Background: Having an audit of common otorhinolaryngological diseases diagnosed on computed tomography (CT) scan in our environment is important as it will help elucidate the sociodemographics and pattern of referral for CT scan from an ear, nose, and throat (ENT) clinic as well as CT findings. Materials and Methods: The request forms as well as the CT scan reports of 203 patients who were referred from the ENT clinic between 2006 and 2014 and had CT scan were retrieved from our records. All CT scans were done using a four-slice BrightSpeed helical GE CT scan machine. Out of the 214 patients recruited for this study, only 203 patients were unanimously agreed upon by the authors as the remaining 11 patients had incomplete data. Results: There were 124 males (61.1%) and 79 females (38.9%). The mean age of patients with nasopharyngeal tumor was 40.67 ± 26.01 years, laryngeal tumor was 57.47 ± 15.64 years, antrochoanal carcinoma was 46.05 ± 22.95 years, and sinusitis was 44.96 ± 17.19 years, while that of otitis media was 43.33 ± 23.60 years. A total of 177 patients representing 87.2% of the study population had one or two pathological findings on CT scan. Sinusitis accounted for most findings on CT scan (12.8%), followed by laryngeal tumor (10.7%) and antrochoanal carcinoma (10.2%). Others were choanal polyp (9.7%), nasopharyngeal tumors (9.2%), rhinitis (6.1%), mastoiditis (5.1%), and mucocele of the sinuses (4.6%). Juvenile angiofibroma (1.0%) and palatal masses (1.0%) were the least in terms of occurrence of all ENT conditions. Conclusion: Common findings on CT scan of the ENT in our environment have been documented.
{"title":"Computed tomographic scan utilization in the diagnosis of otorhinolaryngological diseases","authors":"F. Ehigiamusoe, E. Obi-Egbedi-Ejakpovi","doi":"10.4103/smj.smj_47_19","DOIUrl":"https://doi.org/10.4103/smj.smj_47_19","url":null,"abstract":"Background: Having an audit of common otorhinolaryngological diseases diagnosed on computed tomography (CT) scan in our environment is important as it will help elucidate the sociodemographics and pattern of referral for CT scan from an ear, nose, and throat (ENT) clinic as well as CT findings. Materials and Methods: The request forms as well as the CT scan reports of 203 patients who were referred from the ENT clinic between 2006 and 2014 and had CT scan were retrieved from our records. All CT scans were done using a four-slice BrightSpeed helical GE CT scan machine. Out of the 214 patients recruited for this study, only 203 patients were unanimously agreed upon by the authors as the remaining 11 patients had incomplete data. Results: There were 124 males (61.1%) and 79 females (38.9%). The mean age of patients with nasopharyngeal tumor was 40.67 ± 26.01 years, laryngeal tumor was 57.47 ± 15.64 years, antrochoanal carcinoma was 46.05 ± 22.95 years, and sinusitis was 44.96 ± 17.19 years, while that of otitis media was 43.33 ± 23.60 years. A total of 177 patients representing 87.2% of the study population had one or two pathological findings on CT scan. Sinusitis accounted for most findings on CT scan (12.8%), followed by laryngeal tumor (10.7%) and antrochoanal carcinoma (10.2%). Others were choanal polyp (9.7%), nasopharyngeal tumors (9.2%), rhinitis (6.1%), mastoiditis (5.1%), and mucocele of the sinuses (4.6%). Juvenile angiofibroma (1.0%) and palatal masses (1.0%) were the least in terms of occurrence of all ENT conditions. Conclusion: Common findings on CT scan of the ENT in our environment have been documented.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44873372","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}
C. Igboanusi, A. Nmadu, I. Joshua, M. Onoja-Alexander, B. Olatubosun
Background: Neonatal jaundice (NNJ) is a common cause of hospitalization in the 1st week of life and a significant cause of neonatal morbidity and mortality worldwide. Objectives: The aim of this study was to assess the knowledge and attitude related to NNJ among women of reproductive age group in Basawa community, Zaria, Nigeria. Materials and Methods: The cross-sectional descriptive study was carried out in January 2017 among mothers aged 15–49 years. One hundred and seventy-two structured, pretested, interviewer-administered questionnaires were used to collect data. Data were analyzed using SPSS software version 21. Results were presented in tables and charts. Results: The mean age of respondents was 34 ± 6.98 years; 158 (92%) of them were aware of NNJ and predominant sources of information from relatives (35%) and hospital (33.1%). Ninety-one percent had poor knowledge of NNJ. Only 76 (46%) and 36 (21%) respondents, respectively, identified infection and breast milk as causes of NNJ. Complications of NNJ mentioned included serious illness (56.4%) and disability (21.5%). Majority of respondents (106, 62%) had poor attitude to NNJ. About 132 (77%) believed that NNJ had an effect on neonates and was curable while only 66 (38%) believed that health education during antenatal care was a preventive measure for NNJ. A statistically significant association was found between income and level of knowledge of respondents about NNJ (P = 0.043). Conclusion: This study highlighted inadequate knowledge, poor attitude, and misconceptions about NNJ. It underscores the importance of health education programs and campaigns in addressing the gaps in knowledge.
{"title":"Knowledge and attitude on neonatal jaundice among women of reproductive age group in rural community in northern Nigeria","authors":"C. Igboanusi, A. Nmadu, I. Joshua, M. Onoja-Alexander, B. Olatubosun","doi":"10.4103/smj.smj_43_18","DOIUrl":"https://doi.org/10.4103/smj.smj_43_18","url":null,"abstract":"Background: Neonatal jaundice (NNJ) is a common cause of hospitalization in the 1st week of life and a significant cause of neonatal morbidity and mortality worldwide. Objectives: The aim of this study was to assess the knowledge and attitude related to NNJ among women of reproductive age group in Basawa community, Zaria, Nigeria. Materials and Methods: The cross-sectional descriptive study was carried out in January 2017 among mothers aged 15–49 years. One hundred and seventy-two structured, pretested, interviewer-administered questionnaires were used to collect data. Data were analyzed using SPSS software version 21. Results were presented in tables and charts. Results: The mean age of respondents was 34 ± 6.98 years; 158 (92%) of them were aware of NNJ and predominant sources of information from relatives (35%) and hospital (33.1%). Ninety-one percent had poor knowledge of NNJ. Only 76 (46%) and 36 (21%) respondents, respectively, identified infection and breast milk as causes of NNJ. Complications of NNJ mentioned included serious illness (56.4%) and disability (21.5%). Majority of respondents (106, 62%) had poor attitude to NNJ. About 132 (77%) believed that NNJ had an effect on neonates and was curable while only 66 (38%) believed that health education during antenatal care was a preventive measure for NNJ. A statistically significant association was found between income and level of knowledge of respondents about NNJ (P = 0.043). Conclusion: This study highlighted inadequate knowledge, poor attitude, and misconceptions about NNJ. It underscores the importance of health education programs and campaigns in addressing the gaps in knowledge.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46973848","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}
Objective: The objective of this work was to determine the histological pattern of soft-tissue tumors diagnosed in our hospital and compare findings with those of other places. Background: A comprehensive record of the pattern of histologically diagnosed tumors is a fundamental requirement for good cancer screening policies, effective therapeutic decisions, and developing a regional cancer registry. The objective of this work was to determine the histological pattern of soft-tissue tumors diagnosed in our hospital and compare findings with those of other places. Materials and Methods: A retrospective audit of soft-tissue samples submitted in the histopathology laboratory of a tertiary hospital in Makurdi, North Central Nigeria, was carried out. Results: One hundred and eighty-eight soft-tissue tumors were diagnosed in the study period, and they had a male: female ratio of 1:1.2, with a mean age of 35.05 ± 18.9 years, and the most frequent occurrence in the fourth decade. Benign tumors were more common, 67.0% (n = 126), than malignant ones, 33.0% (n = 62). Lipoma accounted for the largest proportion of the tumors accounting for 38.9% (n = 49) of benign and 26.1% (n = 49/188) of all the soft-tissue tumors. Embryonal rhabdomyosarcoma was the most frequent malignant tumor, with peak occurrence in the first decade, and comprised 25.8% (16/62) of the malignant soft-tissue tumors and 8.5% (n = 16/188) of all soft-tissue tumors. Kaposi sarcoma, a tumor of intermediate malignancy, consisted of 24.2% (n = 15/62) of the malignant soft-tissue tumors. The remaining malignant soft-tissue tumors found in this study included pleomorphic rhabdomyosarcoma, alveolar rhabdomyosarcoma, liposarcoma, angiosarcoma, pleomorphic sarcoma, malignant fibrous histiocytoma, and hemangiopericytoma. Conclusion: Lipoma was the single most common soft-tissue tumor. Half of all the malignant tumors consisted of embryonal rhabdomyosarcomas, most frequent first decade of life, and Kaposi sarcoma, a tumor of intermediate malignancy.
{"title":"Histological spectrum of soft-tissue tumors in a tertiary hospital","authors":"R. Vhriterhire, J. Ngbea, I. Akpor","doi":"10.4103/smj.smj_39_19","DOIUrl":"https://doi.org/10.4103/smj.smj_39_19","url":null,"abstract":"Objective: The objective of this work was to determine the histological pattern of soft-tissue tumors diagnosed in our hospital and compare findings with those of other places. Background: A comprehensive record of the pattern of histologically diagnosed tumors is a fundamental requirement for good cancer screening policies, effective therapeutic decisions, and developing a regional cancer registry. The objective of this work was to determine the histological pattern of soft-tissue tumors diagnosed in our hospital and compare findings with those of other places. Materials and Methods: A retrospective audit of soft-tissue samples submitted in the histopathology laboratory of a tertiary hospital in Makurdi, North Central Nigeria, was carried out. Results: One hundred and eighty-eight soft-tissue tumors were diagnosed in the study period, and they had a male: female ratio of 1:1.2, with a mean age of 35.05 ± 18.9 years, and the most frequent occurrence in the fourth decade. Benign tumors were more common, 67.0% (n = 126), than malignant ones, 33.0% (n = 62). Lipoma accounted for the largest proportion of the tumors accounting for 38.9% (n = 49) of benign and 26.1% (n = 49/188) of all the soft-tissue tumors. Embryonal rhabdomyosarcoma was the most frequent malignant tumor, with peak occurrence in the first decade, and comprised 25.8% (16/62) of the malignant soft-tissue tumors and 8.5% (n = 16/188) of all soft-tissue tumors. Kaposi sarcoma, a tumor of intermediate malignancy, consisted of 24.2% (n = 15/62) of the malignant soft-tissue tumors. The remaining malignant soft-tissue tumors found in this study included pleomorphic rhabdomyosarcoma, alveolar rhabdomyosarcoma, liposarcoma, angiosarcoma, pleomorphic sarcoma, malignant fibrous histiocytoma, and hemangiopericytoma. Conclusion: Lipoma was the single most common soft-tissue tumor. Half of all the malignant tumors consisted of embryonal rhabdomyosarcomas, most frequent first decade of life, and Kaposi sarcoma, a tumor of intermediate malignancy.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42143232","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: Intrauterine contraceptive device (IUCD) placement during cesarean section has been shown to be a safe and effective method of contraception with very low complication and disuse following insertion. Its practice can be of immense benefit, especially in developing countries like Nigeria where high unmet needs for contraception and increasing cesarean section rates are prevalent. Objective: The objective of this study is to evaluate the practice of obstetricians and trainees on counseling and insertion of IUCD during cesarean section. Materials and Methods: A questionnaire-based cross-sectional study was conducted among obstetricians and trainees at the 49th Annual Scientific Conference of the Society of Gynecology and Obstetrics of Nigeria held in November 2015. The data were analyzed using the SPSS version 20. Results: Of 150 respondents, 134 returned completed questionnaires, giving a response rate of 89.3%, 130 of these were adjudged to be correctly filled and were analyzed. Majority of the respondents, 97 (74.6%), were consultants. The mean age of the respondents was 42.01 years ± 7.00. About 95% (125) of the respondents admitted performing cesarean sections, but only 13 (10%) had ever inserted IUCD during cesarean operations. Counseling for the procedure was also low, as only 35 (26.9%) of the respondents had ever counseled the clients toward IUCD placement at cesarean section. Conclusion: For counseling and practice of insertion of IUCD at cesarean section is very low among Nigerian obstetricians, revealing a major barrier to clients' access to this effective and safe method of contraception. Advocacy, education, and training of this category of health-care providers are necessary for improved contraceptive access to cesarean section clients.
{"title":"Intraoperative insertion of intrauterine contraceptive device at cesarean section: A survey on the experiences of trainee and practicing obstetricians","authors":"Tokunbo Adeoye, A. Koledade, O. Shittu","doi":"10.4103/smj.smj_52_18","DOIUrl":"https://doi.org/10.4103/smj.smj_52_18","url":null,"abstract":"Background: Intrauterine contraceptive device (IUCD) placement during cesarean section has been shown to be a safe and effective method of contraception with very low complication and disuse following insertion. Its practice can be of immense benefit, especially in developing countries like Nigeria where high unmet needs for contraception and increasing cesarean section rates are prevalent. Objective: The objective of this study is to evaluate the practice of obstetricians and trainees on counseling and insertion of IUCD during cesarean section. Materials and Methods: A questionnaire-based cross-sectional study was conducted among obstetricians and trainees at the 49th Annual Scientific Conference of the Society of Gynecology and Obstetrics of Nigeria held in November 2015. The data were analyzed using the SPSS version 20. Results: Of 150 respondents, 134 returned completed questionnaires, giving a response rate of 89.3%, 130 of these were adjudged to be correctly filled and were analyzed. Majority of the respondents, 97 (74.6%), were consultants. The mean age of the respondents was 42.01 years ± 7.00. About 95% (125) of the respondents admitted performing cesarean sections, but only 13 (10%) had ever inserted IUCD during cesarean operations. Counseling for the procedure was also low, as only 35 (26.9%) of the respondents had ever counseled the clients toward IUCD placement at cesarean section. Conclusion: For counseling and practice of insertion of IUCD at cesarean section is very low among Nigerian obstetricians, revealing a major barrier to clients' access to this effective and safe method of contraception. Advocacy, education, and training of this category of health-care providers are necessary for improved contraceptive access to cesarean section clients.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49410625","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: Delay in seeking medical care is common and constitutes a major unresolved public health problem. It could contribute immensely to maternal mortality, especially in developing countries, where access and availability of functional health-care facility have remained a challenge. Objective: This study aimed at identifying the forms of delays encountered by pregnant women seeking antenatal care (ANC) services and also factors responsible for such delays. Materials and Methods: This was a cross-sectional study among women attending antenatal care clinic of our hospital. Data were obtained through an interviewer-administered questionnaire and were analyzed by the Statistical Package for the Social Sciences version 17. Results: The mean age of the respondents was 28.6 (standard deviation [SD] ± 5.44) years. About a third (31.5%) experienced Type II delays due to inaccessibility to the mode of transportation and traffic deadlock; while majority (77.1%) experienced intrahospital delays due to delay in retrieving cases notes, seeing an obstetrician, inadequate health personnel, and consulting rooms. The average waiting time was 3.1 ± 0.91 SD hours (188 min). The waiting time was not statistically associated with time of arrival to the clinic. Conclusion: Most women experience intrahospital delays while seeking ANC. Intervention by policymakers and adequate staffing coupled with provision of necessary health-care amenities will go a long way in reducing patients waiting time.
{"title":"Delays in accessing antenatal care services in a developing nation tertiary health center","authors":"N. Adamou, Saeed Abdul, U. Umar","doi":"10.4103/smj.smj_15_19","DOIUrl":"https://doi.org/10.4103/smj.smj_15_19","url":null,"abstract":"Background: Delay in seeking medical care is common and constitutes a major unresolved public health problem. It could contribute immensely to maternal mortality, especially in developing countries, where access and availability of functional health-care facility have remained a challenge. Objective: This study aimed at identifying the forms of delays encountered by pregnant women seeking antenatal care (ANC) services and also factors responsible for such delays. Materials and Methods: This was a cross-sectional study among women attending antenatal care clinic of our hospital. Data were obtained through an interviewer-administered questionnaire and were analyzed by the Statistical Package for the Social Sciences version 17. Results: The mean age of the respondents was 28.6 (standard deviation [SD] ± 5.44) years. About a third (31.5%) experienced Type II delays due to inaccessibility to the mode of transportation and traffic deadlock; while majority (77.1%) experienced intrahospital delays due to delay in retrieving cases notes, seeing an obstetrician, inadequate health personnel, and consulting rooms. The average waiting time was 3.1 ± 0.91 SD hours (188 min). The waiting time was not statistically associated with time of arrival to the clinic. Conclusion: Most women experience intrahospital delays while seeking ANC. Intervention by policymakers and adequate staffing coupled with provision of necessary health-care amenities will go a long way in reducing patients waiting time.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46041657","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: Coronavirus disease-19 (COVID-19) is a potentially lethal infection caused by severe acute respiratory syndrome. Pregnancy is a state of partial immune suppression, which makes pregnant women more vulnerable to viral infections. COVID-19 pandemic presents many challenges in when it coexists with pregnancy in resource-poor countries with background ignorance and deficient health infrastructure. Materials and Methods: A literature search for studies on COVID-19 was performed using Google Scholar search database, PubMed, Medline, and ScienceDirect. The bibliographies of included studies were also searched for additional references. About 85 articles were identified. Twenty-five articles were considered suitable for review. Results: An extensive review of management of COVID-19 in pregnancy and challenges confronting its management in resource-poor countries was presented. These challenges included poor health infrastructure, poor testing capacity, and nonadherence or impracticable preventive measures including physical distancing, hand hygiene, inadequate personal protective equipment, and stigmatization. Specific challenges related to pregnancy were availability of blood and blood products, labor management, operative deliveries, and postdelivery management. Conclusions: Current evidence suggests that its pathogenesis, clinical manifestations, and management are influenced by pregnancy. The outcomes of pregnancy and COVID-19 are negatively influenced by similar problems of ignorance, poverty, and deficient health infrastructure. COVID-19, therefore, has the potential for worsening maternal mortality in low-resource nations.
{"title":"Challenges in the management of corona virus in pregnancy in low resource countries","authors":"A. Abubakar, A. Rabiu","doi":"10.4103/smj.smj_40_20","DOIUrl":"https://doi.org/10.4103/smj.smj_40_20","url":null,"abstract":"Background: Coronavirus disease-19 (COVID-19) is a potentially lethal infection caused by severe acute respiratory syndrome. Pregnancy is a state of partial immune suppression, which makes pregnant women more vulnerable to viral infections. COVID-19 pandemic presents many challenges in when it coexists with pregnancy in resource-poor countries with background ignorance and deficient health infrastructure. Materials and Methods: A literature search for studies on COVID-19 was performed using Google Scholar search database, PubMed, Medline, and ScienceDirect. The bibliographies of included studies were also searched for additional references. About 85 articles were identified. Twenty-five articles were considered suitable for review. Results: An extensive review of management of COVID-19 in pregnancy and challenges confronting its management in resource-poor countries was presented. These challenges included poor health infrastructure, poor testing capacity, and nonadherence or impracticable preventive measures including physical distancing, hand hygiene, inadequate personal protective equipment, and stigmatization. Specific challenges related to pregnancy were availability of blood and blood products, labor management, operative deliveries, and postdelivery management. Conclusions: Current evidence suggests that its pathogenesis, clinical manifestations, and management are influenced by pregnancy. The outcomes of pregnancy and COVID-19 are negatively influenced by similar problems of ignorance, poverty, and deficient health infrastructure. COVID-19, therefore, has the potential for worsening maternal mortality in low-resource nations.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46056497","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: Rational prescribing is essential to prevent medication errors, antibiotic resistance, and treatment failure. Assessment of prescribing practices helps monitor the utilization of medicines. Objectives: The aim of this study was to evaluate the prescribing pattern and utilization of antibiotics for children attending outpatient units. Materials and Methods: This was a descriptive, retrospective study of outpatient pediatric prescriptions received at the pharmacy of a Nigerian teaching hospital, using the World Health Organization (WHO) core prescribing indicators and Index of Rational Drug Prescribing (IRDP). Prescription information for a 2-year period was collected on a standardized prescribing form. Computer data entry was made into Microsoft Excel 2010 spreadsheet. Data analysis was done using SPSS Version 20(IBM, Corp., Armonk, NY, USA). Results were compared with the WHO core prescribing indicators and presented as means, frequencies, proportions, contingency tables, and charts comparing with published standards. Results: There were 3445 eligible prescriptions, with mean child age of 3.2 (±2.9) years. An average of 2.4 (±1.6) drugs were prescribed per encounter, with 48.2% written in generic names. Prescriptions containing oral antibiotics and antibiotic injections constituted 50.2% and 41.2%, respectively. Medicines prescribed were available in the essential medicines list in 95.5% of cases. The IRDP was 2.98 against the ideal of 5. Majority (71.3%) of antibiotic-containing prescriptions had one antibiotic prescribed while β-lactam penicillins and cephalosporins were the most prescribed, with ampicillin/cloxacillin being the most common combination. Conclusion: Irrational prescribing and inappropriate antibiotic use were prevalent in this tertiary hospital. Similar studies are needed to describe the trends in all Nigerian tertiary hospitals, along with retraining on rational prescribing.
背景：合理的处方对于预防用药错误、抗生素耐药性和治疗失败至关重要。对处方做法的评估有助于监测药物的使用情况。目的：本研究旨在评估门诊儿童抗生素的处方模式和使用情况。材料和方法：这是一项描述性的回顾性研究，使用世界卫生组织（世界卫生组织）的核心处方指标和合理药物处方指数（IRDP），对尼日利亚一家教学医院的药房收到的门诊儿科处方进行回顾性研究。在标准化处方表上收集2年的处方信息。计算机数据输入到Microsoft Excel 2010电子表格中。使用SPSS Version 20（IBM，Corp.，Armonk，NY，USA）进行数据分析。结果与世界卫生组织核心处方指标进行了比较，并以手段、频率、比例、列联表和图表的形式与已公布的标准进行了比较。结果：符合条件的处方有3445个，平均儿童年龄为3.2（±2.9）岁。每次用药平均开出2.4（±1.6）种药物，其中48.2%是以通用名称书写的。含有口服抗生素和抗生素注射剂的处方分别占50.2%和41.2%。95.5%的病例在基本药物清单中有处方药。IRDP为2.98，而理想值为5。大多数（71.3%）含抗生素的处方只开了一种抗生素，而β-内酰胺青霉素和头孢菌素的处方最多，氨苄青霉素/氯唑西林是最常见的组合。结论：该三甲医院处方不合理、抗生素使用不当的现象普遍存在。需要进行类似的研究来描述尼日利亚所有三级医院的趋势，并对合理处方进行再培训。
{"title":"Outpatient prescribing and antibiotic use for children in a tertiary hospital","authors":"L. Umar, A. Isah, S. Musa, Bilkisu Umar","doi":"10.4103/smj.smj_27_18","DOIUrl":"https://doi.org/10.4103/smj.smj_27_18","url":null,"abstract":"Background: Rational prescribing is essential to prevent medication errors, antibiotic resistance, and treatment failure. Assessment of prescribing practices helps monitor the utilization of medicines. Objectives: The aim of this study was to evaluate the prescribing pattern and utilization of antibiotics for children attending outpatient units. Materials and Methods: This was a descriptive, retrospective study of outpatient pediatric prescriptions received at the pharmacy of a Nigerian teaching hospital, using the World Health Organization (WHO) core prescribing indicators and Index of Rational Drug Prescribing (IRDP). Prescription information for a 2-year period was collected on a standardized prescribing form. Computer data entry was made into Microsoft Excel 2010 spreadsheet. Data analysis was done using SPSS Version 20(IBM, Corp., Armonk, NY, USA). Results were compared with the WHO core prescribing indicators and presented as means, frequencies, proportions, contingency tables, and charts comparing with published standards. Results: There were 3445 eligible prescriptions, with mean child age of 3.2 (±2.9) years. An average of 2.4 (±1.6) drugs were prescribed per encounter, with 48.2% written in generic names. Prescriptions containing oral antibiotics and antibiotic injections constituted 50.2% and 41.2%, respectively. Medicines prescribed were available in the essential medicines list in 95.5% of cases. The IRDP was 2.98 against the ideal of 5. Majority (71.3%) of antibiotic-containing prescriptions had one antibiotic prescribed while β-lactam penicillins and cephalosporins were the most prescribed, with ampicillin/cloxacillin being the most common combination. Conclusion: Irrational prescribing and inappropriate antibiotic use were prevalent in this tertiary hospital. Similar studies are needed to describe the trends in all Nigerian tertiary hospitals, along with retraining on rational prescribing.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43057596","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: Floating knee is the term applied to the flail knee joint segment resulting from a fracture of the shaft or adjacent metaphysis of the ipsilateral femur and tibia. The fractures are often a result of high-energy trauma. Objectives: The aim of this study was to determine the pattern and distribution of these fracture types, mechanism of injury, associated injuries, method of treatment, complications, and the challenges encountered during the course of managing these patients. Patients and Methods: This is a retrospective study of all cases of floating knee injuries presenting to the Orthopedic Unit of Federal Medical Center and Surgery Department of Sir Yahaya Memorial Hospital all in Birnin Kebbi, Kebbi State, Northwest Nigeria, from January 2011 to December 2017. Data were extracted from the accident and emergency register, operation register, and patients' case folders. Data collected were analyzed using the Statistical Package for the Social Sciences for Windows version 22 (SPSS Inc. Chicago, Illinois, USA). Results: A total of 29 cases of floating knee injuries presented to the accident and emergency units. Males constituted 27 (93.1%) while females constituted 2 (6.9%). Motor vehicle accident was the most common mechanism of injury in 25 (86.3%) of the patients. The most common fracture type according to Fraser et al. classification is Type I which occurred in 12 (41.4%) of the patients. Conclusion: Floating knee injury occurs mostly in the productive age group. Head injury is the most common associated injury seen. This is mostly caused by motor vehicle accidents.
{"title":"Management of floating knees in adults: Experience from tertiary hospital","authors":"C. Nwosu, O. Salawu, J. Mejabi, A. Fadimu","doi":"10.4103/smj.smj_25_18","DOIUrl":"https://doi.org/10.4103/smj.smj_25_18","url":null,"abstract":"Background: Floating knee is the term applied to the flail knee joint segment resulting from a fracture of the shaft or adjacent metaphysis of the ipsilateral femur and tibia. The fractures are often a result of high-energy trauma. Objectives: The aim of this study was to determine the pattern and distribution of these fracture types, mechanism of injury, associated injuries, method of treatment, complications, and the challenges encountered during the course of managing these patients. Patients and Methods: This is a retrospective study of all cases of floating knee injuries presenting to the Orthopedic Unit of Federal Medical Center and Surgery Department of Sir Yahaya Memorial Hospital all in Birnin Kebbi, Kebbi State, Northwest Nigeria, from January 2011 to December 2017. Data were extracted from the accident and emergency register, operation register, and patients' case folders. Data collected were analyzed using the Statistical Package for the Social Sciences for Windows version 22 (SPSS Inc. Chicago, Illinois, USA). Results: A total of 29 cases of floating knee injuries presented to the accident and emergency units. Males constituted 27 (93.1%) while females constituted 2 (6.9%). Motor vehicle accident was the most common mechanism of injury in 25 (86.3%) of the patients. The most common fracture type according to Fraser et al. classification is Type I which occurred in 12 (41.4%) of the patients. Conclusion: Floating knee injury occurs mostly in the productive age group. Head injury is the most common associated injury seen. This is mostly caused by motor vehicle accidents.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46432789","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}
Leishmaniasis, a neglected tropical disease, is of public health significance, especially in the North-West and North-East Nigeria,which forms the belt of the disease in the country. It is caused by flagellate protozoa of the genus Leishmania and is transmitted through the bite of infected female Phlebotomine sandfly. Leishmaniasis presents as self-limiting cutaneous lesions, a mutilating mucocutaneous disease, or a lethal systemic illness. Description of the disease in the southern parts of Nigeria is a rarity. A 28-year-old male presented at the dermatology clinic of UBTH, Benin City, Edo State, South-South Nigeria, with multiple, painless, indurated nodular plaques on the left upper limb. Histology showed features suggestive of leishmaniasis. The patient was treated with oral itraconazole. Diagnosis of leishmaniasis possesses a significant challenge in nonendemic areas; however, a very good history and a high index of suspicion are imperative in overcoming this diagnostic challenge.
{"title":"Cutaneous leishmaniasis: An uncommon finding in South-South Nigeria","authors":"B. Okwara, Edesiri Ighorodje","doi":"10.4103/smj.smj_34_19","DOIUrl":"https://doi.org/10.4103/smj.smj_34_19","url":null,"abstract":"Leishmaniasis, a neglected tropical disease, is of public health significance, especially in the North-West and North-East Nigeria,which forms the belt of the disease in the country. It is caused by flagellate protozoa of the genus Leishmania and is transmitted through the bite of infected female Phlebotomine sandfly. Leishmaniasis presents as self-limiting cutaneous lesions, a mutilating mucocutaneous disease, or a lethal systemic illness. Description of the disease in the southern parts of Nigeria is a rarity. A 28-year-old male presented at the dermatology clinic of UBTH, Benin City, Edo State, South-South Nigeria, with multiple, painless, indurated nodular plaques on the left upper limb. Histology showed features suggestive of leishmaniasis. The patient was treated with oral itraconazole. Diagnosis of leishmaniasis possesses a significant challenge in nonendemic areas; however, a very good history and a high index of suspicion are imperative in overcoming this diagnostic challenge.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43276897","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}
Child sexual assault has gained global attention as a medico-social problem with significant immediate and long-term impact on victims, their families and society. This abhorrent deviant act may present with bizarre manifestations including various objects inserted into body orifices of victims. We report a bizarre case of anal impaction of an organic foreign body in a 9-year old boy. He had been serially abused over a two-year period by an adult male who lures him with candies and inserts a corncob into his anus before having penetrative anal sex intercourse with him. The abuse came to light following impaction of the corncob in the anus with consequent development of sepsis. Fragments of the cob were manually retrieved from the anal canal. He did well on antibiotics and was discharged to the social welfare services and psychotherapist for continued care. This report highlights the bizarre presentations of sexual assault in children. Childcare practitioners should be wary of the possibility of foreign bodies insertion in victims, which may lead to severe complications.
{"title":"Impacted corncob in the anus: An unusual presentation of child sexual abuse","authors":"M. Garba, L. Umar, S. Musa, H. Makarfi","doi":"10.4103/smj.smj_36_18","DOIUrl":"https://doi.org/10.4103/smj.smj_36_18","url":null,"abstract":"Child sexual assault has gained global attention as a medico-social problem with significant immediate and long-term impact on victims, their families and society. This abhorrent deviant act may present with bizarre manifestations including various objects inserted into body orifices of victims. We report a bizarre case of anal impaction of an organic foreign body in a 9-year old boy. He had been serially abused over a two-year period by an adult male who lures him with candies and inserts a corncob into his anus before having penetrative anal sex intercourse with him. The abuse came to light following impaction of the corncob in the anus with consequent development of sepsis. Fragments of the cob were manually retrieved from the anal canal. He did well on antibiotics and was discharged to the social welfare services and psychotherapist for continued care. This report highlights the bizarre presentations of sexual assault in children. Childcare practitioners should be wary of the possibility of foreign bodies insertion in victims, which may lead to severe complications.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561744","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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