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   2013| March-April  | Volume 54 | Issue 2  
    Online since April 4, 2013

 
 
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ORIGINAL ARTICLES
Impact of health education intervention on malaria prevention practices among nursing mothers in rural communities in Nigeria
Olorunfemi Emmanuel Amoran
March-April 2013, 54(2):115-122
DOI:10.4103/0300-1652.110046  PMID:23798798
Introduction: Malaria is the most prevalent parasitic endemic disease in Africa, which is preventable, treatable and curable. This study aims to assess the effect of health education intervention on the knowledge, attitude, and prevention practices amongst mothers of under-five children in a rural area of Ogun State, Nigeria. Materials and Methods: The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples and a semi-structured questionnaire was used to collect relevant information. A total of 400 respondents were recruited into the study with 200 each in both the experimental and control groups and were followed up for a period of 3 months. Results: There was no statistically significant differences observed between the experimental and control groups. Knowledge of indoor spraying increased from 14.7% to 58.2% (P < 0.001) and window and door nets increased from 48.3% to 74.8% (P < 0.001). The proportion of those with ITN use increased from 50.8% to 87.4% (P < 0.001) while those with practice of maintaining clean environment also increased from 40.4% to 54.5% (P < 0.001). There were no significant changes in all the practice of malaria prevention methods in the control group. Conclusion: This suggests that malaria control can be significantly improved in rural areas, if the caregivers are adequately empowered through appropriate health education intervention though change in attitude and belief may require a longer and persistent effort.
  20 7,319 297
Stroke risk factors, subtypes, and 30-day case fatality in Abuja, Nigeria
Nura H Alkali, Sunday A Bwala, Aliu O Akano, Ogugua Osi-Ogbu, Peter Alabi, Ohiole A Ayeni
March-April 2013, 54(2):129-135
DOI:10.4103/0300-1652.110051  PMID:23798800
Background: Stroke is the second leading cause of death and the leading cause of adult disability worldwide. A better understanding of stroke risk factors and outcome may help guide efforts at reducing the community burden of stroke. This study aimed to understand stroke risk factors, imaging subtypes, and 30-day outcomes among adult Nigerians. Materials and Methods: We prospectively recruited all patients presenting with acute stroke at the National Hospital Abuja between January 2010 and June 2012. We assessed clinical and laboratory variables, as well as brain computerized tomography, magnetic resonance imaging, and carotid Doppler ultrasound scans. We also assessed case fatality and functional outcome at 30 days after stroke. Results: Of 272 patients studied, 168 (61.8%) were males. Age at presentation (mean ± standard deviation) was 56.4 ± 12.7 years in males and 52.9 ± 14.8 years in females ( P = 0.039). Neuroimaging was obtained in 96.7% patients, revealing cerebral infarction (61.8%), intracerebral hemorrhage (ICH) (34.8%), and subarachnoid hemorrhage (SAH) (3.4%). Carotid plaques or stenosis ≥50% were detected in 53.2% patients with cerebral infarction. Stroke risk factors included hypertension (82.7%), obesity (32.6%), diabetes (23.5%), hyperlipidemia (18.4%), atrial fibrillation (9.2%), and cigarette smoking (7.7%). At 30 days after stroke, case-fatality rate was 18.8%, whereas modified Rankin Scale (mRS) scores for cerebral infarction, ICH, and SAH were 3.71, 4.21, and 4.56, respectively. Atrial fibrillation, a previous stroke, and age older than 50 years were all associated with worse mRS scores at 30 days. Conclusion: Although hypertension, obesity, diabetes mellitus, and atrial fibrillation were important stroke risk factors, in many patients, these were detected only after a stroke. While the commonest stroke subtype was cerebral infarction, observed in almost two-third of patients, SAH was associated with the highest case-fatality rate at 30 days of 44.4%. Larger population-based studies may provide additional data on stroke incidence and outcome among Nigerians.
  17 6,777 318
Household cost of antenatal care and delivery services in a rural community of Kaduna state, northwestern Nigeria
Mohd Nasiq Sambo, Gobir A Abdulrazaq, Anthony F Shamang, Ahmad A Ibrahim
March-April 2013, 54(2):87-91
DOI:10.4103/0300-1652.110034  PMID:23798792
Background: Maternal mortality remains a leading cause of death among women of reproductive age. While Nigeria has only two percent of the global population, it contributes 10% to the global maternal mortality burden. Antenatal care (ANC) reduces the incidence of maternal mortality. However, financial capability affects access to antenatal care. Thus, the rural poor are at a higher risk of maternal mortality. Materials and Methods: A cross-sectional descriptive study involving 135 women (pregnant women and those who are 6 weeks postpartum). Structured interviewer-administered questionnaires were used for data collection. Data analysis was carried out using statistical package for social sciences software (version 17). Results: The average amount spent on booking and initial laboratory investigations were N77 (half a dollar) and N316 ($2), respectively. Per ANC visit, average amount spent on drugs and transportation were N229 ($1.5) and N139 ($0.9) respectively. For delivery, the average amount spent was N1500 ($9.6). On an average, ANC plus delivery cost about N3,365.00 ($22). There was a statistically significant association between husband's income and ANC attendance (X 2 = 2.451, df = 2, P = 0.048). Conclusion: Cost of Antenatal care and delivery services were not catastrophic but were a barrier to accessing antenatal care and facility-based delivery services in the study area. ANC attendance was associated with the income of household heads. Pro-poor policies and actions are needed to address this problem, as it will go a long way in reducing maternal mortality in this part of the country.
  13 5,090 295
REVIEW ARTICLE
Phosphatase and tensin homologue deleted on chromosome 10
Imran Haruna Abdulkareem, Maria Blair
March-April 2013, 54(2):79-86
DOI:10.4103/0300-1652.110033  PMID:23798791
Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) is a tumor suppressor gene deleted or mutated in many human cancers such as glioblastoma, spinal tumors, prostate, bladder, adrenals, thyroid, breast, endometrium, and colon cancers. They result from loss of heterozygosity (LOH) for the PTEN gene on chromosome 10q23. Previous studies reported that various drugs, chemicals, and foods can up-regulate PTEN mRNA and protein expression in different cell lines, and they may be useful in the future prevention and/or treatment of these cancers. PTEN has also been observed to have prognostic significance and is gradually being accepted as an independent prognostic factor. This will help in monitoring disease progression and/or recurrence, with a view to improving treatment outcomes and reducing the associated morbidity and mortality from these cancers. Neprilysin (NEP) is a zinc-dependent metallopeptidase that cleaves and inactivates some biologically active peptides thus switching off signal transduction at the cell surface. Decreased NEP expression in many cancers has been reported. NEP can form a complex with PTEN and enhance PTEN recruitment to the plasma membrane as well as stabilize its phosphatase activity. MicroRNA-21 (miR-21) post-transcriptionally down-regulates the expression of PTEN and stimulates growth and invasion in non-small cell lung cancer (NSCLC) (lung Ca), suggesting that this may be a potential therapeutic target in the future treatment of NSCLC. PTEN is a tumor suppressor gene associated with many human cancers. This has diagnostic, therapeutic, and prognostic significance in the management of many human cancers, and may be a target for new drug development in the future.
  12 4,235 438
ORIGINAL ARTICLES
Anti-malaria prescription in pregnancy among general practitioners in Enugu state, south east Nigeria
Emmanuel Onyebuchi Ugwu, ES Iferikigwe, SN Obi, AO Ugwu, PU Agu, OA Okezie
March-April 2013, 54(2):96-99
DOI:10.4103/0300-1652.110038  PMID:23798794
Background: The national policy on malaria control recommends use of intermittent preventive treatment with sulfadoxine/pyrimethamine (IPT-SP) for chemoprophylaxis against malaria in pregnancy; and use of quinine and arthemisinin-based combination therapy (ACT) for acute treatment of malaria in the first, and second/third trimesters, respectively. In Nigeria, a large proportion of pregnant women are seen by the general practitioners (GPs). Objective: To determine the pattern of anti-malaria prescription in pregnancy among GPs in Enugu state, and access the level of conformity with the national policy on malaria control. Materials and Methods: Questionnaires were administered to a cross-section of 147 GPs that attended the 2010 Enugu state branch of the Nigeria Medical Association Scientific Conference/Annual General Meeting/Election. Results: The mean age of the GPs was 37 ± 3.6 (range 27-70) years. Quinine was the commonly (45.6% ( n = 67)) prescribed anti-malaria drug in the first trimester while in the second/third trimester ACT was commonly (48.3% ( n = 71)) prescribed. Seventy-six (51.7%) practitioners prescribed IPT-SP for chemoprophylaxis against malaria while the rest (48.3%) prescribed other drugs. GPs who obtained MBBS qualification less than or equal to 5 years prior to the survey were more likely to comply with the national policy on malaria control in their prescriptions ( P < 0.05). Conclusion: The pattern of anti-malaria prescription among GPs in Enugu state is varied, and conformed poorly to the evidence-based national policy on malaria control. There is need for continuing professional development to keep the GPs abreast with current trends in malaria treatment during pregnancy.
  6 5,046 288
Teething myths among nursing mothers in a Nigerian community
Opeodu Olanrewaju Ige, Popoola Bamidele Olubukola
March-April 2013, 54(2):107-110
DOI:10.4103/0300-1652.110042  PMID:23798796
Background: Many symptoms had been associated with teething in children with the possibility of overlooking potentially fatal condition. Symptoms that had been associated with teething include diarrhoea, fever, vomiting and cough. The possibility that any of these symptoms could have been due to other causes call for thorough investigation of the child before concluding that it is only "teething". Objectives: The study was carried out to assess the beliefs of nursing mothers concerning symptoms that are associated with teething among children and to identify those that would seek medical treatments in case of their children having such symptoms during teething. Materials and Methods: Two hundred and ninety nursing mothers whose children had erupted at least a tooth were interviewed in the immunisation clinics of the University College Hospital and Adeoyo Maternity Teaching Hospital, both in Ibadan, Nigeria, on their beliefs and practice concerning teething in children. Results: One hundred and eighty-eight (64.8%) of the mothers associated symptoms such as fever, cough, catarrh and diarrhoea with eruption of teeth in their children. Over half of the women agreed that a child having either fever (51.0%), ear infection (57.6%) or cough (50.3%) should be promptly taken for medical consultation and not be tagged "teething", while for other symptoms such as gum pain (74.5%), sleepless night (56.6%), vomiting (51.4%) and diarrhoea (51.7%), over half of the mothers believed that the symptoms will resolve following the eruption of the teeth. Conclusion: The study demonstrated that mothers in the study attributes several symptoms to teething, which could be detrimental to the survival of their children as the symptom could have been due to other causes. There is, therefore, need for public enlightenment to create awareness on the possible effect of presumptuous belief that childhood diseases are due to teething process.
  5 3,755 177
CASE REPORT
That dyspepsia in the young could be cancer
Abdulfatai B Olokoba, Olusegun A Obateru, Mathew O Bojuwoye, Olatunde K Ibrahim, Lateefat B Olokoba
March-April 2013, 54(2):143-145
DOI:10.4103/0300-1652.110053  PMID:23798802
Malignant tumour of the stomach is not common in young adults. When it does occur, it is associated with a high morbidity and mortality. The objective of this report is to document our experience with three cases of gastric adenocarcinoma in young adult Nigerians seen over a period of 18 months in our centre.
  4 2,507 187
ORIGINAL ARTICLES
Beneficial effects of low dose Musa paradisiaca on the semen quality of male Wistar rats
AS Alabi, Gabriel O Omotoso, BU Enaibe, OB Akinola, C. N. B. Tagoe
March-April 2013, 54(2):92-95
DOI:10.4103/0300-1652.110035  PMID:23798793
Background: This study aimed at determining the effects of administration of mature green fruits of Musa paradisiaca on the semen quality of adult male Wistar rats. Materials and Methods: The animals used for the study were grouped into three: the control group, given 2 ml of double distilled water, a low dose group given 500 mg/kg/day and a high dose group given 1000 mg/kg/day of the plantain fruits, which was made into flour, and dissolved in 2 ml of double distilled water for easy oral administration. Results: Significant increment in the semen parameters was noticed in animals that received a lower dose of the plantain flour, but those animals who received the high dose had marked and very significant reduction in sperm cell concentration and percentage of morphologically normal spermatozoa. Conclusion: Musa paradisiaca should be consumed in moderate quantities in order to derive its beneficial effects of enhancing male reproductive functions.
  4 4,066 229
Effects of indomethacin on expression of PTEN tumour suppressor in human cancers
Imran Haruna Abdulkareem, Maria Blair
March-April 2013, 54(2):100-106
DOI:10.4103/0300-1652.110041  PMID:23798795
Background: Previous studies reported that Non-steroidal Anti-inflammatory Drugs (NSAIDs), chemicals, and food supplements can be used to up-regulate the PTEN mRNA and protein expression, suggesting that these substances may be used in prevention and/or treatment of various human cancers like spinal, brain, colon, breast, prostate, bladder and endometrial cancers. Aim: This was to study expression and sub-cellular localisation of PTEN protein, and review the effect(s) of indomethacin on PTEN's expression in cultured Human Endometrial Cancer (HEC 1B) cell line, which is known to express significant amounts of the wild-type PTEN. Materials and Methods: This involves culture and incubation of artificial HEC 1B cells. All procedures were undertaken in the cell culture hood under the recommended sterile conditions. The cells were then incubated with different concentrations of indomethacin solution, for variable durations and finally fixed (with paraformaldehyde) and stained with fluorescein-labelled diluted secondary antibody (FITC). Immunocytochemistry (IHC) and fluorescent microscopy were then employed for the detection and localisation of the specific antigen (PTEN), using antibodies. Results: The HEC 1B cells, which were cultured and incubated with different concentrations of indomethacin solution, expressed the PTEN protein, most of which was localised to the nucleus with minimal cytoplasmic expression. Increased PTEN expression was observed following treatment of the cells with various concentrations of the solution for variable durations, although there was cell death at higher concentrations and longer duration. This procedure was repeated several times, in order to have consistency and to validate the results. Conclusion: This study agrees with previous studies in similar human cell lines and supports the idea that NSAIDs and other drugs may be used in the future for prevention of human cancers. However, more studies need to be carried out to substantiate these observations.
  3 2,307 279
Indications and findings at colonoscopy in Ilorin, Nigeria
Abdulfatai Bamidele Olokoba, Olusegun Ayodeji Obateru, Mathew Olumuyiwa Bojuwoye, Samuel Adegboyega Olatoke, Oladimeji Akeem Bolarinwa, Lateefat Bukola Olokoba
March-April 2013, 54(2):111-114
DOI:10.4103/0300-1652.110044  PMID:23798797
Background: Colonoscopy is a safe and effective means of visual inspection of the large bowel from the distal rectum to the caecum. It may be carried out for diagnostic and or therapeutic reasons. There is a paucity of data on this procedure in Nigeria. We, therefore, determined the indications, findings, and diagnostic yield in Nigerians at colonoscopy. Materials and Methods: This was a hospital-based cross-sectional study carried out at the Endoscopy unit of Crescent hospital, Ilorin from January 2010 to May, 2012. The endoscopy register was reviewed, and the biodata, indications and colonoscopic findings were recorded on a pro forma. Results: A total of 103 patients had colonoscopy. Seventy (68.0%) were males while 33 (32.0%) were females. The indications for colonoscopy were rectal bleeding 41 (39.8%), suspected colon cancer 32 (31.1%), chronic constipation and chronic diarrhoea nine each (8.7%), abdominal/anal pain five (4.9%), suspected anorectal cancer and enterocutaneous fistula two each (1.9%), faecal incontinence, occult gastrointestinal bleeding, post-colostomy for Hirschsprung disease one each (1.0%). Endoscopic findings were normal findings 21 (20.4%), diverticulosis 17 (16.5%), polyps 16 (15.5%), haemorrhoids 16 (15.5%), anorectal cancer 13 (12.6%), angiodysplasia 12 (11.7%), colon cancer eight (7.8%), colitis 7 (6.8%), anorectal ulcer 4 (3.9%), anal warts two (1.9%), anal fissure, caecal tumour, faecal impaction and proctitis one each (1.0%). The diagnostic yield was 79.6%. Conclusions: The commonest indication for colonoscopy was rectal bleeding, while the most frequent pathology was diverticulosis. The diagnostic yield was high.
  2 2,841 177
Cranial computed tomographic findings in Nigerian women with metastatic breast cancer
Millicent O Obajimi, Godwin Inalegwu Ogbole, Adenike T Adeniji-Sofoluwe, Amos O Adeleye, Theresa N Elumelu, Abideen O Oluwasola, OO Akute
March-April 2013, 54(2):123-128
DOI:10.4103/0300-1652.110048  PMID:23798799
Introduction: Brain metastases (BM) occur in up to one-fifth of patients with metastatic breast cancer (MBC). Imaging plays a key role in diagnosis. The pattern and distribution of these changes are also crucial to their management. These patterns have not been fully studied in Nigerian women. Materials and Methods: Retrospective analysis of the findings on the cranial Computed Tomography (CT) scans performed in 59 breast cancer patients with suspected BM treated at the University Teaching Hospital in Ibadan, between 2005 and 2010. The imaging features were evaluated in relation to their clinical characteristics. Results: In the 59 patients studied (mean age 50.9 years ± 11.75 SD), headache (40.7%) and hemiparesis/hemiplegia (16.9%) were the commonest clinical presentation. Lytic skull lesions were seen in 15 patients (25.4%), most commonly in the parietal bones. Thirty-nine patients (66.1%), had parenchymal brain lesions, and only 8 (20.5%) of these were single lesions. Most of the lesions were isodense (19/39; 51.4%) the parietal lobe was the most common site with 50.8% (30/59) occurrence and the leptomeninges the least with 13.6% (8/59). Orbital or sellar region involvement occurred in only two patients. The size of the lesions, was <2 cm in 17 (28.8%), 2-5 cm in 14 (23.7%) and >5 cm in 5 patients. Sixteen (27.1%) patients were free of any lesion either in the skull or brain. Patient presenting with multiple brain lesions were more likely to have skull lesions though this was not statistically significant ( P = 0.584). Conclusion: The brain continues to be a sanctuary site for breast cancer metastases and CT imaging remains an invaluable tool in the clinical evaluation and therapeutic management of Nigerian women with BM from MBC. It also appears that the demographic and imaging findings in these patients are similar to other racial groups.
  2 2,760 138
COMMENTARY
Parkinson's disease in the elderly and the comprehensive geriatric assessment
Fulvio Lauretani
March-April 2013, 54(2):146-147
DOI:10.4103/0300-1652.110054  PMID:23798803
  1 1,642 134
ORIGINAL ARTICLES
MR urography: Anatomical and quantitative information on congenital malformations in children
Maria Karaveli, Dimitrios Katsanidis, Ioannis Kalaitzoglou, Afroditi Haritanti, Anastasios Sioundas, Athanasios Dimitriadis, Kyriakos Psarrakos
March-April 2013, 54(2):136-142
DOI:10.4103/0300-1652.110052  PMID:23798801
Background and Aim: Magnetic resonance urography (MRU) is considered to be the next step in uroradiology. This technique combines superb anatomical images and functional information in a single test. In this article, we aim to present the topic of MRU in children and how it has been implemented in Northern Greece so far. The purpose of this study is to demonstrate the potential of MRU in clinical practice. We focus both on the anatomical and the quantitative information this technique can offer. Materials and Methods: MRU was applied in 25 children (ages from 3 to 11 years) diagnosed with different types of congenital malformations. T1 and T2 images were obtained for all patients. Dynamic, contrast-enhanced data were processed and signal intensity versus time curves were created for all patients from regions of interest (ROIs) selected around the kidneys in order to yield quantitative information regarding the kidneys function. Results: From the slopes of these curves we were able to evaluate which kidneys were functional and from the corticomedullary cross-over point to determine whether the renal system was obstructed or not. Conclusion: In all 25 cases MRU was sufficient, if not superior to other imaging modalities, to establish a complete diagnosis.
  1 2,673 163
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