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   2013| July-December  | Volume 10 | Issue 2  
    Online since December 7, 2013

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Prevalence of hepatitis B and C virus infections among HIV-infected patients in a tertiary hospital in North-Western Nigeria
Muhammad Hamza, Adamu Alhaji Samaila, Ahmad Maifada Yakasai, Musa Babashani, Musa Muhammad Borodo, Abdulrazaq Garba Habib
July-December 2013, 10(2):76-81
Introduction: Infections from HIV, Hepatitis B and to some extent Hepatitis C viruses constitute a major public health challenge in sub-Saharan Africa, and there are evidences to suggest that there is faster progression of HIV in those co-infected with either HBV or HCV. The aim of this study was to determine the prevalence of HBV and HCV infections among HIV-infected patients, and describe the socio-demographic features and correlates of HIV and HBV/HCV co-infected patients at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Materials and Methods: This was a cross-sectional study carried out among HIV-positive individuals seen at the adult HIV clinic of AKTH. Four Hundred and forty (440) consecutive HIV-positive adult patients who consented to the study were screened for markers of HBV and HCV using Enzyme-linked Immunosorbent Assay (ELISA) technique. CD 4 Count and serum ALT were also obtained from the recruited patients. Socio-demographic characteristics and Body Mass Index (BMI) were obtained. Differences and relationships between groups were determined using students t-test and Chi-square test where appropriate, and a P < 0.05 was regarded as significant. Results: Prevalence rates of Hepatitis B and C virus infections obtained were 12.3% and 1.6%, respectively. Individuals who were 40 years or younger were the most affected. HBV co-infection was more common among males than females (16.9% vs 9.2%, respectively, P = 0.0153). Mean serum ALT among participants with HIV alone was 31.6 International Units (IU), but was significantly higher (45.3 IU) for those with HIV/HBV co-infection, P = 0.048. Mean CD 4 count for HIV/HBV co-infected participants (259.7 c/mm 3 ) was significantly higher than that for participants with HIV alone (240.0 c/mm 3 ), P = 0.0170 whereas the mean BMI was not significantly different between participants with HIV alone (21.3 kg/m 2 ) versus HIV/HBV co-infected participants (22.2 kg/m 2 ), P = 0.1385. Conclusion: Co-infection with hepatitis B virus is common among HIV-infected patients in our setting and this further reaffirms the need for routine baseline screening for this marker, as it is a major consideration in the initiation and choice of highly active antiretroviral therapy. Furthermore, those found to be negative should be immunized with HBV vaccine to improve the prognosis of their HIV status.
  11,104 817 11
Condom use among HIV sero-concordant couples attending a secondary health facility in North-Central Nigeria
AG Salaudeen, A Ojotule, KA Durowade, OI Musa, AS Yusuf, MJ Saka
July-December 2013, 10(2):51-56
Background: Condom use during intercourse is perceived as unnecessary in sexual encounters involving a regular partner. The non-use of condom among HIV-positive people has been found to increase the risk of resistance to anti-retroviral therapy. The objective of this study was to determine the pattern of condom use among HIV sero-concordant couples attending a secondary health facility in North-Central Nigeria. Materials and Methods: This is a cross-sectional survey that was carried out among people living with HIV and AIDS (PLWHA) who have been enrolled into care and treatment at General Hospital Abejukolo in Kogi State, Nigeria. The data instrument used was self-/interviewer-administered questionnaire. The data obtained were analysed using EPI-INFO version 3.4.1 software package. Chi-square test was used and P < 0.05 was considered significant for the study. Results: Assessment of knowledge of the respondents on the correct use of condom showed that two-thirds (60; 65.9%) had good knowledge and 70 (79.6%) of them demonstrated positive attitude towards the use of condom during sexual intercourse. About one-third of the respondents (32; 35.2%) would oblige the spouse sexual intercourse without condom mainly because they are both positive, to fulfil marital obligations and to avoid problems in marital relationship. Less than two-thirds (59.3%) of sero-concordant spouse used condom during sexual intercourse for reasons of preventing re-infection and pregnancy. Conclusion: With one-third of respondents not using condom during sexual intercourse, there is a great challenge for spread of HIV infection and risk of drug resistance in HIV care and management. Therefore, stakeholders at various levels should intensify efforts and support research towards behavioural modification in addressing the existing lacunae in HIV control.
  8,831 2,371 2
Tackling the global burden of cancers
MM Borodo
July-December 2013, 10(2):49-50
  4,578 4,071 -
Maternal risk factors for neonatal conjunctivitis in Aminu Kano Teaching Hospital, Kano, Nigeria
Abdulsalam Mohammed, Mu'utassim Ibrahim, Asani Mustafa, Uchechukwu Ihesiulor
July-December 2013, 10(2):60-65
Background: Neonatal conjunctivitis remains a major cause of preventable childhood blindness in developing countries. There are maternal risk factors, which if identified can assist in its prevention. Objective: This study attempts to determine the maternal risk factors for the development of neonatal conjunctivitis among babies seen in a tertiary health facility in Kano, Nigeria. Materials and Methods: This was a cross-sectional study. Neonates from special care baby unit, postnatal ward, paediatric out-patient unit and labour room who had bilateral or unilateral eye discharge were enrolled in the study. Those neonates whose parents refused consent were excluded from the study. The questionnaire sorted for information including patients' biodata, place and mode of delivery, age at onset of eye discharge, mothers' biodata, antenatal care attendance, educational and socioeconomic status and obstetrics history. Samples were collected and Gram staining was conducted using standard technique. Chlamydial antigens were detected using a rapid immunochromatographic technique (ICT). The data were analysed using EPI INFO version 3.5.1 2002. Proportions were compared using Chi-square test of significance. A probability (P - value) of less than 0.05 was considered statistically significant. Results: A total of 175 neonates were studied. The mean age was 5.7 ± 4.6 days with a male:female ratio of 1.1:1. Low level of maternal education, lack of antenatal care attendance, prolonged rupture of amniotic membranes and low socioeconomic status were significantly associated with isolate positive neonatal conjunctivitis. Conclusion: Maternal factors including lack of antenatal care attendance and poor socioeconomic conditions are significantly associated with isolate positive neonatal conjunctivitis.
  7,961 588 -
Analgesics prescription in Nigerian dental healthcare services
Clement C Azodo, Agnes O Umoh
July-December 2013, 10(2):86-90
Introduction: Alleviation of pain is considered high priority care and service in dental and medical practice worldwide. The study was conducted to evaluate analgesics prescription among dentists in Nigeria. Materials and Methods: This descriptive cross-sectional study was conducted among dentists attending continuing education courses in Nigeria organized by the Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria and Regional Centre for Oral Health Research and Training Initiatives for Africa. Results: Out of the 150 questionnaires distributed, 138 questionnaires were returned giving a 92.0% response rate. Males constituted 88 (63.8%) while the remaining 50 (36.2%) were females. The most common prescribed analgesic among the respondents was paracetamol 54 (39.1%). Factors that influenced the choice of prescribed analgesics among the respondents in descending order were severity of pain or intended pain, patient medical condition, type of procedure, age of the patient, delayed treatment, economic status, uncertainty of diagnosis and patient request Conclusion: The non-opioid analgesics specifically paracetamol was the most commonly prescribed by the respondents and the choice of analgesics was influenced by variety of factors .
  7,665 615 2
Seizures in a young adult Nigerian male abusing codeine containing cough syrup
Saheed O Raji, Chinwe F Inogbo, Sunday Oriji, Bawo O James
July-December 2013, 10(2):98-99
Cough remedies are available in Nigeria as narcotic and nonnarcotic over-the-counter preparations. The narcotic antitussive usually contains codeine, which has a high abuse potential. We report a case of a young Nigerian male, abusing codeine containing cough syrup with a clinical picture complicated by seizures, as well as review of relevant and available literature, including a discussion of its implication for clinical care. Clinicians should be aware of abuse and dependent potential of codeine containing cough syrup with seizures as one of the possible feature of toxicity. This case report buttresses the need for codeine containing cough syrups to be made available only on prescription.
  7,752 470 1
Intestinal parasitic infections among artisans in Benin city, Nigeria
Frederick Olusegun Akinbo, Aghogho Ikedje, Christopher E Okaka
July-December 2013, 10(2):66-69
Context: Human intestinal parasites have always been a major health problem in the developing countries. This study was aimed at determining the prevalence of intestinal parasitic infections among artisans and establishes a relationship between the prevalence of intestinal parasitic infections and risk-factors. Materials and Methods: A total of 353 participants which consisted of 272 males and 81 females were recruited for this study with age ranging from 18 to 65 years. Stool specimens were collected from the participants and analysed using the standard technique. The data obtained were analysed using Chi-square (χ2 ) to compare the frequency data while the odd ratio was calculated for potential risk factors. Results: Out of 353 subjects, 118 (33.4%) subjects had intestinal parasitic infections. Age, gender, marital status, occupation, educational status and source of food did not significantly affect (P = 0.219, P = 0.920, P = 0.276, P = 0.087, P = 0.074 and P = 0.442, respectively) the prevalence of intestinal parasitic infections. The use of well/rain water (odds ratio [OR] =2.721; 95% confidence interval [CI] = 1.452, 5.100; P = 0.002) and presence of diarrhoea (OR = 6.169; 95% CI = 3.665, 10.474; P < 0.0001) were significantly associated with intestinal parasitic infections among artisans. Defecating in nearby bushes resulted in a significantly increased prevalence of intestinal parasitic infections among artisans (P < 0.0001). The intestinal parasites recovered were Ascaris lumbricoides, hookworm, Trichuris trichiura and Entamoeba histolytica. A. lumbricoides had the highest prevalence (77.8%). The male gender had the highest prevalence in all the four intestinal parasites recovered in this study. Conclusion: Overall prevalence of 34.4% of intestinal parasitic infections was observed among artisans in Benin City. The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans. A. lumbricoides was the most prevalent parasitic agent recovered in this study.
  7,580 506 4
Neck circumference: An upcoming tool of adiposity indices
Lawan Hassan Adamu, Abdullahi Yusuf Asuku, Magaji Garba Taura, Idris Abdu Tela, Sa'adu Datti, Aminu Imam
July-December 2013, 10(2):82-85
Context: Obesity is one of the most significant contributors to ill health competing with under-nutrition and infectious diseases. Aims: The aims of the study were to determine the presence and level of sexual dimorphism in adiposity indices, correlation of neck circumference (NC) and body mass index (BMI) with other adiposity indices such as waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) and also to encourage the uses of neck circumferences as valuable tool in assessing upper body central adiposity index. Settings and Design: The study population included 71 undergraduate participants (41 Males and 30 Females) with mean age of 22.68 ΁ 4.23 years. Subjects and Methods: Anthropometric measurements of height, weight, NC, WC and HC were obtained following standard protocols. Statistical Analysis Used: Independent t-test and Pearson's correlation were employed to compare and find the relationship between the variables, using SPSS version 17. Significance level was considered at P ≤ 0.05. Results: The result shows that there was statistically significant (P < 0.05) sexual dimorphism in mean WC, WHR and NC between the sexes. BMI showed strongest correlation with WHtR (r = 0.8, P < 0.001) followed by HC (r = 0.7, P < 0.001), WC (r = 0.7, P < 0.001). On the other hand the NC shows a significant correlation (P < 0.05) with all the variables. Conclusions: Despite the low level of correlation of NC with other adiposity indices compared to the BMI, the NC may serve as an important tool for the assessment of upper body adiposity.
  7,144 547 3
Pattern of congenital heart diseases among children with Down syndrome seen in Aminu Kano Teaching Hospital, Kano, Nigeria
Mustafa Asani, Ibrahim Aliyu, Umar Also
July-December 2013, 10(2):57-59
Background: The association between Down syndrome (DS) and congenital heart disease (CHD) was first recognised by Garrod in 1894. Several studies have reported about 40-60% prevalence of CHD in DS and a predominance of left to right shunts like atrioventricular septal defects (AVSDs), ventricular septal defect, patent ductus arteriosus and atrial septal defect. Objectives: This study was carried out to find out the prevalence and types of CHD among children with DS. Materials and Methods: This was a retrospective study of the echocardiographic data collected over a 24-month period, between October 2009 and September 2011. The echocardiographic diagnosis of all children with DS referred was reviewed. Results: A total of 35 cases of DS were seen. The age ranged from 0.5-30 months. About 60% of the children with DS were aged 6 months and below. There were 19 males and 8 females giving a M: F ratio of about 2:1. A total of 77.1% of the children with DS had CHD. The most common CHD is AVSD (40%), followed by atrial septal defect (22.25%). A total of 22.25% had normal echocardiographic study. Conclusion: Early referral and screening of all babies born with the clinical phenotype of DS should be encouraged due to the high prevalence of CHD.
  6,034 807 5
Severe bone pain as first presentation of gastric malignancy
Tijjani Bashir Mohammed, Samaila Adamu Alhaji, Borodo Musa Muhammad, Bello Ahmad Kumo
July-December 2013, 10(2):91-94
Gastric cancer still accounts for significant cancer mortality world-wide. It generally occurs at advanced ages in most parts of the world but reports in Nigeria so far indicates that gastric carcinoma is seen in younger ages. Most cases of gastric cancer present late; with weight loss, abdominal pain/swelling, anorexia, and vomiting with or without hematemesis. Presentation with bone pains is uncommon. We report a 23-year-old female Nigerian who presented with generalized bone pain with limitation of movement, use of non-steroidal anti-inflammatory drugs and recurrent hematemesis. She was resuscitated and further evaluation revealed; anemia, hypercalcaemia, and X-ray osteolytic lesions, suggestive of multiple myeloma. Bone marrow aspiration cytology however, showed heavy infiltration with clusters of abnormal cells suggestive of mucin secreting adenocarcinoma. Upper gastrointestinal endoscopy revealed gastric tumor, histologically confirmed to be a poorly differentiated adenocarcinoma. Gastric cancer typically presents late and in advanced stages. Typical symptoms may include, weight loss, abdominal pain, vomiting, and hematemesis. It may however present with metastasis to the bone and present with bone pains. It is recommended that evaluation of patients with bone pain should include upper gastrointestinal endoscopy especially, where anemia or upper gastrointestinal bleeding is co-existent.
  6,461 337 -
Primary mesenteric extraskeletal osteosarcoma
SA Ahmed, U Mohammed, ES Garba, B Calvin, MS Shehu
July-December 2013, 10(2):95-97
Extraskeletal osteosarcoma (EOS) is a rare malignant soft tissue tumor. It predominantly occurs in the extremities, and is highly aggressive and rarely involves the visceral organs. Only five cases of mesenteric EOS have been reported in English literature. We describe a male patient of 56 years, who was diagnosed to have EOS arising from small bowel mesentery. Literature search and review was made. This patient presented with lower gastrointestinal bleeding. Resection of the tumor with adjacent small bowel was performed. Histopathology was performed and it revealed an osteosarcoma of mesentery. Given the rarity of cases of mesenteric EOS, its biologic behavior at this location remains to be determined. There should be high index of suspicion because of the possible fatal outcome related to the tumor. EOS has a very poor prognosis and a promising therapeutic regimen does not exist.
  5,726 363 1
Histopathological study of soft tissue sarcomas seen in a teaching hospital in Kano, Nigeria
Ibrahim Yusuf, Aminu Zakari Mohammed, Yawale Iliyasu
July-December 2013, 10(2):70-75
Background and Objective: Malignant soft tissue tumours account for less than 1% of overall human burden of malignant tumours. Increasing incidences of these tumours have been noted worldwide. This study aims to determine the pattern of soft tissue sarcomas seen in a teaching hospital. Materials and Methods: The study comprised of all cases of soft tissue sarcoma diagnosed over a 10-year review from 1 January 1999-31 December 2008. Results: A total of 264 cases of soft tissue sarcomas were reviewed; 162 males and 102 females with a male to female ratio of 1.6:1. The age range was between 3 months and 89 years with a mean age of 39.0 years. Kaposi sarcoma was the predominant histological type with 56 cases (21.2%). This was followed by rhabdomyosarcoma with 54 (20.5%) cases, dermatofibrosarcoma with 52 (19.7%) cases and liposarcoma with 32 (12.0%) cases. The most common site of affectation was the lower limb with 73 (27.7%) cases, followed by the trunk with 66 (25.0%) cases, head and neck with 45 (17.0%) cases and upper limb with 35 (13.3%) cases. Two hundred and eight cases satisfied the criteria for grading, out of which 34.1% were classified in grade I, 32.2% in grade II and 33.7% in grade III. Conclusion: Soft tissue sarcomas accounted for 8.8% of malignant tumours seen over the review period and Kaposi sarcoma was the predominant histological subtype commonly affecting young adults in our centre.
  5,327 438 1