The Nigerian medical practitioner最新文献

{"title":"Women’s Issues and Epilepsy: A Look at Health Care Practitioners","authors":"T. Sunmonu, M. Komolafe, O. Afolabi, O. Ogunrin, S. Ogun","doi":"10.4314/NMP.V57I3.55753","DOIUrl":"https://doi.org/10.4314/NMP.V57I3.55753","url":null,"abstract":"Previous reports from developed countries indicated that health care professionals had poor knowledge of women’s issues and epilepsy and the women with epilepsy may not be adequately informed about their illness. Health care professionals that attended the 18th Pan African Association of Neurological Sciences in Yaounde, Cameroun were asked to complete the knowledge of women issues and epilepsy (KOWIE) II questionnaire. A total of 55 health care professionals participated in the survey. 67.3% were males while 32.7% were females. The mean age of the respondents was 39.35 (+12.07) years. About thirty six percent of the respondents were neurologists, 27.3% were in Internal Medicine while the rest comprised of general practitioners, pediatric neurologists, neurosurgeons, neuroscience nurses and neurophysiologists. There was poor knowledge of the effect of sex hormones on seizure threshold during menstrual cycles while only one fourth of the respondents were aware of the high incidence of sexual dysfunctions in women with epilepsy. About half of the respondents were aware of the deleterious effect of antiepileptic drugs on bone health. Their knowledge was better on pregnancy related issues such as the importance of administration of vitamin K to neonates of women with epilepsy to prevent haemorhagic disease of the newborn, the need for women with epilepsy to continue anti-epileptic drugs during pregnancy. More than half of the respondents were aware that the best antiepileptic drugs in pregnancy is the one that is most appropriate for the patients seizure type or syndrome. However there was no relationship between the number of years in practice or the number of patients seen per month by the respondents and the survey accuracy score. But the specialty of the respondents influenced the survey score as the paediatric and adult neurologists had the highest survey accuracy score. This study showed that the paediatric and adult neurologists were better informed on women’s  issues and epilepsy than other clinical neuroscientists.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84869700","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":"Premarital screening for sickle cell haemoglobin: awareness and acceptability among some categories of Health Professionals and Medical Students at the Lagos University Teaching Hospital.","authors":"B. Animasahun, Co Akintoye, U. Nwodo, O. Njokanma","doi":"10.4314/NMP.V57I4.57941","DOIUrl":"https://doi.org/10.4314/NMP.V57I4.57941","url":null,"abstract":"Urinary tract infection (UTI), a significant but preventable cause of morbidity in children, is an important risk factor for development of renal insufficiency. Having simple and reliable means of screening children facilitate its prompt treatment.To evaluate the use of dipstick test for leukocyte esterase (LE) and nitrite as screening tool in the diagnosis of UTI in children.This cross-sectional study was done in the department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH) from February to October 2005. Children 2 to 15 years with symptoms suggestive of UTI were studied. Midstream urine specimen was collected from each patient forLEtest, nitrite test and culture.Out of 139 children, 72(51.8 percent) males and 67(48.2 percent) females studied, 33(23.7 percent) had positive urine culture. The prevalence of UTI was significantly higher in females than in males (p=0.001). The LE dipstick test correctly identified 17 of the 33 patients with culture proven UTI, with 51.5 percent sensitivity and 79.2 percent specificity. The nitrite dipstick test showed 42.4 percent sensitivity and 93.3 percent specificity. The combination ofLEand nitrite correctly identified 24, giving 73 percent sensitivity and 75.5 percent specificity. The LE seemed to have a higher sensitivity as a screening tool in the diagnosis of UTI than nitrite, but the difference was not statistically significant (p=0.46). However, the combination of LE and nitrite provided a higher sensitivity than either of them with a statistically significant difference (p=0.04). Keywords: Sickle cell anaemia, premarital screening, Haemoglobin genotype.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89620597","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":"Clinicopathological Analysis of Primary Ovarian Cancers in A Tertiary Health Facility In Nnewi, South Eastern, Nigeria","authors":"A. Igwegbe, J. Ugboaja","doi":"10.4314/NMP.V57I3.55749","DOIUrl":"https://doi.org/10.4314/NMP.V57I3.55749","url":null,"abstract":"Next to cervical cancer, ovarian cancer is responsible for most gynaecological cancer death and ill health in Nigeria. However, its management still poses tremendous challenge to the gynaecologist due to late presentation. Over a period of ten years (January 1999 to December 2008) 76 patients presented with carcinoma of the ovary at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. The case files of 70 patients were available and were analysed retrospectively. Ovarian cancer accounted for 76 of the 317 gynaecological malignancies treated in the hospital giving an incidence of 24.0% of all gynaecological cancers. The mean age of the patients was 51.2±1.2 while the modal age group was 50 - 59 years (28.6%). Most of the patients were grandmultiparous (54.3%) and belonged to social classes I (28.6%) and II (20.0%). Abdominal swelling (85.7%), abdominal mass (74.3%), abdominal pain (71.4%) and weight loss (60.0%) were the common presenting features. Majority of the patients (57.1%) presented in stage iv. Serous adenocarcinoma (46.9%) was the commonest histological type found and was followed by mucinous adenocarcinoma (28.1%). Sixty eight (97.1%) of the patients had surgery (cytoreduction) with chemotherapy while 2 patients received chemotherapy only. Sepsis/ wound breakdown (17.2%) and haemorrhage (14.1%) were the main postoperative complications encountered. Following treatment, thirty three (47.1%) of the patients were lost to follow up while Eighteen (25.7%) patients died during the follow up period. We advocate public sensitization and awareness among medical practitioners for early detection, and improved treatment outcome. Key words: ovarian cancer, clinicopathological analysis, Southeast Nigeria","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76122604","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":"Intussusception in Infants, Experience from Lagos, Nigeria","authors":"B. Olayiwola, I. Fadeyibi, P. Jewo, N. Sanyaolu, M. Bankole","doi":"10.4314/NMP.V55I5.45436","DOIUrl":"https://doi.org/10.4314/NMP.V55I5.45436","url":null,"abstract":"Worlwide, intussusception is a fairly common surgical emergency in infants. They often present in ways that mimmick dysenteric diarrheoa, and accurate diagnosis requires both an awareness of its modes of presentation and a healthy index of suspicion. We reviewed and analysed several epidemiologic and clinical parameters as well as management options in cases of intussusception in infants and children treated at the Lagos State University Teaching Hospital between January 2006 and December 2006. There were 33 cases in all. All of them had operative management. The commonest type was ileo-colic intussusception (91%). There was no definite pathologic lead point but enlarged Peyer’s patches were noticed in 5 cases. Delay in diagnosis and referral from various centers was apparent as 23 cases (69.7%) presented beyond three days of onset of symptoms. Manual operative reduction was possible in 50% of cases who presented beyond 5 days of onset of symptoms. There was one unusual case of post operative jejuno-jejunal intussusception after an initial operative manual reduction of ileo-colic intussusception. 36% of the patients that presented more than 72hours after the onset of symptoms required bowel resections, on account of vascular compromise of the intussusception. Yet there was no mortality in this series. Late presentation of patients with intussusception is still quite common in our environment, increasing complications in these cases. However by a combination of aggressive fluid resuscitation and close monitoring prior to surgery, we have been able to manage these cases and achieve good results.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87215942","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":"The Effects of Antiretroviral Drugs on the Lipid Profile in HIV Patients","authors":"Vc Odo, S. Ocheni, M. Ugonabo","doi":"10.4314/NMP.V55I6.45442","DOIUrl":"https://doi.org/10.4314/NMP.V55I6.45442","url":null,"abstract":"The lipid profiles of 40 HIV-seropositive patients were studied. Twenty of them received anti-retroviral drugs while the remaining 20 did not. Elevated levels of serum total cholesterol (6.6±0.3mmol/l), low density lipoprotein (LDL) (5.3±0.4mmol/l) and triglycerides (3.4±0.3mmol/l) were found in HIV-infected patients who received anti-retroviral therapy compared to the patients who did not receive treatment. Serum high density lipoproteins (HDLs) (0.7±0.1mmol/l) were significantly decreased in HIV-infected patients who received antiretroviral therapy compared to those who did not receive anti-retroviral drugs. Although antiretroviral therapy has significantly reduced the morbidity and mortality associated with HIV infection, they are associated with reduced levels of beneficial HDLs and increased levels of harmful LDLs, predisposing patients to increased risks of heart disease. Efforts should be made to aggressively manage these side effects of antiretroviral therapy.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78230322","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":"Airway Management Dilemma in a Patient with Maxillofacial Injury","authors":"O. Oyedepo, B. Bolaji","doi":"10.4314/nmp.v55i5.45439","DOIUrl":"https://doi.org/10.4314/nmp.v55i5.45439","url":null,"abstract":"A 35year old male presented at the Accident and Emergency room of our hospital with partial upper airway obstruction, dysphonea and inability to lie supine following multiple facial injuries from assault. Clinical examination revealed a young man with avulsed floor of the mouth, comminuted fracture of the mandible, ragged laceration of the lower lip and the tongue. The patient could not assume the supine position as any such attempt resulted in immediate airway compromise. He had tracheostomy and repair of the laceration under general anaesthesia. Anaesthesia was induced with intravenous ketamine with the patient in the left lateral position while traction on the tongue using a Magill’s forceps ensured patency of the airway. A classical laryngeal mask airway was subsequently inserted to manage the airway to enable a surgical airway and repair. The patient was discharged home in a satisfactory condition, six weeks after surgery.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72408549","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":"Surgical Pathology of the Appendix in a Tropical teaching Hospital","authors":"F. Abdulkareem, D. Awelimobor","doi":"10.4314/NMP.V55I3.45427","DOIUrl":"https://doi.org/10.4314/NMP.V55I3.45427","url":null,"abstract":"Acute appendicitis is the most common cause of acute surgical abdomen requiring emergency surgery both in developed and developing countries. Appendicectomies in patients presenting with clinically suspected acute appendicitis show a diversity of pathologies. The aim of this study is to evaluate the frequency and types of pathologies seen in appendicectomy samples in Lagos. This is a retrospective histopathological review of slides and paraffin embedded blocks of all appendicectomies received from within and outside the Lagos University Teaching Hospital. The clinical data such as the age, sex and clinical summary were extracted from the request forms. A total of 299 cases of appendicectomies were received during the 8-year period representing 1.7% of all biopsies. There were 164 males and 135 females with M: F ratio of 1.2:1. The ages ranged between 2months and 70years with a mean of 24.2 (SD-12.9). One hundred and eighty-seven out of 266 cases removed for suspected acute appendicitis (70.3%) showed histological evidence of acute appendicitis, 57(30.5%) of which had perforated. Fourty-eight cases (19%) showed reactive lymphoid hyperplasia, 11(4%) had evidence of extra-appendiceal peritonitis. Negative appendicectomy was recorded in 27/ 266(10.2%) Unexpected pathologies such as granulomatous inflammation and neoplastic lesions were recorded in 6 cases (2%). In conclusion, diagnostic accuracy of appendicitis, perforation rate and negative appendicectomy rate in Lagos are comparable with what has been reported in other parts of the world. Other unexpected pathologies were present in 2% underscoring the need for routine histopathological examination of all appendiceal samples.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76582844","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":"Frequency and Pattern of Acute Myocardial Infarction in the University of Benin Teaching Hospital, Nigeria","authors":"V. Joseph","doi":"10.4314/NMP.V55I6.45440","DOIUrl":"https://doi.org/10.4314/NMP.V55I6.45440","url":null,"abstract":"Acute myocardial infarction has been regarded as one of the rarest cardiovascular diseases in the African continent. Recent findings have shown that the incidence is on the increase. To provide more information on the burden of this deadly disease in Nigeria and in the West African sub –region. This study is a 10 - year retrospective study of the frequency and presentation of acute myocardial infarction in the University of Benin Teaching Hospital (UBTH), in Benin City, Nigeria, from January 1998 to December 2007. Twenty-six patients with acute myocardial infarction were admitted into the UBTH within the period of study giving a frequency of 0.4/10,000 hospital population. The average number of patients presenting with this condition increased over the years. The most common risk factors among them were hypertension, hyperlipidemia, age, social class, obesity, high BMI, reduced physical exercise and significant alcohol intake, in order of decreasing frequency. Extreme weakness, sweating, left ventricular failure and severe chest pain were the commonest clinical features in order of decreasing frequency. Q-wave infarct was present in 10(38.5%) cases. Myocardial infarction will not continue to be rare in Nigeria and in Africa.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87360546","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":"Maternal Risks Factors and Delivery Outcome of Fetal Macrosomia in Zaria, Northern Nigeria","authors":"M. Abdul, S. Nasir, S. Shittu, S. Adaji","doi":"10.4314/NMP.V55I4.45434","DOIUrl":"https://doi.org/10.4314/NMP.V55I4.45434","url":null,"abstract":"Although macrosomia may be associated with adverse maternal and perinatal outcome there is paucity of recent data regarding fetal macrosomia in our setting. This study was undertaken to document the prevalence and risk factors associated with fetal macrosomia and also to determine the maternal and perinatal outcome associated with the condition in Ahmadu Bello University Teaching Hospital Zaria, Nigeria. The study was a cross sectional comparative study that was carried out over a five year period (Jan 2001-Dec 2005). Case records of 207 mothers of macrosomic infants (cases) and records of 220 mothers of normal birth weight infants (control) were reviewed. Fetal characteristics such as sex, birth weight, and perinatal complications were also analyzed and compared between the two groups. The prevalence of fetal macrosomia from the study was 4.2%. There was strong association between diabetes mellitus, previous history of macrosomia, gestational age of > 40 weeks, male infant sex and a body mass index at booking of > 30 with fetal macrosomia. Maternal parity was found not to be significantly associated with fetal macrosomia. Labour was significantly prolonged, and there was associated prolonged hospital stay, primary postpartum haemorrhage and genital tract laceration in women with fetal macrosomia. The incidence of caesarean section was three times more in mothers with macrosomic infants compared to mothers with normal weighed infants. There was no maternal mortality recorded. The mean Apgar score at 1 and 5 minutes was not statistically different in the two groups. The stillbirth rate in the macrosomic infants was 4.8% compared with 2.3% among normal weighed babies. It can be concluded that macrosomia is a relatively common complication of pregnancy in our setting and is associated with maternal factors such as obesity, diabetes, previous macrosomia, prolonged pregnancy and adverse perinatal outcome. Identifying the risk factors to fetal macrosomia during antenatal period will be useful to plan appropriate delivery management to optimise good perinatal and maternal outcome.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78913999","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":"Urinary Tract Infection in Children with Acute Glomerulonephritis in Kano","authors":"S. Adeleke, M. Asani","doi":"10.4314/NMP.V55I6.45443","DOIUrl":"https://doi.org/10.4314/NMP.V55I6.45443","url":null,"abstract":"This is a prospective study of 47 cases of acute glomerunephritis seen in paediatric ward of Aminu Kano Teaching Hospital, Kano over a 5year period; they were evaluated for prevalence of urinary tract infection, urine specimen were obtained by midstream urine following careful cleaning of the orifices with chlorhexidine. Urine was collected from children less than 2years by suprapubic aspiration. Urine culture specimen was collected in sterile bottles and was processed within 24hours of collection. Specimen was incubated on sheep agar for 48hours. Antibiotic sensitivity studies were done using disc diffusion technique. There were 25(53.2%) males and 22(46.8) females giving male to female ratio of 1.1:1. The mean age (+SD) of the children was 6.4 + 0.1years. The prevalence of urinary tract infection was 34%. Although the incidence of UTI was higher in females (41%) than in males (16%), the difference was not statistically significant (x2 = 2.2, P>0.05). Escherichia coli (62.5%), Klebsiella pneumoniae (25%) and Staphylococcus aureu s (12.5%) were the commonest bacterial isolates. These bacterial isolates demonstrated appreciable invitro sensitivity to ofloxacin, ceftriaxone and genticin. It is therefore important to screen for UTI in children presenting with glomerulonephritis.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"554 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91179426","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}