Background: Offspring of hypertensive parents have been reported to have alteration on their sympathovagal balance and have exaggerated response to stressful conditions. Many Christians observe a period of fasting at the beginning of every year, which imposes some stress on their bodies. Objective: This study aims to investigate the effect of 21-day intermittent fasting on some cardiovascular parameters in offspring of hypertensive and normotensive parents. Materials and Methods: Eighty young adults (20–28 years) were divided into equal number of male and female offspring of hypertensive and normotensive parents based on questionnaire. Their body weight, height, waist circumference (WC), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded 1 week before the fasting period began and then weekly for 3 weeks, in which they fasted. Results: The weight, BMI, and WC reduced during fasting, but the reductions were not significant (P > 0.05). The SBP and DBP were higher in male offspring of hypertensive parents than all other groups. SBP was also significantly (P < 0.05) higher in males than females before fast and during fast. Fasting significantly reduced the SBP in the male offspring of both hypertensive and normotensive parents. The HR reduced in the females during fast but increased from a lower level in males to a value not significantly different from prefasting level. Conclusion: Fasting reduces the high SBP and DBP in male offspring of hypertensive parents, which is beneficial to their cardiovascular system.
{"title":"Effect of intermittent fasting on cardiovascular parameters of young adult offspring of hypertensive parents","authors":"O. Adeniyi, Owaita Adams, M. Ogiator, D. Musa","doi":"10.4103/smj.smj_72_20","DOIUrl":"https://doi.org/10.4103/smj.smj_72_20","url":null,"abstract":"Background: Offspring of hypertensive parents have been reported to have alteration on their sympathovagal balance and have exaggerated response to stressful conditions. Many Christians observe a period of fasting at the beginning of every year, which imposes some stress on their bodies. Objective: This study aims to investigate the effect of 21-day intermittent fasting on some cardiovascular parameters in offspring of hypertensive and normotensive parents. Materials and Methods: Eighty young adults (20–28 years) were divided into equal number of male and female offspring of hypertensive and normotensive parents based on questionnaire. Their body weight, height, waist circumference (WC), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded 1 week before the fasting period began and then weekly for 3 weeks, in which they fasted. Results: The weight, BMI, and WC reduced during fasting, but the reductions were not significant (P > 0.05). The SBP and DBP were higher in male offspring of hypertensive parents than all other groups. SBP was also significantly (P < 0.05) higher in males than females before fast and during fast. Fasting significantly reduced the SBP in the male offspring of both hypertensive and normotensive parents. The HR reduced in the females during fast but increased from a lower level in males to a value not significantly different from prefasting level. Conclusion: Fasting reduces the high SBP and DBP in male offspring of hypertensive parents, which is beneficial to their cardiovascular system.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"25 1","pages":"15 - 20"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45970070","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-choice question (MCQ) is an effective form of written assessments for knowledge acquisition. Optical mark reading scanner is used for grading MCQs. Major setback in the use of scanner is the cost of acquiring it. Consequently, several manual methods such as conference making and stencil overlay are used to mark MCQ. This paper highlights the use of Microsoft Excel Spreadsheet and printer to mark MCQ and compares the method with other manual methods of marking. Materials and Methods: Five sets of 100 stems of objective questions (true or false, one in five, and matching types) were administered to students. Answer script was designed using Excel Spreadsheet. Three groups of marking were done: directly on the question paper, use of stencil for marking on the answer script, use of Microsoft Excel soft copy. At the end of the marking process, mean marking time, mean collation time, mean counting time, and mean marking error were collated and compared. The instant computer statistical software was used to calculate means, standard deviations, and ANOVA.A P < 0.05 was regarded as statistically significant. Results: Results showed a statistically significant low mean marking time of 0.68 h (P < 0.0001) for the spreadsheet/printer marking method. Marking error was significantly low with this method (P < 0.001) as compared with other manual marking methods. The collation time and counting time were not significantly different across the groups. Conclusion: It is concluded that Excel Spreadsheet and printer marking method significantly reduced marking time and marking errors in marking MCQs.
{"title":"The use of excel spread sheet and printer in marking medical science objective questions: An alternative to manual marking method","authors":"Raymond Okolo, O. Kolawole","doi":"10.4103/smj.smj_61_20","DOIUrl":"https://doi.org/10.4103/smj.smj_61_20","url":null,"abstract":"Background: Multiple-choice question (MCQ) is an effective form of written assessments for knowledge acquisition. Optical mark reading scanner is used for grading MCQs. Major setback in the use of scanner is the cost of acquiring it. Consequently, several manual methods such as conference making and stencil overlay are used to mark MCQ. This paper highlights the use of Microsoft Excel Spreadsheet and printer to mark MCQ and compares the method with other manual methods of marking. Materials and Methods: Five sets of 100 stems of objective questions (true or false, one in five, and matching types) were administered to students. Answer script was designed using Excel Spreadsheet. Three groups of marking were done: directly on the question paper, use of stencil for marking on the answer script, use of Microsoft Excel soft copy. At the end of the marking process, mean marking time, mean collation time, mean counting time, and mean marking error were collated and compared. The instant computer statistical software was used to calculate means, standard deviations, and ANOVA.A P < 0.05 was regarded as statistically significant. Results: Results showed a statistically significant low mean marking time of 0.68 h (P < 0.0001) for the spreadsheet/printer marking method. Marking error was significantly low with this method (P < 0.001) as compared with other manual marking methods. The collation time and counting time were not significantly different across the groups. Conclusion: It is concluded that Excel Spreadsheet and printer marking method significantly reduced marking time and marking errors in marking MCQs.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"172 - 177"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41842880","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}
N. Oyelowo, Muhammed Ahmed, A. Bello, A. Lawal, B. Lawal, J. Olagunju, A. Sudi, M. Awaisu, M. Tolani, H. Maitama
Introduction: Urethral stricture is a common cause of lower urinary tract symptoms in middle-aged and elderly men. Its presentation and management are closely linked with its etiology and this varies across geographical regions of the world as well as overtime. We hereby review the etiology, characteristics, and presentation of men with urethral strictures in a tertiary hospital in northern Nigeria over a year and compare it with previous studies in the region. Patients and Methods: The study was a prospective study from January-December 2016, all patients with urethral strictures and who consented to the study were enrolled in the study. Data was collected using a structured study proforma and analyzed using SPSS version 23. Results: The mean age was 44.1 years with a range of 13-71 years. The age interval 30 – 39 years accounted for most of the patients 24 (28.6%). 43% of the patients had short segment urethral strictures (<2cm) while 57% had long segment strictures (>2cm). The bulbar urethra was the site of most strictures with a frequency of 65%. Strictures were found in the penile and peno-bulbar urethra in 25% and 21% respectively. Only 10% of patients studied had multiple strictures. The etiology was an infection in the majority of the patients with a frequency of 53.3%. Post-traumatic strictures occurred in 33.3% while iatrogenic and catheter –Induced strictures were seen in 7.1% and 6% respectively. 8.3% had recurrent strictures, 1.2 % had previous dilations and 2.4 % had previous DVIU. 88% had no previous intervention for the stricture before the presentation. The complications from urethral strictures observed in the patients were acute urinary retention in 83.4% urethrocutaneous fistulae in 2.4% and urosepsis in 1.2% of the patients. 11% presented with no complication. 68% of these patients were managed by excision and end to end anastomosis, 15 % had a penile pedicled flap 12%, a buccal mucosa graft urethroplasty and 5% with staged urethroplasty. Conclusion: Though there is a gradual rise in post-traumatic and iatrogenic strictures in our environment, Post-inflammatory strictures still predominate. It is however infrequently accompanied by fistulae as seen decades ago. These strictures are mostly long segments single bulbar strictures.
{"title":"Have our strictures changed: A study of the current characteristics and management of urethral stricture disease in Zaria, Nigeria","authors":"N. Oyelowo, Muhammed Ahmed, A. Bello, A. Lawal, B. Lawal, J. Olagunju, A. Sudi, M. Awaisu, M. Tolani, H. Maitama","doi":"10.4103/smj.smj_52_19","DOIUrl":"https://doi.org/10.4103/smj.smj_52_19","url":null,"abstract":"Introduction: Urethral stricture is a common cause of lower urinary tract symptoms in middle-aged and elderly men. Its presentation and management are closely linked with its etiology and this varies across geographical regions of the world as well as overtime. We hereby review the etiology, characteristics, and presentation of men with urethral strictures in a tertiary hospital in northern Nigeria over a year and compare it with previous studies in the region. Patients and Methods: The study was a prospective study from January-December 2016, all patients with urethral strictures and who consented to the study were enrolled in the study. Data was collected using a structured study proforma and analyzed using SPSS version 23. Results: The mean age was 44.1 years with a range of 13-71 years. The age interval 30 – 39 years accounted for most of the patients 24 (28.6%). 43% of the patients had short segment urethral strictures (<2cm) while 57% had long segment strictures (>2cm). The bulbar urethra was the site of most strictures with a frequency of 65%. Strictures were found in the penile and peno-bulbar urethra in 25% and 21% respectively. Only 10% of patients studied had multiple strictures. The etiology was an infection in the majority of the patients with a frequency of 53.3%. Post-traumatic strictures occurred in 33.3% while iatrogenic and catheter –Induced strictures were seen in 7.1% and 6% respectively. 8.3% had recurrent strictures, 1.2 % had previous dilations and 2.4 % had previous DVIU. 88% had no previous intervention for the stricture before the presentation. The complications from urethral strictures observed in the patients were acute urinary retention in 83.4% urethrocutaneous fistulae in 2.4% and urosepsis in 1.2% of the patients. 11% presented with no complication. 68% of these patients were managed by excision and end to end anastomosis, 15 % had a penile pedicled flap 12%, a buccal mucosa graft urethroplasty and 5% with staged urethroplasty. Conclusion: Though there is a gradual rise in post-traumatic and iatrogenic strictures in our environment, Post-inflammatory strictures still predominate. It is however infrequently accompanied by fistulae as seen decades ago. These strictures are mostly long segments single bulbar strictures.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"160 - 164"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46889530","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}
Obiageli Agbogu-Ike, B. Maiha, L. Okonkwo, M. Aliyu, A. Oyati
Background: Hyperhomocysteinemia is a risk factor for heart failure commonly in females. The study aimed at determining Hcy's association with left ventricular (LV) remodeling. Materials and Methods: A cross-sectional study evaluating the relationship of plasma Hcy to echocardiographic LV structure and function in 65 apparently healthy Nigerians (Mean age 41.87 ± 12.90 years, 52.2% females) without cardiovascular disease. Results: The mean Hcy level was 10.76 ± 2.69 μmol/L with no significant (P = 0.89) sex difference and 50.8% of the subjects had Hcy levels within the fourth quartile (hcy: 10.3–17.5 μmol/L). Plasma Hcy showed no significant (P > 0.05) relationship to LV mass (LVM), wall thickness (WT), relative WT, systolic/tissue-Doppler-derived diastolic function, and left atrial dimension in both sexes. Hyperhomocysteinemia (hcy >10.3 μmol/L) was significantly (P < 0.007) correlated to LVM indexed to height2.7 in all subjects but showed no such association in the unadjusted and adjusted binary logistic regression models. The odd of hyperhomocysteinemic patients having thicker LVM trended more toward females (odds ratio: 1.44, 95% confidence interval, 0.59–3.50) than males. Conclusion: Plasma hyperhomocysteinemia found in healthy Nigerian-Africans shows no relationship to LV remodeling, echocardiographic LV structural and functional parameters.
{"title":"Relations of plasma homocysteine to left ventricular geometry and functions","authors":"Obiageli Agbogu-Ike, B. Maiha, L. Okonkwo, M. Aliyu, A. Oyati","doi":"10.4103/smj.smj_12_20","DOIUrl":"https://doi.org/10.4103/smj.smj_12_20","url":null,"abstract":"Background: Hyperhomocysteinemia is a risk factor for heart failure commonly in females. The study aimed at determining Hcy's association with left ventricular (LV) remodeling. Materials and Methods: A cross-sectional study evaluating the relationship of plasma Hcy to echocardiographic LV structure and function in 65 apparently healthy Nigerians (Mean age 41.87 ± 12.90 years, 52.2% females) without cardiovascular disease. Results: The mean Hcy level was 10.76 ± 2.69 μmol/L with no significant (P = 0.89) sex difference and 50.8% of the subjects had Hcy levels within the fourth quartile (hcy: 10.3–17.5 μmol/L). Plasma Hcy showed no significant (P > 0.05) relationship to LV mass (LVM), wall thickness (WT), relative WT, systolic/tissue-Doppler-derived diastolic function, and left atrial dimension in both sexes. Hyperhomocysteinemia (hcy >10.3 μmol/L) was significantly (P < 0.007) correlated to LVM indexed to height2.7 in all subjects but showed no such association in the unadjusted and adjusted binary logistic regression models. The odd of hyperhomocysteinemic patients having thicker LVM trended more toward females (odds ratio: 1.44, 95% confidence interval, 0.59–3.50) than males. Conclusion: Plasma hyperhomocysteinemia found in healthy Nigerian-Africans shows no relationship to LV remodeling, echocardiographic LV structural and functional parameters.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"145 - 153"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42229017","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}
Mohamed Salih, M. Gameraddin, M. Yousef, B. Malik, Q. Alshammari, D. Bilal
Background: Peripheral artery disease (PAD) in patients with Type 2 diabetes mellitus (T2DM) has broad characteristics and various complications. Aim: The purpose of this study is to evaluate PAD in T2DM and their association with age, gender, and the duration of T2DM. Materials and Methods: This study is a prospective cross-sectional one conducted at the radiology department in Royal Care International Hospital, Khartoum, Sudan, over 3 years. A total of one hundred and ten patients, 69 males and 41 females, were examined using MDCT. A binary logistic regression test was applied to identify independent predictors of PAD. Results: PAD in T2DM is found to be 50.91% atherosclerosis, 43.64% plaques, 29.09% stenosis, and 14.55% thrombosis (mean age 65.84 ± 9.57 years; mean duration of T2DM 29.37 ± 6.7 years). The prevalence of PAD was common in patients over 60-year-old. Atherosclerosis is significantly higher in males than females (59.4% vs. 36.6%, 95% confidence interval = 1.092–5.600, P = 0.03%). Plaques and stenosis of lower-extremity arteries were higher in males than females 44.9% vs. 41.5% and 29.0% vs. 29.3%) respectively. The incidence of thrombosis was higher in femoral arteries than lower distal arteries, and the prevalence was higher in females than males (22% vs. 10.1%, odds ratio = 2.228), respectively. Conclusion: Atherosclerosis, plaques, stenosis, and thrombosis were the most common PAD findings in patients affected with T2DM. Age, gender, and duration of diabetes, relatively risk factors associated with PAD. Thrombosis is more prevalent in the femoral artery than lower distal arteries.
背景:2型糖尿病(T2DM)患者的外周动脉病变(PAD)具有广泛的特征和多种并发症。目的:本研究的目的是评估T2DM患者的PAD及其与年龄、性别和T2DM病程的关系。材料和方法:本研究是一项前瞻性横断面研究，在苏丹喀土穆皇家护理国际医院放射科进行，为期3年。共110例患者(男69例，女41例)采用多层螺旋ct检查。采用二元逻辑回归检验来确定PAD的独立预测因素。结果:T2DM患者PAD中动脉粥样硬化占50.91%，斑块占43.64%，狭窄占29.09%，血栓占14.55%(平均年龄65.84±9.57岁;T2DM平均病程29.37±6.7年)。60岁以上患者中PAD患病率较高。男性动脉粥样硬化发生率明显高于女性(59.4%比36.6%，95%可信区间= 1.092-5.600,P = 0.03%)。下肢动脉斑块和狭窄男性高于女性(分别为44.9%比41.5%和29.0%比29.3%)。股动脉血栓发生率高于下远端动脉，女性血栓发生率高于男性(22% vs. 10.1%，优势比= 2.228)。结论:动脉粥样硬化、斑块、狭窄和血栓形成是T2DM患者最常见的PAD表现。年龄、性别和糖尿病病程是与PAD相关的相对危险因素。血栓形成在股动脉比远端动脉更普遍。
{"title":"Evaluation of peripheral arterial disease in type 2 diabetic patients using computed tomography angiography","authors":"Mohamed Salih, M. Gameraddin, M. Yousef, B. Malik, Q. Alshammari, D. Bilal","doi":"10.4103/smj.smj_68_20","DOIUrl":"https://doi.org/10.4103/smj.smj_68_20","url":null,"abstract":"Background: Peripheral artery disease (PAD) in patients with Type 2 diabetes mellitus (T2DM) has broad characteristics and various complications. Aim: The purpose of this study is to evaluate PAD in T2DM and their association with age, gender, and the duration of T2DM. Materials and Methods: This study is a prospective cross-sectional one conducted at the radiology department in Royal Care International Hospital, Khartoum, Sudan, over 3 years. A total of one hundred and ten patients, 69 males and 41 females, were examined using MDCT. A binary logistic regression test was applied to identify independent predictors of PAD. Results: PAD in T2DM is found to be 50.91% atherosclerosis, 43.64% plaques, 29.09% stenosis, and 14.55% thrombosis (mean age 65.84 ± 9.57 years; mean duration of T2DM 29.37 ± 6.7 years). The prevalence of PAD was common in patients over 60-year-old. Atherosclerosis is significantly higher in males than females (59.4% vs. 36.6%, 95% confidence interval = 1.092–5.600, P = 0.03%). Plaques and stenosis of lower-extremity arteries were higher in males than females 44.9% vs. 41.5% and 29.0% vs. 29.3%) respectively. The incidence of thrombosis was higher in femoral arteries than lower distal arteries, and the prevalence was higher in females than males (22% vs. 10.1%, odds ratio = 2.228), respectively. Conclusion: Atherosclerosis, plaques, stenosis, and thrombosis were the most common PAD findings in patients affected with T2DM. Age, gender, and duration of diabetes, relatively risk factors associated with PAD. Thrombosis is more prevalent in the femoral artery than lower distal arteries.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"154 - 159"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45348935","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 rodent ulcer refers to the slowly growing, ulcerated, locally invasive basal-cell carcinoma (BCC) which is the most common cutaneous malignancy in Caucasians but is rare in people with dark skin. We report two morphologically different presentations of nodular BCC in Nigerian patients. The first was a large, slowly growing ulcer on the right side of the face which had been present for many years, with the diagnosis not being made despite visits to various health centers, whereas the second was a much smaller ulcerated nodule on the right alar nasi and dorsum of the nose. We highlight the need for vigilance to make the correct diagnosis early and institute appropriate treatment.
{"title":"The rodent ulcer: Report of two cases","authors":"H. Yahya","doi":"10.4103/smj.smj_47_18","DOIUrl":"https://doi.org/10.4103/smj.smj_47_18","url":null,"abstract":"A rodent ulcer refers to the slowly growing, ulcerated, locally invasive basal-cell carcinoma (BCC) which is the most common cutaneous malignancy in Caucasians but is rare in people with dark skin. We report two morphologically different presentations of nodular BCC in Nigerian patients. The first was a large, slowly growing ulcer on the right side of the face which had been present for many years, with the diagnosis not being made despite visits to various health centers, whereas the second was a much smaller ulcerated nodule on the right alar nasi and dorsum of the nose. We highlight the need for vigilance to make the correct diagnosis early and institute appropriate treatment.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"185 - 187"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45915258","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}
J. Ikubor, Nekwu E. Okolugbo, O. Ogholoh, Nicholas Kogha, Amenaghawon Bemigho-Odonmeta
Introduction: The incidental finding of a paranasal sinus (PNS) abnormality on imaging may lead to early detection of sinus pathologies. Brain magnetic resonance imaging (MRI) is a valuable tool for evaluation of the PNSs. Objectives: The objectives were to determine the prevalence, site, and type of abnormalities in the PNSs of a Nigerian population who had brain MRI for suspected intracranial disease and unrelated sinus disease. Materials and Methods: A cross-sectional design was adopted for this study. Radiology request forms, images, and reports of consecutive patients referred for brain MRI for suspected intracranial disease from January 2018 to December 2019 were studied. Abnormalities detected were complete mucosal opacification, mucosal thickening, collection with air–fluid level, and retention cyst/polyp. Statistical Analysis Used: Data were analyzed using Statistical Package for the Social Sciences for Windows version 22.0 (SPSS Inc. Chicago, IL, USA). Results: Four hundred and seventy-nine patients were referred for brain MRI between January 2018 and December 2019. The prevalence of sinus abnormality detected incidentally was 26.7%. The maxillary sinus was the most frequently involved sinus. Fluid collection with air–fluid level was the most common abnormality. There was no significant relationship between the sinus abnormalities with age and sex. Conclusions: The prevalence rate of abnormal sinus findings on brain MRI is 26.7% in this study, buttressing that morphological changes in the PNSs are frequently encountered incidentally on imaging; hence, there is a need to obtain a relevant history of sinus pathology from patients undergoing brain imaging to aid prompt diagnosis of subclinical sinus disease and achieve optimal therapeutic outcomes.
{"title":"Incidental sinus findings in brain MRI for suspected intracranial disease","authors":"J. Ikubor, Nekwu E. Okolugbo, O. Ogholoh, Nicholas Kogha, Amenaghawon Bemigho-Odonmeta","doi":"10.4103/smj.smj_59_20","DOIUrl":"https://doi.org/10.4103/smj.smj_59_20","url":null,"abstract":"Introduction: The incidental finding of a paranasal sinus (PNS) abnormality on imaging may lead to early detection of sinus pathologies. Brain magnetic resonance imaging (MRI) is a valuable tool for evaluation of the PNSs. Objectives: The objectives were to determine the prevalence, site, and type of abnormalities in the PNSs of a Nigerian population who had brain MRI for suspected intracranial disease and unrelated sinus disease. Materials and Methods: A cross-sectional design was adopted for this study. Radiology request forms, images, and reports of consecutive patients referred for brain MRI for suspected intracranial disease from January 2018 to December 2019 were studied. Abnormalities detected were complete mucosal opacification, mucosal thickening, collection with air–fluid level, and retention cyst/polyp. Statistical Analysis Used: Data were analyzed using Statistical Package for the Social Sciences for Windows version 22.0 (SPSS Inc. Chicago, IL, USA). Results: Four hundred and seventy-nine patients were referred for brain MRI between January 2018 and December 2019. The prevalence of sinus abnormality detected incidentally was 26.7%. The maxillary sinus was the most frequently involved sinus. Fluid collection with air–fluid level was the most common abnormality. There was no significant relationship between the sinus abnormalities with age and sex. Conclusions: The prevalence rate of abnormal sinus findings on brain MRI is 26.7% in this study, buttressing that morphological changes in the PNSs are frequently encountered incidentally on imaging; hence, there is a need to obtain a relevant history of sinus pathology from patients undergoing brain imaging to aid prompt diagnosis of subclinical sinus disease and achieve optimal therapeutic outcomes.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"165 - 171"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47510926","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}
This clinical vignette is that of an 82-year-old woman who was admitted into a geriatrics unit in Nigeria, with acute heart failure and multiple decubitus ulcers. She was subsequently discharged against medical advice after 27 days on account of financial constraints and her children's inability to achieve a unified front for her care provision. The clinical scenario illustrates that medical presentation of disease may be a manifestation of elder mistreatment. It also highlights how discharge against medical advice may be the culmination of mistreatment of hospitalized older adults. We review the literature on types and important features of elder mistreatment and how it may be diagnosed in clinical settings. We also discuss challenges that clinicians in Nigeria may face in diagnosing and managing elder mistreatment as a result of a dearth of training in geriatrics and the absence of a national framework to tackle elder mistreatment.
{"title":"Hospitalization and discharge against medical advice underpinned by elder mistreatment","authors":"O. Akoria, I. Edeki, Ejemenare A. Dawodu","doi":"10.4103/smj.smj_16_17","DOIUrl":"https://doi.org/10.4103/smj.smj_16_17","url":null,"abstract":"This clinical vignette is that of an 82-year-old woman who was admitted into a geriatrics unit in Nigeria, with acute heart failure and multiple decubitus ulcers. She was subsequently discharged against medical advice after 27 days on account of financial constraints and her children's inability to achieve a unified front for her care provision. The clinical scenario illustrates that medical presentation of disease may be a manifestation of elder mistreatment. It also highlights how discharge against medical advice may be the culmination of mistreatment of hospitalized older adults. We review the literature on types and important features of elder mistreatment and how it may be diagnosed in clinical settings. We also discuss challenges that clinicians in Nigeria may face in diagnosing and managing elder mistreatment as a result of a dearth of training in geriatrics and the absence of a national framework to tackle elder mistreatment.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"178 - 184"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42288288","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}
Alimelu Madireddi, V. Mandala, Narahari Bapanpally, Rakesh Kotha, K. Konda, R. Haripriya
Dengue is a Flavivirus, affecting about 100 million people annually and mainly in the tropical and subtropical countries. Neonatal dengue is uncommon and usually by vertical transmission or, in the postnatal period, by horizontal transmission. We describe the clinical profile, management and outcome of neonates with dengue infection. Ten patients were prospectively recruited from August to November 2019 during dengue epidemic season at Niloufer Hospital, Hyderabad, India. Four babies had vertical mode of transmission while 6 had horizontal mode of transmission. All babies were positive for Ns1 antigen and IgM dengue serology, confirming dengue infection. Fever, flushing and thrombocytopenia were observed in all the babies while 2 babies had hypotension requiring inotropes. Oxygen supplementation was required in 8 babies. There was no recorded mortality. We conclude that neonatal dengue should be considered as a differential diagnosis in a neonate with sepsis and thrombocytopenia especially in endemic regions. Judicious use of fluids (avoid excessive) and inotropes (dopamine) form the cornerstone of dengue management in neonates.
{"title":"Neonatal dengue as never before - A case series","authors":"Alimelu Madireddi, V. Mandala, Narahari Bapanpally, Rakesh Kotha, K. Konda, R. Haripriya","doi":"10.4103/smj.smj_41_20","DOIUrl":"https://doi.org/10.4103/smj.smj_41_20","url":null,"abstract":"Dengue is a Flavivirus, affecting about 100 million people annually and mainly in the tropical and subtropical countries. Neonatal dengue is uncommon and usually by vertical transmission or, in the postnatal period, by horizontal transmission. We describe the clinical profile, management and outcome of neonates with dengue infection. Ten patients were prospectively recruited from August to November 2019 during dengue epidemic season at Niloufer Hospital, Hyderabad, India. Four babies had vertical mode of transmission while 6 had horizontal mode of transmission. All babies were positive for Ns1 antigen and IgM dengue serology, confirming dengue infection. Fever, flushing and thrombocytopenia were observed in all the babies while 2 babies had hypotension requiring inotropes. Oxygen supplementation was required in 8 babies. There was no recorded mortality. We conclude that neonatal dengue should be considered as a differential diagnosis in a neonate with sepsis and thrombocytopenia especially in endemic regions. Judicious use of fluids (avoid excessive) and inotropes (dopamine) form the cornerstone of dengue management in neonates.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"140 - 144"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44933099","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: There has been a significant steady rise in the prevalence of cardiovascular disease (CVD) among Nigerian women within the last decade. The balance between pro-atherogenic particles and antiatherogenic particles has been markedly reflected in the apolipoprotein B/A1 ratio (Apo B/A1), and this ratio has been shown to be the strongest single lipoprotein-related cardiovascular risk factor. The cutoff value for the apo B/A1 ratio that defines high cardiovascular risk has been proposed to be 0.8 for women. This study is to determine the apo B/A1 ratio in apparently healthy Nigerian women and to evaluate the relationship of this ratio with other lipid indices. Methods: A total of 161 apparently healthy female adults between the ages of 30 and 66 years were selected for this study over a period of 6 months. Plasma total cholesterols (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) were measured using the enzymatic methods, whereas low-density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald formula. Apolipoprotein A1 and B were determined using immunoturbidimetry methods. Results: The mean of plasma apo B/A-I ratio in the studied participants was 0.68, with values ranging from 0.27 to 1.46. The percentage of participants with the apoB/apoA-I ratio exceeding 0.8 (the cutoff value for CVD risk) was 24.2%. The participants with apoB/apoA-I >0.8 were characterized by higher mean TC (216 mg/dl vs. 171 mg/dl; P < 0.001), TG (80 mg/dl vs. 66 mg/dl; P = 0.007), LDL-C (163 mg/dl vs. 120 mg/dl; P < 0.001), and lower HDL-C (36 mg/dl vs. 43 mg/dl; P < 0.001) compared with women with apoB/apoA-I < 0.8. Conclusion: This study has demonstrated that the women with apo B/A1 >0.8 have worse atherogenic lipid profile (high plasma TC, TG, low-density lipoprotein cholesterol, and low high-density cholesterol). It has also shown that only the apoB/A-I ratio correlates with other lipid markers; it should be considered as a potential useful tool in cardiovascular risk assessment in women. Its potential use in the national guideline for assessment and management of dyslipidemia will be invaluable.
{"title":"Apolipoprotein B/A1 ratio as a potential marker of cardiovascular risk in women","authors":"O. Ayoade, S. Essien, O. Sonuga","doi":"10.4103/smj.smj_62_20","DOIUrl":"https://doi.org/10.4103/smj.smj_62_20","url":null,"abstract":"Background: There has been a significant steady rise in the prevalence of cardiovascular disease (CVD) among Nigerian women within the last decade. The balance between pro-atherogenic particles and antiatherogenic particles has been markedly reflected in the apolipoprotein B/A1 ratio (Apo B/A1), and this ratio has been shown to be the strongest single lipoprotein-related cardiovascular risk factor. The cutoff value for the apo B/A1 ratio that defines high cardiovascular risk has been proposed to be 0.8 for women. This study is to determine the apo B/A1 ratio in apparently healthy Nigerian women and to evaluate the relationship of this ratio with other lipid indices. Methods: A total of 161 apparently healthy female adults between the ages of 30 and 66 years were selected for this study over a period of 6 months. Plasma total cholesterols (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) were measured using the enzymatic methods, whereas low-density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald formula. Apolipoprotein A1 and B were determined using immunoturbidimetry methods. Results: The mean of plasma apo B/A-I ratio in the studied participants was 0.68, with values ranging from 0.27 to 1.46. The percentage of participants with the apoB/apoA-I ratio exceeding 0.8 (the cutoff value for CVD risk) was 24.2%. The participants with apoB/apoA-I >0.8 were characterized by higher mean TC (216 mg/dl vs. 171 mg/dl; P < 0.001), TG (80 mg/dl vs. 66 mg/dl; P = 0.007), LDL-C (163 mg/dl vs. 120 mg/dl; P < 0.001), and lower HDL-C (36 mg/dl vs. 43 mg/dl; P < 0.001) compared with women with apoB/apoA-I < 0.8. Conclusion: This study has demonstrated that the women with apo B/A1 >0.8 have worse atherogenic lipid profile (high plasma TC, TG, low-density lipoprotein cholesterol, and low high-density cholesterol). It has also shown that only the apoB/A-I ratio correlates with other lipid markers; it should be considered as a potential useful tool in cardiovascular risk assessment in women. Its potential use in the national guideline for assessment and management of dyslipidemia will be invaluable.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"24 1","pages":"99 - 103"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417980","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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