Journal of Medicine in the Tropics最新文献

{"title":"Efficacy of bleomycin for non-operative treatment of cervical lymphangioma in University of Ilorin Teaching Hospital, Nigeria","authors":"L. Abdur-rahman, O. Awolaran, A. Nasir, K. Bamigbola, Nurudeen T. Abdulraheem, A. Oyinloye, J. Adeniran","doi":"10.4103/JOMT.JOMT_14_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_14_17","url":null,"abstract":"Background: Lymphangiomas are the developmental defects of the lymphatic channels, and they are most commonly found in the head and neck regions. Late presentation, rejection of surgery, and traditional scarification result in fatal complications. Surgical excision often thought to give immediate relief and aesthetic results is associated with damage to contiguous structures and recurrence, hence, the need for less invasive treatment modality. Objective: To assess the effectiveness of bleomycin sclerotherapy of cervical lymphangiomas. Materials and Methods: This is a prospective study of patients with cervical lymphangioma treated with sclerosant injection between January 2008 and December 2016. Preinjection ultrasound scan and initial ultrasound-guided aspiration of the fluid in the swelling (which many times is multiloculated) using a 20G cannula into a 10 ml syringe were performed. The cannula tip is retained in the space and intralesional injection of double-diluted bleomycin 0.5 i.u./kg body weight was given as outpatient at 2–4-weekly interval. Postinjection events were documented. The clinical assessment of the pre- and postinjection of sclerosant was performed. Result: A total of 23 patients were recruited, and six were females and 17 were males. All swellings were noticed at birth but median time at presentation was 17 days. All patients but one (95.8%) had complete clinical resolution after 1–4 courses of sclerotherapy for 4–16 weeks. Only one patient had residual nodule that required surgical excision. Redundant skin and hyperpigmentation from skin wrinkle were the early effects noticed in three patients; however, these were cosmetically acceptable to the parents. No recurrence was recorded. Conclusion: The treatment of cervical lymphangiomas with intralesional bleomycin injection is shown to be effective. It is safe and associated with no complication. This treatment modality and outcome was found to be acceptable to the parents of these children.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"9 1","pages":"93 - 97"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91544598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikungunya virus-associated arthralgia could have been misdiagnosed by healthcare providers in Nigeria","authors":"I. Nasir, Jessy Thomas Medugu, H. Shuwa, Fatima Yahaya","doi":"10.4103/JOMT.JOMT_3_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_3_17","url":null,"abstract":"","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"24 1 1","pages":"139 - 140"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79302452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis and the determinants of treatment outcome in Zaria, North Western Nigeria – A nine-year (2007–2015) epidemiological review","authors":"A. Oyefabi, E. Adetiba, Emmanuel Leeshak, Olufemi Adesigbin","doi":"10.4103/JOMT.JOMT_25_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_25_17","url":null,"abstract":"Introduction: Tuberculosis (TB) kills, worldwide, about 1.5 million people infected by the disease per year according to the 2015 World Health Organization (WHO) Global TB report. In sub-Saharan Africa, Nigeria accounts for the highest absolute number of TB morbidity and the 4th among the six high-TB burden countries, which account for about 60% of all TB cases globally. Materials and Methods: This study is a retrospective, descriptive cross-sectional review of the facility TB registers of 4054 patients who accessed TB healthcare services at the 25 directly observed treatment short course (DOTS) Primary Health Care facilities in Zaria, Northwestern Nigeria, between January 1, 2007 and December 31, 2015. Results: Majority of the patients were males (2601; 64.2%), belonging to the age group <40 years (2837; 70%) The patients presented mainly with pulmonary TB (3591; 88.6%). Only half the number of patients (50.3%) had smear-positive results before the commencement of short-course chemotherapy with either 2RHZE/6EH or 2SRHZE/IRHZE/5RHE (1, 2 = 1 or 2 months intensive phase, 5 = 5 months continuation phase, R = rifampicin, H = isoniazid, Z= pyrazinamide, E = ethambutol, S = streptomycin). Human immunodeficiency virus (HIV) coinfection was reported in 774 (19.1%) patients. The treatment success rate was 80.2% (3253 patients); 278 (6.9%) of the patients were lost to follow-up, 176 (4.3%) were transferred out, and 235 (5.8%) died. The determinants of the unsuccessful treatment outcome were being a male, aged >40 years, TB and HIV coinfection, a greater degree of sputum smear positivity before treatment, located at far distances from DOTS centers, and being on retreatment or second-line regimen. Conclusion: The treatment success rate falls below the recommended 85% by the WHO. Recommendations: There is a need for the Nigeria government in collaboration with international agencies to intensify effort at TB surveillance, monitoring, and control activities in Nigeria. Effort should be directed at promoting TB/HIV awareness, the early recognition and diagnosis of TB, and strategies to expand and improve DOTS service at community level.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"13 1","pages":"116 - 122"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83450045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age at menarche and its association with overweight/obesity among adolescents in Kano","authors":"I. Garba, A. Rabiu, I. Abubakar","doi":"10.4103/JOMT.JOMT_5_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_5_17","url":null,"abstract":"Background: There was a dramatic decline of adolescents’ menarcheal age worldwide; Africa is witnessing a secular trend of this reducing menarcheal age among its black adolescents. A transition of overweight/obesity among adolescent is believed to be associated with reduced menarcheal age. Materials and Methods: It was a descriptive cross-sectional study that was conducted among female adolescent girls from January to December, 2016. Ethical approval was obtained from the management concerned. All consenting adolescents were recruited for the survey. Information was recorded on a structured, pretested questionnaire. Their respective weight and height were also measured. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2). The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers’ exact test was used, and the P ≤ 0.05 was considered statistically significant. Results: Two hundred and nineteen female adolescents participated in the survey. The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal ages were both 13 years. There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers’) = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers’) = 0.00). Obesity was associated with reduced menarcheal age. Conclusion: The median and mean ages at menarche were 13.0 and 12.8 years respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"35 1","pages":"90 - 92"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73562483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and obstructive sleep apnea risk among Nigerians.","authors":"Maxwell O Akanbi,&nbsp;Patricia A Agaba,&nbsp;Obianuju B Ozoh,&nbsp;Amaka N Ocheke,&nbsp;Zumnan M Gimba,&nbsp;Christiana O Ukoli,&nbsp;Emmanuel I Agaba","doi":"10.4103/jomt.jomt_17_17","DOIUrl":"https://doi.org/10.4103/jomt.jomt_17_17","url":null,"abstract":"<p><strong>Background: </strong>The contribution of obesity to obstructive sleep apnea (OSA) is poorly described in Nigeria. We aimed to compare OSA risk between obese and nonobese adults in urban Nigeria.</p><p><strong>Materials and methods: </strong>An analytic cross-sectional study was conducted. Participants were interviewed using the World Health Organization Non-Communicable Disease questionnaire. OSA risk assessment was performed using the STOP-BANG questionnaire. A total score of ≥3 on the STOP-BANG questionnaire indicated OSA risk, whereas a score ≥5 indicated high OSA risk. Obesity was defined as body mass index (BMI) >30 kg/m². Relationship between obesity and OSA was tested using chi-square and logistic regression models used to control for confounding factors.</p><p><strong>Results: </strong>There were 744 respondents, with a mean age of 44 (standard deviation 10) years. A total of 206 [27.7%, 95% confidence interval (CI) 24.46-30.9] respondents were obese (BMI ≥30 kg/m²). A total of 307 (41.3%, 95% CI 37.7-44.9) respondents scored ≥3 on the STOP-BANG questionnaire, whereas 37 (4.9%, 95% CI 3.6-6.7) scored ≥5. More number of obese than nonobese [57.8% (119/206) versus 34.9% (188/538)] respondents met the criteria for OSA risk (<i>P</i> < 0.001). Similarly, more obese persons [10.3% (21/206)] met the criteria for high-risk OSA compared to the nonobese [3% (16/538)]; <i>P</i> < 0.001. In logistic regression models adjusted for cigarette smoking and alcohol consumption, the odds for OSA risk was 15.76 (95% CI 7.44-33.9) in persons with BMI >35 kg/m² compared to those with a BMI range of 18.5-24.99.</p><p><strong>Conclusion: </strong>Obesity and OSA may be more prevalent in Nigeria than previously predicted. Obesity independently increased OSA risk in this population.</p>","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"19 2","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/67/nihms920625.PMC5701752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35643714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyopericardium − A fatal presentation: A case report","authors":"K. Raju, Gowtham Juvva, R. Prakash, V. Pandit, D. Anandhi","doi":"10.4103/JOMT.JOMT_4_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_4_17","url":null,"abstract":"Pyopericardium is an uncommon presentation of tuberculosis (TB) and has been reported in 6.98% of the cases of pyopericardium. Pyopericardium has been documented in <3% of the cases of large TB pericardial effusions, even in the high-prevalence areas of TB and human immunodeficiency virus infection. Pulmonary TB affects the pericardium in 1–2% of the cases, and pericardial TB is responsible for 7% of the cases of cardiac tamponade. Pericardial TB is usually an insidious illness and may present as acute pericarditis, chronic pericardial effusion, cardiac tamponade, or pericardial constriction; however, purulent pericarditis is rare. To the best of our knowledge, there are no previous case reports from India on acute pyopericardium with tamponade. Purulent pericarditis or pyopericardium is a rare entity and is associated with very high mortality. A 50-year-old woman was brought to the Emergency Department with respiratory distress and shock. Screening echocardiography suggested pericardial effusion with cardiac tamponade. The pericardial aspirate was frankly purulent, but she sustained a cardiac arrest, and resuscitative attempts were futile. The case is highlighted because of its rarity and fatal outcome, especially with late diagnosis and management. The following core competencies are addressed in this article: medical knowledge and patient care.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"93 1","pages":"129 - 132"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91376553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual case of acute kidney injury caused by oxalic acid mistaken for common salt","authors":"Koushik Bhattacharjee, S. Divyaveer, A. Banerjee, V. Tiwari, T. Bhattacharya, A. Raychaudhury, R. Pandey","doi":"10.4103/JOMT.JOMT_10_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_10_17","url":null,"abstract":"Accidental exposure to chemicals and toxins is an important cause of acute kidney injury in the tropics. We report a case of a 26-year-old female who presented with acute kidney injury following a history of accidental ingestion of some white powder mistaken for table salt. Urine microscopy revealed the presence of calcium oxalate crystals. Because accidental poisoning was suspected despite normal 24-h oxalate excretion, renal biopsy was performed, which showed acute tubular injury with occasional refractile oxalate crystals. The patient improved symptomatically with conservative management and did not require haemodialysis. Subsequently, renal functioning showed an improving trend. Oxalic acid poisoning is relatively rare but is an emerging sporadic as well as epidemic poison in some regions.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"26 1","pages":"133 - 135"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87318479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-mode ocular ultrasound findings in adults with refractive errors at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria","authors":"Ibukun Abidoye, C. Asaleye, B. Adegbehingbe","doi":"10.4103/JOMT.JOMT_54_16","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_54_16","url":null,"abstract":"Objective: To ascertain the relationship between B-mode ocular ultrasound findings and standard autorefraction results of participants with refractive errors, with the aim of using B-mode ultrasound as a complementary technique to determine the refractive state of the eye. Materials and Methods: The study population consisted of 255 adult patients with refractive errors, aged 18–40 years. The ocular dimensions were measured using MINDRAY DC-7.0 real-time ultrasound machine with frequency probe of 5 and 7–12 MHz. The ocular shapes and other biometric measurements were then correlated with the results of the standard autorefraction. Results: The sensitivity for prolate ocular shape corresponding with myopia/astigmatism was 88.6%, whereas that of oblate ocular shape corresponding with hyperopia/astigmatism was 87.4%. The Pearson’s correlation coefficient between right axial length and right spherical equivalent was negatively strong at −0.79 (P < 0.001). In addition, the Pearson’s correlation coefficient was negatively strong at −0.76 (P < 0.001) between left axial length and left spherical equivalent. Conclusion: Real-time B-mode ocular ultrasound has a high sensitivity in determining ocular shape, which corresponded well with the refractive state of the participants’ eyes. Axial length (AL) was found to correlate strongly with spherical equivalent, and, thus, a regression equation can be used to predict the spherical equivalent from the AL measurements.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"1 1","pages":"123 - 128"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90024652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs of management of injuries in emergency room patients in Ilorin","authors":"G. Ibraheem, C. Ofoegbu, B. Solagberu, L. Abdur-rahman, A. Adekanye, A. Nasir","doi":"10.4103/JOMT.JOMT_26_16","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_26_16","url":null,"abstract":"Background: Injuries pose a significant economic problem to communities in every society. Studies aimed at estimating the costs of management of injuries are very limited in this environment. Materials and Methods: The patients who presented to the emergency unit of the University Teaching Hospital, Ilorin, Nigeria, with traumatic injuries were recruited. The expenses were classified into various groups. Results: Of the 165 patients recruited, majority were young adult men. The mean direct cost per injury was N4061 ($27.1) with the cost of drugs accounting for the largest share of the costs. The costs incurred were higher with the increasing severity of injury. Conclusion: The direct costs of management of injuries from this study represent a significant economic drain to the low-income population of this environment. Extrapolating these cost estimates of medical treatment to the fatal as well as the even larger non-fatal injury burden in Nigeria exposes the immense financial drain to the individual and community.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"86 1","pages":"21 - 25"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78218273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gametocytocidal clearance by artemether–lumefantrine versus artesunate–amodiaquine in North-Central Nigeria","authors":"D. Shwe, S. Pitmang, J. Abba, Mark Akindigh, D. Egah, S. Oguche","doi":"10.4103/JOMT.JOMT_48_16","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_48_16","url":null,"abstract":"Background: The deployed artemether–lumefantrine (AL) and artesunate–amodiaquine (AA) medicines are known to be gametocytocidal. Continuous monitoring of their efficacies is imperative for malaria elimination interventions. To compare gametocytocidal clearance by AL versus AA. Materials and Methods: Data on demographics, anthropometry measures and gametocytes densities of 111 of 114 Human Immunodeficiency Virus (HIV) sero-negative children aged 6–59 months with uncomplicated Plasmodium falciparum malaria mono-infection, who participated in a drug therapeutic efficacy testing, were extracted. Patients who had severe malnutrition, other causes of common childhood fevers and use of antimalarial medicines in the preceding 1 week were excluded from the study. Study participants who met the enrolment criteria and gave written informed parental consent were randomized to receive AL or AA according to the manufacturer’s instructions. Clinical and parasitological evaluations were performed on D0, D1, D2, D3, D7, D14, D21 and D28. Analysis was restricted to 111 participants who completed the study. Results: Twelve (10.8%) patients had gametocytes on D0. Six (5.4%) study participants were in the AL treatment arm and 6 (5.4%) participants were in the AA treatment arm (P = 0.32). Gametocyte clearance time (GCT)AL was 104 h and (GCT)AA was 152 h (P = 0.44). Conclusion: AL and AA demonstrated comparable gametocytocidal activity in North-Central Nigeria. There is a need for continuous monitoring of the efficacies of these artemisinin-based combination therapies to keep track with the emergence of resistant Plasmodium gametocyte isolates in Nigeria.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"308 1","pages":"60 - 64"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78269737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}