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   Table of Contents - Current issue
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January-June 2022
Volume 19 | Issue 1
Page Nos. 1-92

Online since Tuesday, July 12, 2022

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REVIEW ARTICLES  

A critical review of diet supplementation: The rationale, concerns and guiding principles in modern healthcare p. 1
Abiodun Bamidele Adelowo
DOI:10.4103/njbcs.njbcs_31_21  
There has been a massive surge in the intake of dietary supplements in recent years, with millions of people taking the “magic pills” worldwide, either with the hope of achieving general well-being, treat specific disease, or retard the aging process. Supplementing the diet with multivitamins and minerals (MVMs) has revolutionized modern healthcare, with many “experts” claiming such drugs have a critical role to play in the prevention and treatment of many health conditions. Many are of the opinion that since dietary supplements are mere extracts from certain foods and herbs, so unlike drugs, have no significant side effects, are “all natural,” and are therefore “safe” for a non-medical prescription. The association of the deficiency of some MVMs, such as vitamins C, D, and Zinc, with the increased incidence and progression of COVID-19, has also strengthened the argument in favor of routine diet supplementation. The objectives of this article are to investigate the health and therapeutic claims attributed to some dietary supplements, their safety concerns, and their possible role in modern healthcare. A review of related online free-full articles written in the English language published from 2000 to 2021 was done. While the pharmacokinetics and pharmacodynamics of some dietary supplements are clearly understood and established, others are still shrouded in serious confusions and safety concerns, especially for long-term use. Until more evidence is available, routine intake of dietary supplements should be discouraged, except there are clear medical indications. Rather, all people should ensure they get their required nutrients from whole foods.
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Thyroid Stimulating Hormone (TSH) estimation using point of care testing devices: Pitfalls and opportunities for improvement Highly accessed article p. 8
Mark Onyemaechi Ezegbogu, Clement Uchenna Ugwoke, Zainab Ibrahim, Kabiru Abdulsalam
DOI:10.4103/njbcs.njbcs_47_21  
Since the development of the first Point-of-care Testing device (POCT) in 1962, POCTs have found their way into nearly every facet of laboratory diagnostics due to their rapid turn-around-times, testing convenience, ease of use, and relatively lower costs. This review provides an update on the progress in the development of POCTs for TSH assays while highlighting the challenges of these methods and suggesting ways of overcoming them. To achieve this, a literature search of the appropriate databases (Google Scholar, MEDLINE, Science Direct, and PubMed) was conducted using the keywords: POCT, TSH, hyperthyroidism, and hypothyroidism. Relevant articles were identified, duplicates eliminated, then critically analyzed, and discussed in terms of their relevance to the research questions. The different sensitivities of the POCTs reported in the scientific literature are traceable to the peculiarities of the detection technique adopted and the sensitivity of the immune complex recognition, i.e., labelled versus unlabeled immunoassay methods. The main factors limiting the wide acceptance of POCTs are concerns over their clinical usefulness, accuracy, and data (in)security. Routine assessment of the technical competence of POCT operators and regular quality checks of the performance of these devices are critical to maintaining the clinical usefulness of POCTs in TSH measurement. Finally, further research is required to understand the dynamic expectations of clinicians regarding POCT use in diagnosing thyroid dysfunction especially in low- and middle-income countries where data on this subject is lacking.
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ORIGINAL ARTICLES Top

Evaluation of radiological pattern of HSG in female patients with infertility in Katsina Northwestern Nigeria p. 15
Habiba B Saidu, Mustapha Mohammed, Naimatu A T. Abdullahi, Mohammed A El habeeb, Fatai A Salihu, Habib Ibrahim, Mohammad A Suwaid, Mustapha S Hikima, Abubakar S Sunusi, Maikudi M Haruna, Aliyu M Umar, Mohammed A Hamza, Abdullahi A Sani, Murtala O Abdulwaheed, S Abdulrasheed, SM Abubakar
DOI:10.4103/njbcs.njbcs_34_21  
Context: Hysterosalpingography (HSG), is the radiographic evaluation of the uterine cavity and fallopian tubes after the administration of a contrast medium through the cervical canal. Aims: To determine the pattern of infertility, the risk factors for infertility in women presenting for HSG, and the findings among women with infertility at Federal Medical Centre Katsina. Study Design: Cross-sectional, descriptive study design. Materials and Methods: This was a retrospective study of HSG findings done at the federal medical center Katsina over a 12-month period. Information on the patients was obtained from the Picture Archiving Communication System (PACS) system which includes the presenting clinical history, the age, and the outcome of HSG. Statistical Analysis: Data analysis was performed using SPSS version 23.0. Results: A total of one hundred and forty-four (144) women were examined. Their age ranged from 17 48 years with a mean of 31.2 ± 6.3 years. The most common indication for the procedure was infertility, accounting for 89.6% of all cases. The most common Radiological finding was tubal occlusion (factor), which was seen in 40 patients constituting 28% of the radiological findings. The right tubal occlusion was seen at 11.8% while the left tubal occlusion was seen at 6.9%. Bilateral tubal occlusion was seen in 9.0%. Conclusions: The frequent indication for HSG is infertility and the common finding on HSG was a tubal factor with hydrosalpinx being the frequent cause of infertility in our environment. The right tubal occlusion constitutes a higher percentage than the left. Secondary infertility was more common than primary infertility
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Anticonvulsant effect of flavonoid-rich fraction of ficus platyphylla stem bark on pentylenetetrazole induced seizure in mice p. 20
Madinat Hassan, Sunday Z Bala, Aisha M Gadanya
DOI:10.4103/njbcs.njbcs_33_21  
Context: Epilepsy is characterized by recurrent spontaneous seizures. Several antiepileptic drugs have been used over the years and these drugs have shown serious side effects, thereby prompting the use of medicinal plants to avert the resultant side effects of anti-epileptic drugs. Aim: To evaluate the anticonvulsant effect of the flavonoid-rich fraction (FRF) of Ficus platyphylla stem bark (FPSB) on pentylenetetrazole (PTZ) induced seizures in mice. Study Design: Experimental cohort study. Subjects and Methods: We evaluated the anticonvulsant effect of the flavonoid-rich fraction (FRF) of Ficus platyphylla stem bark (FPSB) on pentylenetetrazole (PTZ) induced seizures in mice by measuring its antioxidant activity in vivo and in vitro and identify possible flavonoids present via Liquid Chromatography Mass Spectroscopy (LC MS) and Fourier Transform Infrared Spectroscopy (FTIR). Statistical Analysis: One way analysis of variance (ANOVA) was used to determine the level of significance at a 95% confidence interval followed by Tukey's multiple comparison test using SPSS software. Result: The FRF of FPSB exhibited weak anticonvulsant activity against PTZ-induced seizure in mice. Maximum anticonvulsant activity (25% protection) was observed at a dose of 100 mg/kg and 200 mg/kg with a delay in the meantime of onset of myoclonic jerks and latency to tonic seizure. The effect of the fraction was found to be dose-independent. The FRF contains a flavanone Astilbin (flavonoid 3 O glycosides) which may have effectuated the high antioxidant activity against 2,2 diphenyl 1 picrylhydrazyl (DPPH) and nitric oxide (NO) while increasing brain glutathione content and decrease in malondialdehyde content. Conclusion: Although the anticonvulsant capacity of FRF on PTZ-induced mice was minimal, this further requires an exploration of other seizure models to ascertain its mechanism of action.
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Clinical characteristics and outcome of pediatric cases managed during the first wave of the Covid-19 pandemic at Ahmadu Bello University Teaching Hospital, Zaria p. 29
Maria A Garba, Abdullahi A Mohammed, Aisha J Mohammed, Sani Musa, Hafsat A Rufai
DOI:10.4103/njbcs.njbcs_26_21  
Context: Over 161 million cases of COVID-19 have so far been confirmed globally with over 3.3 million deaths. An understanding of the local epidemiological characteristics in the pediatric population is necessary to enable proper planning of mitigation strategies. Aim: To describe the clinical characteristics and outcomes of pediatric patients with COVID-19. Setting and Design: We conducted a retrospective study on cases of COVID-19 diagnosed by the real-time polymerase chain reaction of nasopharyngeal samples and oropharyngeal swabs managed during the first wave of the pandemic at the Ahmadu Bello University Teaching Hospital. The severity of illness was graded based on clinical features as classified by the World Health Organization. Statistical Analysis was carried out using IBM SPSS Version 23 (California, USA). Results: Forty-six children met the above criteria. The median age was 7 yrs (IQR = 3.75-12). There were more females than males with Covid-19 infection (M:F = 1:1.55). A third (32.6%) of children were asymptomatic while half (50%) had only mild symptoms. Although school-aged children aged 6-11 years were the most infected (30.4%), more severe disease was seen in infants (25%) and those with co-morbidities. Nasal discharge, cough, and fever were the most common presentation occurring in 34.8%, 32.6%, and 26.1%, respectively. The case fatality rate was 6.5%, all occurring amongst those with comorbidities. Conclusion: COVID-19 infection in children is largely mild or asymptomatic. Symptoms when present are indistinguishable from symptoms of other common viruses causing upper respiratory tract infections. Severe disease and mortality were observed among infants and children with co-morbidities.
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REVIEW ARTICLE Top

Success rate of endotracheal intubation: A comparison of direct laryngoscopy and intubating laryngeal mask airway p. 34
Usman Nasir, Salahu Dalhat, Mamuda Atiku, Abdullahi Mustapha, Adesope Saheed, Ahmad Adam, Abdullahi Mohammad, Ahmed Ado
DOI:10.4103/njbcs.njbcs_70_21  
Context: Direct laryngoscopy (DL) remains the most popular method of endotracheal intubation despite the availability of easier methods like intubating laryngeal mask airway (ILMA)—a blind intubation aid with a high success rate of intubation even when employed by novices. Aim: This study compared the overall success rate of intubation using ILMA and DL during elective surgeries requiring intubation. Study Design: This was a comparative randomized study. Patients and Methods: Following the institutional ethical approval, 86 American Society of Anaesthesiologists physical status (ASA) I and II patients were randomized into DL and ILMA groups. Each received intravenous fentanyl 2 μg/kg, glycopyrrolate 4 μg/kg, intravenous propofol 3 mg/kg, suxamethonium 2 mg/kg to a maximum of 100 mg. Intubation was with DL in the first group and ILMA in the second group. Anesthesia was maintained with isoflurane and muscle relaxation with atracurium. The overall success rate, the success rate at the first attempt of intubation, time for intubation, and airway complications were assessed. Statistical analysis: Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0. The quantitative variables were analyzed using the Student's t-test and qualitative using the Chi-square test. A P value less than 0.05 was considered significant. Results: The success at insertion was 100% in the DL group and 95.3% with ILMA at the first attempt (P = 0.15). The success rate of intubation at the first attempt was 100 and 79.1% in the DL and ILMA groups, respectively. The mean time for intubation was 19.93 ± 6.17 and 46.54 ± 11.63 s in DL and ILMA, respectively (P = 0.001). Six patients (14%) had airway complications in the ILMA group. Conclusion: The overall success rate of intubation via ILMA is comparable to that of DL. In patients with normal airways, DL remains a comparatively faster and easier technique to secure the airway with tracheal intubation than ILMA.
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ORIGINAL ARTICLES Top

The relationship between anthropometric measurements and modified mallampati test in patients with chronic obstructive pulmonary disease p. 39
Songul Cuglan, Evren Köse, Talat Kılıc, Murat Ögetürk, Deniz Senol, Davut Özbağ, Cemil Colak, Hilal Irmak Sapmaz
DOI:10.4103/njbcs.njbcs_44_21  
Context: The modified Mallampati test (MMT) is one of the most common examination methods to predict possible intubation problems. Aim: The present study aims to investigate the relationship between anthropometric measurements and the MMT in patients with chronic obstructive pulmonary disease (COPD) during the exacerbation period (COPD-E) and stable period (COPD-S). Materials and Methods: The present study included two groups of participants that consisted of 107 healthy individuals in the control group and 107 patients who were diagnosed with COPD (patient group). Two measurements were taken from the patients during the exacerbation and stable periods. The MMT, body mass index (BMI), face height, thyromental distance, and sternomental distance were measured and recorded. Statistical Analysis Used: Data collected were analyzed using the SPSS Statistics for Windows, version 22.0. Results: In the COPD-E period, the MMT score increased, whereas the face height value decreased (P = 0.030). During the COPD-S period, it was found that the higher BMI values were related to higher MMT scores (P = 0.025). The MMT score increased significantly during the COPD-S period, whereas the thyromental distance values decreased (P = 0.034). Conclusion: It is considered that the low face height value in the COPD-E period, the increase in the BMI, and the decrease in the thyromental distance in the COPD-S period could increase the difficult intubation possibility. The results of the present study which may lead to progression in the COPD database would contribute to the clinicians.
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Burden and management of urolithiasis in a newly established urology unit of a tertiary hospital p. 44
Muzzammil Abdullahi, Muhammed Mustapha Kura, Makama Baje Salihu
DOI:10.4103/njbcs.njbcs_28_21  
Background: Urolithiasis is the third most common affliction of the urinary tract that constitutes a significant burden on the practice of urology. The incidence and prevalence of urolithiasis are increasing globally. Objective: To assess the burden, presentation, and management of urolithiasis in our hospital. Materials and Methods: It was a retrospective descriptive study of patients who were managed for urolithiasis at the urology unit of our hospital between January 2015 and December 2019. Ethical approval was obtained. Patients' bio-data, clinical features, treatment, and complications were extracted from their medical records and entered into the proforma. The generated data were analyzed using SPSS version 21.0. Results: Complete medical records of 68 patients were retrieved. This constituted about 40.6% of urologic patients managed within the period. Their age ranged from 9 to 86 years with the mean age of 43.2 years ± 8.8 standard deviation (SD). The M F was 1.8:1. Students were predominant (29.4%). Others were traders, housewives, civil servants, and farmers. The majority of the patients presented with flank pain (64.7%) and mostly had renal pelvis stone (35.3%). Others had bladder stone (16.2%) and stag horn calculus (11.8%). Nearly all our patients were treated by open surgeries (98.5%) and most (72.1%) did not have any postoperative complication. Conclusion: Urolithiasis constitutes significant workload for urologists in our environment predominantly affecting young and middle-age males. The stones were predominantly in the upper urinary tract with a significant number of stag horn calculi. Despite the non-availability of uroendoscopic facilities, the majority of our patients had good outcome.
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Pattern of substance abuse in Northwestern Nigeria: A laboratory survey in an urban community p. 48
Sanni Musa, Zainab Uba Ibrahim, Idris Ainavi Isah, Kabiru Abdulsalam
DOI:10.4103/njbcs.njbcs_43_21  
Context: Available information indicates that substance abuse poses a major political, social, and health challenge worldwide. Availability of drugs, negative peer pressure, poverty, and frustration are among the factors that increase the burden of substance abuse. Urine drug testing (UDT) is a reliable laboratory method of analyzing substances of abuse because many drugs and their metabolites remain detectable in the urine for longer periods. Aims: To detect the laboratory pattern of substance abuse among youths in North-Western Nigeria and to make recommendations based on the overall pattern to curtail the effect on society. Settings and Design: A retrospective cross-sectional survey of secondary data of patients who presented to a clinical laboratory for urine drug tests. Methods and Material: Trained personnel carried out a supervised collection of fresh urine samples, which were analyzed using a qualitative immunoassay technique. The presence of a drug was determined by reaching the drug's limit of detection. Statistical Analysis Used: Data were analyzed using a Statistical Package for the Social Science (SPSS) version 2 software. Results: The screen prevalence of substance abuse was 60.9%. Among those who tested positive, 97% were males, whereas 3% were females. The majority of participants were youths below 30 years of age. The observed pattern revealed a few of the participants (26.48%) had only one drug substance present in their urine, whereas 73.53% tested positive for multiple substances ranging from two to five drugs in a urine sample. Conclusion: A high prevalence of substance abuse was observed and most of the participants were multidrug users.
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Sonographic evaluation of liver dimension among apparently healthy pediatrics in Kano Metropolis, Nigeria p. 53
Mohammed Sidi, Ahmad S Idris, Aliyu A Hassan, Umar Mansur, Hassan Muhammad, Adamu Yakubu
DOI:10.4103/njbcs.njbcs_7_21  
Context: Establishing normal liver size is critical in the diagnosis and determining the treatment method for the underlying liver pathology. Aims: This study aimed at evaluating liver dimensions of apparently healthy pediatrics using ultrasonography in Kano metropolis, Nigeria. Settings and Design: This cross-sectional study was conducted in Kano Metropolis, Nigeria, from May 2020 to August 2020. Materials and Methods: Four hundred and twenty-six apparently healthy pediatric subjects; 213 males and 213 females. The liver was examined with the patient in the supine position, the anteroposterior liver dimension was obtained in a transverse plane through the mid clavicular line from the hepatic dome to the inferior angle. Cranio-caudal liver dimension was obtained in a longitudinal plane with an oblique beam at the level where the widest diameter was demonstrated. Statistical Analysis: Both descriptive inferential statistics were employed for the data analysis. Statistical Package for the Social Sciences Version 23.0 was used for the data analysis and P < 0.05 was considered significant. Result: The mean cranio-caudal liver dimension for male and female subjects were 9.28 ± 2.18 cm and 9.17 ± 2.19 cm, respectively, while the mean antero-posterior liver dimension for male and female subjects was 6.87 ± 1.92 cm and 6.74 ± 1.90 cm, respectively. A statistically significant difference between pediatric age groups was observed (p ≤ 0.001). However, there was no statistically significant difference in cranio-caudal and antero-posterior liver dimensions between male and female subjects (p ≥ 0.10, 0.24, 0.66, 0.30, 0.92, 0.33, and P ≥ 0.11, 0.79, 0.69, 0.45, 0.81, 0.29 for the respective pediatric age groups), respectively. Conclusion: References values for pediatric cranio-caudal and antero-posterior liver dimensions were established.
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Diphtheria outbreak during Covid-19 pandemic in Katsina, North-Western Nigeria: Epidemiological characteristics and predictors of death p. 59
Olayinka R Ibrahim, Ibrahim M Lawal, Bashir Mohammed, Suleiman Bello Abdullahi, Surajudeen O Bello, Amudalat Issa, Abdallah Sanda, Bello M Suleiman, Mu'uta Ibrahim
DOI:10.4103/njbcs.njbcs_35_21  
Context: The impact of coronavirus disease 2019 (COVID-19) pandemic on vaccine-preventable diseases, including diphtheria, may hamper the previous gains made in the eradication of the disease. Aims: We report the epidemiological profile, clinical features, laboratory findings, and hospitalization outcomes amongst cases of diphtheria managed at Federal Medical Centre, Katsina, Nigeria during the first wave of COVID-19 pandemic. Settings and Design: This was a retrospective review of cases of diphtheria managed between July and December 2020. Methods and Material: We extracted the clinical (socio-demographics, clinical features, and hospitalization outcomes) and laboratory findings (full blood counts, electrolytes, urea and creatinine) from the record of the children. Statistical Analysis Used: Using SPSS, we carried out a descriptive analysis and applied binary logistic regression to determine factors associated with death. Level of statistical significance was set at P < 0.05. Results: A total of 35 cases of diphtheria were admitted and managed from 1 July to 31 December 2020. The mean age of the children was 7.6 ± 3.1 years. Males were 15 (42.9%). There were 24 deaths (case fatality of 68.6%). Clinical findings were comparable between survivors and non-survivors except the bull neck, which was more common among non-survivors (P = 0.022). The median duration of hospitalization was shorter in those that died (P = 0.001). The age, sex, immunization status, leukocytosis, and biochemical features of renal impairments were not predictive of deaths. Prescence of bull neck was predictive of death (adjusted odds ratio 2.115, 95% CI 1.270, 3.521). Conclusions: The study shows a high number of cases of diphtheria over a short period of six months with high mortality. Amongst the clinical and laboratory variables, only presence of bull neck was predictive of death.
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Efficacy of ultrasonography in the diagnosis of dento-maxillofacial swellings among an urban population in Nigeria p. 66
Yahuza Mansur Adamu, Maryam Olaitan Hassan, Mohammed Abba, Olushola Amole, Idris Garba, Akintade Dare
DOI:10.4103/njbcs.njbcs_5_21  
Context: Ultrasonography as an imaging modality in dentistry has been explored in recent years. It is particularly useful in the examination of superficial structures where the use of a high frequency linear transducer produces clearer sonographic images. Aim: To evaluate the efficacy of ultrasound when compared with other known diagnostic examinations. Materials and Methods: This was a prospective cross-sectional study involving patients with maxillofacial swellings in Aminu Kano Teaching Hospital. They were classified as malignant neoplasms, benign cysts, abscesses and infections and lymphoma, according to clinical, radiographic and ultrasound and diagnosis independently. The findings from these methods were then compared to the gold standard histologic findings. Chi-square test, Pearson contingency coefficient, and 2 x 2 contingency table were used in evaluating the diagnostic accuracy, sensitivity as well as the specificity of the examinations. Results: A total of 36 patients comprising 21 males and 15 females with mean age of 34.97 years were recruited. Diagnostic accuracy of ultrasound was 50% in the diagnosis of malignant tumors, 95.8% in benign cystic swellings, 50% in abscesses and infections, and 100% in lymphoma. Significant relationship exists between ultrasonography with histology, clinical and radiographic diagnosis with a contingency coefficient of 0.833, 0.759, and 0.798, respectively. Overall, the accuracy, sensitivity and specificity of ultrasound was 86.1%, 90.3%, and 60%, respectively. Conclusion: Ultrasonography provides accurate imaging of the maxillofacial region and provides information about the pathological characteristic of lesion, its extent, and relationship with the surrounding structures. Inclusion of ultrasonography to the clinical and histopathological examinations increases the accuracy of orofacial swelling diagnosis.
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Sonographic evaluation of renal volume and its correlation with estimated glomerular filtration rate among hypertensive kidney disease patients in Kano, Nigeria p. 71
Suleiman Alhassan, Kabir Isyaku, Abdu Hamisu Dambatta
DOI:10.4103/njbcs.njbcs_53_21  
Context: Glomerular filtration rate (GFR) is one of the various indicators used to assess the degree of chronic kidney disease and it is considered the best marker for the estimation of renal function. Ultrasonography has become the standard imaging modality in the investigation of renal diseases due to its noninvasive nature and availability. Aims: This study was aimed at sonographically evaluating renal volume and correlating it with estimated GFR among hypertensive kidney disease patients in Kano, Nigeria. Settings and Design: This was a cross-sectional study conducted among adults with hypertensive kidney disease at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria from September 2019 to March 2020. A convenient sampling method was employed and included 242 adults with hypertensive kidney disease in a hypertensive group and 242 normotensive participants in a control group. Materials and Methods: Renal dimensions were measured sonographically. The eGFR of each participant was estimated and recorded. Statistical Analysis Used: The data were analyzed using SPSS Inc, USA version 22. The preset P value was 0.05. Results: The renal volumes in the hypertensive group were 91.5 ± 29.3 cm3 and 103.2 ± 39.6 cm3 for right and left kidneys, respectively, while those of normotensive group were 131.43 ± 34.89 cm3 and 168.49 ± 45.83 cm3 for right and left kidneys, respectively. In the hypertensive group, moderate positive correlations were observed between left kidney volumes and eGFR (r = 0.4; P = 0.001). However, a weak positive correlation was observed between the right kidney volumes and eGFR (r = 0.3; P = 0.001). Conclusion: Renal volume was higher in the control group than in the hypertensive group. There was a moderate positive correlation between the left kidney and eGFR; however, a weak positive correlation was obtained between the right kidney and eGFR.
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Prevalence and antifungal susceptibility of Candida species isolated from HIV seropositive women attending gynecological clinic in Kaduna, Nigeria p. 79
Matthew C Taingson, Oluwafemi Ige, Joel Adze, Stephen Bature, Amina Mohammed Durosinlorun, Caleb Mohammed, Amina Abubakar, LR Airede
DOI:10.4103/njbcs.njbcs_21_21  
Context: Candidal vulvovaginitis causes discomfort and increased HIV infectivity because viral shedding is increased among these women. Aim: To determine the prevalence of Candida infections among HIV seropositive women in the special treatment (STC) and the gynecological clinics of Barau Dikko Teaching Hospital and the antifungal susceptibility patterns of the isolates. Study Design: We conducted a cross-sectional study among HIV-positive women accessing care in our hospital. Methods and Materials: A total of 312 high vaginal swabs (HVS) were collected from HIV seropositive women with clinical features of vulvovaginitis between February and July 2019. Wet mount preparations in potassium hydroxide (KOH) and Gram stained smears were performed directly on specimens. Cultures for Candida species were performed using Sabouraud dextrose agar (SDA) (Oxoid, UK) at room temperature (28°C) and in the incubator at 37 °C. Antifungal susceptibility of the Candida species to amphotericin B, clotrimazole, fluconazole, and miconazole was assessed using the ATB FUNGUS 4 test kits (bioMerieux, Marcy l'Etoile, France). Statistical Analysis Used: Data collected were analyzed using SPSS, Version 23. Results: Out of the 312 HVS cultured, 40 yielded Candida species giving a point prevalence of 12.8% in the study population. Candida species isolated from HVS specimens were Candida tropicalis (n = 14, 4.5%), Candida glabrata (n = 13, 4.2%), Candida krusei (n = 11, 3.5%), Candida dubliniensis (n = 1, 0.3%), and others C. glabrata/C. tropicalis (n = 1, 0.3%). Susceptibility of the isolates to antifungal agents ranged from 27.5% to 52.5%. Amphotericin B was the best performing antifungal agent with a sensitivity of 52.5%. Conclusion: The prevalence from our study was low compared to other studies among HIV seropositive women.
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CASE REPORTS Top

Gynatresia with cryptomenorrhea following cesarean section after failed vacuum extraction: Case report in a 26-year-old woman p. 84
Joel A Adze, Stephen B Bature, Amina Mohammed Durosinlorun, Mohammed Caleb, Matthew C Taingson, Suleman O Moroof
DOI:10.4103/njbcs.njbcs_15_21  
Acquired Gynaetresia is underreported in developing countries and is usually due to harmful cultural practices. It may result from obstructed labor or labor trauma. This is a rare case report of a 26-year-old P1 + 0 who presented with no penetration during coitus and history of amenorrhea about 1 year and 7 months after cesarean delivery. Failed attempts at vacuum extraction were made before surgery. She was investigated and a diagnosis of Gynaetresia with cryptomenorrhea was confirmed. She had vaginoplasty and menstrual and sexual functions were established. Postpartum genital examination should be ensured, no matter the mode of delivery to ensure Gynaetresia is diagnosed early and managed promptly.
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Cross testicular ectopia: A report of 4 cases p. 87
Lawal Barau Abdullahi, Mohammad Aminu Mohammad, Lofty-John Chukwumeka Anyanwu
DOI:10.4103/njbcs.njbcs_35_20  
Cross testicular ectopia is an extremely rare congenital anomaly affecting male children. It is a deviation of testicular descent resulting in unilateral location of both testes which poses a problem in diagnosis and treatment among clinician in the world. Over a period of 4years 4 cases of testicular ectopia were managed by our unit. All of our patients presented as outpatient. The record of their presentation, surgical management and the outcome of the treatment were studied and documented. The age ranges between 2 to 6years. All of the patients had trans septal orchidopexy as a day case surgery. Cross testicular ectopia is rare congenital urologic condition but the outcome of its management seem to be good, however long term follow up is required to evaluate the testicular function.
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Post-COVID-19 infection; paediatric multisystemic inflammatory syndrome in an 8-month-old infant p. 90
Halima Adamu, Aisha Musa Zaidu, Umar Abba Sabo, Lawal Bashir, Umar Isa Umar
DOI:10.4103/0331-8540.350719  
The coronavirus disease 2019 (COVID-19) associated with multisystem inflammatory syndrome in children and adolescents is an emerging challenge and has been described as a new dangerous childhood disease that is temporally associated with COVID-19. An 8-month-old infant presented with unrelenting fever of 2 weeks, associated non-purulent conjunctivitis, redness of the lips and tongue, as well as tenderness, swelling and desquamation of the palms and digits and diarrhoea. She also had associated irritability, refusal to feed and poor sleep. She had positive polymerase chain reaction (PCR) COVID-19 test 3 months earlier. However, a repeat PCR test was negative at presentation. She had raised erythrocyte sedimentation rate of 85 mn/h, good systolic function on echocardiogram with normal rhythm electrocardiogram. She was diagnosed with post-COVID-19 paediatric multisystemic inflammatory syndrome and treated with intravenous immunoglobulin, oral prednisolone and aspirin. Patient symptoms improved significantly after 72 h of treatment. Therefore, a high index of suspicion is required in all children presenting with unexplained fever.
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