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   2007| April-June  | Volume 10 | Issue 2  
    Online since December 4, 2014

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Labour room software development and its importance to the obstetrician and gynaecologist
OM Alimi
April-June 2007, 10(2):53-57
Background/Aim: Reproduction, as an important aspect in population growth and healthy citizens, bring healthy spiritual, physical and mental development to a nation along with healthy economy. The obstetrician and gynaecologist are the foundation developer of human race. A lot of researches are being done in this regards which need computer applications for better and easier means of developing new ideas or having optimum output at all times. This study aimed to look at development of a computer software which could help in collating data relating to Labour Room and Anti-natal-care(ANC) and generate different forms of reports which will be useful to the involved professionals when information relating to the care of babies and their mothers are needed. Method: The techniques used for collection of data included document examination and interview of the professionals in getting the necessary information and parameters for the development of the software. An object oriented programming language called Visual Basic was used to develop the software. The study was carried out between February 1 st 2005 to March 31 st , 2007 in the Health Record Department of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Result: It was found that the use of computers was 0% while manual was 100%. This meant that computers had never been used in keeping records of patients, but done purely manually in the Health Record department. The department was yet to be computerised. The number of Obstetricians and Gynaecologists that were personally collating data using computers were 25% while others that were using manual systems were 75%. Conclusion: The software which could be installed either at Health Record Department or Labour Room area, would greatly assist the professionals. The researcher could get any information at any point in time, make their research efforts easier, and help the hospital in having these information at all times for planning and development of the hospital.
[ABSTRACT]   Full text not available  [PDF]
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Predictive values of screening tests in the diagnosis of neonatal septicaemia
AI Rabasa, Kl Airede, AA Okolo
April-June 2007, 10(2):43-47
Background: Neonatal septicaemia remains a major cause of death worldwide, and it is diagnosed by obtaining positive blood culture. Aim/Objective: Buffy coat microscopy, white cell indices and micro-ESR were evaluated as screening tests for early diagnosis and this worrisome disease. Methodology: There where 156 evaluations from 141 babies. A full blood (total and differential white cell count), micro-erythrocyte sedimentation rate (micro-ESR) and buffy coat smear preparations were prepared from aliquot of the collected blood samples. Results: There were 39 positive blood cultures from 37 babies. Significant difference (p<0.01) between septicaemic and non- septicaemic groups was observed in the band to mature neutrophil ratio. The methylene blue stained smear of the buffy coat and micro-ESR showed high sensitive 96%). Whilst presence of 2, 3 or more abnormal test results compromised the sensitivities of the methylene blue stain and the micro- ESR, the other predictive indices, however, improved. It was also observed that the presence of 2 or more abnormal test results in infants with clinical risk of infection without microbiological proof should be strongly considered infected, especially if there was previous use of antibiotics in the mother. Conclusion: These screening tests for septicaemia could enhance the early diagnosis of neonatal septicaemia in infants with strong clinical risk of infection.
[ABSTRACT]   Full text not available  [PDF]
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Anaesthesia in the undiagnosed thyrotoxic patient: A case report
CN Mato, UU Johnson, MT Odagme
April-June 2007, 10(2):63-66
A 29-year old woman with a diagnosis of septicaemia, ruptured appendix and pelvic abscess was brought into theatre for emergency laparotomy. Pre-anaesthetic evaluation showed an emaciated ill-looking young woman with protuberant eyeballs. She was febrile, had marked tachycardia and a significantly raised blood pressure with a wide pulse pressure. There was no obvious or palpable anterior neck swelling, and a history of recent eye changes was denied. Time limited further investigations, so, with a high index of suspicion, emergency laparotomy was carried out under general anaesthesia with available hypotensive anaesthetic drugs. Thyroid function tests done post-operatively confirmed the suspicion of thyrotoxicosis, and she was commenced on oral carbimazole and propranolol. The case is presented, and the logistic problems of emergency anaesthesia in undiagnosed thyrotoxicosis are highlighted. It is emphasized that thyrotoxicosis should be considered in the differential diagnosis of significant tachycardia > 120min -1 in adults coming for anaesthesia.
[ABSTRACT]   Full text not available  [PDF]
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Peri-Operative complications of spinal anaesthesia: A report of 98 cases in one nigerian hospital
N Jebbin, S Fyneface-Ogan, UU Johnson
April-June 2007, 10(2):48-52
Background: Although spinal anaesthesia is easy and safe, it is not without life-threatening complications. Aim: The study sought to highlight the common perioperative complications of spinal anaesthesia as seen in the University of Port Harcourt Teaching Hospital, and their management. Method: Consecutive elective surgical and gynaecological patients were recruited to study the pattern of complications following spinal anaesthesia. An anaesthetist other than the one administering the anaesthetic answered questions relating to the potential risks of the anaesthetic technique. There were no restrictions on the staff anaesthetists in performing anaesthesia in these patients. A proforma containing the patient's demographic data, American Society of Anaesthesiologists score and secondary outcome data including, total dose of ephedrine used, surgeon's satisfaction, level of block attained, types of complications observed and treatment given, indication for surgery, were kept for each patient recruited for this study. The ranks of the attending anaesthetist were also recorded. Results: One hundred and fifteen elective surgical and gynaecological patients were recruited into this study. Fifty-six patients (57.14%) were females while 42 (42.86%) were males years with a mean age of 33.3 ±4.7 years. There were twelve different complications following the procedure in 40 patients (40.82%). Out of the number, shivering (19 patients) appeared to be the commonest constituting 47.5%. Five patients (12.5%) developed hypotension that was promptly treated while bradycardia occurred in 3 (7.5%) patients. Most of the complications were promptly treated. There was no mortality. Conclusion: Perioperative complications due to spinal anaesthesia were common. Shivering appeared to be the commonest form of morbidity. Good conduct of subarachnoid block and meticulous monitoring are critical to a good outcome.
[ABSTRACT]   Full text not available  [PDF]
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Esophageal foreign body with growth deficiency (failure-to-thrive) in an 8-year-old nigerian girl child, and literature review
KR Iseh, KI Airede
April-June 2007, 10(2):67-70
Esophageal foreign bodies present with various clinical scenarios which must always be considered in children who have recurrent vimiting, cough or dysphagia, and remains an important indication for therapeutic esophagoscopy. The foreign bodies vary in type and duration of impaction with attendant complications which has been widely documented in the literature. We present an eight-year-old girl child with impacted esophageal foreign body (coin) for over 5-years, who presented with persistent vomiting and dyshagia with failure to thrive. The coin was detected radiologically from a Chest X-ray and was removed endoscopically without complications. Patient began to eat voraciously and started gaining weight after the removal of the foreign body.
[ABSTRACT]   Full text not available  [PDF]
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Evaluation of the effectiveness of intra-operative mitomycin C. For pterygium surgery in Warri, Nigeria
JM Waziri-Erameh, CU Ukponmwan, AE Omoti
April-June 2007, 10(2):58-62
AIM: This study was designed to evaluate pterygium surgery and Intra-Operative mitomycim C application in Warri, Nigeria. METHODS: Case files of all patients who had pterygium surgery and intra operative application of 0.4 mg/ml of Mitomycin C; and were followed up for a minimum of 12months at DDS Eye Surgery in Warri, Nigeria between Jan1998-June 2002 were reviewed. RESULTS: One hundred and two eyes (87patients) had pterygium surgery and mitomycin C application intraoperatively. Fifteen eyes (14.7%) had recurrence after a minimum follow up period of 12 months. The male to female ratio was 1.4:1. The mean age of all the patients was 41.6 years. The mean age of the patients with recurrence was 39.6 years while that of the non-recurrence was 43.4 years. Main complications encountered were conjunctival granuloma thirteen (12.8%); delayed healing nine (8.8%); scleral melt three (2.9%). No Eyes with delayed healing or scleral-melt had recurrence of their pterygium, but four out of thirteen eyes (31%) with conjunctival granuloma hid recurrence of their pterygia. Use of native medication (cocktail of herbal extracts) and duration of pterygium before surgery had no bearing on recurrence. Most of the recurrences occurred between the 4 th and the 6 th months (73.3% ). CONCLUSION: Single intra-operative application of 0.4mg/ml of mitomycin C was found to be effective in reducing the incidence of recurrence of pterygium below 15% (14.7%) in African eyes. Ophthalmologists are advised to give patients the maximum benefit of pterygium surgery by using intra-operative mitomycin C.
[ABSTRACT]   Full text not available  [PDF]
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Establishment of regional radiotherapy centres: A strategy for improving access to cancer treatment in Nigeria
JUE Onakewhor, LR Airede, KI Airede
April-June 2007, 10(2):38-42
Cancers are malignant diseases that can originate in virtually all organs and without regards for age or gender. They are associated with high morbidity and mortality and only few of them are preventable. They are diagnosed when they are least expected, a situation that completely upturn the life of their victims. They are dreaded by both patients and clinicians. Cancers with premalignant stages (e.g. Cervical Intraepithelial Neoplasm-CIN for cervical cancers) are preventable by screening and early treatment but most poor countries including Nigeria were yet to make the interventions available to the majority of their citizens. Consequently, many patients present with advanced stages of the diseases and so require radiotherapy services. Nigeria has only four functional radiotherapy centres for her large population of over 130 million people and many of the patients are disenchanted and ultimately resign to fate as they can hardly access them due to over-crowding, high cost and other logistic reasons. To obviate this problem, we recommend intensification of cancer prevention programmes and the establishment of regional radiotherapy centres strategy for improving access to cancer treatment in Nigeria.
[ABSTRACT]   Full text not available  [PDF]
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