Dextrocardia is a cardiac positional anomaly, in which the heart is located in the right hemithorax with its base to apex axis directed to the right and caudad. The malposition is intrinsic to the heart and not caused by extracardiac abnormalities. This is a 9-year-old Nigerian female child who was referred for plain radiograph of the chest on account of recurrent episodes of cough and upper respiratory tract symptoms. The chest and upper abdominal radiograph showed dextrocardia with a right placed heart and gastric fundal gas beneath the right diaphragm. Complimentary abdominal ultrasound showed displaced spleen and stomach to the right with the liver displaced to the left, confirming the diagnosis of dextrocardia with situs inversus.
{"title":"Dextrocardia with situs inversus: An incidental finding in a 9-year-old child","authors":"M. Sule, S. Ma'aji, S. Sa′idu, Amina M. B Shamaki","doi":"10.4103/smj.smj_13_20","DOIUrl":"https://doi.org/10.4103/smj.smj_13_20","url":null,"abstract":"Dextrocardia is a cardiac positional anomaly, in which the heart is located in the right hemithorax with its base to apex axis directed to the right and caudad. The malposition is intrinsic to the heart and not caused by extracardiac abnormalities. This is a 9-year-old Nigerian female child who was referred for plain radiograph of the chest on account of recurrent episodes of cough and upper respiratory tract symptoms. The chest and upper abdominal radiograph showed dextrocardia with a right placed heart and gastric fundal gas beneath the right diaphragm. Complimentary abdominal ultrasound showed displaced spleen and stomach to the right with the liver displaced to the left, confirming the diagnosis of dextrocardia with situs inversus.","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":"48512325","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}
S. Bello, E. Audu, I. Hassan, E. Abolodje, I. Bako
Background: Malaria manifests with life-threatening manifestations resulting in hospital admissions and sometimes death may ensue. This is more devastating among children due to high susceptibility resulting from impaired immune system following severe malaria. Human immunodeficiency virus (HIV) coinfection with malaria further compromises the immune system and increases the vulnerability. The effect of co-trimoxazole prophylaxis in curtailing malaria has not being well evaluated in our environment where both malaria and HIV are endemic. This study sets out to determine the magnitude of asymptomatic malaria among HIV-infected children and adolescents receiving care at our facility. Study Design: This was a descriptive cross-sectional study. Materials and Methods: A prospective study among HIV-infected children aged 2–18 years was enrolled in our care. Nonprobability convenience sampling was used to recruit individuals who fulfilled the criteria. Questionnaire and patients' medical records were used to gather some data. A sample was taken for malaria parasite microscopy. The analysis was done using the Statistical Package for the Social Sciences version 20. Categorical variables were presented as percentages and association assessed using Chi-square test, whereas continuous variables were presented as mean and standard deviation, and the association between two means was checked using Student's t-test. Results: The mean age of the study population is 7.02 ± 2.97 years. Of the 420 participants in this study, 92 (45.7%) had confirmed malaria. There was no significant difference in the gender, age groups, and viral loads of patients with malaria. Conclusion: There is a high prevalence of malaria coinfection with HIV in this study.
{"title":"Asymptomatic malaria parasitaemia among HIV infected children and adolescents","authors":"S. Bello, E. Audu, I. Hassan, E. Abolodje, I. Bako","doi":"10.4103/smj.smj_20_19","DOIUrl":"https://doi.org/10.4103/smj.smj_20_19","url":null,"abstract":"Background: Malaria manifests with life-threatening manifestations resulting in hospital admissions and sometimes death may ensue. This is more devastating among children due to high susceptibility resulting from impaired immune system following severe malaria. Human immunodeficiency virus (HIV) coinfection with malaria further compromises the immune system and increases the vulnerability. The effect of co-trimoxazole prophylaxis in curtailing malaria has not being well evaluated in our environment where both malaria and HIV are endemic. This study sets out to determine the magnitude of asymptomatic malaria among HIV-infected children and adolescents receiving care at our facility. Study Design: This was a descriptive cross-sectional study. Materials and Methods: A prospective study among HIV-infected children aged 2–18 years was enrolled in our care. Nonprobability convenience sampling was used to recruit individuals who fulfilled the criteria. Questionnaire and patients' medical records were used to gather some data. A sample was taken for malaria parasite microscopy. The analysis was done using the Statistical Package for the Social Sciences version 20. Categorical variables were presented as percentages and association assessed using Chi-square test, whereas continuous variables were presented as mean and standard deviation, and the association between two means was checked using Student's t-test. Results: The mean age of the study population is 7.02 ± 2.97 years. Of the 420 participants in this study, 92 (45.7%) had confirmed malaria. There was no significant difference in the gender, age groups, and viral loads of patients with malaria. Conclusion: There is a high prevalence of malaria coinfection with HIV in this study.","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":"48875441","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: Paravertebral block (PVB) is a regional anesthetic technique, in which a local anesthetic is injected into the thoracic PVS, resulting in ipsilateral somatic and sympathetic nerve blockade. Objectives: The present study aimed at observing the extent of thoracic paravertebral space (TPVS) at the levels of T1–2, T6–7, and T11–12 by measuring the horizontal and vertical spread of the dye in the Indian population. Materials and Methods: Methylene blue dye was injected into the TPVS at the levels of T1–2, T6–7, and T11–12 and its spread observed. Results: A total of 25 cadavers were studied. The extent of horizontal the spread was average of 83.0 mm at the level of T1–2, 103.0 mm at the level of T6–7, and 88.2 mm at the T11–12 level. The average vertical spread in the intercostal space at the level of T1–2 was found to 48.1 mm, at the level of T6–7 was found to be 44.6 mm, and at the level of T11–12 was found to be 55.04 mm. The maximum vertical spread of dye was over three intercostal spaces. Sixty-four percent of the cadavers studied showed a spread of dye from TPVS to lumbar paravertebral space. In 20% of the cadavers, a contralateral spread of injected dye was observed. The average depth of the needle to reach the TPVS was observed to be 36.8, 35.7, and 36.1 mm for T1–2, T6–7, and T11–12, respectively. Conclusions: A paravertebral block (PVB) has immense potential in regional anesthetic techniques involving thoracic and lumbar dermatomes. The present study will be helpful for surgeons and anesthesiologists to reduce uncertainties of the spread of anesthetic agents in thoracic PVB and its complications.
{"title":"A cadaveric study of thoracic paravertebral spaces from the point of view of paravertebral block","authors":"Moiz Dayer, V. Bharambe","doi":"10.4103/smj.smj_44_19","DOIUrl":"https://doi.org/10.4103/smj.smj_44_19","url":null,"abstract":"Background: Paravertebral block (PVB) is a regional anesthetic technique, in which a local anesthetic is injected into the thoracic PVS, resulting in ipsilateral somatic and sympathetic nerve blockade. Objectives: The present study aimed at observing the extent of thoracic paravertebral space (TPVS) at the levels of T1–2, T6–7, and T11–12 by measuring the horizontal and vertical spread of the dye in the Indian population. Materials and Methods: Methylene blue dye was injected into the TPVS at the levels of T1–2, T6–7, and T11–12 and its spread observed. Results: A total of 25 cadavers were studied. The extent of horizontal the spread was average of 83.0 mm at the level of T1–2, 103.0 mm at the level of T6–7, and 88.2 mm at the T11–12 level. The average vertical spread in the intercostal space at the level of T1–2 was found to 48.1 mm, at the level of T6–7 was found to be 44.6 mm, and at the level of T11–12 was found to be 55.04 mm. The maximum vertical spread of dye was over three intercostal spaces. Sixty-four percent of the cadavers studied showed a spread of dye from TPVS to lumbar paravertebral space. In 20% of the cadavers, a contralateral spread of injected dye was observed. The average depth of the needle to reach the TPVS was observed to be 36.8, 35.7, and 36.1 mm for T1–2, T6–7, and T11–12, respectively. Conclusions: A paravertebral block (PVB) has immense potential in regional anesthetic techniques involving thoracic and lumbar dermatomes. The present study will be helpful for surgeons and anesthesiologists to reduce uncertainties of the spread of anesthetic agents in thoracic PVB and its complications.","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":"47346467","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: Foreign bodies (FBs) in the ear, nose, and throat are frequently encountered clinical entities among the children. These ear, nose, and throat FBs are often seen by pediatricians, primary care physicians, and otolaryngologists. Aim of the Study: The objective of this study is to analyze various types of FBs in the ear, nose, and throat among children and its clinical profile with its treatment in the pediatric age group. Materials and Methods: This descriptive retrospective study was carried out at a tertiary care teaching hospital. During 10-year period from April 2010 to May 2020, 452 pediatric patients with FB in the ear, nose, and throat were managed. The clinical profile and management of these children were analyzed. The clinical data were collected from the admission charts and clinic tickets. Results: In this study, the majority of the FBs were found in the nasal cavity, which constitutes 30.53%, whereas 28.31% found in the external auditory canal, 11.72% in the pharynx, 13.49% in the esophagus and 15.72% in laryngotracheobronchial (LTB) tract. The age ranges from 0 to 16 years, with a mean age was 7.21 years. The majority of the ear, nose, and throat FBs were found in the age group of 0–5 years. Out of the 452 cases, 243 (53.76%) were removed under general anesthesia. Vegetable seed was the most common FB in the nose. Coin was the most common FB in the esophagus, whereas vegetable seeds were the most common FB found in the bronchus. The open safety pin is a hazardous LTB FB. Conclusion: FBs in the ear, nose, and throat of children are common. The accurate diagnosis and treatment of the FBs in the pediatric age is often challenging. These FBs can be associated with significant morbidity and complications if not removed immediately.
{"title":"Foreign bodies in the ear, nose, and throat of children - A 10 years' experiences at a tertiary care teaching hospital","authors":"S. Swain, I. Behera, Bulu Nahak","doi":"10.4103/smj.smj_65_20","DOIUrl":"https://doi.org/10.4103/smj.smj_65_20","url":null,"abstract":"Background: Foreign bodies (FBs) in the ear, nose, and throat are frequently encountered clinical entities among the children. These ear, nose, and throat FBs are often seen by pediatricians, primary care physicians, and otolaryngologists. Aim of the Study: The objective of this study is to analyze various types of FBs in the ear, nose, and throat among children and its clinical profile with its treatment in the pediatric age group. Materials and Methods: This descriptive retrospective study was carried out at a tertiary care teaching hospital. During 10-year period from April 2010 to May 2020, 452 pediatric patients with FB in the ear, nose, and throat were managed. The clinical profile and management of these children were analyzed. The clinical data were collected from the admission charts and clinic tickets. Results: In this study, the majority of the FBs were found in the nasal cavity, which constitutes 30.53%, whereas 28.31% found in the external auditory canal, 11.72% in the pharynx, 13.49% in the esophagus and 15.72% in laryngotracheobronchial (LTB) tract. The age ranges from 0 to 16 years, with a mean age was 7.21 years. The majority of the ear, nose, and throat FBs were found in the age group of 0–5 years. Out of the 452 cases, 243 (53.76%) were removed under general anesthesia. Vegetable seed was the most common FB in the nose. Coin was the most common FB in the esophagus, whereas vegetable seeds were the most common FB found in the bronchus. The open safety pin is a hazardous LTB FB. Conclusion: FBs in the ear, nose, and throat of children are common. The accurate diagnosis and treatment of the FBs in the pediatric age is often challenging. These FBs can be associated with significant morbidity and complications if not removed immediately.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45154464","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: Polycystic ovarian syndrome (PCOS) is a frequently encountered endocrine disorders in women of the reproductive age. Various studies conclude there is no uniform correlation between the phenotypes of the PCOS and serum anti-Mullerian Hormone (AMH) levels. Aim and Objective: The objective of the study to estimate the association between different phenotypes of PCOS and the serum AMH level. Materials and Methods: This was a cross-sectional analytical study which included sixty subjects with PCOS according to Rotterdam's criteria. After procuring the detailed history, clinically examination and ultrasound scan subjects were classified into one of the phenotypes of PCOS. Auto-analyzer was used to measure serum AMH levels and was correlated with the various phenotypes of PCOS. Results: The study group categorized 28 patients under phenotype D, which was a predominant form. Serum AMH mean was 6.1 (±3.2) ng/ml. The mean serum AMH levels for phenotype A was 7.5 ± 3.0 ng/ml which was higher than the other phenotypes. Phenotype A had high mean body mass index which was significant ( 29.1 ±6.6) kg/m2 (P = 0.046). Phenotype B had significantly higher Hirsutism score 19.8 (±1.7). Phenotype A had significantly higher mean follicular count (19.7 ± 5.1). The difference of mean or median among the phenotypes was compared using Kruskal–Wallis test or ANOVA. P < 0.05 was considered as statistically significant. Conclusion: A positive correlation was seen between the serum AMH levels and the phenotypes of the PCOS. Thus, AMH levels can be used as an adjunct tool in the diagnosis and monitoring of PCOS.
{"title":"Correlation of phenotypes of polycystic ovarian syndrome with anti-Müllerian hormone levels","authors":"R. Santhiya, S. Habeebullah, S. Ghose","doi":"10.4103/smj.smj_50_20","DOIUrl":"https://doi.org/10.4103/smj.smj_50_20","url":null,"abstract":"Background: Polycystic ovarian syndrome (PCOS) is a frequently encountered endocrine disorders in women of the reproductive age. Various studies conclude there is no uniform correlation between the phenotypes of the PCOS and serum anti-Mullerian Hormone (AMH) levels. Aim and Objective: The objective of the study to estimate the association between different phenotypes of PCOS and the serum AMH level. Materials and Methods: This was a cross-sectional analytical study which included sixty subjects with PCOS according to Rotterdam's criteria. After procuring the detailed history, clinically examination and ultrasound scan subjects were classified into one of the phenotypes of PCOS. Auto-analyzer was used to measure serum AMH levels and was correlated with the various phenotypes of PCOS. Results: The study group categorized 28 patients under phenotype D, which was a predominant form. Serum AMH mean was 6.1 (±3.2) ng/ml. The mean serum AMH levels for phenotype A was 7.5 ± 3.0 ng/ml which was higher than the other phenotypes. Phenotype A had high mean body mass index which was significant ( 29.1 ±6.6) kg/m2 (P = 0.046). Phenotype B had significantly higher Hirsutism score 19.8 (±1.7). Phenotype A had significantly higher mean follicular count (19.7 ± 5.1). The difference of mean or median among the phenotypes was compared using Kruskal–Wallis test or ANOVA. P < 0.05 was considered as statistically significant. Conclusion: A positive correlation was seen between the serum AMH levels and the phenotypes of the PCOS. Thus, AMH levels can be used as an adjunct tool in the diagnosis and monitoring of PCOS.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43581978","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: Acne vulgaris is a common dermatological disease which affects a wide range of ages; however, it occurs more in the adolescent years with its attendant psychosocial effects. Aim: The aim of the study was to determine the prevalence and psychosocial effects of acne vulgaris among secondary school students in Egor Local Government Area, Benin City, South–South Nigeria. Materials and Methods: Four hundred and ten students (263 females and 147 males) from two secondary schools were enrolled in this descriptive cross-sectional study using a simple random sampling technique. A structured open- and close-ended interviewer-administered questionnaire was used and each student was examined and a clinical diagnosis was made by a dermatologist. Data were analyzed using the IBM SPSS Version 20 and P < 0.05 was set for statistical significance. Results: The overall prevalence of acne vulgaris was 37.3% with a slightly higher prevalence in females (37.6%) than in males (36.7%). A higher percentage of acne was observed among students in the private school (51.4%) compared to those in public school (32.2%). An increased prevalence (41.2%) was also observed in the higher age group (15–19 years) compared to (35.8%) in the 10–14 years age group. Psychological disorder was found in 170 (41.5%) respondents. The type of school (P < 0.001), class of student (P < 0.014), depression (P < 0.004), anxiety (P < 0.015), worry (P < 0.001), fear (P < 0.001), and anger (P < 0.001) were found to be statistically associated with acne vulgaris. Similarly, the type of school (P < 0.007) and marriage type of parents (P < 0.001) were found to be statistically associated with psychological disorder. Conclusion: School health education about this condition is imperative in order to significantly reduce its psychosocial effects.
{"title":"Prevalence and psychosocial effects of acne vulgaris among secondary school students","authors":"B. Okwara, A. Ofili, E. Effiong, Uhunoma Ekhator","doi":"10.4103/smj.smj_32_20","DOIUrl":"https://doi.org/10.4103/smj.smj_32_20","url":null,"abstract":"Background: Acne vulgaris is a common dermatological disease which affects a wide range of ages; however, it occurs more in the adolescent years with its attendant psychosocial effects. Aim: The aim of the study was to determine the prevalence and psychosocial effects of acne vulgaris among secondary school students in Egor Local Government Area, Benin City, South–South Nigeria. Materials and Methods: Four hundred and ten students (263 females and 147 males) from two secondary schools were enrolled in this descriptive cross-sectional study using a simple random sampling technique. A structured open- and close-ended interviewer-administered questionnaire was used and each student was examined and a clinical diagnosis was made by a dermatologist. Data were analyzed using the IBM SPSS Version 20 and P < 0.05 was set for statistical significance. Results: The overall prevalence of acne vulgaris was 37.3% with a slightly higher prevalence in females (37.6%) than in males (36.7%). A higher percentage of acne was observed among students in the private school (51.4%) compared to those in public school (32.2%). An increased prevalence (41.2%) was also observed in the higher age group (15–19 years) compared to (35.8%) in the 10–14 years age group. Psychological disorder was found in 170 (41.5%) respondents. The type of school (P < 0.001), class of student (P < 0.014), depression (P < 0.004), anxiety (P < 0.015), worry (P < 0.001), fear (P < 0.001), and anger (P < 0.001) were found to be statistically associated with acne vulgaris. Similarly, the type of school (P < 0.007) and marriage type of parents (P < 0.001) were found to be statistically associated with psychological disorder. Conclusion: School health education about this condition is imperative in order to significantly reduce its psychosocial effects.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44717755","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: Feeding a newborn infant with his or her mother's breast milk only or from a wet nurse without giving other liquids up to the age of 6 months is called exclusive breastfeeding (EBF). The promotion of EBF for the first 6 months of infant's life is the most effective way to reduce morbidity and mortality, especially in low- and medium-income countries. Despite several efforts to promote EBF, its practice has remained poor in many Sub-Saharan African countries including Nigeria. EBF practice is to a large extent influenced by the maternal knowledge and attitudes as well as sociodemographic and cultural factors. Objective: To determine the knowledge, acceptance, and practice of EBF among caregivers in Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: This was a cross-sectional, descriptive study involving mothers who were currently breastfeeding at the time of the study or who had stopped breastfeeding not later than 2 years. Questionnaires were administered to breastfeeding mothers or fathers who knew the breastfeeding attitude of their wives during visits to the outpatient unit or immunization clinic. The age, sex, educational status, occupation, awareness, understanding of EBF, acceptance, practice, and benefits of EBF, and distance from health facility were explored from the caregivers. Results: Two hundred and seventy caregivers were studied of which 30 (11.1%) were male and 240 (88.9%) were female. The male-to-female ratio was 1:8 and the age ranges from 19 to 60 years with a mean of 29.4 and standard deviation of ±7.36. Majority of the caregivers (134, 49.6%) had tertiary level of education, while 79 (29.3%) had secondary education. Majority of the caregivers had good awareness and perception of EBF (77% and 51.5%, respectively). The EBF practice rate among the respondents was 68.52%. Caregivers with tertiary and secondary levels of education had good awareness and perception of EBF (χ2 = 48.628, P = 0.000; and χ2 = 49.106, P = 0.000, respectively). They also had good acceptance and practice of EBF (χ2 = 35.897, P = 0.000; and (χ2 = 17.999, P = 0.001, respectively). There were more awareness and perception of EBF among health workers and teachers (χ2 = 33.972, P = 0.000; and (χ2 = 12.925, P = 0.005, respectively). They also accepted and practiced EBF significantly (χ2 = 16.867, P = 0.001; and χ2 = 16.736, P = 0.001). Proximity to health facility had a significant impact on awareness, acceptance, and practice of EBF by the caregivers (χ2 = 17.391, P = 0.002; χ2 = 14.263, P = 0.007; and χ2 = 9.802, P = 0.044, respectively). Conclusion: Educational level, occupation, and proximity to health facility have positive impact on awareness, perception, acceptance, and practice of EBF among caregivers in Kano. Therefore, there is need to educate and empower women and make health facilities accessible to them to support, promote, and protect EBF in our communities.
{"title":"The knowledge, acceptance, and practice of exclusive breastfeeding among caregivers seen in a pediatric outpatient department and immunization clinic","authors":"A. Mohammed, I. Aliyu","doi":"10.4103/smj.smj_28_20","DOIUrl":"https://doi.org/10.4103/smj.smj_28_20","url":null,"abstract":"Background: Feeding a newborn infant with his or her mother's breast milk only or from a wet nurse without giving other liquids up to the age of 6 months is called exclusive breastfeeding (EBF). The promotion of EBF for the first 6 months of infant's life is the most effective way to reduce morbidity and mortality, especially in low- and medium-income countries. Despite several efforts to promote EBF, its practice has remained poor in many Sub-Saharan African countries including Nigeria. EBF practice is to a large extent influenced by the maternal knowledge and attitudes as well as sociodemographic and cultural factors. Objective: To determine the knowledge, acceptance, and practice of EBF among caregivers in Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: This was a cross-sectional, descriptive study involving mothers who were currently breastfeeding at the time of the study or who had stopped breastfeeding not later than 2 years. Questionnaires were administered to breastfeeding mothers or fathers who knew the breastfeeding attitude of their wives during visits to the outpatient unit or immunization clinic. The age, sex, educational status, occupation, awareness, understanding of EBF, acceptance, practice, and benefits of EBF, and distance from health facility were explored from the caregivers. Results: Two hundred and seventy caregivers were studied of which 30 (11.1%) were male and 240 (88.9%) were female. The male-to-female ratio was 1:8 and the age ranges from 19 to 60 years with a mean of 29.4 and standard deviation of ±7.36. Majority of the caregivers (134, 49.6%) had tertiary level of education, while 79 (29.3%) had secondary education. Majority of the caregivers had good awareness and perception of EBF (77% and 51.5%, respectively). The EBF practice rate among the respondents was 68.52%. Caregivers with tertiary and secondary levels of education had good awareness and perception of EBF (χ2 = 48.628, P = 0.000; and χ2 = 49.106, P = 0.000, respectively). They also had good acceptance and practice of EBF (χ2 = 35.897, P = 0.000; and (χ2 = 17.999, P = 0.001, respectively). There were more awareness and perception of EBF among health workers and teachers (χ2 = 33.972, P = 0.000; and (χ2 = 12.925, P = 0.005, respectively). They also accepted and practiced EBF significantly (χ2 = 16.867, P = 0.001; and χ2 = 16.736, P = 0.001). Proximity to health facility had a significant impact on awareness, acceptance, and practice of EBF by the caregivers (χ2 = 17.391, P = 0.002; χ2 = 14.263, P = 0.007; and χ2 = 9.802, P = 0.044, respectively). Conclusion: Educational level, occupation, and proximity to health facility have positive impact on awareness, perception, acceptance, and practice of EBF among caregivers in Kano. Therefore, there is need to educate and empower women and make health facilities accessible to them to support, promote, and protect EBF in our communities.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48303226","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. Aminu, I. Daneji, M. Yusuf, R. Jalo, F. Tsiga-Ahmed, M. Yahaya, A. Adamu, Yahaya Yaqub, F. Dayyab, C. Edwin, Sadiq Garba, G. Gadzama
Background: Globally, intensive care units (ICUs) are encountering emergence and spread of antibiotic-resistant pathogens, and for some pathogens, there are few therapeutic options available. Objectives: The study assessed prevalence, susceptibility pattern, and risk factors of carbapenem-resistant Enterobacteriaceae (CRE) infections among ICU patients in Kano, Nigeria. Materials and Methods: A descriptive cross-sectional study was used to study 190 patients admitted to the ICUs of two tertiary hospitals in Kano. Antibiotic susceptibility of isolated organisms was determined by disc diffusion technique. Suspected carbapenemase producers were further subjected to the modified Hodge test (MHT) method for confirmation. Results: A total of 76 out of the 190 samples yielded clinical isolates of Enterobacteriaceae as follows: 34 (44.7%) Escherichia coli, 19 (25%) Klebsiella pneumoniae, 3 (3.9%) Proteus mirabilis, 4 (5.3%) Enterobacter aerogenes, 3 (3.9%) Proteus vulgaris, 2 (2.6%) Citrobacter freundii, 2 (2.6%) Klebsiella ozaenae, 2 (2.6%) Klebsiella oxytoca, 2 (2.6%) Salmonella subsp. 3b, 2 (2.6%) Enterobacter agglomerans, 2 (2.6%) Enterobacter cloacae, and 1 (1.3%) Serratia odorifera. Screening the Enterobacteriaceae-positive samples for carbapenem resistance using ertapenem disc (10 μg) showed 8 samples (10.5%) as resistant while MHT gave a carbapenem resistance prevalence of 7.9% (6 out of 76). Based on multiplex polymerase chain reaction; the distributions of genotypes of the carbapenemase producers were as follows: Verona Integron Metallo-beta-lactamase (VIM) genes only (4 [50%]) New Delhi Metallo-beta-lactamase (NDM) genes only (2 [25%]), and 1 (12.5%) had Klebsiella pneumoniae carbapenemase (KPC) and VIM gene coexisting. Surgical procedure (P = 0.009) and history of recent admission (P = 0.001) were found to be risk factors for CRE. Conclusion: The study provided evidence of the presence of CRE infections among patients admitted to ICUs in the study centers. This underscores the need for effective infection prevention and control measures to avoid the spread of CRE in hospital setting.
{"title":"Carbapenem-resistant Enterobacteriaceae infections among patients admitted to intensive care units in Kano, Nigeria","authors":"A. Aminu, I. Daneji, M. Yusuf, R. Jalo, F. Tsiga-Ahmed, M. Yahaya, A. Adamu, Yahaya Yaqub, F. Dayyab, C. Edwin, Sadiq Garba, G. Gadzama","doi":"10.4103/smj.smj_14_20","DOIUrl":"https://doi.org/10.4103/smj.smj_14_20","url":null,"abstract":"Background: Globally, intensive care units (ICUs) are encountering emergence and spread of antibiotic-resistant pathogens, and for some pathogens, there are few therapeutic options available. Objectives: The study assessed prevalence, susceptibility pattern, and risk factors of carbapenem-resistant Enterobacteriaceae (CRE) infections among ICU patients in Kano, Nigeria. Materials and Methods: A descriptive cross-sectional study was used to study 190 patients admitted to the ICUs of two tertiary hospitals in Kano. Antibiotic susceptibility of isolated organisms was determined by disc diffusion technique. Suspected carbapenemase producers were further subjected to the modified Hodge test (MHT) method for confirmation. Results: A total of 76 out of the 190 samples yielded clinical isolates of Enterobacteriaceae as follows: 34 (44.7%) Escherichia coli, 19 (25%) Klebsiella pneumoniae, 3 (3.9%) Proteus mirabilis, 4 (5.3%) Enterobacter aerogenes, 3 (3.9%) Proteus vulgaris, 2 (2.6%) Citrobacter freundii, 2 (2.6%) Klebsiella ozaenae, 2 (2.6%) Klebsiella oxytoca, 2 (2.6%) Salmonella subsp. 3b, 2 (2.6%) Enterobacter agglomerans, 2 (2.6%) Enterobacter cloacae, and 1 (1.3%) Serratia odorifera. Screening the Enterobacteriaceae-positive samples for carbapenem resistance using ertapenem disc (10 μg) showed 8 samples (10.5%) as resistant while MHT gave a carbapenem resistance prevalence of 7.9% (6 out of 76). Based on multiplex polymerase chain reaction; the distributions of genotypes of the carbapenemase producers were as follows: Verona Integron Metallo-beta-lactamase (VIM) genes only (4 [50%]) New Delhi Metallo-beta-lactamase (NDM) genes only (2 [25%]), and 1 (12.5%) had Klebsiella pneumoniae carbapenemase (KPC) and VIM gene coexisting. Surgical procedure (P = 0.009) and history of recent admission (P = 0.001) were found to be risk factors for CRE. Conclusion: The study provided evidence of the presence of CRE infections among patients admitted to ICUs in the study centers. This underscores the need for effective infection prevention and control measures to avoid the spread of CRE in hospital setting.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41447874","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}
Perineal injuries are uncommon. More uncommon are severe perineal injuries. This is attributed to the relative protection of the perineum by the bony pelvis. Common causes of perineal injury include injuries from motor vehicular accidents, fall from height, foreign body insertion into the perineum, injuries from rape, and penetrating external trauma. The management of severe perineal injury entails addressing any life-threatening condition in the patient first and, subsequently, the perineal injury. The perineal injury can be repaired primarily with or without colostomy or colostomy carried out alone without primary repair. We present four cases of severe perineal injury managed by colostomy alone without primary repair of perineal soft tissue or anal sphincters. The anal sphincters and perineal soft tissues healed secondarily and sealed without any need for repair with good outcome.
{"title":"Management of severe iatrogenic perineal injury: A case series","authors":"N. Nwashilli, Alexander I. Arekhandia","doi":"10.4103/smj.smj_58_20","DOIUrl":"https://doi.org/10.4103/smj.smj_58_20","url":null,"abstract":"Perineal injuries are uncommon. More uncommon are severe perineal injuries. This is attributed to the relative protection of the perineum by the bony pelvis. Common causes of perineal injury include injuries from motor vehicular accidents, fall from height, foreign body insertion into the perineum, injuries from rape, and penetrating external trauma. The management of severe perineal injury entails addressing any life-threatening condition in the patient first and, subsequently, the perineal injury. The perineal injury can be repaired primarily with or without colostomy or colostomy carried out alone without primary repair. We present four cases of severe perineal injury managed by colostomy alone without primary repair of perineal soft tissue or anal sphincters. The anal sphincters and perineal soft tissues healed secondarily and sealed without any need for repair with good outcome.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49395805","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}
Osita Ezenwosu, B. Chukwu, I. Ndu, N. Uwaezuoke, Ifeyinwa L Ezenwosu, I. Udorah, A. Ikefuna, I. Emodi
Introduction: Majority of Nigerians are not aware of their personal genotype, and the knowledge about sickle cell disease is quite low. We hypothesize that health education will improve the knowledge and awareness of sickle cell genotype among adolescents. This study aimed to determine the effect of health education on knowledge and awareness of sickle cell genotype among adolescents. Materials and Methods: Adolescent students of Federal Government College were recruited, and necessary data on sociodemography, knowledge, and awareness of sickle cell were obtained through a pretested sickle cell knowledge assessment questionnaire. Following health education, the same questionnaire was re-administered to the participants for assessment of any change in knowledge. Results: Majority (58.1%) of the respondents heard about sickle cell during lessons in class, while mass media was the next common source (16.5%) of knowledge and awareness. Following health education, there was an improvement in all the specific knowledge questions, especially the prevalence of sickle cell trait in Nigeria (28.1% vs. 75.2%) and the probability of carrier couple having a child with sickle cell anemia (SCA) (10.3% vs. 48.2%). There was a statistically significant increase in mean knowledge score (t = −14.203, P < 0.001), as well as a significant increase in high knowledge level (χ2 = 105.13, P < 0.001) after education. Conclusion: Health education improved the knowledge and awareness of sickle cell among adolescents in secondary schools, especially the chances of having children with SCA in carrier couples. Inculcating health education on sickle cell in secondary school curriculum will help in informed decision on marriage and birth, ultimately reducing the birth of children with SCA.
{"title":"Effect of health education on knowledge and awareness of sickle cell disease among adolescents","authors":"Osita Ezenwosu, B. Chukwu, I. Ndu, N. Uwaezuoke, Ifeyinwa L Ezenwosu, I. Udorah, A. Ikefuna, I. Emodi","doi":"10.4103/smj.smj_9_20","DOIUrl":"https://doi.org/10.4103/smj.smj_9_20","url":null,"abstract":"Introduction: Majority of Nigerians are not aware of their personal genotype, and the knowledge about sickle cell disease is quite low. We hypothesize that health education will improve the knowledge and awareness of sickle cell genotype among adolescents. This study aimed to determine the effect of health education on knowledge and awareness of sickle cell genotype among adolescents. Materials and Methods: Adolescent students of Federal Government College were recruited, and necessary data on sociodemography, knowledge, and awareness of sickle cell were obtained through a pretested sickle cell knowledge assessment questionnaire. Following health education, the same questionnaire was re-administered to the participants for assessment of any change in knowledge. Results: Majority (58.1%) of the respondents heard about sickle cell during lessons in class, while mass media was the next common source (16.5%) of knowledge and awareness. Following health education, there was an improvement in all the specific knowledge questions, especially the prevalence of sickle cell trait in Nigeria (28.1% vs. 75.2%) and the probability of carrier couple having a child with sickle cell anemia (SCA) (10.3% vs. 48.2%). There was a statistically significant increase in mean knowledge score (t = −14.203, P < 0.001), as well as a significant increase in high knowledge level (χ2 = 105.13, P < 0.001) after education. Conclusion: Health education improved the knowledge and awareness of sickle cell among adolescents in secondary schools, especially the chances of having children with SCA in carrier couples. Inculcating health education on sickle cell in secondary school curriculum will help in informed decision on marriage and birth, ultimately reducing the birth of children with SCA.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41462621","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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