Pub Date : 2011-10-05DOI: 10.4314/NMP.V59I5-6.70363
J. Saleh
It is clear that there are several factors e.g. the increasing disparities in wealth, health inequality leading to poor access to health services, free movement of individuals across the globe thus spreading infectious diseases and lack of commitment of some governments of the world poorest countries towards provision of adequate health care services to the populace, that led to the upsurge in number of Tuberculosis (TB) cases seen in recent times across the globe and more to the sub-Saharan Africa. this rise is not unrelated to the rise of the prevalence HIV (Human Immunodeficiency Virus). It is very clear that airborne route is the most common route of transmission for greater majority of TB cases seen. This is worsened by continual interaction of patients wit overt TB and those with HIV infection in the community, clinics or hospitals. Although most of those immune-competent individuals exposed to the TB pathogen (M. Tuberculosis) do not become infected, the disease seen in HIV immune-compromised patients occurs either as a new infection, re-infection or reactivation as a result of poor cellular immunity. Several studies have shown that despite increase funding towards fighting the infectious diseases across the globe, the population especially on the sub-Saharan continent are now more susceptible to tuberculosis. This is partly as a result of increase prevalence of HIV on the Africam continent leading to lack of cellular immunity on this patients. It is also important to note that there is loss of priority by policy makers in some of these countries diverting resources meant for effective TB control to other health programmes, which they consider more important especially in the short term. This review, discusses the importance of streghthening different TB control measures both in the community and hos[pital environment to be able to reduce the increases in cases of TB seen in HIV patients and further prevent the emergence of drug resistant TB. Keywords: Human immunodeficiency virus, tuberculosis, multidrug resistance TB, surveillance, outbreak
{"title":"TB in HIV Patients: Strengthening Control Measures","authors":"J. Saleh","doi":"10.4314/NMP.V59I5-6.70363","DOIUrl":"https://doi.org/10.4314/NMP.V59I5-6.70363","url":null,"abstract":"It is clear that there are several factors e.g. the increasing disparities in wealth, health inequality leading to poor access to health services, free movement of individuals across the globe thus spreading infectious diseases and lack of commitment of some governments of the world poorest countries towards provision of adequate health care services to the populace, that led to the upsurge in number of Tuberculosis (TB) cases seen in recent times across the globe and more to the sub-Saharan Africa. this rise is not unrelated to the rise of the prevalence HIV (Human Immunodeficiency Virus). It is very clear that airborne route is the most common route of transmission for greater majority of TB cases seen. This is worsened by continual interaction of patients wit overt TB and those with HIV infection in the community, clinics or hospitals. Although most of those immune-competent individuals exposed to the TB pathogen (M. Tuberculosis) do not become infected, the disease seen in HIV immune-compromised patients occurs either as a new infection, re-infection or reactivation as a result of poor cellular immunity. Several studies have shown that despite increase funding towards fighting the infectious diseases across the globe, the population especially on the sub-Saharan continent are now more susceptible to tuberculosis. This is partly as a result of increase prevalence of HIV on the Africam continent leading to lack of cellular immunity on this patients. It is also important to note that there is loss of priority by policy makers in some of these countries diverting resources meant for effective TB control to other health programmes, which they consider more important especially in the short term. This review, discusses the importance of streghthening different TB control measures both in the community and hos[pital environment to be able to reduce the increases in cases of TB seen in HIV patients and further prevent the emergence of drug resistant TB. Keywords: Human immunodeficiency virus, tuberculosis, multidrug resistance TB, surveillance, outbreak","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"42 1","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2011-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89900214","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}
Pub Date : 2011-10-05DOI: 10.4314/NMP.V59I5-6.70365
N. Adeleke, S. olowookere
High maternal mortality has become intractable problem of developing countries despite global efforts at its reduction in the last three decades. Reports form various parts of Nigeria mostly from Teaching Hospitals also confirmed hig maternal mortality. This work on patterns of maternal death from 2002 to 2009 was undertaken to: i. Document the experience in a general hospital. ii. Provide facility baseline data against which trends can be measured in the future. Maternal Mortality ratio over the period was 214 per 100,000 live births. The leading causes of maternal death are Haemorrhage, Induced abortion. Eclampsia and Infectin. Type III delay, low literacy level and low utilization of antenatal services were associated with maternal death. There is need to put in place a sustainable, timely and sfae blood transfusion, obstetric surgical interventions and improved utilization of quality antenatal services in order to meet MDG 5 that is reduction of maternal mortality in a general hospital set up. Keywords: Maternal Mortality, Audit, Haemorrhage, Induce abortion, illiteracy.
{"title":"Pattern of Maternal Mortality in A General Hospital, South Western Nigeria.","authors":"N. Adeleke, S. olowookere","doi":"10.4314/NMP.V59I5-6.70365","DOIUrl":"https://doi.org/10.4314/NMP.V59I5-6.70365","url":null,"abstract":"High maternal mortality has become intractable problem of developing countries despite global efforts at its reduction in the last three decades. Reports form various parts of Nigeria mostly from Teaching Hospitals also confirmed hig maternal mortality. This work on patterns of maternal death from 2002 to 2009 was undertaken to: i. Document the experience in a general hospital. ii. Provide facility baseline data against which trends can be measured in the future. Maternal Mortality ratio over the period was 214 per 100,000 live births. The leading causes of maternal death are Haemorrhage, Induced abortion. Eclampsia and Infectin. Type III delay, low literacy level and low utilization of antenatal services were associated with maternal death. There is need to put in place a sustainable, timely and sfae blood transfusion, obstetric surgical interventions and improved utilization of quality antenatal services in order to meet MDG 5 that is reduction of maternal mortality in a general hospital set up. Keywords: Maternal Mortality, Audit, Haemorrhage, Induce abortion, illiteracy.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"4 1","pages":"68-73"},"PeriodicalIF":0.0,"publicationDate":"2011-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75201949","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}
Pub Date : 2011-10-05DOI: 10.4314/NMP.V59I5-6.70366
A. Adekanmbi, O. Toyobo, T. Ogunlesi, B. Fetuga
Background: Renal dimensions are important for diagnosis and prognosis of nephropathies. These dimensions may be dependent on age and growth parameters. Is there any relationship between renal size and the derivatives of anthropometry? To determine the renal sizes in children sonographically and to correlate these measurements with anthropometric measurements. Children attending the Out-Patient Clinic in a Nigerian Teaching Hospital wothout symptoms or signs referable to renal disorders were prospectively studied between June and August 2009. The weight and height were measured while renal dimensions(length, width and thickness) were sonographically determined. Renal volume, surface area and body mass index were subsequently calculated. A total of 100 subjects aged one month to 14 years were studied: 48% weer female while 52% were males. In male infants the left kidney bipolar length, width, thickness and volume were significantly larger than the right kidney measurements (p = 0.005, p = 0.011, p < 0.001 and 0.02 respectively). Kidney volumes were significantly larger on the left compared to the right in infancy and adolescence among males but not among females. The renal measurements were strongly and positively correlated with age, weight, height and body surface area but not with body mass index. Kidney length appears to consistently increase with age more than width. The strong correlation between anthropometric parameters and renal measurements suggests possible relationship between renal dimensions and somatic growth. Keywords: Anthropometry, Childhood, Renal Sizes, Ultrasonography
{"title":"Correlation of Anthropometric Measurements with Renal Sizes in Nigerian Children: A Preliminary Report","authors":"A. Adekanmbi, O. Toyobo, T. Ogunlesi, B. Fetuga","doi":"10.4314/NMP.V59I5-6.70366","DOIUrl":"https://doi.org/10.4314/NMP.V59I5-6.70366","url":null,"abstract":"Background: Renal dimensions are important for diagnosis and prognosis of nephropathies. These dimensions may be dependent on age and growth parameters. Is there any relationship between renal size and the derivatives of anthropometry? To determine the renal sizes in children sonographically and to correlate these measurements with anthropometric measurements. Children attending the Out-Patient Clinic in a Nigerian Teaching Hospital wothout symptoms or signs referable to renal disorders were prospectively studied between June and August 2009. The weight and height were measured while renal dimensions(length, width and thickness) were sonographically determined. Renal volume, surface area and body mass index were subsequently calculated. A total of 100 subjects aged one month to 14 years were studied: 48% weer female while 52% were males. In male infants the left kidney bipolar length, width, thickness and volume were significantly larger than the right kidney measurements (p = 0.005, p = 0.011, p < 0.001 and 0.02 respectively). Kidney volumes were significantly larger on the left compared to the right in infancy and adolescence among males but not among females. The renal measurements were strongly and positively correlated with age, weight, height and body surface area but not with body mass index. Kidney length appears to consistently increase with age more than width. The strong correlation between anthropometric parameters and renal measurements suggests possible relationship between renal dimensions and somatic growth. Keywords: Anthropometry, Childhood, Renal Sizes, Ultrasonography","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"22 1","pages":"74-82"},"PeriodicalIF":0.0,"publicationDate":"2011-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75521149","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}
Pub Date : 2011-10-05DOI: 10.4314/NMP.V59I5-6.70367
Oo Togun, O. Oyelami
This is a case report of the tragedy of a 20 year old primipara who lost a set of twins to neonatal tetanus and kernicterus on consecutive days. The twins, who were delivered at a private Hospital, presented at the Wesley Guild Hospital, Ilesha on the seventh day of life because the second twin had been unable tp suck for 24 hours and had been having abnormal body movements for 6 hours. The physiacl signs were compatible with a diagnosis of neonatal tetanus and moderate neonatal jaundice secondary to septicaemia. The first twin had no complaint, but examination findings were in keeping with 'severe neonatal jaundice with features suggestive of kernicterus'. Phototherapy was commenced for the twins, and appropriate antispamodics were also instituted fo rthe second twin being managed for tetanus. They had been on admission for thirteen days when second twin died, and the first twin also died a day after. Keywords: Tetanus, Kernicterus, Twins, Preterm.
{"title":"Case Report of A Set of Newborn Twins with Neonatal Tetanus and Kernicterus","authors":"Oo Togun, O. Oyelami","doi":"10.4314/NMP.V59I5-6.70367","DOIUrl":"https://doi.org/10.4314/NMP.V59I5-6.70367","url":null,"abstract":"This is a case report of the tragedy of a 20 year old primipara who lost a set of twins to neonatal tetanus and kernicterus on consecutive days. The twins, who were delivered at a private Hospital, presented at the Wesley Guild Hospital, Ilesha on the seventh day of life because the second twin had been unable tp suck for 24 hours and had been having abnormal body movements for 6 hours. The physiacl signs were compatible with a diagnosis of neonatal tetanus and moderate neonatal jaundice secondary to septicaemia. The first twin had no complaint, but examination findings were in keeping with 'severe neonatal jaundice with features suggestive of kernicterus'. Phototherapy was commenced for the twins, and appropriate antispamodics were also instituted fo rthe second twin being managed for tetanus. They had been on admission for thirteen days when second twin died, and the first twin also died a day after. Keywords: Tetanus, Kernicterus, Twins, Preterm.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"20 1","pages":"83-86"},"PeriodicalIF":0.0,"publicationDate":"2011-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78931797","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}
Pub Date : 2011-06-13DOI: 10.4314/NMP.V59I3-4.67109
T. Raimi, O. Odusan, O. Jagun, B. Aina, O. Sokan
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious acute complications of diabetes. The occurrence of hyperglycaemic emergency in pregnancy compromises both the fetus and the mother and is associated with excess fetal and maternal mortality. It usually occurs in the later stages of pregnancy and is also seen in newly presenting type 1 diabetes patients. We present a case of hyperglycaemic emergency in a pregnant woman with type 1 diabetes mellitus. Key words: Diabetes, Emergency, Pregnancy
{"title":"Hyperglycemic Emergency in Pregnancy- Case Report and Review of Literature","authors":"T. Raimi, O. Odusan, O. Jagun, B. Aina, O. Sokan","doi":"10.4314/NMP.V59I3-4.67109","DOIUrl":"https://doi.org/10.4314/NMP.V59I3-4.67109","url":null,"abstract":"Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious acute complications of diabetes. The occurrence of hyperglycaemic emergency in pregnancy compromises both the fetus and the mother and is associated with excess fetal and maternal mortality. It usually occurs in the later stages of pregnancy and is also seen in newly presenting type 1 diabetes patients. We present a case of hyperglycaemic emergency in a pregnant woman with type 1 diabetes mellitus. Key words: Diabetes, Emergency, Pregnancy","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73597822","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}
Pub Date : 2011-06-13DOI: 10.4314/NMP.V59I1-2.67105
O. Odusan, Ha Raimi, S. Oguntona, O. Adelowo
Various rheumatologic disorders are associated with diabetes mellitus. These include osteoarthritis, shoulder pain syndrome, flexor tendon synovitis and Diffuse Idiopathic Skeletal Hyperostosis (DISH). Although Diabetes Mellitus has been frequently reported among Nigerians, there are few reports on rheumatologic disorders among them. This is a case report of four rheumatologic conditions commonly seen among Nigerian diabetics. Three (3) of the four diabetic patients were females, (ages 67-87yrs) and had limited joint mobility (LJM), Shoulder Pain syndrome with Sudecks Atrophy and neurogenic bladder in the 82yr old. The fourth patient, 61 yr old male had LJM only. Diabetes duration ranged from 10-20 years. They were managed conservatively with NSAID, intra-articular steroid injection into the shoulder joint and intra-lesional injection in the patient with trigger finger. Response to therapy was effective with little or no pain after. Long disease duration and old age are essentials to the onset of rheumatological disorders in diabetes. There may be multiple manifestations in any one patient and multidisciplinary approach in management of patients to improve outcome and overall quality of life is advocated. Keywords: Diabetes mellitus, duration, rheumatologic manifestation.
{"title":"Rheumatologic Disorders in Diabetes Mellitus: Case Reports and Review of Literature","authors":"O. Odusan, Ha Raimi, S. Oguntona, O. Adelowo","doi":"10.4314/NMP.V59I1-2.67105","DOIUrl":"https://doi.org/10.4314/NMP.V59I1-2.67105","url":null,"abstract":"Various rheumatologic disorders are associated with diabetes mellitus. These include osteoarthritis, shoulder pain syndrome, flexor tendon synovitis and Diffuse Idiopathic Skeletal Hyperostosis (DISH). Although Diabetes Mellitus has been frequently reported among Nigerians, there are few reports on rheumatologic disorders among them. This is a case report of four rheumatologic conditions commonly seen among Nigerian diabetics. Three (3) of the four diabetic patients were females, (ages 67-87yrs) and had limited joint mobility (LJM), Shoulder Pain syndrome with Sudecks Atrophy and neurogenic bladder in the 82yr old. The fourth patient, 61 yr old male had LJM only. Diabetes duration ranged from 10-20 years. They were managed conservatively with NSAID, intra-articular steroid injection into the shoulder joint and intra-lesional injection in the patient with trigger finger. Response to therapy was effective with little or no pain after. Long disease duration and old age are essentials to the onset of rheumatological disorders in diabetes. There may be multiple manifestations in any one patient and multidisciplinary approach in management of patients to improve outcome and overall quality of life is advocated. Keywords: Diabetes mellitus, duration, rheumatologic manifestation.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78756371","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}
Pub Date : 2011-06-13DOI: 10.4314/NMP.V59I1-2.67106
H. O. Oboro, C. Azodo, A. Ehizele, M. Sede, N. Chukwumah
To assess the perceived visual deterioration and the determinants among selected dental surgeons in Nigeria. A cross-sectional survey of Resident doctors attending the Revision course of Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria in Lagos University Teaching Hospital, Lagos, Nigeria was conducted in October, 2008. The 21-item self-administered questionnaire was used to obtain demographic information, medicated eyeglass use, self-rating of vision on start of dental practice, self-rating of vision presently, self-rating of illumination in dental operatory, procedure that can be done without adequate illumination and procedures that need light enhancers. Majority of the respondents were male, in the 31-35 year age group, had less than 10 years post-graduation experience and are specializing in oral and maxillofacial surgery. Perceived visual deterioration was reported by 22 (36.1%) of the respondents. Respondents who are 46-50 years, male, with >_ 10 years of experience, using medicated eyeglass and specializing in Restorative dentistry reported higher perceived visual deterioration. The prevalence of use of medicated eyeglass was 22 (36.1%). The illumination of dental operatory was good by 35 (57.4%) of the respondents using a self-rating scale. The predominant procedures performed under limited illumination were oral surgical 16 (26.2%) and orthodontic 16 (26.2%). Light enhancers were advocated by respondents mostly during restorative procedures. Perceived visual deterioration in this study was high. This justifies the need for assessment of vision at employment and longitudinal assessment of vision annually inorder to objectively ascertain the level of visual deterioration. Keywords: visual deterioration, perception, eyeglasses, dental surgeons, Nigeria
{"title":"Perceived Visual Deterioration among a Selected Group of Dental Surgeons in Nigeria","authors":"H. O. Oboro, C. Azodo, A. Ehizele, M. Sede, N. Chukwumah","doi":"10.4314/NMP.V59I1-2.67106","DOIUrl":"https://doi.org/10.4314/NMP.V59I1-2.67106","url":null,"abstract":"To assess the perceived visual deterioration and the determinants among selected dental surgeons in Nigeria. A cross-sectional survey of Resident doctors attending the Revision course of Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria in Lagos University Teaching Hospital, Lagos, Nigeria was conducted in October, 2008. The 21-item self-administered questionnaire was used to obtain demographic information, medicated eyeglass use, self-rating of vision on start of dental practice, self-rating of vision presently, self-rating of illumination in dental operatory, procedure that can be done without adequate illumination and procedures that need light enhancers. Majority of the respondents were male, in the 31-35 year age group, had less than 10 years post-graduation experience and are specializing in oral and maxillofacial surgery. Perceived visual deterioration was reported by 22 (36.1%) of the respondents. Respondents who are 46-50 years, male, with >_ 10 years of experience, using medicated eyeglass and specializing in Restorative dentistry reported higher perceived visual deterioration. The prevalence of use of medicated eyeglass was 22 (36.1%). The illumination of dental operatory was good by 35 (57.4%) of the respondents using a self-rating scale. The predominant procedures performed under limited illumination were oral surgical 16 (26.2%) and orthodontic 16 (26.2%). Light enhancers were advocated by respondents mostly during restorative procedures. Perceived visual deterioration in this study was high. This justifies the need for assessment of vision at employment and longitudinal assessment of vision annually inorder to objectively ascertain the level of visual deterioration. Keywords: visual deterioration, perception, eyeglasses, dental surgeons, Nigeria","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85353973","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}
Pub Date : 2011-06-13DOI: 10.4314/NMP.V59I1-2.67102
A. Mustapha, O. Ogunniyi, E. Sanya
Stroke is a common public health problem in Nigeria and a leading cause of hospitalization in neurological services. Currently, there is limited information on predictors of early mortality in hospitalized patients in this region. The objectives of this study were to determine the 30-day case fatality rate as well as predictors of early mortality after stroke. This was a prospective study of all stroke patients admitted to the University College Hospital Ibadan Nigeria between July 2002 and September 2003.The diagnosis of stroke was mainly clinical using the WHO clinical criteria. Only 21 patients had Cranial CT scans due to the frequent breakdown of the machine during the study and the high cost of the investigation procedure. Predictors of 30-Day mortality: GCS 140mg/dl, Age>70 years, NIHSS score>20, Heamorrhagic stroke, Systolic and Diastolic Hypertension were studied in all the patients. A total of 135 patients were enrolled in the study, comprising 74 males (54.8%) and 61 women (45.2%). Mean age was 62.3±12.Ischaemic CVD accounted for 71% of all cases while ICH was 22% and SAH was 7%. The over-all mortality was 15.5% and was closely related to the NIHSS score, level of consciousness (GCS) and associated complications such as raised intracranial pressure and aspiration pneumonia. NIHSS score > 20 was the only significant independent predictor of thirty days mortality in this study. The case fatality rate in this study was relatively lower than the value obtained in most previous hospital reports from Nigeria and Africa. This may be due to improved stroke care among others in this centre. Key words: Stroke, case fatality rate, predictors of 30- day mortality
{"title":"Acute Stroke at The University College Hospital Ibadan, Nigeria: Clinical Profile and Predictors of 30-day Mortality","authors":"A. Mustapha, O. Ogunniyi, E. Sanya","doi":"10.4314/NMP.V59I1-2.67102","DOIUrl":"https://doi.org/10.4314/NMP.V59I1-2.67102","url":null,"abstract":"Stroke is a common public health problem in Nigeria and a leading cause of hospitalization in neurological services. Currently, there is limited information on predictors of early mortality in hospitalized patients in this region. The objectives of this study were to determine the 30-day case fatality rate as well as predictors of early mortality after stroke. This was a prospective study of all stroke patients admitted to the University College Hospital Ibadan Nigeria between July 2002 and September 2003.The diagnosis of stroke was mainly clinical using the WHO clinical criteria. Only 21 patients had Cranial CT scans due to the frequent breakdown of the machine during the study and the high cost of the investigation procedure. Predictors of 30-Day mortality: GCS 140mg/dl, Age>70 years, NIHSS score>20, Heamorrhagic stroke, Systolic and Diastolic Hypertension were studied in all the patients. A total of 135 patients were enrolled in the study, comprising 74 males (54.8%) and 61 women (45.2%). Mean age was 62.3±12.Ischaemic CVD accounted for 71% of all cases while ICH was 22% and SAH was 7%. The over-all mortality was 15.5% and was closely related to the NIHSS score, level of consciousness (GCS) and associated complications such as raised intracranial pressure and aspiration pneumonia. NIHSS score > 20 was the only significant independent predictor of thirty days mortality in this study. The case fatality rate in this study was relatively lower than the value obtained in most previous hospital reports from Nigeria and Africa. This may be due to improved stroke care among others in this centre. Key words: Stroke, case fatality rate, predictors of 30- day mortality","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85138384","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}
Pub Date : 2011-06-13DOI: 10.4314/nmp.v59i3-4.67111
K. Iseh, A. Obembe
The act of terminating human life may be suicidal or homicidal, involving violent or non violent methods. Cut throat as a violent method in terminating human life is discussed. All cases of cut throat injuries that were from deliberate infliction over a 9year period(September 1999- August 2008) and the circumstances surrounding such injuries were reviewed from a tertiary health institution in north western Nigeria. A total number of 15 cases were seen. All were males with age range of 18 to 60 years(Mean age 32.47years± SD 11.351) . Ten (66.7%) cases were from deliberate self harm(DSH)(Age range:20-60years, mean age 36.9years±SD 13.017) but were known psychiatric patients who had defaulted in follow-up psychiatric care. Five (33.3%) were homicidal(Age range 18-35years ,mean age 23.8years±SD 8.258) as a result of conflicts, three of whom were under the influence of cannabis. Surgical repair and psychiatric treatment were offered concurrently. One required a tracheostomy to prevent upper airway obstruction from laryngeal trauma. Repair was carried out under local anaesthesia in all but one case that required general anaesthesia. Psychosocial disturbances may lead to DSH, suicide or homicidal cut throat injuries. Psychiatric patients who are not on regular medications accounted for 66.7% of the cases of DSH in this study while 33.3% of the cases were homicidal. Therefore continued follow up of psychiatric patients must be emphasized to prevent these injuries in addition to addressing psychosocial issues that may lead to DSH, suicide, or homicide in the society. Key words: Cut throat injury, Deliberate self harm, Homicide,
{"title":"Cut - Throat Injuries from Deliberate Self Harm and Homicide in Sokoto, Nigeria","authors":"K. Iseh, A. Obembe","doi":"10.4314/nmp.v59i3-4.67111","DOIUrl":"https://doi.org/10.4314/nmp.v59i3-4.67111","url":null,"abstract":"The act of terminating human life may be suicidal or homicidal, involving violent or non violent methods. Cut throat as a violent method in terminating human life is discussed. All cases of cut throat injuries that were from deliberate infliction over a 9year period(September 1999- August 2008) and the circumstances surrounding such injuries were reviewed from a tertiary health institution in north western Nigeria. A total number of 15 cases were seen. All were males with age range of 18 to 60 years(Mean age 32.47years± SD 11.351) . Ten (66.7%) cases were from deliberate self harm(DSH)(Age range:20-60years, mean age 36.9years±SD 13.017) but were known psychiatric patients who had defaulted in follow-up psychiatric care. Five (33.3%) were homicidal(Age range 18-35years ,mean age 23.8years±SD 8.258) as a result of conflicts, three of whom were under the influence of cannabis. Surgical repair and psychiatric treatment were offered concurrently. One required a tracheostomy to prevent upper airway obstruction from laryngeal trauma. Repair was carried out under local anaesthesia in all but one case that required general anaesthesia. Psychosocial disturbances may lead to DSH, suicide or homicidal cut throat injuries. Psychiatric patients who are not on regular medications accounted for 66.7% of the cases of DSH in this study while 33.3% of the cases were homicidal. Therefore continued follow up of psychiatric patients must be emphasized to prevent these injuries in addition to addressing psychosocial issues that may lead to DSH, suicide, or homicide in the society. Key words: Cut throat injury, Deliberate self harm, Homicide,","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73158539","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}
Pub Date : 2011-06-13DOI: 10.4314/NMP.V59I3-4.67108
D. Adetoye, No Aigoro, Aa Onabadejo, A. Erinoso
We report a case of stillborn female dicephalus dipus tribrachius twins at the State Hospital, Abeokuta, South West, Nigeria - a secondary health facility and a major referral centre. The mother was a 28-year old unbooked multipara who presented in obstruction at the second stage of labour, and was delivered by caesarean section. This case underscores the need for routine antenatal care for all pregnant women in our environment, use of ultrasonography to detect fetal abnormalities, and early referral to appropriate level of care. To our knowledge, this is the first case of dicephalus dipus tribrachius twins at our centre, and in Abeokuta, South-west, Nigeria. Key words: Conjoined twins, Dicephalus twins, Obstructed Labour, Still birth, Antenatal care, Abeokuta
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