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 Table of Contents  
NPMCN CONFERENCE ABSTRACTS
Year : 2017  |  Volume : 24  |  Issue : 4  |  Page : 257-275

Abstracts of papers presented at the 12th annual scientific conference of the national postgraduate medical college of Nigeria, Kano 2017


Date of Web Publication18-Jan-2018

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/npmj.npmj_194_17

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How to cite this article:
. Abstracts of papers presented at the 12th annual scientific conference of the national postgraduate medical college of Nigeria, Kano 2017. Niger Postgrad Med J 2017;24:257-75

How to cite this URL:
. Abstracts of papers presented at the 12th annual scientific conference of the national postgraduate medical college of Nigeria, Kano 2017. Niger Postgrad Med J [serial online] 2017 [cited 2019 Dec 12];24:257-75. Available from: http://www.npmj.org/text.asp?2017/24/4/257/223468




  NPMCN_ASC_2017_001 Top


Endoscopic Ear Surgery in Kano: Challenges and Prospects

A. D. Salisu, E. S. Kolo

Department of Otorhinolaryngology, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria

Address for correspondence: Prof. A. D. Salisu, Department of Otorhinolaryngology, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: adsalisu@yahoo.com

Aim: To describe challenges with the introduction of endoscopic ear surgery in our practice in Kano. Patients and Methods: Retrospective study of patients who accessed otology services at the main specialist/tertiary health facilities before (2010 - 2012) and after (2012 - 2014) the introduction of endoscopic ear surgery in Kano and Jigawa states. Results: 609 ears (45%) required some form of surgical intervention. Age range was 3 yrs to 62 yrs. There were 415 (58.5%) males and 294 (41.5%) females. Group 1 (pre-endoscopic ear services) had 267 ears seen at secondary health facilities required operation. All cases were referred (100%) to the tertiary facility. At the tertiary institution, only 15 (6%) operations of these were recorded. Group 2 (post-endoscopic ear services) had 342 ears seen at secondary health facilities required operation. 117 (34%) were considered suitable for endoscopic ear operation of which 92 (26%) ears had endoscopic +/- open ear operation at the secondary health facilities.225 (66%) cases were referred to tertiary institution, only 18 (5%) of these had operation. The initial operative challenges were prolong operation time, primary bleeding, reduced dexterity associated with a one-handed technique and lack of facilities in the secondary health facilities. Conclusion: Despite the initial constraints of endoscopic ear surgery in Kano, the technique was feasible with good prospects in our practice.

Keywords: Challenges, ear surgery, endoscopy, prospects and Kano


  NPMCN_ASC_2017_002 Top


Quality of Life and Associated Variables among Life-sentenced Inmates in Jos Maximum Security Prison

Aishatu Yusha’u Armiya’u, Tajudeen Abiola1

Department of Psychiatry, Forensic Unit, Jos University Teaching Hospital, Jos, Plateau State, 1Medical Services Unit, Federal Neuropsychiatric Hospital, Barnawa-Kaduna State, Nigeria

Address for correspondence: Dr. Tajudeen Abiola, Department of Psychiatry, Forensic Unit, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.

E-mail: abiolatob@yahoo.com

Background: People serving life sentences must make prison their homes forever. They will never again have the thousands of freedoms many of us take for granted. The miserable environment of prison means people with life sentences have to preserve even the limited privileges to makes a big difference to their quality of life. This study assessed the relationship between quality of life and sociodemographic and mental health variables of life sentenced inmates. Materials and Methods: A cross-sectional descriptive study was carried out among 26 life-sentenced prisoners, who consented to be studied out of a total of 30. Each of the participants completed the socio-demographic, forensic and mental health variable questionnaire and the WHOQOL-BREF questionnaire. The data was analyzed using the Statistical Package for Social Sciences Version 21. Results: All participants were males and majority were <45 years in age (65.4%). Majority of the participants rated state of prison welfare as poor (65.4%), were visited only once while in prison (57.7%), have low social support (53.8%) and have low resilience (65.4%). Participants who were visited once and those with positive family history of mental illness had poor perception to their overall quality of life on WHOQOL-BREF. Conclusion: The results showed that majority of prisoners on life sentence rated the state of prison welfare as poor, had only one visit in prison with poor social support and low resilience characteristics. Inmates visited once and those with family history of mental illness have poor perception of their overall quality of life.

Keywords: Inmates, Mental health, Quality of life


  NPMCN_ASC_2017_003 Top


Validity of Post-traumatic Check List: Four-item (Pcl-4) as Screening Instrument in Post-traumatic Stress Disorder in Northern Nigeria

M. I. Gudaji, Z. G. Habib, A. M. Yakasai1, A. S. Salihu, H. Muhammad2, G. Iliyasu2, I. M. Yola3, Z. G. Habib4, S. B. Abubakar5, A. G. Habib2

Department of Psychiatry, Aminu Kano Teaching Hospital, Bayero University Kano, 1Infectious and Tropical Diseases Unit, College of Medical Sciences, Public Health and Diagnostic Institute, Northwest University Kano, 2Infectious and Tropical Diseases Unit, Aminu Kano Teaching Hospital, Bayero University Kano, Kano, 3Federal Teaching Hospital, Gombe State University, 5Kaltungo General Hospital, Kaltungo, Gombe, 4Federal Medical Centre, Birnin-Kudu, Nigeria

Address for correspondence: Dr. M. I. Gudaji, Department of Psychiatry, Aminu Kano Teaching Hospital/Bayero University Kano, Kano, Nigeria.

E-mail: mgudaji@yahoo.com

Background: There are many instruments to determine Post traumatic stress disorders in primary care. Most were validated in countries and cultures different from ours. The need to have a validated instrument for use in primary care to screen for PTSD in this environment is crucial. Objectives: The study was carried out with the aim to validate the four item Post traumatic Check List (PCL-4) against the 17 item Posttraumatic Check list (PCL-17). Methods: This retrospective cohort study conducted in Kaltungo, a rural area in northern Nigeria where patients with a history of snake bite (SB) were compared with a relative whom were not (NSB). The subjects were interviewed using authors administered questionnaire. The utility of a shorter version comprising of four questions items (PCL-4) was explored and compared to PCL-17. Data was analysed using stata 10.0. Results: 229 subjects participated in the study, 140 had prior history of snake bite while 89 had none. There was no difference in terms of socio demographic features between the groups. In ROC analysis using the PCL-17 as the standard, at cut off score of ≥2 the PCL-4 has sensitivity and specificity of 56% and 95% respectively. Raising the cut off score to ≥3 yielded sensitivity of (97%) but with reduction in specificity to (16%). Conclusion: The PCL-4 has good psychometric properties making it suitable for screening of patients in rural primary health care areas with no specialized personnel.

Keywords: Post-traumatic check list, post-traumatic check list-4, post-traumatic check list-17, post-traumatic stress disorder, snake bite


  NPMCN_ASC_2017_004 Top


Prevalence and Pattern of Mental Illness among Divorced Women in Kano, North Western Nigeria

Abubakar Sulaiman Baguda, Richard Uwakwe1, Shehu Sale2

Department of Psychiatry, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State, 1Mental Health Unit, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Anambra State, 2Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. Abubakar Sulaiman Baguda, Department of Psychiatry, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State, Nigeria.

E-mail: abaguda@yahoo.com

Background: Divorce is a means of dissolving marriages. Available literature mainly from western world shows there is higher rate of psychiatric illnesses among divorced women compared to those who are still in marriage. Occurrence of psychiatric illnesses among divorced women is not a well-researched area in Nigeria. Aim: To study the prevalence and pattern of psychiatric illnesses among divorced women in Kano, northwestern Nigeria. Methodology: This was a comparative cross-sectional study carried out among divorced women (index group) and women who were still in marriage (comparator arm) in Kano, Nigeria. General Health Questionnaire (GHQ12) was used to screen for mental illnesses. Participants who scored ≥4 on GHQ12, and 10% of those who scored <4 from each arm were administered Mini International Neuropsychiatric Interview. Data obtained was analysed using Statistical Software for Social Sciences version 20. Results: Three hundred women (150 divorced, 150 married) were recruited. Psychiatric illness was commoner among divorced women (58.7%) compared to the married ones (34.7%), (P < 0.001; OR=2.7 (95% C.I = 1.7 – 4.3). Generalized Anxiety Disorders (GAD) was the commonest psychiatric diagnosis, 38 (25.3%) divorced participants versus 27 (18.0%) married, followed by depression 35 (23.3%) versus 16 (10.7%), and comorbid GAD with depression 15 (10.0%) versus 9 (6.0%). Participants who were divorced had more of any of these diagnoses compared to their counterparts (p= <0.001). Conclusion: Psychiatric illnesses were commoner among divorced women compared to married women. Public health measures should be taken to address mental health needs of divorced women to improve their wellbeing.

Keywords: Depression, divorce, generalized anxiety disorders, Nigeria, psychiatric illness, women


  NPMCN_ASC_2017_005 Top


Association between Psychological Stress and Body Mass Index among University Staff and Students in Northwestern Nigeria: A Case-Control Study

Musa Abubakar Kana1,2, F. L. Ciroma3, M. U. Umar 4, B. Yakasai5

1EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal, Departments of 2Community Medicine, 3Physiology and 5Internal Medicine, Kaduna State University, Kaduna, 4Department of Psychiatry, Bayero University, Kano, Nigeria

Address for correspondence: Dr. Musa Abubakar Kana, Department of Community Medicine, Kaduna State University, Kaduna, Nigeria.

E-mail: musakana77@yahoo.com

Background: The burden of obesity is rapidly increasing in Africa and lifestyle transition is considered a risk factor. Psychological stress is characteristic of modern lifestyle that is causally linked with weight gain. However, there is insufficient knowledge about this association in African populations. Therefore, this study aims to investigate the association between psychological stress and body mass index among adult Nigerians. Methods: A case-control study was conducted on 242 participants consisting of staff and students of Kaduna State University, Northwestern Nigeria. Cases (108) were overweight or obese defined as BMI >25 and control (134) had BMI <24.9 kg/m2. Level of psychological stress was assessed with Holmes and Rahe stress scale. Number of “Life Change Units” that apply to events in past year of an individual’s life are added and the final score gives an estimate of how stress affects health. Scores are categorized as <150 (slight risk of illness), 150-299 (moderate risk of illness) and ≥300 (at risk of illness). Results: Overall mean stress score was 288.9 ± 164.81, while the respective scores for cases and control were 296.8 ± 182.79 and 282.7 ± 149.16 (P value = 0.511). Based on the stress scale, 43.5% of cases and 40.3% of control were classified as being at risk of illness (P value = 0.394). Using slight-moderate risk of illness as reference category, crude odds ratio (OR) for being at risk of illness in cases was 1.064 (0.628-1.802). The age and sex adjusted OR was 1.058 (0.614-1.823). Conclusion: Psychological stress risk was higher among overweight/obese participants but it is not significantly associated with body mass index in this population.

Keywords: Body mass index, case-control study, Nigeria, psychological stress


  NPMCN_ASC_2017_006 Top


Dysphagia Following Acute Stroke and its Effect on Short-term Outcome: A Preliminary Study

S. A. Abubakar, B. Y. Jamoh

Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria

Address for correspondence: Dr. S. A. Abubakar, Department of Medicine, Neurology Unit, Ahmadu Bello University, Zaria, Kaduna State, Nigeria.

E-mail: abbatta1@gmail.com

Introduction: Dysphagia is associated with numerous medical conditions including stroke, and there are wide variation in reported frequency of dysphagia in stroke survivors in the literature. Dysphagia has been shown to be an important risk factor for aspiration pneumonia and has profound impact on survivors. This study aim to determine the frequency of dysphagia in stroke survivors and its effects on short-term outcome. Methods: Consecutive patients hospitalized for first-ever acute stroke at Ahmadu Bello University Teaching Hospital Zaria-Nigeria were prospectively enrolled from April 2015 to January 2017. Stroke severity was assessed using the National Institute of Heath Stroke Scale (NIHSS). Water swallowing test was used to screen patients for the presence of dysphagia. This was followed by swallowing provocative test which was aimed at evaluating swallowing reflexes. All the patients were then followed up till day 30. Outcome measures applied were 30-day mortality and functional impairment on the Modified Rankin Scale (mRS). Results: Ninety four patients (53 males and 41 females) with acute stroke were studied. Mean age of patients was 55.51 ± 15.7 years and 32 (34.4%) of the patients had dysphagia at presentation. Mean NIHSS score of patients with dysphagia was significantly higher than those without dysphagia. Aspiration pneumonia occurred more significantly in those with dysphagia. In multivariate logistic regression only aspiration pneumonia was independently associated with 30-day mortality. Conclusion: The major independent determinant of 30-day mortality was development of aspiration pneumonia and not presence of dysphagia at presentation.

Keywords: Acute stroke, dysphagia, outcome


  NPMCN_ASC_2017_007 Top


Public Private Partnership in Haemodialysis: Is it a Better Option?

H. M. Liman, A. M. Sakajiki, M. A. Makusidi, B. I. Ibrahim1, U. A. Faruk2

Renal Centre, Usmanu Danfodiyo University Teaching Hospital, 1Renal Centre, Specialist Hospital Sokoto, 2Renal Centre, Sir Yahaya Memorial Hospital, Birnin Kebbi, Kebbi State, Nigeria

Address for correspondence: Dr. H. M. Liman, Renal Centre, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

E-mail: hamiduliman@gmail.com

Background: MTN and ADCEM Healthcare signed a memorandum of understanding with the management of Specialist Hospital Sokoto in April 2011 with the view of providing regular and subsidised haemodialysis. We set out to compare the performance of the dialysis centre with neighbouring dialysis centres. Methods: We reviewed the records of Dialysis centres of Specialist Hospital, Sokoto, UDUTH Sokoto, FMC Kebbi, Sir Yahaya Hospital, Kebbi and Yariman Bakura Hospital, Zamfara over a six year period. Variables assessed include number of months of active dialysis, mean number of days on dialysis, mean number of dialysis sessions and transplant referral rate. Data was analysed using SPSS Version 20. Results: A total of 252 patients with ESRD were dialysed at Specialist Hospital, Sokoto. The dialysis centre experienced 9 months of intermittent interruption in dialysis service. The mean duration on dialysis was 50.36 days. The mean number of dialysis sessions was 6.94 sessions. Only one patient was referred for kidney transplant from the dialysis centre. Comparison of means of these variables showed that UDUTH Sokoto has a better referral rate for kidney transplantation while there is no significant difference in the other variables (P > 0.05). Conclusion: The availability of regular dialysis service, mean duration on dialysis, mean number of dialysis sessions and kidney transplant referral rate at Specialist Hospital, Sokoto is not better than neighbouring dialysis centres despite partnership with MTN/ADCEM Healthcare.

Keywords: Dialysis service, Haemodialysis, healthcare


  NPMCN_ASC_2017_008 Top


Outcome of Management of Hodgkin’s Lymphoma in a Resource-Poor Setting

Aminu Abba Yusuf, A. B. Umar1, D. H. Gwarzo, I. M. Idris, A. A. Galadanci, A. Kuliya-Gwarzo, S. G. Ahmed

Departments of Haematology and 1Histopathology, Bayero University Kano, Aminu Kano Teaching Hospital, Kano, Nigeria

Address for correspondence: Dr. Aminu Abba Yusuf, Departments of Haematology, Bayero University Kano, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: aayusuf.hae@buk.edu.ng

Background: Hodgkin’s lymphoma (HL) is haemopoietic malignancy that shows unusual biology and epidemiology. Peculiarities in practices and constraints in management of HL have not been well explored in resource-limited settings. Here, we described the outcome of the management of adult patients with HL in a tertiary health facility in North-Western Nigeria over a 5-year period. Methods: This was a retrospective descriptive study of all patients who presented to Haematology Department of Aminu Kano Teaching Hospital (AKTH), between January 2008 and December 2012. Case notes were retrieved and analysed. Only histologically confirmed cases were included. Results: HL constituted 34.6% of all lymphoma. Male: female ratio 6:1. The median age at presentation was 19 years (range 13-55). The most frequently affected anatomical site was the cervical lymph nodes (85.2%). In 11.1% of patients, the anatomical site was not stated. The most predominant histological type was nodular sclerosis (19.4%), while in 38.7% no histological type was specified. 59.3% presented with early(Ann-Arbor stage I-II) disease. In 3.7%, there was no sufficient data for staging. B-symptoms were present in 40.7%. 51.85% had anInternational Prognostic Score (IPS) of <4, while 14.8% had a score ≥4. 33.3% did not have sufficient data for IPS scoring. 81.5%had COPP as first line treatment, 11.1% ABVD and 3.7% COP.3.7% did not commence therapy due to lost to follow-up. 11.11% had ABVD as 2nd line. Complete remission rate was 7.4%, while 29.6% achieved partial remission. 11.1% had progressive disease, while 40.7% were lost to follow-up and 11.1% died. The mean duration between diagnosis and death was 19 months. Conclusion: In spite of early presentation and favourable prognosis in the majority of patients, CR rate remains low in our setting, likely due to limited or sub-optimal use of therapeutic options.

Keywords: Haematological malignancy, Kano, Nigeria, retrospective, therapy


  NPMCN_ASC_2017_009 Top


Computed Tomographic Evaluation of Paediatric Head Injury in Aminu Kano Teaching Hospital, Kano Nigeria

Abdu Hamisu Dambatta, Mohammed Sidi

Department of Radiology, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. Abdu Hamisu Dambatta, Department of Radiology, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.

E-mail: najibdambatta@yahoo.com

Objective: To describe the computerized tomographic findings in children with head trauma who presented at the Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: It is a retrospective review of patients aged 9 months to 12 years with suspected head injury following head trauma, who presented for CT scan at Aminu Kano Teaching Hospital, Kano, Nigeria from January 2016 to December, 2017. Results: Sixty eight cases were reviewed retrospectively. They ranged from 9 months to 12 years with the mean age of 5 years. Fifty four (79.4%) were males. Fourteen were females (20.6%). Thirty five (51.5%) had head injury secondary to RTA. Twenty four (35.3%) had a history of fall from height. Four (5.9%) had a history of fall into a well. Four (5.9%) had a history of assault. Only one had a history of gunshot (1.5%). Twenty one patients (30.9%) had normal findings. Five (7.4%) of them had a frontal bone fracture. Seven (10.3%) had a parietal bone fracture. Two (2.9%) had fracture of base of the skull. Seventeen (25%) had intracerebral haematoma. Three had brain oedema (4.4%). One had epidural haematoma (1.5%). Eight (11.8%) had subdural haematoma. Six (8%) had combined fracture with cerebral contusion. Conclusion: RTA is a major cause of head injury in the most paediatric age group in our environment with CT scan as a valuable imaging tool in the investigation and management of these patients.

Keywords: Aminu Kano Teaching Hospital, computed tomographic, paediatric head injury


  NPMCN_ASC_2017_010 Top


Salivary Flow Rate, Buffering Capacity and Dental Caries among 6–12-Year-Old Schoolchildren in Nigeria: A Comparative Study

W. O. Nasiru, J. O. Taiwo1, O. O. Denloye1

Departments of Family Dentistry and 1Child Oral Health, University College Hospital, University of Ibadan, Ibadan, Nigeria

Address for correspondence: Dr. W. O. Nasiru, Department of Family Dentistry, University College Hospital, University of Ibadan, Nigeria.

E-mail: kemioreofe269@gmail.com

Background: Despite the decrease in the prevalence of dental caries globally, its impact on children can be life threatening. These impacts have been found to constitute health problems which affect their quality of life. Saliva plays an important role in protecting the teeth from dental caries. Aim: To compare the flow rate and buffering capacity of saliva in active dental caries subjects and caries free subjects. Materials and Methods: A comparative study on one hundred and sixty healthy public primary school children who were divided into 80 caries active group and 80 caries free group. Unstimulated saliva samples were collected inside a graduated measuring tube fitted into a funnel over a period of 5 minutes by spittin and salivary flow rates were measured. Buffering capacity of each saliva sample was determined by titration of 3ml of 0.005 mol/L hydrochloric acid (HCL) solution with 1ml of saliva, and the buffering was measured using a pH meter. The data was statistically analysed using student t test, ANOVA and Turkey’s HSD Posthoc test. Results: Mean age was 9.6 ± 2.6. Eighty one (50.6%) of the participants were females. The mean salivary flow rate was 1.0 ± 0.48 mls/min and mean buffering capacity was 6.3 ± 0.7. There was a statistically significant difference between flow rate, buffering capacity and dental caries level (P = 0.005). Caries free children had the highest mean salivary flow rate (1.10 ± 0.48 mls/min) and the highest buffering capacity (6.44 ± 0.63). Conclusion: The study demonstrated that children who had active caries process had lower salivary buffering capacity and lower salivary flow rate.

Keywords: Dental caries, flow rate, Saliva


  NPMCN_ASC_2017_011 Top


Pattern and Outcome of Surgery for Skull Base Tumors: Five Years Retrospective Review at the National Hospital Abuja, Nigeria

C. U. Ugwuanyi, E. E. Nwaribe, S. A. Aliu, S. S. Jamgbadi1, O. Solanke1, O. Ekumankama1, F. E. O. Arewa2, C. Arua2, P. G. Jibril3

Neurosurgery Unit, National Hospital Abuja, 1Neuroanaesthesia Unit, National Hospital Abuja, 2Department of Oncology, Radiation Medicine, National Hospital Abuja, 3Neuropathology Unit, National Hospital Abuja, Abuja, Nigeria

Address for correspondence: Dr. C. U. Ugwuanyi, Department of Surgery, Neurosurgery Division, National Hospital Abuja, Abuja, Nigeria.

E-mail: ugougwuanyi@yahoo.co.uk

Background: Surgery for skull base tumors is often a huge challenge due to difficult surgical corridor and neurovascular involvements. Aims and Objectives: To evaluate the emerging pattern and the outcome of surgical intervention for skull base tumors in National Hospital Abuja. Design/Methods: This was a five years retrospective review of presentation, surgical intervention and outcome of patients with skull base tumors at the National Hospital Abuja. Basic statistical analysis was employed to analyze the data to produce results here presented. Results: A total of 14 cases were studied. M: F ratio was 3:4. Youngest was 26 years, Oldest was 67 years and mean age was45 years. Commonest symptom was headache 9/14(64.2%).Commonest sign was optic nerve palsy 7/14 (50%) and olfactory nerve palsy 5/14(35.7%).Commonest neuroimaging finding was sphenoid wing meningioma in 7/14(50%) followed by olfactory groove meningioma in 6/14(42.8%).Common operationswere pterional craniotomy 7/14(50%) followed by sub-frontal craniotomy 6/14(42.8%). Complete tumor resection was achieved in 10/14(71.4%).Most important immediate post op complication was tension pneumocephalus 1/14(7%). Mortality was 1/14 (7%). Anosmia and visual loss did not reverse but headache and seizures subsided in 11/13(84.6%) survivors. Commonest histopathology picture was meningothelial, 12/14(85.7%).Post op imaging at three months revealed no residual tumor in 9/13(69.2%) but significant residual in 4/13(30.7%). No further treatments was required in 10/13(76.9%) while gamma knife referral was made in 2/13(15.3%) and re-do operation in 1/13(7.6%). Conclusion: Meningioma commonly located on the sphenoid wing and olfactory groove is the commonest skull base tumor in Abuja. Complete resection especially when involved withneurovascular structures is not always feasible.When feasible, it did not necessarily translate to any reversal of cranial nerve deficits but some symptoms such as headache, seizures were improved. Therefore surgery should be encouraged for symptomatic ones.

Keywords: Cranial nerve deficits, craniotomy, meningothelial, skull base tumors


  NPMCN_ASC_2017_012 Top


Clinical Profile and Outcome of Traumatic Spine Injury at National Hospital Abuja

Ayodeji Salman Yusuf, M. R. Mahmud, U. C. Ugwuanyi, O. O. Olaomi, D. J. Alfin, A. A. Aruna, S. Timothy, N. K. Dalhatu, M. M. Idris, S. I. Gana

Department of Surgery, Neurosurgical Unit, National Hospital Abuja, Abuja, Nigeria

Address for correspondence: Dr. Ayodeji Salman Yusuf, Department of Surgery, Neurosurgical Unit, National Hospital Abuja, Abuja, Nigeria.

E-mail: yasalman01@yahoo.com

Introduction: Traumatic spine injury is associated with significant morbidity and mortality. Clinical presentation depends on spine level involved, neurological injury and associated injuries. Optimal care is often impaired by lack of pre-hospital care, inadequate health insurance and support services. This study aimed at evaluating the impact of patient and injury characteristics on patient care and outcome. Materials and Methods: A retrospective study of patients with spine injuries managed in our institution over 30 months using a predesigned proforma. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: A total of 93 patients with clinical and radiological evidence of spine injury were studied. Most of the patient were male (81%), with mean age of 36 years. Motor vehicular crash accounted for most injuries (73%) followed by falls from height (15%). Most injury involved the cervical spine (66.7%). Most of the patients (69.2%) presented within 24 hours of injury andonly 33.3 % were brought to the hospital in an ambulance. None of these patients had pre-hospital treatment. Injury was complete (ASIA A) in 50.5% of patients. Pressure ulcer was the commonest complication (21%). Twenty-eight patients had surgical intervention. Four patients died while waiting for surgery while 2 patients declined surgery for financial reasons. Eight patients died giving a mortality rate of 8.6%. Conclusion: Despite improved training of spine surgeons and better facility for care spine injuries remained a significant cause of morbidity and mortality due to challenges related nature of injury and intervention.

Keywords: Clinical, outcome, spine injury


  NPMCN_ASC_2017_013 Top


Findings on Colposcopy at Federal Medical Centre, Katsina, North-Western, Nigeria

B. Halimi, N. Abdulkarim, Umar N1, Muftau Olalekan Popoola

Department of Obstetrics and Gynaecology, FMC, Katsina, 1Department of Obstetrics and Gynaecology, AKTH, Kano, Nigeria

Address for correspondence: Dr. Muftau Olalekan Popoola, Department of Obstetrics and Gynaecology, FMC, Katsina, Nigeria.

E-mail: mufruq4u@yahoo.com

Background: Several screening programs were described for cancer of cervix; the most widely used is Papanicolaou smear. Other methods include; liquid based cytology, HPV DNA testing, VIA. Colposcope is used in furthering the screening results of the abnormal  Pap smear More Details. Objectives: To determine the various outcomes of Colposcopy findings. Materials and Methods: This study was conducted on 59 patients from 5th of January, 2016 to 26th of May, 2017, based on the following findings; suspicious cervix, abnormal Pap smear, postcoital/unexplained vaginal bleeding and follow-up for previous treatment. Results: Suspicious cervix was found to have the highest frequency 45.7%, followed by vaginal bleeding 40.7% and follow-up (8.5%); these were previously screened cases or those who has had hysterectomy. Twenty seven (27) patients had biopsies taken with incidence of CIN increasing with parity. CIN II/III had the highest occurrence12 (44.5%) while glandular and micro-invasive lesions were not common (3.7%) and only seen in parous women. Patients with CIN I, were followed up with repeat Colposcopy every six months, while glandular and micro-invasive lesions had total abdominal hysterectomy as the two cases had completed their family size. CIN II/III cases were also followed up. Conclusion: Colposcopy is an important procedure in furthering the screening of cervical cancer and provision of treatment.

Keywords: Cervical screening, colposcopy, findings, suspicion cervix


  NPMCN_ASC_2017_014 Top


Morphologic Changes in Placenta from Women with Hypertensive Disorders of Pregnancy in Kano, Northwestern Nigeria

M. A. Bakari, A. T. Atanda1, H. S. Galadanci2, S. A. Gaya2

Department of Obstetrics and Gynaecology, Federal Medical Centre, Yola, Adamawa, Departments of 1Pathology and 2Obstetrics and Gynaecology, Bayero University, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. A. T. Atanda, Department of Pathology, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: akinzo123@gmail.com

Background: Pathology of hypertensive disorders of pregnancy are reflected in morphologic placental changes. These have been poorly studied in the local population of women in northern Nigeria. Objective: To evaluate histo-morphological changes of placenta from women with hypertensive disorders of pregnancy delivered in the department of Obstetrics and Gynecology of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Methodology: Placenta from 100 consenting pregnant women with hypertensive disorders in pregnancy and 100 matched controls delivered in the Obstetrics unit of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria were evaluated for gross morphologic and microscopic changes. Results: The mean age of the cases and control were 28.2 ± 7.4 and 27.5 ± 5.7 years respectively. Mean placental weight, volume, and diameter in the hypertensive group were 403.00 ± 109 g, 314.80 ± 142 ml and 15.58 ± 2 cm respectively and were statistically significant (P < 0.001) compared to controls. Microscopic calcification, infarction, and villous edema were also found to be significantly more common among the hypertensive group (P < 0.001) while fibrinoid necrosis was more common in the severely hypertensive. Conclusion: Gross placental morphometric features were significantly reduced in mothers with hypertension and correlated with severity of blood pressure elevation. In addition, hypertensive mothers most significantly exhibited placental infarction, oedema and microscopic calcification, with gross calcification showing the greatest correlation with severity of blood pressure.

Keywords: Hypertensive disorders, morphology, placenta, pregnancy


  NPMCN_ASC_2017_015 Top


Feasibility Trial for Primary Stroke Prevention in Children with Sickle Cell Anemia in Nigeria (Spin Trial)

Najibah A. Galadanci, Shehu Umar Abdullahi1, Leah D. Vance2, Musa A. Tabari3, Shehi Abubakar3, Raymond Belonwu1, Auwal Salihu4, Aisha A. Galadanci, Binta W. Jibir5, Halima Bello-Manga6, Kathleen Nev ille7, Fenella Kirkham8, Yu Shyr9, Sharon Phillips9, Brittany V. Covert10, Adetola A. Kassim11, Lori C. Jordan10, Muktar H. Aliyu12, Michael R. DeBaun10

Departments of Hematology and Blood Transfusion, 1Pediatrics, 3Radiology and 4Psychiatry, Bayero University, Aminu Kano Teaching Hospital, 5Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, 6Department of Hematology and Blood Transfusion, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria, 2Vanderbilt University Medical Center, Vanderbilt University School of Medicine, 9Department of Biostatistics, Vanderbilt University School of Medicine, 10Department of Pediatrics, Vanderbilt University School of Medicine, 11Department of Medicine, Division of Hematology, Oncology, Vanderbilt University School of Medicine, 12Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, 7Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Arkansas, USA, 8Developmental Neurosciences, UCL Institute of Child Health, London, UK

Address for correspondence: Dr. Shehu Umar Abdullahi, Departments of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: suabdullahi.pae@buk.edu.ng

Background: In Africa, where majority of children with SCA live; evidence-based strategy for primary stroke prevention is lacking. Aim: To determine the acceptability and safety of a hydroxyurea therapy for primary stroke prevention in children with SCA. Methods: We conducted a single site, single-arm feasibility trial of hydroxyurea therapy for primary stroke prevention. A total of 25 children with and abnormal TCD measurements (≥200 cm/second) received moderate fixed-dose hydroxyurea therapy (20 mg/kg/day) for up to 36 months. A comparison group of 210 children with TCD ≤199 cm/sec was followed prospectively. Feasibility was defined based on three key components: recruitment rate, retention rate and adherence to the study medication. Results: A total of 375 participants screened for elevated TCD measurements, of which 90% (330 of 375) enrolled; 8% (27 of 330) had two consecutive abnormal TCD; and 92% (25 of 27) agreed to receive moderate dose hydroxyurea therapy. A comparison group of 210 children with TCD ≤199 cm/sec were followed prospectively. The average mean corpuscular volume increased from 85 fl at baseline to 101.3 fl at 24 months. The incidence rates of hospitalization among the treatment and comparison groups were similar, 35 and 48 per 100 patient-years (P = 0.06), respectively. A total of 9 deaths occurred: 1 death in the treatment group (1.76 per 100 patient-years) and 8 in the comparison group (1.88 per 100 patient-years). Conclusion: Our feasibility trial provided strong evidence for high recruitment, retention, and adherence; and preliminary evidence for tolerability without serious adverse events in children with SCA receiving moderate dose hydroxyurea therapy for primary stroke prevention.

Keywords: Stroke, prevention, sickle cell anemia


  NPMCN_ASC_2017_016 Top


Prevalence of Treatment Abandonment in children with Burkitt’s lymphoma at Aminu Kano Teaching Hospital, Kano, Nigeria

Shehu Umar Abdullahi, Imam Abdul-Aziz, Ibrahim Muuta, F. Hassan-Hanga, Ali B. Umar1

Departments of Paediatrics and 1Histo-pathology, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. Shehu Umar Abdullahi, Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.

E-mail: suabdullahi.pae@buk.edu.ng

Background: In Africa, treatment abandonment (TxA) is a major contributing factor for treatment failure and overall poor survival in children with malignancy. Aim: To determine the magnitude and predictors of treatment abandonment in children with BL. Methods: A retrospective cohort study of children aged 3 to 15 years with Burkitt’s lymphoma admitted to paediatric oncology unit of Aminu Kano teaching hospital (AKTH), Kano between January 2013 and December 2016. Mode of diagnosis, clinical staging, prevalence, and factor contributing to treatment abandonment were extracted from the patients clinical medical records. Results: A total of 63 children with BL aged between 3 and 13 years admitted over the study period. Only 56 (88.9%) case records could be traced and these were included in the final analysis. The median age (IQR) of the study population was 8.0 years, with Male: Female ratio of 1.9:1. Majority (71.4 %) of children presented with stage C and D. Only eight patients completed therapy without relapse (14.3%). Of those who did not complete planned therapy (n = 48), 7 died prior to the completion of therapy, leaving 41 (85.4%) who met criteria for treatment abandonment. Conclusion: Treatment abandonment (TxA) is recognized as a leading cause of treatment failure for children with BL in this study. Alternative treatment strategies are needed to substantially reduced abandonment to improve overall survival.

Keywords: Burkitt’s lymphoma, children, treatment


  NPMCN_ASC_2017_017 Top


Response Strategies to the Meningococcal Meningitis Epidemic in Kano (2017)

Fatimah Hassan-Hanga, Imam Wada Bello1

Department of Paediatrics, Aminu Kano Teaching Hospital, Bayero University, 1Kano State’s Emergency Operations Centre, Kano, Nigeria

Address for correspondence: Dr. Fatimah Hassan-Hanga, Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: fhassanhanga@gmail.com

Background: MenAfriVac 2010 to 2015 mass vaccination caused a 57% meningitis incidence reduction and Meningococcal A [NmA] meningitis epidemic risk but sero-group-replacement by  Neisseria More Details Meningitides group C [NmC] in a major Nigerian and Niger 2015 epidemic. In March to June 2017, another mostly northern Nigerian meningitis epidemic occurred, the Kano characteristics of which, are hereby reported. Aims and Objectives: To determine the profile of meningitis cases, Case Fatality Rate [CFR], the weekly trend, the Ministry of Health [MOH] response and control measures and the lessons learned. Methods: We analysed Kano state-wide, meningitis surveillance data, the case profiles, bacterial aetiology and mortality. Results: In Kano State, total suspected cases were 320, of which 229 cases [72%] were aged 0-14 years, confirmed cases of 28, deaths of 25 [CFR 8%]. Bacterial confirmation was positive in 25 of 99 cases tested with NmC most prevalent [71.4%]. The Epidemic peaked at Week 15 and gradually dissipated by week 25. The MOH responded with community health education and dialogue, daily active health facility [HF] case search and Emergency Operations Centre [EOC] review meetings with National collaboration and designated an isolation centre. Clinicians were sensitised on case management and evaluation. Drugs, laboratory consumables and IEC materials were prepositioned at HFs. The lessons learnt were the slow national response to meningitis alert thresholds, the clinicians’ inadequate lumbar puncture skills, HF poor regulation and quality care enforcement and lack of MCCV. Conclusion: A strong, active surveillance during the epidemic found most meningitis cases unconfirmed, no MCCV and a slow national response.

Keywords: Epidemic, Meningococcal meningitis, surveillance


  NPMCN_ASC_2017_018 Top


Intracarvanous Self Injection of Papaverine Plus Chlorpromazine (bimix) for the Treatment of Erectile Dysfunction: A Preliminary Study

Muzzammil Abdullahi

Department of Surgery, Urology Unit, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. Muzzammil Abdullahi, Department of Surgery, Urology Unit, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: muzzammilabdullahi@yahoo.co.uk

Background: Erectile dysfunction (ED) affects the physical and psychological health of patient and his partner and can have a significant negative impact on their quality of life. An intracavernous injection with vasogenic agents is one of the treatment options for ED. Aims and Objectives: The study was conducted to determine the efficacy and safety of intracavernous injection of papaverine and chlorpromazine (bimix) as a second line treatment modality for ED. Patients and Methods: Fifteen patients with ED who either had failed treatment or complications with phosphodiesterase 5 inhibitors (PDE5-Is) were enrolled haven consented. Each patient had intracavernous bimix (papaverine 60 mg/2 mls and chlorpromazine 1 mg/ml), an office test dose initially and placed on maximum of three home injections per week. Patients were educated on possible complications including persistent pain at injection site, echymosis, hematoma, priapism and fibrosis. Results: The patients’ age ranged 35 year–75 years. Risk factors for ED were Diabetes mellitus in 2 (13.3%) patients, radical prostatectomy 1 (6.7%), Hypertension 4 (26.7%) and none in 8 (53.3%) patients. At 0.1 mls dose, 10 (66.7%) patients had good penile erection lasting ≥30 mins, 2 (13.3%) had good penile erection lasting <30 mins while the remaining 3 (20%) patients had good penile erection lasting ≥30 mins at 0.2 mls. The home self injection produced satisfactory erection and sexual performance in 13 (86.7%) patients, the remaining 2 (13.3%) had weak erection inadequate for penetration. None developed any of the complications. Conclusion: The combination of papaverine and chlorpromazine as bimix showed promising results in the treatment of ED and safe for short term use.

Keywords: Diabetes mellitus, erectile dysfunction, papaverine


  NPMCN_ASC_2017_019 Top


Preliminary Experience on Oncologic Interventions in Aminu Kano Teaching Hospital, Kano, Nigeria

Anas Ismail, Abulkadir M. Tabari, Kabiru Isyaku, Nafiu Ahmed

Department of Radiology, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. Anas Ismail, Department of Radiology, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.

E-mail: aismail.rad@buk.edu.ng

Introduction: Oncologic interventions (OI) are image-guided therapeutic options used in the management of cancers; whether primary or metastatic diseases. OI is gaining relevance in the control of tumor burden and relieving complications there form. Furthermore, OI is useful in safe delivery/placement of therapeutic agents and devices. Aims and Objectives: To present the preliminary audit of early cases of oncologic interventions at Aminu Kano Teaching Hospital. Materials and Methods: Within the last eighteen months, twenty cases were attended to. After establishing the diagnosis, patients with advanced renal carcinoma had coil embolisation of the feeding renal arteries via femoral arterial access. Patients with severe cholestasis were managed with trans-hepatic biliary external drainage. Other patients with pelvic tumors and severe hydro-uretero-nephrosis had nephrostomy. All patients were followed up and to monitor responses. Results: A total of 20 during the period under review. They consist of seven males and nine females. Their ages ranged from 20 to 86 years with a mean of 55.75 + 19.24. The indications for IO include pancreatic cancer with cholestasis (6 cases, had percutanous cholangiography and biliary drainage) and advanced renal cell carcinoma (4 cases, had coil embolisation of the feeding renal arteries). Other patients are those with cervical cancer with compromised renal function (7 cases) and one of bladder, prostatic and ovarian cancers; all of whom had ultrasound-guided percutaneous nephrostomy. Conclusion: Post-procedure follow up revealed remarkable tumor control after coil embolisation of renal arteries. Additionally, improving renal and liver functions were respectively noted following nephrostomy and biliary drainage.

Keywords: Cancer, drainage, interventions, oncology


  NPMCN_ASC_2017_020 Top


Correlation of Tricuspid Regurgitant Jet Velocity with Mean Gradient Measurement in the Echocardiographic Evaluation of Pulmonary Hypertension in Children with Sickle Cell Anaemia

Waziri Usman Muhammad, U. M. Sani, K. O. Isezuo, B. I. Garba, N. M. Jiya1, H. Ahmed2

Department of Paediatrics, Cardio-Pulmonary Unit, Usmanu Danfodiyo University Teaching Hospital, Sokoto, 1Department of Paediatrics, Paediatric Haematology Unit, Usmanu Danfodiyo University Teaching Hospital, Sokoto, 2Department of Paediatrics, Paediatric Neurology Unit, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Address for correspondence: Dr. Waziri Usman Muhammad, Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

E-mail: wazirium@gmail.com

Background: Echocardiography has emerged as an important tool for haemodynamic assessment, especially in resource poor nations where cardiac catheterisation services are still not readily available. Pulmonary hypertension has taken a centre stage as a significant cause of morbidity and mortality both in adult and children, with heterogeneous aetiologies. Objective: To determine the correlation between peak TRV and mean gradientin the assessment of pulmonary artery pressure using echocardiography. Study Design: This is across-sectional study. Subjects and Methods: Three hundred children with SCA aged 0.5 – 15 years in steady were recruited from the Sickle cell clinic of the Department of Paediatrics, UDUTH, Sokoto. All the children had echocardiographic evaluation and their peak TRV and mean gradients measured. Results: There was strong positive correlation between measured peak TRV and mean gradient (r = 0.73, P < 0.001). Although 72 children with SCA (24.0%) were found to have elevated pulmonary artery pressure (PAP) using cut off point of peak TRV ≥2.5 m/s, only 9 (3.0%) had MPAP ≥25 mmHg diagnostic of pulmonary hypertension using the mean gradient method. Conclusion: There is strong positive correlation between measured peak TRV and mean gradient by echocardiography. Though high peak TRV is indicative of elevated PAP, it is not diagnostic of pulmonary hypertension

Keywords: Mean gradient, peak tricuspid regurgitant velocity, pulmonary hypertension


  NPMCN_ASC_2017_021 Top


The Usefulness of Readout Segmented Echo Planar Imaging (Resolve) for Bio-Phantom Imaging Using 3 Tesla Clinical MRI

Babatunde O. Bamgbose1,2, Yuuki Yoshimura3,4, Masahiro Kuroda3

1Department of Oral Diagnostic Sciences, Faculty of Dentistry, College of Health Sciences, Bayero University, Kano, 2Graduate School of Medicine, Okayama University, Okayama University Hospital, 3Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama University Hospital, 4Okayama Saiseikai General Hospital, Okayama, Japan

Address for correspondence: Dr. Babatunde O. Bamgbose, Department of Oral Diagnostic Sciences, Faculty of Dentistry, College of Health Sciences, Bayero University, Kano, Nigeria.

E-mail: drtundebamgbose@yahoo.com

Introduction: The read out segmented echo planar imaging (RESOLVE) is multi-shot echo planar imaging (EPI) with k space segmented in readout direction. Objective: The aim of the study was to investigate whether RESOLVE will decrease distortion and artifact in phase direction and increase signal to noise ratio (SNR) in the bio-phantom image taken with 3 tesla MRI apparatus for clinical practice, compared to the conventional EPI. Materials and Methods: To examine the SNR and distortion, physiological saline was used for the phantom and imaging was performed at room temperature. The difference of SNR was evaluated using subtraction mapping method indicating that the SNR of RESOLVE was higher than EPI. The combination of Special Purpose Coil and Large Loop Coil had higher SNR than Head/Neck Coil using RESOLVE sequence. The degree of distortion was visually evaluated and the image distortion of RESOLVE was less than EPI. To investigate the phase direction artifact, 120 mM polyethylene glycol was used for the phantom and the image was taken at 37°C. The range where the phase direction artifact appeared in the apparent diffusion coefficient (ADC) image was shorter with RESOLVE compared to EPI. The artifact range of RESOLVE was 4.82 mm and that of EPI was 11.00 mm. The RESOLVE image of bio-phantom using Jurkat cells was taken at 37°C. The ADC value of the cell region and the surrounding physiological saline region was calculated. The ADC value of the cell area was 856 × 10-6 mm2/sec, and the surrounding physiological saline was 2951 × 10-6 mm2/sec. Conclusion: The combination of RESOLVE and 3 tesla clinical MRI device reduced image distortion and improved SNR and the evaluation of accurate ADC value due to the reduction of phase direction artifact. This combination is useful for measuring the accurate ADC value of bio-phantom.

Keywords: 3 tesla MRI, apparent diffusion coefficient, bio-phantom, diffusion weighted imaging, RESOLVE


  NPMCN_ASC_2017_022 Top


Assessment of Doppler Velocimetry of the Lower Limb Major Arteries in Adult Diabetic Patients in Kano, Nigeria

M. A. Abdulmalik, S. K. Idris, K. Isyaku, M. A. Suwaid, A. M. Tabari, A. Ismail

Department of Radiology, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano Sate, Nigeria

Address for correspondence: Dr. S. K. Idris, Department of Radiology, Aminu Kano Teaching Hospital, Kano, Kano Sate, Nigeria.

E-mail: malleeqq@yahoo.com

Background: Diabetes mellitus (DM) is a chronic metabolic disease and is an important risk factor for peripheral arterial disease (PAD), which is characterized by occlusive changes in the extremity arteries. PAD is an important cause of diabetic foot ulceration and gangrene leading to limb loss. Aims and Objectives: The study compared Doppler velocimetric indices of the lower limb major arteries in diabetics to control subjects. Methodology: This was a prospective cross sectional study in which Doppler ultrasound was used to examine both lower limbs of 200 subjects (100 diabetics and 100 controls). Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV) were recorded after three consecutive measurements of areas of narrowing. The Resistive Index (RI), Systolic/Diastolic Ratio(S/D) and waveform pattern of the lower limb major arteries were recorded. Results: Total mean PSV and EDV in diabetic males and females (PSV =75.43 ± 16.4 cm/s, 74.57 ± 16.4 cm/s and EDV =3.10 ± 1.4 cm/s, 2.79 ± 1.4 cm/s) were higher than the control (PSV =62.53 ± 10.1 cm/s, 63.47 ± 10.1 cm/s and EDV =1.81 ± 0.23 cm/s, 1.24 ± 0.23 cm/s). RI in both male and female diabetics were same (0.96 ± 0.02) but lower than control (0.97 ± 0.01 and 0.98 ± 0.01), while the S/D in male and female diabetics was significantly lower 24.28 ± 4.93, 27.93 ± 4.93 than control 36.00 ± 10.42, 51.39 ± 10.42. (P < 0.001). Conclusion: Doppler velocimetry in diabetics are abnormally high compared to normal subjects and could be used as a screening tool for detection of early PAD in order to prevent complications and avoidable limb amputation from vascular insufficiency.

Keywords: Diabetes mellitus, Doppler velocimetry, lower limb major arteries, peripheral arterial disease


  NPMCN_ASC_2017_023 Top


Systolic Myocardial Performance of the Left Ventricle in Nigerian Children with Chronic Kidney Disease

I. D. Peter, I. Aliyu, M. O. Asani, P. N. Obiagwu

Department of Paediatrics, Paediatric Cardiology Unit, Aminu Kano Teaching Hospital, 1Department of Paediatrics, Paediatric Nephrology Unit, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. I. D. Peter, Department of Paediatrics, Paediatric Cardiology Unit, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.

E-mail: igopeter@gmail.com

Background: A bilateral relationship exists between renal and cardiac function in all stages of renal disease. Objective: To determine the prevalence of LV systolic dysfunction in CKD children, and its association with age, stage of disease, and ever been dialyzed. Methods: This was a comparative cross-sectional descriptive study. Twenty one children with CKD aged 3-14 years, and an equal number of age- and gender- matched apparently healthy controls. Outcome Measures: Left ventricular internal dimensions in diastole and systole, LV fractional shortening (FS) and ejection fraction (EF). Left ventricular systolic dysfunction was considered present when FS was <28% or FE was <50%. Results: Mean LV internal dimensions in both phases of the cardiac cycle were similar in subjects and controls. The mean FS of 34.7% in the subjects was less than the 35.2% in the controls although this was not statistically significant. Similarly, the mean EF of 63.9% in the subjects was not significantly less than the 65.3% recorded in the controls. Left ventricular systolic dysfunction was detected in 5 (23.8%) and none of the controls. Subjects with LV systolic dysfunction were older than those without (P = 0.01). They also differed significantly with respect to ever been dialyzed (P < 0.001) and stage of disease (P < 0.001). Conclusion: Left ventricular systolic dysfunction is significantly more frequent in children with CKD. Children with LV systolic dysfunction were older and in later stages of CKD.

Keywords: Children, chronic kidney disease, left ventricle systolic dysfunction


  NPMCN_ASC_2017_024 Top


Improving Access to and Utilization of Emergency Obstetric and Newborn Care at Health Facilities: Community Perception of Emergency Transport Scheme in Northern Nigeria

Olugbenga Oguntunde1,2, Salma Anas-Kolo1,2, Farouk Yusuf1,3, Abdulsamad Salihu1,3, Dauda Sulaiman Dauda1,2

1DFID/Nigeria MNCH2 Programme, Kano State, 2Palladium, 3Society for Family Health, Area 11, Garki, Abuja, Nigeria

Address for correspondence: Dr. Olugbenga Oguntunde, DFID / Nigeria, MNCH2 Programme, Kano State, Nigeria.

E-mail: olugbenga.oguntunde@mnch2.com

Background: Poor access to Emergency Obstetric and Newborn Care (EmONC) services resulting from transportation problems still pose a significant problem to women in underserved communities. Removing transportation barriers to EmONC services is key to reducing maternal and newborn mortalities. This study assessed the perception of community members to different models of ETS in two states in northern Nigeria. Methods: The qualitative study was conducted in Jigawa and Kaduna states where DFID/MNCH2 programme implemented ETS. A total of 32FGDs and 50 IDIs were conducted with ETS stakeholders includingdrivers, ETS focal persons, mothers who utilized ETS in the past year and their husbands, healthcare providers, women’s groups, traditional birth attendants (TBAs), and religious leaders. Qualitative interviews were transcribed in Hausa and subsequently translated to English for analysis using thematic analysis. Results: Most community members perceived the ETS as useful in addressing transportation problems during obstetric emergencies. Drivers saw their involvement as an opportunity to serve their communities with accrued spiritual rewards, in addition to the respect they earned. Users of ETS that incorporated other demand-creation interventions such as TBAs and religious leaders further reported models provided a strong linkage that facilitated referrals between the ETS and families of women who needed them in addition to being more acceptable, reliable and responsive. Conclusion: ETS remains a key solution to lack of transport as a barrier to EmONC services in underserved communities. Programs with focus on improving access to EmONC services should explore the potential of increasing utility and reach by implementing alongside other interventions especially TBAs or religious leaders.

Keywords: Emergency, healthcare, transport


  NPMCN_ASC_2017_025 Top


Oral Health Inequalities among Rural and Urban Population: A Third World Example

Abimbola O. Balogun, O. J. Ipeaiyeda, A. D. Odofin, O. I. Akinpelu, C. A. Akinyamoju, J. O. Taiwo

Department of Family Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria

Address for correspondence: Dr. Abimbola O. Balogun, Department of Family Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria.

E-mail: olusolaipe@gmail.com

Introduction: There are wide disparities in health status of different population groups due to factors including social, education, employment status, income level, gender and settlement (urban or rural). The rural population is underserved in terms of health delivery including oral health delivery. Aim: To describe inequalities in oral health among rural and urban population. Materials and Methods: A comparative study involving rural and urban areas in Oyo state. Three rural areas (Egbeda, Akinyele, and Akufo) and 3 urban areas (Mokola, Akobo and Oluyole) were randomly selected from a list of rural and urban communities in Oyo state. Oral health survey was conducted and examination carried out with a dental mirror and CPITN probe under natural light. Data was analysed using SPSS version 22. Level of significance set at P ≤0.005. Results: A total of 1227 patients aged (1-89) years participated in the study. Mean age, 39.9 ± 19.65. Majority were adults, about half (53%) were females. 65% were seen in the urban areas, 35% were from the rural area. Majority (67.4%) of the urban dwellers had asymptomatic presentation, while pain was the predominant presenting complaint in the rural areas (58.1%). There is association between the OHI-S index and the type of settlement: Rural had poorer oral hygiene than urban settlement (P = 0.001). Also, CAL was associated with the type of settlement: periodontal disease was more prevalent in the rural than urban settlement (P = 0.001). Caries experience of both settlements was similar (P = 0.69). Conclusion: Poor oral hygiene and periodontal disease were more prevalent in the rural areas.

Keywords: Oral health, rural, urban and population


  NPMCN_ASC_2017_026 Top


Improving Community Participation in Health Decision Making to Overcome Barriers to Access and Utilization of Maternal, Newborn and Child Health Services in Northern Nigeria

Olugbenga Oguntunde1,2, Salma Anas-Kolo1,2, Dauda Sulaiman Dauda1,2, Abdulsamad Salihu1,3, Ashiru H. Mohammad1

1DFID/Nigeria MNCH2 Programme, Kano State, 2Palladium, 3Society for Family Health, Area 11, Garki, Abuja, Nigeria

Address for correspondence: Dr. Olugbenga Oguntunde, DFID / Nigeria, MNCH2 Programme, Kano State, Nigeria.

E-mail: olugbenga.oguntunde@mnch2.com

Background: Demand for and utilization of health services are often influenced by both demand and supply factors. Poor quality of services at health facilities and other socio-cultural factors may severely limit access and utilization of services. The MNCH2 programme, a 5-year UK Government-funded programme established Facility Health Committees (FHCs) in six states in northern Nigeria. This study assessed the influence of FHCs in improving demand for and access to services at health facilities. Methods: The study utilized amixed method approach including a desk review of FHC-related documentation, analysis of facility service data, survey of 399 randomly sampled FHC members, 18 FGDs with FHC members, 33 IDIs with health providers and exit interviews with 495 clients accessing MNCH services. Quantitative data were analysed with SPSS V22 and presented in tables and chats while qualitative data were transcribed and analysed using thematic analysis. Results: FHCs influenced access and demand for MNCH services in several ways: Enabling community participation in health decision making (70.9%), improving healthcare providers’ attitude (59.4%), helping providers to do a better job (57.6%) and increasing availability of healthcare providers (54.1%). In addition, more than half (56.7%) of the FHC members from one of the states (Jigawa) reported increased access of community members to health services. In addition, 50.0% and 50.4% from Kano and Jigawa respectively reported improved availability of equipment at health facilities. Conclusions: FHCs could be invaluable in contributing to improved demand and access to services in health facilities by serving as a strong linkage between community members and the health facilities.

Keywords: Community, health, newborn


  NPMCN_ASC_2017_027 Top


Prevalence of Household Hunger in a Peri-Urban Community in Southwest Nigeria

Alero Ann Roberts, P. N. Ibeh, T. O. Odugbemi

Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria

Address for correspondence: Dr. Alero Ann Roberts, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.

E-mail: aleroaroberts@gmail.com

Background: Food security is access always to adequate, safe and nutritious food for a healthy and active life. Studies have documented that household food security is still a major problem in developing countries. Emerging peri-urban settlements are noted for household undernutrition. Objectives: This study determined the prevalence of household food insecurity in a peri-urban community in SW Nigeria. Methods: This descriptive, cross sectional study was carried out to determine the prevalence of food security among 260 households in Ado/Odo-Ota community selected using multi stage sampling. The Household Food Insecurity Access scale (HFAIS) for the measurement of food access was used to assess the food security levels. Household food security was classed according to the scale as ‘secure,’ ‘mildly,’ ‘moderately,’ and ‘severely insecure’ based on the score and presented as proportions. Associations were tested using chi square and deemed significant at P < 0.05. Results: Respondents were male (53.9%), with a mean age of 31.7 ± 9.0 years, of Yoruba ethnicity (60.8%) and either the spouse (40.0%) or child (38.2%) of the household head. The percentage of food secure households was 28.1%, mildly food insecure 34.23%, moderately food insecure 23.08% and severely food insecure 14.62%. Household income was a significant determinant (P < 0.001) of household food security in the study area. Conclusion: The study recommends the need to identify households at risk and empower them to enhance their sources of income to meet their minimum food requirement.

Keywords: Assessment, food insecurity, food security, household


  NPMCN_ASC_2017_028 Top


Economic Evaluation of Childhood Epilepsy in a Resource-challenged Setting: A Preliminary Survey

Umar Isa Umar, Aliyu Ibrahim1, Umar M. Usman2, Lukman Femi Owolabi1

Departments of Pediatrics, 1Medicine and 2Psychiatry, Bayero University Kano, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. Aliyu Ibrahim, Departments of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.

E-mail: aialiyubng359@gmail.com

Background: Considerable disease variability exist between patients with epilepsy, and the societal costs for epilepsy care are overall high, due to high frequency in the general population especially in children from developing countries. Methodology: A cross-sectional study where children with established diagnosis of epilepsy were interviewed using a semi-structured questionnaire. Prevalence-based costs were stratified by patients’ socio-demographic characteristics and socioeconomic scores (SES). The ‘bottomup’ and ‘human capital’ approaches were used to generate estimates on the direct and indirect (productivity losses) costs of epilepsy costs respectively. Estimates of the financial burden of the epilepsywere analyzed from the ‘societal perspective.’ All data were analysed using IBM SPSS statistics software, version 20.0. Results: The study had 103 enrollees with most in the age group 0-5 years (45.6%). Majority (61.3%) belong to the low socioeconomic class (Ogunlesi SES class IV and V) and reside (80.6%) in an urban setting. The total direct and indirect costs per month were ?2,149,965.00 ($8,497.88) and ?363,187.80 ($1,435.52) respectively. The cost of care per patient per annum was ?292,794.50 ($1,157.29) and the total cost for all the patients per year was ?30,157,833.60 ($119,200.92). Investigative proceduresare the principal cost drivers (?15,861.17 or ($18.15) comprising approximately 58.7% of the total direct costs per patient. Conclusions: Cost of investigations contributed immensely to the total direct cost of care in our study. With the present economic situation in the country, out-of-pocket payments may contribute significantly to catastrophic expenditures and worsening of secondary treatment gap in children with epilepsy.

Keywords: Childhood, Epilepsy, survey


  NPMCN_ASC_2017_029 Top


Cost-Effective Intervention for Health during Recession: Potentials of Chlorhexidine Gel in Preventing Neonatal Deaths in Kano State, Nigeria

Muktar A. Gadanya

Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. Muktar A. Gadanya, Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria.

E-mail: gadanya@gmail.com

Background: Significant proportion of neonatal deaths (approximately one-sixth) is due to umbilical infections, which can be substantially reduced by the use of Chlorhexidine gel for new born umbilical stump care. Chlorhexidine is a topical antiseptic, which, in gel form, is recommended by the World Health Organisation (WHO) for application to the umbilical cord stump at birth to prevent sepsis. Objective: To model the potentials of universal access to chlorhexidine gel in averting neonatal deaths in Kano State, Nigeria; and to estimate its associated procurement cost. Methods: Distribution of Chlorhexidine in this modelling was based on the Sokoto State Community Based Distribution model. Effectiveness of Chlorhexidine was taken as one-sixth (16.67%) reduction of neonatal mortality from all causes based on pooled analysis by Hodgkins et al in 2013. Procurement costing was supported using the OneHealth® tool, and death averted projection was estimated using the LiST® tool. The presentation of Chlorhexidine digluconate 7.1% delivering Clorhexidine 4% in one-time use tube was also used for this projection. Results: It is estimated that up to 5687 neonatal deaths can be averted in Kano State annually by ensuring universal access to Chlorhexidine gel for cord care, at an estimated annual procurement cost of N 43,645,140. Conclusion: Investments in this evidence-based low cost intervention will aid the State in reducing neonatal deaths, thereby contributing to realization of local, national and global targets of neonatal survival. Chlorhexidine gel has the potential of averting over 5000 annual neonatal deaths in Kano, at an estimated procurement cost ofN 43,645,140.

Keywords: Chlorhexidine gel, Kano state, neonatal mortality, Nigeria, universal access


  DAY-1 POSTERS 9TH AUGUST, 2017 Top



  NPMCN_ASC_2017_030 Top


Pattern of Presentation of Oral Diseases by the Elderly at a Secondary Health Care Facility in Oyo State

Abimbola O. Balogun, O. J. Ipeaiyeda, S. O. Olagba, W. O. Nasiru, J. O. Taiwo

Department of Family Dentistry, University College Hospital, Ibadan, Nigeria

Address for correspondence: Dr. Abimbola O. Balogun, Department of Family Dentistry, University College Hospital, Ibadan, Nigeria.

E-mail: olusolaipe@gmail.com

Background: The elderly constitute an important part of the general population. With increasing life expectancy in most parts of the world, the population of the elderly is increasing concurrently. Oral health is generally believed to be a less important need among the elderly than is physical health and consequently old people are less likely to seek dental care except in emergency situations. Aim: To determine the pattern of occurrence of oral conditions among the elderly that attended a secondary health care facility in Oyo state. Materials and Methods: A retrospective study conducted over a period of 18 months at a Family Dentistry clinic in Egbeda, Ibadan. Relevant data of 188 elderly patients (aged 60-119 years) who attended the clinic from January 2014 to June 2016 were retrieved from the case notes. Data analysis was done using SPSS version 23 and P value set at ≤0.05. Result: A total of 188 elderly aged (60-119) years with a mean age of 69.05 + 10.9 years participated in the study. More males (51.5%) presented than females. Majority (64.9%) visited for symptomatic reasons, while only 36.1% visited for asymptomatic reasons. Caries and its sequelae were found in 31.1%, while periodontal disease was 70.8%. Only 4.9% had dentine hypersensitivity due to tooth wear lesions and 2.4% had neuralgias. The prevalence of periodontal disease increased with age (P = 0.001). Conclusion: Periodontal disease was the most prevalent among the elderly in this study and most patients presented due to pain.

Keywords: Diseases, elderly and health care, Oral


  NPMCN_ASC_2017_031 Top


Effects of Vasoconstrictor on Arterial Blood Pressure during Minor Oral Surgical Procedures in Akth Kano

Mohammad Abubakar Kaura, B. O. Bamgbose1, S. A. Ogunwande2, I. O. Amole3

Departments of Dental and Maxillofacial Surgery, 1Oral Diagnostic Sciences and 3Oral and Maxillofacial Surgery, AKTH, BUK, Kano, Kano State, 2Department of Surgery, Bowen University, Iwo, Osun State, Nigeria

Address for correspondence: Dr. Mohammad Abubakar Kaura, Departments of Dental and Maxillofacial Surgery, Amino Kano Teaching Hospital, Kano, Nigeria.

E-mail: mohd4kmt@yahoo.co.uk

Background: Minor oral surgery is a broad term referring to surgical procedures to the oral cavity and jaws that can be performed safely and comfortably under general anesthesia, local anesthesia, and or sedation in an outpatient setting. The currently used local anesthetic agents consist of vasoconstrictor as part of the composition to improve their biological properties. These vasoconstrictors cause some hemodynamic changes which may be either by direct action on the cardiac muscle or by stimulation of the autonomic innervations of the heart. This study aimed at evaluating the effect of adrenaline contained in dental local anesthetics on blood pressure and pulse rate of patients undergoing extractions. Patients and Methods: This study was conducted amongst 100 patients aged between 18 to 55 years who presented for forceps extraction. They were divided into study and control group using simple random sampling. Blood pressure and pulse rate were measured at different time intervals using a pre-calibrated non-invasive electronic digital blood pressure monitor. The mean age and standard deviation of all the participants was 34.66 ± 10.3. There was no statistically significant difference in the mean age, gender, history of hypertension, number of local anesthetic cartridges used, and injection techniques between the respondents in the two study groups. The result of this study shows that there was no statistically significant difference in blood pressure and pulse rate between the two groups at all-time intervals (P value > 0.05). Conclusion: Optimal use of adrenaline containing local anesthesia does not significantly increase patients’ blood pressure.

Keywords: Adrenaline and adults, minor, oral surgery


  NPMCN_ASC_2017_032 Top


Determinants of Self-rated Oral Health among Undergraduate Students in Port Harcourt Rivers State Nigeria

Soroye Modupeoluwa, B. B. Osagbemiro1, E. A. Aikins2

Departments of Preventive Dentistry and 2Child Dental Health, Faculty of Dentistry, University of Port Harcourt, 1Department of Preventive Dentistry, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria

Address for correspondence: Dr. Soroye Modupeoluwa, Departments of Preventive Dentistry, Faculty of Dentistry, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria.

E-mail: docdupe@yahoo.com

Background: Self rated oral health is a useful and essential indicator of overall oral health status; which in turn have an impact on general well-being and quality of life. However, no study on perception of oral health has been conducted among young adults in Port Harcourt. This study investigated whether socio-demographic factors and oral health practices were associated with self-reported oral health status in a young population in Port Harcourt. Methodology: This cross-sectional survey was conducted among young undergraduate students in University of Port Harcourt, Rivers state. Data was collected using pre-tested self-administered questionnaires and analyzed using the Statistical Package for Social Sciences version 21.0. Results: There were 120 respondents and all were within 16-34 years old (mean age of 21.7 ± 3.8). More females 61 (50.8%) than males 59 (49.2%). Most 66 (55%) were in Health Sciences. Out of 42 (35.0%) of the respondents that had utilized dental service in the past; complaints of toothache accounted for 52.4%. The percentage of participants that rated their oral health as excellent, good, fair, poor was 20.8%, 58.4%, 16.7% and 4.2% respectively. Socio-demographics factors such as age, gender, course of study, level of study and monthly allowance were significantly associated with self-rated oral health (P < 0.05). Oral health practices e.g. previous dental visit, type of toothbrush texture used and frequency of tooth brushing were also significantly associated with perceived oral health. Conclusion: The perceived high oral health status of participants was influenced by socio-demographic factors and oral health practices. However, there is poor utilization of dental services among the students.

Keywords: Oral health practices, self-rated oral health status, socio-demographic factors, undergraduate students


  NPMCN_ASC_2017_033 Top


Culture and Patients’ Perception to Maxillofacial Surgical Practices in Kano, Nigeria

K. U. Omeje, J. B. Adeoye, R. Agbara, I. O. Amole, A. A. Efunkoya, Mohammad Abubakar Kaura

Departments of Dental and Maxillofacial Surgery, Amino Kano Teaching Hospital, Kano, Nigeria

Address for correspondence: Dr. Mohammad Abubakar Kaura, Departments of Dental and Maxillofacial Surgery, Amino Kano Teaching Hospital, Kano, Nigeria.

E-mail: mohd4kmt@yahoo.co.uk

Background: Culture is the way of life of a people; and is an integral component of their day-to-day existence. It influences the daily routine of a people, including their diet, dressing, religious disposition, and surprisingly, the degree to which orthodox medical practices impact their daily lives. Appreciating underlying cultural context will help health care workers influence patient’s perceptions, especially where cultural practices are not in tandem with medical best practices. This is important, for example, in administration of informed consent for surgery. This study explored cultural beliefs of patients in relation to some common maxillofacial practices in Kano, Nigeria. Patients and Methods: Patient’s perceptions on oral cancers; use of nasogastric tubes; and tooth extraction was conducted amongst patients attending maxillofacial outpatient clinic of a tertiary hospital from January to December 2015 using a non-structured, interviewer-administered questionnaire. Results: Seventy-seven (77) patients were surveyed (52 males and 25 females), with ages ranging from 16 to 75 years. Most were aged 51-60 years (44.2%). Only 6.5% of respondents had higher than secondary education. Responses to the aetiology and treatment of oral cancers, use of naso-gastric tubes for maxillofacial surgery patients and extraction of teeth showed cultural perceptions usually at variance with medical best practices. Conclusion: Patients’ expectations and fears of maxillofacial surgery procedures are affected by their cultural beliefs. Proper acceptance of this, combined with targeted education and counseling may enhance patient’s co-operation and acceptance of necessary surgical procedures when orthodox medical care is sought.

Keywords: Culture and perception, Maxillofacial, surgical practices


  NPMCN_ASC_2017_034 Top


Incidence of Root Sensitivity Following Non-surgical Periodontal Therapy in Port Harcourt

M. O. Soroye, B. B. Osagbemiro1

Department of Preventive Dentistry, University of Port Harcourt, 2Dental Center, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria

Address for correspondence: Dr. M. O. Soroye, Department of Preventive Dentistry, Port Harcourt, Rivers State, Nigeria.

E-mail: docdupe@yahoo.com

Background: Patients often experience transient mild to moderate root sensitivity (RS) following scaling and root planning which subside or disappear within the subsequent weeks. However, there is a dearth of data on the incidence and intensity of post-scaling root hypersensitivity in our environment. This study investigated the incidence of RS among patients requiring non-surgical periodontal treatment. Methods: Eighty patients requiring non-surgical periodontal treatment at the periodontal clinic of University of Port Harcourt Teaching Hospital were recruited for this study. Data were collected through self-administered questionnaire after which oral hygiene instruction followed by supra- and subgingival scaling/root planing by hand and ultrasonic instrumentation was done. Post-scaling pain intensity was graded by the patient on a 0-10 Visual Analogue Scale (VAS). Results: Participants age ranged from 17 to 82 years with a mean age of 39.9 ± 16.5 years and a male 39 (48.7%) to female 41 (51.3%) ratio of 1:1.1. The incidence of post-scaling root sensitivity was 21.3% (17/80) with a mean VAS of 4.7 ± 1.9. Most of the patients with post scaling RS (70.6%, 12/17) were within 21-50 years age bracket and 76.5% (13/17) have tertiary level of education. Post scaling RS was higher in females (58.8%) than males (41.2%). However, there were no significant differences with age, gender, level of education, occupation and oral hygiene practices. Conclusion: The incidence of post scaling root sensitivity was 21.3% with moderate intensity in this study and it is commoner in the young and middle age group. We recommend that patients should be made aware of the potential for root sensitivity prior to periodontal treatment.

Keywords: Incidence, intensity, post-scaling root sensitivity


  NPMCN_ASC_2017_035 Top


Co-existing Abdominal and Intrauterine Pregnancies with Live Births

Emily A. Nzeribe, Azibuike N. Ododo, Chiemeka C. Onumajuru, Emeka H. Onwukwe, Stephen C. Eze, Duke A. Onyeabochukwu

Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Imo State, Nigeria

Address for correspondence: Dr. Chiemeka C. Onumajuru, Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Imo State, Nigeria.

E-mail: emilynzeribe@yahoo.com

Background: Heterotopic pregnancies following natural conception are very rare events and can be life-threatening. It is estimated at 1 in 30,000 – 40,000 pregnancies. Abdominal heterotopic pregnancies are even more challenging in diagnosis and management. They can also result from tubal abortion or extrusion of ovarian pregnancy into the abdominal cavity with the placenta able to attach to any of the vital organs. Case Report: Here, we report a case of 41-year-old grand multiparous woman who presented at 30 weeks gestation with 6-month history of recurrent abdominal pain and ultrasound diagnosis of a viable intrauterine pregnancy co-existing with an abdominal pregnancy. She had an elective laparotomy and caesarean section. Both fetuses were born alive: the abdominal fetus was a live female neonate with Apgar score at 1, 5 and 10 minutes of 5, 5 and 6 respectively and birth weight of 1.48 kg. The placenta was attached to the right cornu of the uterus down the right  Fallopian tube More Details to the right ovary, and was excised with these structures. The intrauterine fetus was a live male neonate with Apgar score at 1 and 5 minutes of 9 and 10 respectively, and a birth weight of 1.8 kg. Both were nursed in the Special Care Baby Unit and were subsequently discharged in good conditions.

Keywords: Abdominal pregnancy, intrauterine pregnancy, laparotomy and live birth


  NPMCN_ASC_2017_036 Top


Conservative Radical Surgery for Early Stage Cervical Cancer at Federal Medical Centre Katsina; Low Resource Setting, a Case Report

Nura Abdulkarim, B. Halimi, A. Abdurrahman

Department of Obstetrics and Gynaecology, FMC, Katsina, Nigeria

Address for correspondence: Dr. Nura Abdulkarim, Department of Obstetrics and Gynaecology, FMC, Katsina, Nigeria.

E-mail: drnuraabdulkarim@gmail.com

Background: Cervical cancer is the second most frequent women cancer worldwide. The 5-year cure rates for surgery and for radiation therapy in early stage disease are approximately equal. However we recommend surgery, for our patients with early stage disease. Case Presentation: Mrs. KI was a 55 year old para 9 woman. She presented with excessive watery vaginal discharge of six month duration and bright red post coital bleeding of 4 months duration. Vaginal examination cervix was enlarged, hard with a mass of about 5 cm in size, sparing the parametrium. Sample for biopsy taken and sent to pathologist. Diagnosis of stage 1b2 cervical cancer was entertained. Abdominopelvic CT scan revealed normal organs with negative pelvic lymph nodes. Histology result revealed large cell nonkeratinising squamous cell carcinoma of the cervix. Surgical Procedure: The six avascular spaces of the pelvis were developed. These include the vesicovaginal space; the paired paravesical spaces, the paired pararectal and the rectovaginal space. The infundibulopelvic ligaments were incised and ligated. The uterine vessels were ligated. The ureters were dissected from the cardinal ligament. The cardinal ligaments were ligated. The uterosacral ligaments were clamped, cut and ligated. The vagina was cut through at the junction of its middle and upper third. Haemostasis at the cuff edge was secured. Conclusion: The technique of dissection of six avascular spaces of the pelvis provides good option for radical hysterectomy for patients with early invasive cervical cancer.

Keywords: Cervical cancer, early stage, radical surgery and outcome


  NPMCN_ASC_2017_037 Top


Hydatidiform Mole Coexisting with a Life Fetus: Case Report and Literature Review

A. Natalia, A. U. Usman, B. U. Ali1, L. D. Aliyu, A. Aisha2

Departments of Obstetrics and Gynaecology and 1Pathology, Aminu Kano Teaching Hospital, Bayero University, 2Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria

Address for correspondence: Dr. A. Natalia, Departments of Obstetrics and Gynaecology Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: drnataliarmu@yahoo.com

Introduction: Pregnancy with complete mole and coexisting life fetus is rare with an incidence of 1 in 22000-100000 pregnancies. Such pregnancy is also known as “sad fetus syndrome.” Case Report: We report a case of a 27-year-old Nigerian lady (Hausa) presented to our labor ward at 34 weeks and 3 days of gestational age with complaints of bleeding per vaginam and associated labour pains. Trans-abdominal 2D ultrasound on admission revealed a life fetus in breech presentation, with anteriolly located placenta and a huge mass of mixed echogenicity of “snow-storm” pattern within the uterine cavity posteriolly located and not occluding internal os. She had assisted breech delivery of a life male baby with Apgar scores of 6 and 9 on first and fifth minutes respectively, weighing 2.5 kg. The placenta was delivered by controlled cord traction and she expelled “grape-like” tissues as well. Conclusion: It is very important to present such cases, as it will increase vigilance of medical doctors, who evaluate patients during first presentation to the hospital, as early referral to the tertiary center for prenatal DNA analysis by amniocentesis, patient counseling and close monitoring during the pregnancy and postpartum period is very vital.

Keywords: Case report, complete moles, gestational trophoblastic disease, hydatidiform mole


  NPMCN_ASC_2017_038 Top


Socioeconomic Status of Parents and the Occurrence of Pelvic Inflammatory Disease among Undergraduates Attending Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria

T. I. A. Oseni, M. A. Odewale

Department of Family Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria

Address for correspondence: Dr. T. I. A. Oseni, Department of Family Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.

E-mail: tijanioseni@yahoo.com

Background: Pelvic Inflammatory Disease (PID) is a major cause of gynaecological morbidity among females globally. Complications from PID include infertility, ectopic pregnancy and chronic pelvic pain. Low socioeconomic status is a risk factor for the occurrence of PID. Methodology: The study was a hospital based descriptive cross-sectional study. Three hundred and sixty female undergraduates attending the General Outpatients Department (GOPD), Accident and Emergency (A and E) and the Gynaecological Clinics of the hospital were consecutively recruited and clinically assessed for the presence of PID using the WHO and CDC criteria for clinical assessment of PID. Their socioeconomic status was determined by Oyedeji’s social class categorisation. Data was analysed using Epi info 3.5.4. Descriptive statistics was used to summarise the data and Chi square was used to test for association. Results: Of the 360 participants, 229 (63.6%) had PID and this was found to be highest among students whose parents were in the low socioeconomic class accounting for 192 (53.3%), followed by those in the middle class, 92 (25.6%) and least in students whose parents were in the high socioeconomic class, 76 (21.1%). The difference was however not statistically significant (c2 = 3.97, P = 0.14). Conclusion: Occurrence of PID among undergraduates was not associated with their socioeconomic status (P = 0.14). However, identified risk factors for PID among study population such as multiple sex partners, previous STI, unprotected sex and history of induced abortion were associated with the socioeconomic status of the parents.

Keywords: Parents, pelvic inflammatory disease, socioeconomic status, undergraduates, females


  NPMCN_ASC_2017_039 Top


First Trimester Booking Body Mass Index and Pregnancy Outcome: A 3-Year Retrospective Study from a Low Resource Setting

Idris Usman Takai, Ifesinachi Joy Omeje, Ibrahim Adamu Yakasai, Samaila Danjuma Shuaibu

Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. Idris Usman Takai, Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.

E-mail: takaiidris@yahoo.co.uk

Background: Extremes of body weight are associated with adverse pregnancy outcomes. Objective: The study was conducted to determine the prevalence of obesity and underweight and evaluate the impact of first trimester booking body mass index (BMI) on pregnancy outcome. Methods: Pregnant women who booked in the first trimester of pregnancy in Aminu Kano Teaching Hospital, and met the inclusion criteria, were studied retrospectively for a 3-year period from January 2012 to December 2014. Their booking BMIs was calculated and categorized using WHO classes. Pearson’s Chi square test was used for all categories. Results: A total of 649 pregnant women booked in the first trimester during the study period, out of which 502 were eligible for the study. Of this, 99 women were obese and 57 were underweight giving the prevalence of obesity and underweight in first trimester of pregnancy as 15.3% and 8.8% respectively. Maternal outcomes mostly associated with obesity and overweight were Hypertensive disorders in Pregnancy (42.0%), Gestational Diabetes Mellitus (41.3%), increased abdominal and instrumental delivery (38.6%), as well as 3rd and 4th degree perineal tears (71.4%). Neonatal outcomes were low birth weight and foetal macrosomia (57.8%), preterm delivery and prolonged pregnancy (46.0%). The underweight group had a favourable outcome in majority of the outcomes assessed. Conclusion: Obesity in pregnancy is relatively common in our environment and is associated with adverse feto-maternal outcome when compared to the underweight subjects. There is a need for preconception care and further research to identify and possibly mitigate the risk factors of obesity.

Keywords: Body mass index, booking, first trimester, pregnancy outcome


  NPMCN_ASC_2017_040 Top


Feto-Maternal Outcome in Hypertensive Disorders of Pregnancy in a Tertiary Care Centre in Northern Nigeria

M. A. Bakari, A. T. Atanda1, H. S. Galadanci2, S. A. Gaya2

Department of Obstetrics and Gynaecology, Federal Medical Centre, Yola, Adamawa, Departments of 1Pathology and 2Obstettrics and Gynaecology, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. A. T. Atanda, Department of Pathology, Aminu Kano Teaching Hospital, Bayero University, PMB 3452, Kano, Nigeria.

E-mail: akinzo123@gmail.com

Background: Hypertensive disorders of pregnancy have been characterized by significant feto-maternal mortality. This study aims to evaluate factors associated with outcome in Kano, northwestern Nigeria. Methods: Consenting hypertensive and age-matched normotensive healthy pregnant women were recruited consecutively over a 3-month period. Maternal and foetal obstetric and outcome data, as well as intensive care unit admission and placental morphology were then documented. Result: During the three month period 100 consenting women meeting the inclusion criteria were enrolled for the study. They had mean age of 27.94 ± 6.6 years; 21 (21%) had gestational hypertension, 43 (43.0%) preeclampsia, 9 (9.0%) chronic hypertension, 13 (13.0%) chronic hypertension with superimposed preeclampsia, 11 (11%) eclampsia and 3.0% were unclassified. Placental abruption was seen in 15 (15%) of cases; followed in frequency by 11 (11%) cases of primary postpartum haemorrhage and 4 (4%) cases of maternal mortality. Fetal outcome included 60 healthy babies at discharge, 24 early neonatal deaths and 16 stillbirths. Significant placental calcification was found in these cases. Maternal outcome was associated with severity of blood pressure (BP) elevation (P = 0.004; OR 0.293), gestational age (P = 0.005; OR 0.280) and mode of delivery (P = 0.012; OR 0.252) while fetal outcome was associated with maternal BP (P = 0.008; OR 0.228), Apgar score (P < 0.001; OR 0.368) and SCBU admission (P < 0.001; OR 0.344). Conclusion: Improvement in feto-maternal outcome in hypertensive disorders of pregnancy will be best improved by assiduous BP monitoring; achievable through institution of robust mechanisms to improve antenatal care uptake.

Keywords: Feto-maternal, hypertension, outcome, pregnancy


  DAY-2 POSTERS 10TH AUGUST, 2017 Top



  NPMCN_ASC_2017_041 Top


Bilateral Pleuropericardial Cysts in a Child

M. A. Yahuza, A. H. Dambatta, Umar Also1

Department of Radiology, Aminu Kano Teaching Hospital, Bayero University, Kano, 2Department of Paediatrics, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria

Address for correspondence: Dr. M. A. Yahuza, Department of Radiology, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: almansurudeen@yahoo.com

Background: Pleuropericardial cysts are uncommon mediastinal masses. Bilateral and anterior mediastinal pleuropericardial cysts in children are very rare notwithstanding the increased availability, accessibility and affordability of modern imaging modalities. Objective: To highlight the unusual location and bilaterality of the pleuropericardial cysts in this patient. Methodology: The patient’s images (chest radiographs and computed tomography (CT scan)) and case file were reviewed and summarized. The subject matter of pleuropericardial cyst was reviewed in the literature. The index case was discussed and compared with literature. Result: We report U.H a 5year old boy who presented with recurrent cough of 3 months duration. No history of chest pain, dyspnoea, fever, or weight loss. Initial diagnosis of bronchopneumonia was entertained. Frontal chest radiograph showed well defined oval shaped homogenous opacity of soft tissue density in both cardiophrenic angles. Complimentary lateral chest radiograph confirmed the previously mentioned masses in the anterior mediastinum. Subsequently chest CT scan showed water attenuation cyst (HU 18-24) with well defined smooth thin wall in both cardiophrenic angles measuring 13 cm and 17 cm in longest axis on the right and left sides respectively. Patient was referred to the cardiothoracic unit where he is still on watchful waiting being asymptomatic from the cardiopulmonary point of view. Conclusion: Despite their rarity, bilateral pleuropericardial cysts in the anterior mediastinum may still be encountered in contemporary practice.

Keywords: Anterior, bilateral, pleuropericardial cyst


  NPMCN_ASC_2017_042 Top


Right Crossed Fused Renal Ectopia with Atypical Renal Arteries in a 15-Year-Old Boy

Abdussalam Usman Danjaji, A. M. Tabari1, I. Anas1, I. Kabiru1, M. A. Suwaid1, I. M. Mustapha2

Department of Radiology, Murtala Muhammad Specialist Hospital, 1Department of Radiology, Bayero University, Aminu Kano Teaching Hospital, Kano, 2Department of Radiology, Federal Medical Centre, Katsina, Nigeria

Address for correspondence: Dr. Abdussalam Usman Danjaji, Department of Radiology, Murtala Muhammad Specialist Hospital, Kano, Nigeria.

E-mail: dr.danjaji@yahoo.com

Introduction: Crossed fused renal ectopia is a very rare congenital anomaly of the renal system in which one kidney crosses over to the contralateral side and parenchyma of the two kidneys fuse. Herein, we present an unusual occurrence of right crossed fused renal ectopia with atypical renal arteries in a 15 year old boy to raised clinician awareness of this condition. Case Report: A 15-year-old boy who was referred on account of recurrent left sided abdominal pain, which is said to be provoked by exercise. There was no history of haematuria, dysuria, or abdominal swelling. He had abdominal ultrasound scan prior to presentation, which revealed empty right renal fossa with enlarged left kidney. Further investigations with intravenous urography (IVU) and conventional angiography revealed crossed fused renal ectopia with malrotated collecting system, atypical renal arteries and nephrographic ischaemic cortical defect of the right crossed fused ectopic kidney. Conclusion: Ectopic kidneys have increase susceptibility to develop complications like urinary tract infections, urolithiasis and uroepithelial tumors. However, nephrographic ischaemic cortical defect was noted as the cause of recurrent abdominal pain in this patient. Therefore, finding of crossed fused renal ectopia warrant complete urologic investigation to rule out surgically correctable pathology in the urinary tract. The case was discussed in the light of available relevant literature.

Keywords: Abdominal ultrasound and complications, kidney, Renal ectopia


  NPMCN_ASC_2017_043 Top


Prevalence of Microalbuminuria and its Correlation with Hyperuricaemia and Body Mass Index among Patients with Gestational Hypertension in Kano

Sunusi Yahaya, I. A. Yahaya1, A. A. Akande2

Department of Chemical Pathology, Murtala Muhammed Specialist Hospital, Kano, 1Department of Chemical Pathology and Immunology, Bayero University, Aminu Kano Teaching Hospital, Kano, 2Department of Chemical Pathology and Immunology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

Address for correspondence: Dr. Sunusi Yahaya, Department of Chemical Pathology, Murtala Muhammed Specialist Hospital, Kano, Nigeria.

E-mail: yahayasunusi1@gmail.com

Background: Gestational hypertension is prevalent in developing countries including Nigeria, and studies have shown that there is an eleven-fold higher risk of developing chronic renal disease in patients with this disorder compared with normal individuals. Patients at risk can be identified by determination of urine albumin: creatinine ratio (UACR) and those with microalbuminuria would benefit from preventive and possibly more intensive therapeutic interventions. Objective: To determine the prevalence of microalbuminuria and its correlation with hyperuricaemia and body mass index in patients with gestational hypertension. Methods: This research was a descriptive study that recruited one hundred patients with gestational hypertension and one hundred aged-matched normotensive pregnant women as controls. Urine albumin and urine creatinine and serum uric acid were measured using hemoCue albumin autoanalyser and Kenza autoanalyser respectively. The body mass index and blood pressure of each of the participants were also determined. Results: Prevalence of microalbuminuria in individuals with gestational hypertension was 42%. Microalbuminuria was positively associated with both hyperuricaemia and body mass index in gestational hypertension. Young age, primiparity and high BMI were found to be associated with the development of gestational hypertension. Increased number of parity was found to be associated with severity of hypertension. Conclusion: Microalbuminuria is common among gestational hypertensives and routine screening for microalbuminuria and serum uric acid level as part of the initial evaluation for patients with gestational hypertension is advocated.

Keywords: Microalbuminuria, Hyperuricaemia, Body Mass Index and Patients


  NPMCN_ASC_2017_044 Top


Evaluation of Serum Fructosamine as a Screening Test for the Detection of Gestational Diabetes Mellitus

H. Haladu, I. A. Yahaya1

Department of Chemical Pathology and Immunology, Federal Medical Centre, Katsina, 1Department of Chemical Pathology and Immunology, Aminu Kano Teaching Hospital, Bayero University, Kano, Kano State, Nigeria

Address for correspondence: Dr. H. Haladu, Department of Chemical Pathology and Immunology, Federal Medical Centre, Katsina, Nigeria.

E-mail: sadiamuallim@yahoo.co.uk

Background: The use of serum fructosamine as a screening test for gestational diabetes mellitus (GDM) may provide a simpler alternative compared to oral glucose tolerance test (OGTT) which is tedious, requires multiple venepunctures, overnight fasting and may be associated with unpleasant side effects. Aim: This study evaluated the clinical usefulness of serum fructosamine as a screening test for the detection of GDM. Methods: This descriptive cross sectional study recruited a total of 313 participants, made up of 193 pregnant women with risk factors for GDM referred from antenatal clinic for oral glucose tolerance test (OGTT) and 120 apparently healthy non pregnant women as controls. A 75 g OGTT, serum fructosamine, albumin and total protein measurements were performed on the participants. Data generated were collated and analysed using SPSS version 22.0. Results: Forty one of the 193 pregnant women were diagnosed of GDM based on the World Health Organisation’s (WHO) criteria for OGTT. In comparison with 75 g OGTT, single assay of serum fructosamine gave a sensitivity, specificity, positive predictive value and negative predictive value of 44%, 63%, 24% and 63% respectively for the detection of GDM. Conclusion: Serum fructosamine may not be a useful screening test for the detection of GDM.

Keywords: fructosamine, serum, screening, detection and diabetes mellitus


  NPMCN_ASC_2017_045 Top


Genotypic Profile of Hepatitis C Virus in Patients with Chronic Hepatitis C Virus Infection at Bingham University Teaching Hospital Jos Nigeria

David Olorunfemi Samuel, Musa Bolanle Olufunke1

Department of Internal Medicine, College of Health Sciences, Bingham University, Plateau State, Nigeria, 1Department of Medicine, Immunology Unit, Ahmadu Bello University Teaching Hospital, Kaduna State, Nigeria

Address for correspondence: Dr. David Olorunfemi Samuel, Department of Internal Medicine, College of Health Sciences, Bingham University, Plateau State, Nigeria.

E-mail: daves074ds@gmail.com

Introduction: HCV is recognized as the major cause of chronic post transfusion hepatitis globally. The genetic diversity of HCV and the clinical and virological relevance of HCV genetic classification schemes remain important areas of active research due to its effects on disease progression and severity as well as management. Aim: To determine the genotypic profile of hepatitis C virus (HCV) in patients with chronic HCV infection with or without liver cirrhosis and hepatocellular carcinoma at Bingham University Teaching Hospital Jos Nigeria. Methods: This prospective cohort study enrolled patients who were clinically diagnosed to have chronic HCV infection and subsequently confirmed by polymerase chain reaction (PCR) using the light cycler. Patients attending the clinic from December 2012 to December 2014 who had all the relevant investigations including the complete blood count, liver enzymes, abdominal scan, thyroid function tests, clotting profiles, HCV RNA viral load and HCV genotype done were enrolled. Results: A total of 48 patients were enrolled for this study, 28 (58.3 %) were males. The genotype I patients had a mean age of 51.79 years as compared to the genotype 4 group with a mean age group of 53.14 years, genotype 1 was observed in 34 (70.8 %) of the patients and was the most prevalent. Subtyping was not done. Genotypes 2, 3 and 4 was found in 6 (12.5%), 1 (2.1%) and 7 (14.6%) of the patients respectively. Conclusion: The HCV genotype 1 was the most prevalent among the population studied while genotype- 3 was the least prevalent.

Keywords: Chronic infection, genotypes, viral Hepatitis C


  NPMCN_ASC_2017_046 Top


Haemostatic Parameters of Treatment-Naïve Immunodeficiency Virus Infection Seropositive Individuals in Ahmadu Bello University Teaching Hospital, Zaria

Benjamin Augustine, H. M. Muktar, S. M. Aminu

Department of Haematology, ABUTH, Zaria, Nigeria

Address for correspondence: Dr. Benjamin Augustine, Department of Haematology, ABUTH, Zaria, Nigeria.

E-mail: dbenaugust@yahoo.com

Introduction: Haemostatic abnormalities are emerging complications of Human immunodeficiency virus infection (HIV). Objective: To determining some haemostatic parameters in treatment-naive HIV seropositive individuals. Methodology: A cross-sectional study using structured questionnaire and laboratory tests on 72 treatment-naive HIV seropositive individuals (subjects) and 50 HIV seronegative individuals (controls). Platelets count, Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin degradation products (FDPs) and D-dimer values were determined. Data were performed using SPSS version 20.0. Levels of significance was set at P < 0.05. Results: Subjects comprised of 29 males and 43 females, controls comprise of 26 males and 24 females, mean age of subjects and controls were 34.3 ± 7.2 years and 31.7 ± 8.3 year (P > 0.05). Mean platelets count for subjects and control were 264.9 ± 9.2 and 228.7 ± 9.5 (P > 0.05). Mean PT for subjects and controls were 18 ± 3.4 sec and 14 ± 2.1 sec (P < 0.05), 73.6% of subjects had elevated PT. Mean APTT of subjects and controls were 42.8 ± 5.0 sec and 38.7 ± 3.8 sec (P < 0.05), 27.8% of subjects had prolonged APTT. 36.1% of subjects had elevated FDPs and D-dimer. Values of FDPs and D-dimer were 27.7 ± 9.9 mg/ml and 8.9 ± 2.6 mg/ml-FEU. Conclusion: HIV infection predisposes to prolongation of PT, APTT and elevated levels of FDPs and D-dimer.

Keywords: Immunodeficiency virus infection, seropositive, individuals


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  NPMCN_ASC_2017_047 Top


Electrocardiographic Findings in Apparently Healthy Adolescents in a Southern Region of Nigeria

Petronila Nnenna Tabansi, O. Dibua, B. E. Otaigbe

Address for correspondence: Dr. Petronila Nnenna Tabansi.

E-mail: petronillatabansi@yahoo.com

Background: Electrocardiography is an inexpensive, quick, non-invasive, widely available and reliable screening tool in the assessment of the electrical activity of the heart and is vital in the detection of potentially lethal sub-clinical structural or electrophysiological cardiovascular abnormalities. ECG pattern have been established in some regions in Nigeria but is however lacking in the Niger-Delta region of Southern Nigeria. Objective: To determine the ECG pattern of apparently healthy adolescents in the Niger-Delta Region of Southern Nigeria. Materials and Methods: A cross-sectional, school based, study was carried out on 1002 secondary school subjects, aged 10-19 years. The ECG recording was performed using a standard 12 lead, portable digital electrocardiograph. Results: The respondents constituted 595 (59.4%) males and 407 (40.6%) females with a male to female ratio of 1.5:1. The study population had a mean ECG heart rate of 82 bpm, PR interval of 0.15 sec, P wave duration of 0.08 sec, QRS duration of 0.08 sec, QTc interval of 0.42 sec, and QRS axis of 58º. The mean heart rate and QTc interval were significantly higher in the females, while the QRS duration was significantly higher in the males. The P wave amplitude in lead II was 1.3 mm, R wave amplitude in V1 and V6 were 4.06 mm and 10.68 mm respectively. The S wave amplitude in V1 and V6 were 11.44 mm and 0.56 mm respectively. Conclusion: ECG pattern have now been established in Nigerian children in the Niger-Delta Region of Southern Nigeria, and shows some differences from the studies in other parts of Nigeria.

Keywords: Electrocardiography, Findings, Adolescents and Nigeria


  NPMCN_ASC_2017_048 Top


Grit Attributes among University Students: A Cross-sectional Comparison of Mental Distress, Mindfulness, Resilience and Social Support

Tajudeen Abiola, H. Zom-Ibrahim1, B. A. Yakasai2, T. L. Sheikh, O. Udofia3

Department of Medical Services, Federal Neuro-Psychiatric Hospital, 1Department of Sociology, Kaduna State University, 2Department of Medicine, Faculty of Medicine, Kaduna State University, Kaduna, 3Department of Psychiatry, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

Address for correspondence: Dr. Tajudeen Abiola, Department of Medical Services, Federal Neuro-Psychiatric Hospital, Nigeria.

E-mail: abiolatob@yahoo.com

Background: Good academic performance and educational attainment are among some of the expected outcomes of attending educational institutions. This is particularly more so for university students whose final educational achievement often predicts future endeavour’s engagement and success. This final outcome has been hinged on several assets with grit being one of the foremost. This study examined some of the attributes of students’ grittiness with respect to their current and anticipated experience of mental distress, level of mindfulness practices, degree of individuals’ resilience and role of the available social support. Materials and Methods: Participants were 161 undergraduate students of Kaduna State University. All filled the measuring comprising of socio-demographics questionnaire, Grit Scale, Freiburg Mindfulness Inventory, Resilience Scale, Oslo Social Support Scale, Terrorism Catastrophizing Scale and Hospital Anxiety Depression Scale. Results: Grit is reversely correlated with the three measures of psychological suffering (i.e. fear of future terrorism, depression and anxiety) positively associated with the three remaining measures of psychosocial assets (i.e. mindfulness, resilience and social support) were positively associated. All the variables were significantly related to grit except for social support. A MANOVA analysis showed significant difference between students with high vs. low grit scores. Specifically, mindfulness practice and fear of future terrorism were identified as two of the six psychosocial variables that can respectively raise or deplete grit. Conclusion: The study added to available knowledge on grit and provided some variables that can be manipulated to improve the grittiness of university students. Attainment of this should improve students’ academic performance and enhance their educational attainment.

Keywords: Grit, mental distress, mindfulness, resilience, social support, university students


  NPMCN_ASC_2017_049 Top


Seasonality of Psychotic Illness Hospital Admissions in Kano, Nigeria

A. T. Abdullahi, M. Nuruddeen1, T. Abiola2

Department of Psychiatry, Aminu Kano Teaching Hospital, Bayero University, 1Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, 2Department of Medical Services, Federal Neuropsychiatry Hospital, Barnawa-Kaduna, Nigeria

Address for correspondence: Dr. T. Abiola, Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: abiolatob@yahoo.com

Background: Seasonal variation has been reported for psychotic hospital admissions, but none in Nigeria. This study examnes the seasonality of psychotic mental hospital admissions in Kano, a north western state in peri-equatorial and tropical Nigeria. Methods: The case notes of all psychotic patients (bipolar affective disorder, schizophrenia, and other psychotic disorders) with more than one admission into the psychiatric unit of Aminu Kano Teaching Hospital between 1996 and 2006 were examined for evidence of seasonal variations and admission patterns. Results: The mean age of the 100 psychotic cases reviewed was 28 years (SD=11.4) with 55% being males and 52% not married. There was no significant seasonal variation found in all the psychotic admissions examined. However, high rates of psychotic admissions were observed in summer. Conclusion: The authors concluded that both geographical factors and seasonal variations have limited effect on psychotic illnesses’ hospital admissions in Kano than might have been expected from the literature and prevailing local beliefs.

Keywords: Psychosis, illness, hospital and seasonality


  NPMCN_ASC_2017_050 Top


Correlates of Substance Abuse among Workers of Hausa Movie Industry in Kano, North-Western Nigeria

Aisha Rabiu Mohammed1,2, Musa M. Bello1, Mustapha Ibrahim Gudaji2

Departments of 1Community Medicine and 2Psychiatry, Faculty of Clinical Sciences, College of Health Sciences, Aminu Kano Teaching Hospital and Bayero University, Kano, Nigeria

Address for correspondence: Dr. Aisha Rabiu Mohammed, Departments of Community Medicine Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: aisharm13@gmail.com

Background: Substance abuse is a social problem that has spread and increased rapidly among youths in Nigeria. Abusers erroneously believe that drugs enhance their performance and put them in good mood. The involvement of entertainers in drug abuse is a multidimensional phenomenon and a matter of global concern. This study aimed to determine the prevalence, common substances and factors associated with substance abuse among workers in Hausa movie industry in Kano state. Methods: This was a cross-sectional study that was carried out between August and September, 2016 among workers in Hausa movie industry. A total of 126 participants were selected using systematic random sampling technique. An interviewer administered questionnaire was used in collecting the data. The collected data were analysed using Statistical Software for Social Sciences (SPSS) version 20. Results: Prevalence of substance abuse among respondents was 36.3%. Tobacco (53.3%) and kolanut (40%) were the most commonly abused substances followed by coffee (11.1%). Prevalence of cannabis and alcohol use was 8.9% and 4.4% respectively. The commonest reasons for substance abuse were for enjoyment purposes (63.4%), to overcome stress (29.6%), friend’s influence (20.5%) and to experiment (15.9%). There was no statistically significant association between respondents’ gender, educational level, and duration working in the industry and substance abuse. Conclusion: Substance abuse is common among workers of Hausa movie industry. There is need to raise awareness on dangers of these substances among these influential figures as it may also indirectly help the general public who are influenced by them.

Keywords: Hausa movie industry, Nigeria, prevalence, substance abuse


  NPMCN_ASC_2017_051 Top


Pattern of Paediatric Skin Diseases at Murtala Muhammad Specialist Hospital Kano, Nigeria

Aishatu M. Yahya, S. M. Yusuf

Division of Dermatology, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. Aishatu M. Yahya, Division of Dermatology, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.

E-mail: aishayahya35@yahoo.com

Introduction: At the moment, there has never been any elaborate study on pattern of paediatric skin diseases in Murtala Muhammad Specialist Hospital (MMSH), which has been in existence for over 90 years and one of the busiest medical facilities in northern Nigeria. Skin diseases affect 21-87% of children in developing countries. The spectrum of skin diseases varies from region to region. Objectives: To determine the pattern and associated factors of skin disorders in children under 14 years attending Paediatric specialist dermatology clinic MMSH Kano. Methods: This was a cross- sectional study involving children aged 0-14 years attending the specialist paediatric dermatology clinic MMSH (May 2016-October 2016). Consecutive collection of data of all new skin cases in the clinic was done and placed in proforma for diagnosis. Few investigations were done when diagnosis was not clear clinically. Results were analysed with SPSS version 16.0. Result: A total of 338 children were included in this study. More males were affected (51.2%, n = 173) whose median age was 36 months. Infections accounted for the majority of the skin conditions with Tinea capitis as the commonest skin condition (14.2 %, n = 48). Conclusion: Infections constituted the highest burden of skin diseases among this paediatric age group with more males affected.

Keywords: Children, Murtala Muhammad Specialist Hospital, skin diseases


  NPMCN_ASC_2017_052 Top


Behavioural Determinants of Utilization of Modern Contraception among Women of Reproductive Age in Zaria, Kaduna State

Muhammad Bello Garba, Zubaida Muhammad Ibrahim, Clara Ladi Ejembi

Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria

Address for correspondence: Dr. Muhammad Bello Garba, Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.

E-mail: muhbello02@gmail.com

Background: Modern contraception has been found to avert unintended pregnancies and thus reduce maternal and child mortality. However, its usage still remains low especially in developing countries and efforts aimed at improving uptake are largely focussed on supply side. This assessed the behavioural determinants of the utilisation of modern contraception among women of reproductive age group (WRAG) in Palladan Zaria, Kaduna State. Methodology: This descriptive cross-sectional comparative study was conducted among 200 each of adopters and non adopters of modern contraception selected using systematic sampling technique. Data was collected using interviewer administered semi-structured questionnaire, analysed using SPSS version 23, summarised by means and proportions and presented using tables and charts. Relationship between variables was tested for statistical significance by c2 at 0.05 a level. Results: The study reveals that perceived susceptibility to and severity of unwanted pregnancy and obstetric complications, the thought that one can begin to use modern contraception as well as the feeling that modern contraception can prevent unwanted pregnancy and obstetric complications was significantly higher among adopters compared to non adopters (P < 0.00001). Similarly, significantly higher proportion of adopters appreciated the advantages of modern contraception, tended to think modern contraception was acceptable to most people around them and that their religion approve of the practice compared to their non adopter counterparts (P < 0.00001). Conclusion: Respondents behavioural, normative and control beliefs, motivations to comply as well as perception of Divine will were shown to significantly influence adoption of modern contraception.

Keywords: Contraception, modern, behavioural, determinants and women


  NPMCN_ASC_2017_053 Top


Clinico-Morphological Spectrum of Genito-Urinary Schistosomiasis in Sokoto, North-Western Nigeria

A. S. Muhammad, N. P. Agwu, A. Abdulwahab-Ahmed, S. M. Sahabi1, N. Abubakar1, I. Mungadi

Departments of Surgery and 1 Histopathology, Urology Unit, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Address for correspondence: Dr. A. S. Muhammad, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

E-mail: asmgusau@gmail.com

Background: Schistosoma haematobium is associated with inflammation, obstruction and neoplasia in the uro-genital tract. The aim of this study is to document clinico- morphological spectrum of genito-urinary schistosomiasis in our institution. Methodology: This is a retrospective review of patients with genito-urinary schistosomiasis from January 2010 to May, 2017. Data was entered in to a proforma and analysed using SPSS version 20.0. Results: There were 345 patients with genito-urinary schistosomiasis within the period of study with mean age of 43.61 ± 17.3 years and age range of 7 to 90 years. There were 325 males and 20 females with male: female ratio of 16.3: 1. The diagnosis was histologically confirmed in only 168 patients. The various histological diagnosis include squamous cell carcinoma of the bladder in 45 patients (26.8%), transitional cell carcinoma of the bladder in 28 patients (16.7%), vesical schistosomiasis in 41 patients (24.4%), schistosomal ureteric obstruction in 20 patients (11.9%), chronic cystitis in 13 patients (7.7), prostatic schistosomiasis in 4 patients (2.4%) and others in 17 patients (10.1%). Conclusion: Bladder carcinoma, vesical schistosomiasis and schistosomal ureteric obstruction and prostatic schistosomiasis are commonest pathologies associated with genito-urinary schistosomiasis in our institution.

Keywords: Bladder carcinoma, genito-urinary chistosomiasis, schistosomal ureteric obstruction, vesical schistosomiasis


  NPMCN_ASC_2017_054 Top


Clinical Pattern and Antibiotic Sensitivity of Bacterial Corneal Ulcers in Kano Northern Nigeria

Usman Mijinyawa Abubakar, L. Abdu1, I. Muhammad1

Department of Ophthalmology, Murtala Muhammad Specialist Hospital, 1Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria

Address for correspondence: Dr. Usman Mijinyawa Abubakar, Department of Ophthalmology, Murtala Muhammad Specialist Hospital, Kano, Nigeria.

E-mail: usmanmijinyawa78@gmail.com

Purpose: To determine predisposing factors, common bacterial causes and antibiotic sensitivity of corneal ulcers in Murtala Muhammad Specialist Hospital. Methods: A prospective cross-sectional observational study was carried out on patients with corneal ulcers. Information on relevant clinical, socio-demographic profile was obtained. Examination includes visual acuity test, slit lamp biomicroscopy including Fluorescein staining was performed. Corneal scrapings from the ulcer were inoculated onto differently labelled solid culture media plates. Gram staining for microscopic examination was done. Antibiotic sensitivity test on different antibiograms was done using Modified Kirby Bauer technique, determining bacterial isolate sensitivity or resistance to relevant antibiotics (Chloramphenicol, Ciprofloxacin, Ofloxacin, Gentamicin, Tetracycline, Ceftazidime, Ceftriazone, Cefotaxime, and Penicillin). Results: A total of 77 patients with corneal ulcer were examined. Ocular trauma, application of harmful traditional eye medication, use of unspecified topical medication prior to presentation was amongst the predisposing factors. Bacterial growth was seen in 46.8% of the sample of which 28.6% of the growth were Gram positive. The common bacteria isolated were Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia, Proteus species, and Klebsiella pneumonia. Isolates were sensitivite to Ciprofloxacin and Ofloxacin while an intermediate sensitivity was seen with Chloramphenicol and Gentamicin. Isolates were resistant to Tetracycline, Ceftazidime, Ceftriazone, Cefotaxime, and Penicillin. Conclusion: Ocular trauma was the major predisposing factor to corneal ulcer, and Staphylococcus species was the major bacterial organism isolated. Isolates were found to be sensitivite to Ciprofloxacin and Ofloxacin while an intermediate sensitivity was seen with Chloramphenicol and Gentamicin.

Keywords: Antibiotic sensitivity, cornal ulcer, bacterial and pattern


  NPMCN_ASC_2017_055 Top


A Rare Case Report of Long-Standing Foreign Body in the Abdomen: Forgotten Scalpel Blade in a Multipara

C. Taingson Matthew, G. Makama Jerry1, A. Adze Joel, B. Bature Stephen, Amina Mohammed-Durosinlorun, Mohammed Caleb, Abubakar Amina, Airede Lydia, Sheyin John2

Departments of Obstetrics and Gynaecology, 1Surgery and 2Radiology, Faculty of Medicine, Kaduna State University, Kaduna, Nigeria

Address for correspondence: Dr. C. Taingson Matthew, Departments of Obstetrics and Gynaecology, Faculty of Medicine, Kaduna State University, Kaduna, Nigeria.

E-mail: taingson@yahoo.com

Background: The unintended retention of foreign objects (URFOs) after invasive procedures can cause death, and surviving patients may sustain both physical and emotional harm, depending on the type of object retained and the length of time it is retained. Case Report: A 46-year-old P3 + 0 4-alive presented to the gynaecological clinic of our hospital, following an incidental radiological finding of a size-22 scalpel blade while been evaluated for low back pain. She attributed the pain to spinal anaesthesia. She had three caesarean deliveries in 2006, 2008 and 2011 in our hospital, and an appendectomy as well as a laparotomy for ovarian cystectomy in 1997 and 1998 respectively in a private hospital. She had an exploratory laparotomy and retrieval of scalpel blade, intra-operatively findings were; adhesions in the posterior surface of the previous scar, with attachment of the omentum and bowel. Following extensive exploration, a rusted size-22 scalpel blade was found lodged in the mid-portion of the meso-colon of the transverse colon. Patient had an uneventful post operative course and was discharged on the 7th day. Conclusion: Retained scalpel blade and other material is potentially life threatening, it may cause serious medical and legal problems between the patients and doctor. Hence extensive care should be taken in handling instruments during surgical procedures.

Keywords: Abdomen, foreign body, scalpel blade, multipara and appendectomy


  NPMCN_ASC_2017_056 Top


Arrow Shot Injury to the Head in a Six Month Old Child: Case Report

A. H. Dambatta, I. Hassan1, N. I. Jinjiri1, A. M. Muhammad1

Department of Radiology, Aminu Kano Teaching Hospital, 1Department of Surgery, Neurosurgery Unit, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria

Address for correspondence: Dr. A. H. Dambatta, Department of Radiology, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: najibdambatta@yahoo.com

Background: Arrow shot injury is fairly common among adults especially in Northern Nigeria as result of clashes between cattle rearers and farmers, whose farms are located close to the grazing areas. This kind of injury is however rare among children. Objective: To show the rare case of arrow shot injury in a six-month-old child. Methodology: The patients’ images (computed tomograms) and case file were reviewed and summarized. The subject matter of arrow shot injury was reviewed in the literature. The index case was discussed and compared with literature. Result: We report FU, a six-month-old girl, who was brought to our hospital, two days after arrow shot injury on her forehead. She was said to have been shot at home by her seven year old male sibling while he was practicing arrow shooting taught by their father. On examination, she was conscious, but febrile (38oC), not pale, arrow on her forehead with dried blood around the wound site. No neurological deficit noted. She was admitted, resuscitated and antibiotics were given. Cranial.

Keywords: Arrow shot injury, child, head


  NPMCN_ASC_2017_057 Top


Wilms Tumour in a Child with Horseshoe Kidney Seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto: A Case Report

Bilkisu Ilah Garba, U. M. Sani, K. O. Isezuo, U. M. Waziri, A. S. Muhammad1, I. J. Hano, M. Abubakar

Departments of Paediatrics and 1Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Address for correspondence: Dr. Bilkisu Ilah Garba, Departments of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

E-mail: bgilah@yahoo.com

Background: Wilms’ tumour in a horseshoe kidney is an unusual presentation, with its incidence in patients with horseshoe kidneys being higher than in the general population, leading to a difficult diagnostic and management challenges. Objective: To report a case of Wilms’ tumour in a child with horse shoe kidney in UDUTH, Sokoto. Case Report: UA is an 18 month old boy who presented with six weeks history of progressive painless abdominal swelling. Abdominal examination revealed a huge right sided hypochondrial swelling with bulging of the ipsilateral flank and extending down ward to the iliac fossa. Results: Ultrasound revealed a huge heterogenous mass occupying the right hemi-abdomen extending from hypochondrium to pelvis. It crossed the midline to the contralateral side with multiple cystic portions and calcifications within it. The right kidney was difficult to be demonstrated separate from the mass while the left kidney was demonstrated and appear to be normal. Computed tomography scan showed a huge heterogeneously enhancing isodense mass in the right lumbar region extending to the pelvis and crossing the midline. The mass was continuous with normal renal parenchyma on the inferomedial aspect in keeping with Wilms tumour. The inferior poles of both kidneys were connected in the midline in keeping with a horse shoe kidneys. Chemotherapy was commenced, however he deteriorated and died after 2 courses. Conclusion: Horseshoe kidney should be closely monitored for the possibility of coexisting Wilms tumour as early diagnosis may improve outcome.

Keywords: Horse shoe kidney, unusual, Wilms’ tumour


  NPMCN_ASC_2017_058 Top


Renal Artery Entrapment Syndromes Presenting with Uncontrolled Hypertension: A Case Series

A. H. Dambatta, A. M. Tabari, U. Muhammad, A. Jega

Department of Radiology, Aminu Kano Teaching Hospital, Kano, Nigeria

Address for correspondence: Dr. A. H. Dambatta, Department of Radiology, Aminu Kano Teaching Hospital, Kano, Nigeria.

E-mail: najibdambatta@yahoo.com

Background: The diaphragmatic crura have been reported to cause extrinsic compression of aorta, coeliac, mesenteric, lumbar and both renal arteries. Extrinsic compression of renal arteries by the diaphragmatic crura, known as renal artery entrapment syndrome, is rare. Objective: To show the rare cases of renal artery entrapment syndrome. Methodology: The patients’ images (computed tomography angiograms) and case file were reviewed and summarized. The subject matter of renal artery entrapment syndrome was reviewed in the literature. The index cases were discussed and compared with literature. Result: Case one: We report SA an 11 year old boy who was referred from another hospital for renal CT angiography on account of uncontrolled hypertension with suspicion of RAS. Renal USS and IVU revealed right sided shrunken kidney. CT angiograms showed hypertrophy of right diaphragmatic crus with associated extrinsic compression and narrowing of adjacent proximal portion of right renal artery against the IVC. A diagnosis of renal entrapment sysndrome was made. Case two: We report TS a 30 year old man who was referred for renal CT angiogram on account of persistent high blood pressure with suspicion of renal artery stenosis. CT angiograms showed an elevated and compressed right renal artery at its origin against the IVC by a focal triangular and hypodense mass which was continuous with the right hemidiaphragmatic crus, suggestive of hypertrophied crus. A diagnosis of renal entrapment syndrome was made. Conclusion: Renal entrapment syndrome may still be encountered despite its rarity.

Keywords: Diaphragmatic crus, renal angiogram, renal artery entrapment






 

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