Medical and Dental Consultantsí Association of Nigeria
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   2007| December  | Volume 10 | Issue 4  
    Online since December 1, 2010

 
 
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CASE REPORTS
Antepartum myomectomy with a live term delivery - A case report
AS Adeyemi, SE Akinola, AI Isawumi
December 2007, 10(4):346-348
PMID:18293648
We report a case of successful myomectomy in pregnancy. The patient, a 27 year old nulliparous, presented with 2 year history of progressive abdominal swelling and 13 weeks of amenorrhoea. Abdomino-pelvic ultrasonography revealed a viable intrauterine pregnancy at 18 weeks and 3 days; there was also a huge mass with cystic component, extending from the pelvis to the whole of the abdomen, with associated dilatation of the renal calyces bilaterally; sonographic diagnosis of ovarian mass in pregnancy was made. At exploratory laparotomy, a huge subserous leiomyoma coexisting with pregnancy was found; myomectomy was done. The rest of the pregnancy was uneventful, and the patient had spontaneous vertex delivery of a live infant at term.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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ORIGINAL ARTICLES
Clinical profile of atopic dermatitis in Benin City, Nigeria
AN Onunu, EU Eze, EP Kubeyinje
December 2007, 10(4):326-329
PMID:18293644
OBJECTIVE: To study the clinical presentation and management problems of atopic dermatitis in Benin City, Nigeria. DESIGN: A 15-year retrospective study from May 1985 to April 2000. SETTING: Dermatology clinics of the University of Benin Teaching Hospital, Benin City, Nigeria. SUBJECTS: All new cases of atopic dermatitis presenting to the clinic during the study period. RESULTS: 594 patients suffering from atopic dermatitis, representing 7.92% of new dermatological cases were seen during the study period. There was a slight male preponderance; the male to female ratio was 1.2: 1. Most patients were below 30 years of age with the peak incidence in the 0 9-year age group, with most presenting in the first six months of life. Forty-six percent of the patients had a positive family history of atopy, while 73% also had other atopic disorders. The clinical patterns seen were infantile, childhood and adult forms, which is in keeping with reports from other parts of the world. Precipitating factors were most often obscure; however, high temperatures and humidity were the most common aggravating factors. The important problems encountered were misuse of topical medications, oral antibiotics, anti-fungal drugs and a high follow-up default rate. CONCLUSION: The clinical characteristics of atopic dermatitis in our study population were similar to the pattern in other parts of the world. There is need for increased awareness of its importance as a cause of morbidity especially in children.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  569 0 3
Review of neonatal infections in University of Maiduguri Teaching Hospital : Common bacterial pathogens seen
JP Ambe, IS Gasi, Y Mava
December 2007, 10(4):290-293
PMID:18293637
BACKGROUND: Bacterial infections are important causes of morbidity in the neonatal period. Therefore identification of infecting organisms and the risk factors for possible bacterial infection in the newborn is of great importance. Institution early appropriate therapy is an important step in combating morbidity and mortality in this age group. METHODS: Medical records of patients admitted into the Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital (UMTH) were reviewed over a 5-yaer period (1995-1999) RESULTS: Of the 1,304 newborn admissions over the study period, 813 (62.3%) had risk factors for neonatal infections. Staphyloccus aureus (46.2%) was the predominant organism isolated from blood culture, followed by Klebsiella spp (24.8%). Streptococcus pneumoniae and Pseudomonas are the least encountered in this series. Haemophilus influenzae, Klebsiella pneumoniae and Streptococcus pneumoniae were the predominant pathogens in pyogenic meningitis. Most of the delivery occurred outside the teaching hospital, even those that delivered in the hospital, some come in during labour. CONCLUSION: Neonatal bacterial infections are still a cause of high morbidity and mortality of the newborn in our setting. To reduce the morbidity and mortality from neonatal bacterial infections, mothers need to attend antenatal clinic, so that those who at risk can be taken care off immediately.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  569 0 3
Pattern and outcome of adult tetanus in Ile-Ife, Nigeria
MA Komolafe, EO Komolafe, AO Ogundare
December 2007, 10(4):300-303
PMID:18293639
OBJECTIVE: This is a retrospective study of all adult patients with tetanus managed at the Obafemi Awolowo University Teaching Hospitals Complex from 1995-2004. The aim was to study the pattern of adult tetanus in Ile-Ife, Nigeria, and see what improvements could be made in the future in particular with regard to decreasing the prevalence in our environment. METHOD: Data was obtained from the hospital records of all the patients, the admission and discharge registers of the medical wards of the hospital. RESULT: 79 adult patients with tetanus were managed during the study period and they accounted for 44% of neurological admissions. There were 56 males and 23 females giving a M:F ratio of 2.4 to 1. 45 (57%) of the patients were under 30 yrs of age and two-thirds (67%) had puncture wounds in the lower limbs. 20 patients (25%) had mild tetanus, 16 (20%) had moderate disease and 43 (55%) had severe tetanus. The patients were treated with tetanus antitoxin, antibiotics and sedatives. The mortality rate was 45% and laryngeal spasm was the most common cause of death. None of the patients was managed in the intensive care unit (ICU). CONCLUSION: Tetanus remains a major public health problem in Nigeria. It is commonly associated with high mortality due to late presentation. Health education should be promoted to reduce the unacceptable prevalence in our practice setting.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  540 0 5
Knowledge and attitude of secondary school teachers in Enugu to school based sex education
PN Aniebue
December 2007, 10(4):304-308
PMID:18293640
OBJECTIVE: To assess the knowledge and attitude to sex education among secondary school teachers in Enugu. MATERIALS AND METHODS: A cross sectional study of 300 teachers drawn from nine randomly selected secondary schools in Enugu metropolis was carried out. Pre-tested self administered structured questionnaire was used as instrument for data collection. RESULTS: Three hundred teachers, 215 females and 85 males were interviewed. The mean age of the teachers was 38.1+/-7.5 years. Sixty-nine (23.0%) had adequate knowledge of sex education and 282 (94.0%) approved the inclusion of sex education into the school curriculum. The commonest reason for disapproval of sex education was fear that it would lead to promiscuity amongst the students. Educational status and marital status of the teachers were significant determinants of positive attitude to sex education p<0.05. The most appropriate age to introduce sex education according to the teachers is 11-15 years. Two hundred and thirty eight (79.3%) respondents were of the opinion that teachers needed to be trained to provide sex education to students and 244 (81.3%) admitted that sex education was not in the school curriculum. CONCLUSION: Secondary school teachers are in support of provision of sex education to students. However they need training and skills on how to present sex information in a positive manner to achieve the desired goal. There is need to include sex education in the school curriculum.
[ABSTRACT]   Full text not available     [PubMed]
  529 0 -
Seroprevalence of hepatitis B surface antigenemia among health care workers in a Nigerian tertiary health institution
AO Ajayi, AO Komolafe, K Ajumobi
December 2007, 10(4):287-289
PMID:18293636
OBJECTIVE: The aim of this study was to determine the seroprevalence of Hepatitis B surface antigenaemia among the health care workers at the Federal Medical Centre, Ido-Ekiti, Nigeria. DESIGN AND METHOD: The study was carried out on all the staff members in the employment of the Federal Medical Center, Ido Ekiti, Nigeria as at 30th April 2003. Data were collected by administering a set of questionnaire to every member of staff. Blood samples (3mls) were taken from the left cubital fossa of all the respondents and Hepatitis B surface antigen status determined using the agglutination kits manufactured by Biotech Laboratories USA. RESULTS: A total of 420 staff members were screened. 168 (40%) were males while 252 (60%) were females. Only 18 were found to be positive for Hepatitis B surface antigen giving a prevalence of 4.3%. 9 (50%) of those that were positive for Hepatitis B surface antigen were ward maids/attendants, 6 (33%) were nurses, 2 (11%) were administrative staff and 1 (6%) was a health record staff. CONCLUSION: Health care workers are at increased risk of having hepatitis B infection. Health education should be carried out routinely in our hospitals to raise the awareness level among the hospital staff and standard safety measures such as sharps policy should be adopted in the handling of blood products and sharps.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
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Maternal outcome in eclamptic patients in Abuja, Nigeria - A 5 year review
ER Efetie, UV Okafor
December 2007, 10(4):309-313
PMID:18293641
OBJECTIVE: To assess the outcome ofwomen admitted with eclampsia in the National Hospital, Abuja, Nigeria. STUDY DESIGN/SETTING: A retrospective analysis. The medical records register in the accident and emergency department, labour ward, maternity ward and the intensive care unit were searched to identify cases of eclampsia admitted at the National Hospital,Abuja (NHA) between 1st March 2000 and 28th February 2005. RESULTS: The incidence of eclampsia was 7.8 per 1000 deliveries. Eclampsia significantly occured in nulliparous and unbooked mothers (p < 0.001 & p < 0.0001 respectively). Most (71.5%) of mothers delivered by Caesarean section and the most common indication for this was an unfavourable cervix (cervix thick, firm and closed when assessed at presentation in the labour ward). Nineteen (41.3%) of mothers developed complications with HELLP (hemolysis, elevated liver enzymes, low platelets) occurring in six patients (31.6%). There were 13 maternal deaths giving a case fatality rate of 28.3% and a maternal mortality ratio for eclampsia of222/100,000. HELLP syndrome was responsible for 46.2% of deaths in the study. CONCLUSION: The maternal outcome of eclamptics in Abuja, Nigeria is poor and HELLP syndrome is a major contributor to the high fatality rate. Emphasis should be on primary preventive measures such as early, continuous, good antenatal care and improvement of intensive care facilities. More widespread use of Magnesium sulphate for anticonvulsant prophylaxis is advocated.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  511 0 8
Target organ damage and associated clinical conditions in newly diagnosed hypertensives attending a tertiary health facility
OE Ayodele, CO Alebiosu, PO Akinwusi, A Akinsola, A Mejiuni
December 2007, 10(4):319-325
PMID:18293643
BACKGROUND: Despite the ease of detecting and making a diagnosis of hypertension, various population surveys have shown low awareness and treatment rates of hypertension. Failure to detect and make a diagnosis of hypertension leads to late presentation and institution of treatment with consequent development of target organ damage (TOD) and associated clinical conditions (ACC) which in turn are associated with increased cost of treatment, morbidity and mortality. OBJECTIVE: This study was aimed at determining the presence and severity of TOD and ACC in newly diagnosed hypertensives with a view to ascertaining the magnitude of the problem. METHOD: The study was carried out at Ladoke Akintola University of Technology Teaching Hospital Osogbo, Nigeria. Target organ damage (TOD) and associated clinical conditions (ACC) were determined in successive newly diagnosed hypertensives that presented at the centre during the study period. RESULT: Of 147 newly diagnosed hypertensives seen at Ladoke Akintola University of Technology Teaching Hospital Osogbo, Nigeria, TOD and ACC were found in 98 (66.7%). The most prevalent TOD and ACC were LVH (42.2%), diabetes mellitus (14.3%), CVD (10.9%) and heart failure (8.8%). Patients with TOD andACC were significantly older (p = 0.028), had significantly higher SBP (p = 0.003), higher DBP (p = 0.022) and significantly lower BMI (p = 0.046) when compared with patients without TOD and ACC. CONCLUSION: This study showed presence of TOD and ACC in two-thirds of newly diagnosed hypertensives. This underscores the need for improvement in the awareness, detection and treatment of hypertension in order to prevent TOD and ACC.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  502 0 1
Neonatal morbidity pattern in infants born in Benin City to Nigerian mothers with hypertensive disorders in pregnancy
AN Onyiriuka, AA Okolo
December 2007, 10(4):294-299
PMID:18293638
BACKGROUND: Hypertensive disorders in pregnancy are worldwide in distribution with an incidence that names depending on hospital population and criteria cited for diagnosis METHODS: In a case-control study, the neonatal morbidities of 256 live newborn infants of hypertensive mother were compared with those of 804 infants ofnormotensive mothers. RESULTS: The incidence of some neonatal morbidities such as birth asphyxia, neonatal seizures, neonatal polycythaemia and hyperbilirubinaemia were significantly higher among babies born to hypertensive mothers compared with those born to their normotensive counterparts. The Caesarean delivery rate was also significantly higher in hypertensive than in normotensive mothers. CONCLUSION: Pregnancies complicated by hypertension are associated with an increase in neonatal morbidity. The implication is that newborn infants of hypertensive mothers represent a high-risk group requiring close observation and attention, aimed at prevention and prompt treatment of these morbidities.
[ABSTRACT]   Full text not available     [PubMed]
  487 0 -
The pattern of tobacco use among non-pulmonary tuberculosis patients attending a chest clinic in south-western Nigeria
MO Tanimowo, YA Onaolapo
December 2007, 10(4):314-318
PMID:18293642
OBJECTIVE: To determine the pattern of tobacco use among non-pulmonary tuberculosis patients attending the chest clinic of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria. PATIENTS AND METHODS: One hundred and four non-pulmonary tuberculosis patients attending the chest clinic between January 2003 and December 2005 were studied with respect to their tobacco use habits using a questionnaire after their consents had been obtained. Questions were asked about the form(s) of tobacco used, the mode(s) of use, the duration of use and the amount (in case of cigarette smoking), and the duration of stoppage of tobacco use. RESULTS: There were no current smokers among the patients studied, but 24% of them had used tobacco before presentation, while 84% of these had specifically smoked cigarettes. There were no pipe smokers, no cigar smokers, and no tobacco chewers. The rate of cigarette smoking was highest among the COPD patients (76.5%), and they also have the highest number of pack-years. Smoking rates in the other patients are: lung abscess (50%), empyema thoracis (50%), bronchial asthma (33.3%), and community acquired pneumonia (11.1%). No case of lung cancer was encountered. Two patients with lung abscess had smoked both cigarettes and marijuana in combination while another 2 patients with empyema thoracis had smoked the same combination before presentation. There is no relationship between the duration of stoppage of tobacco use and the subsequent development of non-tuberculous respiratory disease. CONCLUSION: Tobacco remains a very significant threat to respiratory health, as this study has demonstrated. The campaign against its use therefore must be intensified.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  480 0 1
CASE REPORTS
Iatrogenic arterial injury and foot gangrene. A case report
LO Thanni
December 2007, 10(4):352-354
PMID:18293650
BACKGROUND: Elective orthopaedic operations on the knee is rarely complicated by arterial injury. REPORT: A case report is presented of a 10 year old girl that developed gangrene of the foot following an elective orthopaedic operation on the proximal tibial metaphysis. A transfixion wire that breached the posterior tibial cortex was most probably responsible for popliteal artery injury that resulted in ischaemia and gangrene. The patient had an amputation of all the toes in the affected limb and recovered satisfactory limb function. CONCLUSION: In operations on the proximal tibial metaphysis, implants (screws, pins, wires) should not be allowed to perforate the posterior cortex. When this occurs inadvertently, they should be readjusted as soon as radiographs confirm this, to avoid injury to the popliteal artery.
[ABSTRACT]   Full text not available     [PubMed]
  470 0 -
Parasitic leiomyoma : A diagnostic dilemma. A case report
I Okoro, N Ododo, R Egejuru
December 2007, 10(4):349-351
PMID:18293649
Leiomyomata (uterine fibroids) are the most common tumours of the female pelvis. Presentation of most cases of fibroids are usually straightforward making diagnosis and management easy. However, when they undergo various kinds of pathologic changes, they pose both diagnostic and management difficulties. This article presents a rare case of a large degenerated parasitic leiomyoma in the peritoneal cavity deriving its blood supply from the omentum and attached to a normal looking uterus by a narrow avascular stalk. Ultrasound, x-ray and physical examination did not help with the diagnosis. It was at laparatomy that the diagnosis was made and later confirmed by histological examination.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  464 0 1
Eclampsia in advanced abdominal pregnancy
BA Ekele, AN Adamu, H Ladan, H Abitare
December 2007, 10(4):343-345
PMID:18293647
The occurrence of eclampsia in an extra uterine pregnancy is a very rare entity. We report a case of a patient with eclampsia and advanced extra-uterine pregnancy. The fits were controlled with diazepam and the patient had laparotomy for the evacuation of the fetus from the abdominal cavity. She had an uneventful post operative recovery and was discharged home in good health after 10 days.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  463 0 1
ORIGINAL ARTICLES
Ocular disorders in patients infected with the human immunodeficiency virus at the University of Benin Teaching Hospital, Benin City, Nigeria
AI Osahon, AN Onunu
December 2007, 10(4):283-286
PMID:18293635
AIMS: Ocular diseases occur at all stages of HIV infection. Reports have documented that the prevalence of these diseases vary from region to region. Thus the objective of this study is to determine the prevalence of these ocular disorders among people infected with HIV at the University of Benin Teaching Hospital, Benin City, Nigeria METHODS: The study was prospective in design and all patients who tested positive for HIV antibodies over a 5-year period from September 1997 to August 2002 in Dermatology and Ophthalmology Units at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria, were examined for the presence of ocular disease. RESULTS: Twenty-one of the 526 HIV-positive patients had ocular disease, giving a prevalence rate of 4.0%. Their mean age was 39.5 +/- 10.5 years. Fourteen patients (2.7%) had Herpes zoster ophthalmicus, four (0.8%) had Squamuos cell carcinoma, two (0.4%) had Kaposi's sarcoma while one (0.2%) had Cytomegalovirus retinitis. The signs seen on ocular examination were vesicular rash (66.7%) diminished vision (57.1%) corneal ulcers (38.0%), conjunctival injection (38.0%), and eyelid nodules (28.6%), preauricular lymphadenopathy (28.6%), purulent eye discharge (19.0), conjunctival nodules (9.5%), papilledema (9.5%), ptosis (9.5%), sudden visual loss in both eyes (9.5%), pupillary dilatation (4.8%), chemosis (4.8%), uveitis (4.8%), and retinal hemorrhage (4.8%). CONCLUSIONS: In this study the prevalence of ocular disorders was 4.0% in the 526 HIV-positive patients studied. Herpes zoster ophthalmicus was the commonest ocular disease encountered, occurring in 2.7% of the study population. This is in keeping with reports from other parts of the world. We recommend that young patients presenting with Herpes zoster ophthalmicus, conjunctival Squamuos cell carcinoma and sudden onset bilateral blindness should be screened for HIV infection.
[ABSTRACT]   Full text not available    [CITATIONS]  [PubMed]
  451 0 7
Pathology of vaginal cancers in Port Harcourt, Nigeria. A 14-year study
CI Akani, D Seleye-Fubara, SA Uzoigwe
December 2007, 10(4):330-334
PMID:18293645
BACKGROUND: Primary malignancies of the vagina are rare as most are metastatic lesions. This study documents a 14-year experience in a tertiary institution in South Southern, Nigeria. DESIGN AND SETTING: A retrospective study of clinical presentations including anatomic sites and histopathologic diagnosis of cancers of the vagina in the University of Port Harcourt Teaching Hospital METHODOLOGY: The tissues received for histologic diagnosis were fixed in 10% formal saline, processed and embedded in paraffin wax. Microtome sections of the tissue (3 -5 microns) were taken and mounted on glass slides and stained with hematoxylin and eosin (H & E) stains. Cases in which both the slide and blocks could not be traced were excluded from the study. RESULTS: A total of 2389 malignancies were diagnosed during the period under review of which 344 were gynaecological. Fifteen cases of vaginal cancers satisfied the criteria for the study, constituting 0.63% and 4.36% of the total and gynaecological malignancies respectively. Five cases (33.33%) occurred in children below the age of 20 years, while 10 cases (66.67%) were in adults. The peak incidence was in the group 0 9 and 60-69 years. Irregular vaginal bleeding was the commonest clinical presentation and the upper posterior vaginal wall was the commonest anatomic site. The most frequent histological type was the non-keratinizing squamous cell carcinoma while FIGO stage 111 (46.67%) cancer was the commonest stage at presentation. CONCLUSION: Vaginal cancers are rare in this environment but they contribute to high morbidity and mortality among women of all ages as the disease is diagnosed at an advanced stage.
[ABSTRACT]   Full text not available     [PubMed]
  448 0 -
COMMENTARY
Socio-economic differences in health, nutrition, and population within developing countries : An overview
DR Gwatkin, S Rutstein, K Johnson, E Suliman, A Wagstaff, A Amouzou
December 2007, 10(4):272-282
PMID:18293634
Full text not available    [CITATIONS]  [PubMed]
  416 0 15
REVIEW ARTICLE
Recent developments in the management of diabetes mellitus
OA Fasanmade, IA Odeniyi, AO Adeyemi Doro, TH Raimi, JA Adenegan
December 2007, 10(4):335-342
PMID:18293646
Full text not available     [PubMed]
  286 0 -
CASE REPORTS
Post-partum infarction of an axillary breast. Case report
SN Anyanwu, JC Orakwe, U Ezomike
December 2007, 10(4):355-356
PMID:18293651
Full text not available     [PubMed]
  236 0 -
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