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   2008| July-September  | Volume 15 | Issue 3  
    Online since April 22, 2016

 
 
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ARTICLES
Severe burn trauma from deliberate self-harm: the Sokoto experience
JN Legbo, IO Ntia, WE Opara, A Obembe
July-September 2008, 15(3):164-167
BACKGROUND: Burn injury is one of the most severe forms of trauma that can afflict mankind. Although several forms of suicide and para suicide have been reported worldwide, severe burn injuries from deliberate self-harm have been poorly documented in Africa. AIM: To evaluate the pattern of deliberate self-harm by burning in our environment. METHOD: This is a 5-year retrospective analysis of all patients who sustained burns from deliberate self-harm (DSH) seen at the Usmanu Danfodiyo University Teaching Hospital, Sokoto from June 1998 to May 2003. The patients' data and other necessary information were extracted from the case notes. RESULTS: Seven patients were seen over the study period. There were six females and one male, giving a female to male ratio of 6:1. All the injuries occurred at home from kerosene flame burns. In all cases, the intent was to take the patient's own life. The triggering factors were mainly psychosocio-economic. Six patients had up to secondary education while one patient had a degree certificate. None of the patients was gainfully employed at the time of incidence. Two patients had previously attempted suicide. Only one patient had a history of psychiatric illness. All sustained severe flame burns ranging from 45% - 98% body surface area (BSA). Compliance to treatment was generally poor. All patients were managed at the intensive care unit (ICU) of the hospital.. Five patients died, while the remaining two signed against medical advice (SAMA) during the course of management. The duration of hospital stay ranged from 2 - 10 days. CONCLUSION: Severe burn injury from DSH, although previously poorly documented in Africa, is not uncommon in our environment. The morbidity and mortality are high, not only because of the nature of injury, but probably because of poor compliance to treatment. We advocate community based studies and routine screening of adolescents to identify those at risk. The need for the establishment suicide information, intervention and prevention centre in Nigeria cannot be overemphasised.
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Orbito-ocular lesions in Lagos
CC Anunobi, FB Akinsola, FB Abdulkareem, OT Aribaba, MA Nnoli, AA Banjo
July-September 2008, 15(3):146-151
OBJECTIVE: we present a 10year retrospective clinicopathologic study of 135 cases of orbito-ocular lesions. The aim is to document pattern of orbito-ocular lesions, with their site, age and sex distribution. MATERIALS AND METHODS: The materials consisted of slides, paraffin embedded tissue blocks and histology request forms of all orbito-ocular samples received at the Morbid Anatomy Department of Lagos University Teaching Hospital Idi-Araba Lagos between 1994 and 2003. RESULTS: A total of 135 samples from 75(56%) males and 60(44%) females were analysed. The conjunctival, intraocular, orbital and eye lid lesions accounted for 27(20.1%), 75(55.5%), 18(13.4%) and 15(11%) cases respectively. The ages ranged from 20 days to 79 years with a mean age of 35 years. Sixty nine cases (51.1%) of all orbito-ocular lesions were seen in children of age 15 years and below. Squamous cell carcinoma was the commonest malignant conjunctival lesion (4 out of the 5 cases) occurring in adults with a mean age of 45 years. Retinoblastoma accounted for 46(85%) of all orbito-ocular malignancies with the peak in the 1-5year age group accounting for 37(80 %). Panophthalmitis, endophthalmitis and phthisis bulbi were common non neoplastic lesions requiring enucleation. Pseudotumour and rhabdomyosarcoma accounted for 5(27.8 %) and 4(22.2 %) cases respectively of all orbital lesions. CONCLUSION: Retinoblastoma remains the commonest ocular malignancy while rhabdomyosarcoma was the commonest orbital malignancy with both occurring in childhood. Inflammatory lesions unfortunately are important orbito-ocular lesions requiring surgery in our environment.
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Training needs and risk assessment among farmers and animal handlers on zoonoses in Sokoto metropolis
AS Umar, A Nura
July-September 2008, 15(3):168-174
INTRODUCTION: Zoonotic diseases are detrimental to animal health resulting not only in great economic loss due to reduced production of meat, milk, wool, etc, but also a threat to national food security and to achieve the millennium development goals on eradicating extreme hunger and poverty. An important factor that aids the spread of zoonoses is the working conditions and habits (behavioural risks) of livestock farmers and handlers. STUDY DESIGN AND METHODOLOGY: This study was designed to assess the knowledge gap and risk reduction needs among farmers and animal handlers in Sokoto through an explorative cross-sectional study. A total of 400 respondents were recruited through a multi stage and proportionate sampling technique. RESULTS: Overall, there is a knowledge gap on aetiology, mode of transmission and preventive measures with only 31.9%, 25.9% and 25.5% respectively, of the respondents having adequate knowledge, positive health, promotive or disease preventive attitude and having practised effective preventive measures against zoonotic diseases consistently. Respondents' place of work (P<0.0001), educational attainment (P<0.0001), training status on rearing or handling of livestock (p<0.0001) and number of years of experience in livestock production and handling (p<0.001) were the consistent important determinants of the level of knowledge, attitude to and use of preventive measures against the zoonoses. CONCLUSION: There is therefore the need for training, retraining, inter-sectoral sensitisation and awareness creation forum to promote effective prevention and control practices.
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Serum lipid profile in malnourished Nigerian children in Zaria
A Akuyam, HS Isah, WN Ogala
July-September 2008, 15(3):192-196
BACKGROUND/OBJECTIVE: There is paucity of data on the pattern of serum lipids in malnourished children in Zaria. Most of the reported studies were carried out in southern part of Nigeria. The overall objective of this study was therefore to measure serum lipids in children with PEM in Zaria with the view to recommending its use in them. SUBJECTS, MATERIALS AND METHODS: Serum lipids were measured in 115 children presenting with PEM and 115 age- and sex-matched well nourished controls aged 6-36 months .The malnourished children consisted of 25, 30, 30 and 30 children with kwashiorkor, marasmic-kwashiorkor, marasmus and underweight respectively. There were 60 males and 55 females. Serum total cholesterol(TC),high density lipoprotein cholesterol (HDL-C) and triglyceride(TG) were measured by enzymatic colorimetric methods of serum low density lipoprotein cholesterol(LDL-C) and very low density lipoprotein cholesterol(VLDL-C) were estimated using Friedewald formula. RESULTS: Serum TC, LDL-C and HDL-C levels were significantly lower (p<0.01, p<0.05 and p<0.001 respectively), while the ratio TC/HDL-C was significantly higher (p<0.001) in children with PEM than in their well-nourished counterparts. Concentrations of serum TG and VLDL-C were apparently but not significantly lower in children with PEM than in well-fed children (p>0.05).Serum levels of TC, LDL-C and HDL-C were significantly higher (p<0.001, p<0.001 and p<0.01 respectively) in oedematous PEM patients than in their non-oedematous counterparts. Serum TG and VLDL-C values were apparently but not significantly higher in oedematous PEM patients than in non-oedematous ones. CONCLUSION: There was a significant reduction in serum lipid concentrations in children with PEM. The study therefore suggests that measurement of serum lipids could be of importance in the assessment of childhood malnutrition.
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One year echocardiographic study of rheumatic heart disease at Enugu, Nigeria
IO Essien, BJ Onwubere, BC Anisiuba, EC Ejim, JJ Andy, SO Ike
July-September 2008, 15(3):175-178
BACKGROUND: Rheumatic heart disease is one of the commonest causes of heart disease in Nigeria. Previous studies on rheumatic heart disease in Nigeria were either clinical or retrospective echocardiographic studies. This study was aimed at determining the burden of chronic rheumatic mitral valve disease, pattern of valvular involvement, severity and associated valvular lesions, using echocardiography. PATIENTS AND METHODS: Between May, 2004 and April 2005, patients with symptomatic rheumatic heart disease, seen in the cardiac clinics of University of Nigeria Teaching Hospital, Enugu, were recruited for the study. The patients were investigated non-invasively with M-mode, Two-dimensional, Pulsed wave, Continuous wave and colour flow Doppler echocardiographic techniques in order to assess the mitral and other intracardiac valves for evidence of rheumatic heart disease. RESULTS: There were a total of 55 patients, 39 (70.9%) females and 16 (29.1%) males with a mean age of 29.34 +/- 11.57 years. Mitral valve disease was found in 54 (98.2%) and isolated aortic valve disease in 1 (1.8%) of cases. Mitral regurgitation occurred in 64.8%, mixed mitral valve disease in 25.9% and pure mitral stenosis in 9.3%. Mitral valve disease was associated with aortic valve disease in 33.3%, with tricuspid valve disease in 24.1% and with functional pulmonary incompetence in 9.3% of cases. CONCLUSION: Rheumatic heart disease in Nigeria is essentially a disease of the mitral valve as seen elsewhere in the world. Echocardiography should be done routinely for patients with rheumatic heart disease to facilitate accurate diagnosis and definitive treatment.
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Determinants of consistent condom use among adolescents and young adults attending a tertiary educational institution in Ile-Ife, Nigeria
AA Onayade, TC Abiona, C Ugbala, G Alozie, O Adetuyi
July-September 2008, 15(3):185-191
OBJECTIVES: This study evaluated the determinants of consistent condom use among adolescents and young adults aged 15 - 29 years. METHODS: This was a cross-sectional survey to which 600 (300 of each gender) adolescents/young adults who had never married were recruited. Information was collected from respondents by means of a purpose-designed, self-administered questionnaire. Information sought includes the respondents' social and demographic characteristics, sexual practices and issues relating to condom use. RESULTS: Five hundred and thirty-six (89.3%) of the 600 questionnaires were suitable for analysis; 372 (69.4%) had had sexual intercourse. A third reported that they were having sex frequently or fairly frequently; 145 (41.7%) had more than one partner while 74 (19.9%) were aware that their partners had other sexual partners. Two-thirds of currently sexually active respondents reported that condoms were readily available and cheap although only 90 (24.2%) reported using condoms consistently. The factors that were statistically significant predictors of consistent condom use among the males were age; younger respondents were more likely to be consistent users (p = 0.015), having more than one sexual partner (p = 0.030) and ability to refuse sex with a partner who would not want to use condom (p = 0.008). Among the females, statistically significant predictors were frequency of sexual intercourse; respondent who had sex frequently were more likely to use condoms consistently (p = 0.018) and having more than one partner (p=0.018). CONCLUSION: Inconsistent condom use is rampant and females were probably disadvantaged as far as condom negotiation is concerned.
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Analysis of five-year breast biopsies carried out in the University of Benin Teaching Hospital Benin City
OC Osime, EC Ohanaka
July-September 2008, 15(3):160-163
OBJECTIVE: To review the histology of breast biopsies carried out in our hospital with a view to designing management and preventive strategies. PATIENTS AND METHODS: 179 patients who had breast biopsies over a five year-period (January 1999 - December 2003) were included in the study. The patients were sorted out from the records in both the casualty and main theatres of the hospital. The medical records from their case files were analysed in terms of age, sex and the histology of the tissue obtained on biopsy. RESULTS: Benign breast lesions accounted for 73.2% with fibroadenoma constituting a greater percentage. Whereas benign breast lesions were most commonly encountered in the third decade of life, malignant lesions occurred most commonly in the fourth decade. After the age of 60, all the cases analysed were of the malignant variety. CONCLUSION: Young patients with breast lump should be encouraged to come for consultation as most of them are benign. However, any lump in a woman above 30 should be properly screened for cancer. Similarly, any patient who presents with a breast lesion after the age of 60 should be regarded as having breast cancer until proved otherwise.
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Pupillary changes among Nigerian adults following the instillation of Garcinia kola nut extracts: multicentric studies
AO Adefule-Ositelu, OT Aribaba, OO Adegbehingbe, AK Adefule, AA Samaila, K Oladigbolu
July-September 2008, 15(3):152-156
BACKGROUND: A multi-centre, open, within-patient controlled study was performed on 106 adult volunteers to investigate the effects of Garcinia kolanut extracts on the pupillary sizes. STUDY DESIGN: 106 participants in three Nigerian Ophthalmic Centres with no pupillary defects and associated ocular or systemic co-morbidities had their pupillary diameters measured at 0, 15, 30 and 45 minutes respectively with a pupillometer (Neuroptics model # 586009). Using the left eyes as control, Garcinia kolanut extract was instilled into the right eyes at 15 minutes intervals. RESULTS: There were 63 females and 43 males ranging in age from 18 to 58 years with the mean age of 34.9 years. Average pupillary diameter measured among participants was 4.1 - 8.4 mm with the mean value of 6.0 mm prior to garcinia kola nut extract instillation. There was a gradual reduction in the baseline pupillary size with age in years at 0.2mm per decade without garcinia extract instillation. There was a significant higher baseline pupillary diameter in males than females with males and females mean values of 6.29mm (6.00 - 6.56mm) and 5.85mm (5.60 - 6.11mm) in the right eye (p=0.026) and mean pupillary diameters 6.16mm (5.90 - 6.42mm) and 5.80mm (5.56 - 6.04mm) in the left eyes (p=0.05) respectively. There were consistent significant miosis in the right eyes with instilled Garcinia kola nut extract compared to the left eyes at 15, 30 and 45 minutes (p=0.0000). CONCLUSION: 4% Garcinia kola nut extract drop has a transient miotic effect on human pupils not sustainable for more than 45 minutes.
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Implications of antibiotics and oral contraceptive interactions: knowledge and practice of dental surgeons
AO Arigbede, MA Adedigba, BF Adeyemi, OG Omitola
July-September 2008, 15(3):179-184
OBJECTIVES: Unplanned pregnancies may result if antibiotics are prescribed for women using combined oral contraceptive (COC).The current study is designed to determine: the rate and pattern of antibiotic prescription during a normal week, the awareness of Nigerian dentists about possible drug interaction between antibiotics and oral contraceptives, and to determine the knowledge of Nigerian dentists about additional preventive measures to be employed by patients on combined oral contraceptive being placed on broad spectrum antibiotics. MATERIALS AND METHODS: A cross-sectional study was conducted in 3 tertiary and 2 secondary health institutions in Nigeria using dental House Officers and Residents as subjects. Medical House officers were employed as control. An open and close ended questionnaire that sought for information about types and number of times antibiotics are prescribed per week, influence of some medical conditions and drugs like contraceptive on choice of antibiotics and knowledge of relevant advice to be given to patients on oral contraceptive being given broad spectrum antibiotics was employed. RESULTS: Antibiotics are prescribed 1-3 times per week by most dental graduates during a normal week. The antibiotics frequently prescribed by both the cases and the control include: Amoxicillin and Metronidazole. The dentists' decision to select appropriate antibiotics is influenced by the presence of pregnancy (90.52%) and penicillin allergy (85.34%). Only 59.48% of the dentists admitted being so influenced by current history of contraceptive use. Two respondents knew and gave relevant advice on additional preventive measure to be employed by patients on pills being given antibiotics CONCLUSION: This initial report suggests that Nigerian dentists are not well informed about the potential interaction between antibiotics and combined oral contraceptive and the extra precautions to be taken when antibiotics is prescribed for women on COC pills. A cross-section of Nigerian dentists prescribed antibiotics 1-3 times during a normal week.
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Ultrasound findings in amenorrhoeic women with vaginal bleeding
SA Erinle, O Okoye, IT Jimoh
July-September 2008, 15(3):157-159
OBJECTIVE OF STUDY : To document sonographically identifiable causes of vaginal bleeding in secondarily amenorrhoeic women of child bearing age. METHODS: A retrospective study of ultrasonographic findings among 102 secondarily amenorrhoeic women of childbearing age with vaginal bleeding was carried out. Ultrasound scan was carried using Siemens Sonoline SL1 equipment with 3.5MHz and 5.0MHz transducers RESULTS: 75(73.2%) patients had pregnancy-related conditions, 14(13.7%) had normal, non-pregnant uteri while the remaining 13 (12.8%) had other gynaecological conditions namely pelvic inflammatory disease (PID), uterine fibroids and ovarian masses. Though pregnancy-related conditions are the major causes of vaginal bleeding in amenorrhoeic women of childbearing age, PID, fibroids and ovarian masses are possible findings. CONCLUSION: Ultrasound examination is vital in the elucidation of vaginal bleeding in amenorrhoeic women. Pregnancy related conditions are not the only significant cause of amenorrhoea complicated by vaginal bleeding.
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Effect of antiretroviral therapy on asymptomatic malaria parasitaemia in HIV-1 infected children
IM Adetifa, AO Akinsulie, EO Temiye, EO Iroha, VC Ezeaka, AG Mafe, AO Grange
July-September 2008, 15(3):141-145
OBJECTIVE: To investigate the effect of antiretroviral ARV) therapy on the level of asymptomatic malaria parasitaemia in HIV-1 infected children. METHODS: Sixty-six HIV infected children had blood films prepared for malaria parasite identification and count. Mean parasite densities were compared across clinical stages and immunologic categories of disease and antiretroviral treatment status. RESULTS: Forty-five (68%) were less than 6 years old and 50 (75.7%) had advanced HIV disease. Twenty seven (41%) were on antiretroviral therapy. The prevalence of ASMP in the treated and untreated group was 44.4% and 15.4% respectively (p<0.01). The mean parasite density in the ARV treatment group was also significantly higher than in the untreated group (p=0.0071). CONCLUSIONS: ARV therapy seems to be associated with higher rates of ASMP and higher mean parasite counts.
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