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   Table of Contents - Current issue
Coverpage
November-December 2016
Volume 57 | Issue 6
Page Nos. 307-356

Online since Friday, November 11, 2016

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ORIGINAL ARTICLES  

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria p. 307
Idowu O Senbanjo, Ibiyemi O Olayiwola, Wasiu A. O. Afolabi
DOI:10.4103/0300-1652.193854  PMID:27942096
Background: Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. Objective: The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. Methods: This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother-child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. Results: The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively). Conclusions: Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities.
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Sociodemographic profiles and use-dynamics of Jadelle (levonorgestrel) implants in Jos, Nigeria p. 314
VC Pam, JT Mutihir, DD Nyango, I Shambe, CO Egbodo, JA Karshima
DOI:10.4103/0300-1652.193855  PMID:27942097
Background: Contraceptive implants (including Jadelle) are highly effective, safe, and easy to use and have a long duration of action. They do not interfere with intercourse with immediate return to fertility after removal. However, disruption of the menstrual bleeding pattern is almost inevitable and coercive prescription may be a problem because insertion and removal of implants are provider dependent. The objective of this study was to determine the sociodemographic profiles of acceptors of Jadelle and the reasons for discontinuation in Jos, Nigeria. Materials and Methods: This was a 6-year retrospective chart review carried out at the Jos University Teaching Hospital. Results: About 1401 women accepted Jadelle with a mean (΁standard deviation) of 33.4 ΁ 5.9 years. About 88% of the women were Christians and almost three-quarters (73.5%) had at least secondary school education. The means of parity and number of children still alive at the time of accepting Jadelle were 4.1 and 3.8, respectively. Half of the women (49.5%) were breastfeeding and over half (55.9%) had future fertility desires at the time of commencing Jadelle. About 82% had previously used other contraceptives (mostly short-acting methods such as injectables, pills, and condoms), with only 18% starting Jadelle as the first-ever contraceptive method. About 90% of the women had regular menstrual cycles. The major reason for discontinuation of Jadelle was desire for pregnancy although menstrual pattern disruption was the most common reason for removal in the first 6 months of use. Conclusion: The main reason for discontinuation of Jadelle was to have more children although menstrual pattern disruptions accounted for earlier discontinuation.
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Obstetric predictors of hypertension: A cross-sectional study of women attending the postnatal clinic of Jos University Teaching Hospital p. 320
Hadiza A Agbo, Basil N Okeahialam, Patrick H Daru
DOI:10.4103/0300-1652.193856  PMID:27942098
Background: Hypertensive disease in pregnancy (HDP) accounts for high mother and child morbi-mortality and predict future cardiometabolic diseases. This study aimed to identify obstetric predictors of HDP needing preventive action to reduce its consequences; when women present to antenatal clinic (ANC). Materials and Methods: Cross-sectional descriptive this was an Interviewer-administered semi-structured questionnaire-based study of the anthropometric, and blood pressure measurementsin attendees at the postnatal clinic (PNC) of Jos University with ANC records. Setting: Six weeks postnatal clinic (PNC) of Jos University Teaching Hospital (JUTH). Results: The following indices proved predictive of HDP and subsequent hypertension: weight (P = 0.009), hip circumference (P = 0.018), parity (P = 0.043), waist circumference (P = 0.00), abdominal height (P = 0.040), waist/height (P = 0.020), history of developing hypertension in previous pregnancy (P = 0.000), birth weight of baby (P = 0.02), and mode of delivery (P = 0.05). Conclusion: To initiate preventive action on ANC registration in mitigating effects of or outrightly preventing HDP, careful check on anthropometry as well as history of hypertension or operative/preterm delivery in a previous pregnancy is necessary
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Study of pentoxifylline effects on motility and viability of spermatozoa from infertile asthenozoospermic males p. 324
Aliye Ghasemzadeh, Farid Karkon-Shayan, Solmaz Yousefzadeh, Mohammad Naghavi-Behzad, Kobra Hamdi
DOI:10.4103/0300-1652.193857  PMID:27942099
Background: The quality of semen is one of the major parameters in male infertility. Pentoxifylline, a methylxanthine derivative, is an agent primarily used in the treatment of intermittent claudication and other vascular disorders. Studies have shown that pentoxifylline enhances the quality and quantity of sperms. In this study, we have investigated the in vitro effects of pentoxifylline on viability and motility of spermatozoa in samples of infertile oligoasthenozoospermic males. Materials and Methods: In this observer-blinded clinical trial, semen samples of 25 infertile oligoasthenozoospermic males were collected in Alzahra Educational Medical Center of Tabriz University of Medical Sciences from August 2010 to August 2012. After the isolation of spermatozoa by the swim-up method, they were randomized into four groups in ISM1 environment: The controls treated normally: Group 1 treated by pentoxifylline at a dose of 50 ΅g/ml, Group 2 treated by pentoxifylline at a dose of 100 ΅g/ml, and Group 3 treated by pentoxifylline at a dose of 200 ΅g/ml. Sperm viability and motility were compared among the groups on 45 min, 24 h, 36 h, and 48 h intervals. Results: Mean percentages of live sperms were 98.40%, 51.40%, 20.60%, and 6.00% in control group and 98.40%, 69.20%, 38.60%, and 14.60% in Group 3 on the mentioned intervals, respectively. This mean percentage decrease of live sperms was significantly lower in Group 3 comparing with that of other groups (P = 0.01). Mean percentages of motile sperms were 54%, 8.40%, 2.80%, and 0% in control group; and 54%, 16%, 4.80%, and 1.40% in Group 3 on the mentioned intervals, respectively. There was not a significant difference between the four groups in this regard (P = 0.19). Conclusion: Pentoxifylline can enhance the viability of sperm of infertile oligoasthenozoospermic males with no significant effect on its motility.
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Abdominal wall endometrioma: Our experience in Vladimir, Russia p. 329
Mahir Gachabayov, Roman Horta, Dmitriy Afanasyev, Timur Gilyazov
DOI:10.4103/0300-1652.193858  PMID:27942100
Background: Endometriosis is defined as an estrogen-dependent, benign inflammatory disease characterized by the presence of ectopic endometrial implants. Abdominal wall endometrioma (AWE) being a rare entity is a benign tumor defined as ectopic functional, endometrial tissue located in the abdominal wall. Subjects and Methods: A retrospective study of 23 female patients treated with AWE in four departments of three centers in Vladimir city, Russia, from January 2010 to December 2014 was performed. Results: In twenty patients (87%), AWE was symptomatic, and in three patients (13%), AWE was asymptomatic. Esquivel triad presented in 17 patients (74%), and modified Esquivel triad existed in 20 patients (87%). All 23 patients were operated, and AWE excision was performed. Recurrence occurred in 4 cases (17.4%) and was associated with postoperative pain and seroma. Conclusion: Postoperative pain for more than 7 days and seroma (on ultrasonography) seem to be associated with recurrence of AWE.
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Unintended pregnancy among antenatal women in a tertiary hospital in North Central Nigeria p. 334
Teddy E Agida, Godwin O Akaba, Bissalla A Ekele, Francis Adebayo
DOI:10.4103/0300-1652.193859  PMID:27942101
Background: Unintended pregnancy is a pregnancy that is either unwanted or mistimed. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinic at the University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. Materials and Methods: This was a descriptive, cross-sectional study of 300 women attending the antenatal clinic of the Teaching Hospital. Information on sociodemographic characteristics, desirability of the current pregnancy at the time of conception, and knowledge and practice of contraceptive methods were collected using a pretested questionnaire. The data obtained were analyzed using SPSS version 20. Chi-square test was used for tests of associations with the level of significance set at P < 0.05. Results: The average age of the respondents was 30.0 ± 4.7 years. Overall, 33.3% and 58.3% of the respondents attained secondary and tertiary levels of education, respectively. The prevalence rate of unintended pregnancy was 16%. Contraceptive awareness was quite high (259, 86.3%). However, contraceptive usage was low as 192 (61.9%) had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unwanted pregnancy (χ[2] = 68.56, P < 0.001), as well as between parity and unwanted pregnancy (χ[2] = 39.92, P < 0.001). Conclusion: The prevalence of unintended pregnancy among women attending antenatal clinic is high, possibly due to low contraceptive usage. Adequate information, education, and communication materials should be provided during antenatal health talks. Advocacy visits for community sensitization should also be increased.
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Quality of acute asthma care in two tertiary hospitals in a state in South Western Nigeria: A report of clinical audit p. 339
Olufemi Olumuyiwa Desalu, Adekunle Olatayo Adeoti, Olarinde Jeffrey Ogunmola, Joseph Olusesan Fadare, Tolutope Fasanmi Kolawole
DOI:10.4103/0300-1652.193860  PMID:27942102
Background: To audit the quality of acute asthma care in two tertiary hospitals in a state in the southwestern region of Nigeria and to compare the clinical practice against the recommendations of the Global Initiative for Asthma (GINA) guideline. Patients and Methods: We carried out a retrospective analysis of 101 patients who presented with acute exacerbation of asthma to the hospital between November 2010 and October 2015. Results: Majority of the cases were females (66.3%), <45 years of age (60.4%), and admitted in the wet season (64.4%). The median duration of hospital stay was 2 days (interquartile range; 1-3 days) and the mortality was 1.0%. At admission, 73 (72.3%) patients had their triggering factors documented and 33 (32.7%) had their severity assessed. Smoking status, medication adherence, serial oxygen saturation, and peak expiratory flow rate measurement were documented in less than half of the cases, respectively. Seventy-six (75.2%) patients had nebulized salbutamol, 89 (88.1%) had systemic corticosteroid, and 78 (77.2%) had within 1 h. On discharge, 68 (67.3%) patients were given follow-up appointment and 32 (31.7%) were reviewed within 30 days after discharge. Less than half were prescribed an inhaled corticosteroid (ICS), a self-management plan, or had their inhaler technique reviewed or controller medications adjusted. Overall, adherence to the GINA guideline was not satisfactory and was very poor among the medical officers. Conclusion: The quality of acute asthma care in our setting is not satisfactory, and there is a low level of compliance with most recommendations of asthma guidelines. This audit has implicated the need to address the non-performing areas and organizational issues to improve the quality of care.
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Gentamicin-mediated ototoxicity and nephrotoxicity: A clinical trial study p. 347
Parviz Saleh, Shamsi Abbasalizadeh, Saman Rezaeian, Mohammad Naghavi-Behzad, Reza Piri, Hojjat Hossein Pourfeizi
DOI:10.4103/0300-1652.193861  PMID:27942103
Background: Aminoglycosides and mainly gentamicin are the most important antimicrobial agents. Two different methods of administration exist: Single and multiple doses. There has always been a controversy about the less harmful administration method, to minimize adverse effects of gentamicin - deafness and renal insufficiency. In this study, it was aimed to compare two different methods of administration to figure out the least harmful treatment method. Materials and Methods: In a clinical study, eighty patients aged 12-55 years who were admitted with sepsis syndrome were included in the study; they were divided into two groups: The first group received single-dose treatment (5 mg/kg) whereas the second group was treated with multiple doses (1.7 mg/kg three times a day) of gentamicin. Results: The results show that blood urea nitrogen (BUN) and creatinine (CR) levels were decreased in the first group. Both blood urea nitrogen and creatinine and also mean glomerular filtration rate was increased in the same group. In the second group, mean BUN and CR levels were increased while the GFR was decreased in the same group. There was also a gradual increase in GFR in the first group. GFR <80 was decreased from 20% to 5.1% in the first group while increased from 5% to 27.5% in the second group. Results of audiometric studies show 6.1% hearing problem in the first group and 12.8% in the second one. Conclusions: Results of the present study showed that nephrotoxicity and ototoxicity are minimized in single-dose administration compared to multiples doses.
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Serum thyroid-stimulating hormone level and relation with size of hippocampus in patients with mild cognitive disorders p. 353
Mohammad-Hossein Daghighi, Masoud Poureisa, Pegah Ahmadi, Mahmoud Reshadatjoo, Sahar Golestani, Mohammad Naghavi-Behzad, Farid Karkon-Shayan
DOI:10.4103/0300-1652.193862  PMID:27942104
Background: Cognitive disorders and dementia are common problems, and Alzheimer's disease is one of the major leading causes of death worldwide. Thyroid hormone disorders as a common problem effect on hippocampus size which as a prognostic factor in dementia. The aim of the present study was to investigate the relationship between serum thyroid-stimulating hormone (TSH) level and the size of hippocampus in patients with mild cognitive disorders. Materials and Methods: In a descriptive-analytical study, 41 patients with symptoms of mild cognitive disorders whom referred to take the brain magnetic resonance image (MRI) in a radiology center under the direction of Tabriz University of Medical Sciences (Tabriz, Iran) were evaluated. The right and left hippocampal and brain volume was calculated by MRI at coronal T1-weighted. Serum TSH level was also measured in these patients. Correlation between serum TSH level and hippocampal volume size was evaluated. Results: Male to female ratio was 1.05:1 with mean age of 54.09 ± 3.11 years. Mean serum TSH level of patients was 1.55 ± 1.45 uU/ml. The right and left hippocampal volumes were 1.61 ± 0.42 and 1.62 ± 0.39 ml, respectively. There were slight negative correlations between the right and left hippocampal volumes with TSH level (r = −0.133 and r = −0.092, respectively). Correlations between the right and left hippocampal volumes with TSH level were not statistically significant (P = 0.406, P = 0.566, respectively). Conclusion: Based on findings of the present study, there was a weak negative correlation between serum level of TSH with the right and left hippocampal and brain volume ratio, but the correlation was not statistically significant. It seems that controlling of clinical or subclinical hypothyroidism may have a role in slowing of dementia progression and also have a preventive role.
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