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April-June 1999 Volume 2 | Issue 2
Page Nos. 66-113
Online since Tuesday, December 30, 2014
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CURRENT TOPIC |
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Antioxidants in neonatal sytemic diseases |
p. 66 |
KI Airede, M Ibrahim Free radicals are highly reactive, unstable substances which are produced during normal metabolism in the human body. These su6stances such as superoxide dismutase, catalase, ceruloplasmin, glutathione peroxidase, glutathione reductase and micronutrient trace metals, are·taking up significant contributions to causation of disease with important sequelae. The newborn infant bears the brunt of these processes if their antioxidant capacity is
deficient or diminished.
This article attempts to emphasise on recent information and rationale behind free radical injuries to tissues/
systems within the body. The prospects for preventing and potential therapeutic interventions of such damages will also be reached |
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ORIGINAL ARTICLES |
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Emergency contraception: A survey of women's knowledge and attitude in a rural setting of northern Nigeria |
p. 73 |
BA Omotara, A Idrisa, E Ojiyi The objectives of the survey was to assess women's knowledge and attitude in relation to emergency contraception and to identify ways in which these might be improved Questionnaires seeking level of knowledge of emergency contraception, and attitudes to use and publicity were distributed to randomly selected Nigerian women resident in semi-urban towns in Gwoza Local Government area of Barno State, Nigeria. Majority of the women (96.9%) recognised the need for an emergency contraception, although correct knowledge of appropriate methods were deficient.
Hospital and friends represented the commonest source of information. There is need to educate all women including the general populace about emergency contraception and the correct timing of its use. |
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Sweat protein vaitiations in exercise and raised temperature conditons in hot humid climate
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p. 77 |
AC Ugwu, IU Onyewadume The rate of excretion of sweat proteins during sweating was studied under different experimental conditions in healthy Nigerian and Caucasian males. Samples of sweat collected from subjects sweating in a climatic chamber were spectrophotometrically analysed for their protein concentrations using Biuret reagents.
The rate of sweat protein losses were found to increase with exercise and raised temperature conditions. The
rate also increased with increase in sweat rate and duration of sweating under the exercise condition. However, with the raised temperature conditions, protein loss decreased with increase in sweat rate and with duration of sweating. It was found that the more the sweat protein lo s. the higher the pH value of the sweat (r=O. 96), with a tendency towards alkalinity. The findings suggest that the amount of proteins in sweat modifies the quality of sweat under various conditions of thermal stress and their elimination from the body is affected by the level of body heat load. Nigerians had 30% lower rate of water loss and I 0 to 20% higher rate of sweat proteins and sweat electrolytes than their Caucasian counterparts.
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Poor prognostic factors of intussusception in childhood as seen in Ilorin, Nigeria |
p. 82 |
A Ojuawo, R Olateju, GA Rahman This was a prospective study of24 children with intussusception seen over a 3 year period at the University of
Ilorin Teaching Hospital. Males were more affected than females at a ratio of 3: I, with 70% of the cases occurring in children between 6months and 2 years of age. The common presenting symptoms were vomiting in 83.3%, bloody
stool in 75%, abdominal distension in 58.3%, diarrhoea in 58.6% and constipation in 37.5% of the cases. An abdominal mass was palpable in 58.3%. Majority of the patients presented late with 70.8% presenting beyond 24 hours ]rom the onset of the symptoms. Ileocolic intussusception accounted for 72.9% of the cases whilst ileo-ileal occurred in 12.5%. Mesenteric lymphadenopathy was the predorminant detectable predisposing/actor at surgery in 25% of the cases. Fifty percent had gangrenous bowel requiring resection at surgery.
The mortality rate was 29.2%. Mortality was high in those with delayed presentation beyond 48 hours from
onset of symptoms (38.5%, odds ratio "OR"= 2.81, relative risk "RR" = 1.33), severe acidosis (75%, OR=/2.0, RR=3.2), temperature > 38.5 centigrade at admission (80%, OR=21.33, RR=4.2), severe dehydration, and respiratory distress (62.5% and 66.6%, respectively RR=2.3), and a delay in surgical intervention beyond 48 hours from admission (66.6%, OR=6.4, RR=2.29). . f
The poor prognostic factors observed in this study included delayed presentation beyond 48 hours from the onset of symptoms, severe respiratory distress at presentation, temperature > 38.5 centigrade at admission, severe, acidosis, severe dehydration and delay in surgical intervention beyond 48 hours. Children with intussusception still present lafe to our facility with the resultant development of the above stated bad prognostic factors and its attendant high mortality. |
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Childhood intussusception in Ilorin, Nigeria |
p. 86 |
GA Rahman, IA Mungadi A retrospective review of 44 cases of intussusception seen over a 10 year period in children in florin is presented. This study was undertaken to evaluate the differences and similarities in pattern, presentation, morbidity and mortality in childhood intussusception, and identify factors contributing to a persistently high mortality in this environment. Most cases (86.4 percent) occurred in infancy. The classical triad of abdominal pain, rectal bleeding and palpable abdominal mass was noted in 18 cases (40.9%). Thirty-jive (80%) presented with passage of red-currant jelly stool
while 12 (28%) presented with palpable rectal mass with or without anal protrusion. More than 50% of the patients
presented more than 72 hours after the onset of illness.
All the patients had laparotomy and 34. 1% had bowel re5ection and anastomosis. !leo-caecal, /leo-colic and lleo-caeco-colic varieties constituted 80% of the case. 50% of our patients had one form of lead point of the other. Twenty-one (47.7%) of these patients died. The high mortality may be as a result of the age group of patients, delayed presentation, long segment of intussusception and associated septicaemia.
Increased awareness of the disease, improved preoperative care and urgent definitive treatment are factors that
should reduce mortality. |
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A retrospective cohort study of pregnancy complications following abdominal myomectomy |
p. 89 |
JY Obed, DA Omigbodun The course and antenatal outcome of 496 pregnancies following abdominal pyomectomy between /975 and
1989 was analysed in 412 patients at the University College Hospital, Ibadan Nigeria. The results showed that over
% of these patients were aged more than 30 years, either nulligravid or nulliparous or of very low parity.
38% of these patients were admitted for variable periods and 26.7% required prolonged hospitalization for various pregnancy related complaints. Pregnancy were characterised by risks and complications that may be linked to either the myomectomy scar of the surgical process itself These included abortion, ectopic pregnancy, preterm contractions, premature delivery, antepartum haemorrhage and premature rupture of fetal membranes.
These complications in some.instances were more then those observed in a control group comprised of patients
closely matched in age and parity.
Despite the reproductive benefit of myomectomy, pregnancies immediately following a successful myomectomy are still at risk of gynaecological or obstetric complications though at a much reduced degree.
majority of these women were elderly and had had a previous history of reproductive failure coupled with the risk of pregnancy complications, it is recommended that these women be closely monitored from the time of conception to birth. In this way complications can be treated before they become serious and multiple |
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Clinico-pathological study of prostate cancers in central Nigeria
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p. 93 |
BM Mandong, lya Daniel, KS Orkar, AZ Sule One hundred and sixty-seven cases of prostate cancers were reviewed retrospectively over a 10-year period Seventy-five percent (75%) of cases were stage A and were incidental cancer. The study also showed that prostate cancer appeared much earlier than amongst Caucasians in Europe and America. Gleason grades 2 and 3 were the commonest histological type inthis study. The peak age incidence was between 50-60 years which showed a nearly occurrence compared to what is obtained in East Africa. This study showed that prostate cancer is common in
. central Nigeria. The analysis showed a high rate of prostatectomy in this centre. We, therefore, suggest that fine
needle and trucut biopsies may be a more cautious approach to the handling of prostatic diseases, though it might have its own draw-back.
improved diagnostic facilities, early cancers will be detected thereby redu6ing morbidity and mortality. |
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The trend of hiv/aids in adults in the Sokoto area of Nigeria |
p. 98 |
CH Njoku, AC Emakpor, ES Salawu Since the first case of AIDS was diagnosed at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sok oto in June 1993, there has been a steady increase in the number of cases seen in each succeeding year. A total of 35 cases of A IDS wereseenat UDUTH, made up of26 males (74.29%) and 9 females (25.71%). The patients were aged between 17 years and 50 years. The indigenous population contributed 74.29% of the cases while the rest had their origin from other parts of the country.
.57% of the patients were civil servants. 25.7 1% were business men, /4.30% were housewives, 5.7 1% had no
and 2.86% were long distance drivers. The most common-clinical features were weight loss 82.86%, Chronic diarrhoea and prolonged fever (68.57%) respectively, persistent cough 48.5 7%, oropharyngeal candidiasis 28.57% and generalized lymphadenopathy 28. 57%. |
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Diagnostic laparoscopy using room air pneumoperitoneum |
p. 102 |
BA Ekele, C Oriaku Creating a pneumoperitoneum is one of the early steps in laparoscopy. Because of limited options, we present our experience using room air for pneumoperitoneum. Diagnostic laparoscopy was performed on 123 patients, . between January, 1995 and December 1998. Room air was used for pneumoperitoneum. Infertility investigation was the most common indication (100 cases, 81%) for the laparoscopy. Of the complications related to the room air pneumoperitoneum, 7 patients had shoulder-tip pains that responded well to analgesics; while two cases subcutaneous emphysema resolved vl1(thin 5 days. There was no mortality. Room air .for diagnostic laparoscopy is effective, convenient and safe. The fact that it is free and readily available when compared with.other gases that are used for pneumoperitoneum makes it indispensable in centres with limited facilities. |
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Clinical presentation and outcome of measles in Sokoto, Nigeria |
p. 104 |
Mu'uta Ibrahim, NM Jiya A five year analysis of children with measles admitted at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, revealed that 201 cases were admitted during the period, with 70.4% of them aged between 13.2 months. There was a definite seasonal pattern with 71% of cases admitted during the hot dry months of April, May and June. The commonest complication was bronchopneumonia occurring in 67.5% of cases. Overall mortality rate was
.4% and it was significantly associated with malnutrition which came out as a risk .factor for death in measles.
ale education and sincere implementation of the Nigerian programme on immunization (N PI) are suggested as practical and achievable ways Of reducing the scourge of measles in Nigeria. |
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SHORT REPORT |
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Haematological changes in human immunodeficiency virus infected adult patients in Kano |
p. 108 |
MA Emokpae, AAE Otokwula, A Kwaru, AA Gadzama, GA Abubakar Haematological Changes were studied in fifteen (15) HIV positive asymptomatic patients, twenty one (21) HI VI AIDS patients and one hundred apparently healthy, HIV seronegative control adults in Aminu Kana Teaching Hospital, Kana. The subjects were tested using ELISA technique and H1V confirmation done using Immunoconfirm by Orgenics. Packed cell volume, haemoglobin concentration, total white blood cell count, platelet count were lower in HIV positive asymptomatic pptfents (P < O.001) when compared with control subjects. A further decrease was observed in HIVIAIDS patients when compared with HIV positive asymptomatic patients.
was raised/erythrocyte sedimentation rate in HIV positive asymptomatic patients (P < 0.001) compared with controls and HJYIAJDS patients (P < 0:002) compared with HJV asymptomatic patients. It is suggested that these haematological abnormalities be monitored frequently in these patients. |
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CASE REPORT |
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The hazards of ocular self medication |
p. 111 |
OA Daowdu Three patients seen at the Otibhor Okhae' Teaching Hospital, Irrua in February and March; 1999 are presented. Each of them developed complications following prolonged self medications with steroid eye drops which were initially prescribed either by an Ophthalmologist or an Optician. Ways of minimizing this unwholesome practice, and its ensuing consequences are discussed. |
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