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issn:2229-774
1.  An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control 
While outbreaks of infectious diseases have long presented a public health challenge, especially in developing countries like Nigeria; within recent years, the frequency of such outbreaks has risen tremendously. Furthermore, with the recent outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic prone diseases in Nigeria demanding immediate public health action, there is a need to strengthen the existing notifiable disease surveillance and notification system with increased clinicians’ involvement in timely reporting of notifiable diseases to designated public health authorities for prompt public health action. Hence, this paper provides the opportunity to increase awareness among clinicians on the importance of immediate reporting of notifiable diseases and intensify engagement of clinicians in disease notification activities by describing various notifiable diseases in Nigeria using their surveillance case definition, outlines the reporting channel for notifying these diseases and highlights the roles of clinicians in the current disease surveillance and notification network for early disease outbreak detection and public health response in Nigeria.
doi:10.4103/0300-1652.160347
PMCID: PMC4518330
Clinicians; disease outbreak; Nigeria; notifiable disease surveillance
2.  BAX/BCL-2 mRNA and protein expression in human breast MCF-7 cells exposed to drug vehicles-methanol and dimethyl sulfoxide (DMSO) for 24 hrs 
Background:
Methanol and DMSO are commonly used as carrier solvents for lipophilic chemicals in in-vitro experiments. However, very little information is available regarding the effects of these solvents on the expression of pro and anti-apoptotic genes and proteins.
Materials and Methods:
In this study, we examined the cytotoxic effects of methanol and dimethylsulfoxide at 0.5% (final concentrations recommended for in-vitro toxicity assays) on human breast cancer MCF-7 cells. We also investigated the effects of these solvents on the mRNA and immunocytochemical expression of apoptotic proteins BAX and BCL-2.
Results:
The results of neutral red cell viability assay showed that methanol and DMSO concentrations of 0.5% exhibited no cytotoxic effects on MCF-7 cells following a 24 hour exposure. Gene expression and Immunofluorescence results showed that methanol but not DMSO reduced the expression of the BAX pro-apoptotic protein, while both solvents did not alter the expression of the BCL-2 oncoprotein.
Conclusion:
Our results suggest that while methanol concentrations at 0.5% may be appropriate for in vitro toxicity studies in human breast cancer MCF-7 cells, it could alter the results of gene and protein expression experiments.
doi:10.4103/0300-1652.160349
PMCID: PMC4518331
Apoptosis; BAX; BCL-2; cytotoxicity; dimethylsulfoxide; MCF-7 cells; methanol
3.  Haematopoietic stem cell transplantation in Nigerian sickle cell anaemia children patients 
Background:
Sickle cell anaemia (SCA) remains associated with high risks of morbidity and early death. Children with SCA are at high risk for ischaemic stroke and transient ischaemic attacks, secondary to intracranial arteriopathy involving carotid and cerebral arteries. Allogeneic haematopoietic stem cell transplantation (HSCT) is the only curative treatment for SCA. We report our experience with transplantation in a group of patients with the Black African variant of SCA.
Patients and Methods:
This study included 31 consecutive SCA patients who underwent bone marrow transplantation from human leukocyte antigen (HLA)-identical sibling donors between 2010 and 2014 following a myeloablative-conditioning regimen.
Results:
The median patient age was 10 years (range 2–17 years). Before transplantation, 14 patients had recurrent, painful, vaso-occlusive crisis; ten patients had recurrent painful crisis in association with acute chest syndrome; three patients experienced ischaemic stroke and recurrent vaso-occlusive crisis; two patients experienced ischaemic stroke; one patient exhibited leukocytosis; and one patient exhibited priapism. Of the 31 patients, 28 survived without sickle cell disease, with Lansky/Karnofsky scores of 100. All surviving patients remained free of any SCA-related events after transplantation.
Conclusion:
The protocols used for the preparation to the transplant in thalassaemia are very effective also in the other severe haemoglobinopathy as in the sickle cell anaemia with 90% disease free survival. Today, if a SCA patient has a HLA identical family member, the cellular gene therapy through the transplantation of the allogeneic haemopoietic cell should be performed. Tomorrow, hopefully, the autologous genetically corrected stem cell will break down the wall of the immunological incompatibility.
doi:10.4103/0300-1652.160355
PMCID: PMC4518332  PMID: 26229224
Bone marrow transplantation; children; sickle cell anaemia
4.  Caesarean section and perinatal outcomes in a sub-urban tertiary hospital in North-West Nigeria 
Objectives:
This study was undertaken to review the caesarean section rate and perinatal mortality in Federal Medical Centre, Birnin Kudu from 1st January 2010 to 31st December, 2012.
Materials and Methods:
This was a retrospective study involving review of 580 case files. Ethical clearance was obtained. The records of labour ward, neonatal intensive care unit (ICU) and operating theatre were use. Information extracted includes age, parity, booking status, total deliveries, indications for caesarean section and perinatal outcome from 1st January 2010 to 31st December 2012 at Federal Medical Centre, Birnin Kudu. The data obtained was analysed using SPSS version 17.0 statistical software (Chicago, Il, USA). Absolute numbers and simple percentages were used to describe categorical variables. Association between caesarean section and perinatal mortality was determined using Pearson's Coefficient of correlation and student t- test. P - value < 0.05 was considered statistically significant.
Result:
This study reported a caesarean section rate of 17.69 % and a perinatal mortality rate of 165.6 per 1000. Majority of the babies (78.2%) were within normal weight. The mean age of the women was 25.9 ± 6.2 years and mean parity was 4 ± 3. Majority of them were uneducated and unemployed. Obstructed labour was the commonest indication for emergency caesarean section accounting for 31.7% of caesarean sections and foetal distress was the least at 2.6 %. Two or more previous caesarean section was the commonest indication for elective caesarean section (17.1%) and bad obstetrics history the least indication (1.4%). There is a weak positive correlation (r = 0.35) between caesarean section rate and perinatal mortality and this association was not statistically significant (P = 0.12).
Conclusion:
Caesarean section and perinatal mortality rates in the present study are comparatively high. Absence of significant correlation means that a high caesarean section rate is not likely to improve perinatal outcomes in babies of normal weight; therefore the caesarean section rate in this centre should be reduced. Measures to reduce perinatal mortality such as skilled attendant in labour and training of medical staff in neonatal resuscitation should be adopted.
doi:10.4103/0300-1652.160360
PMCID: PMC4518333
Caesarean section; north-west Nigeria; perinatal outcomes
5.  Predictors of breast self-examination as cancer prevention practice among women of reproductive age-group in a rural town in Nigeria 
Background:
Early detection of breast cancer plays an important role in decreasing its morbidity and mortality. This study therefore examines the factors influencing breast self-examination (BSE) awareness and practices among women in Ogun state, Western Nigeria.
Materials and Methods:
This analytical cross-sectional study was conducted between 22 April and 13 May 2013 using a semi- structured questionnaire. A multi-stage cluster sampling technique was used to select one participant per household into the study.
Results:
A total of 495 women were interviewed in this study, the mean age of the respondents was 36.45 ± 5.12 years. About half (58.2%) of respondents have heard of BSE and 24.4% have ever perform BSE. Only 5.3% of our respondents perform BSE regularly (monthly) as recommended. Barrier to non-performance of BSE were perception of not being at risk (47.6%), lack of knowledge of how to perform BSE (47.6%). Only 18.5% of respondents have ever had their breast examined by physicians for lump and all of them had continued to perform BSE afterwards. The only predictor of awareness and practice of breast self-examination was tertiary level of education [odds ratio (OR) = 1.43 cumulative incidence (CI) = 1.12-2.18].
Conclusion:
The study shows level of education, smoking habits and history of breast exam by health professional and were the factors found associated with BSE practice. Training on BSE should be given to women especially during antenatal care in order to increase the practice of BSE thus averting the severe morbidity and mortality of breast cancer in developing countries.
doi:10.4103/0300-1652.160362
PMCID: PMC4518334
Breast; Nigeria; reproductive age; rural; self-examination
6.  Maternal renal artery Doppler sonographic changes in pregnancy-induced hypertension in South West Nigeria 
Background:
To evaluate the renal arterial hemodynamic changes caused by pregnancy-induced hypertension using Doppler ultrasonography.
Materials and Methods:
Eighty (80) subjects with pregnancy-induced hypertension (PIH) and 160 controls (80 pregnant normotensive women and 80 healthy, non-pregnant women) underwent triplex renal sonography prospectively to determine their renal volumes and right renal artery Doppler indices.
Results:
The peak systolic velocity, end diastolic velocity, pulsatility index, systolic/diastolic ratio and acceleration time were respectively significantly higher in the PIH group (68.67 cm/s, 21.55 cm/s, 1.23, 3.38, 123.2 ms) than the pregnant, normotensive group (65.19 cm/s, 20.27 cm/s, 0.88, 3.35, 61.14 ms) and healthy, non-pregnant group (52.06 cm/s, 18.27 cm/s, 0.84, 2.90, 68.48 ms). Resistivity index was also increased in the PIH group, but this was not statistically significant. Conversely, the systolic acceleration was significantly lower in the PIH group (6.06 m/s2) compared to the pregnant, normotensive group (11.82 m/s2) and healthy, non-pregnant group (8.26 m/s2). The right renal volume of the PIH group (132.76 cm3) was significantly higher that of the pregnant, normotensive group (125.29 cm3) and healthy, non-pregnant group (91.66 cm3). The same pattern was observed in the left renal volume which was 168.78 cm3, 164.95 cm3 and 113.80 cm3 in the study groups, respectively.
Conclusion:
Renal Doppler ultrasound is clinically relevant in the diagnosis and follow-up of renal complications in patients with pregnancy-induced hypertension.
doi:10.4103/0300-1652.160367
PMCID: PMC4518335
Doppler ultrasonography; hypertension; pregnancy; renal artery
7.  The effect of hospital infection control policy on the prevalence of surgical site infection in a tertiary hospital in South-South Nigeria 
Background:
Surgical site infections (SSIs) are a significant cause of morbidity, emotional stress and financial cost to the affected patients and health care institutions; and infection control policy has been shown to reduce the burden of SSIs in several health care institutions. This study assessed the effects of the implementation of the policy on the prevalence of SSI in the University of Port Harcourt Teaching Hospital, Nigeria.
Patients and Methods:
A review of the records of all Caesarean sections carried out in the hospital, before and 2 years after the implementation of the infection control policy was conducted. Data collected include the number and characteristics of the patients that had Caesarean section in the hospital during the period and those that developed SSI while on admission.
Results:
The proportion of patients with SSI decreased from 13.33% to 10.34%, 2 years after the implementation of the policy (P-value = 0.18). The implementation of the policy did not also result in any statistically significant change in the nature of the wound infection (P-value = 0.230), in the schedule of the operations (P-value = 0.93) and in the other predisposing factors of the infections (P-value = 0.72); except for the significant decrease in the infection rate among the un-booked patients (P-value = 0.032).
Conclusion:
The implementation of the policy led to a small decrease in SSI, due to the non-implementation of some important aspects of the WHO policy. The introduction of surveillance activities, continuous practice reinforcing communications and environmental sanitation are recommended to further decrease the prevalence of SSI in the hospital.
doi:10.4103/0300-1652.160393
PMCID: PMC4518336
Hospital infection control policy; hospital infection control committee; Nigeria; Port Harcourt; surgical site infection; teaching hospital
8.  Denture care practice among patients attending the prosthetic clinic in a Nigerian teaching hospital 
Background:
Good denture care practice by individuals using Removable Partial Denture (RPD) is an important component of oral health measures. An assessment of denture care practice of such individuals by dental care practitioners is necessary.
Objective:
To evaluate the denture care practice among prosthetics patients attending a tertiary Hospital Dental Centre in Nigeria.
Materials and Methods:
An interviewer administered questionnaire was used to obtain information from RPD wearers that were willing to participate. The questionnaire assessed among other things, patients’ bio-data, frequency, techniques and device used for cleaning their dentures. Data was analyzed using Chi-square test (P < 0.05).
Results:
One hundred and ninety eight denture wearers consisting of 100 (50.5%) males and 98 (49.5%) females participated in the study. Majority 110 (55.6%) cleaned their dentures once daily and toothbrush and pastes were used by 105 (53%) of the participants. More than 70% of the respondents removed their dentures at night. One hundred and sixty-six (83.8%) visited the dentist only when they needed treatment. There was a statistical significant relationship between frequency and technique of cleaning denture, and denture cleanliness (P < 0.05).
Conclusion:
This study shows that once daily cleaning of dentures and cleaning the denture with rest of the teeth are ineffective in prevention of plaque accumulation.
doi:10.4103/0300-1652.160395
PMCID: PMC4518337  PMID: 26229229
Denture care; denture hygiene; Nigeria; practice
9.  Adolescents with sickle cell anaemia: Experience in a private tertiary hospital serving a tertiary institution 
Background:
Many adolescents with sickle cell disease (SCD) have adjustment difficulties in the transition period from paediatric care to the adult system because they find themselves in unfamiliar waters where they have to learn to manage themselves. The aim of this study is to evaluate the prevalent crises and morbidities associated with SCD in adolescents in Babcock University Teaching Hospital (BUTH), to also assess the level of knowledge of these adolescents about SCD and to determine their emotional response to the disease.
Materials and Methods:
This was a retrospective review of case notes of adolescents with sickle cell anaemia that were seen in BUTH, from May 2013 to April 2014. Data extracted from the case notes was entered into a Microsoft (MS) Excel and analysed using descriptive statistics. Results were presented in tables.
Results:
A total of 50 subjects were seen in the department during this study period. Vaso-occlusive crises in the form of bone pains (93.1%) were the commonest crises encountered. Associated morbidities were malaria 34 (85%), tonsilitis 1 (2.5%), pneumonia 1 (2.5%), leg ulcer 1 (2.5%), azotaemia 1 (2.5%) and subarachnoid haemorrhage 2 (5%). Majority (88%) had adequate knowledge about general health maintenance while knowledge on nutrition and appropriate analgesia use is still inadequate. Eleven (22%) had symptoms of depression, four (8%) had suicidal ideation while one (2%) had a history of attempted suicide.
Conclusion:
This study emphasizes the importance of psychosocial intervention as part of a comprehensive health management for people with SCD.
doi:10.4103/0300-1652.160397
PMCID: PMC4518338
Adolescent; psychosocial intervention; sickle cell anaemia
10.  Relationship of blood pressure with some cardiovascular disease risk factors in a rural population of Plateau State, North Central Nigeria 
Background:
Hypertension is associated with certain cardiovascular disease (CVD) risk factors which vary from one place to the other depending on community sophistication. We decided to obtain the situation as it affects this rural Nigerian community to be in an evidence-based position to initiate individual and group prevention strategies.
Design:
Cross-sectional population survey.
Materials and Methods:
We surveyed for CVD risk factors among subjects 15 years and above in this rural community using a questionnaire requesting personal, medical and anthropometric information. One in three of them were randomly assigned to laboratory investigations.
Results:
Of the 840 subjects studied, 25% were males. The population mean age was 45.5 (18.2) standard deviation (SD), with 1.8% smokers and 4.1% using alcohol. Systolic blood pressure (SBP) correlated with age, body mass index (BMI), total cholesterol (TC) and uric acid (UA); while diastolic blood pressure (DBP) correlated with age, BMI, TC, UA and atherogenic index (AI). SBP and DBP improved with exercise but not salt intake. The local seasonings used in cooking had no impact on blood pressure.
Conclusion:
To reduce cardiovascular morbidity in this and probably other rural sub-Saharan African communities, BMI, TC, UA and salt intake in diet should be targeted for reduction. Physical activity should be encouraged. Interestingly, these fall into the sphere of healthy lifestyle which should be encouraged and re-inforced.
doi:10.4103/0300-1652.160400
PMCID: PMC4518339
Blood pressure; cardiovascular diseases; prevention; risk factors; rural Nigeria
11.  A five year audit of mammography in a tertiary hospital, North Central Nigeria 
Background:
Breast imaging plays a vital role in the multidisciplinary approach to management of breast disease. A baseline data is apt and necessary for collaborative studies.
Materials and Methods:
This is a prospective descriptive study carried out between January 2009 and December 2013 at our institution. Patients who had breast imaging were recruited into the study. Film-screen mammograms were acquired with a General Electric (GE) Senographe DMR machine. Breast ultrasound done using an Aloka Prosound SSD-350+ ultrasound machine equipped with linear and curvilinear 7.5–10 MHz transducer. Findings were categorized using the ACR-BIRADS (American college of Radiologists-Breast imaging reporting and data system). Data was collated and analysed using social statistical package (SPSS) version 17.
Result:
The mammograms of 824 patients were evaluated during this study period. Their age ranged from 40–85 years with a mean age of 50.9 ± 8.1 years. Eight hundred and sixteen (99%) were females and eight (1%) were males. The commonest clinical indication was breast lump (23.9%). The commonest density pattern was BIRADS 2-scattered fibroglandular pattern (43.9%). Mammograms were normal in 266 (32.3%) and positive in 558 (67.7%). The final BIRADS assessment showed BIRADS 0, 1, 2, 3, 4, 5 and 6 constituted 6.6%, 30.1%, 29.7%, 22.2%, 5.9%, 5.0% and 0.5% respectively.
Conclusion:
The level of awareness of breast cancer is quite high with the positive mammographic yield emphasizing the value of a multidisciplinary approach in the management of breast diseases.
doi:10.4103/0300-1652.160401
PMCID: PMC4518340  PMID: 26229232
Audit; mammography findings; north central Nigeria
12.  Plasmodium falciparum parasitaemia among booked parturients who received two doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment in pregnancy (IPTp) in a tertiary health facility Southeast Nigeria 
Background:
Malaria is preventable but has contributed significantly to maternal morbidity and mortality in our environment. Malaria parasitaemia during pregnancy is mostly asymptomatic, untreated but with complications.
Aim:
A follow-up study aimed at determining plasmodium falciparum parasitaemia and associated complications among booked parturient who had intermittent preventive treatment with sulfadoxine-pyrimethamine (SP) compared with another study among unbooked parturients who did not take SP for intermittent preventive treatment in pregnancy (IPTp).
Materials and Methods:
This study was conducted in the labour ward complex of Federal Teaching Hospital, Abakaliki from March to May 2012. Five hundred booked parturients at term that received two doses of SP were consecutively recruited. A structured data collection sheet was administered to each parturient. Thick and thin blood films were prepared for quantification and speciation of parasitaemia, respectively. The haemoglobin concentration and birth weights were determined. Analysis was done with the Statistical Package for the Social Sciences (SPSS) software with level of significance at P value < 0.05.
Results:
The prevalence of malaria parasitaemia in the study was 59.6%. The mean age of parturients was 28.7 (5.5). The highest prevalence of malaria parasitaemia, 92% was found among the parturients aged ≤19 years. The association between age and parasitaemia was significant (x2 = 16.496, P = 0.000). The median parity was 1.0 (3.0). The highest prevalence of asymptomatic parasitaemia, 65.5% was noted among the nulliparous parturients. The association between parity and parasitaemia was significant (x2 = 11.551, P = 0.003). Majority of the parturients were of high social class. Those of the lowest social class (class 5) had the highest prevalence (80%) of parasitaemia. The association between social class and parasitaemia was significant (x2 = 9.131, P = 0.003). Prevalence of anaemia in the study was 14%. The non-parasitaemic and parasitaemic parturients had mean haemoglobin concentrations of 12.7 g/dl and 10.4 g/dl, respectively. There was significant association between haemoglobin concentration and parasitaemia (x2 = 39.143, P = 0.000). The prevalence of low birth weight was 3.0%. The relationship between birth weight and parasitaemia was significant (x2 = 2.535, P = 0.000).
Conclusion:
The was reduction in asymptomatic malaria parasitaemia compared to parturients who had no SP though the prevalence was still high showing possibly increasing resistance to SP but the treatment was still very effective in reducing anaemia and low birth weight associated with malaria in pregnancy.
doi:10.4103/0300-1652.160406
PMCID: PMC4518341  PMID: 26229233
Intermittent preventive treatment; malaria; Nigeria; sulfadoxine-pyrimethamine
13.  Role of ultrasound-guided percutaneous antegrade pyelography in malignant obstructive uropathy: A Nigerian experience 
Ultrasound-guided percutaneous nephrostomy of the renal pelvis is a technique that is widely acceptable especially when contrast media is introduced in the procedure of antegrade pyelography. It is a relatively safe procedure that effectively improves renal function in obstructed kidneys. It can be performed in most cases as an alternative to retrograde pyelography. We present our experience and its role in obstructive uropathy due to malignancy.
doi:10.4103/0300-1652.160408
PMCID: PMC4518342
Nephrostomy; percutaneous antegrade pyelography; pelvic malignancy; obstructive uropathy; ultrasound guided
15.  Knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania 
Background:
Childhood obesity has increased over the past two decades. Child obesity is likely to persist through adulthood and increases the risk of non-communicable diseases (NCDs) later in life. This study assessed knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania.
Materials and Methods:
A cross-sectional study was conducted in randomly selected primary schools in Dar es Salaam. A structured questionnaire was used to assess the knowledge and attitudes. Anthropometric and blood pressure measurements were taken using standard procedures.
Results:
A total of 446 children were included in the analysis. The mean age of the participants was 11.1 ± 2.0 years. The mean body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 16.6 ± 4.0 kg/m2, 103.9 ± 10.3 mmHg and 65.6 ± 8.2 mmHg, respectively. Prevalence of obesity (defined as BMI >95th percentile for age and sex) was 5.2%. Half of the children (51.1%) had heard about obesity from teachers at school (20%), radio (19.4%) and books/newspaper (17.3%). Less than half (45.4%) had knowledge about the risk factors for childhood obesity and correctly defined obesity (44.6%). However, a good number of the children (72.1%) were aware that they can be affected by obesity. Majority of them had negative attitude towards obesity and various factors leading to or resulting from childhood obesity.
Conclusions:
Knowledge about childhood obesity among primary school children is moderate and have negative attitude towards obesity. Integrating educational programs early in primary schools may be an effective strategy to impact knowledge about obesity and other non-communicable diseases early in childhood.
doi:10.4103/0300-1652.150692
PMCID: PMC4382598  PMID: 25838624
Attitudes; knowledge; obesity; primary school children; Tanzania
16.  Profile and retrospective analysis of the use of preventive strategies in patients with cervical cancer in South-South Nigeria 
Background:
Cervical cancer is the commonest malignancy of the female genital tract in developing countries, with a global burden of 530,000 new cases annually. This study aims to review the current situation of this important malignancy and to assess the previous use of preventive measures in patients with cervical cancer at the Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.
Materials and Methods:
This was a retrospective review of all cases of cervical cancer managed at the UPTH, Port Harcourt, Nigeria, between 1 January 2008 and 31 December, 2012.
Results:
The prevalence of cervical cancer was 3.53% of all gynaecological admissions. The peak age of incidence was 50-59 years, accounting for 40% of the study population. Women with high parity contributed to 93.3% of the study population. Early coitarche was observed in 78.7% and a history of multiple sexual partners in 65.3%. Vaginal bleeding was the commonest clinical feature seen in all the women studied, followed by pelvic pain in 84% of cases. Advanced-stage cervical cancer was seen in 93.4%. None of the women studied had been previously vaccinated against human papilloma virus (HPV), and only 1.3% had had any form of screening methods for early detection of cervical cancer.
Conclusion:
Cervical cancer remains an important cancer in our environment, and late presentation with advance disease is still the norm despite advances in screening and preventive modalities. The reason for this is buttressed on the finding that despite the availability of these preventive strategies, women in the South-South of Nigeria did not partake of these measures. There is an urgent need to develop programmes to re-sensitise women on the need for screening and vaccination to reduce cancer-associated morbidity and mortality in Port Harcourt, South-South Nigeria.
doi:10.4103/0300-1652.150693
PMCID: PMC4382599  PMID: 25838625
Cervical cancer; human papilloma virus vaccination; papanicolaou smear; port harcourt
17.  Malnutrition in acutely ill children at the paediatric emergency unit in a tertiary hospital in Nigeria  
Background:
In many developing countries, malnutrition remains an important cause of morbidity and mortality particularly in under-five children. The factors responsible for malnutrition could be immediate, underlying or basic, acting either alone or together. It has been shown that children who are malnourished have poorer outcomes from other illnesses than well-nourished children. It is important therefore to periodically describe the extent and pattern of childhood malnutrition so that effective preventive measures can be put in place.
Objective:
To describe the prevalence and pattern of malnutrition in children presenting with acute illnesses at the Jos University Teaching Hospital.
Patients and Methods:
A cross-sectional descriptive study in children aged 6 to 59 months seen at the paediatric emergency unit from April to October 2012. The subjects were recruited consecutively. Each child had both clinical assessment and appropriate laboratory evaluations done alongside anthropometric measurements. The nutritional/dietary and socio-demographic histories were also obtained.
Results:
Of the 379 children, 224 (59.1%) were males and 155 (40.9%) females. The median age was 17 months, range (6-57). Wasting (WFH z-scores ≤−3 to <−1SD) was evident in one hundred children, giving an overall prevalence of 26.9%. Severe wasting (WFH z-score <−3), was present in 22 (5.9%) children indicating the prevalence of marasmus, whereas only two children (0.53%) had oedematous malnutrition (kwashiorkor). Stunting or chronic malnutrition, (HFA z-scores ≤−3 to <−1SD) was present in 67 children (18.0%). Seventeen (4.6%) were severely stunted (HFA z-score <−3).
Conclusions:
Wasting was the most common form of malnutrition in the study.
doi:10.4103/0300-1652.150695
PMCID: PMC4382600  PMID: 25838626
Acute illness; emergency; malnutrition; paediatric
18.  Prevalence and predictors for domestic violence among pregnant women in a rural community Northwest, Nigeria 
Objective:
Domestic violence (DV) against women constitutes a violation of human rights. This study aimed at determining the prevalence and predictors for DV among pregnant women in a rural community northwest Nigeria.
Materials and Methods:
A descriptive cross-sectional study which utilised an interviewer-administered semi-structured pretested questionnaire. This assessed the type of DV experienced, the perpetrators and the trigger factor. Logistic regression analysis was used to assess the relative effect of determinants, adjusting for other predictor variables. The dependent variable was the occurrence of DV classified as Yes or No and the covariates included variables that were significantly associated with DV.
Results:
Of the 314 respondents, 108 (34.3%) had experienced at least one form of DV and the types observed are: Verbal violence 79(68.5%); psychological violence72 (66.7%) and physical violence 55(50.9%). The perpetrators were the current husband in 40 (37.0%); co-wives in 33 (30.6%) and in-laws in 25 (23.1%). Of the cases, domestic issues were the trigger factor in 69 (63.9%) of cases and 54 (50%) of, the incidence was never reported. Ethnicity and type of marriage were significantly associated with occurrence of DV ( P ≤ 0.05) and both remained predictors for DV after controlling for confounders [Adjusted odds ratio (AOR) = 2.20 and 95% C.I = 1.42-11.9; AOR = 4.2 and 95% C.I = 1.36-3.57, respectively].
Conclusion:
The prevalence of DV in pregnancy is high with women of Hausa/Fulani ethnicity and those in polygamous relationships at a higher risk. Effort should be made to screen pregnant women for DV during antenatal care.
doi:10.4103/0300-1652.150696
PMCID: PMC4382601  PMID: 25838627
Domestic violence; pregnant women; Northwest; Nigeria
19.  Screening for diabetes mellitus in patients with chronic obstructive pulmonary disease in tertiary care hospital in India 
Background:
Chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) are common and under diagnosed medical conditions in India. Prevalence of these chronic diseases are high both in rural and urban areas. However, exact prevalence of DM in Indian COPD patients in unclear. Co-morbid conditions like DM have great impact on the outcome of COPD in the form of severity, exacerbations, morbidity and mortality. Hence the present study objective was to screen COPD patients for DM.
Results:
A total of 1662 patients with COPD (Males = 1264, Female = 398) with mean age 58 ± 9.6 were screened for DM. Patients with known history of DM were 353 (21.24%) and were enrolled as Known DM cases. Remaining 1309 (78.76%) patients whose DM status was unclear were screened by random blood sugar (RBS). One-hundred and seventy-one subjects had RBS > 110 mg/dl. About 73 (4.39%) subjects had fasting blood sugar (FBS) > 126 mg/dl. They were considered as Newly Diagnosed DM cases. Total number of DM cases in the study including new and known was 426 (25.63%). Number of patients with deranged FBS (FBS between 110 mg/dl to126 mg/dl) was 84 (5.05%). Among the DM patients with COPD 168 (10.11%) had poor glycemic control with HbA1c > 8. Prevalence of DM in present study was 25.63%.
Conclusion:
Prevalence of DM in COPD patients in the present study is 25.63% when actively screened in tertiary care hospital. It is feasible and imperative to screen all COPD patients for DM in all health care facilities routinely.
doi:10.4103/0300-1652.150699
PMCID: PMC4382602  PMID: 25838628
COPD; diabetes mellitus; prevalence; screening
20.  Clinicopathological features of gastric carcinoma in Ibadan, Nigeria, 2000-2011 
Aim:
The most recent study on the clinicopathological features of gastric carcinoma from the University College Hospital (UCH), Ibadan, was done in 2000. The aim of this study is to update the knowledge on the clinicopathological features of gastric carcinoma diagnosed in the Pathology Department of the UCH Ibadan between 2000 and 2011.
Materials and Methods:
This was a 12-year retrospective review of clinical and demographic data and the histopathological features of gastric cancers diagnosed at the Pathology Department of the UCH. The chi square test, Fisher's exact test, and the t-independent test were used as applicable in the statistical analyses.
Results:
A total of 117 cases of gastric carcinoma were histologically diagnosed at the Pathology Department of UCH, Ibadan in this period giving a relative ratio frequency of 1.38% for all cancers. It represented 18.4% of all gastrointestinal tract malignancies diagnosed in the same period. There was a male preponderance with male:female ratio of 1.72:1; the middle-aged and elderly made up about 76.1% of cases. The disease was clinically and histologically advanced in 92.8% of cases. Gastric tumours were predominantly antral/ pyloric in 80% of cases and exophytic in 62.3% of cases. The intestinal histotype constituted 47.0% cases although a rise in the diffuse histological type was observed.
Conclusion:
There is a decline in the relative ratio frequency of gastric carcinoma in Ibadan; and a fall in the rate of the intestinal type of gastric carcinoma relative to the diffuse type when compared to previous studies from our centre.
doi:10.4103/0300-1652.150700
PMCID: PMC4382603  PMID: 25838629
Clinicopathological features; gastric carcinoma; Ibadan; Nigeria
21.  Cardio-pulmonary resuscitation in the intensive care unit: An experience from a tertiary hospital in Sub-Saharan Africa 
Background:
Cardiopulmonary resuscitation (CPR) is one the most commonly performed procedures in the intensive care unit (ICU). However, success rate of CPR vary widely from 3.1% to 16.5%.
Patients and Methods:
We conducted a retrospective study of all cardiac arrests prompting CPR in our ICU for a period of 12 months. Data retrieved from ICU records included patients demographic characteristics, diagnosis at admission, length of ICU stay, time and day of cardiac arrest, cardiac rhythm, duration of CPR and outcome of CPR.
Results:
A total of 156 CPRs were performed within the study period with 8.3% success rate. Male: female ratio was 1.2:1. Indications for ICU admission, length of stay in ICU, time and day of cardiac and duration of CPR were found to be determinants of outcome.
Conclusions:
There is an urgent need to constitute a cardiac arrest team (CAT) which will be available at all times for improved successful outcome after cardiac arrest in our ICU.
doi:10.4103/0300-1652.150694
PMCID: PMC4382604  PMID: 25838630
Cardiopulmonary resuscitation; ICU; outcome
22.  Knowledge regarding Ebola Hemorrhagic Fever among private dental practitioners in Tricity, India: A cross-sectional questionnaire study 
Background:
Ebola viral fever, a highly contagious haemorrhagic disease has today become a major public health concern in the developing countries worldwide.
Aim:
The purpose of this study was to assess knowledge among dental practitioners regarding Ebola Haemorrhagic Fever (Ebola HF) in Tricity, (Chandigarh, Panchkula and Mohali).
Materials and Methods:
A total of 500 private dental practitioners were randomly approached to participate in this cross-sectional survey. A self-structured, closed ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding Ebola HF. Knowledge section included questions related to communicability; symptomatology and diagnostics; at-risk individuals; prevention and treatment; and, virus characteristics of Ebola HF.
Results:
The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participants's demographic and professional characteristics with the knowledge scores. Statistically significant difference was seen when mean knowledge scores were compared based on the locality and qualification of the participants (P < 0.05).
Conclusion:
Dental practitioners from urban areas with higher qualification had better knowledge yet there were notable deficiencies regarding the virus characteristics, diagnostics, elimination and treatment.
doi:10.4103/0300-1652.153405
PMCID: PMC4382605  PMID: 25838631
Ebola virus disease; Ebola HF; infectious disease; knowledge; prevention
23.  Effect of coconut oil in plaque related gingivitis — A preliminary report 
Background:
Oil pulling or oil swishing therapy is a traditional procedure in which the practitioners rinse or swish oil in their mouth. It is supposed to cure oral and systemic diseases but the evidence is minimal. Oil pulling with sesame oil and sunflower oil was found to reduce plaque related gingivitis. Coconut oil is an easily available edible oil. It is unique because it contains predominantly medium chain fatty acids of which 45-50 percent is lauric acid. Lauric acid has proven anti inflammatory and antimicrobial effects. No studies have been done on the benefits of oil pulling using coconut oil to date. So a pilot study was planned to assess the effect of coconut oil pulling on plaque induced gingivitis.
Materials and Methods:
The aim of the study was to evaluate the effect of coconut oil pulling/oil swishing on plaque formation and plaque induced gingivitis. A prospective interventional study was carried out. 60 age matched adolescent boys and girls in the age-group of 16-18 years with plaque induced gingivitis were included in the study and oil pulling was included in their oral hygiene routine. The study period was 30 days. Plaque and gingival indices of the subjects were assessed at baseline days 1,7,15 and 30. The data was analyzed using paired t test.
Results:
A statistically significant decrease in the plaque and gingival indices was noticed from day 7 and the scores continued to decrease during the period of study.
Conclusion:
Oil pulling using coconut oil could be an effective adjuvant procedure in decreasing plaque formation and plaque induced gingivitis.
doi:10.4103/0300-1652.153406
PMCID: PMC4382606  PMID: 25838632
Coconut oil; oil pulling; plaque induced gingivitis
24.  Basic life support knowledge and skills of Iranian general dental practitioners to perform cardiopulmonary resuscitation 
Background:
When cardiopulmonary arrest occurs, the dentist's ability to perform cardiopulmonary resuscitation (CPR) is the most important factor to minimize morbidity and mortality. This study assessed the basic life support (BLS) knowledge and performance of general dental practitioners in Hamadan, Iran.
Materials and Methods:
The participants in the study were 80 Iranian general dental practitioners who were chosen randomly. Their CPR knowledge was evaluated by verbal questions and their CPR skills were determined by CPR execution on a special manikin. Nearly 39% (n = 31) of dentists answered none of the questions and only 2.50% (n = 2) answered all of the questions correctly. Thirty six dentists had been participated CPR course after graduation.
Result:
There was a significant difference between dentists who participated in CPR training course and those that did not participate (P value = 0.000). Only 3.75% (n = 3) were able to perform CPR properly.
Conclusion:
The results showed that the amount of CPR knowledge and skills were low in participated Iranian general dental practitioners. However, CPR training courses after graduation increased the amount of knowledge significantly, thus, retraining CPR courses is necessary for dentists.
doi:10.4103/0300-1652.153407
PMCID: PMC4382607  PMID: 25838633
Cardiopulmonary resuscitation; general dental practitioners; knowledge; medical emergencies; skill
25.  Desmoplastic fibroma of the ulna bone 
A fibroma is a benign tumour composed of fibrous connective tissue and they can grow in all organs. They can be classified based on consistency into hard or soft fibroma, based on histological characteristics into desmoplastic, chondromyxoid, ossifying, non-ossifying fibroma. They can also be classified based on tissue of origin or location in the body, it can also be classified into superficial or deep fibroma. This is a report of a 15-year-old Nigerian boy with a recurrent left ulnar tumour which was rapidly growing and has been excised three times. Preoperative investigations, i.e., plain radiograph, full blood count and fine needle aspiration cytology were done. Patient could not afford CT scan which was requested for. First excision was in 2009. Recurred within 1 year and had a repeat excision in 2011. He had a second recurrence 9 months after and had to have another excision. The last tumour excision left only the part of the left ulna that forms the proximal radioulnar joint and elbow joint. Patient has been followed up after the last excision for 18 months with no recurrence.
doi:10.4103/0300-1652.153408
PMCID: PMC4382608  PMID: 25838634
Bone; desmoplastic; fibroma; ulna

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