Pub Date : 2018-06-30DOI: 10.4103/ajmhs.ajmhs_67_17
A. Adekanmi, A. Adeniji-Sofoluwe, G. Obajimi, E. Okafor
Introduction: Despite the importance of a thorough clinical evaluation, ultrasonography has emerged as the mainstay of imaging of the scrotum and its contents. Differentiation of testicular lesions and that of adjacent scrotum and content is usually difficult clinically. Scrotal ultrasound (SUSS) is highly sensitive in the detection of intrascrotal abnormalities and in differentiating testicular from paratesticular lesions. SUSS accurately determines the location and nature of palpable lesions and reveals nonpalpable scrotal masses. The aim of this study is to report the various indications for SUSS in this setting and to describe the sonographic findings in these patients. Materials and Methods: A retrospective and descriptive study carried out to evaluate scrotal ultrasound scans performed on 442 patients referred for various clinical indications from the clinics and units of the University College Hospital, to the Radiology department of the same hospital which serves as referral center in Ibadan, and the South-Western Nigeria; over a 10 year period from January 2006 to December 2015, a tertiary health Institution. Results: The mean age of the study population was 36.13 years ± standard deviation 15.88 years. Most of the patients (57.1%) were within the age group of 30 and 49 years. The leading clinical indication for ultrasound referral was infertility/infertility related issues in 56.1% of the total patients. Testicular masses were clinically detected and required SUSS for confirmation in 4.5% of the study population. On USS, the average testicular volume in adults with normal study was 16.38 cm3 and 15.99 cm3 on the right and left side, respectively. The most common USS findings were varicocele (29.4%), this was bilateral in more than half of the cases. Hydrocele was the second most common finding in 18.78% and often bilateral. Testicular masses were seen in 11.1% and were cystic in nature in more than half of the study population. Conclusion: Infertility/infertility related diagnosis were the most frequent indications for testicular ultrasound in adults in our environment. We recommend SUSS as a routine investigation in suspected scrotal/testicular pathologies.
{"title":"A 10-Year review of ultrasonographic findings of scrotal diseases in Ibadan, South Western, Nigeria","authors":"A. Adekanmi, A. Adeniji-Sofoluwe, G. Obajimi, E. Okafor","doi":"10.4103/ajmhs.ajmhs_67_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_67_17","url":null,"abstract":"Introduction: Despite the importance of a thorough clinical evaluation, ultrasonography has emerged as the mainstay of imaging of the scrotum and its contents. Differentiation of testicular lesions and that of adjacent scrotum and content is usually difficult clinically. Scrotal ultrasound (SUSS) is highly sensitive in the detection of intrascrotal abnormalities and in differentiating testicular from paratesticular lesions. SUSS accurately determines the location and nature of palpable lesions and reveals nonpalpable scrotal masses. The aim of this study is to report the various indications for SUSS in this setting and to describe the sonographic findings in these patients. Materials and Methods: A retrospective and descriptive study carried out to evaluate scrotal ultrasound scans performed on 442 patients referred for various clinical indications from the clinics and units of the University College Hospital, to the Radiology department of the same hospital which serves as referral center in Ibadan, and the South-Western Nigeria; over a 10 year period from January 2006 to December 2015, a tertiary health Institution. Results: The mean age of the study population was 36.13 years ± standard deviation 15.88 years. Most of the patients (57.1%) were within the age group of 30 and 49 years. The leading clinical indication for ultrasound referral was infertility/infertility related issues in 56.1% of the total patients. Testicular masses were clinically detected and required SUSS for confirmation in 4.5% of the study population. On USS, the average testicular volume in adults with normal study was 16.38 cm3 and 15.99 cm3 on the right and left side, respectively. The most common USS findings were varicocele (29.4%), this was bilateral in more than half of the cases. Hydrocele was the second most common finding in 18.78% and often bilateral. Testicular masses were seen in 11.1% and were cystic in nature in more than half of the study population. Conclusion: Infertility/infertility related diagnosis were the most frequent indications for testicular ultrasound in adults in our environment. We recommend SUSS as a routine investigation in suspected scrotal/testicular pathologies.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"62 1","pages":"60 - 65"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79074086","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 : 2018-06-30DOI: 10.4103/ajmhs.ajmhs_36_17
Ahmadu Bello, A. Umar, M. Borodo
Background: Helicobacter pylori (H. pylori) has been well noted as a causative agent of many diseases in the gastrointestinal (GI) tract notably, gastritis, peptic ulcer disease, and gastric adenocarcinoma. Determining the burden and the risk factors for acquiring this infection may be crucial to containing it and its sequelae in Kano, Nigeria. Methodology: The study was cross-sectional in design. Questionnaires were administered in dyspeptic patients to obtain the relevant clinical, and sociodemographic data. Upper GI endoscopy was performed in the patients, and gastric biopsy specimens were taken and sent to the histopathology laboratory for assessment and H. pylori identification. Results: Of the 306 participants, 136 (44.4%) were males, while 170 (55.6%) were females, with male: female ratio of 1:1.3. The ages of the participants ranged from 18 to 84 years with a mean of 41.2 ± 15.3 years. Of the 306 samples, 250 (81.7%) were positive for H. pylori. This gives H. pylori prevalence of 81.7%. Only 4 (1.3%) of the participants belonged to the higher social class, out of which 25% had positive H. pylori, while 230 (75.2%) participants belonged to the lower socioeconomic class with 87.8% H. pylori prevalence. The lower social class had a significant association (P < 0.0001) with increased H. pylori infection. A total of 290 subjects (94.8%) shared a room with three or more other siblings in childhood, out of which 233 (80.3%) had H. pylori. Only 80 subjects (26.1%) used pipe-borne water in childhood, while 226 (73.9%) sourced their water from either well, pond or stream during childhood. Conclusion: This study showed a high prevalence of H. pylori in Kano, and low socioeconomic status, unclean water source, overcrowding, and cigarette smoking were significant risk factors for H. pylori infection.
{"title":"Prevalence and risk factors for helicobacter pylori infection in gastroduodenal diseases in Kano, Nigeria","authors":"Ahmadu Bello, A. Umar, M. Borodo","doi":"10.4103/ajmhs.ajmhs_36_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_36_17","url":null,"abstract":"Background: Helicobacter pylori (H. pylori) has been well noted as a causative agent of many diseases in the gastrointestinal (GI) tract notably, gastritis, peptic ulcer disease, and gastric adenocarcinoma. Determining the burden and the risk factors for acquiring this infection may be crucial to containing it and its sequelae in Kano, Nigeria. Methodology: The study was cross-sectional in design. Questionnaires were administered in dyspeptic patients to obtain the relevant clinical, and sociodemographic data. Upper GI endoscopy was performed in the patients, and gastric biopsy specimens were taken and sent to the histopathology laboratory for assessment and H. pylori identification. Results: Of the 306 participants, 136 (44.4%) were males, while 170 (55.6%) were females, with male: female ratio of 1:1.3. The ages of the participants ranged from 18 to 84 years with a mean of 41.2 ± 15.3 years. Of the 306 samples, 250 (81.7%) were positive for H. pylori. This gives H. pylori prevalence of 81.7%. Only 4 (1.3%) of the participants belonged to the higher social class, out of which 25% had positive H. pylori, while 230 (75.2%) participants belonged to the lower socioeconomic class with 87.8% H. pylori prevalence. The lower social class had a significant association (P < 0.0001) with increased H. pylori infection. A total of 290 subjects (94.8%) shared a room with three or more other siblings in childhood, out of which 233 (80.3%) had H. pylori. Only 80 subjects (26.1%) used pipe-borne water in childhood, while 226 (73.9%) sourced their water from either well, pond or stream during childhood. Conclusion: This study showed a high prevalence of H. pylori in Kano, and low socioeconomic status, unclean water source, overcrowding, and cigarette smoking were significant risk factors for H. pylori infection.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"15 1","pages":"41 - 46"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86911632","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 : 2018-01-01DOI: 10.4103/ajmhs.ajmhs_55_17
Vikrant Negi, Monika Pathania, R. Prakash, D. Juyal, M. Sharma, Shekhar Pal
Introduction: Enteric fever, caused by Salmonella enterica subsp. enterica serotype Typhi and Paratyphi, is endemic in India with an incidence of 102–2219/100,000 populations. The definitive diagnosis of enteric fever in patients with compatible clinical picture is isolation of Salmonellae from blood, bone marrow, stool or urine, and demonstration of four-fold rise in antibody titer to both O and H antigen of the organism between acute and convalescent-phase sera. Aim: The aim of the study was to study the prevalence of various serotypes of S. enterica and their antibiogram in foot hills of Himalayas. Materials and Methods: During February 2012–January 2013, all clinically suspected patients were screened for enteric fever by Widal tube agglutination test. For the isolation of etiology, venous blood, stool and urine specimen were obtained from patients with antibody titer of ≥80 and 160 for anti-O agglutinin and anti-H agglutinin of Salmonella typhi, respectively, and ≥20 for anti-H agglutinin of S. paratyphi A and S. paratyphi B. Characterization and antibiogram determination of the isolates was done by conventional microbiological methods including Kirby–Bauer's disc diffusion technique. Result: Among 1173 suspected cases, 373 showed a high titer of antibodies against O (≥80), H (≥160), AH (≥20), and BH (≥20) antigens. A total of 81 isolates were obtained from 76 patients (29 from blood and 49 from stool and three from urine), of which 54 were identified as Salmonella typhi, 20 as Paratyphi A and seven as Paratyphi B. Extended-spectrum beta-lactamase production was observed in four isolates of S. typhi. Ciprofloxacin followed by co-trimoxazole was resistant to 46.5 and 36.5% of the isolates, respectively. Conclusion: This report indicates a significant percentage of drug resistance in S. enterica serotypes in Garhwal region. Periodic monitoring of the antibiogram pattern along with the implementation of strict antibiotic policies and patient education is needed.
{"title":"Prevalence and antibiogram pattern of Salmonella enterica serotypes in Garhwal Region: First report from foothills of himalayas","authors":"Vikrant Negi, Monika Pathania, R. Prakash, D. Juyal, M. Sharma, Shekhar Pal","doi":"10.4103/ajmhs.ajmhs_55_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_55_17","url":null,"abstract":"Introduction: Enteric fever, caused by Salmonella enterica subsp. enterica serotype Typhi and Paratyphi, is endemic in India with an incidence of 102–2219/100,000 populations. The definitive diagnosis of enteric fever in patients with compatible clinical picture is isolation of Salmonellae from blood, bone marrow, stool or urine, and demonstration of four-fold rise in antibody titer to both O and H antigen of the organism between acute and convalescent-phase sera. Aim: The aim of the study was to study the prevalence of various serotypes of S. enterica and their antibiogram in foot hills of Himalayas. Materials and Methods: During February 2012–January 2013, all clinically suspected patients were screened for enteric fever by Widal tube agglutination test. For the isolation of etiology, venous blood, stool and urine specimen were obtained from patients with antibody titer of ≥80 and 160 for anti-O agglutinin and anti-H agglutinin of Salmonella typhi, respectively, and ≥20 for anti-H agglutinin of S. paratyphi A and S. paratyphi B. Characterization and antibiogram determination of the isolates was done by conventional microbiological methods including Kirby–Bauer's disc diffusion technique. Result: Among 1173 suspected cases, 373 showed a high titer of antibodies against O (≥80), H (≥160), AH (≥20), and BH (≥20) antigens. A total of 81 isolates were obtained from 76 patients (29 from blood and 49 from stool and three from urine), of which 54 were identified as Salmonella typhi, 20 as Paratyphi A and seven as Paratyphi B. Extended-spectrum beta-lactamase production was observed in four isolates of S. typhi. Ciprofloxacin followed by co-trimoxazole was resistant to 46.5 and 36.5% of the isolates, respectively. Conclusion: This report indicates a significant percentage of drug resistance in S. enterica serotypes in Garhwal region. Periodic monitoring of the antibiogram pattern along with the implementation of strict antibiotic policies and patient education is needed.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"1 1","pages":"14 - 19"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89491763","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 : 2018-01-01DOI: 10.4103/ajmhs.ajmhs_33_18
V. Obi, O. J. Umeora
Background: Despite the relative safety of cesarean section (CS), increasing CS rate is a cause for concern to obstetricians and anesthetists because of the attendant increased health risk one of which is the risk of anesthesia. The choice of anesthesia for cesarean section depends on the indication for the surgery, the urgency of intervention required, the maternal and/or fetal status, and the patient's desires. Despite the paradigm shift toward spinal anesthesia, general anesthesia is still commonly administered in our facility for some specific indications. Objective: This study was aimed to evaluate the maternal and neonatal outcomes in patients who had emergency CS under spinal anesthesia compared with those who had general anesthesia. Materials and Methods: This was a retrospective study comparing the obstetric outcome of patients who had emergency CS under spinal anesthesia compared with those who had the surgery under general anesthesia. Data analysis was done using statistical Epi Info version 7.2.1. Results: The most common indication for surgery in the spinal group was cephalopelvic disproportion while that for the general anesthesia group was antepartum hemorrhage/placenta previa. Patients who had spinal anesthesia had less intraoperative blood loss compared with those who had general anesthesia (814 ± 124 vs. 842 ± 324; P = 0.0007). There was a significant difference in the intraoperative blood loss >1000 ml among women who had spinal anesthesia relative to women who had general anesthesia (odds ratio [OR]: 0.6832, 95% confidence interval [CI]: 0.3390–0.9779; P = 0.0005). Spinal anesthesia was associated with a reduced risk of having a 1st-min Apgar score <7 (OR: 0.6096, 95% CI: 0.4066–0.9140; P = 0.016). There was no significant difference in the 5th-min Apgar score in both groups. There was also no significant difference in the number of neonates admitted into the Intensive Care Units. The maternal and perinatal mortality was not different in both groups. Conclusion: Spinal anesthesia was associated with reduced risk of blood loss and reduced risk of low Apgar score in the 1st min. There was no difference in the 5th-min Apgar score and maternal and neonatal mortality.
{"title":"Anesthesia for emergency cesarean section: A comparison of spinal versus general anesthesia on maternal and neonatal outcomes","authors":"V. Obi, O. J. Umeora","doi":"10.4103/ajmhs.ajmhs_33_18","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_33_18","url":null,"abstract":"Background: Despite the relative safety of cesarean section (CS), increasing CS rate is a cause for concern to obstetricians and anesthetists because of the attendant increased health risk one of which is the risk of anesthesia. The choice of anesthesia for cesarean section depends on the indication for the surgery, the urgency of intervention required, the maternal and/or fetal status, and the patient's desires. Despite the paradigm shift toward spinal anesthesia, general anesthesia is still commonly administered in our facility for some specific indications. Objective: This study was aimed to evaluate the maternal and neonatal outcomes in patients who had emergency CS under spinal anesthesia compared with those who had general anesthesia. Materials and Methods: This was a retrospective study comparing the obstetric outcome of patients who had emergency CS under spinal anesthesia compared with those who had the surgery under general anesthesia. Data analysis was done using statistical Epi Info version 7.2.1. Results: The most common indication for surgery in the spinal group was cephalopelvic disproportion while that for the general anesthesia group was antepartum hemorrhage/placenta previa. Patients who had spinal anesthesia had less intraoperative blood loss compared with those who had general anesthesia (814 ± 124 vs. 842 ± 324; P = 0.0007). There was a significant difference in the intraoperative blood loss >1000 ml among women who had spinal anesthesia relative to women who had general anesthesia (odds ratio [OR]: 0.6832, 95% confidence interval [CI]: 0.3390–0.9779; P = 0.0005). Spinal anesthesia was associated with a reduced risk of having a 1st-min Apgar score <7 (OR: 0.6096, 95% CI: 0.4066–0.9140; P = 0.016). There was no significant difference in the 5th-min Apgar score in both groups. There was also no significant difference in the number of neonates admitted into the Intensive Care Units. The maternal and perinatal mortality was not different in both groups. Conclusion: Spinal anesthesia was associated with reduced risk of blood loss and reduced risk of low Apgar score in the 1st min. There was no difference in the 5th-min Apgar score and maternal and neonatal mortality.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"1 1","pages":"31 - 34"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74619224","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 : 2018-01-01DOI: 10.4103/ajmhs.ajmhs_54_17
R. Maduka, J. Osaikhuwuomwan, M. Aziken
Background: In vitro fertilization–embryo transfer (IVF − ET) has become a core treatment method for managing infertility. Bacterial contamination of the ET catheter may affect outcome, but there is still no consensus of evidence. Objectives: This study aims to assess the effect of bacterial colonization of the ET catheter tip on the clinical pregnancy rate in an IVF–ET treatment. Methods: An analytical cross-sectional study among women undergoing IVF–ET treatment was undertaken. The patients selected had both cervical swab and the tip of the ET catheter cultured. The patients were grouped into positive (bacterial isolated) and negative (no bacterial isolated) based on the culture result. The clinical pregnancy rate (primary outcome) between the two groups was compared. Results: A total of 80 patients were selected. In 34 patients (42.25%), the cervical culture was positive, while 46 patients (57.50%) had negative cervical culture. Catheter tip culture was positive in 27 patients (33.75%) and negative in 53 patients (66.25%). The predominant microorganisms isolated were Escherichia coli (23.75%), Staphylococcus spp. (18.75%), and Streptococcus spp. (15.00%). The clinical pregnancy rate was 26.25%. The significant factors affecting clinical pregnancy were the age of the patient (P = 0.044), duration of infertility (P = 0.01), and culture result (P = 0.03). Conclusion: Bacterial colonization of the ET catheter tip is associated with a reduction in the clinical pregnancy rate. Utility of routine cervical swab; microscopy, culture, and sensitivity at recruitment of patients for IVF–ET treatment is highlighted.
{"title":"The effect of bacterial colonization of the embryo transfer catheter on Outcome of In vitro Fertilization–Embryo transfer treatment","authors":"R. Maduka, J. Osaikhuwuomwan, M. Aziken","doi":"10.4103/ajmhs.ajmhs_54_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_54_17","url":null,"abstract":"Background: In vitro fertilization–embryo transfer (IVF − ET) has become a core treatment method for managing infertility. Bacterial contamination of the ET catheter may affect outcome, but there is still no consensus of evidence. Objectives: This study aims to assess the effect of bacterial colonization of the ET catheter tip on the clinical pregnancy rate in an IVF–ET treatment. Methods: An analytical cross-sectional study among women undergoing IVF–ET treatment was undertaken. The patients selected had both cervical swab and the tip of the ET catheter cultured. The patients were grouped into positive (bacterial isolated) and negative (no bacterial isolated) based on the culture result. The clinical pregnancy rate (primary outcome) between the two groups was compared. Results: A total of 80 patients were selected. In 34 patients (42.25%), the cervical culture was positive, while 46 patients (57.50%) had negative cervical culture. Catheter tip culture was positive in 27 patients (33.75%) and negative in 53 patients (66.25%). The predominant microorganisms isolated were Escherichia coli (23.75%), Staphylococcus spp. (18.75%), and Streptococcus spp. (15.00%). The clinical pregnancy rate was 26.25%. The significant factors affecting clinical pregnancy were the age of the patient (P = 0.044), duration of infertility (P = 0.01), and culture result (P = 0.03). Conclusion: Bacterial colonization of the ET catheter tip is associated with a reduction in the clinical pregnancy rate. Utility of routine cervical swab; microscopy, culture, and sensitivity at recruitment of patients for IVF–ET treatment is highlighted.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"180 1","pages":"7 - 13"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77336531","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 : 2018-01-01DOI: 10.4103/ajmhs.ajmhs_64_17
O. Salawu, O. Babalola, G. Ibraheem, C. Nwosu, A. Suleiman, D. Kadir, B. Ahmed, J. Mejabi, A. Fadimu, T. Adeyemi, W. Olawole
Background: Patients with musculoskeletal tumors in developing countries often present late to the hospital and this poses serious challenges to the management, especially for malignant tumors. This study aims to highlight the various types of musculoskeletal extremity tumors seen in a Nigerian tertiary health center during the study period, the challenges encountered in managing them, and the outcome of the management. Materials and Methods: A prospective study in which all consenting patients with musculoskeletal extremity tumors who presented to the center from April 2015 to March 2017 were recruited. Results: Seventy-two patients were managed during the study period. The mean age was 22.1 ± 4.5 years and the age group most affected was the 11–20 years group, n = 22 (30.6%). Male-to-female ratio was 1.6:1. The femur was the most commonly involved bone. Forty tumors were benign while 32 were malignant tumors. Osteochondroma was the most common benign tumor while osteosarcoma was the most common malignant tumor. The challenges encountered during the management were a late presentation, poverty, and traditional bonesetter intervention before the presentation. Patients with benign tumor had excision with good outcome in all. Twenty (62.5%) of the patients with a malignant tumor had the ablative procedure, two of these 20 patients died within 6 months of treatment, while 12 (37.5%) of the patients with malignant tumor refused the treatment. Conclusion: Management of musculoskeletal extremity tumors is highly challenging in this part of the country, especially the malignant types, due to the challenges mentioned. There is a need for more awareness about the disease, the Government should subsidize the cost of management of this disease, and more specialty training of personnel is necessary for appropriate management of the diseases.
{"title":"Musculoskeletal tumors of the extremities: Challenges and outcome of management in a Nigeria Tertiary Hospital","authors":"O. Salawu, O. Babalola, G. Ibraheem, C. Nwosu, A. Suleiman, D. Kadir, B. Ahmed, J. Mejabi, A. Fadimu, T. Adeyemi, W. Olawole","doi":"10.4103/ajmhs.ajmhs_64_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_64_17","url":null,"abstract":"Background: Patients with musculoskeletal tumors in developing countries often present late to the hospital and this poses serious challenges to the management, especially for malignant tumors. This study aims to highlight the various types of musculoskeletal extremity tumors seen in a Nigerian tertiary health center during the study period, the challenges encountered in managing them, and the outcome of the management. Materials and Methods: A prospective study in which all consenting patients with musculoskeletal extremity tumors who presented to the center from April 2015 to March 2017 were recruited. Results: Seventy-two patients were managed during the study period. The mean age was 22.1 ± 4.5 years and the age group most affected was the 11–20 years group, n = 22 (30.6%). Male-to-female ratio was 1.6:1. The femur was the most commonly involved bone. Forty tumors were benign while 32 were malignant tumors. Osteochondroma was the most common benign tumor while osteosarcoma was the most common malignant tumor. The challenges encountered during the management were a late presentation, poverty, and traditional bonesetter intervention before the presentation. Patients with benign tumor had excision with good outcome in all. Twenty (62.5%) of the patients with a malignant tumor had the ablative procedure, two of these 20 patients died within 6 months of treatment, while 12 (37.5%) of the patients with malignant tumor refused the treatment. Conclusion: Management of musculoskeletal extremity tumors is highly challenging in this part of the country, especially the malignant types, due to the challenges mentioned. There is a need for more awareness about the disease, the Government should subsidize the cost of management of this disease, and more specialty training of personnel is necessary for appropriate management of the diseases.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"18 1","pages":"20 - 25"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78486748","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}
Njoku Isaac Omoke, Ndubuisi Onu Chukwueloka Onyemaechi
Background: Dog bite injury treated in the emergency room varies from and within subregions in pattern and potential risk of transmission of rabies. This variation has implications in its morbidity and mortality. The aim of this study was to determine the incidence and pattern of dog bite injuries treated in a teaching hospital emergency room setting of a developing country.
Patients and methods: This was a retrospective study of the entire patients with dog bite injury treated in the emergency room of Federal Teaching Hospital Abakaliki from January 2006 to December 2015.
Results: Dog bite injury necessitated visit in 74 patients with an incidence of 2 per 1000 emergency room attendances, and a male to female ratio of 1:1.1. The mean age of the patients was 25.5 ± 1.87 years, and peak age group incidence was 5-9 years. Lower extremity was involved in 77.5% of the injuries, and buttock was the predominant site of injury in 0-4 years old. Fifty-one (68.9%) owned dogs and 23 (31.1%) stray dogs were involved in the attack. There was unprovoked attack in 81.1% of cases, and 51 (68.9%) sustained Grade II injury. Twenty-eight (37.8%) of the dogs had anti-rabies vaccination. Fifty-four (73%) patients had no prehospital care while 64 (86.5%) received postexposure anti-rabies vaccine. Majority of the patients 73 (98.7%) recovered fully. One (1.4%) patient that presented with clinical rabies self-discharged against medical advice.
Conclusion: The incidence of dog bite injury is within worldwide range though the female gender bias is unprecedented. We recommend preventive strategies based on the observed pattern and improvement in the rate of prehospital care and higher coverage of anti-rabies vaccination of dogs.
{"title":"Incidence and Pattern of Dog Bite Injuries Treated in the Emergency Room of a Teaching Hospital South East Nigeria.","authors":"Njoku Isaac Omoke, Ndubuisi Onu Chukwueloka Onyemaechi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Dog bite injury treated in the emergency room varies from and within subregions in pattern and potential risk of transmission of rabies. This variation has implications in its morbidity and mortality. The aim of this study was to determine the incidence and pattern of dog bite injuries treated in a teaching hospital emergency room setting of a developing country.</p><p><strong>Patients and methods: </strong>This was a retrospective study of the entire patients with dog bite injury treated in the emergency room of Federal Teaching Hospital Abakaliki from January 2006 to December 2015.</p><p><strong>Results: </strong>Dog bite injury necessitated visit in 74 patients with an incidence of 2 per 1000 emergency room attendances, and a male to female ratio of 1:1.1. The mean age of the patients was 25.5 ± 1.87 years, and peak age group incidence was 5-9 years. Lower extremity was involved in 77.5% of the injuries, and buttock was the predominant site of injury in 0-4 years old. Fifty-one (68.9%) owned dogs and 23 (31.1%) stray dogs were involved in the attack. There was unprovoked attack in 81.1% of cases, and 51 (68.9%) sustained Grade II injury. Twenty-eight (37.8%) of the dogs had anti-rabies vaccination. Fifty-four (73%) patients had no prehospital care while 64 (86.5%) received postexposure anti-rabies vaccine. Majority of the patients 73 (98.7%) recovered fully. One (1.4%) patient that presented with clinical rabies self-discharged against medical advice.</p><p><strong>Conclusion: </strong>The incidence of dog bite injury is within worldwide range though the female gender bias is unprecedented. We recommend preventive strategies based on the observed pattern and improvement in the rate of prehospital care and higher coverage of anti-rabies vaccination of dogs.</p>","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"17 1","pages":"35-40"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39462437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4103/ajmhs.ajmhs_56_17
A. Lentoor
Objective: In Sub-Saharan Africa, millions of children are suffering from HIV and coexisting child undernutrition. Despite efforts to curb the spread of HIV through the availability of treatment and various nutritional programmes, it has been argued that undernutrition remains highly prevalent in rural areas. The objective of this study was to describe the prevalence and psychosocial factors influencing the nutritional status in the sample of rural-based HIV-infected children on antiretroviral therapy. Materials and Methods: Anthropometric and home environment data were collected from 152 perinatally HIV-infected children on antiretroviral therapy who lived with their primary caregivers in a rural Eastern Cape community. Results: More than half of the sample of children had inadequate nutritional status. The prevalence of stunting particularly was high (36.2%), while 12% were underweight and only 2.7% presented with wasting. Coexisting poor quality home-environment (P < 0.01) added to this burden. Younger age children who lived with a younger biological caregiver were found to present more with stunting than older age children (χ2 [n = 152] = 14.79, P = 0.005), but no significant differences were observed for underweight or wasting. Conclusion: It is important in a context such as South Africa, with the double burden of HIV infection and poverty, that all efforts be directed at alleviating undernutrition. Early pediatric HIV management should not only focus on the provision of treatment but should also prioritize the quality of care of HIV-positive children in the home to improve on their nutritional health.
{"title":"Nutritional status of perinatally HIV-infected children on antiretroviral therapy from a resource-poor rural South African community","authors":"A. Lentoor","doi":"10.4103/ajmhs.ajmhs_56_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_56_17","url":null,"abstract":"Objective: In Sub-Saharan Africa, millions of children are suffering from HIV and coexisting child undernutrition. Despite efforts to curb the spread of HIV through the availability of treatment and various nutritional programmes, it has been argued that undernutrition remains highly prevalent in rural areas. The objective of this study was to describe the prevalence and psychosocial factors influencing the nutritional status in the sample of rural-based HIV-infected children on antiretroviral therapy. Materials and Methods: Anthropometric and home environment data were collected from 152 perinatally HIV-infected children on antiretroviral therapy who lived with their primary caregivers in a rural Eastern Cape community. Results: More than half of the sample of children had inadequate nutritional status. The prevalence of stunting particularly was high (36.2%), while 12% were underweight and only 2.7% presented with wasting. Coexisting poor quality home-environment (P < 0.01) added to this burden. Younger age children who lived with a younger biological caregiver were found to present more with stunting than older age children (χ2 [n = 152] = 14.79, P = 0.005), but no significant differences were observed for underweight or wasting. Conclusion: It is important in a context such as South Africa, with the double burden of HIV infection and poverty, that all efforts be directed at alleviating undernutrition. Early pediatric HIV management should not only focus on the provision of treatment but should also prioritize the quality of care of HIV-positive children in the home to improve on their nutritional health.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"15 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85656697","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 : 2017-07-01DOI: 10.4103/ajmhs.ajmhs_15_17
E. Musa, A. Kodiya, A. Kirfi, O. B. B Nwaorgu
Background: Chronic rhinosinusitis (CRS) is a common disease in otorhinolaryngologic practice. Traditionally, the standard criterion for isolation of pathogens in CRS is the nonendoscopic maxillary sinus puncture through invasive procedures with well-documented hazards. Objectives: To evaluate the pathogens associated with CRS in patients with CRS from endoscopically guided middle meatal swab. Methodology: A prospective cross-sectional study in which endoscopically guided middle meatal swab was aseptically taken from patients with diagnostic criteria of CRS and healthy volunteers. The samples were sent to the laboratory for qualitative and semi-quantitative analysis. Data collected were analyzed using the Statistical Package for the Social Sciences version 16 (SPSS Inc., 233 South Wacker Drive, Chicago, Illinois, USA). Results: A total of 110 microbial isolates were recovered from 82 (63.08%) of the 130 patients with CRS while 46 recorded among 54 (51.92%) of the 104 healthy volunteers. There were 74 (56.92%) bacterial growth out of which 55 (74.32%) were aerobic and 19 (25.68%) anaerobic isolates among the test participants with fungal growth seen in 36 (27.7%) of them while about 18% yielded a mixed growth of aerobic, anaerobic, and/or fungal isolates. Among the control group, however, the 54 people with positive isolates had 21 fungal and 25 aerobic bacteria. Conclusion: Mixed growth of aerobes, anaerobes, and fungal isolates was observed in patients with CRS. Endoscopically guided middle meatal swab is a safe and practical means for collecting samples for microbial culture.
背景:慢性鼻窦炎(CRS)是耳鼻喉科的常见病。传统上，CRS中分离病原体的标准标准是通过有充分证据的侵入性手术进行非内窥镜上颌窦穿刺。目的:评价内镜引导下CRS患者中金属拭子中与CRS相关的病原体。方法:采用前瞻性横断面研究，在内镜引导下，从符合CRS诊断标准的患者和健康志愿者中无菌抽取中间金属拭子。样品送到实验室进行定性和半定量分析。收集的数据使用Statistical Package for Social Sciences version 16 (SPSS Inc.， 233 South Wacker Drive, Chicago, Illinois, USA)进行分析。结果:在130例CRS患者中，82例(63.08%)检出微生物分离株110株，而在104名健康志愿者中，54例(51.92%)检出46株。在测试参与者中，有74个(56.92%)细菌生长，其中55个(74.32%)为好氧分离株，19个(25.68%)为厌氧分离株，其中36个(27.7%)为真菌生长，约18%为好氧、厌氧和/或真菌分离株混合生长。然而，在对照组中，54名分离阳性的人有21种真菌和25种需氧细菌。结论:CRS患者中存在好氧菌、厌氧菌和真菌混合生长。内镜引导下的中间金属拭子是一种安全实用的微生物培养标本采集方法。
{"title":"Microbial isolates from endoscopic middle meatal swab in patients with chronic rhinosinusitis in Kaduna, Nigeria","authors":"E. Musa, A. Kodiya, A. Kirfi, O. B. B Nwaorgu","doi":"10.4103/ajmhs.ajmhs_15_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_15_17","url":null,"abstract":"Background: Chronic rhinosinusitis (CRS) is a common disease in otorhinolaryngologic practice. Traditionally, the standard criterion for isolation of pathogens in CRS is the nonendoscopic maxillary sinus puncture through invasive procedures with well-documented hazards. Objectives: To evaluate the pathogens associated with CRS in patients with CRS from endoscopically guided middle meatal swab. Methodology: A prospective cross-sectional study in which endoscopically guided middle meatal swab was aseptically taken from patients with diagnostic criteria of CRS and healthy volunteers. The samples were sent to the laboratory for qualitative and semi-quantitative analysis. Data collected were analyzed using the Statistical Package for the Social Sciences version 16 (SPSS Inc., 233 South Wacker Drive, Chicago, Illinois, USA). Results: A total of 110 microbial isolates were recovered from 82 (63.08%) of the 130 patients with CRS while 46 recorded among 54 (51.92%) of the 104 healthy volunteers. There were 74 (56.92%) bacterial growth out of which 55 (74.32%) were aerobic and 19 (25.68%) anaerobic isolates among the test participants with fungal growth seen in 36 (27.7%) of them while about 18% yielded a mixed growth of aerobic, anaerobic, and/or fungal isolates. Among the control group, however, the 54 people with positive isolates had 21 fungal and 25 aerobic bacteria. Conclusion: Mixed growth of aerobes, anaerobes, and fungal isolates was observed in patients with CRS. Endoscopically guided middle meatal swab is a safe and practical means for collecting samples for microbial culture.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"2 1","pages":"104 - 108"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90852390","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 : 2017-07-01DOI: 10.4103/ajmhs.ajmhs_37_17
Gayathri Somasheker, A. Ramesh, K. Roopa, C. Dwarakanath
Aims: The purpose of this study was to clinically evaluate the efficacy of Alloderm® with the coronally positioned flap in the treatment of multiple gingival recessions and to assess the esthetic and hypersensitivity evaluation from patient's perspective using visual analog scale (VAS). Subjects and Methods: A total of 10 systemically healthy male and female patients aged 18–50 years with Miller's class I and class II gingival recessions, who had dentin hypersensitivity and esthetic concern were selected for the study. Root coverage (RC) was done using coronally advanced flap with Alloderm®. Statistical Analysis: Descriptive statistical analysis was performed in the present study. Significance was assessed at 5% level of significance. Student's t-test was conducted to find the pairwise significance of the study parameters. Wilcoxon signed-rank test was used to find the significance of percentage of linear RC and percentage of volumetric RC (% of VRC) between 3 and 6 months. Results: A total 31 defects were treated with mean volumetric percentage RC (%RC) at 3 months of 35.21%. This remained the same at 6 months (P = 1.000). There was no statistically significant difference in the volumetric and Linear percentage of root coverage. Dentine hypersensitivity and esthetics were evaluated from patient's perspective using VAS ranging from a score of 0–10. Where 0 indicates very low and score of 10 indicates very high score. VAS indicated a decrease in the sensitivity after treatment. VAS mean score before treatment was 6.22 ± 0.83 with a mean score of 3.90, standard deviation (SD) of ± 1.37 after treatment and mean score of 5.10, SD of ± 0.57 for esthetic evaluation. Conclusions: The use of Alloderm® with coronally positioned flap provided a significant improvement in all the clinical parameters, but did not result in favorable outcome in terms of root coverage of facial gingival recessions of multiple adjacent teeth.
{"title":"Clinical evaluation of acellular dermal matrix allograft (Alloderm®) with coronally advanced flap in the treatment of multiple gingival recessions: A clinical study","authors":"Gayathri Somasheker, A. Ramesh, K. Roopa, C. Dwarakanath","doi":"10.4103/ajmhs.ajmhs_37_17","DOIUrl":"https://doi.org/10.4103/ajmhs.ajmhs_37_17","url":null,"abstract":"Aims: The purpose of this study was to clinically evaluate the efficacy of Alloderm® with the coronally positioned flap in the treatment of multiple gingival recessions and to assess the esthetic and hypersensitivity evaluation from patient's perspective using visual analog scale (VAS). Subjects and Methods: A total of 10 systemically healthy male and female patients aged 18–50 years with Miller's class I and class II gingival recessions, who had dentin hypersensitivity and esthetic concern were selected for the study. Root coverage (RC) was done using coronally advanced flap with Alloderm®. Statistical Analysis: Descriptive statistical analysis was performed in the present study. Significance was assessed at 5% level of significance. Student's t-test was conducted to find the pairwise significance of the study parameters. Wilcoxon signed-rank test was used to find the significance of percentage of linear RC and percentage of volumetric RC (% of VRC) between 3 and 6 months. Results: A total 31 defects were treated with mean volumetric percentage RC (%RC) at 3 months of 35.21%. This remained the same at 6 months (P = 1.000). There was no statistically significant difference in the volumetric and Linear percentage of root coverage. Dentine hypersensitivity and esthetics were evaluated from patient's perspective using VAS ranging from a score of 0–10. Where 0 indicates very low and score of 10 indicates very high score. VAS indicated a decrease in the sensitivity after treatment. VAS mean score before treatment was 6.22 ± 0.83 with a mean score of 3.90, standard deviation (SD) of ± 1.37 after treatment and mean score of 5.10, SD of ± 0.57 for esthetic evaluation. Conclusions: The use of Alloderm® with coronally positioned flap provided a significant improvement in all the clinical parameters, but did not result in favorable outcome in terms of root coverage of facial gingival recessions of multiple adjacent teeth.","PeriodicalId":93249,"journal":{"name":"African journal of medical and health sciences","volume":"12 1","pages":"81 - 88"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72660402","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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