I. Mohammed, J. Ahmad, Tunde Nurein, Naseer Ishaq, I. Aliyu
Background: Patent ductus arteriosus (PDA) is quite a common acyanotic congenital heart disease (CHD). Its ligation in Sub-Saharan Africa is challenging due to lack of adequate cardiothoracic surgeons. We, therefore, present our experience and our challenges in our center with limited resources. Objectives: To determine the challenges and outcome of surgical ligation of PDA in our center. Methods: This was a retrospective review of all PDA ligations done from January 2012 to December 2017. Data were extracted from the operation theater register and patients files. Information such as age, sex, symptoms at presentation, intraoperative findings, and outcome of surgery were analyzed. Discordances between echocardiography and intraoperative finding of PDA were noticed in only two cases, and these were excluded from the study because PDA was not seen intraoperatively and they were referred for further evaluation. Statistical Package for the Social Sciences version 16 was used for data entry and analysis. Results: Twenty-five patients had PDA ligation during the study period; the subjects comprised 17 females and 8 males with a male-to-female ratio of 1:2. Two adult cases were recorded. Three cases had other associated CHD. All surgeries were carried out successfully and only a single case of complication was reported (4%, chylothorax). Conclusion: PDA ligation is relatively safe if properly done with successful outcome.
{"title":"Management of patients with patent ductus arteriosus: Challenges and outcome in low-resource settings","authors":"I. Mohammed, J. Ahmad, Tunde Nurein, Naseer Ishaq, I. Aliyu","doi":"10.4103/smj.smj_66_20","DOIUrl":"https://doi.org/10.4103/smj.smj_66_20","url":null,"abstract":"Background: Patent ductus arteriosus (PDA) is quite a common acyanotic congenital heart disease (CHD). Its ligation in Sub-Saharan Africa is challenging due to lack of adequate cardiothoracic surgeons. We, therefore, present our experience and our challenges in our center with limited resources. Objectives: To determine the challenges and outcome of surgical ligation of PDA in our center. Methods: This was a retrospective review of all PDA ligations done from January 2012 to December 2017. Data were extracted from the operation theater register and patients files. Information such as age, sex, symptoms at presentation, intraoperative findings, and outcome of surgery were analyzed. Discordances between echocardiography and intraoperative finding of PDA were noticed in only two cases, and these were excluded from the study because PDA was not seen intraoperatively and they were referred for further evaluation. Statistical Package for the Social Sciences version 16 was used for data entry and analysis. Results: Twenty-five patients had PDA ligation during the study period; the subjects comprised 17 females and 8 males with a male-to-female ratio of 1:2. Two adult cases were recorded. Three cases had other associated CHD. All surgeries were carried out successfully and only a single case of complication was reported (4%, chylothorax). Conclusion: PDA ligation is relatively safe if properly done with successful outcome.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48512695","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: Mortality audit is in developing countries is sparse despite its importance in guiding decision-making toward reversing the present high death rate. Objective: The study aims to study the profile of in-hospital mortality in a Nigerian hospital. Materials and Methods: This is a retrospective review of the records of all in-hospital mortalities at Delta State University Teaching Hospital, Nigeria, from 2016 to 2018. Information extracted from the records included age, sex, year, and cause of death. The causes were further classified with Global Burden of Disease 2017 classification. Analysis was with SPSS version 21. Results: A total of 1044 mortalities were recorded during the 3-year period, giving a mortality rate of 12.6%, with a male to female ratio of 1.3:1 and a mean age of 42.36 ± 25.23. The peak fatality were in early neonatal and 50–54 years of age group accounting for 96 (9.1%) and 87 (8.3%) cases, respectively. Communicable, maternal and nutritional diseases, noncommunicable diseases and injuries accounted for 276 (26.4%), 642 (61.5%), and 126 (12.1%) fatalities, respectively. The leading causes of fatality are stoke (17.1%), road injuries (7.7%), neonatal disorders (7.6%), HIV/AIDS (6.0%), chronic kidney disease (5.7%), diabetes mellitus (4.6%), chronic liver disease (4.4%), maternal disorders (2.6%), upper digestive system diseases (2.3%), and breast cancer (2.3%). Conclusion: The mortality pattern show male predominance, peak at neonatal period and preponderance of noncommunicable diseases, road injury and HIV/AIDS-related deaths. Increased government funding, universal health coverage, public education, and lifestyle modification are paramount to reducing mortality.
{"title":"Disease mortality audit in a Nigerian tertiary care center","authors":"O. Uchendu","doi":"10.4103/smj.smj_51_19","DOIUrl":"https://doi.org/10.4103/smj.smj_51_19","url":null,"abstract":"Background: Mortality audit is in developing countries is sparse despite its importance in guiding decision-making toward reversing the present high death rate. Objective: The study aims to study the profile of in-hospital mortality in a Nigerian hospital. Materials and Methods: This is a retrospective review of the records of all in-hospital mortalities at Delta State University Teaching Hospital, Nigeria, from 2016 to 2018. Information extracted from the records included age, sex, year, and cause of death. The causes were further classified with Global Burden of Disease 2017 classification. Analysis was with SPSS version 21. Results: A total of 1044 mortalities were recorded during the 3-year period, giving a mortality rate of 12.6%, with a male to female ratio of 1.3:1 and a mean age of 42.36 ± 25.23. The peak fatality were in early neonatal and 50–54 years of age group accounting for 96 (9.1%) and 87 (8.3%) cases, respectively. Communicable, maternal and nutritional diseases, noncommunicable diseases and injuries accounted for 276 (26.4%), 642 (61.5%), and 126 (12.1%) fatalities, respectively. The leading causes of fatality are stoke (17.1%), road injuries (7.7%), neonatal disorders (7.6%), HIV/AIDS (6.0%), chronic kidney disease (5.7%), diabetes mellitus (4.6%), chronic liver disease (4.4%), maternal disorders (2.6%), upper digestive system diseases (2.3%), and breast cancer (2.3%). Conclusion: The mortality pattern show male predominance, peak at neonatal period and preponderance of noncommunicable diseases, road injury and HIV/AIDS-related deaths. Increased government funding, universal health coverage, public education, and lifestyle modification are paramount to reducing mortality.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41938968","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: Interns who would be the future doctors are not being observed for communication skills at their workplace. The Mini-clinical evaluation exercise (mini-CEX) can be used as a “Work Place Based Assessment” (WPBA) tool for the assessment of the communication skills of the interns and also for giving immediate feedback. This study was done to evaluate the acceptability, feasibility, and effectiveness of mini-CEX for improving the communication skills of interns in Pediatrics. Materials and Methods: It was a prospective interventional study which was conducted in the Department of Pediatrics. Forty interns and six faculty who volunteered participated in the mini-CEX encounters. The structured assessment mini-CEX form by the American Board of Internal Medicine was used. Each intern faced six assessment sessions on mini-CEX forms with each of the faculty. At the end of the internship rotation, the perceptions of the interns and faculty were gathered by an anonymous validated questionnaire containing both close-ended (using 5-point Likert scale) and open-ended questions. Statistical Analysis Used: The descriptive data were analyzed on the Statistical Package for the Social Sciences (SPSS) version 23. also done. Qualitative data of open-ended questions were done by thematic analysis. Results: Most interns (87.5%) and all faculty (100%) felt that mini-CEX helped them in achieving good communication skills. Comparison between the 1st and the 6th encounter of mini-CEX showed an increase in the mean score values for all skill competencies, and this improvement was statistically significant (P < 0.001). Conclusions: Mini-CEX is an acceptable, feasible, and effective WPBA tool for communication skills training of interns in pediatrics.
{"title":"Assessment of communication skills of interns in pediatrics using mini-clinical evaluation exercise","authors":"Bindu Nair, V. Negi, A. Prakash","doi":"10.4103/smj.smj_56_20","DOIUrl":"https://doi.org/10.4103/smj.smj_56_20","url":null,"abstract":"Background: Interns who would be the future doctors are not being observed for communication skills at their workplace. The Mini-clinical evaluation exercise (mini-CEX) can be used as a “Work Place Based Assessment” (WPBA) tool for the assessment of the communication skills of the interns and also for giving immediate feedback. This study was done to evaluate the acceptability, feasibility, and effectiveness of mini-CEX for improving the communication skills of interns in Pediatrics. Materials and Methods: It was a prospective interventional study which was conducted in the Department of Pediatrics. Forty interns and six faculty who volunteered participated in the mini-CEX encounters. The structured assessment mini-CEX form by the American Board of Internal Medicine was used. Each intern faced six assessment sessions on mini-CEX forms with each of the faculty. At the end of the internship rotation, the perceptions of the interns and faculty were gathered by an anonymous validated questionnaire containing both close-ended (using 5-point Likert scale) and open-ended questions. Statistical Analysis Used: The descriptive data were analyzed on the Statistical Package for the Social Sciences (SPSS) version 23. also done. Qualitative data of open-ended questions were done by thematic analysis. Results: Most interns (87.5%) and all faculty (100%) felt that mini-CEX helped them in achieving good communication skills. Comparison between the 1st and the 6th encounter of mini-CEX showed an increase in the mean score values for all skill competencies, and this improvement was statistically significant (P < 0.001). Conclusions: Mini-CEX is an acceptable, feasible, and effective WPBA tool for communication skills training of interns in pediatrics.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42588034","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: Fine-needle aspiration cytology (FNAC), a cheap screening technique, has helped reduce the diagnostic turnaround time of palpable swellings from different anatomical sites. In light of the technique increasingly being used as a definitive diagnostic tool, it is thus important to evaluate its accuracy in making specific diagnosis beyond just being a screening tool. Objective: To determine the concordance rate between cytological and histological diagnosis Materials and Methods: Cytology and corresponding histology reports for lesions from patients with maxillofacial, lymph node, and abdominal swellings, where both were available, were compared for the concordance of specific cytological diagnosis with final histological diagnosis. Results: In the 10-year (2006–2015) studied, there were 177 complete cases in which specific diagnoses were made on cytology; of these, 135 (75.3%) were in concordance with histological diagnoses. Concordance for intra-abdominal, maxillofacial, and lymph node aspirates was 90.2%, 85.5%, and 62.9%, respectively. Cytological concordance of specific diagnosis for benign and malignant lesions was 70.7% and 79.5%, respectively. Concordances for lymphomas, carcinomas, and sarcomas were 84.1%, 68.2%, and 66.7%, respectively. The specific cytologic diagnosis was enhanced by preaspirate ultrasound scan while the absence of immunocytochemistry hampered accuracy in specific diagnosis of nodal non-Hodgkin's and Hodgkin's lymphoma (66.7% and 42.9%), respectively. Conclusion: This study concludes that FNAC is a simple technique with fairly reliable utility in proffering specific diagnosis on suitable lesions. However, in developing countries where repertoire of antibodies for immunocytochemistry may be limited, the accuracy will be improved by good clinical history and preaspirate ultrasound where necessary.
{"title":"Study on concordance of specific cytological diagnosis with histology in a teaching hospital","authors":"A. Atanda, Ramat Faro-Tella","doi":"10.4103/smj.smj_63_17","DOIUrl":"https://doi.org/10.4103/smj.smj_63_17","url":null,"abstract":"Background: Fine-needle aspiration cytology (FNAC), a cheap screening technique, has helped reduce the diagnostic turnaround time of palpable swellings from different anatomical sites. In light of the technique increasingly being used as a definitive diagnostic tool, it is thus important to evaluate its accuracy in making specific diagnosis beyond just being a screening tool. Objective: To determine the concordance rate between cytological and histological diagnosis Materials and Methods: Cytology and corresponding histology reports for lesions from patients with maxillofacial, lymph node, and abdominal swellings, where both were available, were compared for the concordance of specific cytological diagnosis with final histological diagnosis. Results: In the 10-year (2006–2015) studied, there were 177 complete cases in which specific diagnoses were made on cytology; of these, 135 (75.3%) were in concordance with histological diagnoses. Concordance for intra-abdominal, maxillofacial, and lymph node aspirates was 90.2%, 85.5%, and 62.9%, respectively. Cytological concordance of specific diagnosis for benign and malignant lesions was 70.7% and 79.5%, respectively. Concordances for lymphomas, carcinomas, and sarcomas were 84.1%, 68.2%, and 66.7%, respectively. The specific cytologic diagnosis was enhanced by preaspirate ultrasound scan while the absence of immunocytochemistry hampered accuracy in specific diagnosis of nodal non-Hodgkin's and Hodgkin's lymphoma (66.7% and 42.9%), respectively. Conclusion: This study concludes that FNAC is a simple technique with fairly reliable utility in proffering specific diagnosis on suitable lesions. However, in developing countries where repertoire of antibodies for immunocytochemistry may be limited, the accuracy will be improved by good clinical history and preaspirate ultrasound where necessary.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41805390","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}
I. Aliyu, H. Ibrahim, Umma Idris, H. Akhiwu, U. Ibrahim, I. Mohammed, G. Michael
Background: Severe malaria is a major public health challenge and a leading cause of morbidity and mortality in tropical countries. Severe malaria is defined as life-threatening manifestation in the presence of asexual forms of Plasmodium falciparum in the peripheral blood; it is also caused by Plasmodium vivax and Plasmodium knowlesi. Materials and Methods: This was a 2-year point retrospective review of cases of severe malaria seen in the Emergency Pediatric Unit of Federal Medical Centre, Birnin Kudu, Jigawa state, between August and November, for each of the years 2016 and 2017. Results: Two hundred and fifty-seven cases of severe malaria were recorded during the study period: 106 (41.2%) cases in 2016 and 151 (58.8%) cases in 2017. There were 156 (60.7%) males and 101 (39.3%) females with a male-to-female ratio of 1.5:1. Their ages ranged from 0.3 to 14.0 years, with a mean age of 4.4 ± 3.6 years. Prostration was the most common form of severe disease; this was followed by multiple convulsion and severe malarial anemia. The year 2017 recorded more cases of severe malaria in all the age groups and majority of the cases were 5 years and below; and these observations were statistically significant for those with hypoglycemia (χ2 = 9.834, df = 2, P = 0.007) and hyperparasitemia (χ2 = 6.226, df = 2, P = 0.044). Majority of the subjects fitted with more than one form of severe malaria; most had two to three combinations. This observation was also statistically significant (χ2 = 12.950, df = 6, P = 0.042). Conclusion: Severe malaria remains a huge strain on the health system; prostration, multiple convulsion, and severe malaria anemia are the most common forms.
{"title":"A review of presentations and outcome of severe malaria in a tertiary hospital in northwestern Nigeria","authors":"I. Aliyu, H. Ibrahim, Umma Idris, H. Akhiwu, U. Ibrahim, I. Mohammed, G. Michael","doi":"10.4103/smj.smj_44_20","DOIUrl":"https://doi.org/10.4103/smj.smj_44_20","url":null,"abstract":"Background: Severe malaria is a major public health challenge and a leading cause of morbidity and mortality in tropical countries. Severe malaria is defined as life-threatening manifestation in the presence of asexual forms of Plasmodium falciparum in the peripheral blood; it is also caused by Plasmodium vivax and Plasmodium knowlesi. Materials and Methods: This was a 2-year point retrospective review of cases of severe malaria seen in the Emergency Pediatric Unit of Federal Medical Centre, Birnin Kudu, Jigawa state, between August and November, for each of the years 2016 and 2017. Results: Two hundred and fifty-seven cases of severe malaria were recorded during the study period: 106 (41.2%) cases in 2016 and 151 (58.8%) cases in 2017. There were 156 (60.7%) males and 101 (39.3%) females with a male-to-female ratio of 1.5:1. Their ages ranged from 0.3 to 14.0 years, with a mean age of 4.4 ± 3.6 years. Prostration was the most common form of severe disease; this was followed by multiple convulsion and severe malarial anemia. The year 2017 recorded more cases of severe malaria in all the age groups and majority of the cases were 5 years and below; and these observations were statistically significant for those with hypoglycemia (χ2 = 9.834, df = 2, P = 0.007) and hyperparasitemia (χ2 = 6.226, df = 2, P = 0.044). Majority of the subjects fitted with more than one form of severe malaria; most had two to three combinations. This observation was also statistically significant (χ2 = 12.950, df = 6, P = 0.042). Conclusion: Severe malaria remains a huge strain on the health system; prostration, multiple convulsion, and severe malaria anemia are the most common forms.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42052660","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: Many women who need caesarian section in most sub Saharan Africa do not get it or do so too late, thereby resulting in an unnecessary increase in maternal and perinatal adverse outcome. Refusal of caesarian section has been attributed to poverty and sociocultural factors. Objective: The objective of the study was to determine the level of acceptance of repeat cesarean section (CS) among pregnant women attending care in a government-funded health facility with a policy of free maternity care services. Materials and Methods: This cross-sectional study surveyed 157 consecutive consenting antenatal clinic clients with previous CS presenting for booking in Central Hospital, Agbor, Delta State, Nigeria. The women completed a questionnaire with sections on sociodemographic attributes, inquiry about previous CS outcome and associated factors, a desire to accept a repeat CS if clinically indicated in index pregnancy, as well as reasons to decline a repeat CS. Results: The acceptance rate of repeat CS was 54%. Women with two or more previous CS were more likely to accept repeat CS (71.8% vs. 48.3%, prevalence ratio: 1.5; P = 0.02). There was no sociodemographic variable or any event related to the previous CS which was significantly associated with the women's choice regarding repeat CS. The rejection of repeat CS was mainly due to concerns about postoperative pain and being tagged with “failure of womanhood.” Conclusions: The level of acceptance of repeat CS in Central Hospital, Agbor, is low despite the policy of free maternity care. Along with the increasing effort to make health care affordable, attention needs to be paid to the role of patient and community engagement in the form of health education and continuous counseling to address noncost barriers to achieving improved maternal and perinatal health indices.
{"title":"Acceptance of repeat cesarean section and its determinants among a Nigerian pregnant women population","authors":"R. Maduka, N. Enaruna","doi":"10.4103/smj.smj_4_20","DOIUrl":"https://doi.org/10.4103/smj.smj_4_20","url":null,"abstract":"Background: Many women who need caesarian section in most sub Saharan Africa do not get it or do so too late, thereby resulting in an unnecessary increase in maternal and perinatal adverse outcome. Refusal of caesarian section has been attributed to poverty and sociocultural factors. Objective: The objective of the study was to determine the level of acceptance of repeat cesarean section (CS) among pregnant women attending care in a government-funded health facility with a policy of free maternity care services. Materials and Methods: This cross-sectional study surveyed 157 consecutive consenting antenatal clinic clients with previous CS presenting for booking in Central Hospital, Agbor, Delta State, Nigeria. The women completed a questionnaire with sections on sociodemographic attributes, inquiry about previous CS outcome and associated factors, a desire to accept a repeat CS if clinically indicated in index pregnancy, as well as reasons to decline a repeat CS. Results: The acceptance rate of repeat CS was 54%. Women with two or more previous CS were more likely to accept repeat CS (71.8% vs. 48.3%, prevalence ratio: 1.5; P = 0.02). There was no sociodemographic variable or any event related to the previous CS which was significantly associated with the women's choice regarding repeat CS. The rejection of repeat CS was mainly due to concerns about postoperative pain and being tagged with “failure of womanhood.” Conclusions: The level of acceptance of repeat CS in Central Hospital, Agbor, is low despite the policy of free maternity care. Along with the increasing effort to make health care affordable, attention needs to be paid to the role of patient and community engagement in the form of health education and continuous counseling to address noncost barriers to achieving improved maternal and perinatal health indices.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47345197","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}
P. Ibinaiye, S. Olarinoye-Akorede, Suleiman Sa'ad, N. Tahir, A. Usman, A. Ali-gombe, Sani Garko, Dahiru M Yunsa, Timothy Y Umoru, B. Usman, A. Umar
Background: Despite current availability of highly active antiretroviral therapy (HAART) in our hospital, neurologic complications of HIV are common. Aim: The aim of this study was to document brain computed tomography (CT) findings in HIV patients receiving HAART who developed neurological complications and to examine the relationship of these findings with CD4 cell counts. Materials and Methods: Twenty patients with central nervous system symptoms out of 200 HIV/AIDS patients receiving HAART at the HIV Clinic of Federal Teaching Hospital, Gombe, were retrospectively studied. The findings were reviewed alongside their clinical features, CD4 + count, and HAART history. Results: CT findings were positive in 12 (60%) of the patients, while no abnormality was seen in 8 (40%). The most common brain abnormality was atrophy (35%). Two out of five patients (40%) with CD4 counts >200 had abnormal CT findings compared with 9 out of 14 patients (64%) with CD4 counts <200 cells who had CT abnormalities. This finding was statistically significant (R = 0.864, P = 0.00). Conclusion: There is high incidence of neurological complications and positive brain CT scan among the patients who defaulted from HAART treatment and with CD4 cell counts of <200 cells/microliter.
{"title":"Computerized tomographic brain findings of CNS manifestations in HIV/AIDS patients receiving HAARTS treatment","authors":"P. Ibinaiye, S. Olarinoye-Akorede, Suleiman Sa'ad, N. Tahir, A. Usman, A. Ali-gombe, Sani Garko, Dahiru M Yunsa, Timothy Y Umoru, B. Usman, A. Umar","doi":"10.4103/smj.smj_68_17","DOIUrl":"https://doi.org/10.4103/smj.smj_68_17","url":null,"abstract":"Background: Despite current availability of highly active antiretroviral therapy (HAART) in our hospital, neurologic complications of HIV are common. Aim: The aim of this study was to document brain computed tomography (CT) findings in HIV patients receiving HAART who developed neurological complications and to examine the relationship of these findings with CD4 cell counts. Materials and Methods: Twenty patients with central nervous system symptoms out of 200 HIV/AIDS patients receiving HAART at the HIV Clinic of Federal Teaching Hospital, Gombe, were retrospectively studied. The findings were reviewed alongside their clinical features, CD4 + count, and HAART history. Results: CT findings were positive in 12 (60%) of the patients, while no abnormality was seen in 8 (40%). The most common brain abnormality was atrophy (35%). Two out of five patients (40%) with CD4 counts >200 had abnormal CT findings compared with 9 out of 14 patients (64%) with CD4 counts <200 cells who had CT abnormalities. This finding was statistically significant (R = 0.864, P = 0.00). Conclusion: There is high incidence of neurological complications and positive brain CT scan among the patients who defaulted from HAART treatment and with CD4 cell counts of <200 cells/microliter.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45610939","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}
Tetanus is a vaccine-preventable disease caused by a potent neurotoxin released following infection with the obligate anaerobic bacterium, Clostridium tetani. Of the four clinical forms of the disease, generalized tetanus accounts for the most common form of the disease. This is a case report of localized tetanus involving the thigh muscles in a 12-year unimmunized girl following a wound sustained around the right groin area initially thought to be an acetabular fracture. The child had antibiotics, antitetanus serum, sedatives, and wound care. She was unable to have full treatment because of parental decision to seek traditional treatment at home. The case is reported because of the rarity of localized tetanus, the diagnostic dilemma presented by the case, and the cultural interplay and understanding of the disease process by the patient/caregivers. It is also reported to highlight the gap in routine immunization and the need for booster doses in this age group.
{"title":"Localized tetanus: A case report","authors":"Mamman Aliyu, Lawson Amagiya, Z. Abdullahi","doi":"10.4103/smj.smj_133_20","DOIUrl":"https://doi.org/10.4103/smj.smj_133_20","url":null,"abstract":"Tetanus is a vaccine-preventable disease caused by a potent neurotoxin released following infection with the obligate anaerobic bacterium, Clostridium tetani. Of the four clinical forms of the disease, generalized tetanus accounts for the most common form of the disease. This is a case report of localized tetanus involving the thigh muscles in a 12-year unimmunized girl following a wound sustained around the right groin area initially thought to be an acetabular fracture. The child had antibiotics, antitetanus serum, sedatives, and wound care. She was unable to have full treatment because of parental decision to seek traditional treatment at home. The case is reported because of the rarity of localized tetanus, the diagnostic dilemma presented by the case, and the cultural interplay and understanding of the disease process by the patient/caregivers. It is also reported to highlight the gap in routine immunization and the need for booster doses in this age group.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49344303","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}
M. Tolani, Muhammed Ahmed, B. Hamza, M. Muhammad, A. Bello, H. Maitama
Background: Due to the invasive nature of prostate biopsy, it is associated with various complications. The study aimed to determine the association of local anesthetic method and prostate volume with the occurrence of these prostate biopsy complications. Materials and Methods: It was a prospective study carried out in 106 patients with indications for prostate biopsy. They were randomized into two equal groups receiving either intrarectal lidocaine gel or periprostatic nerve block. Prostate volume was determined using transrectal ultrasound, and patients were further divided into three prostate volume classes (20-40 ml, 40-100 ml, and ≥100 ml). Systematic sextant prostate biopsy was done, and the occurrence of complications (pain, bleeding, infection, and urinary retention) was documented. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. Results: The pain scores of patients were similar irrespective of their prostate volume even with the use of different types of anesthesia. There was no significant tendency for the occurrence of bleeding, infection, and voiding complications when periprostatic nerve block or intrarectal lidocaine gel was used for pain relief. Postbiopsy cystourethritis was, however, significantly associated with the volume of the prostate (P = 0.006). Conclusion: The choice of local anesthesia does not affect the occurrence of complications following transrectal prostate biopsy. There is, however, a significant potential for the development of postbiopsy cystourethritis in patients with larger prostates.
{"title":"Association of local anesthetic method and prostate volume with the occurrence of prostate biopsy complications","authors":"M. Tolani, Muhammed Ahmed, B. Hamza, M. Muhammad, A. Bello, H. Maitama","doi":"10.4103/smj.smj_23_20","DOIUrl":"https://doi.org/10.4103/smj.smj_23_20","url":null,"abstract":"Background: Due to the invasive nature of prostate biopsy, it is associated with various complications. The study aimed to determine the association of local anesthetic method and prostate volume with the occurrence of these prostate biopsy complications. Materials and Methods: It was a prospective study carried out in 106 patients with indications for prostate biopsy. They were randomized into two equal groups receiving either intrarectal lidocaine gel or periprostatic nerve block. Prostate volume was determined using transrectal ultrasound, and patients were further divided into three prostate volume classes (20-40 ml, 40-100 ml, and ≥100 ml). Systematic sextant prostate biopsy was done, and the occurrence of complications (pain, bleeding, infection, and urinary retention) was documented. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. Results: The pain scores of patients were similar irrespective of their prostate volume even with the use of different types of anesthesia. There was no significant tendency for the occurrence of bleeding, infection, and voiding complications when periprostatic nerve block or intrarectal lidocaine gel was used for pain relief. Postbiopsy cystourethritis was, however, significantly associated with the volume of the prostate (P = 0.006). Conclusion: The choice of local anesthesia does not affect the occurrence of complications following transrectal prostate biopsy. There is, however, a significant potential for the development of postbiopsy cystourethritis in patients with larger prostates.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44623694","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. Salawu, G. Ibraheem, J. Mejabi, C. Nwosu, B. Ahmed, A. Suleiman, O. Babalola
Limb gangrene is a common orthopedic emergency in this part of the world, but neonatal limb gangrene is a rare pathology. Sepsis is a common complication of limb gangrene which can lead to mortality if not managed early. Here is a case of left leg gangrene in a 16-day-old female neonate following the application of local cosmetic agent ("lele") by the mother prior to naming ceremony. The patient presented with features of septicemia; she was resuscitated, and left below-knee amputation was done for her. Harmful and unnecessary cosmetics should be avoided in neonates.
{"title":"Neonatal lower limb gangrene: Effect of local cosmetic agent","authors":"O. Salawu, G. Ibraheem, J. Mejabi, C. Nwosu, B. Ahmed, A. Suleiman, O. Babalola","doi":"10.4103/smj.smj_2_20","DOIUrl":"https://doi.org/10.4103/smj.smj_2_20","url":null,"abstract":"Limb gangrene is a common orthopedic emergency in this part of the world, but neonatal limb gangrene is a rare pathology. Sepsis is a common complication of limb gangrene which can lead to mortality if not managed early. Here is a case of left leg gangrene in a 16-day-old female neonate following the application of local cosmetic agent (\"lele\") by the mother prior to naming ceremony. The patient presented with features of septicemia; she was resuscitated, and left below-knee amputation was done for her. Harmful and unnecessary cosmetics should be avoided in neonates.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46611649","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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