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   2015| April-June  | Volume 18 | Issue 2  
    Online since July 14, 2015

 
 
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ORIGINAL ARTICLES
Vision screening to detect refractive errors in three selected secondary schools in Birnin Kebbi, North West, Nigeria
Aliyu Hamza Balarabe, Ibrahim Adamu, Asmau Abubakar
April-June 2015, 18(2):61-65
DOI:10.4103/1118-8561.160799  
Objective: The objective of this study was to determine the prevalence of uncorrected refractive error among students in three selected secondary schools in Birnin Kebbi metropolis as many children with poor vision due to refractive error remain undiagnosed and perform poorly in schools. Materials and Methods: This was a cross-sectional study that was conducted over a period of 2 months (May-June 2014). A total of 614 students were included from three randomly chosen secondary schools in Birnin Kebbi, Nigeria. Subjects were selected using random sampling technique from the list of students available through the help of their class teachers. Visual acuity (VA) was measured with a Snellen chart, while students with subnormal vision (VA ≤ 6/9) were examined using pinhole, and subsequently referred for detailed eye examination and retinoscopy evaluation. Results: The age range was from 11 to 20 years comprising 50.8% (n = 312) males and 48.2% (n = 302) females. Refractive error in either eye was present in 30 (4.8%) children. Of these, myopia was diagnosed in 18 (60%) children, and then hyperopia in 7 (23.3%), and astigmatism in 5 (16.7%) subjects. Spectacle coverage was low as only three pupils were found to be using glasses with lack of awareness and lack of access to eye care services as major barriers. Conclusions: Uncorrected refractive error is found among secondary schools students in Birnin Kebbi, and there is a need for the establishment of regular and effective school vision screening program to detect and refer patients for treatment.
  6 4,145 472
REVIEW ARTICLE
Relevance of clinical auto psy in medical practice in Sub-Saharan Africa
Victor James Ekanem, Clement O Vhriterhire
April-June 2015, 18(2):49-56
DOI:10.4103/1118-8561.160795  
Autopsy is very important in medical practice and is being increasingly relegated both in the developed and developing countries. Though autopsy rate has been on the decline, the exact rates are difficult to determine because various reports are influenced by many factors. The danger of the decline in the developing countries is that equipment for proper diagnosis is not yet available, therefore, most diagnoses are not made and the cause of death would not have been known. This article reviews the benefits of autopsy in modern practice, the importance of perinatal autopsy and the shortcomings of modern technology in the diagnosis and determination of the cause of death. Electronic literature search combined with the review of both local publications and relevant texts were carried out. Clinicians should endeavor to request for postmortem examination as the benefits far outweigh the reasons proffered for the decline in the autopsy rate.
  3 2,645 360
ORIGINAL ARTICLES
Computed tomographic evaluation of proptosis in a Southern Nigerian tertiary hospital
Ehimwenma Ogbeide, Akhigbe Oriazo Theophilus
April-June 2015, 18(2):66-70
DOI:10.4103/1118-8561.160800  
Objective: To describe the pattern of computed tomographic findings in patients presenting with proptosis at our institution. Methods: A retrospective review of patients with proptosis who were referred to the Radiology Department for cranial Computed Tomography (CT) scan at the University of Benin Teaching Hospital, Benin City, Nigeria from January 2010 to September 2013 was undertaken. SPSS version 16 software was used for data analysis. Results: The request forms, CT images and reports of 33 patients which comprised 15 males and 18 females were reviewed. The mean age of the patients was 28.83 ± 17.43 years (age range 2 to 63 years). The disease presentation was unilateral in 29 patients and bilateral in 4 patients. Computed Tomographic diagnosis of tumor in 27 patients was the commonest finding. Conclusion: Computed tomography is a valuable tool in the management of patients with proptosis providing useful information regarding possible etiology and extent of causative lesion.
  2 2,122 180
Endophthalmitis in a tertiary center in Nigeria
Odarosa M Uhumwangho, Efe P Akpata
April-June 2015, 18(2):74-77
DOI:10.4103/1118-8561.160803  
Background: Endophthalmitis is a sight-threatening condition due to inflammation of intraocular structures usually from infectious organisms. The study aims to identify the pattern of presentation of endophthalmitis in a tertiary center in Nigeria. Materials and Methods: A retrospective observational study of cases with a diagnosis of endophthalmitis. Results: Twenty-six eyes of 26 patients were found comprising, 20 (76.9%) males and 6 (23.1%) females. The mean age of the patients was 32.4 ± 24.5 years (range 2-68 years) of which 11 (42.3%) were ≤ 16 years (P < 0.005). There were 14 (53.8%) right eyes and 12 (46.2%) left eyes involved. The most common etiology was post traumatic infection in 16 (61.5%) cases of which 11 (68.8%) occurred in children ≤ 16 years. Complications of cataract surgery was the only surgically related etiology in 7 (26.9) cases. Endogenous endophthalmitis is a rare occurrence. Conclusion: Supervised play in children, strict adherence to asepsis protocol in surgeries, prompt diagnosis with well-equipped ancillary investigations and appropriate early intervention will help limit the incidence of endophthalmitis and improve outcomes.
  2 1,548 130
CASE REPORTS
A case report of primary Hodgkin's disease of bone marrow
B. M. S. Lamba, Vikas T Talreja, V Sudeep, Sakshi Mittal
April-June 2015, 18(2):87-88
DOI:10.4103/1118-8561.160810  
Hodgkin's disease (HD) is a malignant neoplasm of the lymphoid tissues. It arises almost invariably in a single node or chain of nodes. Extranodal disease can be primary or can result from the spread of primary nodal disease to these sites. Primary bone marrow HD is very rare. Here, we present the case of an elderly male, who presented with primary HD of bone marrow.
  1 1,677 144
ORIGINAL ARTICLES
Electroencephalographic findings in patients referred for electroencephalogram in a University Teaching Hospital in Northern Nigeria
Victor O Olisah, Oluwatosin Adekeye, Christopher I Okpataku, Edwin E Eseigbe
April-June 2015, 18(2):78-82
DOI:10.4103/1118-8561.160805  
Background: Electroencephalogram (EEG) is a valuable investigation for the assessment of patients with seizures and some other neuropsychiatric disorders. The literature is scanty of reports describing its application and usefulness in Nigerian patients. In this study we analyzed the EEG records of a series of patients who were referred with various provisional diagnoses. Materials and Methods: EEG records of the entire 200 consecutive cases referred from various clinics within and outside a tertiary hospital in Northern Nigeria during a 1 year period were analyzed. Information on biodemographic data, clinical description of symptoms and provisional diagnosis made by referring physicians and the EEG diagnosis were obtained from the records. Results: Most of the attendees were aged between 10 years and 29 years (59.5%) and mostly males (63.5%). About 80% of the attendees had received a provisional diagnosis of seizure disorder (generalized and partial). The EEG diagnosis of seizure disorder accounted for 75%, normal EEG record accounted for 21% and organic brain disorder accounted for 4% of all EEG diagnosis. Generalized seizure disorder was the commonest seizure type by EEG diagnosis (50%). There was a significant association between the provisional diagnosis and EEG diagnosis (P < 0.05). Conclusion: Most of the patients referred for the EEG had their reports consistent with clinical suspicion. EEG was found to be a useful tool in the evaluation of seizures and organic brain disorder in our study.
  1 2,259 257
CASE REPORTS
Pseudoxanthoma elasticum: A rare cause of gastrointestinal bleed
Ishrat H Dar, Samia R Mir, Showkat H Dar
April-June 2015, 18(2):83-86
DOI:10.4103/1118-8561.160808  
Causes of obscure gastrointestinal (GI) bleed are diverse and rare. The most common cause for GI bleeding of small bowel origin is angiodysplasia, followed by tumors of the small intestine, and various other causes, including small bowel ulcers and aortienteric fistulas. Pseudoxanthoma elasticum (PXE) is a rare cause of GI bleed. It is an inherited elastic tissue disorder with degeneration of elastic fibers involving mainly skin, eyes and the cardiovascular system. Upper GI hemorrhage occurs in 13% of cases and is often resistant to nonsurgical methods of treatment. Presented herein is a case of GI bleed in a 65-year-old woman who had PXE and hyperplastic polyps in the stomach.
  - 4,295 174
Ectopic pelvic kidney in a neonate in Gusau, Zamfara, North Western Nigeria
Bilkisu Garba Ilah, Aminu Muhammad Sakajiki, Smart Aghadueki, Edem Bassey, Taofik Kolawole, Akeem Oladiran Adeniji
April-June 2015, 18(2):89-90
DOI:10.4103/1118-8561.160812  
Ectopic kidney occurs as a result of cessation in migration of kidneys to their usual position in the lumbar region. Several cases have been reported worldwide, however only one case of ectopic kidney in infant has been reported in North Western Nigeria which was not a pelvic kidney. We present an incidental case of unilateral ectopic pelvic kidney managed in our facility. A 28-day-old male infant presented with a week history of crying while defecating and fever. He had normal abdominal findings. Abdominal ultra sound scan revealed a unilateral left ectopic pelvic kidney with no associated abnormalities. Full blood count showed elevated white blood cell count predominately neutrophils. He was managed as a case of neonatal sepsis with antibiotics. A thorough antenatal ultrasonography and early neonatal ultrasound are required for early diagnosis. Asymptomatic and noncomplicated cases are managed conservatively.
  - 2,108 160
CONFRENCE PROCEEDINGS 2014
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

April-June 2015, 18(2):91-102
  - 4,432 247
ORIGINAL ARTICLES
Submucosal diathermy in inferior turbinate hypertrophy: Review of 12 cases in Benin City
Amina Lami Okhakhu, Festus Oritsemajemite Ogisi
April-June 2015, 18(2):71-73
DOI:10.4103/1118-8561.160802  
Background: Nasal obstruction is a very common Ear, Nose, and Throat outpatient problem. We report a case series illustrating the safety and clinical effectiveness of submucous diathermy (SMD) in the treatment of medically refractory nasal obstruction caused by hypertrophy of the inferior turbinate. Methods: Consecutive patients presenting over a 5-year period with medically refractory nasal obstruction secondary to hypertrophy of the inferior turbinate were offered SMD as a technique for turbinate reduction. Subjective symptom score of the degree of obstruction was assessed preoperatively and 3 and 12 months postoperatively. Results: A total of 12 adults aged between 18 and 42 years with a mean age of 27.8 years, consented to SMD for turbinate reduction. The patients all had subjective improvement in their nasal airways postoperatively. Subjective symptom score declined to 66.7% by the 1 st postoperative year. Recurrence of symptoms of nasal obstruction occurred earlier in patients with allergy. The complications encountered included intranasal adhesions and crusting which was amenable to adhesiolysis with stenting and regular saline douching of the nasal cavity. Conclusion: SMD of the inferior turbinate is an effective and safe way of treating nasal obstruction secondary to hypertrophy of the inferior turbinate.
  - 7,383 235
Ventilator-associated pneumonia: Its incidence, the risk factor and drug resistance pattern in a tertiary care hospital
Sourabh Mitra, Rajdeep Saha, Piyali Datta, Manash Sarkar
April-June 2015, 18(2):57-60
DOI:10.4103/1118-8561.160797  
Background: Ventilator-associated pneumonia (VAP) is an infection of the lung that develops 48 h or longer after mechanical ventilation. Objectives: The present study was aimed to find out the bacteriological profile of VAP along with the resistance pattern of bacteriological isolates. Materials and Methods: A prospective observational study was conducted from January 2013 to May 2014 among 791 patients admitted in critical care units of our tertiary care hospital. After selection by applying inclusion and exclusion criteria endotracheal aspirates were collected from ventilated patients. Samples were subjected to further processing by Gram-staining, culture, biochemical testing and antibiogram. Results : Out of 791 patients admitted in intensive care unit in this tertiary care hospital with VAP 540 (68.2%) patients were culture positive. Pseudomonas aeruginosa was most commonly isolated pathogen of both early onset and late onset VAP. In early VAP Acinetobacter baumannii showed 62.5% metallo-beta-lactamase (MBL) positivity. P. aeruginosa showed 27.5% MBL positivity, whereas in late onset VAP, 71.4% A. baumannii isolates and 75.8% P. aeruginosa isolates showed MBL positivity, respectively. Conclusion : Simple prevention of aspiration, sterilization of equipments, hand washing of personnel can reduce VAP in hospital care setting.
  - 2,602 378
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