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  Citation statistics : Table of Contents
   2015| January-March  | Volume 2 | Issue 1  
    Online since February 17, 2015

 
 
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ORIGINAL ARTICLES
Prevalence of thyroid dysfunction in gestational hypertensive Nigerians
Kabiru Abdulslam, Isah Adagiri Yahaya
January-March 2015, 2(1):19-27
DOI:10.4103/2384-5147.151569  
Background: Thyroid physiology changes significantly during pregnancy. Consequently, thyroid disorders are prevalent in women of child-bearing age and commonly present in pregnancy and puerperium. Untreated thyroid dysfunction in pregnancy has adverse effects on fetal and maternal well-being, including miscarriage, placental abruption, preterm delivery and preeclampsia. Aim: The aim of this study was to determine the prevalence of thyroid dysfunction among patients with gestational hypertension in Nigeria. Materials and Methods: Plasma concentrations of thyroid stimulating hormone, free thyroxine, and free tri-iodothyronine (fT 3 ) were measured in 165 pregnant women (aged 18-40 years) with gestational hypertension and 126 age-matched normotensive pregnant women, who served as controls. All laboratory analyses were conducted on Elecsys 2010 immunology analyzer, using a highly sensitive and specific chemiluminescence immunoassay method. Results: The prevalence of thyroid dysfunction was 23.6% and 10.3% in women with gestational hypertension and the normotensive pregnant women respectively. The most common thyroid dysfunction among the study participants was subclinical hypothyroidism accounting for 41.0% and 46.2% of all cases of thyroid abnormalities among the gestational hypertensive women and their normotensive counterparts, respectively. Conclusion: In view of the relatively high prevalence of thyroid dysfunction found in this study, it is suggested that all pregnant women (especially those with gestational hypertension) should be routinely screened for thyroid function abnormalities.
  6 6,708 507
Determination of normal portal vein parameters on triplex ultrasound scan among adults in Zaria, Nigeria
Philip Oluleke Ibinaiye, Joshua Oluwafemi Aiyekomogbon, Musa Abdulkadir Tabari, Nuhu Dang Chom, Ahmad Umdagas Hamidu, Rasheed Yusuf
January-March 2015, 2(1):33-38
DOI:10.4103/2384-5147.150469  
Background: There are many causes of the portal vein (PV) disease and these include portal hypertension (PHT), PV thrombosis, PV gas and PV stenosis/obstruction. PHT is a common clinical presentation of portal venous disease with multiple causes and several sequelae. There is a need for an imaging parameter that will aid early diagnosis of PHT since portal pressure monitoring devices are not available in most tertiary hospitals in Nigeria. Aims and Objectives: To determine the normal values of PV parameters using triplex ultrasound (US) among adults in Zaria, Nigeria. Settings and Design: This prospective study was conducted over a period of 6 months between November 2011 and May 2012 at the Radiology Department of Ahmadu Bello University Teaching Hospital, Zaria. Materials and Methods: Following an overnight fast, US scan was performed on 186 eligible participants. The diameter, cross-sectional area (CSA) and flow velocity of the PV were obtained. Results: The PV parameters obtained were as follows (mean ± standard deviation): PV diameter, 1.09 ± 0.22 cm (range: 0.87-1.31); CSA, 1.10 ± 0.203 cm 2 (range: 0.89-1.30) and mean flow velocity, 15.44 ± 2.63 cm/s (range: 12.80-18.10). All the measurements in males were significantly higher than those in females (P < 0.001). Conclusion: The normal values of PV parameters have been established in adult subjects in Zaria. These values will serve as a reference to detect abnormalities of dimensions and flow velocities in the PV, thus enabling quantitative evaluation of patients with suspected PV disease.
  5 7,024 400
Glycemic control and radiographic manifestations of pulmonary tuberculosis in patients with type 2 diabetes mellitus
Sindhuri Avuthu, Vinay Mahishale, Bhagyashri Patil, Ajith Eti
January-March 2015, 2(1):5-9
DOI:10.4103/2384-5147.151564  
Background: Diabetes mellitus (DM) is a risk factor for tuberculosis (TB) and may modify its presenting features. Atypical radiologic images of pulmonary TB are common in DM. Many studies have compared the radiological manifestations of TB between patients with and without DM. Aim of the Study: To study the impact of poor glycemic control on radiographic manifestations of the newly diagnosed smear-positive pulmonary TB patients with type 2 DM. Materials and Methods: In a tertiary care hospital, 70 patients newly diagnosed with smear-positive pulmonary TB and with coexisting type 2 DM were enrolled. Glycemic control was assessed by glycosylated hemoglobin (HbA1 C ). A pretreatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader. Radiological lesions on chest radiograph were classified into minimal, moderately advanced and far advanced as per American Thoracic Society criteria. Results: Of 70 patients, 47 (67.1%) had their HbA1c level ΃7%. Patients with poor glycemic control (HbA1c ΃7%) were more likely to have lower lung field involvement (29.8% vs. 13.04%; P < 0.01), far advanced lesions (40% vs. 4%; P < 0.001) and cavitary disease on chest radiograph (76.6% vs. 43.4% P < 0.05). Conclusion: Poor glycemic control significantly influences radiographic manifestations of pulmonary TB in patients with DM. Uncontrolled diabetics seem to have multiple and large cavities. Also isolated lower lung field involvement is more common in uncontrolled diabetics than in optimal control patients. High index of suspicion is, therefore, required in uncontrolled diabetics when radiological patterns are atypical.
  5 6,608 627
Hypospadias: 10 year review of outcome of treatment in pediatric urological practice
Ahmad Bello, Maitama Yusuf Hussaini, Mustapha Muhammed Kura, Ahmed Muhammed, Lawal Ahmad Tijjani
January-March 2015, 2(1):28-32
DOI:10.4103/2384-5147.151571  
Introduction: Hypospadias and its surgical correction is a challenging urologic discipline. Various surgical procedures for correction of this anomaly have evolved, in order to reduce complication rate and improve cosmetic outcome. The aim of this study is to review the complication rate and cosmetic outcome in patients who had hypospadias surgery at Ahmadu Bello University Teaching Hospital, Zaria. Patients and Methods: The case records and clinical appearance of 54 patients with hypospadias who had surgery between June1998 and June 2008 were reviewed. The effect of different variables on the overall complication rates were evaluated, including: the degree of chordee; the urethral meatal site after correction of any penile curvature; the age of the patient at surgery; the source of the neourethra; and tubularization of the flap. Result: The mean age of the patients was 1.97 (0.5-12) years. Most patients had their repair at 2 years of age. Twenty-six had distal hypospadias while twenty-eight were mid penile or proximal hypospadias. Distal hypospadias have a better outcome than proximal hypospadias. Onlay flaps have lower stricture and fistula compared with tubularized flaps. Repairs are done recently at earlier age with equal or better outcome. Conclusion: Skin flap procedures have had sufficiently extensive use to support the feasibility of a one-stage repair of different types of hypospadias. Snodgrass is gaining popularity in recent times, and more procedures are likely to evolve in order to improve cosmetic outcome.
  4 8,105 527
Histopathological review of breast tumors in Kano, Northern Nigeria
Imam Mohammed Ibrahim, Yawale Iliyasu, Aminu Zakari Mohammed
January-March 2015, 2(1):47-51
DOI:10.4103/2384-5147.150471  
Context: Breast tumors are common worldwide, and various reports suggest an increasing incidence in Nigeria, which necessitates an urgent need to differentiate benign from malignant tumors. Aims: To classify, grade and to determine the changing pattern, frequency, age and sex distribution of breast tumors seen in a tertiary hospital. Materials and Methods: This was a 10-year retrospective study of all breast tumors diagnosed at the Pathology Department of a Teaching Hospital from 1 January 2001 to 31 December 2010. Results: A total of 1,566 breast tumors were diagnosed during the study period, of which 1035 (66.1%) were benign, and 531 (33.9%) were malignant. Fibroadenoma was the commonest benign breast tumor followed by fibrocystic change, and they accounted for 47.1% and 25.4% of benign breast tumors respectively. Out of the 531 malignant cases reviewed; 496 (93.4%) were females, and 35 (6.6%) were males with a female to male:ratio of 14.2:1.0. The age range of malignant cases was between 21 and 79 years with a mean age of 42.0 years. Invasive ductal carcinoma was the predominant histological type with 316 cases (59.5%). This was followed by medullary carcinoma with 61 (11.5%) cases, invasive lobular carcinoma and invasive papillary carcinoma each with 37 (6.9%) cases. Three hundred and ninety-eight cases satisfied the criteria for grading, out of which 237 (59.5%) cases were classified in Grade 1, 133 (33.4%) cases in Grade 2 and 28 (7.1%) cases in Grade 2. Conclusions: Breast tumors are quite common which are mostly benign and are seen in both sexes with a striking female preponderance. The findings are generally similar to most previous studies from Nigeria, Africa and western world with minimal variations.
  4 7,102 525
Pathologic characteristics and management of renal cell carcinoma in Zaria, Nigeria
Ahmed Muhammed, Bello Ahmad, Maitama Hussaini Yusuf, Liman A Almustapha, Sudi Abdullahi, Lawal Ahmad Tijjani
January-March 2015, 2(1):1-4
DOI:10.4103/2384-5147.151559  
Background: The incidence of renal cell carcinoma (RCC) has been on the increase. Small (early stage) RCC is potentially curable by surgery; however, advanced RCC has a very poor prognosis. Recent advances in the treatment of advanced/metastatic RCC have improved the hitherto gloomy outcome. Objectives: To determine the clinical presentation, pathologic characteristics and survival outcome of patients managed for RCC in our center. Materials and Methods: We retrospectively analyzed the data retrieved from case notes, operation registers and histopathology records of all the patients that underwent nephrectomy for RCC over a 10-year period (2004-2013). Details of the clinical presentation, evaluation, histopathologic characteristics, treatment and outcome were recorded. Data were displayed in charts and tables and survival analysis was done using Kaplan-Meier survival curve. Results: A total of 51 patients had nephrectomy for RCC during the period of study. The mean age was 43.1 years standard deviation 15.3 with a male-to-female ratio of 2:3. An unexpected finding was the relatively high incidence of right-sided tumors 35 (68.6%) compared to left side 14 (27.5%). Over 90% of the patients had advanced disease (T3 or greater). It was also observed that most of the young patients were females and had predominantly right-sided tumors. Clear cell RCC accounted for the most common histologic type 38 (74.5%). Only 6 patients had incidental (early) disease, and they had the best outcome. Overall survival was poor but patients who had adjuvant treatment fared relatively better. Conclusion: RCC remains a highly lethal urologic malignancy. Recent advances in targeted molecular therapies have improved the outcome of the advanced disease. In our environment, the outcome has remained dismal due to multiple factors, including late detection, cost and relative scarcity of the new treatment modalities.
  3 5,564 435
Presbyopia among health workers in a tertiary hospital in north western Nigeria
Aliyu Hamza Balarabe, Sadiq Adamu, Rabia Musa
January-March 2015, 2(1):10-13
DOI:10.4103/2384-5147.151566  
Objective: The aim was to determine the prevalence of presbyopia among workers at Federal Medical Centre (FMC) in Birnin-Kebbi, Nigeria. Materials and Methods: A cross-sectional survey of 145 persons at FMC Birnin-Kebbi, Nigeria. Subjects were selected by random sampling technique from the two directorates of the hospital, clinical, and administrative. Visual acuity was measured with the Snellen's chart while persons with subnormal vision were examined using pinhole and correction if required. Near vision was tested at a distance of 40 cm with a near vision chart. Subjects not using correction were asked on their perceived barrier for not using correction. Results: The age range was from 35 to 57 years (mean age 44.7 years), including 65.5% males and 34.5% females. The prevalence of presbyopia was 42.1%. Spectacle coverage was 51.5% with 48.5% of persons needing correction not using correction. Lack of awareness and no felt need were the major barriers to non-use of the spectacles. Conclusions: Many of the cohorts remained uncorrected despite their presbyopic errors. There is a need to create more awareness among health workers about presbyopia and its correction. Ensuring adequate treatment of presbyopia among health workers can impact positively on the quality of life and productivity of health personnel.
  1 6,799 463
Perspectives of Mothers on Childhood Epilepsy in Kaduna, Northern Nigeria
Edwin E Eseigbe, Jim Enogela, Sam J Adama, Folorunsho T Nuhu, Taiwo L Sheikh, Patricia Eseigbe
January-March 2015, 2(1):39-46
DOI:10.4103/2384-5147.150470  
Introduction: Epilepsy is one of the most common childhood neurological diseases and is associated with poor outcomes in developing countries where it is most prevalent. The epilepsy perspectives of adults in these countries have been found to influence epilepsy outcomes significantly. Assessing the epilepsy perspectives of mothers, who play a pivotal role in child care, is important to providing comprehensive epilepsy care and ensuring better outcomes. Objective: To assess the knowledge and attitude of mothers, as primary child care providers toward children with epilepsy. Materials and Methods: A structured questionnaire was administered to mothers attending a primary healthcare center, and it assessed their sociodemographic characteristics, knowledge and attitude with regards to childhood epilepsy. Knowledge was assessed based on responses to queries about etiology, manifestation, treatment and outcome of epilepsy in childhood. Attitude was assessed based on mothers' tendency toward stigmatization or discrimination against children with epilepsy. Results: A total of 523 mothers, whose age range was 17-52 years (mean 27.5 ΁ 10.3 years), was interviewed. Most were <30 years old (300, 57.4%), petty traders (217, 41.5%) and had a primary education (221, 42.3%). Spiritual cause (247, 47.2%) and "falling to the ground" (361, 69%) were the commonest epilepsy etiology and manifestation indicated respectively. Orthodox medical therapy (239, 45.7%), prayers (138, 30.2%) and traditional medication (118, 22.6%) were the main treatment modalities indicated. Most of the mothers (277, 53%) were uncertain about the outcome in childhood epilepsy. Stigmatization and discrimination against children with epilepsy were indicated by 120 (22.9%) and 481 (92%) of the mothers respectively. Lack of any formal education, indication of a spiritual etiology and perception of a poor outcome for epilepsy were significantly (P < 0.05) associated with the attitudinal disposition of the mothers. Conclusion: Majority of the mothers demonstrated appreciable deficiencies in their knowledge of epilepsy and had a negative attitudinal disposition toward epilepsy in childhood.
  1 6,813 464
CASE REPORTS
Gross hematuria in a child with tuberous sclerosis complex
Mairo Adamu Bugaje, Abubakar Yakubu, Rosemund Akuse, Henry Abiodun Aikhionbare
January-March 2015, 2(1):52-55
DOI:10.4103/2384-5147.151572  
Tuberous sclerosis is an under diagnosed autosomal dominant neurocutaneous syndrome characterized by the presence of benign congenital tumors in multiple organs expression and a prevalence of 1/6,000-1/12000 newborns. There are varying degrees of renal involvement in tuberous sclerosis complex, which is usually bilateral and asymptomatic. We report a case of Tuberous sclerosis with left sided renal angiomyolipoma and bilateral multiple renal cysts in a 12-year-old boy, who presented with massive hematuria warranting blood transfusion and urosepsis. There was past medical history of repeated seizures. This case highlights the need for a high index of suspicion in a child with un-explained skin lesions, recurrent seizures, mental retardation and symptoms referable to the urinary system.
  - 5,489 350
ORIGINAL ARTICLES
Accuracy of ultrasound in fetal birth weight estimation and sex determination in singleton term pregnancies from two tertiary institutions of northwestern Nigeria
Sadisu Mohammed Ma`aji, Daniel Dirioha Odunko
January-March 2015, 2(1):14-18
DOI:10.4103/2384-5147.151568  
Background: Ultrasonographic assessment of fetal growth for the estimation of fetal weight (EFW) is a common obstetrics practice and provides valuable information for planning the mode of delivery. The aim of this study is to determine the accuracy of fetal birth weight estimation and sex determination using ultrasonography from two tertiary institutions of Northwestern Nigeria. Materials and Methods: This was a prospective study involving 109 singleton uncomplicated pregnancies from January 2013 to January 2014. All the patients are booked at the antenatal clinic of two tertiary institutions (Usmanu Danfodiyo University Teaching Hospital [UDUTH] Sokoto and Federal Medical Center Birnin Kebbi). Inclusion criteria in the study were term pregnancy (36-42 weeks), reliable date of last menstrual period, regular menstrual cycle, a close correlation between menstrual age and clinical gestational age measurements. Results: The mean maternal age was 29.01 ΁ standard deviation 4.81 (range: 18-40 years). One hundred and nine term live-born singleton infants delivered at UDUTH and Federal Medical Center Birnin Kebbi during the study period had undergone ultrasound EFW <7 days preceding birth. Twenty-one (19.3%) fetuses were identified as male while 38 (34.9%) was identified as female during the ultrasound examinations. In about 40 (36.7%) of the fetuses, the gender was not seen. Conclusion: There was a significant error while estimating fetal weight by ultrasound and underestimation has the highest percentage. Determination of fetal sex with ultrasound show some degree of accuracy in our study because 21 (19.3%) fetuses were identified as male, while 38 (34.9%) was identified as female during the ultrasound examinations. Hence, it should be recommended only if the mother requested for the gender during the scanning taking into account the social implications.
  - 39,806 797
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