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   2017| April-June  | Volume 4 | Issue 2  
    Online since March 29, 2018

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A diary of endometrial malignancies in Zaria, Northern Nigeria
Abdul Adogie Muhammad, Oguntayo O Adekunle, Samaila O Modupeola, Umar Muhammad, SarkinPawa Zulaiha, Adamu Abdullahi
April-June 2017, 4(2):43-46
Context: Endometrial malignancies are uncommon tumors in sub-Saharan Africa. However, it has been observed that the incidence of endometrial cancer may be increasing. Objectives: To document the prevalence, clinical profile, and histological types of endometrial malignancies in Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria. Study Design: Descriptive study. Setting: Departments of Obstetrics & Gynecology and Histo-Pathology Ahmadu Bello University Teaching Hospital Zaria. Materials and Methods: Data of histologically proven cases of endometrial malignant tumors from January 1992–December 2011 were extracted from case notes, cancer registry and histology forms/reports and analyzed using the Statistical Package for the Social Sciences version 17.0 software (SPSS Inc., Chicago, IL, USA). Results: Seventy-seven cases were recorded during the period under review, and this constituted 5% of all genital tract malignancies. The number of cases seen in the first 10 years under review (1992–2001) were 24 (2.4 cases/year), while that of the second decade (2002–2011) were 55 (5.5 cases/year), reflecting more than two-fold increase. The mean age and parity of the patients were 52 ± 14.9 years and 7.4 ± 2.5, respectively. Over 67% of the cases were postmenopausal. Vaginal bleeding was the principal presenting symptom occurring in 100% of cases, and the uterus was enlarged in 82% of patients. Endometrial biopsy was the main method of diagnosis (60% of cases), and 89% of cases were diagnosed in clinical stages 1 and 11. Adenocarcinoma was seen in 78% of cases, while stromal sarcoma constituted 13% and mixed Mullerian tumor accounted for 9%. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was the main treatment offered. Conclusion: The incidence of endometrial carcinoma may be on the increase in our setting. High index of suspicion and endometrial biopsy will diagnose majority of cases.
  5,161 425 -
Knowledge regarding co-trimoxazole preventive therapy among patients who are HIV positive in a tertiary health facility, northeastern Nigeria
Ballah Akawu Denue
April-June 2017, 4(2):31-36
Background: Co-trimoxazole (sulfamethoxazole and trimethoprim, CTX) is known to be effective against common opportunistic infections associated with severe immunosuppression such as AIDS. Its use among patients with defects in immunity and multiple infections is associated with significant reduction in morbidity and mortality. Objective: To determine and predict the level of knowledge regarding co-trimoxazole preventive therapy (CPT) among patients with HIV. Materials and Methods: This was a descriptive cross-sectional study conducted among 358 patients who were HIV positive. An expert-validated, interviewer-administered questionnaire with Cronbach alpha of 0.67 was used to assess patients’ knowledge regarding CPT. Results: Most respondents, 323 (90.2%) in total, reported not to have ever been counseled on CPT. The proportion of those counseled showed female preponderance, with 26 females (74.3%) compared with nine males (25.7%). Among those who responded to ever been counseled, only 19% had questionnaire-defined (≥50% score) adequate knowledge. The level of education and counseling regarding CPT were independent predictors of knowledge. Patients with secondary and tertiary education were three times [P = 0.021, odds ratio (OR) = 3.098, 95% confidence interval (CI) = 1.187–8.084] and 18.7 times (P < 0.001, OR = 18.764, CI = 6.862–51.313) likely to demonstrate having adequate knowledge than those without formal education. Similarly, adherence counseling was associated with 16 times greater chance for demonstrating adequate knowledge (P < 0.001, OR = 16.063, CI = 5.768–44.733). Conclusion: Knowledge on the use of CPT is poor in our setting; adherence counseling on its use is recommended at services delivery points.
  4,758 334 2
Perceptions and practices related to health hazards of patronizing traditional nail cutters and barbers among market men in Samaru – North Western Nigeria
Aisha A Abubakar, Ibrahim A Dangana, Babajide A John, Abdulrazak A Gobir, Mohammed S Ibrahim, Ahmed A Umar, Suleiman S Bashir, Adamu U Shehu
April-June 2017, 4(2):37-42
Introduction: Several health hazards including infectious blood-borne communicable diseases and skin conditions are associated with traditional nail cutting and barbering. Negligence and accidents during the use of sharp instruments such as nail cutters, razors, shaving blades and clippers may be risk factors for blood-borne infections such as Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immune-deficiency Virus (HIV), causing serious health problems. Materials and Methods: This was a cross-sectional descriptive study. Interviewer-administered questionnaires were administered to 231 market men in Samaru, Zaria. Data collected were coded and analyzed with IBM SPSS 20.0. Results: Of 231 sampled men, 223 (96.5%) were aware of HIV infection and mentioned sexual contact as its main mode of transmission. Similarly, 220 (95.2%) knew HIV could also be transmitted through contaminated barbering and nail cutting instruments. Majority 146 (63.2%) had no knowledge of HBV and HCV infections and did not know they are health hazards associated with nail cutting and barbing. Most 196 (84.8%) think barbers and nail cutters should sterilize their instruments. Personal risk perception and knowledge scores were majorly fair for HIV (45.5%) and poor for HBV and HCV (78.4%). Conclusion: Knowledge of market men in Samaru-Zaria about HIV was found to be higher than that of HBV and HCV infections. They have poor knowledge about HBV and HCV and their transmission. Majority have good perceptions and fair practices towards health hazards associated with barbering and nail cutting. Health authorities must carry out more health education and sensitization on HBV and HCV among market men (traders).
  3,858 299 1
Transfusion-dependent anemia in a patient with sickle cell disease as well as HIV-associated tuberculosis
Awwalu Sani, Bello A Kumo, Pindiga M Kasim, Muktar M Haruna
April-June 2017, 4(2):52-55
Patients with hemoglobin SC (HbSC) often have unique presentations. Challenges in managing them are further compounded by the presence of other co-morbidities. Transfusion dependence is not a common feature in the course of HbSC. Therefore, when a patient with HbSC becomes transfusion-dependent, then there is a need to evaluate for possible co-morbid conditions. The coexistence of human immunodeficiency virus (HIV) infection and tuberculosis in patients with HbSC is not a common finding, and this poses unique challenges to the managing teams. We present the case of a patient with HbSC with transfusion-dependent anemia, HIV, and disseminated tuberculosis. The challenges faced in the management of this case highlight the importance of a multidisciplinary approach as well as the impact of financial constraints in our setting.
  3,057 208 1
Clinical competence with central venous lines by resident doctors in a Nigerian teaching hospital
Sunday A Edaigbini, Muhammad B Aminu, Ibrahim Z Delia, Abdulrasheed Ibrahim, Okwuoma Okwunodulo, Mojirola Alegbejo-Olarinoye
April-June 2017, 4(2):47-51
Introduction: Central venous catheterization has become not only common but a very useful clinical procedure in all well-established tertiary hospitals world over. This study aims to assess the competence of resident doctors with central venous lines in a tertiary institution in the subregion. Materials and Methods: A structured proforma was used to assess the information from resident doctors in four departments of the training institution. The result was analyzed with SPSS version 15.0 software program (SPSS 2006, Inc., Chicago, IL, USA). Results: A total of 40 residents were assessed, 30 (75%) males and 10 (25%) females with a mean age of 35.08 ± 4.999 years. Twelve (30%) and 28 (70%) had spent <2 years and >2 years in residency, respectively. Nineteen (47.5%) ticked that a line in the subclavian vein is a central line while 1 (2.5%) ticked same for femoral vein. Fifteen (37.5%) ticked correctly types of central line. Nineteen (47.5%) had observed the procedure in their institution and 7 (17.5%) elsewhere. Eleven (27.5%) knew that any experienced doctor could insert a central. Only 1 (2.5%) resident had inserted a central line. Ten (25%) knew that central line is inserted by ‘’SELDINGER’S’’ technique. Fourteen (35%), 4 (10%), and 20 (50%) said central line can be inserted only in the theatre, by the bedside, and both respectively. Thirty (75%) ticked correctly the uses of central line. Only 3 (7.5%) knew correctly a combination of central line complications. Twenty-five (62.5%) knew that chest X-ray is required after central line insertion. Conclusion: Based on knowledge assessment, the resident doctors in this institution are clinically incompetent in central venous line and efforts must be made to reverse the situation.
  2,986 206 3