A. Olayinka, O. Jimoh, J. Ejembi, Oluwafemi Ige, Zainab Lamido, A. Ibrahim, Victoria Aganabor, B. Olayinka
Background: Antimicrobials are nonreplaceable in the treatment of bacterial infections and thus should be used judiciously. In Nigeria, there is currently no restriction on the prescription and sale of antimicrobials. This study was conducted to assess the antimicrobial prescription pattern of physicians at a tertiary hospital in Northwestern Nigeria. Materials and Methods: A point prevalence survey was carried out among all inpatients at Ahmadu Bello University Teaching Hospital in June 2015. Those receiving an antimicrobial agent during the survey period were included in the study while patients admitted on the day of the survey were excluded from the study. Data were obtained using a structured interviewer-administered questionnaire and abstraction from patient records. Information obtained included demographic data, antimicrobial agents prescribed, indication for treatment, laboratory data, and stop/review dates of prescriptions. Data were analyzed using SPSS version 20.0. Results: Twenty-three wards with a total number of 318 inpatients were enlisted. Of these, 210 (66%) patients were on treatment with antimicrobials. Male: female ratio of patients on antimicrobials was 1.2:1, and age of respondents ranged from 1 day (0.0027 years) to 75 years. The overall antimicrobial prevalence rate was 210 (66%) with surgical prophylaxis 100 (47.6%) as the most common indication. Overall, 332 antimicrobials were prescribed with cephalosporins as the most common class prescribed 96 (28.9%). Majority of the prescriptions (328, 98.8%) were based on empirical treatment, 288 (86.7%) were open prescriptions, and only 4 (1.2%) were according to treatment guidelines. Conclusion: The high prevalence of antimicrobial use highlights the need for an antimicrobial stewardship program in this facility.
{"title":"Antimicrobial prescription pattern in a tertiary hospital","authors":"A. Olayinka, O. Jimoh, J. Ejembi, Oluwafemi Ige, Zainab Lamido, A. Ibrahim, Victoria Aganabor, B. Olayinka","doi":"10.4103/smj.smj_17_18","DOIUrl":"https://doi.org/10.4103/smj.smj_17_18","url":null,"abstract":"Background: Antimicrobials are nonreplaceable in the treatment of bacterial infections and thus should be used judiciously. In Nigeria, there is currently no restriction on the prescription and sale of antimicrobials. This study was conducted to assess the antimicrobial prescription pattern of physicians at a tertiary hospital in Northwestern Nigeria. Materials and Methods: A point prevalence survey was carried out among all inpatients at Ahmadu Bello University Teaching Hospital in June 2015. Those receiving an antimicrobial agent during the survey period were included in the study while patients admitted on the day of the survey were excluded from the study. Data were obtained using a structured interviewer-administered questionnaire and abstraction from patient records. Information obtained included demographic data, antimicrobial agents prescribed, indication for treatment, laboratory data, and stop/review dates of prescriptions. Data were analyzed using SPSS version 20.0. Results: Twenty-three wards with a total number of 318 inpatients were enlisted. Of these, 210 (66%) patients were on treatment with antimicrobials. Male: female ratio of patients on antimicrobials was 1.2:1, and age of respondents ranged from 1 day (0.0027 years) to 75 years. The overall antimicrobial prevalence rate was 210 (66%) with surgical prophylaxis 100 (47.6%) as the most common indication. Overall, 332 antimicrobials were prescribed with cephalosporins as the most common class prescribed 96 (28.9%). Majority of the prescriptions (328, 98.8%) were based on empirical treatment, 288 (86.7%) were open prescriptions, and only 4 (1.2%) were according to treatment guidelines. Conclusion: The high prevalence of antimicrobial use highlights the need for an antimicrobial stewardship program in this facility.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"103 - 108"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43633025","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: Ultrasound scanning presently forms an integral part of antenatal care around the globe. It is a common investigative tool in most public and private health facilities in developing countries. Routine obstetric ultrasound has been one of the most important advances in antenatal care worldwide. It is also useful in the early detection and monitoring of the conditions that give rise to fetal and maternal compromise and has become an indispensable adjunct to the management efforts of practitioners in this regard. Therefore, utilization of this innovation by pregnant mothers is paramount toward good outcome. Objective: The objective is to determine the factors affecting utilization of ultrasound by pregnant mothers attending antenatal care in Zaria Local Government, Kaduna State, Northern Nigeria. Materials and Methods: This cross-sectional descriptive was used to carry out the study among 200 pregnant mothers selected through multistage sampling technique. This study was conducted over a period of 6 months from November 6, 2017, to May 6, 2018, after approval was given by the ethical committee of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A structured interviewer-administered, validated questionnaire was administered to each participant to ascertain the factors affecting utilization of obstetric ultrasound by pregnant women in Zaria Local Government, Kaduna State. Data were analyzed using IBM SPSS 22. Results: The data obtained from the questionnaire were scored for proper evaluation. Furthermore, all collected data were carefully tallied, various frequencies, ranges, and mean (standard deviation) were determined. Most (29.5%) of the respondents aged 20–24 years, majority (95.5%) were homemakers that are not gainfully employed. Majority of the respondents were Hausa (94.5) and Muslims (96.5%). The findings of this study have shown that educational status, husband occupation, and knowledge affect the utilization of ultrasound by respondents. Conclusion: The common factors that affect the utilization of obstetric scan in Zaria were knowledge, education background, and husband occupation. Attitude, age, and the occupation of the respondents do not affect the utilization of obstetrics scan in Zaria.
{"title":"Factors affecting utilization of obstetric ultrasound: a study of semi-urban pregnant women in a developing nation","authors":"B. Usman, S. Idris, U. Abdulaziz, A. Abdulhakim","doi":"10.4103/smj.smj_5_19","DOIUrl":"https://doi.org/10.4103/smj.smj_5_19","url":null,"abstract":"Background: Ultrasound scanning presently forms an integral part of antenatal care around the globe. It is a common investigative tool in most public and private health facilities in developing countries. Routine obstetric ultrasound has been one of the most important advances in antenatal care worldwide. It is also useful in the early detection and monitoring of the conditions that give rise to fetal and maternal compromise and has become an indispensable adjunct to the management efforts of practitioners in this regard. Therefore, utilization of this innovation by pregnant mothers is paramount toward good outcome. Objective: The objective is to determine the factors affecting utilization of ultrasound by pregnant mothers attending antenatal care in Zaria Local Government, Kaduna State, Northern Nigeria. Materials and Methods: This cross-sectional descriptive was used to carry out the study among 200 pregnant mothers selected through multistage sampling technique. This study was conducted over a period of 6 months from November 6, 2017, to May 6, 2018, after approval was given by the ethical committee of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A structured interviewer-administered, validated questionnaire was administered to each participant to ascertain the factors affecting utilization of obstetric ultrasound by pregnant women in Zaria Local Government, Kaduna State. Data were analyzed using IBM SPSS 22. Results: The data obtained from the questionnaire were scored for proper evaluation. Furthermore, all collected data were carefully tallied, various frequencies, ranges, and mean (standard deviation) were determined. Most (29.5%) of the respondents aged 20–24 years, majority (95.5%) were homemakers that are not gainfully employed. Majority of the respondents were Hausa (94.5) and Muslims (96.5%). The findings of this study have shown that educational status, husband occupation, and knowledge affect the utilization of ultrasound by respondents. Conclusion: The common factors that affect the utilization of obstetric scan in Zaria were knowledge, education background, and husband occupation. Attitude, age, and the occupation of the respondents do not affect the utilization of obstetrics scan in Zaria.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"82 - 87"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41403442","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: Surgeons sometimes perform appendectomies during abdominopelvic surgeries for surgical conditions unrelated to the appendix. A retrospective study of the histopathological diagnoses of incidental appendectomy specimens was performed to see the value of this practice. Materials and Methods: Records of incidentally resected appendices submitted to the Histopathology Department of the University of Benin Teaching Hospital from January 2005 to December 2014 were reviewed retrospectively. Results: A total of 129 histopathological reports of incidental appendectomy were retrospectively reviewed; 67 (51.9%) of the patients were male and 62 (48.1%) were female, giving a male-female ratio of about 1.1:1. Fifty-four cases (41.9%) had histologically normal appendices, while 75 cases (58.1%) had various histopathologically demonstrable lesions ranging from acute appendicitis (the most frequent with 27%) to neoplasia (one case of mucinous adenocarcinoma). Conclusion: Significant pathology can be uncovered on histopathological examination of the clinically normal appendix. Incidental appendectomy is thus a useful procedure.
{"title":"Evaluating the benefit of incidental appendectomy","authors":"I. Obahiagbon, M. Udoh","doi":"10.4103/smj.smj_62_17","DOIUrl":"https://doi.org/10.4103/smj.smj_62_17","url":null,"abstract":"Background: Surgeons sometimes perform appendectomies during abdominopelvic surgeries for surgical conditions unrelated to the appendix. A retrospective study of the histopathological diagnoses of incidental appendectomy specimens was performed to see the value of this practice. Materials and Methods: Records of incidentally resected appendices submitted to the Histopathology Department of the University of Benin Teaching Hospital from January 2005 to December 2014 were reviewed retrospectively. Results: A total of 129 histopathological reports of incidental appendectomy were retrospectively reviewed; 67 (51.9%) of the patients were male and 62 (48.1%) were female, giving a male-female ratio of about 1.1:1. Fifty-four cases (41.9%) had histologically normal appendices, while 75 cases (58.1%) had various histopathologically demonstrable lesions ranging from acute appendicitis (the most frequent with 27%) to neoplasia (one case of mucinous adenocarcinoma). Conclusion: Significant pathology can be uncovered on histopathological examination of the clinically normal appendix. Incidental appendectomy is thus a useful procedure.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"99 - 102"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42078363","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: Hearing loss is one of the preventable diseases listed by the WHO, even though the prevalence is decreasing in the developed countries. The pediatric age is very important in terms of hearing and therefore speech development. The prevalence and pattern of hearing loss in this age group in this environment is not known. Objective: The aim of the study was to determine the etiology and pattern of hearing loss in the pediatric age group in Port Harcourt. Materials and Methods: The study involved the pediatric age group (0-18 years) presenting with hearing loss, seen in the ENT Surgery Department of UPTH from January 2010 to December 2016. The clinic registers and patients' folders were the sources from which the biodata, clinical presentations, audiological assessments, possible etiologies, and treatment were extracted. These were analyzed using IBM SPSS Statistics, version 20.0. Results: A total of 752 patients with hearing impairment were seen: males – 502 and females – 250 with a ratio of 2.01:1. Patients with the age group of 0–3 years (28.6%) were more affected, whereas 16–18 years (11.2%) were the least affected. Sensorineural hearing loss (SNHL) was 37.6%; among this, birth asphyxia made up 38.5%, syndromic 6.0%, postmeningitis (2.7%, and neonatal jaundice 21.9%. However, conductive hearing loss (62.4%); was made up of cerumen auris (31.8%), otomycosis (19.4%), chronic suppurative otitis media (13.6%), Otitis media with effusion (11.7%). Most children with SNHL had severe-to-profound degree. The most common clinical presentation was hearing impairment and speech impairment followed by discharging ears. Conclusion: Hearing loss secondary to preventable causes such as birth asphyxia and neonatal infections still ranks high among the pediatric age group in this environment.
背景:听力损失是世界卫生组织列出的可预防疾病之一，尽管发达国家的患病率正在下降。就听力和语言发展而言，儿童时期非常重要。在这种环境下，这一年龄组听力损失的患病率和模式尚不清楚。目的:本研究的目的是确定哈科特港儿童年龄组听力损失的病因和模式。材料与方法:本研究纳入2010年1月至2016年12月在UPTH耳鼻喉外科就诊的听力损失儿童年龄组(0-18岁)。临床登记和患者档案是提取生物资料、临床表现、听力学评估、可能病因和治疗的来源。使用IBM SPSS Statistics, version 20.0对这些数据进行分析。结果:共观察到752例听力障碍患者，其中男502例，女250例，男女比例为2.01:1。0-3岁患者(28.6%)最易受影响，16-18岁患者(11.2%)最不受影响。感音神经性听力损失(SNHL)占37.6%;其中，出生窒息占38.5%，综合征性占6.0%，脑膜炎后占2.7%，新生儿黄疸占21.9%。传导性听力损失(62.4%);由耳耵聍(31.8%)、耳真菌病(19.4%)、慢性化脓性中耳炎(13.6%)、分泌性中耳炎(11.7%)组成。SNHL患儿多为重度至重度。最常见的临床表现是听力障碍和语言障碍，其次是脱耳。结论:听力损失继发于可预防的原因，如出生窒息和新生儿感染，在儿童年龄组中仍然是很高的。
{"title":"Hearing loss in the pediatric age group","authors":"U. Ibekwe, E. Oghenekaro","doi":"10.4103/smj.smj_30_19","DOIUrl":"https://doi.org/10.4103/smj.smj_30_19","url":null,"abstract":"Background: Hearing loss is one of the preventable diseases listed by the WHO, even though the prevalence is decreasing in the developed countries. The pediatric age is very important in terms of hearing and therefore speech development. The prevalence and pattern of hearing loss in this age group in this environment is not known. Objective: The aim of the study was to determine the etiology and pattern of hearing loss in the pediatric age group in Port Harcourt. Materials and Methods: The study involved the pediatric age group (0-18 years) presenting with hearing loss, seen in the ENT Surgery Department of UPTH from January 2010 to December 2016. The clinic registers and patients' folders were the sources from which the biodata, clinical presentations, audiological assessments, possible etiologies, and treatment were extracted. These were analyzed using IBM SPSS Statistics, version 20.0. Results: A total of 752 patients with hearing impairment were seen: males – 502 and females – 250 with a ratio of 2.01:1. Patients with the age group of 0–3 years (28.6%) were more affected, whereas 16–18 years (11.2%) were the least affected. Sensorineural hearing loss (SNHL) was 37.6%; among this, birth asphyxia made up 38.5%, syndromic 6.0%, postmeningitis (2.7%, and neonatal jaundice 21.9%. However, conductive hearing loss (62.4%); was made up of cerumen auris (31.8%), otomycosis (19.4%), chronic suppurative otitis media (13.6%), Otitis media with effusion (11.7%). Most children with SNHL had severe-to-profound degree. The most common clinical presentation was hearing impairment and speech impairment followed by discharging ears. Conclusion: Hearing loss secondary to preventable causes such as birth asphyxia and neonatal infections still ranks high among the pediatric age group in this environment.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"116 - 120"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48382000","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: Vaccine hesitancy defined as “delay in acceptance or refusal of vaccination despite availability of vaccination services is a global phenomenon. There have been anecdotal evidence or rather poor documentation of hesitancy or noncompliance among medical practitioners in Northern Nigeria. Objective: We explored the perceptions and perspectives of doctors in Kebbi State, Nigeria, on immunization programs. Materials and Methods: We conducted this cross-sectional study involving 63 medical doctors, whose self-administered questionnaires were analyzed using descriptive statistics. Results: Only 43.55% of the doctors reported having under-five children with complete vaccination, whereas 84% of the doctors surveyed had a child or a relative with a child who had missed routine immunization (RI) previously. Approximately 66.67% and 67.74% of the doctors believed in the quality of the vaccine and capacity of the health workers to effectively deliver polio supplementary immunization activities (PSIAs), respectively. Adequate training of workers (26.23%) and public enlightenment campaigns (23.68%) were suggested as PSIAs enhancers. Collaboration with community and religious leaders (29.2%), education and public sensitization (28.09%), and improved government funding (13.48%) to improve RI were suggested. Others include incentives and fines (8.99%), adequate training of staff (10.11%), house-to-house vaccination (4.49%), and media publicity (5.62%). Conclusion: Vaccine hesitancy among medical doctors could be a threat to sustained polio interruption and efforts toward improving RI in Kebbi State. The state government and development partners should modify the current approaches to attaining polio-free certification standards and strengthen RI in the state. In addition, there is a need to improve sensitization of doctors in the state on vaccines and their safety profiles with a view to reducing vaccine hesitancy among them.
{"title":"Vaccine hesitancy among medical practitioners","authors":"S. Omoleke, O. Ajibola, O. Omisakin, G. Umeh","doi":"10.4103/smj.smj_32_18","DOIUrl":"https://doi.org/10.4103/smj.smj_32_18","url":null,"abstract":"Background: Vaccine hesitancy defined as “delay in acceptance or refusal of vaccination despite availability of vaccination services is a global phenomenon. There have been anecdotal evidence or rather poor documentation of hesitancy or noncompliance among medical practitioners in Northern Nigeria. Objective: We explored the perceptions and perspectives of doctors in Kebbi State, Nigeria, on immunization programs. Materials and Methods: We conducted this cross-sectional study involving 63 medical doctors, whose self-administered questionnaires were analyzed using descriptive statistics. Results: Only 43.55% of the doctors reported having under-five children with complete vaccination, whereas 84% of the doctors surveyed had a child or a relative with a child who had missed routine immunization (RI) previously. Approximately 66.67% and 67.74% of the doctors believed in the quality of the vaccine and capacity of the health workers to effectively deliver polio supplementary immunization activities (PSIAs), respectively. Adequate training of workers (26.23%) and public enlightenment campaigns (23.68%) were suggested as PSIAs enhancers. Collaboration with community and religious leaders (29.2%), education and public sensitization (28.09%), and improved government funding (13.48%) to improve RI were suggested. Others include incentives and fines (8.99%), adequate training of staff (10.11%), house-to-house vaccination (4.49%), and media publicity (5.62%). Conclusion: Vaccine hesitancy among medical doctors could be a threat to sustained polio interruption and efforts toward improving RI in Kebbi State. The state government and development partners should modify the current approaches to attaining polio-free certification standards and strengthen RI in the state. In addition, there is a need to improve sensitization of doctors in the state on vaccines and their safety profiles with a view to reducing vaccine hesitancy among them.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"126 - 131"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49492395","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: Kidney transplant-related medical tourism is still prevalent in developing countries for patients with end stage renal disease. Objectives: We set out to review our single centre experience with kidney transplant-related medical tourism. Materials and Methods: We reviewed the demographic and clinical characteristics of our endstage renal disease patients who opted for kidney transplant over an 11 year period. Endpoint was kidney transplantation. Data was analysed with SPSS Statistical software Version 20. Results: A total of 27 patients were referred for kidney transplant evaluation, out of which 12(44.4%) were transplanted. All the 15 patients who were not transplanted died within one year of returning to our centre. The finding of co-morbidity during pre-transplant evaluation and lack of a suitable donor were the major reasons for our patients returning without a transplant. Of those who were transplanted, 5(41.7%) patients died from various complications. Conclusion: Kidney transplant-related medical tourism is still prevalent in Nigeria. Comorbidity and lack of suitable donor remain important impediments to kidney transplantation even when finance is available. Local Kidney transplant needs to be encouraged in Nigeria.
{"title":"Kidney transplant-related medical tourism in patients with end-stage renal disease: A report from a renal center in a developing nation","authors":"H. Liman, M. Makusidi, A. Sakajiki","doi":"10.4103/smj.smj_17_19","DOIUrl":"https://doi.org/10.4103/smj.smj_17_19","url":null,"abstract":"Background: Kidney transplant-related medical tourism is still prevalent in developing countries for patients with end stage renal disease. Objectives: We set out to review our single centre experience with kidney transplant-related medical tourism. Materials and Methods: We reviewed the demographic and clinical characteristics of our endstage renal disease patients who opted for kidney transplant over an 11 year period. Endpoint was kidney transplantation. Data was analysed with SPSS Statistical software Version 20. Results: A total of 27 patients were referred for kidney transplant evaluation, out of which 12(44.4%) were transplanted. All the 15 patients who were not transplanted died within one year of returning to our centre. The finding of co-morbidity during pre-transplant evaluation and lack of a suitable donor were the major reasons for our patients returning without a transplant. Of those who were transplanted, 5(41.7%) patients died from various complications. Conclusion: Kidney transplant-related medical tourism is still prevalent in Nigeria. Comorbidity and lack of suitable donor remain important impediments to kidney transplantation even when finance is available. Local Kidney transplant needs to be encouraged in Nigeria.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"7 - 11"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42851907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Nwafor, D. Ugoji, B. Onwe, V. Obi, C. Obi, Victor Uchenna Onuchukwu, C. Ibo
Background: Conservative management of early-onset severe preeclampsia is gaining widespread acceptance among obstetricians despite well-known maternal risks associated with it. There is limited data on the outcome of pregnancy of women managed with this modality of management in Nigerian setting. Objective: We determined the maternal and perinatal outcome of women managed conservatively for early-onset severe preeclampsia. Materials and Methods: This was a 7-year retrospective study of 118 women with early-onset severe preeclampsia that were managed conservatively at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The data were entered and analyzed using the SPSS software version 22.0 (SPSS Inc., Chicago, IL, USA). Results: The median duration of expectant management was 12 days (range 3–20 days). The mean gestational age at delivery was 33.4 ± 2.5 weeks. The most common indication for delivery was uncontrolled hypertension (35.6%). Adverse maternal outcomes found in the study included abruptio placentae (11%), acute renal failure (2.5%), pulmonary edema (0.8%), eclampsia (11.9%), disseminated intravascular coagulation (2.5%), Haemolysis, elevated liver enzymes and low platelet (HELLP) syndrome (2.5%), and maternal death (2.5%). Perinatal mortality occurred in 68 (57.6%) cases in the study. Perinatal survival improved significantly with gestational age, with reductions in perinatal mortality of approximately 50% per week between 28 and 34 weeks' gestation on admission. Conclusion: Delayed delivery of women with early-onset severe preeclampsia improved perinatal outcome in this study, but it was associated with considerable maternal morbidity and mortality. Therefore, proper patient selection, adequate counseling of women on the risks and benefit of conservative management, close maternal monitoring, and the presence of advanced neonatal care are necessary to optimize pregnancy outcome when this management modality is adopted.
{"title":"Pregnancy outcomes among women with early-onset severe preeclampsia managed conservatively","authors":"J. Nwafor, D. Ugoji, B. Onwe, V. Obi, C. Obi, Victor Uchenna Onuchukwu, C. Ibo","doi":"10.4103/smj.smj_28_19","DOIUrl":"https://doi.org/10.4103/smj.smj_28_19","url":null,"abstract":"Background: Conservative management of early-onset severe preeclampsia is gaining widespread acceptance among obstetricians despite well-known maternal risks associated with it. There is limited data on the outcome of pregnancy of women managed with this modality of management in Nigerian setting. Objective: We determined the maternal and perinatal outcome of women managed conservatively for early-onset severe preeclampsia. Materials and Methods: This was a 7-year retrospective study of 118 women with early-onset severe preeclampsia that were managed conservatively at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The data were entered and analyzed using the SPSS software version 22.0 (SPSS Inc., Chicago, IL, USA). Results: The median duration of expectant management was 12 days (range 3–20 days). The mean gestational age at delivery was 33.4 ± 2.5 weeks. The most common indication for delivery was uncontrolled hypertension (35.6%). Adverse maternal outcomes found in the study included abruptio placentae (11%), acute renal failure (2.5%), pulmonary edema (0.8%), eclampsia (11.9%), disseminated intravascular coagulation (2.5%), Haemolysis, elevated liver enzymes and low platelet (HELLP) syndrome (2.5%), and maternal death (2.5%). Perinatal mortality occurred in 68 (57.6%) cases in the study. Perinatal survival improved significantly with gestational age, with reductions in perinatal mortality of approximately 50% per week between 28 and 34 weeks' gestation on admission. Conclusion: Delayed delivery of women with early-onset severe preeclampsia improved perinatal outcome in this study, but it was associated with considerable maternal morbidity and mortality. Therefore, proper patient selection, adequate counseling of women on the risks and benefit of conservative management, close maternal monitoring, and the presence of advanced neonatal care are necessary to optimize pregnancy outcome when this management modality is adopted.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44604401","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: Parotid gland neoplasms usually present as pre-auricular swellings. Sometimes, they present as solitary infra-auricular swellings which make their localization difficult as they may be confused with submandibular gland or other lateral upper neck masses. Clinicopathological reports of discrete infra-auricular parotid lesions and their surgical managements are few. Objectives: To describe the clinical features and management of discrete infra-auricular parotid masses in a series of Nigerian patients seen during a surgical outreach mission. Methodology: This is a retrospective study of all infra-auricular swellings managed by a Nigerian surgical mission over 6 years. Patients' demographics, duration of swelling, symptoms, treatment, histopathological diagnosis, postoperative complications were retrieved from patients' records. Results: A total of 124 facial tumors were seen, of which 15 (12.1%) were parotid tumors. Eight cases (53.3%) of parotid tumors presented as discrete infra-auricular masses. Age range was 13–57 years (mean = 40.9 ± 15.4 years) with male predilection. Duration of swelling was between 1 and 15 years. All lesions were treated with extracapsular dissection. One patient had postoperative facial nerve paresis, but no facial palsy and sialocele. The histopathological results were 5 (62.5%) pleomorphic adenomas, 1 (12.5%) Warthin's tumor, and 2 (25%) low-grade mucoepidermoid carcinomas. Conclusion: Discrete infra-auricular swellings may present as benign and malignant parotid gland neoplasms.
{"title":"Parotid gland neoplasms presenting as discrete infra-auricular swellings","authors":"Seidu A. Bello, B. Famurewa, O. Omoregie","doi":"10.4103/smj.smj_59_18","DOIUrl":"https://doi.org/10.4103/smj.smj_59_18","url":null,"abstract":"Background: Parotid gland neoplasms usually present as pre-auricular swellings. Sometimes, they present as solitary infra-auricular swellings which make their localization difficult as they may be confused with submandibular gland or other lateral upper neck masses. Clinicopathological reports of discrete infra-auricular parotid lesions and their surgical managements are few. Objectives: To describe the clinical features and management of discrete infra-auricular parotid masses in a series of Nigerian patients seen during a surgical outreach mission. Methodology: This is a retrospective study of all infra-auricular swellings managed by a Nigerian surgical mission over 6 years. Patients' demographics, duration of swelling, symptoms, treatment, histopathological diagnosis, postoperative complications were retrieved from patients' records. Results: A total of 124 facial tumors were seen, of which 15 (12.1%) were parotid tumors. Eight cases (53.3%) of parotid tumors presented as discrete infra-auricular masses. Age range was 13–57 years (mean = 40.9 ± 15.4 years) with male predilection. Duration of swelling was between 1 and 15 years. All lesions were treated with extracapsular dissection. One patient had postoperative facial nerve paresis, but no facial palsy and sialocele. The histopathological results were 5 (62.5%) pleomorphic adenomas, 1 (12.5%) Warthin's tumor, and 2 (25%) low-grade mucoepidermoid carcinomas. Conclusion: Discrete infra-auricular swellings may present as benign and malignant parotid gland neoplasms.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"67 - 71"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49087831","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}
Said Amin, K. Abdullahi, Mukhtar Muhammad, L. Mohammed, R. Mahmoud, R. Muhammad
Introduction: In Nigeria, cancer of the cervix is known to be the second commonest malignancy among females. In developed countries, there has been a paradigm shift attributed to effective cervical cancer screening predominantly using the Papanicolaou (Pap) smear. This screening tool is highly sensitive and specific; having a commendable positive predictive value as well as relatively cheap and effective means of screening cervical cancer for early detection. Objectives: The aim of this study is to assess the perception of Pap smear among medical students in College of Health Sciences, Usmanu Danfodiyo University, Sokoto (CHS-UDUS) in order to be able to recommend ways for improving acceptability, usage, and dissemination of information of the screening tool (Pap smear). Materials and Methods: The study utilized a cross-sectional study design. Preclinical students of CHS-UDUS were selected using random sampling technique. Pretested semi-structured, self-administered questionnaires were administered on the students. Quantitative variables were analyzed and presented using measures of central tendency [mean and median] and measures of dispersion (standard deviation), while Chi-square test was used in bivariate analyses, to determine the statistical association between the categorical groups, with a P < 0.05 considered as statistically significant. Results: Preclinical medical students in UDUS were found to have high awareness of cervical cancer-screening (82%) which made them positively disposed toward the screening tool. Most of them (75.6%) believe that Pap smear is effective in detecting cervical cancer. Majority of respondents obtained their information from routine lectures (81%) as against mass media (7%) and other extraneous source. However 42.8% were unaware of Pap smear screening services availability in their institution. Conclusion: The level of awareness about cervical cancer screening is high among the study population. Future studies should concentrate on utilization of this service in later life of young students.
{"title":"Perception of cervical cancer and its cytological screening among medical students","authors":"Said Amin, K. Abdullahi, Mukhtar Muhammad, L. Mohammed, R. Mahmoud, R. Muhammad","doi":"10.4103/smj.smj_26_18","DOIUrl":"https://doi.org/10.4103/smj.smj_26_18","url":null,"abstract":"Introduction: In Nigeria, cancer of the cervix is known to be the second commonest malignancy among females. In developed countries, there has been a paradigm shift attributed to effective cervical cancer screening predominantly using the Papanicolaou (Pap) smear. This screening tool is highly sensitive and specific; having a commendable positive predictive value as well as relatively cheap and effective means of screening cervical cancer for early detection. Objectives: The aim of this study is to assess the perception of Pap smear among medical students in College of Health Sciences, Usmanu Danfodiyo University, Sokoto (CHS-UDUS) in order to be able to recommend ways for improving acceptability, usage, and dissemination of information of the screening tool (Pap smear). Materials and Methods: The study utilized a cross-sectional study design. Preclinical students of CHS-UDUS were selected using random sampling technique. Pretested semi-structured, self-administered questionnaires were administered on the students. Quantitative variables were analyzed and presented using measures of central tendency [mean and median] and measures of dispersion (standard deviation), while Chi-square test was used in bivariate analyses, to determine the statistical association between the categorical groups, with a P < 0.05 considered as statistically significant. Results: Preclinical medical students in UDUS were found to have high awareness of cervical cancer-screening (82%) which made them positively disposed toward the screening tool. Most of them (75.6%) believe that Pap smear is effective in detecting cervical cancer. Majority of respondents obtained their information from routine lectures (81%) as against mass media (7%) and other extraneous source. However 42.8% were unaware of Pap smear screening services availability in their institution. Conclusion: The level of awareness about cervical cancer screening is high among the study population. Future studies should concentrate on utilization of this service in later life of young students.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"41 - 46"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45385188","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}
V. Olisah, T. Abiola, C. Okpataku, R. Obiako, I. Audu
Background: In human immunodeficiency virus (HIV)-infected persons, low serum concentrations of vitamins and minerals, termed micronutrients, may be associated with an increased risk of psychiatric morbidity and HIV disease progression. Objectives: This study investigated the effects of micronutrient supplementation on psychological well-being of highly active antiretroviral therapy (HAART)-naïve HIV-infected patients. Materials and Methods: A total of 90 HAART-naïve HIV-infected patients completed the Distress Thermometer and its Problem Checklist, the Hospital Anxiety and Depression Scale, the Oslo Social Support Scale, and the 14-Item Resilience Scale (RS-14) at baseline. They all received a micronutrient supplement for 6 months, and 68 of the participants who remained in treatment at 6 months were reassessed with the same instruments. Results: There was no significant difference between sociodemographic characteristics of participants at baseline and 6 months. After 6 months of micronutrient supplementation, participants were found to have significantly lower mean scores on the anxiety (P = 0.003), depression (P = 0.001), and overall distress (P = 0.001) subscales and significantly higher mean scores on the RS (P = 0.025). Conclusion: Micronutrient supplementation can reduce the experience of distress, anxiety, and depression and increase the resilience in HAART-naïve HIV-infected persons.
{"title":"Impact of micronutrients on the psychological well-being of highly active antiretroviral therapy-naïve human immunodeficiency virus-infected patients","authors":"V. Olisah, T. Abiola, C. Okpataku, R. Obiako, I. Audu","doi":"10.4103/smj.smj_6_19","DOIUrl":"https://doi.org/10.4103/smj.smj_6_19","url":null,"abstract":"Background: In human immunodeficiency virus (HIV)-infected persons, low serum concentrations of vitamins and minerals, termed micronutrients, may be associated with an increased risk of psychiatric morbidity and HIV disease progression. Objectives: This study investigated the effects of micronutrient supplementation on psychological well-being of highly active antiretroviral therapy (HAART)-naïve HIV-infected patients. Materials and Methods: A total of 90 HAART-naïve HIV-infected patients completed the Distress Thermometer and its Problem Checklist, the Hospital Anxiety and Depression Scale, the Oslo Social Support Scale, and the 14-Item Resilience Scale (RS-14) at baseline. They all received a micronutrient supplement for 6 months, and 68 of the participants who remained in treatment at 6 months were reassessed with the same instruments. Results: There was no significant difference between sociodemographic characteristics of participants at baseline and 6 months. After 6 months of micronutrient supplementation, participants were found to have significantly lower mean scores on the anxiety (P = 0.003), depression (P = 0.001), and overall distress (P = 0.001) subscales and significantly higher mean scores on the RS (P = 0.025). Conclusion: Micronutrient supplementation can reduce the experience of distress, anxiety, and depression and increase the resilience in HAART-naïve HIV-infected persons.","PeriodicalId":52324,"journal":{"name":"Sahel Medical Journal","volume":"23 1","pages":"29 - 35"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44475633","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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