|CONFRENCE PROCEEDINGS 2014
|Year : 2015 | Volume
| Issue : 2 | Page : 91-102
Abstract proceedings of the 4 th Annual Scientific Conference of Nigerian Medical Association, Sokoto State Branch held on 19 th to 21 st june 2014 at Giginya Coral Hotel, Sokoto, Nigeria
|Date of Web Publication||14-Jul-2015|
|How to cite this article:|
. Abstract proceedings of the 4 th Annual Scientific Conference of Nigerian Medical Association, Sokoto State Branch held on 19 th to 21 st june 2014 at Giginya Coral Hotel, Sokoto, Nigeria. Sahel Med J 2015;18:91-102
|How to cite this URL:|
. Abstract proceedings of the 4 th Annual Scientific Conference of Nigerian Medical Association, Sokoto State Branch held on 19 th to 21 st june 2014 at Giginya Coral Hotel, Sokoto, Nigeria. Sahel Med J [serial online] 2015 [cited 2020 Feb 29];18:91-102. Available from: http://www.smjonline.org/text.asp?2015/18/2/91/160820
Chairman Organizing Committee:
Prof. S. A. Isezuo
| Abstract 001|| |
| Gestational Diabetes Mellitus and Outcome of Pregnancy among Women Attending Antenatal Care Clinic in North Western Nigeria|| |
A. U. Adoke, C. E. Shehu, E. I. Nwobodo, B. A. Ekele 1 , A. Sabir 2 , A. U. Gambo
Departments of Obstetrics and Gynaecology and 2 Internal Medicine Usmanu Danfodiyo University Teaching Hospital, PMB 2370, Sokoto, Sokoto State, 1 Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
Background: Gestational diabetes mellitus (GDM) is any degree of glucose intolerance with onset or first recognition during pregnancy. It affects 2-10% of pregnancies, and there appears to be a rising trend in its prevalence worldwide. A history of GDM is a strong predictor of subsequent Type 2 diabetes especially among women of African descent. The aims of the study were to determine the prevalence, risk factors, and outcome of GDM among women attending the antenatal care clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto. Materials and Methods: A prospective study of 207 consecutively recruited women that were <28 weeks pregnant who came to book for antenatal care was carried out using a structured questionnaire. Relevant data including demographic information, obstetric history, and risk factors for GDM and OGTT results were collected and analyzed using SPSS version 20 SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Chi-square and t-test were used for statistical analysis, and P < 0.05 was considered as statistically significant. Result: The prevalence of GDM was 7.7%. Advancing maternal age (P = 0.000), high parity (P = 0.000), and previous history of macrosomia (relative risk = 3.056, confidence interval: 1.208-7.728, P = 0.015) were risk factors for GDM. Cesarean delivery was more common (P = 0.000), and fetal weight was significantly higher (P = 0.005) among those with GDM. The outcome of pregnancy was favorable among the GDM patients. Conclusion: The prevalence of gestational diabetes mellitus in our environment is relatively high. Thus, routine screening of patients especially those with identifiable risk factors is imperative.
Keywords: Gestational diabetes mellitus, outcome of pregnancy, risk factors
| Abstract 002|| |
| Sickle Cell Disease and Outcome of Pregnancy among Women in North Western Nigeria|| |
C. E. Shehu, A. U. Adoke, A. A. Panti, K. Tunau, M. Hassan, M. Ndakotsu 1
Departments of Obstetrics and Gynaecology and 1 Haematology, Usmanu Danfodiyo University Teaching Hospital, PMB 2370, Sokoto, Sokoto State, Nigeria
Background: Sickle cell disease (SCD), an autosomal linked recessive genetic disorder is most prevalent in individuals of African descent. Pregnancy increases the risk of maternal and fetal morbidity and mortality in SCD patients. This study aims to determine the incidence and outcome of pregnancy among SCD patients in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A 10-year retrospective study of SCD in pregnancy managed in UDUTH, Sokoto from January 1, 2001 to December 31, 2011 was carried out. Relevant data were extracted from case files and analyzed using SPSS for Windows version 20.0 SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Results: There were 64 cases of SCD in pregnancy during the period under review giving an incidence of 0.26%. None of the patients had any form of documented preconceptional care. The majority (87.5%) were booked. Most, 57 (89.1) were of SS-genotype, and 7 (10.9%) were SC. The average gestational age at booking was 20 ± 2 weeks. The mean parity was 3 with the highest parity being 6. There were 7 maternal deaths giving a case fatality rate of 10.9%. Conclusion: The incidence of SCD in pregnancy is relatively low in the study population. Preconceptional care, multidisciplinary approach to management and the need to limit family size among SCD patients may improve the outcome of pregnancy.
Keywords: Maternal morbidity, mortality, sickle cell disease
| Abstract 003|| |
| A 10-Year Review of Pelvic Organ Prolapses at Usmanu Danfodiyo University Teaching Hospital Sokoto|| |
Y. Ahmed, A. A. Panti, A. A. Ladan, A. T. Burodo, M. A. Hassan, S. Nasir S
Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
Background: Prolapse is the protrusion of an organ or structure beyond its normal anatomical confines. Pelvic organ prolapse is a very common problem among multiparous women over the age of 40 years. This study determined the prevalence, determinants, and complications of pelvic organ prolapse at the Usmanu Danfodiyo University Teaching Hospital, Sokoto (UDUTH). Materials and Methods: We carried out a retrospective study of patients with pelvic organ prolapse managed at UDUTH, Sokoto between January 1, 2003 and December 31, 2012. Results: The prevalence of pelvic organ prolapse was 1.42% of all gynecological admissions. The mean age of the patients was 45.3 ± 16.1 years. The majority of the patients (63.7%) were premenopausal. Grand multiparous women constituted 65.9% of the patients. The most common presenting symptom was "something protruding through the vagina" which was observed in all the patients. Among the patients 74.8% had uterovaginal prolapse, 12.1% had a cystocele, 6.6% had a rectocele while 5.5% had a combined cystocele and rectocele. The most common risk factor identified was unsupervised home delivery. Most of the patients had surgical interventions including vaginal hysterectomy 59.3%, anterior colporrhaphy 7.7%, and posterior colpoperineorrhaphy 6.6%, while combined anterior colporrhaphy and posterior colpoperineorrhaphy 5.5%. Bleeding was the most common intra-operative complication encountered in 10.7% of the patient that had surgery. Anemia (10.7%) and wound infection (2.7%) were the most common postoperative complications. Conclusion: Multiparity, prolonged labor, and unsupervised deliveries were significant determinants of pelvic organ prolapse. We recommend good antenatal care, deliveries attended by skilled birth attendant and access to effective family planning as preventive measures.
Keywords: Bleeding, hysterectomy, utero-vaginal prolapse
| Abstract 004|| |
| Hemostatic Parameters in Women on Hormonal Contraceptives in Ahmadu Bello University Teaching Hospital Zaria|| |
S. B. Abubakar, A. I. Mamman 1 , M. A. Abdul 2 , A. O. Jimoh 3 , K. Abubakar 4
Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Departments of 1 Haematology and 2 Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria, 3 Department of Pharmacology and Therapeutics, College of Health Sciences, 4 Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Usamnu Danfodiyo University, Sokoto, Nigeria
Background: The prevalence of contraceptive use among women of reproductive age has been on the increase worldwide. Increased risk of venous thromboembolism due to alteration in the clotting profile among users has been documented in both Caucasians and Nigerians. Materials and Methods: A total of 200 consenting participants made of 140 subjects on different forms of hormonal contraceptives (oral, injectables, and intradermal implant) and 60 controls on nonhormonal intrauterine contraceptive device were recruited into this study. Four and half milliliter of blood were collected into a test bottle containing 0.5 ml of 3.2% sodium citrate for assay of hemostatic parameters namely prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT). These were measured using standard methods. The results were analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 software SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Statistical significance was based on P < 0.05. Results: The average PT and APTT of the subjects were below the normal reference ranges (12-17 s) and (30-40 s), respectively. The mean PT of the subjects was 11.46 ± 1.23 s, while the mean PT of the controls was 13.79 ± 1.27 s with a statistically significant difference (P < 0.05). Similarly, the subjects and controls differed significantly in APTT (27.99 ± 4.08 vs. 32.49 ± 2.81 s) and TT (17.57 ± 2.04 vs. 20 ± 2.81 s); (P < 0.05). The study group had about 19-fold higher thrombogenic risk than the control group (odds ratio 18.8). Conclusion: The use of hormonal contraceptives results in altered hemostatic profile resulting in a hypercoagulable state, which confers a higher thrombogenic risk on the user compared to nonusers.
Keywords: Hemostatic parameters, hormonal contraceptives, thrombogenic risk
| Abstract 005|| |
| Pattern of Cancers Treated with Radiotherapy in Usmanu Danfodiyo University Teaching Hospital, Sokoto: A New Center Experience|| |
Usman M. Aliyu, Abdulgafar O. Jimoh 1 , Sani B. Abubakar 2 , Edith G. Odoh 3
Departments of Radiotherapy, 2 Haematology and 3 Pharmacy, Usmanu Danfodiyo University Teaching Hospital, 1 Department of Pharmacology and Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
Background: In recent years, there has been an increase in the incidence of cancer cases in the developing world where late presentation is common thereby compounding the already existing challenges in its treatment particularly radiotherapy. This study was carried out to describe the pattern of cancers managed in the Radiotherapy Department in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: This was a cross-sectional descriptive study involving patients with malignancies that attended the new Oncology Department of the UDUTH, Sokoto, North-West Nigeria for the period of 1-year (June 2013 to May 2014). The data were analyzed by using SPSS (versions 20) SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Result: A total of 304 patients were seen. Two hundred and three patients with complete records met the criteria for the study. The majority of 201 (66.1%) were females with mean age of 44.6 ± 16.8 years. The male patients were aged 42.9 ± 14.2. The spectrum of malignant lesions observed were cancer of the cervix 77 (37.9%), breast 74 (36.5%), nasopharyngeal 20 (9.9%), larynx 18 (8.9%), and rectum 14 (6.8%). Late presentation was most common with 6 (3%), 101 (49.8%), and 58 (28.6%) patients presenting with Stage I, III, and IV, respectively. Conclusion: Our data demonstrates that cancer of the cervix is the leading malignancy in the study population. Late presentation was common. Screening and public enlightenment are advocated.
Keywords: Cancer, late presentation, new center, radiotherapy
| Abstract 006|| |
| Outcome of Locked Intramedullary Nailing of Long Bone Fractures: Experience from A Tertiary Hospital in North West Nigeria|| |
M. Oboirien, S. Ukwuani
Department of Orthpaedics and Trauma, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: The management of diaphysial fractures of long bones especially of the femur and tibia has evolved over the years from the use of unlocked Kutscher's nail to locked intramedullary nails. We sought to document our experience with this method of fracture fixation. Methods: A retrospective review of cases of long bone fractures managed in North-West Nigeria from June 2013 to May 2014. Hospital records of patients were retrieved and collated. Statistical analysis was done with SPSS version 20 SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Results: A total of 17 patients with a mean age of 34.5 ± 14.5 years made of 14 males and 3 females were operated. Eighteen long bones (12 femurs and 6 tibiae) were operated. The motor vehicular accident was the most common cause of fracture in 14 (82.4%) patients. Eleven patients presented early, and indications for surgery were closed fractures 4 (36.4%) and open fractures 7 (63.6). Nonunion 3(42.8%), mal-union 2 (28.6%), and failed plate osteosynthesis 2 (28.6%) were the indications in those that presented late. Distal locking was achieved with the aid of external jig in 14 cases and with C-arm in 2 cases. Average hospital stay was 3 weeks. Union was achieved in 12 cases after 12 weeks follow-up. Complications included failed fixation, wound infection, and breach of the ankle in 1, 2, and 1 cases, respectively. Conclusion: Locked intramedullary fixation is a useful method with reduced radiation and short hospital stay.
Keywords: Intramedullary fixation, outcome, radiation
| Abstract 007|| |
| Survey of Endemic Bacterial Species in the Theater of A Tertiary Health Care Institution in the North West of Nigeria|| |
R. F. Atata, A. Abdulwahab Ahmed 1 , A. U. Kaoje 2 , A. A. Sabir 3 , A. O. Jimoh 4
Department of Pharmaceutics and Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Departments of 1 Surgery, 2 Community Health, 3 Medicine and 4 Pharmacology and Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
Background: Surgical wound nosocomial infections have been linked with bacteria from the hospital environment. Data on organisms present in most of the Nigeria hospitals and particularly the theaters are scanty. The aim of this work was to isolate the endemic bacterial type in the theater of a university teaching hospital in the North West of Nigeria. Materials and Methods: The aerial bacteria in 15 different points comprise of 6 theaters and sterile room were trapped by settling plate method, using nutrient, MacConkey and Blood agar as the culturing media. Plates were incubated aerobically for 24 h after 30 min of exposure. The colonies developed were counted and fully characterized by using both traditional biochemical and E-test kits. Result: The result showed that average bacterial counts in the theater and the sterile room ranged from 4 to 34 cfu/m 3 . The isolated and identified bacterial species included the following: Bacillus megaterium (45%), Bacillus subtilis (6%), Bacillus cereus %), Escherichia More Details coli (9%), Staphylococcus aureus (15%), Staphylococcus epidermidis , and Proteus mirabilis (10%). Conclusion: In term of bacterial count, all the theater meet the standard for type B clean room, with bacterial count <100 cfu/m 3 predominance of Bacillus species is an indication of common source of contamination. Therefore, there is a need for comprehensive review of disinfection policy in this theaters.
Keywords: Bacteria isolates, disinfection, teaching hospital theater
| Abstract 008|| |
| Cranial Index and Head Shape Pattern in Children with Sickle Cell Disease from Sokoto, Nigeria: A Comparative Study|| |
M. A. Musa, H. Ahmed 1 , A. D. Zagga, M. Danfulani 2
Department of Anatomy, College of Health Sciences, Usmanu Danfodiyo University, Departments of 1 Pediatrics and 2 Radiology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: Cranial index (CI) is one of the clinically recognized anthropometric parameters in the investigation of the craniofacial skeleton. Sickle cell disease (SCD) is a common single gene disorder in Africa. This study evaluated CI and head shape pattern of children with SCD in comparison with normal growing children without SCD from Sokoto, Nigeria. Materials and Methods: The head length and head width of 103 children (54 males and 49 females) with SCD and 218 normal growing non-SCD children (121 males and 97 females) aged 0-18 years old were measured using internationally accepted standards and CIs calculated. This study was conducted over a period of 6 months (July to December, 2012). Results: The overall mean CI in normal growing non-SCD children was 79.82 ± 3.35 and 80.12 ± 3.39 in children with SCD. The difference was not statistically significant (P = 0.4526). Brachycephaly was more frequent in SCD than non-CSD children (75 [72.8%] vs. 20 [10.1%]) while mesocephalic head shape had an opposite trend (10 [9.7%] vs. 178 [81.7%]). The proportion of children with hyperbrachycephaly (10 [9.7%] vs. 13 [5.9%]) and dolicocephalic head shape (3 [2.9%] vs. 7 [3.2%]) were similar 1 and 2 groups. Conclusion: Brachycephalic head shape was predominant in children with SCD while the mesocephalic head shape was predominant in normal growing children without SCD.
Keywords: Cranial index, head shapes, sickle cell disease
| Abstract 009|| |
| Awareness and Acceptance of Renal Donation and Transplant among Health Workers in Sokoto, Nigeria|| |
N. P. Agwu, K. Awosan 1 , S. Ukwuani, E. U. Oyibo, M. Makusidi 2
Department of Surgery, Urology Unit, Usmanu Danfodiyo University Teaching Hospital, 1 Department of Public Health, Usmanu Danfodiyo University Teaching Hospital, 2 Department of Internal Medicine, Nephrology Unit, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: Kidney transplant is the accepted gold standard treatment for the end-stage renal disease. Renal transplantation depends not only on the enabling laws, trained personnel but also on the availability of donor kidneys, which may be obtained from either living or cadaveric donors. Health workers serve as important links in communicating health-related issues to the community. Therefore, their knowledge, and acceptance of this form of therapy may have a great impact on the larger community. The objective of this study was to determine the awareness and acceptance of health workers to kidney donation and transplant. Materials and Methods: This was a questionnaire-based prospective study of randomly selected 472 staff of the Usmanu Danfodiyo University Teaching Hospital, Sokoto in North-Western Nigeria. Results: There were 286 males (60.6%) and 186 (39.4%) females with a mean age of 34.08 ± 7.81 years. Religious affiliations consisted of 347 (73.5%) Muslims and 125 (26.5%) Christians. About 463 (98.1%) knew about renal transplant. The majority knew of the acceptance of transplant in their respective faiths. Four hundred and sixteen (88.1%) were willing to accept living donation while 46 (9.7%) were not sure. Religious belief was the most important reason for not accepting the renal transplant. There was no significant difference between the sexes in their willingness to donate kidneys (P - 0.485). However, there was a significant difference between Muslims and Christians in their willingness to donate (P - 0.019). Married persons and medical doctors were more willing to donate than single persons and nonmedical doctors (P - 0.005 and 0.006, respectively). Conclusions: Health workers in Sokoto are aware of the practice of renal donation and transplant. However, religious beliefs marital status and the professional category of the health worker had a significant influence on their acceptance to participate in living kidney donation and transplant.
Keywords: Acceptance, awareness, kidney transplant and donation
| Abstract 010|| |
| Pattern pf Presentation and Management Outcome of Priapism in Sokoto|| |
A. S. Muhammad, N. P. Agwu, A. A. Abdulwahab, A. Alhassan, I. A. Mungadi, S. B. Abubakar 1 , A. U. Musa 1 , M. A. Ndakotsu 1
Departments of Surgery and 1 Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: Priapism is a persistent erection, which is usually painful, not relieved by ejaculation and unrelated to sexual stimulation. It is a urologic emergency. Presentation in our environment is late, and consent for surgical intervention is also delayed or refused. We studied the pattern of presentation, management, and outcome of priapism at Usmanu Danfodiyo University Teaching Hospital, Sokoto (UDUTH) over 5 years period. Materials and Methods: A retrospective study of 17 out of 20 patients managed for priapism by Urology Unit of UDUTH between 2009 and 2014. Results: The mean age of presentation was 20.8 years (range 8-55 years). Fifteen patients (88%) presented beyond 72 h of the onset. All the patients had ischemic priapism. Predisposing factors to priapism included sickle cell disease 9 (52.9%), an overdose of aphrodisiacs-sildenafil - 3 (17.6%), chronic myeloid leukemia 2 (11.9%), and unknown 3 (17.6%). The most effective form of treatment was glanulo-cavernosal shunt (Al-Ghorab). Other forms of treatment were a corporal aspiration, winter's shunt. Spontaneous resolution was observed in 2 (11.8%) patients. There was one patient had erectile dysfunction as a complication. Conclusion: Sickle cell disease is the most common cause of priapism in our practice. Late presentation is frequent.
Keywords: Predisposing factor, priapism, treatment
| Abstract 011|| |
| Lymph Node Fine-Needle Aspiration Cytology in A Tertiary Institution in North-Western Nigeria|| |
U. Mohammed, K. Abdullahi, A. S. Maiyaki 1 , K. Mande 1 , M. A. Usman 2 , O. Y. Bashir 1
Departments of Pathology, 1 Medicine and 2 Radiotherapy and Oncology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: Extrapulmonary tuberculosis, lymphoma, and metastatic carcinoma often manifest as peripheral lymphadenopathy or palpable intra-abdominal masses and can be diagnosed by fine-needle aspiration cytology (FNAC). The objective of this study was to analyze the various peripheral lymph node FNAC requests as seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, a tertiary health center that subserves much of North-Western Nigeria, determine pattern of diagnosis and compare with other studies. Materials and Methods: This is a 4 years review of patients with palpable peripheral lymph node enlargement referred to the Department of Pathology, UDUTH, from 1 st January 2010 to December 31, 2013. They were subjected to FNAC using a disposable 21 gauge needle and 20 ml disposable plastic syringe. Aspirates were smeared on microscopic slides and immediately fixed in 95% alcohol and stained using Papanicolaou, Hematoxylin and Eosin, Leishman and Ziehl-Nielseen stain specific for acid fast bacilli of mycobacterium tuberculosis. Results: A total of 94 FNACs were performed. There were 68 (72.3%) males and 26 (27.7%) females. The cervical region was the most common site for the FNAC accounting for 58 (61.7%) cases. Other sites included intra-abdominal 13 (13.8%), axillary 11 (11.7%), supraclavicular 4 (4.3%), submandibular 3 (3.2%), and concurrent sites involving axillary and cervical areas 5 (5.3%). The indications for FNAC included lymphoma 38 (40.4%), tuberculous adenitis 30 (31.9%), and others 26 (27.7%). Cytological diagnosis were chronic granulomatous inflammation 40 (42.6%), malignant neoplasms 31 (33.0 %), and reactive nonspecific hyperplasia 23 (24.5%). Malignant aspirates appeared more in 1 st and 2 nd decades of life followed by the 5 th while chronic granulomatous inflammation was common in the 2 nd and 3 rd decades of life. Reactive changes were most common in the 5 th decade. Conclusion: The diagnostic dilemma posed by extrapulmonary tuberculosis, lymphoma, and metastatic lesions in resource-limited developing countries could be minimized by FNAC. This will ensure prompt treatment and curtail unnecessary delays in management.
Keywords: Cytology, fine-needle aspirate, lymph node
| Abstract 012|| |
| Histopathologic Diagnosis of Products of Conception Following First Trimester Spontaneous Miscarriages in a Tertiary Hospital|| |
C. E. Shehu, B. Sulaiman, M. Umar, A. Kabiru 1
Departments of Obstetrics and Gynaecology and 1 Pathology, Usmanu Danfodiyo University Teaching Hospital, PMB 2370, Sokoto, Sokoto State, Nigeria
Background: Histopathological examination of products of conception from miscarriages was part of routine clinical practice. However, the National Institute for Health and Care Excellence guideline now recommends only a home pregnancy test in 3 weeks instead. We evaluated and compared the histopathologic findings relating to tissue samples collected at manual vacuum aspiration for first-trimester spontaneous miscarriages with the initial clinical diagnosis. Materials and Methods: A retrospective study of histopathologic diagnosis of the tissue samples obtained by manual vacuum aspiration from January 1, 2009 to December 31, 2013 in patients who were admitted to the Gynecology Ward of Usmanu Danfodiyo University Teaching Hospital, Sokoto with the diagnosis of incomplete miscarriage, missed miscarriage and inevitable miscarriage in the first trimester was carried out. The findings were recorded and compared with the presurgery diagnosis. The data obtained were analyzed using SPSS version 16.0 SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Results: Five hundred and sixty-eight patients with the diagnosis of incomplete, inevitable or missed miscarriage were seen during the study period. Their mean age was 27.2 ± 5.7 years; mean parity was 2.9 ± 2.5, and mean gestational age at presentation was 10.1 ± 2.3 weeks. The most common parity was Para 0 constituting 23.4%, and lower abdominal pain with vaginal bleeding 398 (70.1%) was the most common presenting complaint. The major histopathologic diagnosis was products of conception 486 (85.6%). There were 5 (0.9%) diagnoses of partial hydatidiform mole. Conclusion: Histopathological examination of the products of conception following miscarriage may not be necessary as other cheaper laboratory tests can be employed to detect molar pregnancy.
Keywords: Histopathology, miscarriage, product of conception
| Abstract 013|| |
| Knowledge, Attitudes, and Perceptions of Adults About Hypertension in a Rural Area of Sokoto State, Nigeria|| |
B. A. Isah, A. A. Sabir 1 , K. J. Awosan, A. U. Kaoje, M. O. Raji, S. M. Sulley 2 , V. A. Ofuje 2 , Y. M. Umar 2
Departments of Community Medicine and 1 Internal Medicine, Usmanu Danfodiyo University and Teaching Hospital, 2 Depatment of Community Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
Background: Hypertension has become a significant disease as a result of the rising incidence and epidemiological transition from communicable to noncommunicable diseases. This study assesses the knowledge, attitudes, and perceptions of individuals in a rural area of Sokoto State. Materials and Methods: A cross-sectional study carried out at Sifawa, Bodinga local government area of Sokoto State. Data were obtained using an interviewer - administered questionnaire, which was randomly administered to 176 respondents and analyzed using SPSS version 20 SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Results: The age of the patients ranged from 18 to 83 years with 45 of the respondents between 16 and 25 years of age having highest percentage (25.60%); and lowest being the 66-75 and 76-85 years age groups having 12%. Of the 176 respondents, 123 (69.9%) were male and 53 (30.1%) female. Most of them (50%) were into business as an occupation. About 74.4% Hausa, 99.4% Muslim, and 75% married. The proportion of respondents with good knowledge score was 45.5%. However, knowledge of the risk factors of hypertension ranged from 40% for alcohol to 76.6% for lack of exercise. The knowledge about complications ranges from 50.3% for kidney damage (nephropathy) to 82.3% for heart failure. Most of the respondents had a poor attitude with an attitude score of 47%. There are various perceived causes of hypertension; however, the majority (46%) thought it to be caused by excessive stress and 42.3% to genetics. There was a significant statistical association between gender and the knowledge. However; there was no association between gender and attitudes toward hypertension. Conclusion: Our data demonstrate inadequate knowledge and poor attitude toward hypertension by the study subjects. Health education, motivation, and public enlightenment are imperative in this community.
Keywords: Attitude, hypertension, knowledge, rural area
| Abstract 014|| |
| Awareness, Knowledge, Risk Perception of HIV/AIDS, 0 and Risky Sexual Behaviors among Commercial Motorcyclists in Sokoto Metropolis|| |
B. A. Isah, K. J. Awosan 1 , Z. Ahmed 1 , Y. A. Raheem 1 , A. Gambo 1
Department of Community Medicine, Usmanu Danfodiyo University and Teaching Hospital, 1 Depatment of Community Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
Background: This study was a descriptive cross-sectional study conducted among 265 commercial motorcyclists in Sokoto Metropolis to determine awareness, knowledge, risk perception, and risky sexual behaviors among the respondents. Materials and Methods: The study population included all commercial motorcyclists within Sokoto Metropolis who have spent at least 6 months in the business. Data were collected using semi-structured interviewer administered the questionnaire, and the results were analyzed using SPSS version 20 SPSS Manufacturer (IBM Software Group's Business Analytic Portfolio). Informed consent was obtained from each respondent. Result: The average age of the respondents was 28.24 years, 99.2% were Hausa/Fulani, 100% were Muslims, and 32.1% were single. About 97% of the respondents were aware of HIV/AIDS, but only 64.5% had good knowledge. Their risk perception is low as 60.9% of the respondents perceive themselves as having no risk. They have low risky sexual behaviors as only 7.6% admitted to having extramarital affairs, but 30% of them use condom regularly. Conclusion: The findings in this study showed a high level of awareness and good knowledge of HIV/AIDS with low-risk perception and low risky sexual behaviors among respondents.
Keywords: Attitude, commercial motor cyclist, HIV/AIDS, knowledge, risky behaviors
| Abstract 015|| |
| Cleft Lip and Palate: Experience at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria|| |
O. A. Taiwo, J. N. Legbo 1 , A. C. Opara 1 , O. Opara 1
Departments of Dental and Maxillofacial Surgery and 1 Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: Cleft lip with or without palate is the most common orofacial birth defect worldwide. It has significant medical, psychosocial, and economic impact on the afflicted and health resource. There is a paucity of information in the North-Western Nigeria and our center on the management of this condition. Hence, the aim of this study was to determine the pattern of presentation and treatment of cleft lip and palate at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria between 2006 and 2011. Materials and Methods: Relevant clinical data of the subjects were retrieved and analyzed. Results: A total of 19 patients were managed during this period, and there was a male preponderance (male:female = 5.3:1). Their ages ranged from 3 months to 39 years (mean: 8.8 ± 12.5). Cleft lip with or without alveolus was the most commonly seen defect (36.8%). The left side was twice involved as the right. Nineteen primary cleft surgeries were done (cheilorraphy, n = 13; palatorraphy, n = 6). Conclusion: Late presentation still remains a problem in our center and highlights the urgent need to create more public awareness.
Keywords: Cheilorraphy, cleft lip and palate, palatorraphy
| Abstract 016|| |
| Hysteroscopic Adhesiolysis for Asherman's Syndrome: A Case Report|| |
A. N. Adamu, T. S. Yusuf
Laparoscopic Surgical Unit, Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin-Kebbi, Kebbi State, Nigeria
Background: Asherman's syndrome is a recognized cause of secondary amenorrhea. In most centers in Nigeria, it is managed by blind adhesiolysis. We present a case of hysteroscopic adhesiolysis in a patient with secondary amenorrhea due to Asherman's syndrome. Case Report: A 27-year-old Para 0 + 2 presented with the absence of menstruation for 3 years. General and systemic examinations at presentation were normal, and an assessment of secondary amenorrhea due to suspected Ashermann's syndrome was made. A pelvic ultrasound scan revealed a normal sized empty uterus and hysterosalpingography revealed a uterine cavity that was reduced to a tubular irregular channel consistent with severe uterine adhesions. Both tubes were not demonstrated. She was counseled on hysteroscopic adhesiolysis, and she consented. Intra-operatively, hysteroscopy revealed multiple fibrotic bands stretching haphazardly between anterior and posterior uterine walls. Adhesiolysis was carried out, and a size 12 Foley's catheter inflated with 2 ml of normal saline left in the cavity. The procedure was uneventful, and the patient was discharged home a day after surgery. The catheter was removed after 10 days and menses resumed within 2 weeks of surgery. It lasted 6 days, and the flow was normal. Conclusion: Hysteroscopic adhesiolysis offers the opportunity for direct visualization of the uterine cavity as the procedure is being done thereby reducing the risk for complications.
Keywords: Adhesiolysis, Asherman's syndrome, hysteroscopy
| Abstract 017|| |
| Neuromyelitis Optica and Myasthenia Gravis in A Young Nigerian Girl: A Case Report|| |
S. A. Balarabe, M. D. Adamu 1 , N. M. Jiya 2
Departments of Medicine, 1 Surgery and 2 Paediatrics, Usmanu Danfodiyo University Sokoto, Nigeria
Background: Myasthenia gravis (MG) and neuromyelitis optica (NMO) are rare autoimmune disorders, with upper-limit prevalence estimates in the general population of 15 per 100,000 and 5 per 100,000, respectively. There is some evidence that patients with MG have a higher risk of developing autoantibodies and other neuroimmune disorders than normal individuals. Coexistence of the two disorders has rarely been documented, especially in Nigeria. Case Report: This is a case report of a 16-year-old secondary school student who presented with recurrent episodes of transverse myelitis and optic neuritis after 8 years of diagnosis with MG. A 16-year-old Fulani girl, who presented with 3 weeks history of sudden weakness of her lower limbs that, was preceded by numbness and parasthesia. There was associated the history of mild bladder and bowel dysfunctions. More than two episodes of the disease, varying in duration, have been described in the past. Based on previous diagnosis of MG, history of relapsing and remitting signs, clinical evidence of spinal cord and optic nerve involvement, high level of acetylcholine receptor binding AB, chest computed tomography finding of thymoma, as well as positive NMO-IgG antibody, the diagnosis of neuromylitis optica on background MG was made. Conclusion: A high index of suspicion is required in the diagnosis of NMO co-existing with MG in low-income resource-limited society like Nigeria.
Keywords: Autoimuune disease, myesthenia gravis, neuromyelitis optica
| Abstract 018|| |
| Mycophenolate Mofetil Therapy in Scleritis: Analysis of Seven Cases in a Tertiary Eye Care Center in India|| |
K. F. Monsudi, Jyotirmay Biswas 1
Department of Ophthalmology, Federal Medical Centre, Birnin Kebbi, Nigeria, 1 Department of Ocular Pathology, Medical and Vision Research Foundations (Sankara Nethralaya Eye Hospital), Tamil Nadu, Chennai, India
Background: Mycophenolate mofetil (MMF) is a newer immunomodulatory agent. It is the morpholinoethyl ester of the mycophenolic acid, which causes reversible inhibition of ionosine-5'-monophosphate dehydrogenase. It has been used widely and successfully in the various immune mediated conditions and solid organ transplantation. The purpose of this study was to evaluate the effectiveness of MMF in the treatment of scleritis. Materials and Methods : A retrospective, noncomparative study of seven cases of scleritis managed with MMF. Results: There were 5 females and 2 males. Three patients with anterior nodular and four patients with diffuse anterior scleritis were identified. The mean follow-up was 6 months. Six patients maintained the pretreatment visual acuity (VA) and one with improved VA. At 6 months follow-up, all patients were free of premedication symptoms and inflammatory signs (redness, conjunctiva edema). No side effect was reported by the patients. Conclusion: MMF is an effective drug in the management of anterior scleritis.
Keywords: Corticosteroids, mycophenolate mofetil, scleritis
| Abstract 019|| |
| Congenital Anterior Urethral Diverticulum Co-Existing with Phimosis: A Case Report|| |
A. Abubakar, A. Abdullahi
Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
Background: Congenital anterior urethral diverticulum (CAUD) is a rare urethral pathology. We report its coexistence with pathological phimosis. Case Report: We report a case of a 7-year-old boy we managed in January, 2014 at Abubakar Imam Urology Centre who presented with CAUD coexisting with pathological phimosis. A case of 7-year-old boy presented in Abubakar Imam Urology Centre, Kano with difficulty in passing urine including obstructive and irritative lower urinary tract symptoms. His prepuce was not retractable and balloons at voiding. Urine MCS yielded no growth, and the results of U/E/Cr and PCV were normal. Associated CAUD was discovered at circumcision. He did well with no lower urinary tract symptoms at follow-up after treatment. The symptoms of CAUD and phimosis mimic one another, and the clinical diagnosis of phimosis overshadows the needed imaging studies confirmatory for CAUD. Conclusion: CAUD can co-exist with pathological phimosis and should be looked during circumcision. Excision of the diverticulum and urethroplasty is the treatment for the diverticulum while circumcision at the same sitting cured the phimosis.
Keywords: Circumcision, Phimosis, urethral diverticulum
| Abstract 020|| |
| Bilateral Femoral Catheter Fracture and Migration: A Case Report|| |
U. Abubakar, H. M. Liman 1 , A. M. Makusidi 1 , E. O. Oyibo 2 , S. M. Ibrahim 2
Department of Surgery, Cardiothoracic Surgery Unit, Usmanu Danfodiyo University Teaching Hospital, 1 Department of Medicine, Nephrology Unit, Usmanu Danfodiyo University Teaching Hospital, 2 Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: Catheter embolization is the term generally applied to catheter fragments that embolize to various locations including pulmonary arteries. The population at risk has grown considerably due to the use of central venous catheters for long-term parenteral nutrition, blood sampling, delivery of chemotherapeutic agents for cancer, and for maintenance hemodialysis. Case Report: A 26-year-old housewife with end-stage renal disease on hemodialysis was referred to our hospital on account of bilateral fracture and migration of femoral dialysis catheters of a month duration. She had bilateral groin exploration and successful removal of the catheters. Conclusion: Bilateral femoral catheters are at risk of fracture and migration with attendant potential for embolization and fatal consequences. We advocate early removal to avert these consequences.
Keywords: Embolization, femoral catheter, fracture, hemodialysis
| Poster Presentations|| |
| 021|| |
| Primary Umbilical Endometriosis|| |
A. A. Panti, K. A. Tunau, S. P. Agbo 1 , U. Mohammed 2 , I. O. Omokanye 3 , B. Ugege
Departments of Obstetrics and Gynaecology, 1 Surgery and 2 Pathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, 3 Department of Obstetrics and Gynaecology, University Teaching Hospital Ilorin, Kwara State, Nigeria
Background: Primary endometriosis is the presence of endometrial glands and tissues outside the endometrial cavity. Primary umbilical endometriosis is a very rare disease entity. Case Report: We report a 40-year-old Para 2 plus 9 (2 alive) woman who presented with 2 years history of umbilical swelling with cyclical pain. She was managed by simple excision, and a diagnosis of umbilical endometriosis was confirmed by histopathological examination. Conclusion: Endometriosis should be considered as a differential diagnosis in cases of any cyclical umbilical pain or swelling in women of reproductive age group.
Keywords: Endometriosis, primary, Sokoto, umbilicus
| 022|| |
| Awake Craniotomy: Usmanu Danfodiyo University Teaching Hospital Experience|| |
N. J. Ismail, A. Lasseini, O. O. Ogunleye
Department of Neurosurgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Background: In Nigeria, the most cases of intraaxial brain tumors are done under general anesthesia. This is quite costly to both patients and service providers awake craniotomy has allowed us use limited resources available to remove intraaxial brain tumors effectively and cheaply with excellent patient satisfaction. Methods: Adults patients with intraaxial tumors were counseled on awake craniotomy. The surgeries were done under local anesthesia while the patients interacted with the surgical team during the course of surgery. Results: Tumor excision was done effectively and efficiently in all patients without the need for ICU care. Most of the patients were discharged home within 48 h after surgery. All patients reported great satisfaction for the procedure and the rate of recovery. Conclusion: Awake craniotomy has allowed us use limited resources available to remove intraaxial brain tumors effectively and cheaply with excellent patient satisfaction. This efficient and cost-effective procedure is recommended for resource-limited settings, especially in Africa.
Keywords: Awake craniotomy, cost effectiveness intracranial tumour
| 023|| |
| Iatrogenic Fecal Diversion via Suprapubic Catheter in Patient with Urethral Stricture: Case Report|| |
A. S. Muhammad, M. Bello 1 , M. Ahmad 1 , H. Y. Maitama 1
Division of Urology, Usman Danfodiyo University Teaching Hospital, Sokoto, 1 Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Background: Suprapubic cystostomy (SPC) is a procedure of diversion of urine at the level of the bladder in infra vesical obstruction. It is done commonly to relieve acute, chronic or acute on chronic urine retention from urethral stricture, urethral injury or rarely following failed catheterization in patients with medial lobe enlargement. It can be open or percutaneous via ultrasound guidance or blind. Blind punctures and sometimes open procedures are associated with bowel injury. Our objective was to report a case of iatrogenic suprapubic fecal diversion in a patient with acute-on-chronic urinary retention from urethral stricture. Case Report: A 60-year-old military officer with 6 months history of SPC for acute on chronic urine retention from urethral stricture and regular monthly change of suprapubic catheter, presented with urine retention. The effluent was noticed to be feculent. He had abdominal exploration, repair of jejunal perforation, segmental resection of devitalized Jejunum, and end-to-end anastomosis. SPC was also done. He had urethroplasty after 6 months. Conclusion: Bowel injury may occur during blind percutaneous or stab SPC. For suprapubic or stab SPC, full bladder, and ultrasound guidance are necessary to avoid bowel injury.
Keywords: Bowel injury, suprapubic cystostomy, urine retention
| 024|| |
| Rare Presentation of Malignant Oral Melanoma: A Case Report|| |
O. A. Taiwo, R. A. Adewole 1 , O. M. Gbotolorun 1
Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, 1 Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Nigeria
Background: Malignant oral melanoma is a very rare fatal disease, with rapid progression, frequently seen with lymph node metastasis and high mortality. It may be encountered as asymptomatic benign pigmented oral lesions in routine clinical practice. Although uncommon, it presents major challenges in terms of clinical classification, staging, and treatment. Case Report: A 60-year-old man with 5 months history of persistent bleeding from a pigmented progressive intraoral swelling. There were findings of bluish gingival swelling around the lower right first molar with ipsilateral submandibular lymphadenopathy. Chest X-ray showed some canon ball appearances in both lung fields. Fine-needle aspiration biopsy suggestive of oral melanoma. Patient decline treatment and opt for alternative medicine. A diagnosis of malignant oral melanoma was made and presently undergoing radiotherapy. Conclusion: Pigmented lesion should be viewed with suspicion. Possible early biopsy should be encouraged to rule out oral melanoma.
| 025|| |
| Palliative Nephrectomy: Extending the Indications: A Case Report|| |
A. Abubakar, S. Suleiman 1
Departments of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, 1 University of Abuja Teaching Hospital Gwagwalada, Nigeria
Background: Renal cell carcinoma remains the most lethal of all urological tumors and has the highest reported associated paraneoplastic syndromes, but nonmetastatic contralateral renal dysfunction is not common. Case Report : MH is a 49-year-old widow who presented with a 2 months history of right flank swelling and pain, hematuria and features of uremia. Examination revealed a ballotable right renal mass. Abdominal computed tomography (CT) scan showed Stage III right renal tumor with normal contralateral kidney. She was hemodialysis-dependent but was prepared and offered palliative nephrectomy. Postpalliative nephrectomy she had a resolution of symptoms, U/E + Cr remained normal and hence required no further dialysis. Histology revealed clear cell carcinoma. Conclusion: Palliative nephrectomy for advanced renal tumor has its standard indications. These can be extended to include patient with renal tumor and impaired kidney functions with CT findings of normal contralateral kidney. Palliative nephrectomy may lead to spontaneous resolution of the renal impairment and abate the need for continuous dialysis.
Keywords: Palliative nephrectomy, paraneoplastic syndromes, renal cell carcinoma
| 026|| |
| Rare Presentation of Malignant Oral Melanoma: A Case Report|| |
O. A. Taiwo, R. A. Adewole 1 , O. M. Gbotolorun 1
Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, 1 Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Nigeria
Background: Malignant Oral melanoma is a very rare fatal disease, with rapid progression, frequently seen with lymph node metastasis and high mortality. It may be encountered as asymptomatic benign pigmented oral lesions in routine clinical practice. Although uncommon, it presents major challenges in terms of clinical classification, staging, and treatment. Case Report: A 60-year-old man with 5 months history of persistent bleeding from a pigmented progressive intraoral swelling. There were findings of bluish gingival swelling around the lower right first molar with ipsilateral submandibular lymphadenopathy. Chest X-ray showed canon ball appearances in both lung fields. Fine-needle aspiration biopsy was suggestive of oral melanoma. The patient is presently undergoing radiotherapy. Conclusion: Pigmented intraoral lesions should raise suspicion of possible malignancy.
Keywords: Metastasis, oral melanoma, radiotherapy
| 027|| |
| Ultrasound Diagnosis of Giant Vesical Calculus in A 10-Year-Old Boy: Case Report|| |
M. Danfulani, M. A. Musa 1 , B. M. Bashir 2
Departments of Radiology and 2 Surgery, Usmanu Danfodiyo University Teaching Hospital, 1 Department of Human Anatomy, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
Background: Ultrasonography plays a vital role in the management of children with urinary tract infection as it helps not only in assessing the urinary tract but also in excluding any complication that may arise from the disease like urinary tract stone formation. Case Report: We report a 10-year-old boy with giant vesical calculus. The ultrasonographic features demonstrated a huge echogenic, well defined and rounded mass in the urinary bladder casting an acoustic shadow suggestive of a giant vesical calculus. This may be a rare complication of urinary tract infection.
Keywords: Giant vesical calculus, urinary tract infection, ultrasound diagnosis