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   2009| July-September  | Volume 50 | Issue 3  
    Online since November 16, 2010

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Incidence and patterns of cardiovascular disease in north western Nigeria
Akindele O Mukadas, Uba Misbau
July-September 2009, 50(3):55-57
Background:Cardiovascular disease (CVD) has been major problem in the developed and developing countries and its burden in these countries is overwhelming. There is a dearth of literature and data on the prevalence and patterns of CVD in developing countries, especially Nigeria. Objectives: This study was carried out to determine the most common cardiovascular disorder, the mostly affected age and sex groups and annual increase/decrease between 2001 and 2005 in Northwestern Nigeria. Methods: Our study reviewed the pattern and incidence of CVD in North western Nigeria. Case notes of patients in Aminu Kano Teaching Hospital and Usman Dan Fodio University Teaching Hospital were reviewed between 2001 and 2005. These two teaching hospitals provide tertiary health care services to six out of seven states that form north western Nigeria with a population of 29,720,322 Nigerians. Results: A total number of 4103 case notes of CVDs were reviewed out of which 2159(52.69%) were males while 1944(47.40%) were females. A steady rise in the incidence of CVD between 2001-2005 was observed. Hypertension (39.1%) was the most prevalent CVDs while congenital heart disease (1.1 %) had the lowest. Conclusion: It was concluded that hypertension was the most prevalent CVD while congenital heart disease was the lowest. A steady increase in the incidence of CVD was observed during the period under review.
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Managing sacrococcygeal teratoma in a new born of a psychopathic widow: Case report
C. E. O. Onuoha, CC Amah, HA Ezike
July-September 2009, 50(3):74-76
Background:Sacrococcygeal tumors are composite embryonal turn ours reflecting any one or more of ernbryonallfoetal remnants such as germinoma, embryonal carcinoma, teratoma, choriocarcinoma and yolk sac tumors. Teratomas are the commonest variety of these tumours encountered in clinical practice. Sacrococcygeal tumors are most commonly found in females. Male presentations tend to carry high risk of malignancy. Clinical management of sacrococcygeal tumours in males therefore requires more meticulous attention to the details of surgery and follow-ups. Study design:This is a clinical case report of a huge sacrococcygeal tumour highly valued by a mentally deranged mother, which was excised from a three (3) month old baby boy under general anaesthesia in prone position over a three and half hour period. The purpose of the report is to highlight the special challenges in the management of the case not only on account of the sheer size of the tumour but also the unusual psychopathic attachment of the mother to her baby's tumour. The accompanying literature review was by both manual and Medline searches. Result:Surgery and postoperative recovery were uneventful. Histology showed tumour variety to be sacrococcygeal teratoma. Patient showed steady progress with each follow-up visit. Conclusion: Sacrococcygeal tumours are rare, but are the commonest tumours of the newborn. Early surgery avoids tendency to malignant transformation and a good follow-up program is necessary for a guarded prognosis.
  6,053 220 -
Caesarean section in a secondary health hospital in Awka, Nigeria
LC Ikeako, L Nwajiaku, HU Ezegwui
July-September 2009, 50(3):64-67
Setting:Amaku General Hospital, Awka is a state government owned secondary health facility in South East Nigeria. Objectives: To determine the rate, indications, outcome and complications of caesarean sections with a view to improving on our service delivery. Patients and Methods: A retrospective review of all caesarean deliveries over a five year period, January 2005 to December 2009. Results: A total of 291 caesarean sections were performed. A total of 2809 patients were delivered giving a caesarean section rate of 10.4%. The incidence was commoner in the multigravidae. The commonest indication and morbidity were cephalopelvic disproportion 72(25.6%) and wound sepsis 40 (33.3%) respectively. There was a gradual yearly increase in rate from 9.0% in 2005 to 11.4%m' 2009. Maternal mortality rate was 480 per 100,000 deliveries while the perinatal mortality rate was 63.8 per 1000 total births. Conclusions: The rate of caesarean section has shown a gradual yearly increase. There is need to improve on the facilities and manpower in the secondary health care facilities as these will impact positively on the quality and safety of its services.
  5,249 309 -
Posterior communicating artery aneurysm in a 20 year old boy presenting as non-isolated third nerve palsy
HC Obiudu, A Chuku, IO Chukwukwe, EO Chude
July-September 2009, 50(3):68-70
Objective: The need for neuro-imaging in non-isolated third nerve palsy remains uncertain. Even with associated partial pupillary involvement, the possibility of aneurysm is said to be low. We highlight the need for vigilance for possible life-threatening aneurysms in cases of non-isolated third nerve palsies. Method: Case report of a 20 years old boy who presented with drooping of the left upper eyelid, double vision and dull headache. Examination showed moderate ptosis, 300 exotropia and limited extraocular movements of the left eye. Quantitative pupillary measurement revealed 1mm anisocoria with decreased left pupillary light response. Result: A clinical diagnosis of left third and fourth cranial nerve palsies from intracranial space-occupying lesion was made. Computed tomography and computed tomography angiography confirmed left posterior communicating artery aneurysm. Conclusion: Any degree of pupillary involvement in third nerve palsy, whether isolated or not should warrant neuroimaging in view of the high mortality risk from intracranial aneurysms.
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Unilateral renal agenesis coexisting with bilateral cryptorchidism in an adult Nigerian: Case report
RC Onwuchekwa, MK Sapira, AC Onwuchekwa
July-September 2009, 50(3):71-73
A case of unilateral renal agenesis discovered incidentally during an abdominal ultrasound scan to locate undescended testes in a 38 year old man is presented. There are very few reports about cryptorchidism in unilateral renal agenesis. In the general population cryptorchidism is seen in 4% of boys at birth decreasing to 1.8% at lmonth of age and 0.8% at 9 months of age. This case is reported to highlight the association of the two conditions and to emphasize the importance of early diagnosis in order to institute treatment early to salvage the testis and preserve the solitary kidney from damage.
  4,265 187 -
Epidemiology of anaemia necesitating bone marrow aspiration cytology in Jos
OJ Egesie, DE Joseph, UG Egesie, OJ Ewuga
July-September 2009, 50(3):61-63
Objective: The study aims at investigating, identifying and classifying the various causes of anaemia necessitating bone marrow aspiration cytology in our enviromnent. Methodology:A retrospective review of all bone marrow aspiration cytology reports of patients referred to Haematology and Blood Transfusion department of the Jos University Teaching Hospital between January 1st 2005 and December 31st 2008 on account of anaemia was carried out. Results: The commonest cause of anaemia was acute leukaem is (n=45: 24.3%); followed by combined megaloblastic and iron deficiency anaemia (nutritional deficiency anaemia) (n=34: 18.4%); and bone marrow failure (Aplastic anaemia) (n=20: 10.8%). Bone marrow aspiration cytology alone failed to identify causes of anaemia in a few patients (n=6: 3.2%). Conclusion: The study provides a valuable insight into the causes of anaemia in our environment. In contrast to the general opinion that iron deficiency is the commonest cause of anaemia, acute leukaemia was found to be the commonest cause of anaemia in this environment followed by deficiency of nutritional factors and bone marrow failure. Lack of laboratory facilities has hindered further investigation of causes of anaemia in this environment. More emphasis should be placed on identifying and managing the specific cause of anaemia rather than the current broad based approach to management. Public enlightenment on the need for early presentation to hospital and thorough investigations is necessary as early diagnosis affects positively the overall outcome of haematological diseases.
  2,573 186 -
Determination of in-vitro antibacterial effects of breast milk
CN Akujobi, I Egbuonu, CC Ezechukwu, FT Ogunsola
July-September 2009, 50(3):58-60
Background:Breast milk undisputedly is the ideal baby food. It provides a lot of protective functions for the baby as well complete nutrition. It contains fat, proteins carbohydrates, vitamins and minerals. There have been various claims that it cures ailments. The study was therefore designed to substantiate those claims. Objective: To determine the in vitro antibacterial effects of breast milk Methodology:Expressed breast milk of nursing mothers who were not on antibiotics was challenged with 0.5 McFarland's standard of overnight cultures of common bacteria that cause infections. The mixture was sub cultured at 30 minutes, 1 hour and lastly 2 hour intervals. The plates were read the following day for evidence of growth. Result:Overnight incubation yielded growth of the various organisms that were inoculated. Conclusion:Breast milk does not have in vitro antibacterial effect although it may possess same in vivo with the synergistic effect of other substances in the body.
  2,110 156 -