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   Table of Contents - Current issue
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April-June 2022
Volume 25 | Issue 2
Page Nos. 37-60

Online since Monday, August 22, 2022

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ORIGINAL ARTICLES  

Pattern of contraceptive choice among clients attending a tertiary health institution in Ogbomoso, Southwestern Nigeria p. 37
Olufemi Opeyemi Aworinde, Daniel Adebode Adekanle, Oluwatosin Ilori, Adewale Samson Adeyemi
DOI:10.4103/smj.smj_5_20  
Background: There is no ideal contraceptive method; therefore, likelihood of method choice shifts among clients from time to time. Aim: The aim of this study is to determine the most chosen modern contraceptive method, and the factors influencing that choice among clients attending a relatively new tertiary health institution in Southwestern Nigerian. Methods: A retrospective review of the case records of clients attending the family planning clinic of Ladoke Akintola University of Technology Teaching Hospital Ogbomoso, southwestern Nigeria, from January 2012 to December 2017. Results: Six hundred and twenty-nine clients accessed modern contraceptive methods during the study period. Their age ranged between 15 and 50 years with a mean of 33.0 ± 12.93. Most of the clients were married 616 (97.9%), had postsecondary education 405 (64.4%), and were of Christian faith 460 (73.1%). Progestogen-only injectable was the mostly chosen by the clients 228 (36.2%), and this is followed by intrauterine contraceptive device 186 (29.6%). Child spacing was the most common reason for contraception by the clients 357 (56.8%). Parity, postpartum contraception, previous contraceptive use, outcome of last delivery, mode of delivery of antecedent pregnancy, and educational status were all significantly associated with the mostly chosen method. Conclusion: Progestogen-only injectable contraceptive is the mostly chosen method among the clients, and this is a shift from what is obtained in southwestern Nigeria where intrauterine contraceptive device used to be the modern contraception method of choice.
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Effect of varying storage time and temperature on unspun blood samples for prothrombin time and activated partial thromboplastin time in a tertiary hospital laboratory in the tropics p. 41
Ann A Ogbenna, Oluwafikewa A Oyedele, Titilope A Adeyemo, Kunmi Mathew Oyewole
DOI:10.4103/smj.smj_44_21  
Introduction: Delays in the time of analysis of unspun blood samples stored at varying temperatures received in the laboratory pose a risk for unreliable prothrombin time (PT) and activated partial thromboplastin time (APTT) result; hence, consequent detrimental effect on patient care. This study's aim was thus to determine the optimal storage conditions and the potential effect of various storage times and temperatures on unspun samples for PT and APTT for a reliable test result. Materials and Methods: In a cross-sectional study, 33 eligible apparent healthy volunteers were recruited. Eighteen milliliters (ml) of venous blood were collected into 20 ml plastic bottles containing 2 ml of 0.109 M sodium citrate as an anticoagulant. Each citrated sample was separated into nine 2 ml aliquots. Baseline PT and APTT were determined with a coagulometer immediately and the remaining aliquots were analyzed after 3, 6, 12, and 24 h storage time at refrigerated (4°C) and room temperature (RT), respectively. The Statistical Package for the Social Sciences and Paired student t-test were used for statistical analysis. Results: At 24 h storage time at both RT and 4°C for PT, there was a statistically significant difference (P = 0.000). For APTT, a statistically significant difference was observed at 12 h (P = 0.009) and 24 h (P = 0.000) at RT whereas, at 4°C, all storage time had a statistically significant difference (P < 0.05). Conclusion: Unspun blood samples can be stored maximally for 12 h at RT and 4°C for PT whereas it is 6 h at RT only for APTT.
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Association between hormonal contraceptive use and derangement of lipid profile among women attending Muhoza Health Center, Rwanda p. 47
Thierry Habyarimana, Callixte Yadufashije, Vestine Mukantwali, Alexis Nshimiyinana, Francois Niyonzima, Clementine Yamukujije, Joseph Mucumbitsi
DOI:10.4103/smj.smj_70_20  
Background: Contraception is a method used to prevent unwanted pregnancies and child spacing. Although the method is beneficial in over birth control and stabilization of population explosion, the hormonal components of used drugs have been shown to generate many sides' effects among users. Aim and Objective: This study was conducted to investigate the effect of hormonal contraceptives (HCs) on lipid profile among women attending family planning services at Muhoza Health Center, Rwanda. Materials and Methods: This was a cross-sectional study and purposive sampling was used to select study participants among HC users, although simple random sampling was used to select study participants of nonusers. A total of 88 participants were recruited and among them, 57 were HC users, while 31 were nonusers known as controls. Blood sample was collected after the consent of the participant accepting to participate in the study. Collected blood samples were analyzed to evaluate parameters of the lipid profiles, including high-density lipoprotein (HDL), triglycerides (TG), total cholesterol (TC), and low-density lipoprotein (LDL) by using Humalyzer plus at INES-Ruhengeri clinical biochemistry laboratory. Results: Findings of this study show a high risk of developing abnormal lipid profile among the exposed group compared to controls. Association was found in LDL-cholesterol (LDL-C) (odds ratio [OR] = 11 > 1), TC (OR = 14 > 1) and TG (OR = 2.8 > 1). The high risk of developing abnormal lipid profile among users compared to controls was observed in LDL-C and TC. HDL-cholesterol (OR = 0.8 < 1) showed that there is no risk of developing abnormal lipid profile among users and controls. Implant (χ2 = 10, df = 3, P = 0.018397 < 0.05) was statistically significant to affect all studied lipid profile parameters while TC (χ2 = 20.88, df = 3, P = 0.000111 <0.05) was statistically significant to be affected by all HCs studied among users. Conclusion: Lipid profile is affected by HCs among users. Most of the studied lipid profile parameters were seen to be affected by HC use. HC users should be followed up as dyslipidemia could lead to different health conditions.
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Clinico-Demographic characteristics, morbidity and mortality patterns of sickle cell disease in a tertiary institution p. 52
Jamilu A Faruk, Mustapha Niyi Adebiyi, Hafsat Rufai Ahmad
DOI:10.4103/smj.smj_78_20  
Introduction: Sickle cell disease (SCD) is the most common hereditary hematological disorder in Nigeria with an annual incidence of more than 100,000 new births which contributes to the high Nigerian under-five childhood morbidity and mortality. Sufferers of the disease are frequently admitted into emergency rooms for presentations and complications such as pain crisis, anemia, stroke, and acute chest syndrome, in addition to other childhood infections such as severe malaria, sepsis, and acute respiratory tract infections. The aim of the study was to describe the clinicodemographic features and morbidity and mortality patterns of children with SCD in a tertiary institution. Methods: The study was a retrospective review of case records of children with SCD admitted with various diagnoses. Results: Complete records of 460 patients were reviewed and this constituted 10.1% of all new admissions during the period. There were more males, 286 (62%), than females, 174 (38%). The mean age was 6.3 ± 5.1 years and 249 (54.1%) were under the age of 5 years. The most common admitting diagnosis was a pain crisis comprising 168 cases (36.5%). The mean packed cell volume was 20.6 ± 4.1 inclusive of hemoglobin SC phenotype, and 197 (42.8%) had simple top-up transfusion, while 28 (6.1%) had exchange transfusion. A total of 438 (95%) patients were discharged, 21 (4.6%) died, and the highest mortality was from severe anemia (47.6%). Conclusion: This study describes the high burden of SCD constituting 10.1% of admissions, as well as the pattern of morbidity and mortality largely from severe anemia in the area under study.
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Osteoarthritis of the knee joint in the obese patient: Do metabolic factors play a role? p. 57
Obinna Henry Obiegbu
DOI:10.4103/smj.smj_79_20  
Introduction: Osteoarthritis (OA), a disease process characterized by progressive softening of the articular cartilage, sclerosis of subchondral bone, and cyst formation often affects the knee joint. Although OA has traditionally been interpreted as wear and tear, its etiology is now thought to be multifactorial with both biomechanical and metabolic factors implicated. Of the metabolic factors, leptin a glycosylated peptide hormone produced by the adipocytes has received major attention because of its correlation to body size. The aim of this study was to determine the correlation between the clinical severity of knee OA and serum leptin in obese patients. Materials and Methods: This was a prospective study; recruiting 100 patients (50 obese and nonobese patients) with OA of the knee joint. The severity of knee OA was ascertained using the WOMAC scoring system, and serum leptin of all patients was determined. Results: The age group most commonly affected by knee OA was 51–60 years. The mean serum leptin level in nonobese patients was 4.88 ± 5.08, compared to 20.11 ± 15.04 in obese patients. There was a statistically significant correlation between the severity of knee OA (using WOMAC score) and serum leptin level; P = 0.001. Conclusion: This study shows a statistically significant positive correlation between serum leptin and severity of clinical symptoms in obese patients with knee OA.
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