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   2017| January-March  | Volume 20 | Issue 1  
    Online since April 11, 2017

 
 
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ORIGINAL ARTICLES
Sonographic measurement of uterine dimensions in healthy nulliparous adults in Northwestern Nigeria
Umar Muhammad Umar, K Isyaku, Yahuza Mansur Adamu, SA Abubakar, NA Kabo, I Nura, AT Naimatu
January-March 2017, 20(1):1-7
DOI:10.4103/1118-8561.204328  
Background: Data on uterine dimensions in nulliparous women are vital for public health consideration as the presence of uterine pathology in nulliparous women effectively reflects the status of fertility and other gynecological conditions in general population. In the last two decades, sonography has become the most important imaging modality for the study of the uterine pathology. The estimation of uterine size has been widely reported by several authors from different parts of the world. Materials and Methods: Sonographic measurements of the uterine size in 400 nulliparous women with age ranging from 15 to 25 years were done during the secretory phase of the menstrual cycle, with the uterus measured in the anteroposterior (AP), longitudinal, and transverse planes. The uterine volume was calculated using the ellipsoid algorithm. Height and weight of the subjects were also measured. The data were analyzed with the aid of computer-based SPSS 20.0 software for Windows. Results: The mean AP diameter of the uterus was 3.3 cm with standard deviation of 0.3 while the mean longitudinal and transverse dimensions were found to be 6.4 cm ± 0.4 cm and 5.1 cm ± 0.2 cm, respectively. The mean uterine volume of the subjects was 57.4 cm 3 with standard deviation of ± 9.1. The uterine AP diameter showed poor correlation with age and weight but showed positive correlation with the height. Uterine length and width correlated positively with age and height but poorly correlated with weight of the subjects. Conclusion: Mean uterine dimensions in nulliparous women in Kano, Northwestern Nigeria, is virtually the same as that reported in Southwestern and north central parts of Nigeria, Iran, and Scandinavia but differ from those of other Europeans probably due to body habitus, racial, and genetic factors. This emphasizes the fact that normograms for each geographical area should be established.
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The prevalence of genital Candida species among pregnant women attending antenatal clinic in a tertiary health center in North-west Nigeria
Daniel Chukwunyere Nnadi, Swati Singh
January-March 2017, 20(1):33-37
DOI:10.4103/1118-8561.204333  
Background: Vulvovaginal candidiasis (VVC) is a common genital tract infection that affects the quality of life in many women. It is more prevalent in pregnancy and may lead to complications. Aims and Objectives: The study aimed to determine the prevalence of VVC among pregnant women attending the antenatal clinic of a tertiary health institution in North-West Nigeria and to emphasize the need for accurate diagnosis and adequate treatment. Subjects and Methods: This is a 2-month cross-sectional study performed at the Department of Obstetrics and Gynaecology in association with the Department of Medical Microbiology of the Usmanu Danfodiyo University Teaching Hospital, Sokoto in North-Western Nigeria. It involved pregnant women at various periods of gestation presenting with vaginitis and selected by simple random sampling. A pair of high vaginal swabs was collected aseptically from the study subjects which was used for Gram's staining and inoculation into Sabouraud's dextrose agar (SDA). The samples were then cultured according to standard procedures on sterile SDA. Infection with Candida species was diagnosed by microscopy of a saline wet mount, Gram-stained smear and colony growth on SDA. Results: Of the 288 pregnant women sampled, 175 were positive for candidiasis giving a prevalence rate of 60.8%. The ages of the women ranged from 16 to 45 years with a mean of 26.8 (standard deviation ± 4.93). Pregnant women aged 26–30 years recorded the highest prevalence of 37.1% (65/175). The multigravidae were more affected 41.7% (120/288) than the primigravidae 19.1% (55/288). VVC showed a progressive increase with trimester of pregnancy. Candida albicans was the most prevalent species isolated in 73.7% of the women. Conclusion: There is a high prevalence of VVC among pregnant women in our institution. There is need to educate the women on genital hygiene and practice of regular screening for candidiasis in our antenatal program.
  10,768 718 -
Awareness and perception of pregnant women about obstetrics ultrasound at Aminu Kano Teaching Hospital
AA Saleh, G Idris, A Dare, MA Yahuza, MA Suwaid, SK Idris
January-March 2017, 20(1):38-42
DOI:10.4103/1118-8561.204332  
Background: Ultrasonography is firmly embedded in antenatal maternity care around the world. It proves accuracy in calculation of gestational age, earlier identification of multiple pregnancies, and diagnosis of nonviable pregnancies and certain fetal malformations. Objective: The study is aimed to determine the awareness and perception of pregnant women towards obstetric scan, at Aminu Kano Teaching Hospital (AKTH). Materials and Methods: This was a prospective and cross-sectional study conducted among 400 pregnant women that attended antenatal ultrasound scan at AKTH. A pretested and structured questionnaire was used. Only women that agreed to participate were included in the study. Convenience sampling technique was employed for the data collection. Information collected from the participants was: Age, marital status, occupation, level of education, parity, level of awareness and level of perception. The collected data was analyzed using SPSS (16.0) software for windows (SPSS Inc., Chicago, IL, USA) to obtain frequency, mean and percentages. Results: A total of 400 women were included in the study, of which most of them were within the age range of 21–30 years. Almost all the participants (97%) had ultrasound before, and they believed it is safe. The majority (93.8%) believed that ultrasound is necessary during pregnancy. Ninety-seven percent believed it is done to determine fetal viability and wellbeing. Conclusion: The study established that most of the participants are aware of ultrasound scan. The subjects also believed that the procedure is safe, and the main purpose is for fetal wellbeing and viability.
  4,532 360 -
A histopathologic review of cervical cancer in Kano, Nigeria
Alfa Alhaji Sule, Ochicha Ochicha
January-March 2017, 20(1):16-20
DOI:10.4103/1118-8561.204331  
Background: Although cervical cancer is the most common gynecological malignancy globally, with high incidence in developing countries, there has been no formal study in our locality. We, therefore, undertook this review to document and evaluate the pattern in Kano, Northern Nigeria. Materials and Methods: This is 10 years (2002–2011) retrospective study of all cervical cancers diagnosed at the Pathology Department of Aminu Kano Teaching Hospital, Kano. Results: Five hundred and forty-five cervical cancers were diagnosed during the 10 years study. Patients' ages ranged from 20 to 80 years (mean 48.30 ± standard deviation 12.61 years), with highest occurrence in the fifth to seventh decade age group. Squamous carcinoma was by far the most common histological type (82.2%), distantly followed by adenocarcinoma (12.8%) and mesenchymal/mixed Mullerian malignancies comprising 0.01% (5 cases). Conclusion: Our findings were consistent with most published reports in Nigeria and sub-Saharan Africa but somewhat at variance with the developed world where cervical cancer is much less common and afflicts a slightly older age group.
  4,153 327 -
Pelvic organ prolapse managed at Usmanu Danfodiyo University Teaching Hospital, Sokoto: A 10-year review
Ahmed Yakubu, Abubakar Abubakar Panti, Ashiru Argungu Ladan, Ahmed Tanko Burodo, Mairo A Hassan, Sadiya Nasir
January-March 2017, 20(1):26-29
DOI:10.4103/1118-8561.204335  
Background: Pelvic organ prolapse can have a detrimental effect on woman's quality of life by limiting physical, social, psychological, and sexual functions. We determined the prevalence, predisposing factors, and complications of pelvic organ prolapse at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A retrospective study of the cases of pelvic organ prolapse managed at UDUTH, Sokoto, between January 1, 2003, and December 31, 2012. Results: The prevalence of pelvic organ prolapse was 1.4% of all gynecological admissions. The mean age of the patients was 45.3 ± 16.1 years. Majority of the patients, i.e., 63.7% were premenopausal. The grand multiparous women constituted 65.9% of the patients. The most common presenting symptom was a mass protruding through the vagina. The prolapsing organs included uterus 75.8%, bladder 12.1%, rectum 6.6%, and a combination of bladder and rectum 5.5%. The most common predisposing factor identified was unsupervised home delivery. Most of the patients had surgical intervention that included vaginal hysterectomy 59.3%, anterior colporrhaphy 7.7%, posterior colpoperineorrhaphy 6.6%, and combined anterior colporrhaphy and posterior colpoperineorrhaphy 5.5%. Hemorrhage was the most common intraoperative complication encountered in anemia 10.7% and wound infection 2.7% was most prevalent in the postoperative period. Conclusion: Multiparity, prolonged labor, and unsupervised deliveries were significant predisposing factors of pelvic organ prolapse antenatal care; skilled supervised deliveries and access to effective family planning methods will decrease the prevalence.
  4,007 323 -
Assessment of kidney function in sickle cell anemia patients in Zaria, Nigeria
Rasheed Yusuf, Abdulaziz Hassan, IN Ibrahim, AA Babadoko, PO Ibinaiye
January-March 2017, 20(1):21-25
DOI:10.4103/1118-8561.204326  
Introduction: Sickle cell anemia (SCA) patients are prone to kidney injury by various mechanisms including reduced blood flow, ischemia, and papillary necrosis. Sickle cell nephropathy may progress to end-stage renal disease with increased morbidity and mortality. Objective: To assess renal function tests and their relationship with kidney length in steady state SCA patients. Subjects and Methods: Seventy-four adult SCA patients in steady state and 20 hemoglobin AA controls were enrolled into the study. Serum urea, electrolytes, creatinine, and uric acid were assayed while estimated glomerular filtration rate (eGFR) was calculated. Renal scan was also performed to assess the kidney length. Results: Serum potassium, phosphate, and uric acid were statistically significantly higher while sodium, chloride, bicarbonate, calcium, and eGFR were significantly lower in SCA patient than in controls (P < 0.05). eGFR of <90 ml/min was found in 50 (67.6%) of SCA patients out of which 7 (9.5%) had Stage 3 chronic kidney disease (CKD) (<60 ml/min) and one patient with Stage 4 CKD who also had shrunken kidneys with elevated serum creatinine (203 μmol/L) and urea (11.7 mmol/L) concentration. Renal ultrasonography revealed reduced renal size in 20 (27.1%) of the patients while 2 (2.7%) had a renal enlargement. There was no correlation between renal length and serum electrolytes, urea, creatinine, and eGFR. Conclusion: The majority of steady state SCA patients in Zaria have reduced eGFR and dyselectrolytemia. However, there was no association between the kidney length and the biochemical parameters. We, thus, recommend renal function tests to be routinely requested for proper management of these patients.
  3,884 359 -
Spectrum of tuberculosis in children at Federal Medical Centre, Gusau, Zamfara State, Northwestern Nigeria
Sani Malam Mado, Abdulkadir Isa, Usman Abubakar, Sunday O Onazi, Adeoye O Gbemiga
January-March 2017, 20(1):8-12
DOI:10.4103/1118-8561.204330  
Background: Children contribute a significant proportion of tuberculosis (TB) burden and suffer severe morbidity and mortality, particularly in endemic areas. The diagnosis of TB in children can be challenging because TB can mimic many common childhood diseases, and therefore, high index of suspicion is required to improve detection of cases. Aims: To determine the prevalence and pattern of TB in children at Federal Medical Centre, Gusau. Subjects and Methods: A retrospective study in children aged 4 months to 13 years admitted to the pediatrics medical ward with TB (over a 1 year period) in the year 2008. Results: Of the 1392 children admitted over this period, 67 were suspected cases of TB, giving a prevalence of 4.8%. Six (9%) patients had TB-human immunodeficiency virus co-infection. Only 6 (9%) children received Bacille-Calmette–Guerin (BCG) vaccine. Disseminated TB (DTB) accounted for 34 (50.7%) of the 67 cases, pulmonary TB was present in 26.9% while 9 (13.4%) had spinal TB. Forty (59.7%) patients successfully completed treatment, 15 (22.4%) were lost to follow-up, and 7 (10.4%) died in the course of treatment. Three (4.5%) defaulted and were retreated while 2 (3%) were referred. Conclusion: The prevalence of childhood TB was 4.8% with low BCG vaccine uptake. DTB was the predominant form, followed by pulmonary and spinal TB. Significant proportion of children successfully completed their treatment regimen while case fatality rate was 10.4%.
  3,079 238 -
Malaria parasitemia in HIV-infected children attending antiretroviral therapy clinic in a teaching hospital
Ben Oloche Onankpa, Nma M Jiya, Tahir Yusuf
January-March 2017, 20(1):30-32
DOI:10.4103/1118-8561.204329  
Background: Malaria and HIV are important health problems in developing countries. They cause more than 4 million deaths a year globally. The interaction of these two infections is both synergistic and bidirectional. We determined the prevalence of malaria coinfection in HIV-infected children attending antiretroviral therapy (ART) clinic. Materials and Methods: A prospective study of all HIV-infected children attending the ART clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, over a 5-year period was carried out. Malaria parasite was identified by Giemsa-stained blood films using a light microscopy. Statistical analysis was carried out using SPSS version 20.0. Results: The total numbers of children screened were 236. Of those, 73 (31%) had malaria/HIV coinfection. One hundred and twenty-one (51.3%) were males and 115 (48.7%) were females. The mean age of the children was 8.63 ± standard deviation 3.76 years (range of 1–17 years). Conclusions: The study shows that the rate of malaria and HIV coinfection is high. Prompt treatment of malaria and malaria disease prevention are recommended for children.
  2,566 177 -
CASE REPORT
Familial athrogryposis multiplex congenita in Gusau, Nigeria: Case report and review of the literature
Bilkisu Ilah Garba, Aminu Sakajiki Muhammad, Abdullahi Musa, Sunday O Onazi, Adaobi Amarachi Ben-Wazieh, Ibrahim Yusuf, Akeem Oladiran Adeniji
January-March 2017, 20(1):43-46
DOI:10.4103/1118-8561.204334  
Arthrogryposis multiplex congenita (AMC) is characterized by contractions of multiple joints present at birth with fat or fibrous tissue partially or totally replacing muscles. The etiology is from the interplay of genetic and environmental factors. A 2-day-old male term neonate presented with a history of multiple contractures in all limbs since birth, fever, and vomiting of 1-day duration. An older sibling, a male child had similar multiple contractures in all limbs and died a few days after birth. A maternal aunt had a male child with multiple contractures of all limbs who also died a few days after birth. Parents are young and not related. Our case had multiple contractures and specific posture involving all the limbs; however no cardiac or neurological abnormality was observed. He was managed as a case of neonatal sepsis with AMC (likely X-linked) with antibiotics and had plaster of Paris applied on the lower limbs. He did well and was discharged home to be followed up at the clinic. He, however, did not come for follow-up and died at home at the age of 10 weeks. Arthrogryposis is a common congenital presentation which requires comprehensive musculoskeletal evaluation and genetic consultation. Early rehabilitation requires the involvement of the parents or guardians and a multidisciplinary approach. This is to optimize possibility of making a diagnosis and providing parents with accurate information regarding the likelihood of recurrence. However, accurate information on recurrence is only possible when the cause of the AMC in any patient/family under investigation is identified.
  2,391 113 -
ORIGINAL ARTICLES
Etiology and management of splenic injuries: The experience at Federal Teaching Hospital, Gombe, Northeast Nigeria
AA Adejumo, YH Suleiman, MI Guduf
January-March 2017, 20(1):13-15
DOI:10.4103/1118-8561.204327  
Objective: To appraise the current management of splenic trauma with the available resources in our environment and re-emphasizing the role of a sound clinical judgment and early intervention. Methodology: This is a prospective cross-sectional study in which patients that sustained splenic injuries were resuscitated and optimized for laparotomy. Broad spectrum antibiotics and generous analgesia were given. Laparotomy was carried out in all patients and treatment was given according to the grade of injury sustained. Other systemic injuries were co-managed with other subspecialties. Results: Patients in the study were aged 7–52 years (male: female = 3.4:1). The modal age group was 11–20 years. All patients were managed operatively. The majority (51.5%) of splenic trauma in our study were due to vehicular accidents. There was no statistical association between sonographic and intraoperative findings (P = 0.218). Splenectomy was the most common procedure carried out. Complications encountered include surgical site infection (9, 27.3%), respiratory tract infection (6, 18.2%), and deep vein thrombosis (1, 3.0%). The duration of hospital stay for patients was 9–26 days (mean = 12.69 ± 6.30 days). Conclusion: The management of splenic injuries has evolved over the years. The role of a sound clinical judgment is crucial to a successful management outcome, especially in the third world countries.
  2,170 152 -
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