Nigerian Medical Journal : Journal of the Nigeria Medical Association最新文献

{"title":"A Comparison of Pain Scores in Neonatal Circumcision with or without Local Anesthesia in Jos, Nigeria.","authors":"Aminu Gango Fikin,&nbsp;Stephen Yohanna","doi":"10.4103/nmj.NMJ_68_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_68_19","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal circumcisions are commonly performed in Nigeria, most often without anesthesia. The aim of this study was to determine whether anesthesia was required for neonatal circumcision.</p><p><strong>Materials and methods: </strong>All new-born male neonates presenting for routine circumcision were considered for inclusion in the study. This was a randomized control study, comparing pain scores during circumcision with local anesthesia or without local anesthesia. A total of 72 neonates were randomly assigned to the two groups using computer-generated random numbers, with 36 in each group. The neonates were not matched for age or weight. All the anesthetic procedures and circumcisions were performed in identical manner by the principal investigators using the plastic bell technique. Approval for the study was obtained from the Research Ethics Committee of the hospital. Written voluntary informed consent was obtained from the parents of the neonates.</p><p><strong>Results: </strong>The mean age and weight of the neonates in the study were 17 ± 2 days and 3.2 ± 0.68 kg, respectively. The mean Neonatal/Infant pain score was 4.8 in the local anesthesia group and 6.0 in those without anesthesia. The mean transcutaneous PO₂ was 90.47 ± 7.53 in those with anesthesia compared to 85.83 ± 5.61 in those without anesthesia. The mean heart rate was 133.88 ± 35.00 beats/min in the anesthesia group compared to 152.11 ± 79.80 in those without anesthesia. Neonates circumcised without local anesthesia had higher respiratory rate compared to those circumcised with local anesthesia.</p><p><strong>Conclusion: </strong>Neonates circumcised without local anesthesia had higher mean pain scores, heart rate, lower oxygen saturation and increased mean respiratory rate than those that had local anesthesia. Local anesthesia should be routinely used during neonatal circumcision.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/af/NMJ-61-11.PMC7113820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857024","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":"An Overview of Peripheral Artery Disease in the Elderly: A Study in a Tertiary Hospital Southern Nigeria.","authors":"Iboro Samuel Akpan, Osahon Enabulele, Afolabi Joseph Adewole","doi":"10.4103/nmj.NMJ_142_19","DOIUrl":"10.4103/nmj.NMJ_142_19","url":null,"abstract":"<p><strong>Background: </strong>The incidence of Peripheral Artery Disease (PAD), one of the manifestations of atherosclerosis, is increasing worldwide with significant effects on the quality of life. The disease is a strong prognostic marker for future cardiovascular events in people over 60 years, but relatively little is known about the condition among the elderly in sub-Saharan Africa.</p><p><strong>Objective: </strong>The objective of this study was to determine the prevalence and pattern of peripheral artery disease in elderly patients. Materials and Methods: A cross-sectional hospital-based study was carried out among elderly patients aged 60 years and above attending the Geriatric Clinic of the Department of Family Medicine of University of Benin Teaching Hospital, Edo State, Nigeria, from September to November 2017. Using systematic random sampling technique, 370 respondents were recruited from a sampling frame of 2160 respondents and a sampling fraction of 6. A structured questionnaire was administered to collect data on sociodemographic characteristics, lifestyle variable, and medical history. The ankle-brachial index (ABI) and toe-brachial index (TBI) were used to assess for PAD. The analysis was done using descriptive statistics.</p><p><strong>Results: </strong>The mean age was 69.3 ± 7 years comprising 76.5% females, 50% of the respondents were married, while 47% were widowed. The ABI showed 35.4% prevalence of PAD, while TBI for respondents with elevated ABI was 45.0%.</p><p><strong>Conclusion: </strong>The study showed a point prevalence of PAD to be 37.8%. From the total respondents, 45.7% had mild, while 2.9% had severe PAD. Routine screening for PAD is recommended for the early detection and management.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/46/NMJ-61-1.PMC7113815.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857023","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":"Hypertensive Disorders in Pregnancy: Pattern and Obstetric Outcome in Bida, Nigeria.","authors":"Haruna Idris,&nbsp;Nwachukwu Chiemezie Nwagbo Duum,&nbsp;Umar Gati Adamu,&nbsp;Rasheedat Morayo Abdullateef,&nbsp;Isah Aliyu Yabagi","doi":"10.4103/nmj.NMJ_29_18","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_29_18","url":null,"abstract":"<p><strong>Context: </strong>Cases of hypertensive disorders in pregnancy (HDP) are an increase in developing economies. Identifying the pattern of HDP in a particular community and documenting their management outcome may allow for proper planning by all stakeholders.</p><p><strong>Aims: </strong>The objective was to determine the pattern and management outcome of hypertensive disorders among pregnant women.</p><p><strong>Settings and design: </strong>This was a prospective cohort study involving 183 consecutive cases of HDP at Federal Medical Centre, Bida, Niger State, Nigeria, between September 2015 and August 2016.</p><p><strong>Subjects and methods: </strong>Pregnant women with hypertension were recruited and managed according to the departmental protocol. They were followed up till 6 weeks after delivery; fetal and maternal outcomes were documented.</p><p><strong>Statistical analysis used: </strong>Data were analyzed using the SPSS software version 23. The level of statistical significance was set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 1956 deliveries occurred during the study with 183 cases of HDP, giving an incidence of 9.4%. Pregnancy-induced hypertension alongside preeclampsia constitutes the majority of HDP during the study and had accounted for over 64%. Women who did not receive antenatal care in our center were at significantly greater risk of eclampsia (<i>P</i> = 0.000), abruption placentae (<i>P</i> = 0.003), maternal death (<i>P</i> = 0.002), very low-birth-weight (LBW) babies (<i>P</i> = 0.002), extremely LBW babies (<i>P</i> = 0.03), and perinatal death (<i>P</i> = 0.000).</p><p><strong>Conclusion: </strong>The need for prenatal screening that enables the early identification and prompt management of all expectant mothers with HDP is advised.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/9c/NMJ-61-42.PMC7113814.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857486","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":"Near Miss and Maternal Mortality at the Jos University Teaching Hospital.","authors":"Ephraim Samuels,&nbsp;Amaka Ngozi Ocheke","doi":"10.4103/nmj.NMJ_103_18","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_103_18","url":null,"abstract":"<p><strong>Background: </strong>Some women who enter pregnancy in a healthy state may survive with serious complications while others may die. This study sets out to determine the frequency of maternal near-miss (MNM) and maternal death. It also intended to identify common causes and determinants.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study from June 2012 to May 2013 that involved women who were admitted for delivery, within 42 days of delivery or termination of pregnancy and those who died from pregnancy, childbirth, or puerperal complications. Data obtained were analyzed using Epi info 2002.</p><p><strong>Results: </strong>There were 105 maternal near misses and deaths. Nineteen of them were mortalities, whereas 86 were MNMs. The maternal mortality ratio over the period was 806/100,000 live births and near miss was 3649/100,000 live birth. Hypertensive disorders in pregnancy were the leading cause of maternal deaths (47.36%) and MNMs (47.7%). Maternal deaths (57.9%) and near misses (43%) were the highest among those that treatment was instituted after 60 min and within 30-60 min of diagnosis, respectively. The consultants were the highest level of expertise involved in the management of 73.3% and this group recorded the least maternal death and highest MNM.</p><p><strong>Conclusion: </strong>Hypertensive disorder was the leading cause of MNM and mortality. Involving the highest level of expertise in patient management and reducing the time interval between diagnoses and instituting definitive treatment is essential for a better outcome. Health institutions will benefit from the evaluation of their quality of obstetric care by including near miss investigations in their maternal death enquiries.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/f8/NMJ-61-6.PMC7113817.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857026","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":"Unilateral Sinonasal Masses: Review of Clinical Presentation and Outcome in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.","authors":"Iliyasu Yunusa Shuaibu,&nbsp;Muhammed Aminu Usman,&nbsp;Abdulrazak Ajiya","doi":"10.4103/nmj.NMJ_128_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_128_19","url":null,"abstract":"<p><strong>Background: </strong>Unilateral persistent nasal obstruction may indicate the presence of sinonasal lesion, which could be inflammatory or neoplastic. It is a common practice to assume that unilateral nasal mass in adults is either inverted papilloma or a malignant lesion.</p><p><strong>Objectives: </strong>The objective is to study the pattern of clinical presentation and outcome of treatment of patients managed for unilateral nasal masses at Ahmadu Bello University Teaching Hospital, Zaria.</p><p><strong>Materials and methods: </strong>The record of patients managed for unilateral nasal masses over 5 years between January 2013 and December 2017 was reviewed. Data obtained for this study included demographic characteristics such as age, sex, occupation, main presenting symptoms, duration of symptoms, histological type, type of treatment given, and current status of patients. The data were analyzed using the Statistical Package for the Social Science version 23.0.</p><p><strong>Results: </strong>A total of 38 cases were reviewed for this study and there were 25 (65.8%) males and 13 (34.2%) females with a sex ratio (male: female) of 1.9:1. The mean age was 50.8 years, with the standard deviation of ± 13.7. Rhinorrhea, nasal blockage and the presence of nasal growth were the most common symptoms at presentation seen nearly in all the patients. Inflammatory polyp 16 (42.1%) was the most common histological type observed in this study. The majority of patients with malignant sinonasal masses had well-differentiated squamous cell carcinoma 5 (13.2%). Most of our patients 29 (76.3%) presented to the hospital within 1-3 years of the onset of the symptoms. The majority of our patients 26 (68.4%) did very well and were discharged from the clinic following resolution of their symptoms. Three (7.9%) had recurrent nasal mass. We recorded three cases of mortality from the 38 patients managed.</p><p><strong>Conclusion: </strong>Inflammatory polyp was the most common unilateral sinonasal mass followed by inverted papilloma. A thorough clinical evaluation of any patients with prolonged nasal symptoms will go a long way in the early detection of these lesions.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/fb/NMJ-61-16.PMC7113818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857028","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":"Reported Adherence to Antihypertensive Treatment and Outcome at Postmortem in Southwestern Nigerians.","authors":"Uchenna Simon Ezenkwa,&nbsp;Sebastian Anebuokhae Omenai,&nbsp;John Olufemi Ogunbiyi","doi":"10.4103/nmj.NMJ_99_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_99_19","url":null,"abstract":"<p><strong>Background: </strong>Systemic hypertension is referred to as a silent killer. Knowledge of disease and religious use of medication could mitigate against complications in hypertensives. This study evaluated outcome among decedent essential hypertensive patients in southwestern Nigeria in relation to their compliance with prescribed antihypertensive medication.</p><p><strong>Materials and methods: </strong>This is a 10-year retrospective review of routine postmortem data. Archival postmortem records from January 1, 2008 to December 31, 2017 in the Department of Pathology, University College Hospital, Ibadan, Nigeria, were reviewed. Data extracted from the records included age, gender, knowledge of hypertension status, systolic and diastolic blood pressure at time of diagnosis, reported adherence to medications, complications of systemic hypertension, duration of survival from diagnosis to demise, cause of death, body length, and heart weight at autopsy. Descriptive, Students <i>t</i>-test, Chi-square test, Pearson correlation and Cox proportional-hazards model statistics was conducted using SPSS version 20 (IBM SPSS Statistics for windows, IBM Corp., Armonk, N.Y., USA).P < 0.05 was considered significant.</p><p><strong>Results: </strong>Eighty-one cases met the inclusion criteria, consisting of 60 males and 21 females with overall mean age of 55.65 ± 12.1 years. Seventy-five (91.7%) cases were known hypertensives prior to admission or demise while 6 (8.3%) were not known hypertensives. The duration of survival from diagnosis to death ranged from 1-month (0.08 years) to 31 years with overall mean duration of 5.2 years. Fifty-two (63.4%) of the 75 known hypertensive cases had documented medication compliance. Medication noncompliant cases had lower mean survival interval (5 vs. 8 years), died younger (53.5 ± 10.8 years vs. 54.8 ± 15.5 years), had higher mean blood pressures (systolic blood pressures: 197 ± 45.8 mmHg vs. 180 ± 55.4 mmHg; diastolic blood pressures: 117 ± 27.2 mmHg vs. 101 ± 32.8 mmHg) and heavier heart weights (476 ± 142 g vs. 390.8 ± 107.6 g). However, only the difference in heart weight was statistically significant (<i>P</i> < 0.036). Age and mean systolic blood pressures were correlated with interval from diagnosis to death (<i>r</i> = 0.5, <i>P</i> < 0.000; <i>r</i> = -0.4,<i>P</i> < 0.017, respectively). Death from complications of hypertension and all-cause mortality occurred with higher frequencies among medication noncompliant cases (40 vs. 12).</p><p><strong>Conclusion: </strong>Noncompliance with antihypertensive medication is associated with more cardiovascular and all-cause mortality among Southwestern Nigerians with essential hypertension.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/2d/NMJ-61-22.PMC7113819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857025","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":"Challenges of Tuberculosis Control in Lagos State, Nigeria: A Qualitative Study of Health-Care Providers' Perspectives.","authors":"Olusola Adedeji Adejumo,&nbsp;Olusoji James Daniel,&nbsp;Victor Abiola Adepoju,&nbsp;Toriola Femi-Adebayo,&nbsp;Bisola Ibironke Adebayo,&nbsp;Andrew Oseghae Airauhi","doi":"10.4103/nmj.NMJ_108_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_108_19","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) burden in Nigeria is a reflection of the challenges of TB control strategy in the country. This study explored the challenges encountered by the health workers in public and private TB treatment centers in Lagos, Nigeria.</p><p><strong>Methods: </strong>In-depth interviews were held with 34 health workers providing TB services in private and public health facilities and the Lagos state Program Officer between October 1, 2016 and January 31, 2017. The transcripts were read severally and coded for qualitative data analysis. Themes were developed from coding.</p><p><strong>Results: </strong>Insufficient or lack of funds to track patients lost to follow-up, conduct home visits, collect drugs from the central stores, and shortage of laboratory reagents were some of the logistical challenges encountered by the health workers. There was shortage of health workers and some were yet to be trained resulting in work overload. This was situation aggravated by the frequent redeployment and health worker attrition in the public and private sector respectively.</p><p><strong>Conclusion: </strong>The government need be proactive and show leadership by finding lasting solutions to the logistical and human resource challenges facing the LAgos State TB and Leprosy Program.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"61 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/d3/NMJ-61-37.PMC7113816.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857480","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":"Profile of Medicolegal Deaths in Females: An Autopsy-Based Study.","authors":"Chukwuemeka Charles Nwafor, Wilson Oberifo Akhiwu","doi":"10.4103/nmj.NMJ_153_19","DOIUrl":"10.4103/nmj.NMJ_153_19","url":null,"abstract":"<p><strong>Background: </strong>The rate of female medicolegal deaths (MLD) due to homicides and road traffic accidents (RTAs) is the highest in Africa, compared to the rest of the world, though there is scanty literature locally on this subject.</p><p><strong>Materials and methods: </strong>The major sources of information reviewed in this study were the autopsy registers and autopsy reports of the police clinic, Benin City, Edo State, over 10 years.</p><p><strong>Results: </strong>A total of 331 female medicolegal autopsies were performed, accounting for 21.8% of all cases. The mean age of cases was 40.11 ± 20.25. Age group of 30-39 years accounted for 22.1% (<i>n</i> = 73) of cases, closely followed by the age group of 20-29 years, which accounted for 20.5% (<i>n</i> = 68) of cases. Accidental deaths accounted for 36.9% (<i>n</i> = 122) of cases. RTA was the most common cause of accidental deaths (<i>n</i> = 105; 86%). The most common pattern of RTA was a vehicle knocking down a pedestrian as seen in 45 cases (42.9%). The most common age group involved in RTA was 20-29 years (<i>n</i> = 23; 22%). For homicides, shotguns were mainly used (<i>n</i> = 31; 31.6%), distantly followed by those caused by the use of sharp objects (<i>n</i> = 17; 17.3%) and most cases belonged to the age groups of 40-49 years and 30-39 years (21.5% and 19.5%, respectively). In 5 (71.4%) cases, hanging was the method of choice for suicide. A majority of suicide victims (<i>n</i> = 4; 57.1%) were aged between 30 and 39 years, with an average age of 36.3. Diseases of the cardiovascular system accounted for 41.8% (<i>n</i> = 41) of cases, whereas pregnancy-associated deaths (excluding criminal abortions) accounted for 29.6% (<i>n</i> = 29) of cases in the natural causes group. Preeclampsia/eclampsia (<i>n</i> = 9; 31%) followed by postpartum hemorrhage (<i>n</i> = 8; 27.6%) were the leading causes of maternal deaths.</p><p><strong>Conclusion: </strong>There is a need to provide basic infrastructure, formulate policies, and implement them, to reduce female MLD, which a significant number of them are preventable.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 6","pages":"300-305"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/8b/NMJ-60-300.PMC7053274.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37743677","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":"Short-Term Outcomes of Treatment of Boys with Posterior Urethral Valves.","authors":"Abdulrasheed A Nasir,&nbsp;Adewale O Oyinloye,&nbsp;Lukman O Abdur-Rahman,&nbsp;Kayode T Bamigbola,&nbsp;Nurudeen T Abdulraheem,&nbsp;Olanrewaju T Adedoyin,&nbsp;James O Adeniran","doi":"10.4103/nmj.NMJ_118_18","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_118_18","url":null,"abstract":"<p><strong>Background: </strong>Posterior urethral valve (PUV) is a significant cause of morbidity and mortality among male children resulting in renal failure in 25%-30% before adolescence irrespective of initial treatment. This study aimed at evaluating the early outcomes of children managed for PUV.</p><p><strong>Materials and methods: </strong>This was a prospective study of all children who were treated for PUV between 2012 and 2016 at a single referral institution. Information reviewed included demographic and clinical data, imaging findings, pre- and post-operative serum electrolytes, and postoperative renal outcomes.</p><p><strong>Results: </strong>Twenty-nine male children were managed for PUV at a median age of 6 months including 7 (24.1%) neonates. Two (6.9%) patients had antenatal diagnosis. Micturating cystourethrogram confirmed PUV in all patients. Fourteen (48.3%) patients had impaired renal function (IRF) at presentation and 8 (57%) had improved renal function (RF) after initial catheter drainage. The mean creatinine at presentation was 1.86 ± 1.69 mg/dl and the mean serum creatinine following initial catheter drainage was 0. 93 ± 0.49 mg/dl (<i>P</i> = 0.003). For those patients with normal RF, the mean creatinine at presentation was 0.81 ± 0.22 mg/dl versus 0.74 ± 0.21 mg/dl (<i>P</i> = 0.012), following initial catheter drainage. Children with IRF on admission had mean creatinine at presentation of 2.61 ± 2.00 mg/dl compared to 1.17 ± 0.53 mg/dl (<i>P</i> = 0.002) after initial catheter drainage. Valve ablation was achieved with Mohan's valvotome in 26 (96.3%) patients. All patients had good urine stream at a median follow-up of 5 months. Four (13.8%) patients developed IRF at follow-up. Renal outcomes of patients presenting before 1 year and those presenting after 1 year were similar. Two children died preoperative of urosepsis and one out of hospital death given an overall mortality of 10.3% (<i>n</i> = 3).</p><p><strong>Conclusion: </strong>There was significant improvement in RF after initial catheter drainage. The incidence of IRF at follow-up was 13.8%. Long-term follow-up is necessary to identify patients at risk of end-stage renal disease.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 6","pages":"306-311"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/af/NMJ-60-306.PMC7053278.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37743680","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":"A Comparative Study of Serum Ferritin Levels Among Unfit and Fit Blood Donors.","authors":"Olusola Festus Olowoselu,&nbsp;Ebele Uche,&nbsp;Olufemi Oyedeji,&nbsp;Oluwakemi E Otokiti,&nbsp;Oluwamuyiwa Anthony Ayanshina,&nbsp;Akinsegun Akinbami,&nbsp;Vincent Osunkalu","doi":"10.4103/nmj.NMJ_48_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_48_19","url":null,"abstract":"<p><strong>Background: </strong>Cheap methodologies are being utilized by low-resource countries to determine blood donors' fitness. Important hematological biomarkers might have to be evaluated to enhance the use of these methods.</p><p><strong>Aims: </strong>The study evaluated the pattern of serum ferritin in 18-24 fit and unfit prospective blood donors (PDBs) and the prevalence of iron store deficiency.</p><p><strong>Settings and design: </strong>This study was a cross-sectional, comparative study which was conducted at the blood donor clinic of the Lagos University Teaching Hospital.</p><p><strong>Materials and methods: </strong>Blood samples were collected by venipuncture into sodium-ethylenediaminetetraacetic acid and plain bottles. The latter was centrifuged and used for ferritin determination via human ferritin enzyme-linked immunosorbent assay test kit, while the former was used for red cell indices analysis using an autoanalyzer.</p><p><strong>Statistical analysis: </strong>Data were analyzed using SPSS version 20, values were presented as mean ± standard deviation, and <i>P</i> ≤ 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 263 PDB were recruited into the study consisting of 210 (79%) males and 53 (21%) females, with a mean age of 32.88 ± 8.22. Only 110 (41.8%) of the participants were considered fit, while 153 (58.2%) were unfit using copper sulfate specific gravity. There was no statistically significant difference (<i>P</i> = 0.301) in the mean level of serum ferritin in unfit blood donors (74.5 ± 90.8 μg/L) compared to that of the fit blood donors (61.5 ± 54.5 μg/L). The prevalence of iron store depletion among blood donors in Lagos state was 11.8% (31 of 263) with a higher proportion (7.6%) occurring among unfit donors. However, low levels of serum ferritin (<15 μg/L) were significantly associated with the occurrence of anemia (hemoglobin < 12.5 g/gl) among unit donors (19%; <i>P</i> = 0.05).</p><p><strong>Conclusion: </strong>Although serum ferritin depletion appears to be higher in the unfit blood donors, the use of serum ferritin as an index for the screening and determination of PDBs' fitness requires further evaluation.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 6","pages":"312-316"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/1d/NMJ-60-312.PMC7053277.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37743682","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}