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ORIGINAL ARTICLES
Experiences of sexual abuse by adolescent girls in Ife/Ijesa zone, Nigeria
AA Ogunfowokan, BR Fajemilehin
July-December 2015, 15(2):89-97
DOI:10.4103/1596-4078.182322  
Background: Sexual abuse of adolescent girls is a menace that has been reported globally, and it is increasing at an alarming rate. Objectives: The study assessed experiences of sexual harassment (SH), sexual exploitation (SE), and rape among school adolescent girls in Ife/Ijesa Zone of Osun State, Nigeria. It also assessed the perpetrators, settings of the abuse, and reactions of survivors to sexual abuse. Latent variables underlying revictimization during adolescent years were also explored. Methods: Cross sectional design was employed with qualitative and quantitative components. Two hundred twenty four adolescent girls from two public high schools were selected using cluster sampling technique. Quantitative data were collected using a semi structure questionnaire while qualitative data were collected using Focus Group Discussion Guide (FGDG). Institutional Review Board approval was received for the study. Results: Quantitative findings showed that 55.5% experienced SH and 23.7% experienced SE while 20.8% experienced rape. Three factors that were extracted using factor analysis were labeled as "forceful sexual interaction," "romance," and "actual sexual intercourse." Perpetrators of rape and SH were mostly male friends (69% and 50% respectively) while perpetrators of SE were mostly sexual partners (91%) which some of girls referred to as "aristos" in FGD. The mostly reported setting for various acts of sexual abuse was the perpetrators' house (rape 3%; SH 7%; SE 6%) and many of the survivors reported they did nothing about the abuse (rape 1%; SH 1%; SE 1%). However, all those who were sexually abused as children experienced high level of sexual abuse in adolescent stage. The FGD revealed that perpetrators of sexual abuse were mostly teachers, sexual partners, and peers while the bush path was mentioned as setting for rape contrary to data from the questionnaire. Conclusion: Sexual abuse educational intervention should focus more on male friends and sexual partners as perpetrators; the perpetrator's house as the settings for abuse; the necessity to report; and romance and force as elements of sexual abuse.
  2,792 15 -
Knowledge, attitude, and practice of voluntary blood donation among residents in a rural local government area in Lagos state: A mixed methods survey
ALN Udegbe, OO Odukoya, BE Ogunnowo
July-December 2015, 15(2):80-88
DOI:10.4103/1596-4078.182321  
Background: The safest blood is obtained from voluntary, non-remuneration blood donors. Objectives: This study was carried out to assess the knowledge, attitude, and practice of voluntary blood donation, and to determine the factors associated with willingness to donate blood among residents of Badagry, Lagos State, Nigeria. Methods: This descriptive cross-sectional study used quantitative and qualitative techniques. Multistage sampling method was used to select 439 respondents and pretested, interviewer-administered questionnaires were used to collect the quantitative data. Qualitative data were collected through two focus group discussions (FGDs) with male and female adult residents. Ethical approval was obtained from the Human Research and Ethics Committee of the University of Lagos, Lagos, Nigeria. Results: Most of the respondents were male (55.1%), married (60.6%), of Yoruba ethnicity (71.4%), and had, at least, a secondary education (81.0%). The mean age was 36.7 ± 11.1 years. All the respondents had heard of blood donation primarily from health workers (46.7%). Only 35.5% had ever donated blood, and this was primarily for a relative or friend (72.8%). Only 2.3% of previous donations were for an unknown person. Males were more likely to have donated blood (P < 0.001) and more willing to donate blood voluntarily (P = 0.015) compared to females. The FGDs showed that voluntary blood donation practice within the community was poor. Conclusion: The respondents are knowledgeable about blood donation and expressed positive attitude. However, this has not been translated into practice. Health authorities should collaborate with rural communities to organize blood donation campaigns to provide opportunities for altruistic blood donation.
  2,582 22 -
Serum electrolyte profiles of under-five Nigerian children admitted for severe dehydration due to acute diarrhea
AN Onyiriuka, EC Iheagwara
January-June 2015, 15(1):14-17
DOI:10.4103/1596-4078.171374  
Background: Serum electrolyte disturbances are common in under-five children with acute diarrhea but may remain unrecognized, resulting in morbidity and sometimes mortality. Objective: The objective was to assess the type and prevalence of electrolyte abnormalities in severely dehydrated under-five children with acute diarrhea at the point of hospital admission. Patients and Methods: This was a descriptive, hospital-based cross-sectional study of children aged 1–59 months with severe dehydration due to acute diarrhea. Serum electrolyte profiles were determined. Outcome measures such as death or survival were recorded. The co-morbidities were also recorded. Results: Of the 63 children studied, 50 (79.3%) subjects were aged below 36 months. Vomiting and fever accompanied diarrhea in 33 (52.4%) of the cases. The frequencies of the various types of dehydration were hyponatremic in 41 (65.1%), isonatremic in 17 (27.0%), and hypernatremic in 5 (7.9%) of the children. Of the electrolyte abnormalities observed, hyponatremia and hypokalemia ranked first and second in frequency, respectively. The overall case fatality rate was 6 (9.5%). All the patients that died were aged below 24 months. 5 (83.3%) of the 6 patients that died had a combination of metabolic acidosis in association with one or two other electrolyte abnormalities. 6 (10.5%) of the 57 patients that survived had normal serum electrolyte profiles. Conclusion: Hyponatremia, hypokalemia, and metabolic acidosis were the leading electrolyte abnormalities in acute diarrheal illnesses and were responsible for most diarrhea-related deaths, particularly when measles or bronchopneumonia is a co-morbid condition.
  2,456 14 2
Biomechanical effect of sitting postures on sitting load and feet weight in apparently healthy individuals
CE Mbada, MOB Olaogun, OB Oladeji, JO Omole, AO Ogundele
January-June 2016, 16(1):15-21
DOI:10.4103/1596-4078.190030  
Background: Controversies exist about the ideal sitting position. Objective: The present study compared sitting load and feet weight in ischial, sacroischial and ischiofemoral support sitting postures. Methods: Apparently healthy individuals who were asymptomatic of low-back pain for at least 6 months were recruited in the present study. Ischial, sacroischial and ischiofemoral support sitting postures were described based on literature. Assessment of sitting weight was carried out with a standard weighing chair, whereas a bathroom weighing scale was used to assess feet weight. Anthropometric variables were assessed following standard procedures. Data were analysed using descriptive and inferential statistics. Statistical significant level was set at P < 0.05. Results: There were 210 participants comprising 113 males and 97 females, aged 17-35 years. Sacroischial sitting weight of 51.86 (6.57) kg was the highest followed by ischiofemoral sitting weight of 49.52 (6.19) kg and ischial sitting weight of 44.87 (5.99) kg; the differences were statistically significant (P = 0.001). Similarly, ischial feet weight was 19.64 (2.49) kg, followed by ischiofemoral feet weight of 15.92 (2.08) kg and sacroischial feet weight of 12.60 (1.90) kg in sitting positions; the differences were statistically significant (P = 0.000). There was a significant correlation between sitting and feet weights in the different sitting postures and each of height, weight, body mass index (BMI) and femoral length (P < 0.05). Conclusion: The ischial sitting position had the least sitting load, whereas the feet bears the least load in sacroischial sitting. The amount of load experienced in sitting, and the corresponding feet weight was influenced by height, weight, BMI and femoral length. It is implied that sitting position with the highest amount of trunk load has the least amount of feet weight and vice versa.
  2,368 17 -
Prevalence of symptoms of self-reported knee osteoarthritis in Odo-Ogbe community, Ile-Ife
AO Ojoawo, AO Oyeniran, MOB Olaogun
January-June 2016, 16(1):10-14
DOI:10.4103/1596-4078.190001  
Background: Osteoarthritis, (OA) the most common of all the types of arthritis, is a significant public health problem which contributes greatly to disability in the elderly. Community-based prevalence studies of OA in South-Western Nigeria were scanty for referencing. Objective: This study investigated the prevalence of symptoms of self-reported knee OA (KOA) in a heterogeneous community of Odo-Ogbe in Ile-Ife, South-Western Nigeria. Methods: All houses in Odo-Ogbe community were numbered, and all odd numbered houses were selected for the study. Every adult individual of aged 35 years and above living in the selected houses were recruited for the study. The total number of participants was 119 individuals and all of them participated in the study by completing Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire. Their anthropometric variables were also measured. Data were analyzed using descriptive and inferential statistics. Results: There were 99 females and 20 males respondents that participated in the study. Forty-seven (39.5%) had knee pain and other KOA symptoms. Among those with KOA symptoms, six of them were males while 41 (87.2%) of them were females. There was a significant negative relationship (P < 0.001) between academic qualification and pain intensity (−0.292), stiffness (−0.336), and difficulty (−0.267) of participants with KOA. Age was also found to be significantly related (P < 0.001) with all symptom of KOA. Conclusion: The prevalence of symptomatic KOA at Odo-Ogbe community is high, more female were affected, and many of those affected had family history of arthritis.
  2,267 19 -
CASE REPORTS
Symptomatic hypermetropia with glycemic control in a recently diagnosed diabetic
SA Badmus, OH Onakpoya, AO Adeoye, BO Adegbehingbe
January-June 2015, 15(1):55-57
DOI:10.4103/1596-4078.171384  
Changes in refraction are one of the problems that have been associated with changes in blood glucose level as well as glycemic control. A 52-year-old teacher was seen on account of bilateral poor vision a few days after commencement of treatment for diabetes mellitus. Unaided visual acuity (VA) was count fingers at 3 m in either eye which improved to 6/18 with a pin-hole. Refraction at presentation was +2.50DS/−0.50DC axis 90° in the right eye improving VA to 6/5 and +3.00DS/−0.50DC axis 90° in the left eye improving VA to 6/9. No other ocular abnormality was detected. Uncorrected VA improved to 6/12 and 6/18 in the right and left eyes respectively after 2 weeks of control of blood sugar. Refraction changed to +1.00DS and +2.00DS/−0.50DC axis 140 in the right and left eyes, respectively, improving VA to 6/4 in both eyes. Rapid glycemic control caused temporary severe visual impairment in the patient presented. It is important for the endocrinologist to be aware of this possibility and warn patients to avoid medical mistrust.
  1,916 14 -
EDITORIAL
Editorial for January-June 2016 issue of Nigerian Journal of Health Sciences
JA Owa
January-June 2016, 16(1):1-1
DOI:10.4103/1596-4078.189947  
  1,759 30 -
ORIGINAL ARTICLES
Noise Pollution: Knowledge, Attitudes and practice of sawmill workers in Osun State, Nigeria
J. A. E. Eziyi, IO Akinwumi, IO Olabanji, OO Ashaolu, YB Amusa
January-June 2015, 15(1):36-39
DOI:10.4103/1596-4078.171380  
Background: Literature on awareness of the harmful effect of noise on the health, hearing, and the quality of life of Nigerians engaged in noisy occupation is scarce. Objective: The objective was to assess the knowledge, attitudes, and practice of sawmill workers and owners to noise pollution; and the need for prevention with the use of hearing protection devices. Subjects and Methods: This was a purposive sampling of sawmills in 6 local government areas in Osun state. The respondents were studied using interviewer-administered questionnaires. The workplace noise levels were assessed. Results: A total of 412 male respondents, consisting of 400 sawmill workers and 12 sawmill owners were studied. The mean age of the respondents was 32 years. Average time of exposure to noise was 10 h/day. The average level of noise at the sawmills was 108 ± 9 dB. 140 (35.0%) sawmill workers could not identify the sources of noise correctly. 140 (85.0%) would endure noise exposure, and 376 (94.0%) did not know that hearing loss could be due to noise exposure. 176 (44.0%) of the workers believed that noise had no impact on health, while 373 (93.3%) did not believe that noise was associated with a change in productivity. None of the sawmill owners was familiar with policy on noise control and none of them provided earmuffs or plugs for their workers. Conclusion: Sawmill workers and their employers in the present study were not aware of the harmful effects of noise on their health. Hearing protection devices were therefore not available or worn by most sawmill workers. The sawmill workers were thus at risk of developing noise-induced hearing loss.
  1,763 15 -
Cytokines responses to human African trypanosomiasis infection in Abraka, Nigeria
C Isaac, OPG Nmorsi, IB Igbinosa
January-June 2016, 16(1):6-9
DOI:10.4103/1596-4078.189972  
Background: The staging of human African trypanosomiasis (HAT) has been greeted with different benchmarks ranging from white blood cell counts to the use of immune component profiles across regions. Objective: The aim of this study was to analyze an array of cytokines to identify potential markers that could be used in the staging of HAT in Nigeria. Methods: Sera and cerebrospinal fluid (CSF) of 35 HAT seropositives from Abraka, Delta State, Nigeria were subjected to cytokines (interleukin-10 [IL-10], tumor necrosis factor-α, IL-1α, IL-7, and IL-13) analysis using enzyme-linked immunosorbent assay. Welch t-test and Tukey analysis of variance were used to analyze the data. Results: Comparing mean cytokine levels of weakly, moderately, and strongly positives and between as early and late stages results showed significantly depressed CSF levels of IL-1α and IL-7 while IL-10 was significantly elevated in the strongly positives as well as in the late stage. Conclusion: We strongly suggest that IL-10 could be playing a key role in the immuno-pathology of HAT, thus should be considered a biomarker for the late stage.
  1,755 16 -
Association of fasting blood glucose and glycated haemoglobin with some markers of oxidative stress in Ile-Ife, Nigeria
TO Odewole, BO Emma-Okon, FK Agboola, BA Kolawole, OH Onakpoya, OF Fagboun
January-June 2016, 16(1):2-5
DOI:10.4103/1596-4078.189948  
Background: Increased oxidative stress is a widely accepted contributor to the development and progression of diabetes mellitus (DM). A lot of work is being done to unravel the mechanisms linking oxidative stress with diabetes and its complications. Objective: The objective was to investigate the relationship between blood glucose levels, glycated haemoglobin and three markers of oxidative stress in DM: catalase (CAT), superoxide dismutase (SOD) and glutathione transferase (GST). Methods: Subjects were consecutive patients with Type 2 DM receiving treatment and apparently healthy controls. Fasting blood glucose, HbA1c, CAT, SOD and GST were assayed in the diabetic subjects and controls using standard procedures. Information on the presence of neuropathy and nephropathy was obtained from case notes, whereas screening for retinopathy was carried out at the Ophthalmology Unit of Obafemi Awolowo University Teaching Hospitals Complex. Data were analysed using Statistical Package for the Social Sciences for Windows, version 17. Results: A total of 115 subjects comprising 65 diabetics and 50 controls were studied. Mean fasting blood glucose, CAT, SOD and GST activities in test and control subjects were 9.12 (0.48) and 4.78 (0.63) mmol/L, 48.20 (2.69) and 63.22 (1.83) units/mg, 53.22 (2.44) and 62.55 (2.68) units/mg and 1.35 (0.09) and 3.47 (0.11) units/mg, respectively. Statistically significant differences were observed when levels of fasting blood sugar, CAT, SOD and GST were compared between diabetic and non-diabetic subjects. Diabetic subjects with one or more microvascular complications were found with significantly higher HbA1c levels than those without apparent complication. There was significant negative correlation between fasting blood glucose and all three antioxidant enzymes. Conclusion: The results of the present study suggested that fasting blood sugar modulated levels of antioxidant enzymes while protein glycation plays a role in the development of microvascular complications.
  1,722 23 -
Neonatal morbidity among infants of diabetic mothers in Sagamu: A 10-year eview
OB Ogunfowora, TA Ogunlesi, TI Runsewe-Abiodun, MB Fetuga
January-June 2015, 15(1):40-44
DOI:10.4103/1596-4078.171375  
Background: Diabetes in pregnancy constitutes a high risk factor for increased maternal and perinatal morbidity and mortality. There is inadequate knowledge of the diabetic pregnancy and its impact on neonatal health in our environment, hence the need for more research. Objective: To describe the morbidity pattern among infants of diabetic mothers (IDMs). Materials and Methods: Hospital records of all neonates diagnosed as IDMs and admitted into the neonatal ward of a tertiary hospital in South-Western Nigeria over a 10-year period were reviewed. Relevant data were extracted and analyzed. Results: Twenty-four cases met inclusion criteria, with a slight male preponderance. Mean (standard deviation [SD]) gestational age was 38.1 (1.8) weeks while the mean (SD) birth weight was 3.9 (0.4) kg. Fifty-eight percent of the subjects were delivered by cesarean section. 12 (50%) babies were macrosomic while the most common morbidities among the subjects were hypoglycemia, neonatal jaundice, and birth asphyxia which were observed in 75%, 75%, and 33.3% of the study population, respectively. Less frequently observed conditions include prematurity, transient tachypnea of the newborn, neonatal sepsis, and birth injury. 2 (8.3%) babies presented with congenital malformation affecting the heart and central nervous system, respectively. There was only one case of mortality. Conclusion: IDMs are prone to macrosomia, hypoglycemia, neonatal jaundice, and birth asphyxia in our environment. Early antenatal screening of all pregnant women for diabetes mellitus is required and good glycemic control of diabetic pregnancies should be the ultimate goal in order to minimize neonatal complications.
  1,721 16 -
Perceived hindrances and factors influencing acceptability of HIV/AIDS counseling and testing among commercial drivers in Ile-Ife
MY Ijadunola, TO Ojo, O Ogunlesi, A Adewumi, RO Kolade, B Thomas
January-June 2015, 15(1):30-35
DOI:10.4103/1596-4078.171371  
Background: HIV/AIDS Counseling and Testing (HCT) is an effective tool in HIV prevention and control. However, perceived hindrances may limit the utilization of HIV Counseling and Testing (HCT) services, particularly among high-risk groups. Therefore, this study assessed perceived hindrances and factors influencing the acceptability of (HCT) among commercial drivers. Methods: This was a cross-sectional survey of commercial drivers in Ife Central Local Government Area. Data were analyzed using Statistical Package for Social Sciences for Windows version 20. The dependent variable for the multiple regressions was commercial drivers willingness to uptake free HCT services in their motor parks, while independent variables were their age, marital status, and the level of education. Results: Three-hundred commercial drivers were surveyed. 76 (25.3%) of respondents had previously undergone HIV test. 184 (61.3%) of the 300 respondents were willing to uptake HCT services. Perceived possible hindrances to HCT uptake were fear of a positive HCT test by 259 (86.3%), stigmatization by 260 (86.7%), lack of in-depth knowledge about HCT 258 (86.0%), and confidentiality concerns by 267 (89.0%) while 151 (50.3%) perceived poor access to HIV testing services as a hindrance. Multivariate analysis revealed that drivers aged 30–39 years were twice more likely to accept HCT service compared to their 20–29-year-old colleagues. Car drivers were twice more likely to accept HCT compared to bus drivers, whereas drivers with secondary education were four times less likely to accept HCT compared with their colleagues with tertiary education. Conclusion: This study revealed that a high proportion of drivers was willing to uptake HCT services. The introduction of free HCT education and services at motor parks would, therefore, enhance HCT uptake.
  1,637 15 1
Awareness of indoor air pollution and prevalence of respiratory symptoms in an urban community in South West Nigeria
OT Afolabi, OF Awopeju, OO Aluko, SA Deji, BB Olaniyan, LC Agbakwuru, OO Oyedele, KR Oni, BO Ojo
January-June 2016, 16(1):33-38
DOI:10.4103/1596-4078.190036  
Background: Air pollution is often perceived as an outdoor public health problem but the air in residential buildings, cars and offices can also be polluted. Indoor air pollution (IAP) is the presence of one or more contaminants in the indoor environment that has a degree of human health risk. IAP is a risk factor for respiratory tract infection and is associated with increased risk morbidity and mortality in developing countries. Objective: The present study determined the relationship between awareness of IAP and prevalence of respiratory symptoms. Methods: This was a descriptive cross-sectional study. Respondents were selected using a multistage sampling technique. Data were collected using structured questionnaires with the aid of interviewers. Results: Two hundred and thirty-nine (95.6%) of 250 who were given questionnaires responded. One hundred and fifty (62.8%) of respondents were aware of IAP. The major source of their information was through the radio in 57 (23.8%). One hundred and four (43.5%) prepare food on the corridor with cooking with a kerosene stove, and 211 (88.3%) were using mosquito coil. Shortness of breath was reported by 49 (20.5%) while 25 (10.5%) expectorated phlegm. Respondents with exposure to tobacco smoke in the indoor environment had a 12-fold likelihood of having phlegm and an 8-fold likelihood of having shortness of breath. Conclusion: The level of awareness of IAP by the respondents was low in this study. Indoor smoking was a major determinant of respiratory symptoms. There is thus, a need for widespread health promotion to raise awareness about IAP and its effects.
  1,624 16 1
Challenges of body mass index classification: New criteria for young adult Nigerians
O Ogunlade, OA Adalumo, MA Asafa
July-December 2015, 15(2):71-74
DOI:10.4103/1596-4078.182319  
Background: There are evidences to suggest that the World Health Organization (WHO) general cutoff points for body mass index (BMI) may not be the most appropriate for young adults globally irrespective of racial and ethnic considerations. Objective: This study assessed body anthropometric parameters in healthy population of young adult Nigerians with a view to determining race and gender-specific criteria (Ife criteria) for BMI classification. Methods: Four hundred and eighty-four (242 males and 242 females) healthy subjects aged between 18 and 41 years (inclusive) were recruited for the study. The participants were age- and sex-matched (mean age: 22.81 ± 3.83 years). The weight and height of the subjects were obtained using standard techniques while BMI was calculated as derivatives of height and weight. The BMI was classified using 5 th , 85 th , and 95 th percentiles and delineated into underweight (<5 th percentile), normal (5-85 th percentile), overweight (85-95 th percentile), and obese (>95 th percentile). Results: The result showed that the general BMI cutoff values for underweight, normal, overweight, and obesity were <17.8, 17.8-24.7, 24.8-27.8, and ≥27.9, respectively. The sex-specific BMI cutoff values for underweight, normal, overweight, and obesity in males and females were < 17.8 and < 17.8; 17.8-23.6 and 17.8-25.6; 23.7-26.8 and 25.7-28.7; and ≥26.9 and ≥28.8, respectively. Conclusions: The cutoff values for the new criteria for BMI classification were lower than the WHO defined values and sex differences were demonstrated in BMI. Therefore, WHO criteria may not be universally applicable.
  1,615 23 -
Child survival dynamics in Nigeria: Is the 2006 child health policy target met?
JO Akinyemi, AS Adebowale, EA Bamgboye, O Ayeni
January-June 2015, 15(1):18-26
DOI:10.4103/1596-4078.171378  
Background: The childhood mortality rate in Nigeria continued to remain high. Unfortunately, information on the regional trajectories, progress, and sociodemographic determinants of childhood mortality in Nigeria are not readily available. The objectives of this study are to describe the childhood mortality trajectory in Nigeria, assess progress made toward achieving the 2006 child health policy targets, and determine the peculiar factors associated with childhood mortality in Nigeria regions. Materials and Methods: Birth history data from the Nigeria Demographic and Health Surveys for 1990, 2003, 2008 and 2013 were analysed. Childhood mortality levels were derived using indirect demographic techniques. Locally weighted scatterplot smoothing technique was employed to ascertain the childhood mortality trajectory. Weibull frailty models were fitted to determine the influence of unmeasured variables and factors associated with childhood death in each region. Results: Childhood mortality stagnated at 207/1000 live births until the year 2000, after which there was a linear decline to 137/1000 live births in 2010 at an annual rate of 4.91% (confidence interval: 4.52–5.29). The rate of decline was least in the South West (2.97%) and highest in the North Central (7.40%). Multivariate analysis revealed that unmeasured community factors played significant roles in North East and North West. Birth interval < 24 months, multiple births, and young maternal age were risk factors across all regions. Conclusions: Nigeria child survival dynamics differ between the Northern and Southern regions and rural and urban locations. Only the North Central and South-South regions are on course to achieve the 2006 targets for under-five mortality reduction. Multiple birth, short birth intervals, and young maternal age at child's birth were risk factors for childhood mortality in the six geo-political regions in Nigeria.
  1,598 14 6
Paracetamol-induced liver damage: Ameliorative effects of the crude aqueous extract of Musanga cecropioides
SI Omoruyi, AB Enogieru, OI Momodu, BA Ayinde, BD Grillo
January-June 2015, 15(1):2-7
DOI:10.4103/1596-4078.171381  
Objective: The protective role of the aqueous stem bark extract of Musanga cecropioides against paracetamol-induced liver damage was investigated in Wistar rats using silymarin as a reference drug. Materials and Methods: The animals were randomly assigned into five groups of six rats each (A, B, C, D, and E). Rats in group A served as controls and received an equivalent volume of distilled water used to dissolve the extract. To effect liver damage, animals in groups B-E were administered paracetamol at 500 mg/kg body weight orogastrically for 14 days using a metal cannula. Animals in groups C, D, and E were simultaneously pretreated with silymarin at 25 mg, 250 mg, and 500 mg, of the extract, per kg body weight, respectively. The effects of M. cecropioides and silymarin were examined on hepatic marker enzymes; aspartate amino-transferases (AST), alanine amino-transferases (ALT), alkaline phosphatase (ALP), and total protein (TP). Antioxidant enzyme activities such as superoxide dismutase (SOD), catalase (CAT), and lipid malondialdehyde (MDA), as well as changes in liver histology, were also evaluated. The animals were sacrificed via cervical dislocation and blood was collected via cardiac puncture into plain bottles. Furthermore, liver tissues were excised and processed for routine hematoxylin and eosin staining. Results: M. cecropioides and silymarin produced significant (P < 0.05) hepatoprotective activity by decreasing the serum levels of AST, ALT, ALP, and lipid peroxidation marker, MDA significantly (P < 0.05) increased the levels of TP, SOD, and CAT except for the group administered 250 mg/kg of M. cecropiodes. Liver histology revealed the presence of vacuolations and mild chronic infiltrates of inflammatory cells in the livers of paracetamol treated animals. Pretreatment with silymarin and M. cecropioides extract produced a remarkable reduction in the severity of vacuolations. Conclusion: Crude aqueous extract of M. cecropioides protected against paracetamol-induced liver damage perhaps, by its antioxidative effect on hepatocytes, hence eliminating the deleterious effects of toxic metabolites of paracetamol.
  1,595 14 -
CASE REPORTS
Treatment of irritable bowel syndrome somatic comorbidities by osteopathic approach
M Goyal, K Goyal, R Singal, S Sharma, N Arumugam, A Mittal
January-June 2016, 16(1):47-49
DOI:10.4103/1596-4078.190042  
Irritable bowel syndrome (IBS) is a chronic continuous or intermittent gastrointestinal tract dysfunction encountered by the health professionals. IBS patients are afflicted with intestinal and extraintestinal somatic morbidities. The aim of the present case study was to explore the effect of osteopathic treatment (OT) on somatic comorbidities in IBS patients. The author reported a 43-year-old female case who presented with a headache, abdominal pain, pain in the one-half of the body, lower back pain, increased the frequency of stool passage in a day, with alternating diarrhea or constipation, bloating; with few occasions of nausea and vomiting. The patient had history of 3-year-old hysterectomy and with no other relevant medical history. On endoscopic, colonoscopy, and blood investigations, no abnormality was detected. In this case, the osteopathic diagnosis was made as visceral somatic dysfunction and the OT made the remarkable difference in the patient symptoms as assessed by bowel symptom scale.
  1,457 16 -
ORIGINAL ARTICLES
Plasma lactate dehydrogenase level as indicator of severe Homozygous sickle cell disease
O Adefehinti, OO Adeodu, EM Obuotor
July-December 2015, 15(2):75-79
DOI:10.4103/1596-4078.182320  
Background: Homozygous sickle cell disease (SCD) (SS), also called sickle cell anemia (SCA) is the most common SCD in Nigeria. Studies done in the developed world showed that serum lactate dehydrogenase (LDH) levels correlated positively and significantly with clinical severity of the disease. This study attempts to provide information on the relationship between the plasma LDH level and the clinical severity of SCA in Nigerian children. Objective: The objective of this work was to assess plasma LDH level in Nigerian SCA children, aged 5-15 years, as a clinical indicator of disease severity. Methods: Plasma LDH level was measured quantitatively using Randox LDH reagent kit. A semi-quantitative assessment of clinical severity of SCA was carried out on all the SCA subjects using the Bienzle et al. assessment profile modified for this study. Subjects were classified as having mild, moderate, or severe disease based on their clinical severity score. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21 software. Results: Eighty SCA children, 40 in steady state and 40 in hemolytic (with or without vaso-occlusive) crises were studied. Mean plasma LDH level was significantly higher in SCA subjects in crises than for those in steady state (P = 0.0284). Only steady state plasma LDH level correlated positively and significantly with clinical severity score (P = 0.0151). Conclusion: Plasma LDH appears to be a reliable indicator of SCA disease severity in the steady state in Nigerian children.
  1,442 21 -
REVIEW ARTICLE
All-cause mortality among elderly patients admitted to the medical wards of hospitals in Africa: A systematic review
LA Adebusoye, MO Owolabi, SZ Kalula, A Ogunniyi
January-June 2015, 15(1):45-51
DOI:10.4103/1596-4078.171372  
Geriatric medicine as a speciality is just evolving in Africa. There is scanty data on the mortality and associated factors among elderly patients admitted to the hospital medical wards in Africa. The objective of this review was to identify, describe, and analyze systematically the available studies on all-cause mortality and associated factors among elderly patients admitted to the medical wards of a hospital in Africa. Online and hand-based systematic searches were conducted for literature (primary and secondary) describing the mortality in elderly patients admitted to the medical wards of a hospital in Africa. These included original research, review articles, proceedings, and transactions from 1969 to 2014. All identified studies were screened using the Population, Intervention, Comparison, and Outcomes criteria. Five studies describing 3427 hospitalized elderly patients reported 773 deaths giving an unadjusted proportion of admissions which resulted in in-hospital deaths of 22.6% (range: 6.8–44.7%). This was higher among the males (38.8–48.0%) compared with the females (29.4–40.7%). There was no significant association between the age and mortality. Mortality was high among patients who had stroke, meningitis, septicaemia, renal failure, chronic liver disease, chronic obstructive pulmonary disease, severe asthma, and heart failure. High mortality was associated with high serum creatinine and urea, tachycardia, reduced length of stay from admission to death, and low serum protein. In conclusion, the few available data showed high unadjusted all-cause mortality among hospitalized elderly patients in Africa. More studies are needed in Africa to quantify this health burden and identify the major factors causing the high mortality in elderly patients.
  1,420 14 1
ORIGINAL ARTICLES
Childhood community-acquired pneumonia at the wesley guild hospital, Ilesa: Prevalence, pattern, and outcome determinants
BP Kuti, AO Oyelami
July-December 2015, 15(2):98-104
DOI:10.4103/1596-4078.182323  
Background: Pneumonia remains a leading cause of childhood morbidity and mortality despite the presence of effective preventive and curative management. The factors at presentation that determine prognosis particularly mortality among children with pneumonia have not been fully characterised in resource-poor centres. Objectives: This study set out to determine the hospital prevalence, pattern of presentation, associated risk factors, and determinants of deaths among children admitted with community-acquired pneumonia in Ilesa. Methods: We carried out a retrospective review of 352 children managed for pneumonia at the Wesley Guild Hospital, Ilesa, Nigeria over a three year period (2011 to 2013) by analysing hospital records. History, clinical features and laboratory findings at presentation were compared in children who survived and those who died. Binary logistic regression analysis was used to determine the independent predictors of mortality. Results: Pneumonia accounted for 23.5% of the 1470 total admission among children one month - 15 years during the period with a male preponderance of 1.4:1 and 84.9% of the children being less than two years. Sixty (17.0%) of the children were undernourished with 12 (3.4%) being severely wasted. Radiological pneumonia was observed in 44.0% of the children, 116 (33.3%) presented with heart failure while 18 (5.1%) had underlying cardiac lesions. Thirty-five (9.9%) of the children died. Children with pneumonia who in addition had concurrent measles infection, heart failure, cyanosis, head nodding and severe undernutrition were at increased risk of death. (p < 0.05) Severe wasting independently predicts mortality among the children. (RR = 5.86; 95% CI = 1.34 - 12.11; p = 0.01). Conclusion: Children with pneumonia who in addition had measles, heart failure, cyanosis and severe protein energy malnutrition should be aggressively managed because they are at increased of dying
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The third ventricle in Kaolin-induced hydrocephalus in juvenile rats
OA Ayannuga
January-June 2015, 15(1):8-13
DOI:10.4103/1596-4078.171376  
Background: The enlargement of the third ventricle in hydrocephalus has mechanical effects on the structures that form its boundaries such as thalamus and hypothalamus. This may explain some of the symptoms associated with hydrocephalus. While the lateral ventricles had been widely investigated in hydrocephalus, studies of the third ventricle are sparse. The present study set out to investigate the ependymal lining and the direction of enlargement of the third ventricle in hydrocephalus. Materials and Methods: Three-week old rats were divided into 6 groups (A-F) of five each. Groups A-C were experimental and sacrificed after 1, 4, and 8 weeks of induction, respectively, while groups D-F served as age-matched controls. Hydrocephalus was induced by intracisternal injection of 0.04 ml of 200 mg/ml kaolin suspension. Rats were sacrificed by cervical dislocation and approximately 1 mm thick coronal brain slices were obtained at optic chiasma level. Slices were fixed in 10% formal saline, processed and stained with hematoxylin and eosin. Results: Compared with corresponding control rats, the lateral ventricle width was significantly increased in 1 and 8 weeks postinduction experimental rats (P = 0.005 and 0.012 respectively), while supero-inferior distance of the experimental third ventricle was significantly lower at 1-week postinduction (P < 0.001), and increased at 8-week postinduction (P = 0.025). However, differences in the inter-thalamic distance at 1- and 8-week were not statistically significant (P = 0.14 and 0.224, respectively). Ependymal detachment was patchy and generalized at 1 and 4 weeks, respectively. Thinned and detached ependymal lining were noted 8-week postinduction. Conclusion: Kaolin-induced hydrocephalus caused early ependymal detachment in the third ventricle of rats, while ependymal thinning and villi sparing was a feature of chronicity. The third ventricle enlarges in the supero-inferior direction, this might explain some symptoms associated with hydrocephalus.
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Healing of postsurgical wound in the maxillofacial region: The role of exposure time
A Nwashindi, BD Saheeb
July-December 2015, 15(2):105-108
DOI:10.4103/1596-4078.182324  
Background: Although the maxillofacial region is very rich in blood supply, surgical wounds in this region are also prone to infection, if good aseptic techniques are not strictly followed. There is a need to evaluate healing of surgical wound following the removal of wound dressing at different days postoperative in the maxillofacial region. This paper describes and compares healing in terms day of exposing a clean surgical wound. Objective: To evaluate healing of surgical wound following the removal of wound dressing at different days postoperative in the maxillofacial region. Materials and Methods: One hundred and fifteen patients who met inclusion criteria, admitted for surgeries in maxillofacial regions were randomly grouped into one of the five surgical dressing options. ASEPSIS wound scoring system was used for the study. All patients were monitored for a period of 7 days when wound healing and suture removal is expected to take place uneventfully. Chi-square, Fisher's exact, and nonparametric Kruskal-Wallis tests as appropriate. Statistical significance was set at P < 0.05. Results: There was no difference in healing between males and females (χ[2] = 2.832, df = 4, P = 0.586). There was no significant difference in healing within the different days of exposure of the wound (χ[2] = 8.479, df = 4, P = 0.076). Conclusion: Early exposure of surgically clean wounds does not impair healing.
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CASE REPORTS
Cardiac disease in limb-girdle muscular dystrophy type 2
EJ Ogbemudia, F Odiase
January-June 2016, 16(1):43-46
DOI:10.4103/1596-4078.190041  
Limb-girdle muscular dystrophy is a rare inheritable muscle disease, and cardiovascular involvement is of prognostic significance. Only a few cases have been reported in our population. We, therefore, present the case of a 20-year-old student who was referred to the cardiac clinic on account of cardiomegaly on routine chest X-ray. He had dyspnoea on exertion, and occasional palpitations. There was a history of difficulty with standing from a sitting position, climbing stairs and raising his upper limbs above his head. His younger sister also has difficulties performing these tasks but has no cardiac symptoms. On examination, there was bilateral proximal muscle weakness with severe atrophy and an abnormal gait. There was sinus bradycardia on electrocardiography. Echocardiography revealed dilated cardiac chambers with ventricular dysfunction.
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REVIEW ARTICLE
Deep brain stimulation in Parkinson's disease
H Kaptan, H Ekmekci, M Ayaz
July-December 2015, 15(2):109-115
DOI:10.4103/1596-4078.182325  
Before the era of L-Dopa, surgical ventures (pallidotomy and thalamotomy) were applied in the treatment of Parkinson's disease (PD). The first experience of deep brain stimulation (DBS) was carried out by Heath and Pool for chronic pain in mid-1950s. From those times, DBS is placed a legitimate position in PD treatment whereas that it is in principle "reversible lesion" - in the state of previous ones where the condition was "irreversible lesion" - in the target nuclei. The latter are globus pallidus inserta or subthalamic nucleus and DBS does not interfere with the use of other future therapies. The touchstone for DBS surgery is "the right patient" by "the experienced team" at "the right time" so that the last three can provide magnificent benefits. Indeed both acute and the long-term results ends up with a dramatic and stable improvement of a patient's having DBS. The outlet of this article is to build an awareness of the roles of DBS in PD with clinical evaluation, electrophysiological bases, importance of surgical techniques with unilateral - bilateral approaches, postoperative follow-up early, and late acquirement of DBS and the gainings of the interdisciplinary - team approach.
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ORIGINAL ARTICLES
Assessing the impact of polio eradication initiative and routine immunization in Zamfara State, North-West, Nigeria
KM Yusuf, ED Jatau, OS Olonitola, SE Yakubu, BS Ahmed, ZA Gaiya, AE Yahaya, YY Pala
January-June 2015, 15(1):27-29
DOI:10.4103/1596-4078.171383  
Background: Evaluation of effectiveness of polio immunization has to be monitored continuously, particularly in endemic countries so that the immunity status can be precisely and effectively established. The aim of the present study was to determine the seroprevalence of poliovirus antibody in Zamfara State, Nigeria. Materials and Methods: This was a cross-sectional study of children aged 0–59 months. The children were randomly selected across the state. Blood samples collected from the children were tested for the presence of antibodies to poliovirus. Results: Blood samples from 63 (78.8%) of the 80 children had antibodies to all the three poliovirus serotypes. Seventy-five (93.8%), 68 (85.0%), and 75 (93.8%) of blood samples had antibodies to poliovirus serotypes 1, 2, and 3 respectively. All (100.0%) blood samples from children in the age group of 48–59 months tested positive for poliovirus. All (100.0%) the females had poliovirus antibody. In general, poliovirus antibody prevalence increased with increase in oral polio vaccine doses received. Urban children had higher poliovirus antibody prevalence of 81.0%, higher than their rural counterpart. Children whose fathers were educated up to tertiary level had 100.0% poliovirus antibody. There was no association among seroprevalence of poliovirus antibody and number of vaccine doses received and location of child's place of residence. Prevalence of poliovirus antibody was statistically significant based on age and father's educational level (χ[2] = 0.1360, χ[2] = 0.2923, respectively, P < 0.05). Conclusion: For the state to sustain the gains made in interrupting poliovirus transmission, more work need to be done so as to close the gap observed in the study.
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