Pub Date : 2019-10-01DOI: 10.4103/npmj.npmj_105_19
C. Ononuju, A. Ogbe, Lucky Changkat, B. Okwaraoha, Uzoma Chinaka
Context: Ectopic pregnancy is a common life-threatening emergency and a notable cause of maternal morbidity and mortality. Aims: This study aims to determine the prevalence of ectopic gestation, the associated risk factors, the pattern of presentation and management of ectopic pregnancy in Dalhatu Araf Specialist Hospital (DASH) Lafia. Patients and Methods: This was a retrospective study of all cases of ectopic pregnancy managed at the gynaecological unit of the DASH Lafia, North-central Nigeria from 1st January, 2013 to 31st December, 2017. The data were analysed with simple descriptive statistics and were reported as frequencies and percentages. Results: During the 5-year period, there were a total of 93 ectopic pregnancies, 10,401 deliveries and 3399 gynaecological admissions in the hospital. The prevalence of ectopic pregnancy was 0.89% of all deliveries and 2.74% of all the gynaecological admissions. The majority of the patients were in the age group of 26–30 years, and significant number of the affected them were nulliparous, 30 (32.3%). Furthermore, majority of the patients had past history of sexually transmitted diseases 48 (51.6%), multiple sexual partners 40 (43.0%) and induced abortions. Abdominal pains, amenorrhoea and vaginal bleeding were the most common presenting complaints. Unilateral salpingectomy was done for majority of the patients. Conclusions: Ectopic pregnancy is an important gynaecological challenge associated with notable morbidity. Past history of sexually transmitted diseases, multiple sexual partners and induced abortions were the associated risk factors identified, and nulliparous women were mostly affected. This can limit their future reproductive accomplishments. Targeted health education campaigns should be embarked on to enlighten this group of women and the public at large.
{"title":"Ectopic pregnancy in Dalhatu Araf Specialist Hospital Lafia Nigeria – A 5-year review","authors":"C. Ononuju, A. Ogbe, Lucky Changkat, B. Okwaraoha, Uzoma Chinaka","doi":"10.4103/npmj.npmj_105_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_105_19","url":null,"abstract":"Context: Ectopic pregnancy is a common life-threatening emergency and a notable cause of maternal morbidity and mortality. Aims: This study aims to determine the prevalence of ectopic gestation, the associated risk factors, the pattern of presentation and management of ectopic pregnancy in Dalhatu Araf Specialist Hospital (DASH) Lafia. Patients and Methods: This was a retrospective study of all cases of ectopic pregnancy managed at the gynaecological unit of the DASH Lafia, North-central Nigeria from 1st January, 2013 to 31st December, 2017. The data were analysed with simple descriptive statistics and were reported as frequencies and percentages. Results: During the 5-year period, there were a total of 93 ectopic pregnancies, 10,401 deliveries and 3399 gynaecological admissions in the hospital. The prevalence of ectopic pregnancy was 0.89% of all deliveries and 2.74% of all the gynaecological admissions. The majority of the patients were in the age group of 26–30 years, and significant number of the affected them were nulliparous, 30 (32.3%). Furthermore, majority of the patients had past history of sexually transmitted diseases 48 (51.6%), multiple sexual partners 40 (43.0%) and induced abortions. Abdominal pains, amenorrhoea and vaginal bleeding were the most common presenting complaints. Unilateral salpingectomy was done for majority of the patients. Conclusions: Ectopic pregnancy is an important gynaecological challenge associated with notable morbidity. Past history of sexually transmitted diseases, multiple sexual partners and induced abortions were the associated risk factors identified, and nulliparous women were mostly affected. This can limit their future reproductive accomplishments. Targeted health education campaigns should be embarked on to enlighten this group of women and the public at large.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"235 - 238"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45135518","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}
O. Ilo, Adetunji Adenekan, A. Alabi, A. Onakoya, O. Aribaba, M. Kehinde, O. Salako
Background: Knowledge of the ophthalmic manifestations of leukaemia is important not only because of the frequency with which changes are seen but because the eye often reflects the disease state of the illness, and once identified, prompt referral, early treatment can be instigated, blindness can be averted and a life may be saved. These manifestations are often overlooked because of the underestimation of the magnitude of the ocular sequelae which may be blinding. Aim: This study aims to describe the ophthalmic findings in adult leukaemic patients at two teaching hospitals in Lagos, Nigeria. Patients and Methods: This was a clinic-based, comparison multicentre study conducted at Lagos University Teaching Hospital and Lagos State University Teaching Hospital over a 9-month period of May 2012–January 2013. The cases were newly diagnosed leukaemic patients (acute and chronic) from the haematology clinics. Controls were escorts of apparently normal patients. Detailed ocular examination was carried out after written informed consent was obtained. Analysis was done using SPSS 17. Results: A total of 160 eyes in 80 individuals examined comprised forty cases and forty controls. The results of the cases were compared with the age- and sex-matched controls. Leukaemic-related ophthalmic manifestations were present in 56 eyes (70.0%) of the cases studied. Findings in cases were periorbital oedema in 8 eyes (10%), subconjunctival haemorrhage in four eyes (5%), intraretinal haemorrhage as found in 25 eyes (31.3%), retinal venous tortuosity in 21 eyes (26.3%), Roth spots in 19 eyes (23.8%) and retinal infiltrates in 17 eyes (21.3%). Conclusion: Ophthalmic disorders occur in adult patients living with leukaemia. Prompt initial and periodic ophthalmic evaluation is recommended in all leukaemic patients.
{"title":"Ocular manifestations of leukaemia: A teaching hospital experience","authors":"O. Ilo, Adetunji Adenekan, A. Alabi, A. Onakoya, O. Aribaba, M. Kehinde, O. Salako","doi":"10.4103/npmj.npmj_50_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_50_19","url":null,"abstract":"Background: Knowledge of the ophthalmic manifestations of leukaemia is important not only because of the frequency with which changes are seen but because the eye often reflects the disease state of the illness, and once identified, prompt referral, early treatment can be instigated, blindness can be averted and a life may be saved. These manifestations are often overlooked because of the underestimation of the magnitude of the ocular sequelae which may be blinding. Aim: This study aims to describe the ophthalmic findings in adult leukaemic patients at two teaching hospitals in Lagos, Nigeria. Patients and Methods: This was a clinic-based, comparison multicentre study conducted at Lagos University Teaching Hospital and Lagos State University Teaching Hospital over a 9-month period of May 2012–January 2013. The cases were newly diagnosed leukaemic patients (acute and chronic) from the haematology clinics. Controls were escorts of apparently normal patients. Detailed ocular examination was carried out after written informed consent was obtained. Analysis was done using SPSS 17. Results: A total of 160 eyes in 80 individuals examined comprised forty cases and forty controls. The results of the cases were compared with the age- and sex-matched controls. Leukaemic-related ophthalmic manifestations were present in 56 eyes (70.0%) of the cases studied. Findings in cases were periorbital oedema in 8 eyes (10%), subconjunctival haemorrhage in four eyes (5%), intraretinal haemorrhage as found in 25 eyes (31.3%), retinal venous tortuosity in 21 eyes (26.3%), Roth spots in 19 eyes (23.8%) and retinal infiltrates in 17 eyes (21.3%). Conclusion: Ophthalmic disorders occur in adult patients living with leukaemia. Prompt initial and periodic ophthalmic evaluation is recommended in all leukaemic patients.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"205 - 210"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42023258","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: Neonatal sepsis-related mortalities are the outcome of a complex interaction of maternal–foetal colonisation, transplacental immunity and physical and cellular defence mechanisms of neonates. Objective: The objective of this study was to evaluate the risk factors of mortality in outborn neonatal sepsis. Materials and Methods: A 1-year prospective observational study was undertaken at a tertiary care centre. All referred neonates with maternal and neonatal risk factors of sepsis were enrolled. Blood culture, sepsis screen and other relevant investigations were performed. Results: The mortality rate of neonatal sepsis among outborns was 38.24%. The common presentations of these neonates were respiratory distress, lethargy and hypothermia. On univariate analysis, significant risk factors for mortality included male sex (P = 0.05), weight on admission <1500 g (P < 0.001), hypothermia (P = 0.003), respiratory distress (P = 0.04), cyanosis (P = 0.001), convulsions (P = 0.02), prolonged capillary refill time (P < 0.001), thrombocytopenia (P < 0.001), abnormal radiological finding (P = 0.01), cerebrospinal fluid cellularity (P = 0.002) and positive C-reactive protein (P < 0.001). Maternal factors such as hypertension in pregnancy (P = 0.001) and antepartum haemorrhage (P = 0.03) were associated with statistically significant mortality. Gestational age (odds ratio [OR]: 0.49, confidence interval [CI]: 0.26–0.90, P = 0.02), weight on admission (OR: 1.57, CI: 1.08–2.27, P = 0.01), age at admission (OR: 0.89, CI: 0.78–0.99, P = 0.04), distance travelled with neonate (OR: 1.01, CI: 1.00–1.01, P = 0.003), duration of hospital stay (OR: 0.69, CI: 0.63–0.74, P < 0.001), hypothermia (OR: 1.87, CI: 1.01–3.42, P = 0.04), convulsion (OR: 2.88, CI: 1.33–6.20, P = 0.007), cyanosis (OR: 2.39, CI: 1.07–5.35, P = 0.03) and prolonged capillary refill time (OR: 3.34, CI: 1.78–6.24, P < 0.001) were the independent predictors of mortality in neonatal sepsis. Conclusion: Gestational age; birth weight; long distance travelled with neonate and presentation with hypothermia, cyanosis, convulsions and prolonged capillary refill time were the independent risk factors for mortality in neonatal sepsis among outborns.
背景:新生儿败血症相关死亡是母婴定植、经胎盘免疫以及新生儿身体和细胞防御机制复杂相互作用的结果。目的:本研究的目的是评估早产新生儿败血症死亡的危险因素。材料和方法:在一家三级保健中心进行了为期1年的前瞻性观察研究。所有有产妇和新生儿脓毒症危险因素的新生儿纳入研究。进行血培养、脓毒症筛查等相关检查。结果:新生儿败血症死亡率为38.24%。这些新生儿的常见表现是呼吸窘迫、嗜睡和体温过低。在单因素分析中，死亡率的重要危险因素包括男性(P = 0.05)、入院时体重<1500 g (P < 0.001)、体温过低(P = 0.003)、呼吸窘迫(P = 0.04)、发绀(P = 0.001)、惊厥(P = 0.02)、毛细血管再灌注时间延长(P < 0.001)、血小板减少(P < 0.001)、放射学异常(P = 0.01)、脑脊液细胞结构(P = 0.002)和c反应蛋白阳性(P < 0.001)。妊娠期高血压(P = 0.001)和产前出血(P = 0.03)等母体因素与死亡率有统计学意义。胎龄(优势比[OR]: 0.49，可信区间[CI]: 0.26-0.90, P = 0.02)、入院时体重(OR: 1.57, CI: 1.08-2.27, P = 0.01)、入院时年龄(OR: 0.89, CI: 0.78-0.99, P = 0.04)、与新生儿同行距离(OR: 1.01, CI: 1.00-1.01, P = 0.003)、住院时间(OR: 0.69, CI: 0.63-0.74, P < 0.001)、体温过低(OR: 1.87, CI: 1.01 - 3.42, P = 0.04)、惊厥(OR: 2.88, CI: 1.33-6.20, P = 0.007)、发绀(OR: 2.39, CI: 0.39)。1.07-5.35, P = 0.03)和毛细血管再充盈时间延长(OR: 3.34, CI: 1.78-6.24, P < 0.001)是新生儿脓毒症死亡率的独立预测因素。结论:胎龄;出生体重;新生儿长途旅行、体温过低、发绀、惊厥和毛细血管再充血时间延长是新生儿败血症死亡的独立危险因素。
{"title":"Predictors of mortality in outborns with neonatal sepsis: A prospective observational study","authors":"R. Meshram, Vishal S Gajimwar, S. Bhongade","doi":"10.4103/npmj.npmj_91_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_91_19","url":null,"abstract":"Background: Neonatal sepsis-related mortalities are the outcome of a complex interaction of maternal–foetal colonisation, transplacental immunity and physical and cellular defence mechanisms of neonates. Objective: The objective of this study was to evaluate the risk factors of mortality in outborn neonatal sepsis. Materials and Methods: A 1-year prospective observational study was undertaken at a tertiary care centre. All referred neonates with maternal and neonatal risk factors of sepsis were enrolled. Blood culture, sepsis screen and other relevant investigations were performed. Results: The mortality rate of neonatal sepsis among outborns was 38.24%. The common presentations of these neonates were respiratory distress, lethargy and hypothermia. On univariate analysis, significant risk factors for mortality included male sex (P = 0.05), weight on admission <1500 g (P < 0.001), hypothermia (P = 0.003), respiratory distress (P = 0.04), cyanosis (P = 0.001), convulsions (P = 0.02), prolonged capillary refill time (P < 0.001), thrombocytopenia (P < 0.001), abnormal radiological finding (P = 0.01), cerebrospinal fluid cellularity (P = 0.002) and positive C-reactive protein (P < 0.001). Maternal factors such as hypertension in pregnancy (P = 0.001) and antepartum haemorrhage (P = 0.03) were associated with statistically significant mortality. Gestational age (odds ratio [OR]: 0.49, confidence interval [CI]: 0.26–0.90, P = 0.02), weight on admission (OR: 1.57, CI: 1.08–2.27, P = 0.01), age at admission (OR: 0.89, CI: 0.78–0.99, P = 0.04), distance travelled with neonate (OR: 1.01, CI: 1.00–1.01, P = 0.003), duration of hospital stay (OR: 0.69, CI: 0.63–0.74, P < 0.001), hypothermia (OR: 1.87, CI: 1.01–3.42, P = 0.04), convulsion (OR: 2.88, CI: 1.33–6.20, P = 0.007), cyanosis (OR: 2.39, CI: 1.07–5.35, P = 0.03) and prolonged capillary refill time (OR: 3.34, CI: 1.78–6.24, P < 0.001) were the independent predictors of mortality in neonatal sepsis. Conclusion: Gestational age; birth weight; long distance travelled with neonate and presentation with hypothermia, cyanosis, convulsions and prolonged capillary refill time were the independent risk factors for mortality in neonatal sepsis among outborns.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"216 - 222"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43988872","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}
O. Onyekwelu, O. Aribaba, K. Musa, Oluwatobi O. Idowu, M. Salami, Yvonne Odiaka
Context: Proper use of protective eyewear (PEW) is important in the prevention of occupational eye injury. Aim: The aim of this study was to determine the ocular morbidity and utilisation of PEW among carpenters in Mushin Local Government, Lagos, with a view to promoting ocular health and safety in the workplace. Subject and Methods: This was a cross-sectional study of one hundred and fourteen (114) carpenters that were enrolled into the study. Interviewer-administered questionnaires were used to collect information on socio-demographics, work-related ocular history, awareness and utilisation of, as well as barriers to utilisation of PEW. Ophthalmic examination was done. In-depth interviews were also carried out to probe the barriers to utilisation of PEW. Quantitative responses were analysed using the IBM SPSS software, and content data analysis was performed for qualitative responses. Results: The prevalence of reported work-related eye injury and complaints were 30.7% and 32.5%, respectively. The prevalence of ocular morbidity among the respondents was 74.6%. Seventy-seven respondents (67.5%) were aware of PEW; only 21.1% owned PEW, whereas the utilisation level was 26.3%. In-depth interviews revealed ignorance, forgetfulness, and unfamiliarity as the key barriers to PEW use. The odds of using PEW were about three-fold with previous eye injury at work and history of eye complaint. Conclusions: This study demonstrates a significant prevalence of ocular morbidity and poor utilisation of PEW among carpenters in Mushin, Lagos. There was a significant relationship between previous eye injury or complaint and PEW use. Thus, there is a need to create awareness among carpenters and develop occupational safety policies to improve the use of PEW.
{"title":"Ocular morbidity and utilisation of protective eyewear among carpenters in Mushin local government, Lagos, Nigeria","authors":"O. Onyekwelu, O. Aribaba, K. Musa, Oluwatobi O. Idowu, M. Salami, Yvonne Odiaka","doi":"10.4103/npmj.npmj_51_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_51_19","url":null,"abstract":"Context: Proper use of protective eyewear (PEW) is important in the prevention of occupational eye injury. Aim: The aim of this study was to determine the ocular morbidity and utilisation of PEW among carpenters in Mushin Local Government, Lagos, with a view to promoting ocular health and safety in the workplace. Subject and Methods: This was a cross-sectional study of one hundred and fourteen (114) carpenters that were enrolled into the study. Interviewer-administered questionnaires were used to collect information on socio-demographics, work-related ocular history, awareness and utilisation of, as well as barriers to utilisation of PEW. Ophthalmic examination was done. In-depth interviews were also carried out to probe the barriers to utilisation of PEW. Quantitative responses were analysed using the IBM SPSS software, and content data analysis was performed for qualitative responses. Results: The prevalence of reported work-related eye injury and complaints were 30.7% and 32.5%, respectively. The prevalence of ocular morbidity among the respondents was 74.6%. Seventy-seven respondents (67.5%) were aware of PEW; only 21.1% owned PEW, whereas the utilisation level was 26.3%. In-depth interviews revealed ignorance, forgetfulness, and unfamiliarity as the key barriers to PEW use. The odds of using PEW were about three-fold with previous eye injury at work and history of eye complaint. Conclusions: This study demonstrates a significant prevalence of ocular morbidity and poor utilisation of PEW among carpenters in Mushin, Lagos. There was a significant relationship between previous eye injury or complaint and PEW use. Thus, there is a need to create awareness among carpenters and develop occupational safety policies to improve the use of PEW.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"199 - 204"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46000339","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}
Context: Pre-eclampsia (PrE), a clinical syndrome characterised by elevated blood pressure arising after 20 weeks of gestation, is a leading cause of maternal death worldwide. We evaluated the role of uterine artery Doppler (UtAD) in screening for PrE among unselected, pregnant women. Methodology: This was a prospective cohort study of 170 healthy gravid women between 18 and 26 weeks of gestation recruited consecutively from the Antenatal Clinic of Braithwaite Memorial Specialist Hospital, Port-Harcourt, Nigeria, between July 2016 and June 2017. All had UtAD scans with an abnormal result defined as pulsatility index (PI), resistance index or systolic/diastolic (S/D) ratio >95th centile for gestational age or proto-diastolic notching. Outcome was obtained from antenatal records. Data were analysed using Statistical Package for Social Sciences, version 20 at statistical significance level of P < 0.05. Results: The prevalence of PrE was 7.6%. There was significant association between an abnormal PI (χ2 = 16.29, P = 0.00), S/D ratio (χ2 = 8.55, P = 0.00) and the combined result (χ2 = 11.5, P = 0.007) with subsequent PrE. The highest sensitivity (53.8%) was obtained for the combined result with specificity, negative predictive value (NPV) and positive predictive value of 86.6%, 95.8% and 25%, respectively, area under the curve (AUC) of 0.71 (95% confidence interval [CI]: 0.534–0.871). A normal result had a very high NPV for all indices. The accuracy for the prediction of severe PrE was greater for all indices being highest for the combined result AUC of 0.830 (95% CI: 0.624–1.000; P = 0.01). Conclusion: Abnormal UtAD indices were associated with PrE and may be used in PrE screening.
{"title":"The use of uterine artery doppler indices for prediction of pre-eclampsia in Port-Harcourt, Nigeria","authors":"E. Okwudire, O. Atalabi, U. Ezenwugo","doi":"10.4103/npmj.npmj_54_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_54_19","url":null,"abstract":"Context: Pre-eclampsia (PrE), a clinical syndrome characterised by elevated blood pressure arising after 20 weeks of gestation, is a leading cause of maternal death worldwide. We evaluated the role of uterine artery Doppler (UtAD) in screening for PrE among unselected, pregnant women. Methodology: This was a prospective cohort study of 170 healthy gravid women between 18 and 26 weeks of gestation recruited consecutively from the Antenatal Clinic of Braithwaite Memorial Specialist Hospital, Port-Harcourt, Nigeria, between July 2016 and June 2017. All had UtAD scans with an abnormal result defined as pulsatility index (PI), resistance index or systolic/diastolic (S/D) ratio >95th centile for gestational age or proto-diastolic notching. Outcome was obtained from antenatal records. Data were analysed using Statistical Package for Social Sciences, version 20 at statistical significance level of P < 0.05. Results: The prevalence of PrE was 7.6%. There was significant association between an abnormal PI (χ2 = 16.29, P = 0.00), S/D ratio (χ2 = 8.55, P = 0.00) and the combined result (χ2 = 11.5, P = 0.007) with subsequent PrE. The highest sensitivity (53.8%) was obtained for the combined result with specificity, negative predictive value (NPV) and positive predictive value of 86.6%, 95.8% and 25%, respectively, area under the curve (AUC) of 0.71 (95% confidence interval [CI]: 0.534–0.871). A normal result had a very high NPV for all indices. The accuracy for the prediction of severe PrE was greater for all indices being highest for the combined result AUC of 0.830 (95% CI: 0.624–1.000; P = 0.01). Conclusion: Abnormal UtAD indices were associated with PrE and may be used in PrE screening.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"223 - 229"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49530548","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}
B. James, S. Olotu, O. Ayilara, Olubukola O. Arigbede, Goodnews Anozie, Hope Ogiku, J. Ariyo, Veronica Efiong, A. Adeyelu, Majesty Oni, Dora Odu
Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.
{"title":"Drug treatment presentations at a treatment centre in southern Nigeria (2015–2018): Findings and implications for policy and practice","authors":"B. James, S. Olotu, O. Ayilara, Olubukola O. Arigbede, Goodnews Anozie, Hope Ogiku, J. Ariyo, Veronica Efiong, A. Adeyelu, Majesty Oni, Dora Odu","doi":"10.4103/npmj.npmj_36_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_36_19","url":null,"abstract":"Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"211 - 215"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47264839","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}
B. Abtahi-Naeini, Zabihollah Shahmoradi, M. Hadian, Elmira Niknami, A. Saffaei
Cosmetic tattooing using micro-pigmentation has gained popularity in recent years. Tattoos can cause a broad range of clinical and psychosocial problems. Several medical complications may arise after tattooing. A 35-year-old female was referred with an 8-week history of grey-to-smoky hyperpigmentation of permanent makeup of lips and lip lines. Histopathological examination revealed lichenoid lymphocytic infiltrations in the dermis. Clinical and histopathological findings were compatible with the diagnosis of multiple pigmented macules as a sequel of cosmetic lip micro-pigmentation. Here, we report the first case of lichenoid-type tattoo reactions with new presentation as multiple asymptomatic pigmented macules after lip tattooing. The current report emphasises the requirement of a skin biopsy of all tattoo reactions. Considering the new component in the tattoo material, a dermatologist should be aware of the new clinical presentation of tattoo reactions that may occur.
{"title":"Multiple pigmented macules as a sequel of cosmetic lip micro-pigmentation: New clinical presentation of tattoo reactions","authors":"B. Abtahi-Naeini, Zabihollah Shahmoradi, M. Hadian, Elmira Niknami, A. Saffaei","doi":"10.4103/npmj.npmj_88_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_88_19","url":null,"abstract":"Cosmetic tattooing using micro-pigmentation has gained popularity in recent years. Tattoos can cause a broad range of clinical and psychosocial problems. Several medical complications may arise after tattooing. A 35-year-old female was referred with an 8-week history of grey-to-smoky hyperpigmentation of permanent makeup of lips and lip lines. Histopathological examination revealed lichenoid lymphocytic infiltrations in the dermis. Clinical and histopathological findings were compatible with the diagnosis of multiple pigmented macules as a sequel of cosmetic lip micro-pigmentation. Here, we report the first case of lichenoid-type tattoo reactions with new presentation as multiple asymptomatic pigmented macules after lip tattooing. The current report emphasises the requirement of a skin biopsy of all tattoo reactions. Considering the new component in the tattoo material, a dermatologist should be aware of the new clinical presentation of tattoo reactions that may occur.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"244 - 246"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43279060","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: Hearing loss in paediatric age group may be inherited, developmental or caused by maternal rubella. It may also be due to complications at birth or certain infections such as meningitis and measles. Ototoxicity and exposure to excessive noise also contribute significantly. Majority of hearing loss in children can be prevented primarily. We aimed to share our findings on assessing the hearing thresholds of pupils in deaf schools in Northwestern Nigeria. Participants and Methods: This was a cross-sectional study which assessed the hearing threshold of pupils in deaf schools in Kaduna metropolis, Kaduna, Nigeria. Approval was obtained from the State Ministry of Health Ethics Committee. Multi-staged sampling method was used to enrol 430 deaf pupils. Consent was obtained and a structured pre-tested questionnaire was used to generate data on the participant's biodata, history and detailed examination findings as well as pure-tone audiometry. Collated data were documented and entered into Statistical Product and Service Solutions version 20 for windows then analysed. Results: Mean pure-tone average of the right ear was 103.4 ± 8.3 and the left ear was 104.3 ± 8.9. Majority had bilateral profound hearing loss (99.0%). Severe hearing loss was seen in 0.9%, whereas the remaining 0.1% had moderate hearing loss. The hearing loss sensorineural in majority (97.6%) and the remaining 2.4% had mixed hearing loss. High-frequency hearing loss predominated (98.6%). Conclusion: Majority of the deaf pupils had bilateral, profound, sensorineural hearing loss, involving higher frequencies.
{"title":"Hearing threshold of deaf pupils in Kaduna metropolis, Kaduna, Nigeria: A cross-sectional survey","authors":"A. Kirfi, M. Samdi, A. Salisu, M. Fufore","doi":"10.4103/npmj.npmj_56_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_56_19","url":null,"abstract":"Background: Hearing loss in paediatric age group may be inherited, developmental or caused by maternal rubella. It may also be due to complications at birth or certain infections such as meningitis and measles. Ototoxicity and exposure to excessive noise also contribute significantly. Majority of hearing loss in children can be prevented primarily. We aimed to share our findings on assessing the hearing thresholds of pupils in deaf schools in Northwestern Nigeria. Participants and Methods: This was a cross-sectional study which assessed the hearing threshold of pupils in deaf schools in Kaduna metropolis, Kaduna, Nigeria. Approval was obtained from the State Ministry of Health Ethics Committee. Multi-staged sampling method was used to enrol 430 deaf pupils. Consent was obtained and a structured pre-tested questionnaire was used to generate data on the participant's biodata, history and detailed examination findings as well as pure-tone audiometry. Collated data were documented and entered into Statistical Product and Service Solutions version 20 for windows then analysed. Results: Mean pure-tone average of the right ear was 103.4 ± 8.3 and the left ear was 104.3 ± 8.9. Majority had bilateral profound hearing loss (99.0%). Severe hearing loss was seen in 0.9%, whereas the remaining 0.1% had moderate hearing loss. The hearing loss sensorineural in majority (97.6%) and the remaining 2.4% had mixed hearing loss. High-frequency hearing loss predominated (98.6%). Conclusion: Majority of the deaf pupils had bilateral, profound, sensorineural hearing loss, involving higher frequencies.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"164 - 168"},"PeriodicalIF":1.1,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41950056","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}
Barbara Mensah, Irene Agyemang, D. Afriyie, S. Amponsah
Objective: In most resource-poor settings, there is a paucity of data on self-medication and possible factors that influence this practice. The current study assesses self-medication among the people of Akuse, a rural setting in the Eastern Region of Ghana. Methods: A quantitative cross-sectional study was carried out in Akuse from 4th January 2016 to 27th February 2016. Using a questionnaire, interviews were conducted to assess self-medication: class of drugs taken, sources of drugs, knowledge of potential adverse effects, among others. Results: Of the 363 participants enrolled, 361 completed questionnaires administered. Of the 361 respondents, 58.4% were female. A majority of the respondents were within the ages of 30 and 45 years. Respondents were mainly farmers (40.2%), and a majority (44.6%) had primary level as the highest education. One major reason for self-medication was influence from family and friends (32.7%). Antibiotics (32.1%) and analgesics (21.0%) were the most common self-medicated drugs, and these drugs were mostly obtained from licenced chemical sellers (32.5%). A little more than a third (39.9%) of the respondents said that their condition did not change after self-medication. A greater number of the respondents (81.7%) did not have knowledge of potential adverse reactions associated with self-medicated drugs. However, respondents with high educational level had the most knowledge of adverse drug reactions. Conclusion: The study found self-medication as a common practice among a number of residents of Akuse. Findings from this study provide data that could be used for targeted education and sensitisation of self-medication and its demerits in similar resource-poor rural settings.
{"title":"Self-medication practice in Akuse, a rural setting in Ghana","authors":"Barbara Mensah, Irene Agyemang, D. Afriyie, S. Amponsah","doi":"10.4103/npmj.npmj_87_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_87_19","url":null,"abstract":"Objective: In most resource-poor settings, there is a paucity of data on self-medication and possible factors that influence this practice. The current study assesses self-medication among the people of Akuse, a rural setting in the Eastern Region of Ghana. Methods: A quantitative cross-sectional study was carried out in Akuse from 4th January 2016 to 27th February 2016. Using a questionnaire, interviews were conducted to assess self-medication: class of drugs taken, sources of drugs, knowledge of potential adverse effects, among others. Results: Of the 363 participants enrolled, 361 completed questionnaires administered. Of the 361 respondents, 58.4% were female. A majority of the respondents were within the ages of 30 and 45 years. Respondents were mainly farmers (40.2%), and a majority (44.6%) had primary level as the highest education. One major reason for self-medication was influence from family and friends (32.7%). Antibiotics (32.1%) and analgesics (21.0%) were the most common self-medicated drugs, and these drugs were mostly obtained from licenced chemical sellers (32.5%). A little more than a third (39.9%) of the respondents said that their condition did not change after self-medication. A greater number of the respondents (81.7%) did not have knowledge of potential adverse reactions associated with self-medicated drugs. However, respondents with high educational level had the most knowledge of adverse drug reactions. Conclusion: The study found self-medication as a common practice among a number of residents of Akuse. Findings from this study provide data that could be used for targeted education and sensitisation of self-medication and its demerits in similar resource-poor rural settings.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"189 - 194"},"PeriodicalIF":1.1,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42248953","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}
O. Olatosi, N. Onyejaka, A. Oyapero, J. Ashaolu, A. Abe
Background: An early first dental clinic appointment offers the prospect of prompt preventative care and parental education regarding the oral health of the child. The evidence-based recommendation by dental professionals all over the world is that a child should visit a dentist before or by 1 year of age. Aim: This study aimed to determine the chronological age at and the purpose for a first dental clinic visit amongst children aged 16 years and below attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital (LUTH). Materials and Methods: This was a retrospective study conducted amongst children who attended the Paediatric Dental Clinic at the LUTH between January 2017 and December 2018. Data on age at first dental visit, reasons for attending and other information relevant to the study were collected. Descriptive statistics and Chi-square analysis were conducted, and the level of significance was set at P < 0.05. Results: A total of 1157 children were studied, comprising 580 (50.5%) males and 577 (49.9%) females. Their mean age on their first dental visit was 7.9 ± 3.7 years. Most of the children (31.4%) had their first dental visits at 7 and 9 years, and 0.8% of the children had their first dental visit below the age of 1 year. The most common reason for visiting the dental clinic was dental pain (33.1%). A higher proportion of the children (911 [79.0%]) had their first dental visit for therapeutic purposes, whereas 246 (21.0%) children visited the dental clinic for preventive care. Sex and age at first dental visit were statistically significantly associated with the reason for attendance (P < 0.001). Conclusion: Most children had their first dental visit between the ages of 7 and 9 years, mainly because of pain. It is necessary to create more awareness among parents/caregivers and to establish the concept of dental home.
{"title":"Age and reasons for first dental visit among children in Lagos, Nigeria","authors":"O. Olatosi, N. Onyejaka, A. Oyapero, J. Ashaolu, A. Abe","doi":"10.4103/npmj.npmj_60_19","DOIUrl":"https://doi.org/10.4103/npmj.npmj_60_19","url":null,"abstract":"Background: An early first dental clinic appointment offers the prospect of prompt preventative care and parental education regarding the oral health of the child. The evidence-based recommendation by dental professionals all over the world is that a child should visit a dentist before or by 1 year of age. Aim: This study aimed to determine the chronological age at and the purpose for a first dental clinic visit amongst children aged 16 years and below attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital (LUTH). Materials and Methods: This was a retrospective study conducted amongst children who attended the Paediatric Dental Clinic at the LUTH between January 2017 and December 2018. Data on age at first dental visit, reasons for attending and other information relevant to the study were collected. Descriptive statistics and Chi-square analysis were conducted, and the level of significance was set at P < 0.05. Results: A total of 1157 children were studied, comprising 580 (50.5%) males and 577 (49.9%) females. Their mean age on their first dental visit was 7.9 ± 3.7 years. Most of the children (31.4%) had their first dental visits at 7 and 9 years, and 0.8% of the children had their first dental visit below the age of 1 year. The most common reason for visiting the dental clinic was dental pain (33.1%). A higher proportion of the children (911 [79.0%]) had their first dental visit for therapeutic purposes, whereas 246 (21.0%) children visited the dental clinic for preventive care. Sex and age at first dental visit were statistically significantly associated with the reason for attendance (P < 0.001). Conclusion: Most children had their first dental visit between the ages of 7 and 9 years, mainly because of pain. It is necessary to create more awareness among parents/caregivers and to establish the concept of dental home.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"26 1","pages":"158 - 163"},"PeriodicalIF":1.1,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45102486","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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