Pub Date : 2014-07-01DOI: 10.4103/0331-3131.153359
D. Balasubramanian, S. Subramanian, K. Shanmugam
Introduction: India has a high suicide rate, and a large proportion of these suicides occur through poisoning. Poisoning by hair dye has been increasing, and in some regions, constitutes a large proportion of the poisoning cases. Aims: To determine the clinical and biochemical features of hair dye poisoning, and to identify factors affecting mortality among these cases of hair dye poisoning. Subjects and Methods: A cross-sectional study conducted from April to December 2010 in Thoothukudi, Tamil Nadu, among 125 cases of hair dye poisoning. Cases with the prior history of cardiac/respiratory illness, seizure disorder, and those consuming a mixture of poisons were excluded from the study. A standardized questionnaire was administered. Biochemical and other investigations were carried out; and patient outcomes were documented. Statistical Analysis Used: The results were compiled and analyzed using Statistical Package for the Social Sciences (version 20) software. Chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test at 5% level of significance was used to analyze the data. Results: Among the 125 cases, 68.8% were females, and the overall median age was 24 (20-30.5) years. The median time of presentation was 155 min (40-275), and the average amount of hair dye consumed was about 50.0 mls (25-55 mls). Almost 68.8% of the cases developed oropharyngeal edema, and among them, 57 (66.28%) had an emergency tracheostomy performed. About 27.2% of the patients died. Conclusions: The time of presentation to the hospital is an important risk factor for developing oropharyngeal edema, which in turn determines the risk of mortality. Females, especially those in the younger age groups should be targeted for supportive and preventive strategies, so as to reduce the incidence of hair dye poisoning.
引言:印度的自杀率很高，其中很大一部分是通过中毒自杀的。染发剂中毒一直在增加，在一些地区，染发剂中毒占中毒病例的很大比例。目的:了解染发剂中毒的临床及生化特点，探讨染发剂中毒患者死亡的影响因素。研究对象和方法:2010年4月至12月在泰米尔纳德邦Thoothukudi进行了一项横断面研究，共125例染发剂中毒。既往有心脏/呼吸系统疾病史、癫痫发作史和混合中毒史的病例被排除在研究之外。进行了标准化问卷调查。进行了生化和其他调查;病人的结果被记录下来。使用统计分析:使用Statistical Package for The Social Sciences (version 20)软件对结果进行编译和分析。采用5%显著性水平下的卡方检验、Mann-Whitney u检验和Kruskal-Wallis检验对数据进行分析。结果:125例患者中，女性占68.8%，总体中位年龄24(20 ~ 30.5)岁。平均出现时间为155分钟(40-275分钟)，染发剂的平均用量约为50.0毫升(25-55毫升)。68.8%的患者出现口咽水肿，其中57例(66.28%)急诊行气管切开术。约27.2%的患者死亡。结论:就诊时间是发生口咽水肿的重要危险因素，进而决定死亡风险。应针对女性，特别是年轻年龄组的女性采取支持和预防策略，以减少染发剂中毒的发生率。
{"title":"Clinical profile and mortality determinants in hair dye poisoning","authors":"D. Balasubramanian, S. Subramanian, K. Shanmugam","doi":"10.4103/0331-3131.153359","DOIUrl":"https://doi.org/10.4103/0331-3131.153359","url":null,"abstract":"Introduction: India has a high suicide rate, and a large proportion of these suicides occur through poisoning. Poisoning by hair dye has been increasing, and in some regions, constitutes a large proportion of the poisoning cases. Aims: To determine the clinical and biochemical features of hair dye poisoning, and to identify factors affecting mortality among these cases of hair dye poisoning. Subjects and Methods: A cross-sectional study conducted from April to December 2010 in Thoothukudi, Tamil Nadu, among 125 cases of hair dye poisoning. Cases with the prior history of cardiac/respiratory illness, seizure disorder, and those consuming a mixture of poisons were excluded from the study. A standardized questionnaire was administered. Biochemical and other investigations were carried out; and patient outcomes were documented. Statistical Analysis Used: The results were compiled and analyzed using Statistical Package for the Social Sciences (version 20) software. Chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test at 5% level of significance was used to analyze the data. Results: Among the 125 cases, 68.8% were females, and the overall median age was 24 (20-30.5) years. The median time of presentation was 155 min (40-275), and the average amount of hair dye consumed was about 50.0 mls (25-55 mls). Almost 68.8% of the cases developed oropharyngeal edema, and among them, 57 (66.28%) had an emergency tracheostomy performed. About 27.2% of the patients died. Conclusions: The time of presentation to the hospital is an important risk factor for developing oropharyngeal edema, which in turn determines the risk of mortality. Females, especially those in the younger age groups should be targeted for supportive and preventive strategies, so as to reduce the incidence of hair dye poisoning.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130432359","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}
Pub Date : 2014-07-01DOI: 10.4103/0331-3131.153358
Ekaete Alice Tobin, A. Ofili, Nkemka Enebeli, Ogochukwu Enueze
Background: The principle and practice of birth preparedness and complication readiness (BP/CR) in resource-poor settings have the potential of reducing maternal, and neonatal morbidity and mortality rates. Aim: The aim was to assess BP/CR among pregnant women attending Antenatal care in Primary Health Care Centres in Oredo Local Government Area (LGA) in Benin City, Edo State. Materials and Methods: A descriptive cross-sectional study carried out among pregnant women attending antenatal clinic in Primary Health Centres in Oredo LGA. Data were collected using structured questionnaires, and analyzed using the Statistical Package for Social sciences (SPSS) Version 16.0. Descriptive data were presented in frequency tables. Statistical testing using Chi-square was carried out with level of significance set as P < 0.05. Results: One hundred and fourteen pregnant women (49.6%) were aware of at least one danger sign associated with pregnancy, labor, and postpartum, while 201 women (87.4%) had identified a skilled birth attendant. Twenty-six (11.3%) had saved money for obstetric care, and 143 (62.2%) had purchased or made plans to purchase birth supplies. Two hundred and one (87.4%) respondents were found to be well-prepared for the birth. Having a tertiary education and being married were factors found to be significantly associated with BP. Conclusion: Majority of the women had BP/CR in place. However, emphasis should be placed on identifying target groups and practice gaps, for intensified health education.
{"title":"Assessment of birth preparedness and complication readiness among pregnant women attending Primary Health Care Centres in Edo State, Nigeria","authors":"Ekaete Alice Tobin, A. Ofili, Nkemka Enebeli, Ogochukwu Enueze","doi":"10.4103/0331-3131.153358","DOIUrl":"https://doi.org/10.4103/0331-3131.153358","url":null,"abstract":"Background: The principle and practice of birth preparedness and complication readiness (BP/CR) in resource-poor settings have the potential of reducing maternal, and neonatal morbidity and mortality rates. Aim: The aim was to assess BP/CR among pregnant women attending Antenatal care in Primary Health Care Centres in Oredo Local Government Area (LGA) in Benin City, Edo State. Materials and Methods: A descriptive cross-sectional study carried out among pregnant women attending antenatal clinic in Primary Health Centres in Oredo LGA. Data were collected using structured questionnaires, and analyzed using the Statistical Package for Social sciences (SPSS) Version 16.0. Descriptive data were presented in frequency tables. Statistical testing using Chi-square was carried out with level of significance set as P < 0.05. Results: One hundred and fourteen pregnant women (49.6%) were aware of at least one danger sign associated with pregnancy, labor, and postpartum, while 201 women (87.4%) had identified a skilled birth attendant. Twenty-six (11.3%) had saved money for obstetric care, and 143 (62.2%) had purchased or made plans to purchase birth supplies. Two hundred and one (87.4%) respondents were found to be well-prepared for the birth. Having a tertiary education and being married were factors found to be significantly associated with BP. Conclusion: Majority of the women had BP/CR in place. However, emphasis should be placed on identifying target groups and practice gaps, for intensified health education.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129015608","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133097
S. Abubakar, A. Sabir
Background: The profile of patients seen with acute stroke has been sparsely described in north-western Nigeria, even though stroke constitutes an important cause of severe disability in adults. Aims: (1) The primary aim is to determine the clinical and socio-demographic profile of stroke patients seen in a tertiary hospital. (2) The secondary aim is to determine the 30-day case fatality. Patients and Methods: A retrospective study carried out using the case records of patients admitted from January 2007 to December 2009 with the clinical diagnosis of stroke at Usmanu Danfodiyo University Teaching Hospital. Relevant clinical data were extracted using a structured questionnaire designed for the study. Results: A total of 370 case files with the clinical diagnosis of stroke were traced, but only 260 had complete information. The mean age of patients was 55.7 ± 14.3 years; hypertension (74.6%) was the most common modifiable risk factor for stroke followed by diabetes mellitus (8.8%). Stroke constituted 1.2% of all hospital admissions and 8.5% of death in the medical units. The 24-h and 30-day case fatalities were 11.9% and 38.4%, respectively. The mean duration of hospitalization for stroke survivors was 21 days, but the duration of hospitalization prior to death for those that died was 4 days. Conclusion: The 30-day case fatality of acute stroke was high and hypertension was the most common modifiable risk factor for stroke. Prompt and adequate measures should be taken to improve outcome of stroke.
{"title":"Profile of stroke patients seen in a tertiary health care center in Nigeria","authors":"S. Abubakar, A. Sabir","doi":"10.4103/0331-3131.133097","DOIUrl":"https://doi.org/10.4103/0331-3131.133097","url":null,"abstract":"Background: The profile of patients seen with acute stroke has been sparsely described in north-western Nigeria, even though stroke constitutes an important cause of severe disability in adults. Aims: (1) The primary aim is to determine the clinical and socio-demographic profile of stroke patients seen in a tertiary hospital. (2) The secondary aim is to determine the 30-day case fatality. Patients and Methods: A retrospective study carried out using the case records of patients admitted from January 2007 to December 2009 with the clinical diagnosis of stroke at Usmanu Danfodiyo University Teaching Hospital. Relevant clinical data were extracted using a structured questionnaire designed for the study. Results: A total of 370 case files with the clinical diagnosis of stroke were traced, but only 260 had complete information. The mean age of patients was 55.7 ± 14.3 years; hypertension (74.6%) was the most common modifiable risk factor for stroke followed by diabetes mellitus (8.8%). Stroke constituted 1.2% of all hospital admissions and 8.5% of death in the medical units. The 24-h and 30-day case fatalities were 11.9% and 38.4%, respectively. The mean duration of hospitalization for stroke survivors was 21 days, but the duration of hospitalization prior to death for those that died was 4 days. Conclusion: The 30-day case fatality of acute stroke was high and hypertension was the most common modifiable risk factor for stroke. Prompt and adequate measures should be taken to improve outcome of stroke.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123517116","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133096
L. Owolabi, S. Shehu, S. Owolabi, M. Umar
Background: Different studies have reported various frequencies of electroencephalographic (EEG) abnormalities in patients with epilepsy. There is, however, a paucity of data on EEG in Nigeria; hence, the need for this study. Objective: The objective of the following study was to evaluate interictal EEG pattern in patients with epilepsy in Kano, Northwestern Nigeria. Subjects and Methods: A cross-sectional study involving the analysis of EEGs of consecutive patients with clinical diagnosis of epilepsy over a 5 year period at two diagnostic centers in Kano, northwestern Nigeria. Information on socio-demographic and seizure characteristics was obtained. The recordings from patients were obtained using the standard methods and interpreted by two of the investigators. The International Federation of Societies for Electroencephalography and Clinical Neurophysiology definition of interictal epileptiform discharges (interictal epileptiform activity [IEA]) was adopted for the study. Result: Out of 2219 patients referred for EEG at the two diagnostic centers during the study period, 2041 (92%) patients had a clinical diagnosis of epilepsy. Their age ranged between 0.04 and 75 years, with a mean age of 22.8 ± 14.9 years. Overall, EEG was abnormal in 1178 (57.7%) and 919 (45.1%) had an epileptiform pattern. A total of 1691 patients had hyperventilation (HV) and response to HV was unremarkable in 1286 (76%) of them. Out of 405 who had remarkable changes on HV; 302 had increase in epileptiform discharges, whereas 103 had abnormal discharges only on HV. Seventeen (89.5%) out of 19 patients with 3 Hz spike and wave complexes had activation by HV. The most common IEA were focal spike/sharp and wave and generalized spike/sharp and slow waves. More antiepileptic drug (AED) naive patients (678) than those that were on AED (500) had EEG abnormality and the difference was statistically significant, P < 0.001. Conclusion: The study showed that the occurrence of interictal EEG abnormality in patients with epilepsy was about 58%. The proportion of interictal epileptiform discharges was 45% in routine first EEG studies. Among those with epileptiform activity, generalized sharp and wave complexes and focal sharp and slow wave complexes were the most common findings.
{"title":"Interictal electroencephalography in patients with epilepsy in northwestern Nigeria","authors":"L. Owolabi, S. Shehu, S. Owolabi, M. Umar","doi":"10.4103/0331-3131.133096","DOIUrl":"https://doi.org/10.4103/0331-3131.133096","url":null,"abstract":"Background: Different studies have reported various frequencies of electroencephalographic (EEG) abnormalities in patients with epilepsy. There is, however, a paucity of data on EEG in Nigeria; hence, the need for this study. Objective: The objective of the following study was to evaluate interictal EEG pattern in patients with epilepsy in Kano, Northwestern Nigeria. Subjects and Methods: A cross-sectional study involving the analysis of EEGs of consecutive patients with clinical diagnosis of epilepsy over a 5 year period at two diagnostic centers in Kano, northwestern Nigeria. Information on socio-demographic and seizure characteristics was obtained. The recordings from patients were obtained using the standard methods and interpreted by two of the investigators. The International Federation of Societies for Electroencephalography and Clinical Neurophysiology definition of interictal epileptiform discharges (interictal epileptiform activity [IEA]) was adopted for the study. Result: Out of 2219 patients referred for EEG at the two diagnostic centers during the study period, 2041 (92%) patients had a clinical diagnosis of epilepsy. Their age ranged between 0.04 and 75 years, with a mean age of 22.8 ± 14.9 years. Overall, EEG was abnormal in 1178 (57.7%) and 919 (45.1%) had an epileptiform pattern. A total of 1691 patients had hyperventilation (HV) and response to HV was unremarkable in 1286 (76%) of them. Out of 405 who had remarkable changes on HV; 302 had increase in epileptiform discharges, whereas 103 had abnormal discharges only on HV. Seventeen (89.5%) out of 19 patients with 3 Hz spike and wave complexes had activation by HV. The most common IEA were focal spike/sharp and wave and generalized spike/sharp and slow waves. More antiepileptic drug (AED) naive patients (678) than those that were on AED (500) had EEG abnormality and the difference was statistically significant, P < 0.001. Conclusion: The study showed that the occurrence of interictal EEG abnormality in patients with epilepsy was about 58%. The proportion of interictal epileptiform discharges was 45% in routine first EEG studies. Among those with epileptiform activity, generalized sharp and wave complexes and focal sharp and slow wave complexes were the most common findings.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130609019","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133100
X. Tao, Yan-shi Mo, Y. Guan
We describe a male patient who presented with a 2 years history of recurrent ulcers and erythematous plaques on the buttocks. Skin biopsy and tissue culture on Lowenstein Jensen media resulted in the isolation of Mycobacteria, which was further identified as Mycobacterium tuberculosis (MTB) by polymerase chain reaction. The results of drug susceptibility tests showed that the MTB isolated was resistant to isoniazid (INH), rifampicin (RIF), ethambutol (ETH) and rifapentine (RFT). During 7 years of follow-up after discharge from hospital admission, the erythematous plaques and atrophic scars remained confined to the patient′s buttocks. This is the first reported case of cutaneous multidrug-resistant tuberculosis (MDR-TB) in China. Given the increasing incidence of MDR-TB in china, our case report calls for heightened clinical awareness and improved facilities to confirm the diagnosis of MDR-TB.
{"title":"Multidrug resistant Mycobacterium tuberculosis in cutaneous tuberculosis in China","authors":"X. Tao, Yan-shi Mo, Y. Guan","doi":"10.4103/0331-3131.133100","DOIUrl":"https://doi.org/10.4103/0331-3131.133100","url":null,"abstract":"We describe a male patient who presented with a 2 years history of recurrent ulcers and erythematous plaques on the buttocks. Skin biopsy and tissue culture on Lowenstein Jensen media resulted in the isolation of Mycobacteria, which was further identified as Mycobacterium tuberculosis (MTB) by polymerase chain reaction. The results of drug susceptibility tests showed that the MTB isolated was resistant to isoniazid (INH), rifampicin (RIF), ethambutol (ETH) and rifapentine (RFT). During 7 years of follow-up after discharge from hospital admission, the erythematous plaques and atrophic scars remained confined to the patient′s buttocks. This is the first reported case of cutaneous multidrug-resistant tuberculosis (MDR-TB) in China. Given the increasing incidence of MDR-TB in china, our case report calls for heightened clinical awareness and improved facilities to confirm the diagnosis of MDR-TB.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121339858","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133102
A. Pai, K. Balakumar, S. Shankar, V. Umadevi, B. Manash, S. Narayanasamy
Paget′s disease of bone (osteitis deformans) is a condition of unknown etiology, characterized by rapid bone remodeling and formation of new bone that is structurally abnormal. A wide range of clinical manifestations are reported among patients with Paget′s disease including bone pain, fractures, secondary osteoarthritis, hearing loss, and syndrome of neurological compression secondary to vascular steal phenomenon. Here we report a rare case of recurrent transient ischemic attacks due to vascular steal syndrome secondary to Paget′s disease of bone.
{"title":"Recurrent transient ischemic attacks due to vascular steal syndrome secondary to the Paget′s disease of bone: A rare presentation","authors":"A. Pai, K. Balakumar, S. Shankar, V. Umadevi, B. Manash, S. Narayanasamy","doi":"10.4103/0331-3131.133102","DOIUrl":"https://doi.org/10.4103/0331-3131.133102","url":null,"abstract":"Paget′s disease of bone (osteitis deformans) is a condition of unknown etiology, characterized by rapid bone remodeling and formation of new bone that is structurally abnormal. A wide range of clinical manifestations are reported among patients with Paget′s disease including bone pain, fractures, secondary osteoarthritis, hearing loss, and syndrome of neurological compression secondary to vascular steal phenomenon. Here we report a rare case of recurrent transient ischemic attacks due to vascular steal syndrome secondary to Paget′s disease of bone.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124651132","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133098
J. Fadare, O. Babatunde, T. Olanrewaju, O. Busari
Introduction: Discharge against medical advice (DAMA) is a worldwide problem with negative health and socioeconomic effects. Factors that have been implicated as causes or contributing to DAMA include financial constraints, lack of health insurance, deteriorating clinical condition of the patient, and problematic doctor-patient relationships. Aims: determine the incidence and profiles ofDAMA on the medical wards, so as to allows for evidence-based interventions to reduce this problem to a minimum. Materials and Methods: This was a case-control study carried out on the medical wards of Federal Medical Center, Ido-Ekiti, South-West Nigeria. The medical records of all patients admitted to the male and female medical wards between January 2008 and April 2011 were reviewed. After being identified through the admission/discharge log, patients who were DAMA and a similar number of patients with regular discharge had their case notes retrieved. Information extracted included bio-data, diagnosis, duration of hospital stay, and reason for discharge. Results: One hundred and thirty-eight patients representing 7.2% were DAMA during the study period. Ninety five cases had complete medical records, and full analysis was carried out on these and 94 other cases with regular discharge as control. The mean age of the DAMA cases was 50.8 ± 18.3 years, with 58 (61.1%) of these patients being male; while the mean age of the control group was 54.1 ± 16.5, of which 54 (57.4%) were male. The mean duration of admission for patients with DAMA was 10.4 ± 9.2 days as against 11.9 ± 10 in the control group, a difference that is not statistically significant. The associations between type of discharge, sex, and duration of admission are shown through odds ratios of 0.883 and 0.833 respectively. Financial problems (48%), lack of clinical improvement (28.8%) and leaving to seek alternative/complimentary medical care (23.1%) were the factors found to be responsible for DAMA in the study. Conclusion: The incidence of discharge against medicine is high in this study. There is a need for all stakeholders to evaluate factors responsible for DAMA, with the aim of reducing this trend.
{"title":"Discharge against medical advice: Experience from a rural Nigerian hospital","authors":"J. Fadare, O. Babatunde, T. Olanrewaju, O. Busari","doi":"10.4103/0331-3131.133098","DOIUrl":"https://doi.org/10.4103/0331-3131.133098","url":null,"abstract":"Introduction: Discharge against medical advice (DAMA) is a worldwide problem with negative health and socioeconomic effects. Factors that have been implicated as causes or contributing to DAMA include financial constraints, lack of health insurance, deteriorating clinical condition of the patient, and problematic doctor-patient relationships. Aims: determine the incidence and profiles ofDAMA on the medical wards, so as to allows for evidence-based interventions to reduce this problem to a minimum. Materials and Methods: This was a case-control study carried out on the medical wards of Federal Medical Center, Ido-Ekiti, South-West Nigeria. The medical records of all patients admitted to the male and female medical wards between January 2008 and April 2011 were reviewed. After being identified through the admission/discharge log, patients who were DAMA and a similar number of patients with regular discharge had their case notes retrieved. Information extracted included bio-data, diagnosis, duration of hospital stay, and reason for discharge. Results: One hundred and thirty-eight patients representing 7.2% were DAMA during the study period. Ninety five cases had complete medical records, and full analysis was carried out on these and 94 other cases with regular discharge as control. The mean age of the DAMA cases was 50.8 ± 18.3 years, with 58 (61.1%) of these patients being male; while the mean age of the control group was 54.1 ± 16.5, of which 54 (57.4%) were male. The mean duration of admission for patients with DAMA was 10.4 ± 9.2 days as against 11.9 ± 10 in the control group, a difference that is not statistically significant. The associations between type of discharge, sex, and duration of admission are shown through odds ratios of 0.883 and 0.833 respectively. Financial problems (48%), lack of clinical improvement (28.8%) and leaving to seek alternative/complimentary medical care (23.1%) were the factors found to be responsible for DAMA in the study. Conclusion: The incidence of discharge against medicine is high in this study. There is a need for all stakeholders to evaluate factors responsible for DAMA, with the aim of reducing this trend.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130235188","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133104
N. Ali, Mohammed Mubarak, Yakubu Ali
Small bowel volvulus is an occasional cause of mechanical intestinal obstruction in our practice causing diagnostic problems. We report a case of primary small bowel volvulus with gangrene. A 30-year-old farmer who presented with features of acute intestinal obstruction, which at laparotomy revealed a primary small bowel volvulus with a gangrenous loop of ileum. The patient was resuscitated and had exploratory laparotomy; with operative findings of a twisted loop of gangrenous ileum adjoining the ileocecal valve. This was resected and an end to end ileotransverse anastomosis effected. The patient made an uneventful recovery and was discharged on the 7 th postoperative day. Primary small bowel volvulus should be suspected in acute intestinal obstruction. It presents as an acute abdomen due to occlusion of bowel lumen alone or with obstruction of its blood supply leading to gangrene. Treatment includes resection and end to end anastomosis, which can help to reduce mortality and morbidity.
{"title":"Primary volvulus of the small intestine","authors":"N. Ali, Mohammed Mubarak, Yakubu Ali","doi":"10.4103/0331-3131.133104","DOIUrl":"https://doi.org/10.4103/0331-3131.133104","url":null,"abstract":"Small bowel volvulus is an occasional cause of mechanical intestinal obstruction in our practice causing diagnostic problems. We report a case of primary small bowel volvulus with gangrene. A 30-year-old farmer who presented with features of acute intestinal obstruction, which at laparotomy revealed a primary small bowel volvulus with a gangrenous loop of ileum. The patient was resuscitated and had exploratory laparotomy; with operative findings of a twisted loop of gangrenous ileum adjoining the ileocecal valve. This was resected and an end to end ileotransverse anastomosis effected. The patient made an uneventful recovery and was discharged on the 7 th postoperative day. Primary small bowel volvulus should be suspected in acute intestinal obstruction. It presents as an acute abdomen due to occlusion of bowel lumen alone or with obstruction of its blood supply leading to gangrene. Treatment includes resection and end to end anastomosis, which can help to reduce mortality and morbidity.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125713106","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133099
H. Sulayman, N. Ameh, A. Adesiyun, I. Ozed-Williams, A. Ojabo, S. Avidime, Nosa E Enobun, A. Yusuf, Abdulsalam Muazu
Background: Nigerian adolescents constitute about 20% of the total population. Problems associated with menstruation affect 75% of adolescent females in both the developing and the developed world. Objectives: The objective of this study is to establish the age at menarche and menstrual abnormalities among adolescents in secondary schools in Zaria. Materials and Methods: A descriptive cross sectional study in which a self-administered pretested, semi-structured questionnaire in english was administered to 535 female secondary school students in Zaria, northern Nigeria. The students were selected from five schools that were chosen by simple random sampling from a list of schools in Zaria metropolis. Information obtained included age at menarche and menstruation related issues. Results: Of the 535 female secondary school students interviewed, 448 (83.7%) were in senior secondary school. The mean age of the respondents was 15.35 ± 1.48 years. The average age at menarche was 12.53 ± 1.33 years. Most respondents, 369 (69.0%) experienced regular menses. The average duration of menstruation was 5.45 ± 1.81 days in 354 (66.2%) of the respondents. Three hundred and forty-four (64.3%) of the respondents had dysmenorrhea, and it was severe in 229 (66.6%) of them. Only, 137 (25.6%) experienced premenstrual symptoms, the most common symptom being breast tenderness in 62 respondents (45.2%). Conclusion: The age at menarche and the menstrual pattern amongst adolescents in Zaria, northern Nigeria is similar to findings from other parts of Nigeria as well as from other parts of the world. Further studies are however needed to explore the full range of menstrual abnormalities that can occur in the adolescent age group.
{"title":"Age at menarche and prevalence of menstrual abnormalities among adolescents in Zaria, northern Nigeria","authors":"H. Sulayman, N. Ameh, A. Adesiyun, I. Ozed-Williams, A. Ojabo, S. Avidime, Nosa E Enobun, A. Yusuf, Abdulsalam Muazu","doi":"10.4103/0331-3131.133099","DOIUrl":"https://doi.org/10.4103/0331-3131.133099","url":null,"abstract":"Background: Nigerian adolescents constitute about 20% of the total population. Problems associated with menstruation affect 75% of adolescent females in both the developing and the developed world. Objectives: The objective of this study is to establish the age at menarche and menstrual abnormalities among adolescents in secondary schools in Zaria. Materials and Methods: A descriptive cross sectional study in which a self-administered pretested, semi-structured questionnaire in english was administered to 535 female secondary school students in Zaria, northern Nigeria. The students were selected from five schools that were chosen by simple random sampling from a list of schools in Zaria metropolis. Information obtained included age at menarche and menstruation related issues. Results: Of the 535 female secondary school students interviewed, 448 (83.7%) were in senior secondary school. The mean age of the respondents was 15.35 ± 1.48 years. The average age at menarche was 12.53 ± 1.33 years. Most respondents, 369 (69.0%) experienced regular menses. The average duration of menstruation was 5.45 ± 1.81 days in 354 (66.2%) of the respondents. Three hundred and forty-four (64.3%) of the respondents had dysmenorrhea, and it was severe in 229 (66.6%) of them. Only, 137 (25.6%) experienced premenstrual symptoms, the most common symptom being breast tenderness in 62 respondents (45.2%). Conclusion: The age at menarche and the menstrual pattern amongst adolescents in Zaria, northern Nigeria is similar to findings from other parts of Nigeria as well as from other parts of the world. Further studies are however needed to explore the full range of menstrual abnormalities that can occur in the adolescent age group.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116226820","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}
Pub Date : 2013-07-01DOI: 10.4103/0331-3131.133094
S. Aliyu
Corresponding Author: Dr. Shamsudin Aliyu, Department of Medical Microbiology, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria. E-mail: shamsualiyu@gmail.com The rapid spread of carbapenemase producing Gram-negatives (CPGNs) continues to pose a significant health threat globally. The potential threat to patients and health personnel is unprecedented. This has heightened the global awareness of the need to prioritize infection prevention and control (IPC) strategies, with the aim of reducing the burden of infection caused by these bacteria. Developing countries have experienced unfavorable trends in antimicrobial resistance.[1] CPGNs have now emerged as a significant threat in Africa.[2] Implementation of effective infection control strategies are hampered by many factors, some of which are specific to developing countries. An understanding of the basic principles of CPGN IPC is crucial to the battle against these multidrug resistant bacteria.
{"title":"Controlling the spread of carbapenemase-producing Gram-negative bacteria","authors":"S. Aliyu","doi":"10.4103/0331-3131.133094","DOIUrl":"https://doi.org/10.4103/0331-3131.133094","url":null,"abstract":"Corresponding Author: Dr. Shamsudin Aliyu, Department of Medical Microbiology, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria. E-mail: shamsualiyu@gmail.com The rapid spread of carbapenemase producing Gram-negatives (CPGNs) continues to pose a significant health threat globally. The potential threat to patients and health personnel is unprecedented. This has heightened the global awareness of the need to prioritize infection prevention and control (IPC) strategies, with the aim of reducing the burden of infection caused by these bacteria. Developing countries have experienced unfavorable trends in antimicrobial resistance.[1] CPGNs have now emerged as a significant threat in Africa.[2] Implementation of effective infection control strategies are hampered by many factors, some of which are specific to developing countries. An understanding of the basic principles of CPGN IPC is crucial to the battle against these multidrug resistant bacteria.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128280431","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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