An Indian study
A Pakkala, CP Ganashree, T Raghavendra
April-June 2014, 9(2):74-78
DOI:10.4103/9783-1230.139168  
Background: Smokeless tobacco has been used in various forms orally alone or in combination with other ingredients. In India, tobacco is taken in gutkha form by a large section of the population. Use of gutkha indeed represents a health concern of growing magnitude among these groups. As a consequence of its addictive qualities, the consumption of smokeless tobacco often becomes a lifelong habit with cumulative and deleterious effects on health. Chewable tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risk and needs to be discouraged. Previous reports have described long term harmful effects of nicotine on various body parameters, little is known about acute effect of smokeless tobacco on cardiopulmonary parameters. Very few studies have been undertaken on the acute effect of use of gutkha, a common form of smokeless tobacco in India on cardiopulmonary parameters of youngsters. Materials and Methods: Treadmill exercise testing and pulmonary function tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups' viz., healthy sedentary controls and healthy gutkha chewers. Results: On studying the differences in cardiopulmonary efficiency in the two groups the resting heart rate (HR) was found to be statistically significantly higher in the study group and the delta HR was found to be statistically significantly lower among gutkha chewers. There was no significant difference seen in parameters like maximal oxygen consumption, maximum oxygen pulse, maximum voluntary ventilation, and maximum minute ventilation as an acute effect of gutkha chewing. Conclusion: In this study, it appears that gutkha chewers are physically fit like controls, but after immediate tobacco chewing a lesser delta HR suggests a higher risk for cardiovascular mortality. Stopping gutkha chewing at this juncture can be helpful in reverting back the risk and parameters like resting HR, recovery HR, and delta HR can be used as prognostic assessment tools for any intervention therapy to stop gutkha chewing in asymptomatic individuals.
  2,935 142 -
EDITORIAL
Fertility following myomectomy
Onwere Nwankwo Stephen
October-December 2014, 9(4):135-135
DOI:10.4103/9783-1230.157041  
  1,021 2,020 -
ORIGINAL ARTICLES
Onychomycosis: Etiology, diagnosis, and treatment
AC Ngwogu, IEK Mba, KO Ngwogu
January-March 2014, 9(1):43-46
DOI:10.4103/9783-1230.132559  
Background: Onychomycosis, although a common problem in all age groups, is often misdiagnosed and consequently under-treated. There is need for improved awareness and proper laboratory diagnosis to ensure effective therapy. Objective: To review the etiology, diagnosis, and treatment of onychomycosis. Design: Data sources from internet searches on AJOL and Pubmed conducted using the keywords "onychomycosis," fungal nail infections. Setting: Abia State University Teaching Hospital (ABSUTH), Aba, in South Eastern Nigeria. Subjects: A total of 38 articles and laboratory manuals. Materials and Methods: A total of 38 articles including laboratory manuals, published between 1974 and 2009, were selected and reviewed. Results: Onychomycosis is gradually increasing in the general population. The etiological agents differ from person to person and from place to place. Conclusion: There is need for proper laboratory diagnosis prior to institution of therapy. Effective therapy is with the use of systemic drugs with or without topical agents.
  2,677 324 -
Congenital malformations as seen in a secondary healthcare institution in Southeast Nigeria
CN Onyearugha, BN Onyire
April-June 2014, 9(2):59-62
DOI:10.4103/9783-1230.139163  
Objective: The aim was to determine the prevalence and pattern of congenital malformations. Materials and Methods: A retrospective study of neonates with congenital anomalies delivered at Federal Medical Centre Abakaliki, Ebonyi state over 10 year period was conducted. Data were extracted from the delivery records of neonates and mothers. Results: The prevalence of congenital anomalies was 0.42%. Highest frequency of congenital anomalies occurred in the digestive system (36.7%), followed by the skeletal system and the least in the cardiovascular system (5%). Majority of cases (83.3%) were term babies while 85% had normal birth weight. Highest proportion of babies with congenital anomalies (35%) was delivered by mothers aged 25-29 years and 40% by those of parities 4, 5. Ninety-three percent of the mothers were booked. Conclusion: The prevalence of congenital malformations in this study was 0.42%.Congenital malformations of the digestive system are the most prevalent in this study.
  2,797 154 -
Fertility following myomectomy at Aba, Southeastern Nigeria
B Chigbu, S Onwere, C Aluka, C Kamanu, P Feyi-Waboso, O Okoro, E Ezirim, P Ndukwe, E Akwuruoha, M Ejikem, C Aharauka, U Ojike
October-December 2014, 9(4):136-139
DOI:10.4103/9783-1230.157045  
Background: While hysterectomy remains the gold standard treatment for fibroids, it is an unacceptable treatment option for women who wish to conserve their fertility. The actual effects of myomectomy on fertility remain uncertain though. Objective: The objective was to ascertain pregnancy and live birth rates among a small group of women undergoing abdominal myomectomy. Methods: The study population consisted of women of reproductive age intending to conceive soon after undergoing abdominal myomectomy. A total of 40 women who met the inclusion criteria were recruited for the study and followed-up for 4 years. Women who achieved pregnancy within the study period were analyzed in terms of their demographics and intra-operative findings. Results: The mean age of the women was 28 years (range 24-35) married for about 3 years. Majority of the women (50%) had more than 11 fibroid nodules, and the largest nodule was bigger than 5 cm in 35 women (87.5%). Cumulative pregnancy rate was 60% (24/40) while live birth rate was 22/40 (55%) following myomectomy and majority 19/22 achieved this within 2 years of myomectomy. Conclusion: Myomectomy for fibroid-associated infertility increase pregnancy rates such that approximately 60% of women undergoing the procedure subsequently conceive.
  2,028 852 -
Microbiological studies of waste dumpsite in Abia State University Teaching Hospital, Aba
Eugene Chimezie Ndimele, Uzochukwu Godswill Ekeleme, Alloysius Chibuike Ogodo, Nkechi Chinyere Nwachukwu, Chidiebere James Nnadi, Elijah Akachukwu Otutu
October-December 2014, 9(4):151-156
DOI:10.4103/9783-1230.157058  
Background: Hospital is a vital place for our life, health and well-being. However, the waste generated from hospital can be hazardous, toxic and even lethal because of their high potential for disease transmission. Objective: The work is aimed at doing microbiological studies of hospital waste dumpsite in Abia State University Teaching Hospital (ABSUTH), Aba. Materials and Methods: The study area was ABSUTH, Aba. Passive air sampling was performed using settle plates, wastewater samples from the drippings, soil sediment underlying solid waste and soil adjacent to the dumpsite were collected from a depth of 0.9-30 cm and was evaluated using the standard microbiological and molecular techniques. Result: The result of the total microbial count of air samples within the waste dumpsite and reception unit of ABSUTH, Aba revealed that the total viable count (TVC) was 182 ± 0.5 air within waste dumpsite (AW) and 70 ± 2.0 air within reception unit (AR), the total coliform count (TCC) was 17 ± 0.2 (AW) and 5 ± 1.0* (AR), the total staphylococcal count (TSC) was 8 ± 0.1 (AW) and 3 ± 0.5* (AR) while the total fungal count was 60 ± 0.4 (AW) and 42 ± 0.7 (AR), the variations in the results differ significantly at P < 0.05. The total microbial count of soil samples within the waste dumpsite showed that the TVC was 3.0 ± 1.7 × 10 8 cfu/g which was significantly different (P < 0.05) when compared with the control, 3.2 ± 0.8 × 10 6 cfu/g. The TCC was 1.6 ± 0.4 × 10 4 cfu/g and do not differ significantly (P > 0.05) with the control (1.0 ± 1.0 × 10 4 cfu/g), the TSC was 2.6 ± 0.7 × 10 2 cfu/g and do not differ significantly (P > 0.05) with the control (2.1 ± 0.1 × 10 2 cfu/g) while the total fungal counts (6.8 ± 0.3 × 10 7 cfu/g) showed a significant difference when compared with the control (5.3 ± 0.6 × 10 6 cfu/g). The total microbial count of dripping samples from the waste dumpsite of ABSUTH showed that the TVC, TCC, staphylococcal count and the fungal count were 6.9 ± 1.7 × 10 7 , 3.5 ± 1.0 × 10 3 , 1.8 ± 0.6 × 10 2 , and 7.4 ± 0.1 × 10 5 , respectively. The variations in microbial counts of the dripping hospital waste dumpsite samples differed significantly (P < 0.05) when compared with the controls which showed no growth. The most occurring microorganisms were Bacillus species, Staphylococcus aureus, Streptococcus sp. and Aspergillus fumigatus. The susceptibility profile of bacterial isolates revealed that ciprofloxacin and augmentin produced the highest percentage inhibition of 33 to 100% against all the bacterial isolates except Actinomycetes isreali which was resistant. Most of the isolates had no plasmid except for Escherichia coli which produced equal size of 23 kb of plasmid. Conclusion/Recommendation: The high microbial load densities suggests that the hospital wastes in the environment pose a major health and environmental threat. This study therefore calls for a proper regulatory system on disposal of hospital waste.
  2,528 212 -
Appraisals for potential hazards in the operational environment and facilities of petroleum refining and distribution industry in Nigeria
TIN Ezejiofor, HC Nwigwe, FOU Osuala, MOE Iwuala
January-March 2014, 9(1):39-42
DOI:10.4103/9783-1230.132558  
Objective: To appraise operational environments and facilities of petroleum refining and distribution industry in Nigeria with a view to establishing the potential hazards/health risks Design: A prospective study. Setting: The Operational environments- facilities and activities of PHRC and PPMC, Eleme near Port Harcourt, Nigeria. Materials and Methods: Personal walk-through of the operational sites and facilities using checklist, participation in the various units' activities, and oral interviews of staff concerning the health hazards/risks of their workplace. Results: Five main occupational hazard categories were revealed- physical, chemical, biological, psychosocial, and ergonomic hazards. Sundry job exposures to these workplace hazards are suspected to be responsible for the accidents, injuries morbidities, and mortalities recorded in this industry. Conclusion: Current state of facilities and activities at the operational units of petroleum refining and distribution industry in Nigeria are fraught with several hazards, categorizable into five main hazard types, a situation that disposes staff to sundry health risks. Facility upgrade and industrial health services updates are thus warranted for abatement of hazards/associated health risks, and securing safer facilities and healthier work environment.
  2,511 176 -
Pattern of suicide in Nigeria: The Niger Delta Experience
SAU Offiah, CC Obiorah
January-March 2014, 9(1):8-11
DOI:10.4103/9783-1230.132550  
Background: Suicide is becoming a major public health problem. Objective: To determine the pattern of suicide cases with respect to age, sex, and methods employed. Design: A 10-year retrospective study of suicide cases reported to the Coroner in Rivers and Abia states of Nigeria. Materials and Methods: Data on the age, sex, circumstances, and methods of all suicide cases handled by the authors were extracted and analyzed. Results: There were 32 cases (0.9%) of suicides out of a total of 3,555 medico-legal autopsies reviewed over the period. Of the 32 cases, 28 (87.5%) were males and 4 (12.5%) were females, giving a male to female ratio of 7:1. The age distribution showed a peak incidence in the third decade. The commonest method of committing suicide in this environment is by hanging. The range and mean of the ages is 16 - 64 yrs and 31 yrs, respectively. Conclusion: This review shows that the choice of how to die often depends on the most available and most convenient means at hand. Women chose less violent means of suicide such as drowning or poisoning, while males often chose violent methods such as hanging or firearms.
  2,434 199 -
Prevalence of extended spectrum beta-lactamase-producing Klebsiella species at the University of Ilorin Teaching Hospital
BU Faari, AA Akanbi, A Fadeyi, KW Wahab, C Nwabuisi
January-March 2015, 10(1):20-23
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.
  2,252 363 -
Scaling up the practice of sanitary refuse disposal in Aba, South Eastern Nigeria
UM Nwosu, RA Eke, KA Uwakwe
April-June 2014, 9(2):70-73
DOI:10.4103/9783-1230.139166  
Background: Scaling up the practice of sanitary refuse disposal is currently a challenge facing Abia State Environmental Protection Agency in Aba. Objectives: The objective was to identify factors contributing to low level practice of sanitary refuse disposal in Aba and to determine the effects of health promotion intervention in addressing these factors. Design: A prospective, interventional study. Setting: Aba North and South Local Government Areas in Aba. Materials and Methods: Interventional study was carried out in two randomly selected communities in Aba March 2013 to September 2013. Sample size of 443 persons was systematically selected for the study. Instrument for data collection was questionnaire. Chi-square and McNemar statistic were used in testing for statistical significance. Results: Factors contributing to low level practice of sanitary refuse disposal in Aba were broadly categorized into four: Ignorance, inadequate sanitary refuse bins at homes and collection centers, poor attitude toward sanitation, delay in refuse evacuation. Conclusion: Health promotion intervention increased the practice of sanitary refuse disposal by 62% and is hereby recommended as a veritable tool for scaling up the practice of sanitary refuse disposal in urban areas.
  2,413 168 -
Serologic survey of rubella virus igG in an African obstetric population
S Onwere, B Chigbu, C Aluka, CI Kamanu, O Okoro, FP Waboso, P Ndukwe, A Onwere, E Akwuruoha, E Ezirim, C Aharauka, I Ojike, M Ejike, C Ndukwe
January-March 2014, 9(1):5-7
DOI:10.4103/9783-1230.132549  
Objectives: To determine the seroprevalence of rubella infection in pregnancy. Materials and Methods: A cross-sectional survey of 345 consecutive and consenting antenatal attendees at Aba, Southeastern Nigeria over the period 1 June - 1 September, 2012. A structured pretested questionnaire was used to collect and record data on the socio-demographic characteristics of the subjects. Blood samples were collected from the subjects and tested for rubella IgG antibodies using the QikTech TM One-Step Rubella Test (LuSys Laboratories, USA). Results: Sixteen (4.6%) of the 345 subjects were found to have rubella IgG antibodies in their blood. None of the subjects had been vaccinated against rubella. Maternal age, parity, educational level attained, and marital status did not show any association with rubella IgG antibodies seropositivity. Conclusion: Our findings imply immunity to rubella in 4.6% of the subjects. Thus, 95.4% of the subjects were seronegative and non-immune. This large pool of seronegative and non-immune population will benefit from education on the availability of vaccination, prevention, and consequences of congenital rubella.
  2,409 153 -
CASE REPORT
Cystolithiasis with coexisting nephrolithiasis: A radiodiagnostic discovery in an adult Nigerian male with lower urinary tract symptoms
Olufunso Simisola Aduayi, Olusola Comfort Famurewa
January-March 2015, 10(1):30-32
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.
  2,388 136 -
ORIGINAL ARTICLES
Determinants of noninstitutional deliveries in an urban community in Nigeria
I Nduka, EC Nduka
July-September 2014, 9(3):102-107
DOI:10.4103/9783-1230.144770  
Background: Maternal mortality in developing countries is an issue of global concern. Delivery attended to by skilled birth attendants is emphasized as an important strategy for reducing maternal deaths. Choice of birth place is determined by various factors. This study thus evaluates determinants of noninstitutional birth places and reasons for the choice among women in Aba, South-East, Nigeria. Materials and Methods: The study was descriptive cross-sectional in design carried out among 420 women in Aba, a commercial city in Abia state, Nigeria. Cluster and simple random sampling techniques were used to select the study participants. Data was collected using interviewer administered questionnaire and analysed by SPSS version 17 software. Logistic regression analysis was done to determine predictors of noninstitutional birth places and the result presented in tables. Result: One hundred and sixty-four respondents (39%) had their last deliveries in a nonhealth facility with unskilled attendants. These places included maternity homes (10.2%), traditional birth attendants (11.9%), religious home (7.4%) and home deliveries (9.5%). There was statistical significant difference between age, marital status, level of education, number of living children and noninstitutional birth places. Reasons cited for choice of nonhealth birth places included cost, friendly staff and perceived experience of birth attendant. Conclusion / Recommendation: Noninstitutional birth places are still prevalent in urban communities and women prefer these birth places for diverse reasons. This study recommends an address of reasons for the choice of birth places among women.Background: Maternal mortality in developing countries is an issue of global concern. Delivery attended to by skilled birth attendants is emphasized as an important strategy for reducing maternal deaths. Choice of birth place is determined by various factors. This study thus evaluates determinants of noninstitutional birth places and reasons for the choice among women in Aba, South-East, Nigeria. Materials and Methods: The study was descriptive cross-sectional in design carried out among 420 women in Aba, a commercial city in Abia state, Nigeria. Cluster and simple random sampling techniques were used to select the study participants. Data was collected using interviewer administered questionnaire and analysed by SPSS version 17 software. Logistic regression analysis was done to determine predictors of noninstitutional birth places and the result presented in tables. Result: One hundred and sixty-four respondents (39%) had their last deliveries in a nonhealth facility with unskilled attendants. These places included maternity homes (10.2%), traditional birth attendants (11.9%), religious home (7.4%) and home deliveries (9.5%). There was statistical significant difference between age, marital status, level of education, number of living children and noninstitutional birth places. Reasons cited for choice of nonhealth birth places included cost, friendly staff and perceived experience of birth attendant. Conclusion / Recommendation: Noninstitutional birth places are still prevalent in urban communities and women prefer these birth places for diverse reasons. This study recommends an address of reasons for the choice of birth places among women.
  2,021 308 -
LETTERS TO EDITOR
Commitment to ensure an effective quality assurance in diagnosis of tuberculosis
SR Shrivastava, PS Shrivastava, J Ramasamy
April-June 2014, 9(2):99-100
DOI:10.4103/9783-1230.139176  
  1,972 326 -
ORIGINAL ARTICLES
The impact of collaboration and family planning counseling in the community setting
B Chigbu, S Onwere, P Feyi-Waboso, C Kamanu, C Aluka, O Ezirim, O Okoro, E Akwuruoha
January-March 2014, 9(1):16-20
DOI:10.4103/9783-1230.132552  
Background: Since uptake of family planning methods is influenced by poor knowledge of modern contraceptive methods and by cultural beliefs and community opinions, there may be benefit in having the counseling on offer from someone who lives within the community he/she serves, and who is cognizant of the nature of local concerns. Objective: To assess the impact of collaboration between a private health care facility, a non-governmental organization, and community health care workers on the uptake of modern methods of contraception by women in the rural community of Ekeakpara in Osisioma Ngwa LGA of Abia State, Nigeria. Design: A cross-sectional study. Setting: A health care facility. Subjects: All acceptors of modern methods of contraception at the facility from January 2004 to December 2006, and from June 2010 to May 2012. Materials and Methods: Contraceptive uptake between two periods (January 2004 - December 2006 and June 2010 - May 2012) was compared. Qualitative data on acceptors of contraception between June 2010 and May 2012 were collected using in-depth interviews. Results: Mean age of the women was 33.4 years. Majority (38%) of the women had only primary education. Their parities ranged from 1 to 10 with a mean parity of 5.1. With community mobilization, the women acceptance and attitude to modern methods of contraception was better than previously. Prior to community mobilization, 13 out of 30 women in need of permanent limitation of their family size chose injectable contraceptives. With community mobilization, majority of the women (120 out of 122) in need of permanent limitation of their family size opted for either the long-acting reversible contraceptive methods or bilateral tubal ligation. Conclusion: The positive impact of community mobilization in collaboration with an NGO as exemplified in this study suggests the need to encourage donors, governments, and the private sector to increase resources to fund family planning in rural communities in Nigeria.
  2,084 191 -
CASE REPORT
Pansinusitis, cavernous sinus thrombosis and cerebral infarction
Y Singh, M Singh, SR Saxena, J Kumar
April-June 2014, 9(2):95-97
DOI:10.4103/9783-1230.139174  
Cavernous sinus thrombosis is a fatal disease and require aggressive treatment. This progresses rapidly and sometimes there is intracranial extension. Here, we report a case of pansinusitis and cavernous sinus thrombosis that eventually developed middle cerebral artery territory infarct. Patient was middle aged diabetic and was having a history of tooth extraction 10 days back. We suggest that unusual complication of ischemic stroke with cavernous sinus thrombosis should be kept in mind, while dealing with these patients.
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ORIGINAL ARTICLES
Prevalence of hearing impairment amongst primary school children in Port-Harcourt, Rivers State: Implication for strengthening of school health programme in Nigeria
I Nduka, EJ Aitafo, EC Nduka
July-September 2014, 9(3):120-125
DOI:10.4103/9783-1230.144774  
Introduction: Hearing impairment is the most frequent sensory deficit in humans with a higher prevalence in developing countries. Materials and Methods: Hearing assessment was carried out in lower primary school children in Port Harcourt City (PHC) between January 10th and May 21, 2010. A total of 802 school children were selected by multistage sampling technique, consisting of 405 (50.5%) males and 397 (49.5%) females. Screening for hearing impairment was done using pure tone audiometry after an otoscopic examination. The prevalence of hearing impairment was found to be 29.4%. Result: Hearing impairment was significantly more prevalent (32.8%) among children in the older age group (11-13 years) than in children 5-7 years of age (24.2%). Most (58.9%) of the children had slight hearing impairment (16-25 dB HL). Unilateral hearing loss was seen in 54.1% of the children while 45.9% had bilateral hearing loss. Conclusion /Recommendation: The study revealed that hearing impairment is common among primary school children in PHC. We therefore recommend that routine hearing screening should be part of the school health program at school entry for primary school pupils, for early detection and treatment of hearing impairment to enhance total development of the child and maximize academic performance.
  1,997 205 -
CASE REPORT
Breast abscess complicting prolactinoma
F Uduma, M Motah
January-March 2014, 9(1):47-50
DOI:10.4103/9783-1230.132560  
Prolactinoma is an intra-sellar benign adenoma. It could be micro- or macro-adenoma. The commoner micro-adenoma is an endocrine active. The distant effect of Prolactinaemia is on reproductive system and breast as seen in our Para-2 45 year old woman with pituitary micro adenoma, dense breasts and right breast abscess.
  1,971 153 -
ORIGINAL ARTICLES
Macrosomia: Prevalence and predisposing factors as seen at a university teaching hospital, South-South Nigeria
CN Onyearugha, HAA Ugboma
January-March 2014, 9(1):12-15
DOI:10.4103/9783-1230.132551  
Background: The rising prevalence and the attendant morbidity and mortality arising from macrosomic births require a good understanding and good management protocol. Objective: To determine the prevalence and associated factors of macrosomia. Design: Retrospective study Setting: The labor ward, isolation ward and main theatre of the University of PortHarcourt Teaching Hospital ( UPTH ). Subjects: Four hundred and sixty babies with macrosomia delivered at UPTH. Patients and Method: Data including the birth weight, gestational age, sex, and mode of delivery, Apgar score, morbidity in the newborn, duration of admission, outcome of management, maternal age, parity, pregnancy and labor complications relating to the subjects were extracted and analyzed. Results: The prevalence of macrosomia was 7.4% (490/6642). It was highest in multiparous parturients (77.8%) (358/460) aged 30-34 years (42%) (193/460). Significantly more males 302(65.7%) (302/460) than females 158(34.3%) (158/460) were macrosomic p<0.001. Ninety five (20.6%) (95/460) had moderate to severe birth asphyxia while 2% (9/460) were still births. Among the pregnancy and labor complications respectively noted in the parturients, gestational diabetes mellitus (18.2%) (28/154) and cephalopelvic disproportion (43%) were the most frequent. Majority, 299 (65.2%) (299/460) had spontaneous vertex delivery, while 150 (32.6%) (150/460) were delivered by Caesarean section. Birth asphyxia (20.6%) (95/460) and prematurity (8.5%) (39/460) were the leading fetal complications. Conclusion: Multiparous expectant women aged 30-34 years and those with gestational diabetes mellitus are prone to delivering macrosomic babies in this community. They should therefore be properly supervised with the fetus monitored for growth and size and appropriate mode of delivery and neonatal resuscitation determined prenatally to reduce the incidence of adverse perinatal outcome.
  1,892 196 -
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