New Nigerian Journal of Clinical Research最新文献

{"title":"Primary B-Cell jejunal maltoma in a young adult male: A case report and review of literature","authors":"M. Al-Mendalawi","doi":"10.4103/nnjcr.nnjcr_15_18","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_15_18","url":null,"abstract":"Sir, I read with interest the case report by Ezejiofor et al.[1] on the primary B-cell jejunal maltoma, a rare variety of lymphoma, in a Nigerian patient. The authors described nicely the clinical presentation, results of imaging studies, laparotomy and histopathological findings, and treatment plan in the studied patient. I presume that the rare occurrence of the tumor and its aggressive nature should alert the authors to consider altered immune status in the studied patient. Among conditions associated with altered immune states, human immunodeficiency virus (HIV) infection is of utmost importance. My presumption is based on the following points. It is obvious that individuals infected with HIV are more susceptible to various types of tumors compared to healthy individuals. The increased susceptibility has been suggested to be related to different factors, including immunosuppression, coinfection with oncogenic viruses, and life prolongation secondary to the use of antiretroviral therapy.[2] Among tumors, intestinal lymphoma has been reported among HIV-positive patients.[3,4] To my knowledge, Nigeria is one among the Sub-Saharan countries importantly facing the serious health consequences of HIV infection. The recently published data pointed out to the substantial HIV seroprevalence (3.2%) in Nigeria.[5] Hence, determining HIV status in the studied patient by the diagnostic battery of blood CD4 count and viral overload estimations was envisaged. If that cluster of tests were to reveal HIV infection, the case in question could be truly regarded as a novel case report. This is because HIV-associated B-cell intestinal maltoma has never been reported in the literature to date. Financial support and sponsorship","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129904955","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":"Pattern of utilization of dental services and oral self-care practices of people living with HIV/AIDS in two tertiary health institutions in Nigeria","authors":"K. Umeizudike, O. Daramola, B. Osagbemiro, T. Adeyemo","doi":"10.4103/nnjcr.nnjcr_35_18","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_35_18","url":null,"abstract":"Background: People living with HIV/AIDS (PLWHA) have a high risk of oral health problems. However, little is known about their utilization of oral health services in Nigeria. Objectives: The aims of this study were to determine utilization of dental services and oral hygiene practices among PLWHA attending two tertiary health institutions. Materials and Methods: This was a descriptive, cross-sectional study among PLWHA attending HIV clinics in two teaching hospitals in South West and South South Nigeria. Information obtained using self-administered structured questionnaires included questions on pattern of dental services' utilization and oral hygiene behavior. P < 0.05 was considered as statistically significant. Results: Three hundred and fifty-two (352) PLWHA participated. Mean age was 42.5 ± 9.4 years, 64.2% were females, and 36.9% were of middle socioeconomic status (SES). Previous dental visits (36.9%) were associated with perception of dental need, center of study, and SES (P < 0.05). Odds of utilizing dental health services were higher among those who perceived they needed dental care (odds ratio: 4.12; 95% confidence interval: 2.13–7.96). Eighty-eight (25%) had visited the dentist in the preceding 12 months and received dental treatment in the form of extraction (64.4%), routine dental check (13.8%), and scaling and polishing (5.8%). Lack of perceived dental need and financial limitations were the main barriers for lack of dental visits. Twice daily tooth brushing was practiced by 40.1% of the respondents. Conclusion: Utilization of the dental services among PLWHA was low and influenced by self-perception of dental need, study center, and higher SES. Oral hygiene practices were less than optimal.","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"52 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116566253","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":"Stress response associated with elective cesarean delivery: A comparison of the effect of general versus subarachnoid anesthesia","authors":"O. Akitoye, M. Atiku, N. Adewole","doi":"10.4103/nnjcr.nnjcr_37_18","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_37_18","url":null,"abstract":"Context: Pregnancy, surgery, and anesthesia are identified forms of stress to the body. Sustained response to stress has been associated with increased morbidity and mortality. Aim: The aim of the study is to determine the effect of anesthetic techniques on the response to the stress of surgery and anesthesia. Study Design: This was a prospective, randomized, double-blind study. Subjects and Methods: One hundred and forty patients scheduled for elective cesarean section were recruited and randomized into two groups: general anesthesia and subarachnoid anesthesia. Heart rate (HR), blood glucose, and cortisol levels were used to evaluate the body response to stress. Blood samples to estimate glucose and cortisol levels were taken the night of the day before surgery, just before induction, 30 min after induction, 60 min after induction, and 24-h postsurgery. The Statistical Package for the Social Sciences Version 23 was used for analysis to find the mean and standard deviation of both categorical and noncategorical variables. The Independent t-test and two-tailed test were used to show the differences in the HR, blood glucose, and cortisol levels within and between the general anesthesia and subarachnoid anesthesia groups. Results: The two groups were comparable in terms of age, height, weight, and American Society of Anesthesiologists status. The changes in HR and blood glucose were similar in both groups. However, a statistically significant difference was noted in the level of cortisol between the two groups at 60-min postskin incision with 494 ± 161 nmol/L in the general anesthesia group as opposed to 347 ± 161 nmol/L in the subarachnoid anesthesia group with a P = 0.01. Conclusions: The study demonstrated that subarachnoid anesthesia offers an advantage over general anesthesia in terms of the reduction to stress response to surgery and anesthesia. However, patient's choice and the urgency in the delivery of the fetus should be considered in choosing a mode of anesthesia.","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124950821","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":"Palpitation in a known hypertensive patient, looking beyond the obvious: A case of pheochromocytoma coexisting with hypothyroidism","authors":"A. Idowu, A. Mene, O. Salami, T. Ajiro, Daniel Ezuduemoih, C. Inyang","doi":"10.4103/nnjcr.nnjcr_1_19","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_1_19","url":null,"abstract":"Pheochromocytoma is an uncommon tumor arising from the chromaffin cells of the adrenal medulla. It is a potential life-threatening endocrine disorder. We report a case of a 56-year-old woman who presented on account of recurrent episodes of palpitation with frontal headache that was associated with visual flashes and episodic sweating. Abdominopelvic computed tomography scan showed a well-circumscribed homogeneous mass within the left adrenal gland. The urinary metanephrine and normetanephrine were markedly raised, with an assessment of pheochromocytoma made. Pheochromocytoma should be strongly considered in any patient presenting with palpitations and other neurological symptoms after ruling out cardiac abnormalities. It is important to screen for secondary cause of hypertension in a newly diagnosed hypertensive with ultrasound, which is cheap and readily available. Likewise, ambulatory blood pressure monitoring is highly recommended in any patient with strong suspicion of pheochromocytoma but with normal blood pressure to demonstrate the lability in the pattern.","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115681178","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":"A 5-year prospective review of postoperative pain management in Ahmadu Bello University Teaching Hospital Zaria: Challenges and way forward","authors":"Yunus Abdulghaffar, F. Ejagwulu, B. Fomete, A. Obidike, S. Abdullahi, T. Akande","doi":"10.4103/nnjcr.nnjcr_32_18","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_32_18","url":null,"abstract":"Background: Perception of postoperative pain varies. It depends on the type of surgery and the individual involved, which is influenced by race. Postoperative pain, in general, is inadequately managed in developing countries. This study prospectively reviewed the challenges of postoperative pain management in our center, the incidences and other options available for effective postoperative pain management. Methods: Following hospital ethics approval and informed consent, a 5-year prospective review of postoperative pain management was carried out on 3623 patients operated in Ahmadu Bello University Teaching Hospital under subspecialty of general, maxillofacial, orthopedic, and obstetrics and gynecology surgeries, from January 2013 to December 2017. Following the enlightenment of patients about numeric pain score scale, pain scores of the patients that met the inclusion criteria were determined 24 h postoperatively through a predesigned questionnaire. Numeric pain scale was used to ascertain pain intensity and the level of satisfaction following postoperative pain management. The surgeons' and the anesthetic review, as well as the anesthetic chart of the 3623 patients managed, were studied. The incidence of the degree of pain scores was calculated for the different patient's populations. Techniques of anesthesia were also computed. Data were analyzed using Chi-square statistical package. Results: High rate of severe pain incidences was observed. Out of the overall 3623 patients managed within the study period, 42.1% (1525) of the patients reported severe pain. About 43.8% (1587) of patients had moderate pain and only 14.1% (511) of the patients recorded mild pain. Most of the patients [56.1% (2033)] had general anesthesia, while 41.5% (1503) had regional anesthesia. Around 2.4% (87) of the patients had both general and regional anesthesia. Conclusion: Postoperative pain is inadequately managed. There is need for the policymakers to provide intensive intervention on postoperative pain management by considering adequate supply of strong opioids regularly. More so, knowledge of the anesthetists and physicians involved in postoperative pain management need to be improved and updated, especially on the techniques for managing postoperative pain.","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129139533","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":"Willingness to pay for antipsychotic medications in two tertiary health institutions in Nigeria","authors":"Wednesday J Edefo, S. Usifoh, W. Udezi","doi":"10.4103/nnjcr.nnjcr_23_19","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_23_19","url":null,"abstract":"Objectives: Antipsychotic medications availability and affordability enhance patients' compliance and consequently improving their productivity. In Nigeria, where about half the number of her population is impoverished, and health-care cost burden is mostly out of pocket of patients. The study objectives are to determine patients' preference in three antipsychotic medications with different attributes and side/adverse effects and a hypothetical antipsychotics medication with highest efficacy and highest risk, which of the drug's willingness to pay (WTP) price is closer to the actual amount of the medication, as well as the demographic factors that influence WTP of antipsychotic medications. Methods: WTP instrument was administered to 706 consenting patients. The characteristics ranging from efficacy, duration of administration, and possibility of eliciting side/adverse effects of the drugs was provided. A contingent valuation method was used where a virtual market scenario of 20 payment options was presented to the patients with different prices ranging from N 100 ($ 0.33) to NGN5000 (USD16.67). As at the time of this study, $1 (USD) was equivalent to N300.00 (NGN). A linear multivariate analysis was employed to determine the influence of sociodemographic factors on WTP. Results: At most of the given prices, more patients were willing to pay for the hypothetical antipsychotic D. The WTP for all the medications except haloperidol indicated by most of the respondents were above their reference prices. Longer duration of previous treatment, higher educational status, higher income, and stable marital status gave P = 0.001, P = 0.015, P < 0.001, and P = 0.002, respectively. Conclusion: Patients preferred the medication that has the highest efficacy and attendant risk; majority of the patients are willing to pay at a lower price than the prevailing price for all medications used except haloperidol. The duration of previous drug treatment, income, age, education, and marital status significantly affected the WTP of drugs.","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130880661","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":"Cervical cystic teratoma of the neck in a neonate: A case report and literature review","authors":"A. Singh, Ramesh Tanger, Vinay Mathur, Arun Gupta","doi":"10.4103/nnjcr.nnjcr_45_16","DOIUrl":"https://doi.org/10.4103/nnjcr.nnjcr_45_16","url":null,"abstract":"Cervical teratoma is very rare. We are presenting here a case of cervical immature teratoma in a neonate with review of literature. A 17-day-old male baby with huge cervical teratoma and oral extension presented to us with feeding difficulties. We completely excised the tumor. The infant was discharged after 7 days with mild facial palsy. Uneventful recovery followed without recurrence. Histopathology suggested immature cystic teratoma. There was huge cervical teratoma with oral extension in the neonate. It was located at the cervical region which is very rare, and it was present in the male baby. We completely excised the tumor with mild facial palsy without recurrence. It should be kept in mind in case of neck swelling in a neonate. Cervical teratoma is a rare variety.","PeriodicalId":261902,"journal":{"name":"New Nigerian Journal of Clinical Research","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132352780","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}