The Nigerian medical practitioner最新文献

{"title":"Pattern of Serum Electrolytes and Cortisol levels in Nigerians with Uncomplicated Type 2 Diabetes Mellitus","authors":"O. Odusan, A. A. Amballi, B. O. Oduyale, A. Idowu","doi":"10.4314/NMP.V76I1-3","DOIUrl":"https://doi.org/10.4314/NMP.V76I1-3","url":null,"abstract":"Diabetes mellitus (DM) is a metabolic disorder, the commonest endocrine disease with increasing prevalence worldwide. Studies on electrolytes derangement in complicated diabetes abound but there are few in uncomplicated diabetes. To determine, compare and correlate serum electrolytes and Cortisol levels in a cohort of uncomplicated type 2 diabetics. A cross sectional study of sixty (60) type 2 diabetes patients of 5-10 years duration without complications and 50 healthy non-diabetic controls that were recruited from the diabetes and general out-patient clinics of a tertiary care facility over 3 months. Using a study questionnaire, information on age, anthropometry, fasting blood Glucose, serum electrolytes and Cortisol were obtained and analyzed following standard procedures. The mean 2 age (years) of diabetics was 49.58 ( ± 11.2) and controls 47.00 ( ± 12.1) and their BMI (Kg/m )[26.47 ( ± 3.97) vs 25.77 ( ± 4.85) respectively were not significantly different (p=0.524; p=0.407). The Waist-hipratio (WHR) was significantly higher in diabetics [0.933 ± 0.004 vs 0.905 ± 0.83) p=0.024]. The mean values of studied parameters among the diabetics and controls respectively are as follows: fasting blood glucose (FBG) [138.4 ± 78.7 vs 82.5 ± 73.7 mg/dl]; serum electrolytes: Sodium 139.0 ± 8.4 vs 142 ± 4.2mg/dl], Potassium [5.2 ± 1.4 vs 4.1 ± 0.53mg/dl] and Chloride [99.3 ± 6.8 vs 104.5 ± 5.0 mg/dl] with significant differences in each (p=0.000, 0.011, 0.000, 0.000 respectively). The mean serum Cortisol was not statistically different [125.5 ± 43.2 vs 121.5 ± 61.3 ng/mL (p=0.693)]. There was no correlation between the various serum electrolytes and Cortisol levels. Electrolytes imbalance in uncomplicated diabetes are present, with higher potassium and lower sodium than in controls with no accompanying change in Hypothalamus-Pituitary-Adrenal activity as measured by serum Cortisol level. This derangement in electrolyte level may be attributed to hyperglycaemia, osmotic diuresis and dietary habit.Key words: Uncomplicated Type 2 diabetes mellitus, serum Electrolytes, serum Cortisol, Anthropometry.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"62 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79343674","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":"Depression, anxiety, stress and self-esteem among students in Owo, Southwest, Nigeria","authors":"A. Coker, H. I. Okunrinboye, A. Adesokan, J. Azegbeobor","doi":"10.4314/NMP.V75I4-6","DOIUrl":"https://doi.org/10.4314/NMP.V75I4-6","url":null,"abstract":"Communication between primary healthcare workers and paediatricians is important, if we want patients to receive the right type of care at the right moment. The aim of the study is to assess the contents of information of referral letters issued by primary healthcare workers to the children emergency unit. Descriptive cross-sectional analyses of 142 consecutive referral letters from primary healthcare centres during the study period were evaluated according to specific quality criteria. Twofifths of the letters had no deducible identity of the writers. There-quarter of the referral letters that had the identity of the writers known were written by medical officers. Asignificant proportion of the referral letters lack adequate information. The proportion of Good referral letter practice was 2.11%. This study showed that referral letters written from various primary healthcare centres to the children emergency ward of a teaching hospital is generally of unacceptable quality and the content could be improved upon. Keywords: healthcare. emergency, referral, quality","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"19 1","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2019-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82022120","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":"Diversity of rotavirus strains circulating in Maiduguri, Borno State, Northeast, Nigeria","authors":"M. Akinola, A. Uba, A. F. Umar, E. Agbo","doi":"10.4314/NMP.V76I4-6","DOIUrl":"https://doi.org/10.4314/NMP.V76I4-6","url":null,"abstract":"Melkersson Rosenthal Syndrome (MRS) is a rare neurological disorder characterized by swelling of the face, particularly one or both lips (granulomatous cheilitis), facial muscle weakness (palsy) and a fissured tongue. We present a patient with Melkersson Rosenthal Syndrome, highlighting the clinical triad of symptoms and management. A74-year-old Nigerian male presented to the Oral Medicine Clinic of the University of Benin Teaching Hospital for evaluation of right-sided facial numbness, inability to close the right eye, left facial deviation suggestive of a lower motor neuron type facial palsy of 4 days, and painless swelling of the upper and lower lips for seven days. On examination, he was found to have swelling of the upper and lower lips, multiple fissures on the tongue, right facial paresthesia, and an isolated right-sided facial nerve paralysis. He was empirically managed with 50mg prednisone daily for seven days, which was tapered over two weeks and neurobion 1 tablet daily for a month. This resulted in remission of lip swelling, however fissured tongue remained. Two months later, facial deviation had become less apparent. Patient is being followed up in the outpatient clinic. Melkersson Rosenthal Syndrome is a rare disorder with features of facial swelling, facial nerve palsy and fissured tongue. Some affected individuals may have all three of these features and others may have only one or two. The diagnosis of MRS can be made clinically when there is a complete triad of symptoms as reported in our patient.Keywords: Melkersson Rosenthal Syndrome, clinical symptoms, management","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"281 1","pages":"47-49"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79596774","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":"Behavioral management of the pediatric dental patient among clinical dental students and interns","authors":"A. Oguntona, A. Fawole, T. Sobowale","doi":"10.4314/NMP.V74I1-2","DOIUrl":"https://doi.org/10.4314/NMP.V74I1-2","url":null,"abstract":"Anaemic syndrome is a common manifestation of rheumatoid arthritis. Both anaemia of chronic disease and iron deficiency anaemia are present in patients with rheumatoid arthritis. Patients with active rheumatoid arthritis are more like to be anaemic with a high impact on the quality of life. The diagnosis of anaemia of chronic disease is made by exclusion. Treatment of the anaemia consists merely of anti-rheumatic treatment. This was a retrospective study of 34 patients diagnosed of rheumatoid arthritis between July 2013 and June 2016. These were the patients that satisfied the 1987 revised diagnostic criteria of the American College of Rheumatology for the diagnosis of rheumatoid arthritis. Anaemia was diagnosed based on the packed cell level and laboratory analysis of red blood cell morphology. Patients with rheumatoid arthritis were divided into 3 groups; rheumatoid arthritis patients without anaemia, rheumatoid arthritis patients with anaemia of chronic disease, and rheumatoid arthritis patients with iron deficiency anaemia. The laboratory results for packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and mean corpuscular haemoglobin concentration (MCHC) were noted and analyzed. Erythrocyte sedimentation rate and rheumatoid factor results were documented. Five hundred and two rheumatology patients were seen over a period of three years (July 2013 –June 2016). Thirty-four rheumatoid arthritis patients were diagnosed (F-26, M-8) with a female to male ratio of 3.3:1. The age range was 18 to 65 years with a mean age of 45 ± 6yrs. The mean duration of onset at presentation was 5 ±2.6 years, and the mean early morning joint stiffness was 3 ±1.2 hours. The mean swollen and tender joint count was 14 ± 2. Erythrocyte sedimentation rate was uniformly elevated with a mean value of 78 ± 5mm/hr. Rheumatoid factor was positive in 27 patients. Anaemia was predominant in age group 41 to 50 years. The prevalence of anaemia was 70.6%, and anaemia of chronic disease was predominantly seen (70.8%). Among patients with rheumatoid arthritis, the prevalence of anaemia was found to be relatively high. Anaemia of chronic disease was the leading cause of anaemia. The degree of anaemia was closely related to the age and duration of the disease.Keywords: Haemoglobin, iron deficiency, mean corpuscular haemoglobin, anti-rheumatic drugs, rheumatoid arthritis","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"57 6","pages":"12-15"},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72509652","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":"Essential thrombocythaemia: a phenotypic spectrum with polycythaemia vera – a case report","authors":"T. Akingbola, O. Aworanti","doi":"10.4314/NMP.V74I3-4","DOIUrl":"https://doi.org/10.4314/NMP.V74I3-4","url":null,"abstract":"Essential thrombocythaemia (ET) is a non-leukaemic myeloproliferative neoplasm (MPN) associated marked proliferation of the megakaryocytes and elevated platelet count (≥450,000/mm3). This condition is characterized by splenomegaly, vascular complications, thrombotic and / or hemorrhagic clinical course episode. ET despite being a distinct clinical entity presents with characteristic phenotypic spectrum similar to the other non-leukemic MPNs including polycythaemia vera (PV) and primary myelofibrosis (PMF) and are characterized by the involvement of similar genetic drivers. In this report, we present a case of essential thrombocythaemia in a woman previously diagnosed with uterine fibroid and an intractable thrombotic complication. We also highlight the relevance of therapeutic phlebotomy as an important approach for management of thrombotic events.Keywords: Essential thrombocythaemia, Polycythaemia vera, myeloproliferative neoplasm, thrombosis, platelet count","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"9 1","pages":"51-55"},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74469992","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":"Psychiatric morbidity including substance use among HIV/Aids patients at the University of Benin Teaching Hospital, Benin City, Nigeria","authors":"V. Adekoya, A. Oyewole, O. Akinlade, A. Adeyinka, A. O. Coker","doi":"10.4314/NMP.V74I5-6","DOIUrl":"https://doi.org/10.4314/NMP.V74I5-6","url":null,"abstract":"","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"9 1","pages":"62-68"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87436842","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 Six Year Review of Caesarean Sections at Olabisi Onabanjo University Teaching Hospital Sagamu, South West Nigeria","authors":"A. Akadri, O. Odelola","doi":"10.4314/NMP.V7I3-4","DOIUrl":"https://doi.org/10.4314/NMP.V7I3-4","url":null,"abstract":"Caesarean section is one of the most commonly performed major operative  procedures. There appears to be an increase in the rate of caesarean delivery in our environment, the safety of the procedure has also improved over decades. However, the procedure is still associated with some complications. The aim of this study was to determine the rate, indications and complications of caesarean sections in  Olabisi Onabanjo University Teaching Hospital (OOUTH) Sagamu, Ogun State, Nigeria. This was a six year retrospective study of all caesarean deliveries in  OOUTH between January 1st 2009 and December 31st 2014. Relevant informationwas retrieved from the medical records and case notes using a purpose designed proforma. The data was analyzed using IBM-SPSS windows version 21. A total of 1390 caesarean section were performed out of 4219 deliveries during the period of review giving a caesarean section rate of 32.9%. The commonest indication was previous caesarean section (25.2%), followed by obstructed labour (17.0%).  Maternal complications occurred in 23.1% of the subjects with wound infection being the commonest. Birth asphyxia was the commonest foetal complication. This study demonstrates a high caesarean section rate in OOUTH. Efforts geared towards reducing primary caesarean sections by encouraging instrumental delivery in nulliparous women and improving skills in destructive vaginal delivery for  obstructed labour with intrauterine fetal death will assist in reversing the trend.Keywords: Caesarean section rate, Indications, Complications","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"193 1","pages":"53-57"},"PeriodicalIF":0.0,"publicationDate":"2017-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72807748","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":"Histopathological of lymph node biopsies in Lagos, South West Nigeria","authors":"F. Faduyile, S. Soyemi, Oyewole Oo, Oluseun Williams","doi":"10.4314/NMP.V71I1-2","DOIUrl":"https://doi.org/10.4314/NMP.V71I1-2","url":null,"abstract":"Lymph nodes are discrete ovoid lymphoid structures that are widely distributed throughout the body. Lymph node enlargement is a common clinical problem, and biopsies are usually undertaken to determine the cause of nodal enlargement. The aim of this study is to elucidate the pattern of lymph node biopsies seen in Lagos State University Teaching Hospital (LASUTH), Ikeja. This is an 8 year retrospective study of all lymph node biopsies sent to our laboratory between 1st January 2008 and 31st December 2015. All slides were retrieved and reviewed. The demographic data regarding age, sex, provisional diagnosis and site of biopsy were obtained from request forms. The data were analysed using the Statistical Package for Social Science version 21. There were 123 lymph node biopsies seen during the study period with age range of 1- 78 years and male to female ratio of 1.2:1. The first decade recorded the highest samples (17.9%), followed by the 4th decade (17.1%). The cervical region is the most common site biopsied, (41.5%), followed by axillary lymph node (17.1%). Metastasis was the most common diagnosis (26.0%), then tuberculous lymph nodes (22.8%). Metastasis was commonest in females and in the 5th decade while tuberculosis was most common in males and in the 4th decade. Metastasis is the most common cause of lymph node enlargement and seen predominantly in females in the fifth decade of life. Tuberculosis is commonest in fourth decade while lymphoma showed bimodal frequency in first and sixth decade.Keywords: nodal enlargement, metastasis, tuberculosis, lymphoma","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"37 1","pages":"15-18"},"PeriodicalIF":0.0,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75083194","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":"Chronic invasive fungal granulomatous rhino-sinusitis: a case report with review of literature","authors":"N. Awolola, R. Oladele, A. Or, B. Bamigboye, O. Oguntunde","doi":"10.4314/nmp.v72i1-2","DOIUrl":"https://doi.org/10.4314/nmp.v72i1-2","url":null,"abstract":"Fungal Rhino-Sinusitis (FRS) is a relatively uncommon entity. The chronic invasive granulomatous form of FRS (FGRS) is a slowly progressive form of fungal infection characterized by chronic granulomatous process with a time course of longer than 12 weeks. The aim of this report is to draw the attention of colleagues to the clinical presentation and histopathological diagnosis of FGRS of the paranasal sinuses, as differential diagnosis in lesions of the maxillofacial region. We present a 30-year-old Nigerian undergraduate who had a four-year history of right nasal blockage. He also presented with a two-year history of proptosis of the right eye. Clinical and radiological findings were reported to be consistent with nasopharyngeal tumour. A trans-nasal biopsy was, initially, histologically, diagnosed as chronic granulomatous inflammation However, after a second opinion, at our centre, the granulomatous lesion was confirmed. Periodic Acid Schiff (PAS) and Gomori Methenamine Silver (GMS) stains showed presence of numerous septate fungal hyphae, within the giant cells and extracellularly. An assessment of FGRS was made. The patient was commenced on voriconazole, and there was a dramatic regression. Fungal infection should be considered in patients with chronic sinusitis and, if they present late with, orbital apex syndrome. If diagnosed and treated early, there is a rapid response rate. Effective collaboration between the Surgeon, Radiologist, Microbiologist and Histopathologist will ensure early diagnosis.Keywords: Invasive Fungal Granulomatous Rhino-Sinusitis, PAS, GMS, Naso-Pharyngeal Tumor","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"199 1","pages":"16-17"},"PeriodicalIF":0.0,"publicationDate":"2017-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75421444","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 audit of diagnostic tests performed in medical microbiology, and immunology lLaboratories of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria","authors":"B. Oderinde, O. Agbede, U. A. Mohammed, K. Okon, P. Ghamba, As Galdi, S. Zailani, Z. G. Arjinoma","doi":"10.4314/NMP.V72I3-4","DOIUrl":"https://doi.org/10.4314/NMP.V72I3-4","url":null,"abstract":"Clinical audit is an important tool for reviewing and improving the  quality of service in clinical laboratories. This is a three year audit of diagnostic test carried out in Medical Microbiology and Immunology laboratories of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. The objectives were to document and analyze the frequency of test and in relation to monthly and yearly requests, enhance  communication between the clinics and laboratories, review and improve the laboratory services from the outcome. All diagnostic tests requested for the year 2014 to 2016 from laboratory records were grouped base on months and year. The frequency and percentage of both positive and negative test out of the total test requested were calculated. There were 19 and 15 types of tests in Medical Microbiology and Immunology  laboratories respectively. Some tests (HIV Viral Load, HBeAg, and nDNA) have neither been requested nor carried out in the Laboratory for 3-year study period. In addition, high incidence of HBsAg (12.1%) and Mantoux (14.5%) tests. Also high incidence of Malaria parasites (53.7%) was recorded, while, 50.2% for Wound swab/Tissue biopsy, Microscopy-Culture-Sensitivity (MCS) followed by Sputum MCS (45%) were recorded for the mean. This reflects accuracy of clinician judgment in some test and failure in others, prevalence of different diseases, variation in number of test requested for some tests and impact of awareness  campaigns on attitude of clinician toward certain diseases. This will help in planning laboratory services, requirements to improve quality, and capacity development. Key words : Audit, diagnosis, tests, laboratory.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"44 1","pages":"55-62"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73475763","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}