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  Citation statistics : Table of Contents
   2017| July-September  | Volume 4 | Issue 3  
    Online since April 2, 2018

 
 
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CASE REPORT
Probable lamivudine-resistant hepatitis B infection in children: A case report involving two Nigerian siblings at Ahmadu Bello University Teaching Hospital, Shika, Zaria
Sani M Mado, Hafsat W Idris, Sakinatu M Abdullahi, Sani Musa
July-September 2017, 4(3):87-90
DOI:10.4103/ssajm.ssajm_21_17  
Currently, up to 65 million Africans have chronic hepatitis B (CHB) infection, with the majority acquiring it in the first 5 years of life and living in Nigeria. Lamivudine is generally accepted for use as the first-line treatment of CHB in children under the age of 12 years. However, the drug has a low genetic barrier to resistance. Lamivudine-resistant CHB is a serious challenge in resource-limited settings. This case report is intended to study a probable lamivudine-resistant CHB in two siblings aged 9 and 11 years and to highlight the challenges of managing CHB in children from resource-limited settings. There is a need to develop national guidelines for the management of CHB in children. Other suitable antiviral agents should be subsidized, so that they could be used to salvage lamivudine-resistant cases.
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ORIGINAL ARTICLES
Benign epileptiform variant electroencephalography
Frank A Imarhiagbe, Oladunni V Ogundare, Abiodun L Azeez
July-September 2017, 4(3):57-61
DOI:10.4103/ssajm.ssajm_1_17  
Background: Benign Epileptiform Variant EEG (BEV), are suspicious but innocuous EEG that are not predictive of epilepsy. The confident detection of BEV in routine EEG is vital so as not to misinterpret them as pathological, with its attendant clinical and sundry consequences. Objective: To profile BEV in routine EEG. Materials and Methods: Two hundred seventeen consecutive routine EEG done in 2013–2014 were reviewed for demographics of age and sex of the subjects, indications for EEG or clinical diagnosis, mental state of subjects during EEG procedure, EEG diagnosis and BEV. Operationally, EEG was done with an 18 channel machine without video recording and mental state of subjects was either awake and relaxed with eyes closed or asleep in uncooperative patients. Sleep was induced with parenteral or oral diazepam or chlorpheniramine. Procedure was done by EEG technologists and all records were interpreted by Consultant Neurologists. Results: The prevalence of BEV was 13.8%, mean age of subjects with BEV was significantly higher than that of subjects with essentially normal and abnormal EEG, sex distribution and handedness were however not significantly different. The distribution of BEV was wickets (5.5%), SREDA (4.1 %), FIRDA (1.4 %), RTTD (0.5%), Phantom spikes or 6-Hz spikes (1.0%) and POSTS (1.4%). Conclusion: BEV may be relatively infrequent in routine EEG, however their detection prevents the untoward consequences and the attendant clinical and other effects that a misinterpretation of EEG engenders. A second or third opinion is advised where there is equivocation in routine EEG or when BEV is suspected.
  - 3,637 281
Effect of a community-based health education intervention on participation in household chores among husbands of pregnant women in a rural community in Northwestern Nigeria
Muhammed S Ibrahim, Kabir Sabitu, Muawiyyah B Sufiyan, Aisha A Abubakar
July-September 2017, 4(3):62-68
DOI:10.4103/ssajm.ssajm_3_17  
Introduction: Reduction of workload on pregnant women has positive effect on pregnancy outcome. However, participation in household chores among husbands of pregnant women continues to be low. This study assessed the effect of a community-based health education intervention on men’s participation in household chores during their wives’ pregnancy in a rural community. Materials and Methods: Its is a quasi-experimental study involving men whose wives were currently pregnant. Preintervention, quantitative, and qualitative data were collected from the men and selected community leaders. Then a three-component intervention was conducted in the study community as follows; interactive workshop with the men, a film show with interactive discussion, and distribution of Islamic calendar for the current year carrying messages on men’s participation in pregnancy care. Six months later, postintervention data were collected using the same approach as the preintervention survey. Quantitative data were analyzed using IBM SPSS Statistics 20.0 and qualitative data were analyzed manually. Results: Mean age of men in the study group was 37.6 ± 10.5 years, and in the control group, it was 35.8 ± 10.8 years (P = 0.275). Men’s participation in household chores was low and showed no statistically significant change between pre- and postintervention data in study (P = 0.937) and control (P = 0.941) groups. Qualitative data showed most men perceived and treated household chores as women’s responsibility. Conclusion: Participation in household chores by husbands of pregnant women was low, and health education intervention did not significantly increase it. Further studies should evaluate the effectiveness of engaging community and religious leaders in eliminating the norms of gender roles.
  - 2,677 187
Assessment of plasma fibrinogen and vitamin D levels among participants with different haemoglobin phenotypes in a Nigerian tertiary health care facility
Patrick O Manafa, Chide E Okocha, John C Aneke, Nancy C Ibeh, Glory U Uduma
July-September 2017, 4(3):69-74
DOI:10.4103/ssajm.ssajm_13_17  
Background: Hyperfibrinogenaemia and vitamin D deficiency have been implicated in the pathogenesis and severity of sickle cell anaemia (SCA). Objective: To determine the levels of fibrinogen and vitamin D in persons with different haemoglobin phenotypes and correlate these levels with disease severity. Patients and Methods: Ninety adult volunteers were recruited, comprising 30 each of SCA (HbSS), heterozygous and normal (HbAA) haemoglobin type. Each volunteer had 6 mL of venous blood collected; 1.8 and 2 mL were used for plasma fibrinogen and serum vitamin D assay, respectively, while the remaining 2.2 mL was used for haemoglobin phenotype and full blood count determination. The disease severity for patients with SCA was determined using an objective scoring system. Data were analyzed using the Statistical Programme for Social Sciences version 20 software (SPSS Inc., Chicago, IL, USA); the level of significance was at P < 0.05. Results: The median plasma fibrinogen and serum vitamin D levels in patients with HbSS vs. HbAA volunteers were 295.00 mg/dL (Q1–Q3; 230.00–342.25 mg/dL) and 27.35 ng/mL (Q1–Q3; 19.75–36.20 ng/mL), respectively. The levels of plasma fibrinogen and serum vitamin D were not significantly different in patients with HbSS vs. HbAA volunteers (P values = 0.32 and 0.47, respectively) and were not significantly correlated with disease severity. Conclusion: Plasma fibrinogen and serum vitamin D levels do not predict the disease severity in steady-state SCA.
  - 2,785 175
The haematological parameters of normal pregnant women and cord blood of their newborns in Aminu Kano Teaching Hospital, Kano, Nigeria
Ibrahim Abdulqadir, Sagir G Ahmed, Aisha G Kuliya, Jamilu Tukur, Aminu A Yusuf, Muhammad A Ndakotsu
July-September 2017, 4(3):75-78
DOI:10.4103/ssajm.ssajm_16_17  
Context: Haematological parameters are frequently used to determine the health status of an individual, and their values are varied among different populations. Hence, there is a need for a local data repository to serve as a reference source for appropriate adoption of therapeutic interventions. Aims: To determine the haematological parameters of normal pregnant women at term and cord blood of their newborns. Materials and Methods: One hundred and forty normal pregnant women and their newborns were enrolled in this study. Bio-demographic and clinical data were extracted from the client folder. In addition, 4 mL of blood was obtained from pregnant women and from the cord of their newborns. Full blood count was obtained using Swelab automatic analyser, whereas reticulocyte count and erythrocyte sedimentation rate (ESR) were determined manually. Results: The mean haematological parameters of pregnant women and their newborns respectively were as follows: haemoglobin − 11.35 ± 1.28 g/dL and 16.67 ± 1.11 g/dL; mean cell volume − 80.43 ± 7.44 fL and 109.09 ± 3.49 fL; white blood cell count (WBC) − 8.52 ± 2.06 × 109/L and 12.11 ± 1.80 × 109/L; platelet count − 247.33 ± 87.81 × 109/L and 250.06 ± 54.65 × 109/L; reticulocyte count − 1.24 ± 0.72% and 4.08 ± 0.39%; ESR − 40.74 ± 17.82 mm and 2.41 ± 1.13 mm in the first hour. There was a positive correlation between maternal and cord blood WBCs and neutrophil count (P = 0.03 and 0.02, respectively). Conclusion: The values obtained in this study will serve as a guide for interpreting the haematological parameters of pregnant women at term and cord blood of newborns in the environment.
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Risk factors for Group B streptococcal infection among women attending antenatal clinic in a tertiary health institution in Edo State, Nigeria
Sunday Yerumoh, Innocent O Alenoghena, Peter Isabu, Gbolagade Adewusi
July-September 2017, 4(3):79-86
DOI:10.4103/ssajm.ssajm_39_16  
Introduction: Group B Streptococcus (GBS) colonisation of the anus, rectum and/or vagina in pregnant women is a known risk factor for GBS neonatal infection with high morbidity and mortality as a result of pneumonia and septicaemia mainly and less commonly from meningitis, bone and joint infections, cellulitis, otitis media, conjunctivitis, pleural empyema, peritonitis, endocarditis and deep abscess. Objectives: The aim of this study was to assess the proportion women with risk factors for Group B streptococcal infection and the association between the risk factors and recto-vaginal colonisation with GBS among women attending antenatal clinic. Materials and Methods: A cross-sectional study was conducted in Irrua specialist Teaching Hospital, South-South geo-political zone of Nigeria. A total population study was conducted among 234 pregnant women who attained 35–37 weeks gestation, and those who were admitted for preterm labour at earlier gestations were involved in the study. An interviewer-administered questionnaire was used for data collection. Data were analysed using the Statistical Package for the Social Sciences version 17.0 software (SPSS Inc., Chicago, IL, United States). Results: A total of 234 respondents were assessed in this study. Most respondents had tertiary education (53.4%). The risk factors for GBS were present in the following proportions: not living with their partners, 21.8%, previous miscarriage(s) 10.7% and multiple pregnancies, 5.6%. Other risk factors included previous preterm births, 7.7%, and preterm rupture of membranes. There was a statistically significant (P = 0.001) association between respondents’ history of previous miscarriages and GBS colonisation. There was no statistically significant association between GBS colonisation and diabetes mellitus (P = 1.000), multiple sexual partners (P = 0.425), rupture of membranes >18 (P = 0.623) and preterm labour (P = 1.000). Conclusion: The proportion of clients with risk factors for GBS colonisation was moderate (compared with other sub-Saharan countries). Identified risk factors in favour of the higher rates of GBS colonisation included frequent sexual intercourse while previous miscarriage, previous preterm birth, diabetes in pregnancy, where associated with lower rates of colonisation. There was a statistically significant relationship between the GBS status and a history of previous miscarriage (P = 0.001) and a history of previous preterm birth (P = 0.229). Guidelines on the prevention and management of GBS infection for clients attending antenatal clinics and delivery should be made available at all levels of care by regulatory agencies in Nigeria. There should be health education at all levels of care by the Federal, State and Local Government on preventing of and control GBS infection, especially at the community level.
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