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   2003| January-March  | Volume 10 | Issue 1  
    Online since December 11, 2015

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Spinal and general anaesthesia for emergency caesarean section: Effects on neonatal Apgar score and maternal haematocrit
BB Afolabi, AA Kaka, OO Abudu
January-March 2003, 10(1):51-55
This is a prospective comparative study to determine the effect of the type of anaesthesia used for emergency Caesarean section on neonatal and maternal outcome. The patients were recruited into the study after being given either general or spinal anaesthesia. Neonatal outcome was assessed using Apgar scores and need for respiratory assistance at birth. Maternal outcome was assessed using the difference between pre- and post-operative packed cell volumes (PCV), need for blood transfusion and estimated blood loss. The groups were matched for pre-existing risk factors. Apgar scores at 1 and 5 minutes were found to be significantly lower for the general anaesthesia group (GA) than the spinal anaesthesia group (SA) and need for respiratory assistance was greater for the GA group. Difference between pre- and post-operative PCV and need for blood transfusion were also significantly greater in the GA group. This study confirms that the current practice of spinal anaesthesia for Caesarean section in the Lagos University Teaching Hospital is a good one, but further studies need to be done to assess other outcome variables.
[ABSTRACT]   Full text not available   
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Knowledge and practice of universal precautions among nurses in central hospital, Benin-City, Edo State, Nigeria.
AN Ofili, MC Asuzu, OH Okojie
January-March 2003, 10(1):26-31
Nurses are faced with professional hazards such as needle pricks and blood-borne infections in their day to day activities in the work place. This study is aimed at finding out the knowledge and practice of universal precautions among nurses at the Central Hospital, Benin City, Edo State, Nigeria. One hundred and fifty-five (155) nurses participated in the cross-sectional study. The nurses were selected using the stratified random sampling method. The nurses had a poor knowledge about universal precautions as only 34.2% of nurses had heard about universal precautions. There was also a poor observance of universal precautions. Knowledge of measures to be taken after the occurrence of occupational accidents/ injuries was also poor, as only 26(16.8%) nurses would report puncture injuries to the clinic, only 13(8.4%) nurses would screen patients for HIV antibody after consent when they sustain work related accident/injuries. Twelve (7.7%) nurses would screen patient to determine hepatitis B status of patient while only 8(5.2%) nurses would go for medical check-up/immunisation with hepatitis B vaccine.
[ABSTRACT]   Full text not available   
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Histopathological review of prostatic diseases in Kano, Nigeria
AZ Mohammed, SU Alhassan, ST Edino, O Ochicha
January-March 2003, 10(1):1-5
Diseases of the prostate are common causes of morbidity in adult males and show wide geographical and ethnic variations in incidence and mortality worldwide. It is in the light of this that records of prostatic biopsies were reviewed in retrospect at the Aminu Kano Teaching Hospital, Kano and Murtala Mohammed Hospital Kano over a 4-year period in order to determine the histological pattern and age distribution of the various prostatic lesions. Three hundred and three prostatic lesions constituting 7.4% of all surgical biopsy specimens received were studied. Two hundred and thirty five (77.6%) of these were cases of BPH while prostatic cancer accounted for 22.4% of cases. The ratio of benign to malignant prostatic disease was 3:5:1. Chronic non-specific prostatitis, acute prostatitis, schistosomiasis and tuberculosis were present in 22.8%, 3.3%, 0.7% of the total number of cases respectively. The mean age of BPH patients was 63.7 years, and 88% of them had a glandulostromal histological pattern. Majority (64.2%) of the prostate cancers were well-differentiated adenocarcinoma and the mean age was 67.1 years. The findings confirm earlier observations that prostatic diseases are common causes of morbidity in our environment, and early diagnosis and treatment remain key measures in reducing mortality. The practice of 5-region biopsy is advocated to improve detection of clinical prostate cancer.
[ABSTRACT]   Full text not available   
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Pattern of abdominal injuries in Aminu Kano Teaching Hospital, Kano
ST Edino
January-March 2003, 10(1):56-59
This study was carried out to look at the pattern of abdominal trauma in Kano, and to compare our findings with those of other centres in Nigeria, and elsewhere. This was a retrospective analysis of all cases of abdominal trauma seen and operated upon from January 1997 to December 2001, in Aminu Kano Teaching Hospital, Kano. Sixty-seven patients were managed during the study period. They were all males, with a peak age range of 20 - 29 years. Penetrating abdominal injury occurred in 36 patients (53.7%), with 15 of them (44.4%) arising from missile injuries. Thirty-one patients (46.3%) sustained blunt abdominal trauma, mainly from road traffic accidents in 80.6% of cases. The spleen was the most commonly injured organ in blunt abdominal trauma occurring in 18 patients (58.1%), while in penetrating injury, it was the small bowel in 19 patients (55.5%). The mortality rate in this study was 8.9%. Abdominal injuries are quite common in Nigeria and remain a major source of morbidity and mortality. Preventive strategies should be focused on reduction of road traffic accidents, violent crimes and social conflicts.
[ABSTRACT]   Full text not available   
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Prevalence of lupus anticoagulant in multiparous women in Benin City, Nigeria
OA Awodu, OA Ejele, WA Shokunbi, ME Enosolease
January-March 2003, 10(1):19-22
Lupus anticoagulant which in the past was regarded as a laboratory nuisance is now known to be associated with numerous clinical conditions including thrombosis and recurrent foetal loss, however, no work has been done to assess its prevalence in non-pregnant healthy multiparous women. Our aim therefore was to determine the prevalence of lupus anticoagulant in non-pregnant multiparous Nigerian women of childbearing age. Fifty non-pregnant multiparous women who were considered healthy following verbal interviews were studied. An eligibility criterion was used. Coagulation studies were performed on plasma samples from all the women using the Kaolin clotting time. Mixing experiments were conducted on samples with prolonged clotting time to detect the presence of the lupus anticoagulant. The Kaolin clotting time ratio of greater than or equal to 1.2 was considered positive for the lupus anticoagulant. Forty-four (88%) of the 50 women had a normal cloning time, 2(4%) had subnormal clotting time while 4(8%) of them had a prolonged Kaolin clotting time. Mixing experiments on these 4 samples revealed Kaolin clotting time ratios of over 1.2, signifying the presence of the lupus anticoagulant (i.e. 8 per cent prevalence) among the population of women studied Multiparous women with the lupus anticoagulant may not be symptomatic therefore the anticoagulant should be screened for in women with unexplained prolongation of cloning time. We recommend that these women should be followed up especially in pregnancy to forestall any of the obstetric complications that have been associated with the lupus anticoagulant.
[ABSTRACT]   Full text not available   
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Fasting plasma glucose and cholesterol levels in pregnant Nigerian women
OA Adegoke, EE Iyare, SO Gbenebitse
January-March 2003, 10(1):32-36
There are numerous reports of altered carbohydrate metabolism in pregnancy. Normal pregnancy is sometimes characterised by mild fasting hypoglycaemia, postprandial hyperglycaemia and hyperinsulinaemia. Pregnancy has also been observed to be associated with a hypercholesterolaemic state in some individuals with pregnancy-induced hypertension. The aim of the present study was to assess the fasting plasma levels of glucose and cholesterol in pregnant Nigerian women, and to find out any differences from previously reported observations. Twenty pregnant consenting females were used for the study while twenty non-pregnant females were used as controls. Blood samples were taken from each subject after an overnight fast, and assayed for plasma glucose and cholesterol. Results obtained showed a decrease in fasting plasma glucose (from 3.96 mmo1/L to 3.12 mmo1/L) in early pregnancy (p < 0.05) but no change in late pregnancy. Plasma cholesterol was significantly higher (p < 0.05) in pregnant subjects (3.89 mmo1/L) than in the non-pregnant (2.40 mmo1/L), the increase being more appreciable in early pregnancy. These results are similar to data from non-African blacks and Caucasians.
[ABSTRACT]   Full text not available   
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A review of medico-legal deaths in Kano
O Ochicha, AZ Mohammed, EE Nwokedi, AB Umar
January-March 2003, 10(1):16-18
Medicolegal death (MLD) is a relatively uncommon subject of study in Nigeria. This prospective review of 200 cases in Kano found the commonest cause to be road traffic accidents (48.5%) followed by homicides (34%) and natural deaths (5%). Gang violence among local youths with blunt and sharp weapons accounted for most of the homicides. MLDs most frequently (60.5%) occurred in the 3rd to 5th decades of life and males were predominant (M:F = 3.5:1). Our findings differed significantly from MLDs in the developed world where natural deaths were overwhelmingly preponderant. The prevalence of MLDs in Kano can be substantially reduced if the recommendations of this study are implemented.
[ABSTRACT]   Full text not available   
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The effect of warmth or/and vitamin E supplementation on forearm blood flow and forearm vascular resistance in sickle cell and non sickle cell anaemia subjects
SI Jaja, TA Gbadamosi, MO Kehinde, S Gbenebitse
January-March 2003, 10(1):6-12
The effects of warmth stimulation and/or supplementation with vitamin E (300 mg/day for 6 weeks) on forearm blood flow (FBF) and forearm vascular resistance (FVR) were measured in 8 sickle cell anaemia (SCA) (mean age = 22.8 + 0.8 years) and 11 non sickle cell anaemia (NSCA) subjects (mean age = 23.2 + 1.1 years) of both sexes. Warmth stimulation was induced by immersing the left foot in warm water at 400C for 2 minutes. Forearm blood flow was measured with the venous occlusion plethysmography method. Warmth increased FBF (p <0.01 in each group) and reduced FVR (p <0.05) in NSCA subjects. The change in FBF was greater (p < 0.05) in the NSCA subjects than in the SCA subjects. Supplementation with vitamin E reduced systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) (p < 0.001 in each case) in the NSCA subjects but had little or no effect on the SCA subjects. Vitamin E increased FBF in NSCA subjects (p < 0.05) and SCA subjects (p < 0.01) and decreased FVR in both groups (p < 0.05 in NSCA and p < 0.01 in SCA subjects). The change in FVR seen in the NSCA subjects was less (p < 0.01) than the change in SCA subjects. After supplementation with vitamin E, warmth further decreased SBP (p < 0.01 in each group) and FVR (p < 0.01 in each case) and increased FBF in both groups (p < 0.01 respectively). The changes caused by warmth after vitamin E supplementation on the blood pressure parameters, FBF and FVR were similar in the two groups of subjects.
[ABSTRACT]   Full text not available   
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Colorectal perforation following barium examination in children
EA Ameh, ND Chom
January-March 2003, 10(1):64-66
Barium contrast study is a frequently performed investigation in children, but colorectal perforation complicating the procedure is uncommon. A 2-month-old boy suspected of having Hirschsprung s disease developed an intraperitoneal rectal perforation following barium enema for which repair and diversion colostomy was performed. Another 4-year-old boy with Hirschsprung s disease and a transverse colostomy developed a colorectal perforation during distal colostogram using barium and was managed non-operatively. Both patients are well. The management of this uncommon complication is discussed.
[ABSTRACT]   Full text not available   
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Histopathology of orbito-ocular diseases seen at University of Benin Teaching Hospital, Benin City
JU Aligbe, UO Igbokwe, EE Akang
January-March 2003, 10(1):37-41
Ninety-three biopsied lesions of the orbito-ocular region seen over a fifteen year period at the Pathology department of the University of Benin Teaching Hospital (UBTH) Benin City were reviewed. The aim was to determine the morphological patterns and the age, sex and site distribution of these lesions. Majority of the lesions (43.3%) were found in children less than 15 years of age. There was no difference in frequency between the two sexes. 41.9% of the lesions were malignant while 58.1% were benign. The commonest site of orbito ocular lesions was conjunctival (55.9%), followed by intraocular lesions (24.7%). About 50% of the lesions of the orbit were inflammatory pseudotumours. Inflammatory pseudotumours also formed the majority (33.3%) of the lesions in the eyelid. However, squamous cell carcinomas were the commonest lesions of the conjunctiva seen accounting for 25% of these. Retinoblastomas formed 95.7% of the intra-ocular tumours seen.
[ABSTRACT]   Full text not available   
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The effect of the cyclooxygenase blockers, ibuprofen on the development of glomeruli in Sprague-Dawley rats
O Akinola, C Noronha, A Oremosu, O Kusemiju, OA Okanlawon
January-March 2003, 10(1):46-50
Cyclo-oxygenase mediated prostaglandins are important determinants of glomerular development and kidney function. Ibuprofen inhibit the enzyme cyclo-oxygenase and thereby block the prostaglandin synthesis in the kidneys. Cyclo-oxygenase exist in two iso-forms (COX-1 and COX-2). It has ben proposed that Non-steroidal anti-inflammatory drugs (NSAIDs) with preferential COX-2 selectivity have fewer renal side effects than drugs with preferential COX-1 selectivity. The significance of this remains unclear since nephrotoxicity is relatively uncommon with ibuprofen and, when present is usually rapidly reversible although, ibuprofen has a higher potency against COX-1 than COX-2. We therefore investigated the effect of ibuprofen on glomerulogenesis in Sprague-Dawley rats. Ibuprofen (22 mg/kg/day) was administered orally from day 10 of gestation to day 15 after parturition. Light microscopic examination of ibuprofen-treated neonatal kidneys show hypoplastic glomeruli. These results suggest that low dose ibuprofen is deleterious to glomerular development.
[ABSTRACT]   Full text not available   
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Risk factors of placenta accreta in Ile-Ife, Nigeria
FO Dare, VO Oboro
January-March 2003, 10(1):42-45
Our objective was to identify the independent risk factors of placenta accreta. The hospital records of 44 pregnancies complicated by placenta accreta, and 1371 controls over a 10-year period were reviewed. Univariate analysis was followed by multivariate logistic regression analyses with adjustment for potentially confounding variables to determine the statistically significant independent predictors of placenta accreta (p <.05). The following factors were associated with placenta accreta: maternal age of at least 35 years (P =.004), gravidity = 5 (P =.004), placenta praevia (P <.001), previous uterine curettage (P =.006) and previous caesarean delivery (P =.014). However, when examined with a multivariate model, only placenta praevia (Odds Ratio [OR] 49.3; 95% confidence interval [95% CI] 13.1, 119.0) and maternal age = 35 (OR 2.7; 95% CI 1.3, 7.9) reached a significant association. Independent risk factors of placenta accreta include placenta praevia and maternal age 35 and over.
[ABSTRACT]   Full text not available   
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Primary jejuno-ileal neoplasms in eastern Nigeria
SN Anyanwu, AM Nwofor
January-March 2003, 10(1):23-25
Small intestinal neoplasms are uncommon with reported incidences of less than 1% of GI neoplasms. A retrospective review of cases of small intestinal neoplasms seen by the authors in a ten-year period is presented. Ten cases were seen during the period (8 females and 2 males). Seven patients were aged less than 20 years while the rest were aged above 2 years. Six patients presented with intestinal obstruction, 3 with features of chronic ill-health while 1 was an incidental finding. The ileum was involved in 5 patients, the jejunum in 4 while 1 showed multiple gut involvement. One patient had a benign lesion (Peutz-Jeghers Syndrome). The rest consisted of lymphosarcoma [5],adenocarcinoma [3] while 1 patient had leiomyo-sarcoma. Treatment offered included resection of small gut in 7 patients and ileo-colectomy in 3 patients. Three patients with lymphosarcoma had a full course of cytotoxic chemotherapy. The outcome was poor; 2 patients were alive after 3 years, 3 died within 6 months of surgery while the rest were lost to follow-up at variable periods after surgery. Neoplasms of the small gut presents late in our environment. Lymphosarcoma seems commoner in childhood and carries a better prognosis.
[ABSTRACT]   Full text not available   
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Malignant haemangio endothelioma (angiosarcoma) concomitant presentation in the mandible and occiput--A case report
AL Ladeinde, SO Elesha, SO Arigbabu
January-March 2003, 10(1):60-63
A case of angiosarcoma presenting simultaneously in the mandible and occiput is presented. The mandibular swelling was preceded by toothache for which the patient had tooth extraction, after which the rate of growth increased tremendously. It was not possible to determine without doubt which lesion presented first. The need to evaluate and investigate all cases of jaw swelling that require tooth extraction is emphasised. Angiosarcoma being a haemorrhagic lesion could be complicated life threatening haemorrhage, if a tooth related to it is extracted, as was experienced on incisional biopsy of this lesion. The procedure was accompanied by torrential bleeding which was only controlled after external carotid artery ligation. This, to our knowledge, is the first reported case of angiosarcoma occurring simultaneously in the mandible and occipital bones.
[ABSTRACT]   Full text not available   
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A review of 101 homicide cases in Jos, Nigeria
AZ Mohammed, BM Mandong, AN Manasseh
January-March 2003, 10(1):13-15
A five-year retrospective analysis of 101 homicide cases in Jos, Nigeria was carried out between 1995 and 1999. Of the total number, 47 were killed with sharp cutting or piercing instruments, 28 with firearms and 21 died from physical assaults. Five of the victims sustained fatal burn injuries. Majority of the cases (62.4%) were aged between 21 and 40 years and males outnumbered females by a ratio of 7.4:1. It is concluded that although a significant proportion of homicides are not premeditated, communal violence and robbery attacks remain the most frequent precipitating events that result in homicide in this environment.
[ABSTRACT]   Full text not available   
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