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2014| April-June | Volume 17 | Issue 2
Online since
June 13, 2014
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ORIGINAL ARTICLES
Management of breast lumps in Maiduguri, Nigeria
Ali Nuhu, S. Aliyu, A. B. Musa
April-June 2014, 17(2):50-53
DOI
:10.4103/1118-8561.134475
Background:
Reported changes in the demography, modes of presentation and histological variants of tumors of the breast have been published in developed and some developing countries. Although benign lesions have persistently accounted for most breast tumors, the incidence of malignant breast lesion in young women in sub-Saharan Africa has been disturbingly high. We reviewed the demographics, pattern and management of breast lumps excised at University of Maiduguri Teaching Hospital (UMTH) over a 6 year period.
Patients
and Methods:
A retrospective study of patients with breast lumps at UMTH was carried out between January 2005 and December 2010. Details of their bio-data, clinical, and histopathology details were analyzed using descriptive statistics.
Results:
A total of 913 patients, comprising 887 females (97.2%) and 26 males (2.8%) were reviewed. The mean age was 33.1 ± 14.6 years (range: 12-80 years) and the mean duration of symptoms was 8 ± 2.14 months (range: 2-23 months). 359 (39.3%) were malignant and 577 (63.2%) were benign. The mean ages of women and men with invasive carcinomas of the breast were 45.58 ± 13.22 and 49.75 ± 18.28 years, respectively. The mean age of women with benign breast disease was 28.4 ± 10.0 for fibrocystic disease and 21.8 ± 5.31 years for fibroadenoma. Mode of presentations included ulcers (8.7%), axillary lymph node enlargement (30.0%), nipple discharge (13.0%) and breast pain (21.7%). The most common histological diagnoses were carcinoma of the breast,
N
= 340 (37.2%), fibroadenoma,
N
= 276 (30.2%) and fibrocystic disease,
N
= 199 (21.8%). The least common pathology was tuberculosis of the breast,
N
= 6; (0.7%).
Conclusion:
Though benign diseases are still more common, a high percentage of breast lumps in Maiduguri are due to malignant disease and this is frequent in younger women.
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Vernal keratoconjunctivitis in Jos, North-Central Nigeria: A hospital-based study
Keziah N. Malu
April-June 2014, 17(2):65-70
DOI
:10.4103/1118-8561.134486
Background:
Vernal keratoconjunctivitis (VKC) is a chronic, seasonally recurrent bilateral external ocular allergic inflammatory condition in response to allergens. It is more prevalent in the warm and dry tropical and subtropical climates of Africa, Middle East, Latin America, Asia (Indian Sub-Continent). VKC is a self-limiting disorder with spontaneous resolution after puberty or early adult life with male preponderance. The purpose of the study is to determine the prevalence and clinical presentation of VKC in a hospital clinic in Jos, Plateau State, North-Central Nigeria.
Materials and Methods:
This is a retrospective hospital-based study of patients seen with clinical diagnosis of VKC from 2000 to 2009 at Adoose Specialist Hospital, Jos, Nigeria.
Results:
The mean age of presentation was 14.6 ± 12.0 years while 62.8% were 16 years or younger, and 55% were male. Most of the patients had hyperpigmentation of the conjunctiva. The prevalence of the limbal (46.5%) and mixed (45.7%) subtypes of VKC were almost equal. The most frequently associated ocular conditions were refractive error (6.7%) and eye lid disorders (3.3%). Keratopathy was present in 2.2% patients with one case of keratoconus. Systemic allergic associations were rare.
Conclusion:
Clinical presentation of VKC in these patients is similar to those in other African countries and systemic associations were rare.
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Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria
Charles Ikechukwu Ezema, Amarachi A. Onwunali, Sikiru Lamina, Uche A. Ezugwu, Augustine A. Amaeze, Maduabuchukwu Joseph Nwankwo
April-June 2014, 17(2):54-59
DOI
:10.4103/1118-8561.134476
Background:
Control of diabetes involves maintaining normal or near normal blood glucose levels through appropriate therapy: insulin, oral hypoglycemic agents, diet and exercise. The aim of this study was to investigate the blood glucose response to aerobic exercise training among subjects with type 2 diabetes mellitus (T2DM) at University of Nigeria Teaching Hospital (UNTH), Enugu.
Materials and Methods:
Subjects with diagnosis of T2DM attending the diabetes clinic of the UNTH participated in the study. A total of 54 subjects with T2DM (fasting blood sugar [FBS] of between110 and 225 mg/dl) were randomized into two age matched groups: Exercise (
n
= 30) and control (n = 24) groups. The exercise group involved in an 8 week continuous training (60-79% heart rate [HR] max) of between 45 and 60 min, 3 times/week, while the controls group remain sedentary. Systolic blood pressure (SBP), diastolic blood pressure (DBP), aerobic fitness (VO
2
max) and FBS were assessed. Analysis of covariance and Pearson correlation tests were used in data analysis.
Results:
We observed significant effect of exercise training program on, SBP (
P
= 0.000), DBP (
P
= 0.007), FBS (
P
= 0.001) and VO
2
max (
P
= 0.013). Changes in VO
2
max significantly and negatively correlated with changes in FBS (
r
= −0.220) at
P
< 0.05.
Conclusion:
It was concluded that aerobic exercise program is an effective adjunct in controlling blood glucose level among type 2 diabetic subjects.
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1
Prevalence and risk factors associated with intradialysis mortality among renal failure patients in a tertiary hospital in a developing nation
Hamidu M. Liman, Muhammad A. Makusidi, Muawiya U. Zagga, Shehu Nuhu, Istifanus B. Bosan, Isah A. Umar, Abdullahi Sadeeq, Khadijat Idris, Peace Onyema
April-June 2014, 17(2):43-46
DOI
:10.4103/1118-8561.134471
Background:
Hemodialysis is associated with potential risk of intradialysis death as a complication. We set out to determine some predialysis factors associated with intradialysis death in hemodialysis patients.
Materials and Methods:
We retrospectively reviewed the records of 457 patients who had hemodialysis at our facility over a 5-year period. Demographic and clinical data of patients who died during dialysis were compared with a control group made of the survivors of hemodialysis. Data was analyzed using SPSS IBM version 20. Numerical data were reported as mean ± SD. Comparison of means of continuous variables was done using student t-test. Chi square was used for comparing proportions. Multivariate logistic regression was done to determine the independent determinants of intradialysis mortality. P value < 0.05 was considered significant.
Results:
Of the 457 patients who had hemodialysis, 20 (4.4%) died while on hemodialysis during the review period. They were aged 47.35 ± 21.16 years (range, 16-85 years). The deceased were more likely to be elderly (P = 0.003), have pre dialysis hypotension (P < 0.004), depressed level of consciousness (P < 0.0001), predialysis pulmonary edema, and hospital admission (P = 0.047). Multivariate regression analysis identified low Glasgow coma scale (coma) as an independent risk factor for intradialysis death (P < 0.017).
Conclusion:
Intradialysis mortality risk is increased in a setting of elderly patients, impaired level of consciousness, pulmonary edema, and predialysis hypotension.
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A study of the histopathologic pattern of orbito-ocular disease in a tertiary Hospital in Nigeria
Nwafor Chukwuemeka Charles, Ekanem Victor James
April-June 2014, 17(2):60-64
DOI
:10.4103/1118-8561.134485
Background:
Estimates by WHO show show thatthere are about 37 million blind people and 161 million people with visual impairment. About 90% of these people live in developing countries. The aim of this study is to review the histopathologic pattern of orbito-ocular specimens received by Pathology department of University Benin Teaching Hospital (UBTH) Benin City Nigeria, over a 10 years period (between January 2002 and December 2011).
Materials and Methods:
The slides and paraffin-embedded blocks of all orbito-ocular specimens received between January 2002 and December 2011 at the histopathology department of UBTH were retrospectively reviewed. were retrospectively reviewed. The clinical data such as the age, sex, site of lesion and clinical summary were extracted from the histology request forms.
Results:
Children (less than 15 years of age) accounted for 28.6% (
n
= 30) of all the specimens seen, while adults accounted for 71.4% (
n
= 75). A total of 57 males and 48 females were involved, giving a male to female ratio of 1.2:1. The mean age was 31.3 years (range: 1 month-84 years), (range: 1 month-84 years). The common sites of pathologies were the conjunctiva (45.7%,
n
= 48), intraocular (29.5%,
n
= 31), eyelid (21.9%,
n
= 23) and orbit (2.9%,
n
= 3). Most of the eyelid lesions (45.5%) and conjunctival lesions (43.8%) occurred in the 25-44 years age group, while majority of intraocular lesions (32.3%) occurred in the 1-4 years age group.). Malignant specimens were seen in 31.4% (
n
= 33) of cases, benign specimens 29.5% (
n
= 31), inflammatory specimens 21.9% (
n
= 23), degenerative specimens 10.5% (
n
= 11) and trauma-related specimens 6.7% (
n
= 7).
Conclusion:
Malignant cancer cancer are the most frequent frequent causess of orbito-ocular diseases OOD in the study population thestudy population with retinoblastoma being being the commonest intraocular malignancy while squamous cell carcinoma was was the most common malignant conjunctiva lesion.
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CASE REPORTS
A peculiar accessory renal artery giving origin to the left testicular artery
Satheesha B. Nayak, Srinivasa Rao Sirasanagandla, Surekha D. Shetty, Ravindra S. Swamy
April-June 2014, 17(2):75-77
DOI
:10.4103/1118-8561.134488
The occurrence of the accessory left renal artery (ALR) and its giving origin to the left testicular artery (LTA) is not a common variation. We report a rare type of course and branching of an ALR which was observed in an approximately 65-year-old male cadaver of the Indian origin. The left kidney (LK) was supplied by two renal arteries (RA). The main RA arose from the abdominal aorta (AA) and then reached the LK by passing above the renal vein. It gave three segmental branches before entering into the hilum. The ALR was smaller in size than the main RA and it arose from the AA below the level of the main RA. It hooked around the left renal vein (LRV) and entered into the hilum without branching, passing posterior the renal vein. ARA presented a peculiar S shape in its course. Further, the ALR gave origin to LTA at its middle segment. The LRV was normal in formation, course and drainage. Knowledge of the unusual perihilar vascular variations of the kidney is of significance during the radiologic and angiographic and surgical procedures.
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ORIGINAL ARTICLES
Epidemiology of H1N1 in western Rajasthan
Mahendra Singh, Prashant Babaji, Nitin Sharma, Subash Chandra
April-June 2014, 17(2):47-49
DOI
:10.4103/1118-8561.134473
Background:
H1N1 pandemic posed a serious threat to world health community. We described the epidemiology of H1N1 in western Rajasthan.
Materials and Methods:
This study was a retrospective descriptive analysis all 686 confirmed cases of H1N1 in western Rajasthan from the month of August 2009 to March 2010 and conducted in hospitals attached to Dr. S. N. Medical College, Jodhpur. Data were analyzed using GraphPad software (GraphPad Prism
®
.) and Chi-square test.
Results:
A total of 686 cases were confirmed positive with positivity ratio of 32.3%. The overall case fatality rate was 11.7%. The highest number of cases (50.7%) and deaths (60%) were seen during the month of Decemberand among the age group of 16-30 years. About 54% of patients were males. Mortality rate was higher in females (64%). Although, there were more cases reported from the urban area (60%), the mortality was higher in patients of the rural area (62.5%). The mortality rate among pregnant women was also higher than other groups.
Conclusions:
H1N1 influenza occurred predominantly among the younger age group with high case fatality especially among postpartum women in the study population
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Comparative analysis of tuberculosis in geriatric and younger age group: An experience from rural West Bengal, India
Swapnil Shivam, Indranil Saha, Tushar Kanti Mondal, Samir Dasgupta, Krishna Das Bhattacharyya, Rabindra Nath Roy
April-June 2014, 17(2):71-74
DOI
:10.4103/1118-8561.134487
Introduction:
Tuberculosis differs clinically and radiologically in the geriatrics compared with young.
Objective:
The objective of the following study is to compare the profile and treatment outcome of geriatric and young tuberculosis patients.
Materials and Methods:
A retrospective analysis of 58 tuberculosis patients seen from November 2010 to December 2011. Study period was October to December 2012 in tuberculosis unit of Burdwan district of West Bengal Data were analyzed using Statistical Package for the Social Sciences software (version 19.0 Inc., IBM, Chicago, IL, USA).
Results:
Male populations were significantly more among geriatric patients. New smear positive sputum conversion and relapse cases were found more in the geriatric age group Overall, unfavorable outcome was significantly higher in geriatric compared with younger age population (33.3% vs. 17.8%).
Conclusion:
Geriatric and pediatric tuberculosis patients differ in diseases characteristics and outcome.
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2,816
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Online since 08 April, 2013