Eziamaka Enemuo, K. Iloh, A. Ubesie, H. Okafor, A. Ikefuna
Background: Although Bacillus Calmette Guerin (BCG) vaccine remains one of the most important public health preventive measures against tuberculosis (TB), the presence of a BCG scar may not imply an immune response. Tuberculin reactivity after BCG vaccination has been the most common measure of the effect of the BCG vaccine. Post-vaccination BCG-induced tuberculin reactivity ranges from no induration to an induration diameter of 15 mm. However, tuberculin conversion in infants is usually about 10 mm in more than 90% of infants tested at 12 weeks post-vaccination age. Objective: This study sought to assess the tuberculin conversion rate after BCG vaccination. Materials and Methods: It was a hospital-based cross-sectional study. Two hundred and eighty (280) infants aged 13 to 15 weeks who received BCG vaccination within one month of birth were enrolled. The BCG scar diameter was measured, and Mantoux test was done. Data were analyzed by using the Statistical Package for Social Sciences (SPSS), version 20 (Chicago Il). Results: Among the 280 BCG-vaccinated infants, tuberculin conversion rate was 64%, whereas scar failure rate was 28.9%. Overall, 75.9% of infants with a BCG scar had a positive Mantoux test. The BCG-vaccinated infants with a BCG scar were about six times more likely to have a tuberculin conversion than those without a BCG scar (OR =5.641, 95% C.I = 3.227 to 9.859). Conclusion: There was a 64% conversion rate among the BCG-vaccinated infants. The presence of the BCG scar correlated well with the tuberculin conversion rate.
背景:虽然卡介苗(BCG)疫苗仍然是预防结核病(TB)最重要的公共卫生措施之一，但卡介苗疤痕的存在可能并不意味着免疫反应。卡介苗接种后结核菌素反应性一直是衡量卡介苗效果的最常见指标。接种后bcg诱导的结核菌素反应性从无硬化到直径为15mm的硬化不等。然而，在接种疫苗后12周接受检测的90%以上的婴儿中，结核菌素在婴儿中的转化通常约为10毫米。目的:探讨卡介苗接种后结核菌素的转换率。材料和方法:这是一项以医院为基础的横断面研究。280名13至15周的婴儿在出生一个月内接受了卡介苗接种。测量卡介苗瘢痕直径，并进行曼图试验。数据分析使用社会科学统计软件包(SPSS)，版本20(芝加哥ii)。结果:280例接种bcg的婴儿结核菌素转化率为64%，瘢痕失败率为28.9%。总体而言，75.9%的卡介苗疤痕婴儿的曼图克斯检测呈阳性。接种过卡介苗疫苗的有卡介苗疤痕的婴儿发生结核菌素转化的可能性约为无卡介苗疤痕婴儿的6倍(OR =5.641, 95% ci = 3.227 ~ 9.859)。结论:接种bcg的婴幼儿转换率达64%。卡介苗疤痕的存在与结核菌素转化率密切相关。
{"title":"Tuberculin conversion rate after BCG vaccination of apparently healthy infants in a resource-poor setting","authors":"Eziamaka Enemuo, K. Iloh, A. Ubesie, H. Okafor, A. Ikefuna","doi":"10.4103/ijmh.ijmh_9_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_9_21","url":null,"abstract":"Background: Although Bacillus Calmette Guerin (BCG) vaccine remains one of the most important public health preventive measures against tuberculosis (TB), the presence of a BCG scar may not imply an immune response. Tuberculin reactivity after BCG vaccination has been the most common measure of the effect of the BCG vaccine. Post-vaccination BCG-induced tuberculin reactivity ranges from no induration to an induration diameter of 15 mm. However, tuberculin conversion in infants is usually about 10 mm in more than 90% of infants tested at 12 weeks post-vaccination age. Objective: This study sought to assess the tuberculin conversion rate after BCG vaccination. Materials and Methods: It was a hospital-based cross-sectional study. Two hundred and eighty (280) infants aged 13 to 15 weeks who received BCG vaccination within one month of birth were enrolled. The BCG scar diameter was measured, and Mantoux test was done. Data were analyzed by using the Statistical Package for Social Sciences (SPSS), version 20 (Chicago Il). Results: Among the 280 BCG-vaccinated infants, tuberculin conversion rate was 64%, whereas scar failure rate was 28.9%. Overall, 75.9% of infants with a BCG scar had a positive Mantoux test. The BCG-vaccinated infants with a BCG scar were about six times more likely to have a tuberculin conversion than those without a BCG scar (OR =5.641, 95% C.I = 3.227 to 9.859). Conclusion: There was a 64% conversion rate among the BCG-vaccinated infants. The presence of the BCG scar correlated well with the tuberculin conversion rate.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77175102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. V. Ugwueze, C. Ezeude, ChinweubaM Abonyi, C. Nwatu, K. Ukwaja, E. Young
Recently, there have been notices of drug recalls by different pharmaceutical companies. This is based on the finding of high level of N-nitrosodimethylamine (NDMA) in such medications. These medications are useful in the management of some diseases which affect a significant percentage of the population. It is therefore necessary to evaluate the chemical substance (NDMA), the sources, mechanisms, and the effects it can pose on the users of implicated medications. It is also important to consider the possible ways to avert the entry of NDMA into the medications. The substance, NDMA, has been found to be present as an impurity in high concentration in certain drugs, especially metformin slow release, valsartan and ranitidine. The approved healthy daily intake of NDMA by Food and Drug Administration (FDA) is about 96 ng. However, the concentrations of NDMA found in these drugs were exceptionally high which led to their recall. The high level of NDMA may arise from contamination, direct synthetic process, or from the degradation process of the medicine. Chromatography is the best detection modality of NDMA. The carcinogenic risk is the most feared effect of accumulated NDMA beyond the acceptable limit. On the basis of the frequent recalls of these medications, it is therefore imperative that pharmacists, pharmacologists, and physicians are acquainted with the sources of NDMA. This is in view of the serious risk it can pose to patients’ safety and quality of life. These concerns have given rise to this review article.
{"title":"N-nitrosodimethylamine (NDMA) and some prescribed medicines: A mini-review","authors":"C. V. Ugwueze, C. Ezeude, ChinweubaM Abonyi, C. Nwatu, K. Ukwaja, E. Young","doi":"10.4103/ijmh.ijmh_15_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_15_21","url":null,"abstract":"Recently, there have been notices of drug recalls by different pharmaceutical companies. This is based on the finding of high level of N-nitrosodimethylamine (NDMA) in such medications. These medications are useful in the management of some diseases which affect a significant percentage of the population. It is therefore necessary to evaluate the chemical substance (NDMA), the sources, mechanisms, and the effects it can pose on the users of implicated medications. It is also important to consider the possible ways to avert the entry of NDMA into the medications. The substance, NDMA, has been found to be present as an impurity in high concentration in certain drugs, especially metformin slow release, valsartan and ranitidine. The approved healthy daily intake of NDMA by Food and Drug Administration (FDA) is about 96 ng. However, the concentrations of NDMA found in these drugs were exceptionally high which led to their recall. The high level of NDMA may arise from contamination, direct synthetic process, or from the degradation process of the medicine. Chromatography is the best detection modality of NDMA. The carcinogenic risk is the most feared effect of accumulated NDMA beyond the acceptable limit. On the basis of the frequent recalls of these medications, it is therefore imperative that pharmacists, pharmacologists, and physicians are acquainted with the sources of NDMA. This is in view of the serious risk it can pose to patients’ safety and quality of life. These concerns have given rise to this review article.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78098519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Driving requires good vision for safe and effective execution. Eye examination is required before issuance of drivers’ license, but seldom conducted. Aim: The study aimed to evaluate the visual status of drivers in the Enugu state government house and to determine the adequacy of their vision for the job. Materials and Methods: Case files of drivers working in the government house that came for eye check in May 2015, at Enugu State University of Science and Technology, Teaching hospital were retrieved. Sociodemographic data, relevant history, and clinical ophthalmic findings were reviewed. Descriptive and inferential statistics were done using the Epi-info (version 7.2.4.0). A value of P ≤ 0.05 was considered statistically significant. Results: Fifty drivers’ case files were selected, of which 47 (94%) had complete information and 3 (6%) case files were grossly inadequate and were thus discarded. All were men aged 27–59 years. The mean age was 49.787 ± 7.3 years. Three (6%) underwent a visual test before obtaining their first drivers’ license. None had a comprehensive eye examination at employment. Eye tests are not regularly conducted. Forty-one (87.23%) had mild, 4 (8.51%) moderate, and 2 (4.26%) had severe visual impairment. Refractive errors accounted for 76.60% of ocular morbidities. Thirty-five (81.40%) of the 43 (91.49%) drivers who were above 40 years had presbyopia. Four (8.51%) were below 40 years, and only one was presbyopic (odds ratio [OR] 11.333; 95%; confidence interval [CI] 1.049–122.393; P = 0.0459). Glaucoma accounted for 10.64%. Esterman’s efficiency score showed 91.49% with scores of 96–100. Conclusion: Uncorrected refractive errors were quite common among the drivers. Periodic eye tests should be performed on drivers. This should be enforced to ensure safer road travel.
{"title":"Eye health status of government employed drivers in Enugu, Nigeria","authors":"Ifeoma N. Asimadu","doi":"10.4103/ijmh.ijmh_18_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_18_21","url":null,"abstract":"Background: Driving requires good vision for safe and effective execution. Eye examination is required before issuance of drivers’ license, but seldom conducted. Aim: The study aimed to evaluate the visual status of drivers in the Enugu state government house and to determine the adequacy of their vision for the job. Materials and Methods: Case files of drivers working in the government house that came for eye check in May 2015, at Enugu State University of Science and Technology, Teaching hospital were retrieved. Sociodemographic data, relevant history, and clinical ophthalmic findings were reviewed. Descriptive and inferential statistics were done using the Epi-info (version 7.2.4.0). A value of P ≤ 0.05 was considered statistically significant. Results: Fifty drivers’ case files were selected, of which 47 (94%) had complete information and 3 (6%) case files were grossly inadequate and were thus discarded. All were men aged 27–59 years. The mean age was 49.787 ± 7.3 years. Three (6%) underwent a visual test before obtaining their first drivers’ license. None had a comprehensive eye examination at employment. Eye tests are not regularly conducted. Forty-one (87.23%) had mild, 4 (8.51%) moderate, and 2 (4.26%) had severe visual impairment. Refractive errors accounted for 76.60% of ocular morbidities. Thirty-five (81.40%) of the 43 (91.49%) drivers who were above 40 years had presbyopia. Four (8.51%) were below 40 years, and only one was presbyopic (odds ratio [OR] 11.333; 95%; confidence interval [CI] 1.049–122.393; P = 0.0459). Glaucoma accounted for 10.64%. Esterman’s efficiency score showed 91.49% with scores of 96–100. Conclusion: Uncorrected refractive errors were quite common among the drivers. Periodic eye tests should be performed on drivers. This should be enforced to ensure safer road travel.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82156660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder characterized by multiple-organ involvement including the gallbladder. Subjects with SCD are prone to developing pigment gallstones due to chronic red blood cell hemolysis, increased bilirubin levels, cholecystitis, and biliary sludge.Ultrasonography is a noninvasive, readily available, and permits a fast evaluation of the gallbladder. It is useful in establishing the various patterns of gallbladder disease and volume abnormalities. Objectives: The objectives of this study were to sonographically evaluate cholelithiasis and gallbladder volume in patients with SCD and correlate the findings with age and gender. A comparison of the above parameters in sickle cell patients was also made with apparently healthy controls. Materials and Methods: This was a prospective study of 150 patients with SCD and an equal number of apparently healthy control subjects in Benin City. Each subject was sonographically evaluated for possible gallbladder stones and its volume using a 3–5 MHz curvilinear array transducer with a SonoaceX4 ultrasound machine (Medison, Seoul, South Korea). Result: The prevalence of cholelithiasis among subjects with SCD in this study was 10%. Patients with SCD had a significantly higher mean gallbladder volume (34.50 ± 20.43 cm3) compared with apparently healthy control subjects (20.39 ± 10.71 cm3; P = 0.000). Conclusion: The prevalence of cholelithiasis in SCD was shown to increase with age. There was a positive linear correlation between the incidence of cholelithiasis and gallbladder volume with age of the patient.
背景:镰状细胞病(SCD)是一种常染色体隐性血液病，以包括胆囊在内的多器官受累为特征。SCD患者由于慢性红细胞溶血、胆红素水平升高、胆囊炎和胆道淤积，容易发生色素胆结石。超声检查是一种无创的，容易获得的，并允许快速评估胆囊。它有助于建立胆囊疾病和容量异常的各种模式。目的:本研究的目的是超声评估SCD患者的胆石症和胆囊体积，并将结果与年龄和性别联系起来。镰状细胞患者的上述参数也与明显健康的对照组进行了比较。材料和方法:这是一项前瞻性研究，在贝宁市150例SCD患者和同等数量的表面健康对照受试者。每位受试者使用SonoaceX4超声机(Medison, Seoul, South Korea)使用3-5 MHz曲线阵列换能器对可能的胆囊结石及其体积进行超声评估。结果:本研究SCD患者胆石症患病率为10%。SCD患者的平均胆囊体积(34.50±20.43 cm3)明显高于表面健康对照组(20.39±10.71 cm3);P = 0.000)。结论:SCD患者胆石症患病率随年龄增长而增加。胆石症的发生率和胆囊体积与患者年龄呈线性正相关。
{"title":"The prevalence of cholelithiasis and variations in gallbladder volume among sickle cell anemia patients seen in a Nigerian tertiary health care institution","authors":"Osaigbovo Ighodaro","doi":"10.4103/ijmh.ijmh_11_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_11_21","url":null,"abstract":"Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder characterized by multiple-organ involvement including the gallbladder. Subjects with SCD are prone to developing pigment gallstones due to chronic red blood cell hemolysis, increased bilirubin levels, cholecystitis, and biliary sludge.Ultrasonography is a noninvasive, readily available, and permits a fast evaluation of the gallbladder. It is useful in establishing the various patterns of gallbladder disease and volume abnormalities. Objectives: The objectives of this study were to sonographically evaluate cholelithiasis and gallbladder volume in patients with SCD and correlate the findings with age and gender. A comparison of the above parameters in sickle cell patients was also made with apparently healthy controls. Materials and Methods: This was a prospective study of 150 patients with SCD and an equal number of apparently healthy control subjects in Benin City. Each subject was sonographically evaluated for possible gallbladder stones and its volume using a 3–5 MHz curvilinear array transducer with a SonoaceX4 ultrasound machine (Medison, Seoul, South Korea). Result: The prevalence of cholelithiasis among subjects with SCD in this study was 10%. Patients with SCD had a significantly higher mean gallbladder volume (34.50 ± 20.43 cm3) compared with apparently healthy control subjects (20.39 ± 10.71 cm3; P = 0.000). Conclusion: The prevalence of cholelithiasis in SCD was shown to increase with age. There was a positive linear correlation between the incidence of cholelithiasis and gallbladder volume with age of the patient.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86674609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Different schools of thought hold different opinions regarding the use of statins in the perioperative period for cardiac surgery patients. There seems not to be a consensus yet on when to commence statin therapy for cardiac surgery patients not yet on treatment for dyslipidemia, but the beneficial effects of dyslipidemia management are not in doubt. Objectives: The objective was to characterize the pattern of dyslipidemia and atherogenic indices present in cardiac surgery patients. Materials and Methods: The study was a retrospective record review of patients who presented for open heart surgery between 2013 and 2017. Results of pre-operative lipid profile of patients were extracted and analyzed using SPSS version 22. Atherogenic risk was determined using three different risk ratios: atherogenic plasma index and Castelli’s risk indices-I and II. Results: The study included a total of 51 adult patients with the age range 18–75 years and male: female ratio of 1:1.4. Dyslipidemia observed in participants was majorly in the form of low high-density lipoprotein 24 (49.0%) and elevated low-density lipoprotein 11 (22.5%). Using atherogenic plasma index, more than one-quarter of participants 15 (30.6%) were found to be in the high- and medium-risk groups. Conclusion: Incidental findings of dyslipidemia made in this group of patients have its associated health implications. Hence, it buttresses the importance of assessing for and adequate management of the medical condition, particularly in a group of patients already burdened with CVD.
{"title":"Pre-operative lipid profile of cardiac surgery patients: Implications of incidental findings","authors":"P. Njoku, I. Meka, N. Mbadiwe","doi":"10.4103/ijmh.ijmh_43_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_43_21","url":null,"abstract":"Background: Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Different schools of thought hold different opinions regarding the use of statins in the perioperative period for cardiac surgery patients. There seems not to be a consensus yet on when to commence statin therapy for cardiac surgery patients not yet on treatment for dyslipidemia, but the beneficial effects of dyslipidemia management are not in doubt. Objectives: The objective was to characterize the pattern of dyslipidemia and atherogenic indices present in cardiac surgery patients. Materials and Methods: The study was a retrospective record review of patients who presented for open heart surgery between 2013 and 2017. Results of pre-operative lipid profile of patients were extracted and analyzed using SPSS version 22. Atherogenic risk was determined using three different risk ratios: atherogenic plasma index and Castelli’s risk indices-I and II. Results: The study included a total of 51 adult patients with the age range 18–75 years and male: female ratio of 1:1.4. Dyslipidemia observed in participants was majorly in the form of low high-density lipoprotein 24 (49.0%) and elevated low-density lipoprotein 11 (22.5%). Using atherogenic plasma index, more than one-quarter of participants 15 (30.6%) were found to be in the high- and medium-risk groups. Conclusion: Incidental findings of dyslipidemia made in this group of patients have its associated health implications. Hence, it buttresses the importance of assessing for and adequate management of the medical condition, particularly in a group of patients already burdened with CVD.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86256327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mammary ductal ectasia (MDE) is both rare and benign in children. Less than 50 cases have so far been reported in the literature. It often presents as bloody nipple discharge (BND) and results in significant parental anxiety. Although mostly thought to be developmental in origin, the practice of pressing breast swellings in neonates and infants could potentially predispose the breast tissues to infection. Lack of awareness of MDE among healthcare providers may result in unnecessary, expensive, and even invasive investigations. We report a case of MDE presenting as BND and subclinical mastitis in a 5-month-old girl.
{"title":"Bloody nipple discharge in a 5-month-old female: A case report of mammary ductal ectasia from subclinical mastitis","authors":"M. Garba, Stephen Akau, H. Laila","doi":"10.4103/ijmh.ijmh_22_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_22_21","url":null,"abstract":"Mammary ductal ectasia (MDE) is both rare and benign in children. Less than 50 cases have so far been reported in the literature. It often presents as bloody nipple discharge (BND) and results in significant parental anxiety. Although mostly thought to be developmental in origin, the practice of pressing breast swellings in neonates and infants could potentially predispose the breast tissues to infection. Lack of awareness of MDE among healthcare providers may result in unnecessary, expensive, and even invasive investigations. We report a case of MDE presenting as BND and subclinical mastitis in a 5-month-old girl.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90278212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Winged scapula is most commonly caused by injury of the long thoracic nerve which results in paralysis of the serratus anterior muscle. Scapular osteochondroma is uncommon and rarely presents as winged scapula in the skeletally matured patients. We report a 9-year-old female with progressive winging of the left scapula due to osteochondroma on its costal surface. The clinical diagnosis of the cause of the scapular winging was difficult because the tumor was non-palpable, mainly cartilaginous, and not visible on a plain radiograph but was unraveled with ultrasonography. Diagnosis of osteochondroma in a pre-teen is unusual but should be considered in the differential diagnosis for static-winged scapula in a child.
{"title":"Scapular osteochondroma: An unusual cause of static winged scapula in a pre-teen","authors":"O. Onwuasoigwe, A. Onuh, A. Nwosu","doi":"10.4103/ijmh.ijmh_29_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_29_21","url":null,"abstract":"Winged scapula is most commonly caused by injury of the long thoracic nerve which results in paralysis of the serratus anterior muscle. Scapular osteochondroma is uncommon and rarely presents as winged scapula in the skeletally matured patients. We report a 9-year-old female with progressive winging of the left scapula due to osteochondroma on its costal surface. The clinical diagnosis of the cause of the scapular winging was difficult because the tumor was non-palpable, mainly cartilaginous, and not visible on a plain radiograph but was unraveled with ultrasonography. Diagnosis of osteochondroma in a pre-teen is unusual but should be considered in the differential diagnosis for static-winged scapula in a child.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73666565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Multiple myeloma (MM) is a very common hematological malignancy and constitutes about 10% of hematological malignancies. Laboratory investigations including haematological, biochemical, and molecular studies play an important role in the diagnosis, monitoring of response, and relapse in patients with MM. Objectives: The objectives of this article were to assess the initial clinical features, hematological profile, and biochemical parameters of newly diagnosed patients with MM. Materials and Methods: This was a retrospective study of MM patients seen from February 2010 to January 2020 at a tertiary hospital in Nigeria. A total of 51 patients’ case notes were retrieved from the Medical Records Department of the hospital. The socio-demographic data were collected using a Microsoft Excel Sheet. Data on age, sex, hematological parameters, presence of bone lesions (fractures, and osteolytic findings from radiographs), and biochemical parameters were extracted and analyzed. Results: The median age was 60.5 years, and the mean age was 59.6 ± 9.3 with a range of 35–89 years and a male-to-female ratio of 1.7:1. Only 1 (2.0%) patient was aged below 40 years, and the rest 50 (98.0%) were above 40 years of age. The 61–70 age group had the highest number of cases, 31 (60.8%). The mean hemoglobin, white cell count, and platelet count were 7.96 ± 2.2; 6.76 ± 0.6; and 213.50 ± 98 respectively. Serum protein was >80 g/L in 33 (64.7%) and <80 g/L in 18 (35.3%) patients. Two-thirds of the patients, 34 (66.7%) had albumin level <35 g/L. The mean albumin and globulin levels were 36.2 ± 10.9 and 59.2 ± 1.9 respectively, giving an albumin–globulin ratio (AGR) of 0.611. The mean calcium level was 2.6 ± 0.29 mmol/L. The overall mean urea and creatinine levels were 8.02 ± 3.2 (mmol/L) and 169.5 ± 89.4 (μmol/L), respectively. The most common clinical presentations were weakness, pallor, and bone pains with a proportion of 49 (96.1%), 47 (92.2%), and 45 (88.3%), respectively. Conclusion: The physicians should be alerted on the possibility of MM when an elderly patient presents with weakness and bone pains. The AGR is commonly low, connoting a poor prognosis.
{"title":"Evaluation of the clinico-laboratory manifestations of newly diagnosed multiple myeloma","authors":"A. Ugwu","doi":"10.4103/ijmh.ijmh_44_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_44_21","url":null,"abstract":"Background: Multiple myeloma (MM) is a very common hematological malignancy and constitutes about 10% of hematological malignancies. Laboratory investigations including haematological, biochemical, and molecular studies play an important role in the diagnosis, monitoring of response, and relapse in patients with MM. Objectives: The objectives of this article were to assess the initial clinical features, hematological profile, and biochemical parameters of newly diagnosed patients with MM. Materials and Methods: This was a retrospective study of MM patients seen from February 2010 to January 2020 at a tertiary hospital in Nigeria. A total of 51 patients’ case notes were retrieved from the Medical Records Department of the hospital. The socio-demographic data were collected using a Microsoft Excel Sheet. Data on age, sex, hematological parameters, presence of bone lesions (fractures, and osteolytic findings from radiographs), and biochemical parameters were extracted and analyzed. Results: The median age was 60.5 years, and the mean age was 59.6 ± 9.3 with a range of 35–89 years and a male-to-female ratio of 1.7:1. Only 1 (2.0%) patient was aged below 40 years, and the rest 50 (98.0%) were above 40 years of age. The 61–70 age group had the highest number of cases, 31 (60.8%). The mean hemoglobin, white cell count, and platelet count were 7.96 ± 2.2; 6.76 ± 0.6; and 213.50 ± 98 respectively. Serum protein was >80 g/L in 33 (64.7%) and <80 g/L in 18 (35.3%) patients. Two-thirds of the patients, 34 (66.7%) had albumin level <35 g/L. The mean albumin and globulin levels were 36.2 ± 10.9 and 59.2 ± 1.9 respectively, giving an albumin–globulin ratio (AGR) of 0.611. The mean calcium level was 2.6 ± 0.29 mmol/L. The overall mean urea and creatinine levels were 8.02 ± 3.2 (mmol/L) and 169.5 ± 89.4 (μmol/L), respectively. The most common clinical presentations were weakness, pallor, and bone pains with a proportion of 49 (96.1%), 47 (92.2%), and 45 (88.3%), respectively. Conclusion: The physicians should be alerted on the possibility of MM when an elderly patient presents with weakness and bone pains. The AGR is commonly low, connoting a poor prognosis.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84279493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The causes of upper urinary tract (UUT) obstruction vary from one geographical location to another, and across gender and age. Similarly, the site of obstruction along the ureter varies with the nature of the obstructing lesion. Data in this regard from southeast Nigeria are deficient. Objective: To determine the causes of symptomatic UUT obstruction in southeast Nigeria. Materials and Methods: The medical records of individuals with confirmed UUT obstruction presenting from January 2011 to November 2017 were reviewed for information on the cause and location of obstruction. In addition, the pattern of the obstructions caused by UUT stones was compared across the gender and age of individuals. All statistical analyses were done using SPSS® version 21. Results: The medical reports of 267 individuals are included for analysis. Overall, urinary stone is the most prevalent cause of UUT obstruction, with a male-to-female ratio of 1.25. From 50 years of age onward, obstructing UUT stones are commoner in females (χ2 = 5.03; P = 0.03). In addition, obstructing UUT stones are more common on the right (55.1%) and in the upper ureter (48.9%) in univariate analyses. Congenital pelvi-ureteric junction (PUJ) obstruction is observed to be the most prevalent congenital cause of UUT obstruction. Uterine fibroids in females and advanced prostate cancer in males are also notable causes of ureteric obstruction. Conclusion: Beyond urinary stone and congenitally defective PUJ, uterine fibroids and prostate cancer are other notable causes of ureteric obstruction in southeast Nigeria.
{"title":"Etiology of symptomatic upper urinary tract obstruction in southeast Nigeria","authors":"S. Anyimba, I. Nnabugwu, A. Onuh","doi":"10.4103/ijmh.ijmh_12_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_12_21","url":null,"abstract":"Background: The causes of upper urinary tract (UUT) obstruction vary from one geographical location to another, and across gender and age. Similarly, the site of obstruction along the ureter varies with the nature of the obstructing lesion. Data in this regard from southeast Nigeria are deficient. Objective: To determine the causes of symptomatic UUT obstruction in southeast Nigeria. Materials and Methods: The medical records of individuals with confirmed UUT obstruction presenting from January 2011 to November 2017 were reviewed for information on the cause and location of obstruction. In addition, the pattern of the obstructions caused by UUT stones was compared across the gender and age of individuals. All statistical analyses were done using SPSS® version 21. Results: The medical reports of 267 individuals are included for analysis. Overall, urinary stone is the most prevalent cause of UUT obstruction, with a male-to-female ratio of 1.25. From 50 years of age onward, obstructing UUT stones are commoner in females (χ2 = 5.03; P = 0.03). In addition, obstructing UUT stones are more common on the right (55.1%) and in the upper ureter (48.9%) in univariate analyses. Congenital pelvi-ureteric junction (PUJ) obstruction is observed to be the most prevalent congenital cause of UUT obstruction. Uterine fibroids in females and advanced prostate cancer in males are also notable causes of ureteric obstruction. Conclusion: Beyond urinary stone and congenitally defective PUJ, uterine fibroids and prostate cancer are other notable causes of ureteric obstruction in southeast Nigeria.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81868999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bisi-Onyemaechi, A. Aronu, U. Chikani, Pascal U. Chime, N. Uwaezuoke, Obinna Chukwuebuka Nduagubam, NgoziC Ojinnaka
Background: COVID-19 pandemic has had a severe impact on the global economy and the public health systems of all affected countries. Objectives: To understand the challenges (health, cognitive, economic, and psychological) posed by the lockdown for the COVID-19 pandemic on caregivers of children with chronic neurological disorders in Enugu, Nigeria. Materials and Methods: A focused group discussion was done with seven caregiver-patient pairs while observing all precautionary measures. The responses of the participants were recorded, transcribed, and analyzed. Results: There was limited access to physicians to review the children’s health, lack of money for medications with worsening of symptoms in some cases. Some children had forgotten what they had learnt during the previous academic period whereas others had torn their books. The policy imposed hunger on the households. Caregivers lost their jobs, and others had their businesses locked down and were unable to provide food. Children had access to cloth face masks but seldom adhered to its use. The participants were well adapted to handwashing. One participant had access to a hand sanitizer. The lockdown of worship centers conferred a sense of anger, frustration, and hopelessness among some of the participants. Conclusion: The lockdown affected access to health services, interrupted learning, superimposed hunger, and affected the social well-being of the study participants. It is recommended that locally adapted strategies be developed to mitigate unintended effects of health policies on sick children and their caregivers.
{"title":"COVID-19 lockdown in Enugu, Nigeria: Challenges and concerns of caregivers of children with chronic neurological illnesses","authors":"A. Bisi-Onyemaechi, A. Aronu, U. Chikani, Pascal U. Chime, N. Uwaezuoke, Obinna Chukwuebuka Nduagubam, NgoziC Ojinnaka","doi":"10.4103/ijmh.ijmh_16_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_16_21","url":null,"abstract":"Background: COVID-19 pandemic has had a severe impact on the global economy and the public health systems of all affected countries. Objectives: To understand the challenges (health, cognitive, economic, and psychological) posed by the lockdown for the COVID-19 pandemic on caregivers of children with chronic neurological disorders in Enugu, Nigeria. Materials and Methods: A focused group discussion was done with seven caregiver-patient pairs while observing all precautionary measures. The responses of the participants were recorded, transcribed, and analyzed. Results: There was limited access to physicians to review the children’s health, lack of money for medications with worsening of symptoms in some cases. Some children had forgotten what they had learnt during the previous academic period whereas others had torn their books. The policy imposed hunger on the households. Caregivers lost their jobs, and others had their businesses locked down and were unable to provide food. Children had access to cloth face masks but seldom adhered to its use. The participants were well adapted to handwashing. One participant had access to a hand sanitizer. The lockdown of worship centers conferred a sense of anger, frustration, and hopelessness among some of the participants. Conclusion: The lockdown affected access to health services, interrupted learning, superimposed hunger, and affected the social well-being of the study participants. It is recommended that locally adapted strategies be developed to mitigate unintended effects of health policies on sick children and their caregivers.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90357825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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