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   2013| May-June  | Volume 54 | Issue 3  
    Online since July 5, 2013

 
 
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ORIGINAL ARTICLES
Prevalence of obesity among adolescents in Ile-Ife, Osun state, Nigeria using body mass index and waist hip ratio: A comparative study
Adedayo O Sabageh, Ebenezer O Ojofeitimi
May-June 2013, 54(3):153-156
DOI:10.4103/0300-1652.114566  PMID:23900669
Background: Obesity is a global epidemic not just among adults but also among children and adolescents. This study described the prevalence and pattern of obesity among in-school adolescents in Ile-Ife, Osun State using two standard methods, Body Mass Index (BMI) and Waist Hip Ratio (WHR) with a view of comparing the two methods as well as identifying any correlation between the two methods. Materials and Methods: Five hundred male and female respondents, aged 10-19 years, were randomly selected through a multistage sampling technique from private and public schools in Ife Central Local Government Area. Quantitative data were collected with the aid of a pre-tested, semi-structured, self-administered questionnaire. Anthropometric measurements of respondents, BMI and WHR, were recorded. Chi square and linear regression analyses were used. Statistical significance was tested at the 5% level. Results: The prevalence of obesity was 4.2% using BMI of which 12 (57.1%) were females and nine (42.9%) were males. There was significant association between sex and BMI, χ2 = 9.490 ( P = 0.020). Using WHR, the prevalence was 37.2% of which 180 (96.8%) were females and six (3.2%) were males. There was also significant association between sex and WHR ( P < 0.001). Weak correlation ( r = 0.02) was found between BMI and WHR among the females, P = 0.043. Conclusion: There was a difference in the prevalence of obesity using the two methods. Although, the correlation between the two methods was weak among females, WHR yielded a higher prevalence for obesity with remarkable difference especially among the females. Prevention of adolescent obesity should be encouraged especially among females.
  6,771 392 3
Anthropometry and cardiovascular disease risk factors among retirees and non-retirees in Ile-Ife, Nigeria: A comparative study
Israel Arogundade Ojo, Jibril Mohammed
May-June 2013, 54(3):160-164
DOI:10.4103/0300-1652.114568  PMID:23901177
Background: Increasing affluence in low-income countries has been associated with lifestyle-related conditions, which may afford some people the opportunity to retire from gainful employment. This study examined the relationship between selected anthropometric variables and cardiovascular disease risk factors among age-matched retirees and non-retirees in Ile-Ife, Nigeria. Materials and Methods: Self-reported healthy adults (104 retirees and 99 age-matched non-retirees) were purposively recruited. Weight, height, waist circumference, systolic blood pressure and diastolic blood pressure were measured with standard equipment and procedures. An established questionnaire was used to classify the subjects into high, medium and low cardiovascular disease risk categories. The data were analysed with basic description and inferential statistics. Results : Mean ages for the retirees and non-retirees were 64.8 ± 7.0 years and 63.8 ± 4.5 years, respectively. The mean systolic blood pressure, diastolic blood pressure and waist circumference were higher for the retirees than for the non-retirees (all P < 0.01) as were the mean cardiovascular disease risk factors scores ( P < 0.01). Conclusion: The study concludes that retirees have a higher risk for cardiovascular disease than non-retirees and weight and Body Mass Index are the major determinants. Studies are needed to explain the differences in body composition indices and cardiovascular disease risk factors between retirees and age-matched non-retirees
  5,697 154 -
Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
Solomon Odafe, Kwasi Torpey, Hadiza Khamofu, Edward Oladele, Oluwasanmi Adedokun, Otto Chabikuli, Halima Mukaddas, Yelwa Usman, Bolatito Aiyenigba, MacPaul Okoye
May-June 2013, 54(3):176-184
DOI:10.4103/0300-1652.114590  PMID:23901180
Background: Human immunodeficiency virus positive (HIV+) women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA) into HIV care as well as to describe patients' characteristics associated with positive VIA findings amongst HIV+ women. Materials and Methods: A cross-sectional study analysed routine service data collected at the antiretroviral therapy (ART) and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement, capacity building for health workers, creating a bi-directional referral between HIV and reproductive health (RH) services and provider initiated counselling and screening for cervical cancer. Information on patients' baseline and clinical characteristics were captured using an electronic medical records system and then exported to Statistical Package for the Social Sciences (SPSS). Logistic regression model was used to estimate factors that influence VIA results. Results: A total of 834 HIV+ women were offered VIA screening between April 2010 and April 2011, and 805 (96.5%) accepted it. Complete data was available for 802 (96.2%) women. The mean age at screening and first sexual contact were 32.0 (SD 6.6) and 18.8 (SD 3.5) years, respectively. VIA was positive in 52 (6.5%) women while 199 (24.8%) had a sexually transmitted infection (STI). Of the 199 who had a STI, eight (4.0%) had genital ulcer syndrome, 30 (15.1%) had lower abdominal pain syndrome and 161 (80.9%) had vaginal discharge syndrome. Presence of lower abdominal pain syndrome was found to be a significant predictor of a positive VIA result ( P = 0.001). Women with lower abdominal pain syndrome appeared to be more likely (OR 47.9, 95% CI: 4.8-480.4, P = 0.001) to have a positive VIA result. Conclusion: The high burden of both HIV and cervical cancer in developing countries makes it a necessity for integrating services that offer early detection and treatment for both diseases. The findings from our study suggest that integrating VIA screening into the package of care offered to HIV+ women is feasible and acceptable.
  5,056 218 16
CASE REPORTS
Polyembolokoilamania: Self-insertion of transistor radio antenna in male urethra
Jibril Oyekunle Bello, Kamil O Badmus, Abdul-Lateef Babata, Halima S Bello
May-June 2013, 54(3):206-208
DOI:10.4103/0300-1652.114578  PMID:23900734
Though self-insertion of a foreign body in the male urethra is an infrequent urologic emergency, a weird variety of self-inserted foreign bodies have been reported. Most of these are attributed to autoerotic stimulation, a consequence of mental illness or the result of drug intoxication. We report an unusual case of a 65-year-old African man who self-inserted a broken transistor radio antenna into his urethra to serve as an improvised 'itchstick' to ease a bothersome itchy urethral condition. The foreign body subsequently migrated proximally out of reach. He presented a week after with urethral bleeding following nocturnal penile erections and we describe his evaluation and the challenge of retrieval. The reasons for self-inserting objects into the urethra may be as varied as the foreign bodies themselves and may include objects being used as an improvised 'itchstick' for itchy urethral conditions. The urologist's creative tendencies will often be required in safely removing these objects.
  4,571 111 1
ORIGINAL ARTICLES
Cardiovascular disease risk factors among HIV-infected Nigerians receiving highly active antiretroviral therapy
Sanusi Muhammad, Mahmoud Umar Sani, Basil N Okeahialam
May-June 2013, 54(3):185-190
DOI:10.4103/0300-1652.114591  PMID:23901181
Background: Highly active antiretroviral therapy (HAART) has become more accessible to Human immunodeficiency virus infection/Acquired Immunodeficiency Syndrome (HIV/AIDS) patients worldwide. There is growing concern that the metabolic complications associated with HIV and HAART may increase cardiovascular risk and lead to cardiovascular diseases. We, therefore, set out to describe the cardiovascular risk profile of HIV/AIDS patients receiving HAART at a health facility in northern part of Nigeria. Materials and Methods: This cross-sectional study was conducted at the Aminu Kano Teaching Hospital, Kano, Nigeria. Consenting patients, who had been receiving HAART, were compared with age and sex matched HAART-naive subjects. Questionnaire interview, electrocardiography, anthropometric and blood pressure measurements were conducted under standard conditions. Blood samples were obtained for the determination of plasma glucose, uric acid and lipid levels. Results: Two hundred subjects were studied, 100 were on HAART (group 1) and the other 100 (group 2) were HAART-naive. Subjects' mean age for all the participants was 32.5 (7.6) years. The prevalence of hypertension was 17% in group 1 and 2% in group 2 ( P < 0.001). Similarly, 11% and 21% of group 1 subjects were obese or had metabolic syndrome compared with 2% and 9% of group 2 patients ( P < 0.05 for both) . Conclusion: HAART treatment was associated with significantly higher prevalences of hypertension, obesity and metabolic syndrome.
  4,245 219 27
Acute renal failure in pregnancy: Tertiary centre experience from north Indian population
Munna Lal Patel, Rekha Sachan, Radheshyam , Pushpalata Sachan2
May-June 2013, 54(3):191-195
DOI:10.4103/0300-1652.114586  PMID:23900700
Background: Obstetrical acute renal failure ARF is now a rare entity in the developed countries but still a common occurrence in developing countries. Delay in the diagnosis and late referral is associated with increased mortality. This study aimed to evaluate the contributing factors responsible for pregnancy-related acute kidney failure, its relation with mortality and morbidity and outcome measures in these patients. Materials and Methods: Total 520 patients of ARF of various aetiology were admitted, out of these 60 (11.5%) patients were pregnancy-related acute renal failure. Results: ARF Acute renal failure occurred in 32 (53.3%) cases in early part of their pregnancy, whereas in 28 (46.7%) cases in later of the pregnancy. Thirty-two (53.3%) patients had not received any antenatal visit, and had home delivery, 20 (33.4%) patients had delivered in hospitals but without antenatal care and eight (13.3%) patients received antenatal care and delivered in the hospitals. Anuria was observed in 23 (38.3%) cases, remaining 37 (61.7%) cases presented with oliguria. Septicemia was present in 25 (41.7%), hypertensive disorder of pregnancy in 20 (33.3%), haemorrhage in eight (13.3%), abortion in 5 (8.3%), haemolysis elevated liver enzymes low platelets counts (HELLP) syndrome in one (1.67%) and disseminated intravascular coagulation in one (1.67%). (61.7%) patients were not dialyzed, 33 (55%) recovered normal renal function with conservative treatment. Complete recovery was observed in 45 (75%) patients, five (8.4%) patients developed irreversible renal failure. Maternal mortality was nine (15%) and foetal loss was 25 (41.7%). Conclusion: Pregnancy-related ARF is usually a consequence of obstetric complications; it carries very high morbidity and mortality.
  3,513 224 8
Endoscopic versus external approach dacryocystorhinostomy: A comparative analysis
Rinki Saha, Anuradha Sinha, Jyoti Prakash Phukan
May-June 2013, 54(3):165-169
DOI:10.4103/0300-1652.114580  PMID:23901178
Background: Dacryocystorhinostomy (DCR) consists of creating a lacrimal drainage pathway to the nasal cavity to restore permanent drainage of previously obstructed excreting system. Aim: To compare the result and advantages of both endonasal endoscopic and external DCR regarding the patency rate, patient compliance and complications. Study Design: Prospective non-randomized comparative study. Materials and Methods: Study was conducted for 16 months duration in a teaching hospital with 50 cases of endoscopic and 30 cases of external DCR with a follow-up of minimum 6 months. Data regarding surgical outcome and complications were analysed and compared using χ2 test. Results: Total 72 patients were included in the study with six having bilateral involvement, out of which 20 were male and 52 were female. The mean age for endoscopic and external DCR was 33.6 years and 46.0 years, respectively. Right eye (63.8%) was involved more commonly than left eye (36.2%). Epiphora was the commonest presenting symptom (63.7%). Mean duration of surgery was much lengthier in external (mean 119.6 minutes) than endoscopic (mean 49.0 minutes) DCR. Bleeding was the most common immediate postoperative complication seen in 33.3% and 10.0% of external and endoscopic DCR cases, respectively. Primary surgical success rate was 90% and 96.7% for endoscopic and external DCR, respectively ( P = 0.046). Among the endoscopic DCR group, four patients underwent revision surgery giving a total successful surgical outcome of 98% at third month of follow-up. However, at 6 month of follow-up, success rate was 92% for endoscopic DCR and 93.3% for external DCR. The difference was not statistically significant ( P = 0.609). Conclusion: Intranasal endoscopic DCR is a simple, minimally invasive, day care procedure and had comparable result with conventional external DCR.
  3,458 218 11
Effect of intermittent preventive treatment of malaria on the outcome of pregnancy among women attending antenatal clinic of a new Nigerian teaching hospital, Ado-Ekiti
Aduloju Aduloju Peter
May-June 2013, 54(3):170-175
DOI:10.4103/0300-1652.114582  PMID:23901179
Background: Malaria is a public health problem globally especially in the Sub-Saharan Africa and among the under five children and pregnant women and is associated with a lot of maternal and foetal complications. Objective: The study was on the effect of intermittent preventive treatment of malaria in pregnancy on the prevalence of malaria in pregnancy and the outcome of pregnancy. Materials and Methods: In a descriptive cross-sectional study, a semi-structured questionnaire was administered to women admitted in Ekiti State University Teaching Hospital labour ward, Ado-Ekiti. About 4,200 women participated in the study and the inclusion criteria were women who were booked in the hospital, attended at least four antenatal clinic visits, and consented to the study while the exclusion criteria were those who didn't book in the hospital and failed to give their consent. Results: The study revealed that about 75% of the pregnant women studied had access to intermittent preventive treatment of malaria. Among the women attending the antenatal clinic that received sulphadoxine-pyrimethamine (SP), about 78% of them took two doses of SP. The prevalence of clinical malaria was statistically higher in women who did not receive intermittent preventive treatment with SP during pregnancy (44.7% vs. 31.3%, P = 0.0001) and among women who had one dose of the drug instead of two doses (40.0% vs. 28.7%, P = 0.0001). There was no statistical significant difference in the mean age in years (31.53 ± 5.238 vs. 31.07 ± 4.751, P = 0.09 and the gestational age at delivery (38.76 ± 1.784 vs. 38.85 ± 1.459, P = 0.122) between the women who did not receive SP and those who had it. There was a statistical significant difference in the outcome of pregnancy among women who had Intermittent Preventive Treatment in pregnancy (IPTp) and those who did not viz.-a-viz. in the duration of labor (8.6 ± 1.491 vs. 8.7 ± 1.634, P = 0.011) and the birth weight of the babies (3.138 ± 0.402 vs. 3.263 ± 0.398, P = 0.0001). Conclusion: SP is an effective malarial prophylaxis in pregnancy.
  3,159 142 5
Association of Helicobacter pylori infection with the Lewis and ABO blood groups in dyspeptic patients
Kamran Aryana, Mohammad Reza Keramati, Seyed Rasoul Zakavi, Mohammad Hadi Sadeghian, Hedieh Akbari
May-June 2013, 54(3):196-199
DOI:10.4103/0300-1652.114583  PMID:23901182
Background: Helicobacter pylori infection is a basic risk factor for chronic gastritis, and gastric carcinoma. Based on some studies, the reason is binding of H. pylori to H and Le b antigens in gastric mucosa. However, some other findings have not determined any association between the infection and these antigens. Because of this controversy and the fact that H. pylori infection and gastric adenocarcinoma are common diseases in Iran, the assessment of the association of H. pylori infection with these blood groups could be valuable. Materials and Methods: In a cross sectional study on 135 adult dyspeptic patients in Mashhad, Iran, from 2009 to 2010, H. pylori infection was evaluated by using the Heliprobe 14 C-urea breath test and the ABO and Lewis blood group antigens were determined by the tube method. Association between the Lewis and ABO phenotypes with H. pylori infection were analysed by Fisher's exact test. A P ≤ 0.05 was considered to be significant. Results: 68 (50.4%) patients were positive for H. pylori infection. The frequencies of the ABO, Lewis and secretion phenotypes were not significant in the infected and non-infected patients. We also did not find a significant association between Le a and Le b antigens and this infection. Conclusion: We could not establish a significant association between the Lewis, ABO and secretion phenotypes with H. pylori infection. Diversity of sequences of blood group antigen b-binding adhesion (babA gene) of H. pylori may be a reason why our findings are different from other studies in other geographic areas.
  3,114 154 5
Relationship between the concentration of volatile sulphur compound and periodontal disease severity in Nigerian young adults
Adebola O Ehizele, Patrick I Ojehanon
May-June 2013, 54(3):149-152
DOI:10.4103/0300-1652.114564  PMID:23901175
Background: The aim of this study was to determine the relationship between the concentration of volatile sulphur compounds (VSC) in mouth air and the severity of periodontal diseases in young adults. Materials and Methods: A total of 400 subjects were studied. Estimation of periodontal disease severity was done using the basic periodontal examination (BPE) and the baseline measurement of the concentration of VSC in the mouth air of the subjects was done objectively using the Halimeter®. Result: The mean concentration of VSC for the group with BPE code 0 was 91.0 ± 5.9 parts per billion (ppb), 156.4 ± 9.4 ppb for BPE code 1, 275.2 ± 38.5 ppb for BPE code 2, 353.5 ± 72.3 ppb for BPE code 3, and 587.0 ± 2.1 ppb for BPE code 4 ( P = 0.001). Majority (79.0%) of the subjects with BPE code 0 had concentration of VSC <181 ppb. Sixty-two (54.9%) with BPE code 1 had concentration of VSC <181 ppb, 34% with BPE code 2 had concentration of VSC <181 ppb and 42.9% with BPE code 3 had concentration of VSC <181 ppb. Only 6.5% of the subjects with BPE code 0 had VSC concentration >250 ppb, whereas all (100%) of those with BPE code 4 had VSC concentration >250 ppb ( P = 0.001). Conclusion: It was concluded that a relationship exists between the periodontal pocket depth and the concentration of VCS in mouth air of young adults.
  2,893 195 2
CASE REPORTS
Endoscopic management of emphysematous periurethral and corporal abscess
Priyadarshi Ranjan, Saurabh Sudhir Chipde, Sandeep Prabhakaran, Surabhi Chipde, Rakesh Kapoor
May-June 2013, 54(3):209-210
DOI:10.4103/0300-1652.114579  PMID:23900773
We came across an interesting case which was presented with fever, dysuria and perineal pain, not responding to antibiotics. The computed tomography scan showed periurethral abscess containing multiple air specs with involvement of bilateral corpora cavernosa. We successfully treated this patient with endoscopic drainage. Spontaneous periurethral and corporal abscess in male is a rare entity and emphysematous form in corpora has not been described before.
  2,887 111 1
ORIGINAL ARTICLES
Outcome of bronchoscopic biopsies in the University of Benin Teaching Hospital
SU Okugbo, Ezekiel E Ugiagbe
May-June 2013, 54(3):157-159
DOI:10.4103/0300-1652.114567  PMID:23901176
Aim: Our study was done to evaluate our bronchoscopic techniques, sizes and diagnostic yield. Materials and Methods: This was a retrospective study comprising all cases of bronchial biopsies done in the University of Benin Teaching Hospital from 2007 to 2011. All patients who had flexible bronchoscopy under general anaesthesia during the period under review where enrolled in the study. Results: There were a total of 16 patients: Nine males and seven females, with a mean age of 46.9 years. The main indications were cough (87.5%), weight loss (62.5%), X-ray findings of a chest lesion (87.5%), chest pain (62.5%), difficulty with breathing (31.3%) and massive haemoptysis (25%). Histology results showed inadequate samples in six and Bronchogenic carcinoma in four patients. The histology was pivotal in eight patients. Conclusion: Bronchoscopic biopsies are fraught with problems and other clinical investigative tools would certainly be important in improving the results.
  2,574 128 -
CASE REPORTS
Bilateral orbital infarction and retinal detachment in a previously undiagnosed sickle cell hemoglobinopathy African child
Onakpoya Oluwatoyin Helen, KO Ajite, OA Oyelami, CM Asaleye, AO Adeoye
May-June 2013, 54(3):200-202
DOI:10.4103/0300-1652.114571  PMID:23901183
Bone infarction involving the orbit in sickle cell disease is not common. Bilateral orbital infarction in a previously undiagnosed sickle cell hemoglobinopathy has not been previously reported. In this report, we present a case of an 11-year-old previously undiagnosed sickle cell disease Nigerian girl with severe acute bilateral orbital infarction and retinal detachment to highlight that hemoglobinopathy induced orbital infarction should be considered in African children with acute onset proptosis with or without previous history of sickle cell hemoglobinopathy.
  2,574 106 2
Pentalogy of Cantrell; complete expression in a nine-month-old-boy
Ibrahim Aliyu, Mohammad Aminu Mohammad
May-June 2013, 54(3):203-205
DOI:10.4103/0300-1652.114576  PMID:23901184
Pentalogy of Cantrell is a rare congenital malformation whose exact cause is not completely understood; it is characterized by defects in the anterior abdominal and thoracic walls consisting of omphalocoele, diaphragmatic defect, ectopia cordis, intracardiac defects and sternal clefts. The complex has variable clinical expression with complete and incomplete expressions reported. We, therefore, report a case of complete manifestation of the pentad in a 9-month-old boy.
  2,483 118 -
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