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   Table of Contents - Current issue
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October-December 2019
Volume 22 | Issue 4
Page Nos. 157-235

Online since Friday, November 29, 2019

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REVIEW ARTICLE  

Prevalence of enuresis among children and adolescents: A systematic review and meta-analysis Highly accessed article p. 157
Abubakar Abdulkadir, Babagana Mustapha Abubakar, Usman Mohammed Tela, Muhammed Ahmed, Ahmad Bello, Maifada Yakasai Ahmad
DOI:10.4103/smj.smj_41_18  
Background: Enuresis is a common dilemma among minors, which is under-documented and under-disclosed. The plight has a negative effect on the quality of life, with an adverse bearing on social and academic development. The recognition of its strains on the family added to the aforementioned necessitated the designation of every last Tuesday of May as annual bedwetting day to create complacent personality among subjects faced with this challenge. Enuresis has worldwide distribution; however, the national prevalence of enuresis is unknown in Nigeria. Objective: The aim of our review is to determine the prevailing prevalence of juvenile enuresis in the country and its regions. Materials and Methods: We used electronic databases to explore reviews and select studies, and then extracted necessary data from the appraisals on prevalence and incidence of enuresis among children and adolescents from Nigerian communities. STATA 12 random effect meta-analysis of observational studies was used to compute the pooled prevalence and other estimates. Results: Twenty-four studies fall within the inclusion criteria. The combined pooled population studied was 15,172 (n = 3567 children and adolescents). The pooled prevalence of enuresis was 28.19% (22.37%–34.00%) (95% confidence interval). Conclusion: This study showed that enuresis is hyperendemic among Nigerian children and adolescents.
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ORIGINAL ARTICLES Top

Circulating brain-derived neurotrophic factor level in patients with primary open angle glaucoma p. 164
Ahmed Saidu, Sadiq Hassan, Ahmadu Shehu Mohammed, Isyaku Umar Yarube
DOI:10.4103/smj.smj_63_18  
Background: Glaucoma constitutes a serious health problem in Nigeria and beyond. It is a leading cause of bilateral blindness and its burden remains high. There is a paucity of literature on the levels of circulating brain-derived neurotrophic factor (BDNF) in health and disease among Africans. In addition, the dynamics and reasons for variation in the levels of BDNF in the local population of glaucoma patients are yet to be demonstrated. Objective: This study determined the circulating level of BDNF and factors associated with it among glaucoma patients. Materials and Methods: Serum concentration of BDNF and other oculo-visual and sociodemographic characteristics were determined in glaucoma patients and controls. Data were processed using IBM SPSS Statistics version 20. Results: Forty-four adult glaucoma patients of both sexes and 41 nonglaucoma controls matched for age and sex with an average age of about 50 years were studied. BDNF level among the glaucoma patients was higher (2.578 ± 1.394) than that of the controls (1.745 ± 0.707) (t = 3.436, P = 0.001). Glaucoma patients who were blind had the lowest levels of circulating BDNF (P = 0.022); the level of BDNF in the naïve patients (not yet placed on medication) is about five times less than in those patients placed on medication (P = 0.001). Circulating BDNF was associated with glaucoma treatment among the patients. Conclusion: The level of circulating BDNF in primary open angle glaucoma patients on treatment is high than those who were not on treatment. It influenced by coexisting medical conditions.
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Cognitive impairment and reduced antioxidant capacity in patients with type 2 diabetes p. 171
Isyaku Umar Yarube, Isyaku Mukhtar Gwarzo
DOI:10.4103/smj.smj_37_18  
Background: Type 2 diabetes (T2D) has been linked to mild cognitive impairment (MCI). Increased oxidative stress and a decrease in antioxidant capacity are believed to be one of the pathophysiological mechanisms mediating MCI in T2D. Objective: The aim of this study was to assess MCI and total antioxidant capacity in T2D patients and their nondiabetic controls. Materials and methods: A total of 34 T2D patients attending the diabetic clinic of Murtala Muhammad Specialist Hospital, Kano, between June and December 2017 and age, sex, and level of education matched controls were recruited for the study. MCI was assessed using Montreal cognitive assessment test (MoCA) version 7.3. Serum albumin, total protein, uric acid, bilirubin, and malondialdehyde (MDA) were determined using spectrophotometric method, whereas Vitamins C and E were determined using competitive-ELISA (Elabscience, USA). Data were analyzed on SPSS version 23.0. The value of P ≤ 0.05 was considered statistically significant. Results: Diabetic group had significantly lower MoCA score (U = 216.50, P = 0.001), compared to the controls (19.5 and 26, respectively). MoCA score was influenced by sex (U = 88.0, P = 0.05) and level of education (χ2 =12.826, P = 0.005) among diabetic patients. MoCA score was correlated with serum levels of Vitamin E (ρ = −0.412, P = 0.015), total protein (ρ = −0.359, P = 0.037), and level of education of the diabetic patients (χ2 =14.664, P = 0.002). Diabetic patients had significantly higher serum MDA (U = 238.50, P = 0.001) (0.19 nmol/ml and 0.11 nmol/ml, respectively) and lower serum bilirubin (U = 351.50, P = 0.05) (1.28 mg/dl and 1.68 mg/dl, respectively). Conclusion: There was MCI with median MoCA score of 19.50 among the diabetics. T2D was associated with MCI, increased oxidative stress and reduced antioxidant capacity. Routine screening for MCI should be employed in the management of T2D.
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Perception and determinants of knowledge and practice of birth preparedness and complication readiness in a rural community p. 179
Abdulhadi Diyo Saidu, Mansur Oche Oche, Mansur Olayinka Raji, Daniel Chukwunyere Nnadi, Bello Alhaji Mohammed, Jamila Abubakar Garba, Jamila Amin, Ismail Raji
DOI:10.4103/smj.smj_74_17  
Background: Maternal deaths are thought to occur due to delay in making appropriate decision to seek care, delay in reaching appropriate health facility, and delay in the provision of care in the health facility. Birth preparedness and complication readiness (BP/CR) ensure that women access care when needed. Objective: This study aimed to assess the knowledge, perception, and practice of BP and CR in a rural community of Sokoto State. Materials and Methods: This was a community-based cross-sectional study; a total of 198 women who were either pregnant or had their last child birth within 2 years of the study were recruited using a systematic sampling method. Result: The study showed that 185 (93.4%) had poor knowledge and 162 (81.2%) had a poor practice of BP/CR although 159 (80.3%) had good perception. Only husband's education was a significant predictor of knowledge of BP/CR, while knowledge of BP/CR and husband's occupation were the predictors of practice. Conclusion: The study revealed that women in the study area had poor knowledge and practice of BP/CR although perception was good. Education of the husband was the only significant predictor of knowledge of BP/CR, while husband's occupation and respondent's knowledge of BP/CR were the significant predictors of practice. Efforts should be made to improve the educational status of the community since education is a predictor of knowledge.
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Prevalence of genital Chlamydia trachomatis infection among patients attending a gynecological clinic in a tertiary hospital p. 188
S Bello, K Tunau, S Nasir, M Yahaya, A Panti, M Hassan, EI Nwobodo, BA Ekele
DOI:10.4103/smj.smj_64_18  
Background: Chlamydia trachomatis is the most common cause of sexually transmitted infections in the world. The organism causes silent infection in women and could remain unnoticed for a very long time. Nearly 80% of women are asymptomatic. It is an established and recognized cause of pelvic inflammatory disease, ectopic pregnancy, and infertility among women. In most parts of Nigeria, including the study area, the organism is not routinely screened for, hence the paucity of information about its prevalence. Objectives: The objectives of this study were to determine the prevalence and risk factors associated with genital C. trachomatis infection among women attending the Gynaecological Clinic of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Materials and Methods: A prospective study was carried out among new patients attending the Gynaecological Clinic of UDUTH, Sokoto. The women were consecutively recruited as they presented to the clinic until the desired sample size was achieved. A structured questionnaire was administered, and related information and consent were obtained. Endocervical swab was collected and tested using Eugene Chlamydia Rapid Test Device following manufacturer's instructions. Results: Samples were collected from a total of 400 women aged between 15 and 49 years. The prevalence of genital C. trachomatis among gynecological patients was 3.5%. The risk factors identified include age of patients below 29 years, early age of onset of sexual activity, and marital status. Conclusion: The study showed that the prevalence of genital C. trachomatis was low. The rate was higher among respondents with infertility. There is a need for routine screening of patients with infertility.
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Clinical and demographic profile of patients with snakebite in a tertiary hospital in Ghana p. 194
Abdul-Subulr Yakubu, Alhassan Abdul-Mumin, Atiku Adam
DOI:10.4103/smj.smj_68_18  
Background: Snakebite is a public health problem affecting mainly rural populations. Objective: To determine the clinical pro le, manifestation, and outcome of snakebite cases presenting to the Tamale Teaching Hospital in Northern Ghana. Materials and Methods: This is a hospital record-based retrospective descriptive study of all confirmed snakebite cases recorded at the Tamale Teaching Hospital over a 2-year period from January 2016 to December 2017. Relevant demographic and clinical information were extracted from patient folders and analyzed. Results: One hundred and nineteen snakebite cases were recorded. The mean age of the victims was 26.38 years, 69.7% being male. Snakebites were recorded all year round with a slight peak in November. Most bites occurred in the interval between 4:00 PM and 8:00 PM and the lower extremity was the most common site of bite (71.4%). The major symptoms of envenomation included coagulopathies (86.5%) and local swelling/ulceration (78.2%); 68.9% had both coagulopathies and local cytotoxicity. Cellulitis/infected wounds (35.3%) and anemia (21.0%) were the major complications reported. 96.6% of the snakebite cases received antivenom on presentation. There was an average delay of 36.42 h from bite before seeking hospital care. No mortality was recorded. The causative snake species was identified in only 6.7% of cases. Conclusion: Snakebite is a potentially life-threatening disease in developing countries such as Ghana and disproportionately affects rural farmers who are mostly active young males. It occurs all year round. More accurate data on snakebites in Ghana are needed for planning purposes and to ensure the continuous availability of antivenom.
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Pattern of malocclusion in children living with sickle cell anemia p. 200
Orighoye Tosan Temisanren, Babatunde Oludare Fakuade, Fadekemi Adetutu Ajibade, Saleh Yuguda, Ahmed Girei
DOI:10.4103/smj.smj_49_18  
Background: Sickle cell anemia is a hereditary disorder of the hematological system. It involves the production of abnormal hemoglobin, which is sickle in shape and has a short life span, resulting in secondary hemopoietic function by the long bones and the jaw bones. The disorder burden not only presents with systemic affectations and morbidity that is commonly observed but also has immense effects on the jaw bones presenting as malocclusion and in severe cases causing gnathopathy and psychosocial disturbance, especially with esthetics. Other dental effects include functional disturbances and diseases of the oral tissue. Objective: The aim of this study is to determine the occlusal pattern of children with sickle cell anemia. Materials and Methods: Consecutive patients attending the Sickle Cell Clinic of the department of Hematology, Federal Teaching Hospital Gombe, aged 6 to 16years. The inclusion criteria included individuals who have been diagnosed to have HbSS using electrophoresis. Sociodemographic data and oral examination were carried out, and dental and occlusal parameters were recorded in a data collection form. Data were analyzed using the SPSS software version 19. The level of statistical significance was set at P < 0.05. Results: The mean age was 10.12 ± 3.10 years. Ninety (55.6%) patients were male. The samples were grouped into two: Group I ages 6–10 years comprising 92 children and ages 11–16 years comprising 70 children in Group II. Angle's Class I molar relationship was observed to be 86 (93.5%) and 57 (81.4%), respectively, for Groups I and II. Overjet and overbite were found to be increased in 34 (37.0%) and 5 (5.4%) for Group I and 23 (32.9%) and 5 (7.1%) for Group II, respectively. Conclusion: The burden of sickle cell anemia is not limited to systemic manifestations alone. Dental presentations that could affect psychosocial, function, health of oral tissues, and speech have also been observed. Therefore, it is expedient that these individuals on presentation to the clinic are examined in a holistic manner with a view to attending to all their presenting problems at an early stage.
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Oral health status and treatment needs of internally displaced persons p. 207
Kehinde Adesola Umeizudike, Aderonke Adewunmi Dedeke, Chioma Love Nzomiwu, Uyi Idah Ekowmenhenhen
DOI:10.4103/smj.smj_19_18  
Background: Internally displaced persons (IDPs) from North Eastern Nigeria have limited access to dental health facilities. Information on their oral health problems is limited. There is a need to determine their oral health status and treatment needs. Objectives: The objective of this study is to assess the oral health status and treatment needs of persons in an IDP camp and provide needed oral health services. Materials and Methods: A descriptive cross-sectional study among adults and their children in an IDP camp in Lagos. Pro forma with sections on biodata, oral hygiene practice and status, and periodontal parameter was used. Descriptive statistics were used in data analysis, with P < 0.05 considered statistically significant. Results: One hundred and twenty-three individuals (67 adults and 56 children) were seen. Mean age was 16.7 ± 12.8 years, adults were 28 ± 4.9 years, and children were 3.8 ± 3.1 years. Females represented 61%. Most (68.7%) adults had secondary school education, while most children (73.2%) had not commenced formal education. Fewer (41.7%) brushed twice daily. Only 8.5% had visited the dentist. Overall caries prevalence was 20.3%, and mean Decayed, Missing, and Filled Teeth (DMFT) was 0.7 ± 1.7, while the mean dmft for children with primary teeth was 0.3 ± 1.0. Mean DMFT was significantly associated with the past dental visits (P = 0.003) and presence of at least one oral condition (P = 0.000). The restorative index was zero, while unmet treatment need was 76.7%. Low dental treatment index was 30.6%. Of the 30.1% with toothache, only 16.2% sought treatment in the hospital. Sixty-three respondents received dental treatment in the form of scaling and polishing, fluoride therapy, atraumatic restorative treatment and extractions. Conclusion: The IDPs had a caries prevalence of 20.3% and a DMFT of 0.7 which were relatively low. However, their unmet treatment needs were high, coupled with a zero-restorative index. The IDPs benefited from free oral health-care services.
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Urologic day-care surgery in a Tertiary Hospital in Nigeria: A 4-year review p. 214
Abubakar Sadiq Muhammad, Abdulwahab-Ahmed Abdullahi, Ngwobia Peter Agwu, Ismaila Arzika Mungadi
DOI:10.4103/smj.smj_6_18  
Background: Day-care surgery is associated with economic, social, and health benefits to the patients. The increasing pressure on hospital bed and theater space serves as impetus for renewed interest in day-care surgery in our facility. Objective: To report our experience in day-care surgery in the past 4 years. Materials and Methods: This is a retrospective review of patients who had urologic day-care procedures in our facility, from January 2014 to December 2017. Data were collected through pro forma and analyzed using SPSS version 20.0 for windows. Results: There were 502 patients who had day-care procedures within the study period which accounted for 43.5% of elective procedures. The patients' age ranged from 1 to 90 years. There were 494 males (98.4%) and 8 females (1.6%). The procedures were diagnostic in 89.6%, therapeutic in 9.8%, and both diagnostic and therapeutic in 0.6% of the patients. The procedures included transrectal ultrasound (TRUS)-guided prostatic biopsy (74.5%), urethrocystoscopy ± biopsy and double J stent retrieval (16.7%), varicocoelectomy (2.8%), circumcision (1.4%), meatoplasty (0.6%), excisional biopsy (0.6%), and others (3.4%). Two patients (0.4%) had a conversion to inpatient admission due to persistent hematuria following urethrocystoscopy and biopsy. There were three re-admissions (0.6%) for postprostatic biopsy infection (0.4%) and surgical site infection (0.2%) following varicocoelectomy in an obese patient. Conclusion: TRUS-guided biopsy, urethrocystoscopy, and varicocoelectomy are the most common day-care procedures in our facility. The morbidity, conversion, and re-admission rates were acceptable.
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Research productivity of academic staff in a Medical School p. 219
Adetoyeje Y Oyeyemi, Donald R Ejakpovi, Adewale L Oyeyemi, Tolulope Adeniji
DOI:10.4103/smj.smj_13_19  
Background: Research productivity is a measure of achievement of a scholar. The number of research publication in peer-reviewed journals and scholastic presentations in conferences and other gatherings of peers are important criteria for assessing productivity and prestige in the academia. Objective: This study aimed to explore the research productivity of the academic staff of a College of Medical Sciences in a Nigerian University. Materials and Methods: A cross-sectional design study was conducted among 51 academics at the College of Medical Sciences, University of Maiduguri, Nigeria. The participants completed a 31-item questionnaire that explored information on their research publication and conferences presentations in the past 3 years. The questionnaire also elicited information on their teaching load, and the time devoted to research per week. The questionnaire also elicited information on journals, in which the academics published their research, and on any institutional and departmental support for research that is available to them. Descriptive and inferential statistics were used to analyze the data. Results: Overall, the mean number of research publication in 3 years for this cohort of academics was 6.6 ± 6.8 (median = 4.0) papers, while that of conference presentation was 4.5 ± 4.0 (median = 4.0) papers in 3 years. Academics in the clinical sciences subgroup tend to have more research papers published and conference papers presented than their counterparts in the Basic and Allied Health Sciences subgroup. The overall subgroups combined number of research papers published increases absolutely but not significantly with age and rank. Conclusion: Using a productivity threshold set at six papers in 3 years, many academics in this cohort may not be considered to be highly productive. Future studies on an expanded scale are needed to elucidate on the present findings.
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CASE REPORTS Top

Prenatal sonographic diagnosis of limb body wall complex: A rare lethal fetal anomaly p. 226
Janet A Akinmoladun, Oluwasomidoyin Olukemi Bello
DOI:10.4103/smj.smj_51_18  
Limb-body wall complex (LBWC) is a rare fatal congenital malformation syndrome. We report a case of sonographically diagnosed LBWC at the gestational age of 28 weeks which was confirmed after delivery. The parents opted for termination of pregnancy. Physical examination postdelivery revealed a large abdominal and thoracic wall defect with the contents protruding outside the body without any covering membrane. The umbilical cord and the eviscerated urinary bladder arose from the midline. In addition, there was the absence of the right upper limb. The baby died few minutes after the delivery. Early antenatal sonological diagnosis is necessary so that the parents can make an informed decision on the options of continuation or termination of pregnancy. Therefore, expertise in prenatal detection of congenital anomalies is invaluable in antenatal care.
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Poor radiographic access: Cause of delayed diagnosis of esophageal foreign body in a 5-year-old p. 230
Suleiman Lawal, Halima Muhammad, Nafisa Bello, Mubarak A Zubair, Shu'aibu Iliyasu Yunusa, Abubakar Yakubu
DOI:10.4103/smj.smj_3_19  
Foreign-body ingestion is a global public health problem especially among children under-5 years of age. The diagnosis is difficult in children who cannot communicate, especially if the event was not witnessed. We present a child who presented with foreign-body ingestion simulating upper respiratory tract infection. This case highlights the crucial role of radiology in the diagnosis, treatment, and complications of esophageal foreign bodies in children.
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LETTER TO THE EDITOR Top

Three-rooted mandibular third molar in a Nigerian adult p. 234
Aliu Adamson Rufai, Bamidele Adetokunbo Famurewa, Stephen Babatunde Aregbesola
DOI:10.4103/smj.smj_44_18  
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