Ibom Medical Journal

A 15-Year Retrospective Survey of the Cytopathologic Spectrum of Cerebrospinal Fluid Aspirate in a Teaching Hospital in Uyo, Southern Nigeria

2023-12-22T18:48:05+00:00

Background: The cytopathologic evaluation of cerebrospinal fluid (CSF) aspirates is a vital diagnostic tool for neurological disorders. This research aimed to characterize the diverse range of cytopathological diagnoses encountered in the CSF specimens within 15 years in a teaching hospital while highlighting their clinical significance.

Materials and Methods: A thorough review of cytopathology records from January 1, 2006, to December 31, 2020, was conducted. CSF samples were collected through lumbar punctures and subsequently subjected to cytopathological examination. The data were collected from the Department of Histopathology, University of Uyo Teaching Hospital archives. The inclusion criteria encompassed all cases with available CSF cytopathology results during the study period. Cases with inadequate or missing data were excluded from the analysis. Data regarding patients’ ages, sex, clinical, and cytopathologic diagnoses were extracted and analyzed.

Results: Thirty-four (34) CSF samples were analyzed during the study period. The mean age was 11.45 ± 12.20 years. The most common clinical indication for CSF analysis was suspected Burkitt’s Lymphoma (34.78%), followed by other Non-Hodgkin Lymphoma (13.04%). The cytopathologic diagnoses exhibited a diverse spectrum, including Acellular Smear (26.5%), Inflammatory Smear (2.9%), Negative for Malignant Cells (52.9%), Positive for Malignant Cells (14.7%), and Suspicious for Malignant Cells (2.9%). This study also observed a significant association between age groups (particularly 0-10 years) and cytopathological diagnoses, with a p-value of 0.023.

Conclusion: A retrospective survey of CSF cytopathology in a Nigerian teaching hospital reveals diverse cytopathological diagnoses, providing insights for neuropathology clinicians and researchers.

Effect of office hysteroscopy on in-vitro fertilization in a fertility centre in Abuja, Nigeria: A prospective study

2023-12-22T22:07:53+00:00

Background: Fifteen percent of married couples worldwide experience infertility despite unprotected intercourse and approximately 50% of infertile women has uterine pathologies. The success of in vitro fertilization can be assessed using various measures including pregnancy rate, implantation rate and the most acceptable, live birth rate. Various modalities have been employed to investigate endometrial pathologies responsible for infertility.

Objectives: To determine and compare the incidence, and pathology in infertile women seen on hysteroscopy and TVS, and the effect on IVF success

Methods: This study had 41 participants, 24 had previous Assisted Reproductive Therapy while 17 had not undergone the process. The 41 participants included those that had both TVS and office hysteroscopy. Abnormal findings were recorded and management carried out based on the abnormality detected.

Result: Forty-one infertile women aged 26 to 45 years were included in the study. About fifty-eight percent had history of IVF attempts, while 41.46% had no history of IVF. TVS and hysteroscopic examinations were performed on all the patients. TVS findings indicated 26.83% normal findings and 73.17% abnormal pelvic findings. Hysteroscopic findings showed 90.25% patients had abnormal uterine findings

Conclusion: This study shows that Hysteroscopy is more sensitive and useful in the diagnosis and treatment of infertility than TVS. Diagnostic measures for hysteroscopic detection of uterine lesions revealed a sensitivity of 78.95% (95% CI 62.68- 90.45), 100% specificity and positive predictive value, with a Negative predictive value of 33.33% (95% CI 21.27 – 48.07) and diagnostic accuracy of 80.95% (95% CI 65.88 – 91.40). These are in keeping with other studies.

Knowledge and preventive practices related to Monkey pox among medical doctors in Sokoto metropolis of Sokoto State, Nigeria

2023-12-22T23:02:51+00:00

Background: For effective control of Monkey pox (Mpox), clinicians need to have adequate knowledge of the disease and adopt appropriate practices to contain it. This study sought to assess the knowledge and practices of medical doctors regarding Monkey pox.

Methodology: A descriptive cross-sectional design was utilized for the study and using a two stage sampling method, 210 medical doctors working in Sokoto metropolis were recruited into the study. A set of structured, pretested and self-administered questionnaire was used to obtain relevant information from the study participants. Data obtained was analyzed using SPSS computer software version 23 with level of statistical significance set at p<0.05

Results: All the respondents were aware of Mpox with more than half (52.3%) having the internet as their commonest source of information. The majority, ((72%) of the clinicians had good knowledge and only years of working experience was significantly associated with knowledge of the disease. Preventive practices were well exhibited by all the respondents with the majority (73%) having appropriate preventive practices.

Conclusion and recommendation: This study has demonstrated good knowledge towards Mpox by clinicians in Sokoto metropolis, with a greater majority exhibiting appropriate preventive practices. Sustained awareness and retraining of health care workers in general is necessary to maintain the tempo of high index of suspicion for outbreaks of Mpox and other potential epidemics and also regular use of personal protective equipment

Sonographic evaluation of the commonest sites of placental localization in pregnant women in Umuahia, Abia State

2023-12-25T07:57:09+00:00

Background: The Placenta is an organ of pregnancy that provides nutrition, excretory functions and oxygen to the fetus.

Aim: The purpose of the study is to determine and provide information on the commonest sites of placental localization in pregnant women in their second and third trimesters in Umuahia, Abia state because there are few documented reports on the sonographic assessment of placental localization in Umuahia.

Methodology: Prospective study of pregnant women in their second and third trimesters was carried out trans- abdominally using an ultrasound scan machine with a 3.5 MHz transducer. Placental localization was classified into anterior, posterior, fundal and low-lying, Ultrasonography was used because it is non-ionizing, cheap and readily available. Exclusion criteria; pregnant women with a history of Caesarian section, uterine fibroids and multiple gestation.

Results: One hundred women between the ages of 20yrs and 42yrs with a mean age of 28.60±4.95 on their routine antenatal visit were used for the study. The women were in their second and third trimesters, and fetal gender distribution was 55 males and 45 females. Placental localization was classified into Anterior 44%, fundal 20%, posterior 30% and previa 3%.

Conclusion: Anterior placentation was the commonest, followed by posterior, then fundal with placenta previa being the least site of placental localization. There was no statistical significance between placental localization and maternal age, gestational age, fetal weight, gender, fetal presentation and heart rate. Evaluation for placental localization in the second and third trimesters is important to rule out placenta previa.

Prevalence of brain fag syndrome and its correlation with stimulant use and socio-economic/demographic characteristics among university undergraduate students in Nigeria

2023-12-25T09:14:31+00:00

Background: Brain Fag Syndrome (BFS) is a culture-bound syndrome characterized by cognitive and somatic symptoms, commonly reported among African students. This study aimed to determine the prevalence of BFS among Nigerian university students and examine its associated factors.

Methods: A cross-sectional survey was conducted among undergraduate students from a university in the northwest region of Nigeria. The study utilized a self-administered questionnaire to collect data on socio-demographic characteristics, stimulant use, course of study, and academic performance. The presence of BFS was assessed using standardized diagnostic criteria.

Results: The study included a total of 625 participants, in their young adulthood. The prevalence of BFS among Nigerian university students was found to be 62.7%. The majority of affected students were aged 20-30, male, and from the Hausa ethnic group. No significant association was found between stimulant use and BFS. However, there was a significant relationship between the course of study and the occurrence of BFS. Academic performance (CGPA) showed a weak negative association with BFS. Other socio-demographic factors such as age, gender, ethnicity, relationship status, birth position, type of home, and family income did not predict the occurrence of BFS.

Conclusion: The high prevalence highlights the need for attention to mental health issues among this population. The results emphasize the importance of considering the course of study and academic performance when studying BFS. Further research is warranted to explore the underlying mechanisms and develop effective interventions for students affected by BFS.

Pattern and outcome of paediatric pleural effusion seen at Usmanu Dafodiyo University Teaching Hospital, Sokoto: A 5-year retrospective study

2023-12-25T16:19:55+00:00

Background: Pleural effusion is an abnormal accumulation of fluid in the pleural cavity which present with spectrum of clinico-aetiological manifestations often requiring multidisciplinary approach.

Objectives: This study set out to determine the prevalence, aetiology, clinical presentation, treatment modalities and outcome of pleural effusion in children.

Materials and Methods: This was a retrospective study where records of children with diagnosis of pleural effusion admitted at UDUTH, Sokoto were obtained between January 2017 and December 2022 and reviewed. Diagnosis was based on clinical presentation and radiological confirmation of pleural effusion. Data was analyzed with SPSS version 20.0.

Results: A total of 49 cases were retrieved. The prevalence of pleural effusion was 0.54% (9,056). It was more prevalent in males with ratio of 2.5:1 (χ² = 9.833, P = 0.007). The median age was 9 years (IQR 7). The most common cause of pleural effusion was pneumonia 26 (53.1%) followed by tuberculosis 16 (32.6%), malignancy 3 (6.1%), cardiac and renal causes accounted for 2 (4.1%) each. Cough (100.0%), difficulty in breathing (100.0%), tachypnea (100.0%), respiratory distress (100.0%), and desaturation (98.0%) were the common presentations. Most (77.5%) of them presented with right sided pleural effusion. The majority (93.9%) had closed thoracostomy tube drainage. The outcome showed majority (83.7%) of the cases been discharged, with a median duration of hospital stay of 22days (IQR 17). However, mortality rate for the malignant causes was 100.0%.

Conclusion: Infections were the major cause of paediatric pleural effusion with relatively good outcome. Surgical intervention and multidisciplinary team approach are needed to reduce the morbidity and mortality in patients with pleural effusion especially for the malignant causes.

Assessment of patients’ knowledge, attitude and practice of cross-infection control in the dental clinic during COVID-19 pandemic

2023-12-25T21:01:52+00:00

Background: The emergence of coronavirus disease 2019 (COVID-19), a highly contagious disease that causes viral respiratory illness, has changed the lifestyle of humans worldwide. Dental practitioners and patients are at high risk of infection during their routine practice due to their exposure to saliva, blood, and droplet production.

Aim: To gain insight into the patient’s viewpoint regarding the practice, altitude, and knowledge of COVID-19 and its transmission and cross-infection in dental clinics.

Methods: This was cross–sectional analytic survey in dentistry during the COVID-19 pandemic. A self-administered close-ended questionnaire consisting of 32 variables was distributed among the study participants. The data were analysed using the Statistical Package for the Social Sciences (SPSS) version 25. The level of significance was p ≤ 0.05.

Results: The age of the participants varied from 20 - 58 years, with a mean age of 34.6 ±5. The majority (89.3%) felt COVID-19 was a highly contagious disease, while 50.0% of the respondents believed that the most common route of COVID-19 transmission in dentistry is through aerosols. The majority, 78.6%, recorded good knowledge of infection control following the COVID-19 outbreak. The number of married patients who had good knowledge of cross-infection control was 118, which was statistically significant.

Conclusion: From the study, it is evident that the patients possess a good range of knowledge in both preventive and cross-infection protocols to follow during the COVID-19 pandemic. However, the same cannot be said about the practice.

Occurrence of high level methicillin resistance Staphylococcus aureus in patients from health facilities in Akwa Ibom State, Nigeria

2023-12-25T22:20:41+00:00

Background: Methicillin resistant S. aureus (MRSA) has become a major public health predicament worldwide. This is owing to its involvement in the evolution of MDR strains and difficulty in therapeutic management of infected patients. This study was conducted to investigate the prevalence of methicillin resistance Staphylococcus aureus among patients in two health facilities in Akwa Ibom State, Nigeria.

Materials and Methods: Clinical isolates of patients from University of Uyo Teaching Hospital (UUTH), Uyo and General Hospital, Ikot Abasi (GHIA) were investigated based on the strategic location of the hospitals. The study design was a descriptive cross-sectional study. Three hundred clinical samples were collected from male and female in and out-patients of all ages and processed using standard bacteriological methods. Detection of Staphylococcus aureus and MRSA strains were done according to standard protocols while antibiotic susceptibility testing of MRSA isolates was conducted using Kirby-Bauer disc diffusion method and interpreted following the CLSI 2021 guidelines.

Results: The prevalence of MRSA strains in this study was 42.9%. Majority of patients with MRSA were from UUTH (44%) closely followed by patients from GHIA (40%). High antibiotics resistant rates of MRSA were recorded for ampicillin (96.6%), ciprofloxacin (73.3%), erythromycin (63.3%) and cotrimoxazole (60%). Gentamicin and ceftriaxone sensitivity rates were 53.3% and 63.4%, respectively.

Conclusion: Health facilities in the state should institute effective antimicrobial stewardship, intensify surveillance and screening of Staphylococcus aureus for MRSA strains to guard against dissemination of multidrug resistant strains in both hospital and community settings because of the clinical implications.

Prevalence and Pattern of Psychiatric Morbidity among People Living with Human Immunodeficiency Virus in Kano

2023-12-26T08:41:04+00:00

Background: Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae.

Objectives: To determine the prevalence and pattern of psychiatric morbidity among PLWHA attending Aminu Kano Teaching Hospital, Kano.

Materials and methods: This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used.
Patients aged 18years and above who had been on ARV drugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded.
Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview.

Results: A total of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively.

Conclusion: Psychiatric disorders are common in PLWHA, with major depression being the commonest.

Morbidity pattern of underfives with moderate acute malnutrition in southern Nigeria

2023-12-26T09:06:53+00:00

Background: Moderate acute malnutrition (MAM) is a leading cause of childhood morbidity and mortality globally. The morbidity pattern of underfives with this condition is yet to be described.

Objective: To describe the morbidity pattern of underfives with MAM

Method: A cross sectional study was conducted in two Primary Health Centres in Uruan Local Government Area of Akwa Ibom State. Caregivers’ brought children aged 6- 59 months to the health facilities following community mobilization. Eligible children were recruited into the study after obtaining parental consent. A validated proforma was used to obtain the biodata and symptoms of common illnesses in the children. A general physical examination, anthropometric measurements and systemic examination were performed.

Results: A total of 162 children were recruited into the study. Their mean (±SD) age was 20.4 ± 13.0 months. Over 70% of them were 6 - 23 months of age. Their mean (±SD) length/height was 77.3 ± 29.6 cm, mean (±SD) weight was 8.3 ± 3.4 kg and mean (±SD) mid upper arm circumference was 12.4 ± 4.5 cm. The main symptoms noted in the children were; fever 99 (61.1%), cough 84 (51.9%), weight loss 81 (50.0%), diarrhoea 40 (24.7%) and vomiting 40 (24.7%) while pallor 77 (47.5%), lymphadenopathy 56 (34.6%), hair changes 49 (30.2%), skin changes 27 (16.6%) were the main signs in them.

Conclusion: The main symptomatology of underfives with MAM were fever, cough and weight loss while pallor, lymphadenopathy and hair changes were the topmost signs. This morbidity pattern is related to interactions between malnutrition and infection in childhood.

Sonographic Evaluation of Renal dimensions in a healthy adult Nigerian Population

2023-12-26T10:24:41+00:00

Background: This study is on sonographic evaluation of renal dimensions in the healthy adult Nigerian population.

Aim: The objective of the study was to determine normal dimensions of the kidney sonographically and to correlate the measurements with the sex, age, height, weight and body mass index, in the adult Nigerian population.

Methodology: This was a prospective hospital based ultrasound study of five hundred (500) apparently healthy adults that were 20 years and above as at the time of data collection, Renal dimensions, length, width and cortical renal thickness were measured. A questionnaire was used for inclusion and exclusion criteria. Consent was obtained from the individuals before the study and strict confidentiality was maintained. Descriptive and inferential statistics were deployed to realize the objectives. The data was analyzed using SPSS statistical package version 20.0. The mean, median, variance, standard deviation of the kidney sizes were evaluated and correlated with the age, sex, weight, height and body mass index of the subjects.

Result: The mean right kidney length measured 94.2+8mm for male and 91.8+9mm for females with a range of 64.0-113mm and 76.0-123mm for males and female respectively. The left mean kidney length measured 99.4+8.1mm and 95.5+9.5mm with a range of 76.0-119.0mm and 76.0-114.mm for males and females respectively while the width was 40.7±3.4mm for males and 40.5±3.4mm for females with P values of 0.599mm which is not significant. Mean left kidney width was 44.7±5.8mm for males and 44.5±9.5mm for females with ranges of 33.0-65.0mm and 30.0-61.0mm for males and females respectively with P values of 0.719 which is not significant. Males had a mean renal cortical thickness of 18.3±2.9mm while females had 16.6±2.9mm with P values of 0.000.

Conclusion: The renal cortical thickness in males is greater than in females. The left cortical renal thickness is greater than the right. There is positive correlation of the left cortical renal thickness with age, but not with body mass index and height. Males have greater kidney length than females but the differences in length are not significant. Also, Males have greater kidney width than females. When correlated with age, height, weight and body mass index of the subjects.

Ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja, Nigeria

2023-12-26T10:54:42+00:00

Objectives: To determine the pattern of ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja (FTHL).

Materials and Methods: Consecutive new stroke patients seen at the Federal Teaching Hospital, Lokoja over a 3-month period were studied. Data was collected with the use of a structured questionnaire divided into four major sections: bio-data, visual history, results of ocular assessment and NEI VFQ-25 quality of life questionnaire. Data analysis was done using SPSS for Windows, version 23.0. Univariate analyses were presented in the form of frequencies, percentages, means, ranges, and standard deviations, charts and tables.

Results: Eighty-three patients were recruited with an age range of 40-71 years, a mean age of 55.3(±7.1) years. Thirty-nine patients (47.0%) were between the ages of 51 and 60 years. Thirty-four (41.0%) patients were females while 49(59.0%) were males. Of 46 (55.4%) patients that had neuro-imaging, stroke was ischaemic in 37(80.4%) and haemorrhagic in 9(19.6%). Of the 63 patients with left sided stroke, 2 (2.4%), 4(4.8%) and 57(68.7%) had severe, moderate and mild and normal visual impairment respectively while of the 20 patients with right sided stroke, 3(3.6%) each had severe and moderate visual impairment and 14(16.9%) had normal or mild visual impairment. Other ocular abnormalities included corneal anaesthesia and macular hole in 2(1.2%).

Conclusion: Anterior and posterior segments, together with neuro-ophthalmic disorders were found among stroke patients in this study. Many of the ocular abnormalities are as a result of long-standing uncontrolled hypertension which caused the stroke. It is recommended that awareness should be created among the populace about uncontrolled hypertension. It is also advised that internists should refer hypertensive patients for routine ophthalmic screening.

Awareness of malocclusion and attitude towards orthodontic treatment among trainee dental surgery technicians in Nigeria

2023-12-26T11:38:02+00:00

Objective: Malocclusion affects aesthetics, the physical, psychological and social life of a person. The aim of this study was to evaluate the awareness of malocclusion and attitude towards orthodontic treatment among trainee dental surgery technicians in Nigeria.

Materials and Methods: This was a descriptive cross-sectional study carried out among 68 final year (sixty-eight) trainee dental surgery technicians in Nigeria. The research instrument was a self-administered close ended questionnaire. Data was analyzed using SPSS version 20. P value (P<0.05) was regarded as significant.

Results: Sixty-one (89.7%) of the respondents were females, while 7 (10.3%) were males. Fifty-seven (83.8%) have heard of the term malalignment of teeth, 53 (77.9%) of the students think malalignment is due to external habits. 61 (89.7%) are aware that few teeth may have to be removed for proper positioning of irregular teeth and 51 (75.0%) were aware that the irregular teeth can be corrected even after 40 years of age. More females were aware of malocclusion and had positive attitude towards orthodontic procedures when compared to the males, but the difference was not statistically significant (P>0.05).

Conclusion: Majority of the respondents in this study were aware of the term malalignment and had positive attitude towards orthodontic treatment. More females constituted the study population.

Disrespect and abuse of women during childbirth in selected health facilities in Sokoto metropolis, Nigeria

2023-12-26T21:20:23+00:00

Background: The promotion of respectful care during delivery is of utmost importance if the goals of attainment of quality health care and utilization of skilled birth attendants in our health facilities are to be achieved. This study sought to assess the prevalence, forms, and factors associated with Disrespect and Abuse (D&A) of women during childbirth in Sokoto metropolis of Sokoto state.

Method: A descriptive cross-sectional design was used to study 290 women who had facility-based delivery within the past eight weeks in Sokoto metropolis and were attending childhood immunization or family planning clinics. Data was collected using a set of structured questionnaire and was analyzed using IBM SPSS version 23 computer software. Level of statistical significance was set at p<0.05 and approval for the study was obtained from the Research Ethics Committee of Usmanu Danfodiyo University Teaching Hospital, Sokoto while written informed consent was obtained from respondents after explaining the objectives of the study to them.

Results: A total of 57 (19.7%) of the respondents had experienced at least one form of D &A with bad attitude accounting for 75.4%, followed by Physical abuse (50.9%). Nurses and Midwives ranked highest (78.9%) among the perpetrators of D&A. Emotional distress, injury and death of baby were some of the negative effects of D&A.

Conclusion: The incidents of D&A have wider implications for the utilization of maternity services and maternal mortality. There is an urgent need for the training and re-training of health workers about respectful maternity care in Nigeria.

Frequency of Blood Donation and Malaria Occurrence among Blood Donors in a Tertiary Hospital, Nigeria

2023-12-26T22:23:52+00:00

Context: Malaria is a significant cause of morbidity and mortality in Sub-Saharan Africa (SSA). Transfusion transmitted malaria contributes significantly to the burden of malaria in SSA. The safety of blood transfusion as it relates to frequency of blood donation and malaria occurrence on the part of donors is an aspect that has not been properly investigated hence this study.

Objectives: This study was conducted to assess the frequency of blood donation and occurrence of malaria among blood donors at OAUTHC, Ile-Ife.

Materials and methods: This was a cross-sectional study. Ethical approval was obtained. One hundred and thirty-three consenting blood donors aged between 18-50 years were recruited for the study. Two millilitres of blood were collected from each study participant and immediately transported to the laboratory for processing. Giemsa-stained films of the samples were viewed under the oil immersion objective of the microscope. Questionnaires were administered to the study participants to obtain relevant information. Data generated were analysed using descriptive and inferential statistics with SPSS software version 20. The level of significance was set at p < 0.05.

Results: The prevalence of malaria among the blood donors was 21.1% with the highest rate among commercial donors (33.3%) followed by family donors (12.9%) then voluntary donors (11.9%). Evaluation of the frequency of donation showed that malaria occurred more in recurring donors (77.78%) than first time donors (22.22%).

Conclusion: Malaria is highly prevalent among blood donors and occurs more in recurring blood donors than first time donors.

Pattern of Childhood malignant tumours in Umuahia South East Nigeria

2023-12-28T12:28:05+00:00

Introduction: Cancers in children should be incorporated as one of the childhood killer diseases in developing countries.

Aim: The aim of this study is to evaluate the demographic and pathologic characteristics of childhood tumours in Umuahia. South East Nigeria

Methodology: The Operative records, histology request and report forms were studied and the clinico-pathologic information were retrieved and analysed using SPSS version 20.0

Results: A total of 50 cases of malignant diseases of children were clinically diagnosed and histologically confirmed. The mean age of the patients were 8 years with age range of 1 to 17 years. The male to female ratio was 1:1. The peak age of incidence falls in the 1-5 age groups which accounted for 40%. Wilm’s tumour was the commonest 25, Rhabdomyosarcoma 10 cases, Neuroblastoma 5cases, Oesteosarcoma 5cases, Teratomas 5 cases.

Conclusion: childhood cancer is increasing in our environment. However, late presentation, ignorance, poverty leads to poor outcome.

Knowledge of Ocular prosthesis among students of Optical Dispensary Technology, Birnin Kebbi, Nigeria

2023-12-27T21:28:35+00:00

Background: Ocular prosthesis (OP) is produced and fitted by eye care personnel called Ocularist. OP is made from cryolite glass or acrylic resin. OP can either be customized or stock and it is commonly inserted by 6-8 weeks following destructive ocular surgery.

Aim: The aim of this study was to ascertain the knowledge and awareness of ocular prosthesis among students of School of Optical Dispensary Technology, Birnin Kebbi, Nigeria.

Materials and methods: This was a cross-sectional study conducted over 3 months (1st April 2022-30th June 2022) among the students of School of Optical dispensary technology using self-administered questionnaires. The questionnaires extracted information on the socio-demographic characteristics such as age, sex, tribe, religion, marital status, year of study and knowledge of ocular prosthesis among the students. Data was analyzed using SPPS version 21.

Results: One hundred and thirteen questionnaires were distributed to all the students in the school and 97 students participated in the study leading to a response rate of 86 %.

There were 47(48.5%) males and 50 (51.5%) females aged between 16 - 40 (mean age 24±5) years. Most of the participants 72 (74.2%) agreed that eye care (management of patient with eye problem) is a team work. Most (67, 69%) participants have heard about ocular prosthesis mainly through Seminar/Teaching (32%) and television (26%). Overall, third year students had adequate knowledge (73%) of ocular prosthesis compared with second year (49%) and first year (43%) students.

Conclusion: The awareness of ocular prosthesis among students of School of Optical dispensary technology Birnin Kebbi appeared better with number of years spent in the school. The importance of seminar/teaching and television in the dissemination of health information is underscored.

Comparative study of sonourethrography and conventional urethrography in determining the length of anterior urethral strictures

2023-12-27T21:43:09+00:00

Background: Conventional urethrography has been the “Gold standard” in the evaluation of anterior urethral strictures. Sonourethrography (SUG) is less invasive, more readily available, and cheaper and does not use ionizing radiation.

Objective: To determine the length of anterior urethral strictures diagnosed on conventional urethrography using SUG and compare findings on SUG with conventional urethrography in adult male patients

Methodology: This was a prospective cross-sectional study carried out over a period of twelve months, whereby 66 male patients with clinically suspected anterior urethral strictures and confirmed on retrograde urethrography (RUG)/ Micturatingcystourethrography (MCUG) were examined using SUG. The length of anterior urethral strictures from both procedures were compared. The data analysis was done using statistical package for social sciences (SPSS) version 23(SPSS Inc, IL, USA). At 95% confidence interval, P-value ≤ 0.05 was considered statistically significant.

Result: Sixty six patients were studied. The mean age of the participants was 56.7±13.7years with an age range of 20 – 78 years. The stricture lengths and diameters were consistently higher on SUG compared to conventional urethrography. The mean length of stricture on RUG/MCUG and SUG were 19.4 ± 6.0mm and 21.3± 6.7 mm respectfully. The mean difference for the stricture lengths on RUG/MCUG and SUG was 1.9 mm and this was statistically significant (CI = 0.983 – 2.761, p < 0.001). The mean diameter of the stricture on RUG/MCUG and SUG were 2.2± 0.7mm and 5.6± 1.2mm and the mean difference for the stricture diameter on both techniques was 3.4mm (CI= 3.158 – 3.577, p<0.001), which was statistically significant.

Conclusion: Significantly higher mean stricture length and diameter were found on SUG compared with RUG/MCUG.

Assessment of dry eye using Schirmer test in patients attending a tertiary hospital eye clinic in Nigeria

2023-12-30T23:50:54+00:00

Background: Dry eye disease (DED) is a frequently encountered ocular morbidity seen among adult patients attending ophthalmic clinics in Nigeria. It can be assessed using different methods although there is differing consensus on reliable tests for accurate diagnosis.

Aim: The aim of this study was to assess DED using Schirmer 1 without anaesthesia among adult patients attending the Eye Clinic in a tertiary hospital in Calabar.

Methodology: This was a cross sectional study among adult patients who attended the Eye Clinic of University of Calabar Teaching Hospital who were recruited consecutively from January 1st to March 31st, 2019. All consenting participants had comprehensive eye examination and were assessed for DED using the Schirmer 1 Test. Test values of less than 10mm were diagnostic of aqueous tear deficiency. Initial data categorization yielded frequencies, percentages and proportions. Categorical variables were analysed using Chi-square test and continuous variables using Student’s t-test. Statistical significance was found where p-values were <0.05 at one degree of freedom.

Results: Overall, 73 participants were included in the study 29 males and 44 females with male-female ratio of 1:1.5, and the prevalence of DED was 28.8%. Most participants had normal distance visual acuity in both eyes. There was a statistically insignificant inverse linear relationship between age and Schirmer 1 test. The relationship between gender and Schirmer 1 test values and consequently for dry eye was statistically significant, p 0.04.

Conclusion: This study showed no significant association between DED and age. Female gender was associated with a higher risk of DED but a significant association between DED compared to the male gender. Its assessment in persons with other ocular complains is important. Primary and secondary prevention strategies are recommended.

Mixed chorangioma of the placental disk of a 29-year-old pregnant woman: A case report with literature review

2023-12-27T21:03:11+00:00

A Chorangioma is a rare benign non-trophoblastic placental vascular neoplasm that develops from the placental primitive chorionic mesenchyme. It happens in 1% of pregnancies. Because Chorangioma may hurt the health of both the mother and the fetus, it is crucial to distinguish it from other placental disorders. In this article, we present a case study of an incidental Mixed Chorangioma variant found in a 29-year-old mother's placental disk during routine histopathological examinations as part of a large-scale prospective histopathological survey of the placenta in a tertiary healthcare facility in Uyo, Akwa Ibom State, Nigeria. In addition, we offer a comprehensive overview of the existing literature on Chorangiomas, focusing on their pathology, clinical importance, and treatment. This article aims to advance the understanding of Chorangiomas and increase clinicians' and pathologists' awareness of the need for early detection and suitable treatment.

Congenital lung cyst: Report of two cases

2023-12-28T13:29:51+00:00

Background: Bronchogenic cysts are lesions of congenital origin derived from the primitive foregut and are the most prevailing primary cysts of the mediastinum. Most commonly unilocular, they contain clear fluid or mucinous secretions or, less commonly, haemorrhagic secretions or air. They are lined by columnar ciliated epithelium, and their walls often contain cartilage and bronchial mucous glands. It is unusual for them to have a patent connection with the airway, but when present, such a communication may promote infection of the cyst by allowing bacterial entry. The first successful surgical excision of a bronchogenic cyst was reported by Maier in mid twentieth century leading to its classification based on Mailer postulation. No such reports have been described in South/South Nigeria.

Guillain – Barre syndrome associated with Helicobacter pylori isolates from rectal swabs of Four Patients: University of Benin Teaching Hospital Experience

2023-12-28T14:45:47+00:00

Background: A Gram-negative bacteria known as Helicobacter pylori (H. pylori) is thought to be the cause of autoimmune gastrointestinal diseases. Additionally, this pathogen has been connected to peripheral neuropathies and extra-gastrointestinal illnesses with autoimmune sequelae. H. pylori may be involved in the 30% of GBS cases that Campylobacter jejuni is blamed for. Guillain-Barré syndrome (GBS) typically has a post-infectious aetiology. The Aim of the study is to show that rectal swabs to isolate Helicobacter pylori as a cause of Guillain - Barre syndrome should be a routine instead of gastric biopsy.

Methods: The study was a Retrospective Cross Sectional Study. It involved a review of Case notes of Patients that were admitted in the Neurology Unit of UBTH from 2014-2019, been managed for Guillain-Barre syndrome associated with H. pylori infection and also a review of their Medical microbiology laboratory test records during management especially their rectal swab Microscopy, Culture and Sensitivity results. It has never been the practice of the Neurology unit to do rectal swabs for patients with Guillain - Barre syndrome, this was done by the medical microbiology unit that co-managed the patient. Patients with incomplete or missing medical data were excluded from the study.

Results: Four case series of one male and three female patients, age ranged from 7 years to 23years with the mean age of 15 ± 8 years. The most common initial symptom was weakness in the extremities which was seen in all the patients. Motor deficit involved all four limbs in all the patients. The mode of onset was progressive in all the cases and ascending.

History of peptic ulcer disease was present in all four patient and H. pylori was isolated from rectal swabs from all the patients. Three (75%) of the patient showed marked improvement on commencement of Omeprazole and erythromycin, while one (25%) ,did well on amoxicillin and Omeprazole. One (25%) had complications of bilateral patchy lower limb skin exfoliation and desquamation. A case of death was recorded. On discharge complete functional recovery was noted in two (50%), while one (33%) had partial recovery.

Conclusion: This study of four case series highlights a relatively inexpensive and straightforward faecal specimen collection by rectal swab, and readily available faecal specimen compared with gastric biopsy specimen, in the laboratory diagnosis and isolation of Helicobacter pylori, a cause (among other causes) of Guillain-Barre Syndrome, which is a medical emergency in most cases.
In addition Guillain-Barre Syndrome linked with H. pylori is not always a Post-infectious diseases because medications used to clear the gastrointestinal tract of Bacterial usually lead to recovery from the paralysis caused by Guillain-Barre Syndrome.

Giant juvenile fibroadenoma in a 15-year-old Nigerian female: A case report with review of literature

2023-12-28T15:02:43+00:00

Introduction

Breast mases in female adolescents are rare and consist mainly of developmental lesions and benign tumours.¹ The benign tumours seen are mostly fibroadenoma which is the most common breast tumour seen in adolescent females.² It may present as solitary or multicentric tumour.³ It may also vary in size and is designated as giant juvenile fibroadenoma “GJF” if it is greater than 5cm, 500g or replaces at least 80% of the breast tissue.³ GJF accounts for 1-8% of breast lesions in the adolescent population.^3,4 Overall, giant fibroadenoma accounts for 0.5-2% of all fibroadenomas.⁴ We present a case of GJF in a 15-year-old female who was managed in our clinical setting.

Post circumcision Fournier’s gangrene in an infant: A case report

2023-12-28T15:45:47+00:00

Fournier’s gangrene is a rare life-threatening condition that is characterized by rapid necrotizing spread from the scrotum and perineal area along facial planes to the abdominal wall, the flanks and the upper thighs. We present a case report of post-circumcision Fournier’s gangrene in an infant that was associated with spontaneous rupture of the lower pole of the left scrotum. This report highlights the need for practitioners of circumcision to be skillful in the procedure, use sterile instruments for it and adhere to standard infection prevention and control measures in health facilities.

Resolution of PIN syndrome following Physiotherapy: A case report

2023-12-28T16:04:39+00:00

This case report highlights the use of physiotherapy as monotherapy for non-traumatic posterior interosseus nerve palsy, which is a rare compression neuropathy that usually gets referred to a surgeon and for which the patient may undergo surgical decompression. However, in a resource limited setting, patients are often not able to afford advanced radiographic modalities like high resolution ultrasound and MRI scans. Hence the standard pathway to surgery is uncertain and they often get referred to physiotherapy while awaiting surgery. In this case, the patient was referred for Physiotherapy and the palsy improved. This suggests there was no defined surgical lesion, as has been found in many patients who have undergone ultrasound. This case highlights the need for robust research on the role of physiotherapy for PIN palsy in resource limited settings and a possible treatment algorithm that reserves investigations and surgery for patients whose PIN palsy does not improve with physiotherapy and for whom surgery is not clearly indicated from the outset.

Thoracic Endometriosis Syndrome: a case series and review of literature

2023-12-28T16:35:30+00:00

Background: The presence of endometrial tissue in the tracheobronchial tree, pleural, and lung is normally referred to as thoracic endometriosis. The association of catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and pulmonary nodules is referred to as thoracic endometriosis syndrome (TES). TES is rare but not as rare as it has always been thought of.

Case summaries:

Case 1: We present EA, a 26-year-old chef/baker who presented to our unit on account of recurrent cyclical right sided chest pain and difficulty in breathing, recurrent haemoptysis and cyclical abdominal pain and swelling with multiple tender umbilical nodules. On general physical examination she was found to be in respiratory distress but not cyanosed with peripheral arterial oxygen saturation 97% on room air. Examination of the chest revealed a right sided chest fullness and reduced movement with breathing. Percussion note was stony dull and absent of breath sound on right hemithorax. Abdominal examination revealed a moderately distended abdomen with positive fluid thrill. Both Pleurocentesis (thoracocentesis) and paracentesis abdominis yielded a haemorrhagic fluid acellular and pleural and lung biopsy demonstrated endometrial stroma and glands. Imaging examination by way of chest X-ray showed a homogenous opacity of the right hemithorax, and pulmonary nodule following drainage. A diagnosis of Thoracic Endometriosis Syndrome was made. She had VAT with lung and pleural biopsy, pleural abrasion and a thoracostomy tube drainage.

Case 2: We present IAE, a 29year-old Po+0 who presented to our unit on account of recurrent cyclical right sided chest pain and difficulty in breathing, unproductive cough. On general physical examination she was found to be in moderate respiratory distress but not cyanosed with peripheral arterial oxygen saturation of 98% on room air. Chest examination revealed an apical flattering of anterior chest wall with left trachea deviation. Percussion note was stony dull on the right lower third and hyper resonance middle and upper zones of right hemithorax. Pleurocentesis (thoracocentesis) yielded air and haemorrhagic fluid acellular and pleural and lung biopsies demonstrated endometrial stroma and glands. Imaging examination by way of chest X-ray and chest CT-scan showed air fluid level of the right hemithorax. A diagnosis of TES was made. She had Laparoscopy and VAT at the same sitting with pleural and lung biopsies. She was managed medically after closed thoracostomy tube drainage. She had partial collapse of right lower lobe and thoracotomy with right lower lobectomy was planned but patient declined. She also had Stage IV endometriosis by (rASRM)/ENZIAN systems

Case 3: We present JA a 29-year-old lady, a filling station attendant who presented to our unit with a history of gradual onset of right sided chest pain, progressive difficulty in breathing and non-productive cough, and abdominal pain and swelling. On general physical examination she was found to be in respiratory distress but not cyanosed with SPO2 of 98% on room air. Examination of the chest revealed a right apical flattening, reduced ipsilateral chest movement with breathing. Percussion notes were stony dull and absent air entry on the ipsilateral hemithorax. Abdominal examination showed a mildly distended abdomen with a positive shifting dullness. Both Pleurocentesis (thoracocentesis) and paracentesis abdominis yielded a haemorrhagic fluid acellular at cytology and pleural and lung biopsy demonstrated endometrial stroma and gland. Imaging examination by way of chest X-ray showed a homogenous opacity of the right hemithorax. A diagnosis of Familial Thoracic Endometriosis Syndrome (FTES). Had USS guided lung and pleural biopsy and a thoracostomy tube drainage. She had chemical pleurodesis with tetracycline

Conclusion: Thoracic endometriosis syndrome is the diagnosis in a lady of reproductive age who present with cyclic or a cyclical recurrent right sided chest pain, cyclical or a cyclical dyspnoea, haemoptysis, cyclical or a cyclical abdominal swelling and peritonitis.

Pericardial Effusion

2023-12-28T17:01:45+00:00

Background: Pericardial effusion is defined as the accumulation of fluid in the pericardial sac, this can lead to life-threatening cardiac complications if not promptly diagnosed and managed effectively. This radiographic case study aims to demonstrate the crucial role of imaging techniques in diagnosing pericardial effusion, providing valuable insights into its characteristics, and guiding appropriate clinical interventions.

Methods: This is a case study of a 37yr old patient with suspected cardiac failure who underwent diagnostic imaging, including chest X-rays and echocardiography. The imaging findings were analyzed to assess the extent and severity of the disease and to help in the treatment decisions.

Results: The radiographic evaluation revealed a moderate pericardial effusion with characteristic findings on chest X-rays and echocardiography. The size, location, and hemodynamic impact of the effusion were assessed, informing the clinical team's decision to proceed with pericardiocentesis for therapeutic relief.

Conclusion: This case study underscores the pivotal role of radiographic imaging, particularly echocardiography and chest X-rays, in diagnosing and characterizing pericardial effusion. Timely and accurate diagnosis is essential for appropriate management and the prevention of life-threatening complications. Radiographic imaging serves as an indispensable tool in guiding clinical decisions and improving patient outcomes.

Unusual presentation of peripheral artery disease

2023-12-28T17:17:02+00:00

Peripheral artery disease usually presents as intermittent claudication, with leg pain associated with walking and relieved by rest. We report a 52 year old man with pains in the left arm and peripheral vascular disease was confirmed with Doppler ultrasound. This presentation which is unusual in sub-Saharan Africa should be recognized.