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  Citation statistics : Table of Contents
   2017| October-December  | Volume 20 | Issue 4  
    Online since April 17, 2018

 
 
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ORIGINAL ARTICLES
Prevalence of diabetes mellitus and its risk factors among the suburban population of Northwest Nigeria
Anas Ahmad Sabir, Salisu Balarabe, Abubakar Atta Sani, Simeon A Isezuo, Kabiru Sada Bello, Abdulgafar O Jimoh, Sandra O Iwuala
October-December 2017, 20(4):168-172
DOI:10.4103/smj.smj_47_16  
Background: Diabetes mellitus (DM) was previously considered to be rare in sub-Saharan Africa. However, the prevalence is on the increase mainly because of urbanization and changes in lifestyle. Aim: The aim of our study was to determine the prevalence of DM and its correlates in the suburban population of Northwest Nigeria. Materials and Methods: A cross-sectional community-based study was carried out. Two hundred and eighty participants were recruited using a multistage sampling technique. Interviewer-administered questionnaire was utilized in obtaining demographic data from the participants. Anthropometric variables, fasting plasma glucose (FPG), and blood pressure measured using standard guidelines. The diagnosis of DM was based on the WHO guidelines. Results: The mean age was 42.3 ± 10.7 years. The overall prevalence of DM was 4.3% (males 4.5% and females 4.0%). The mean FPG was higher in the females (5.9 ± 1.2 mmol/L) than males (5.8 ± 2.5 mmol/L) though the difference was not statistically significant (P = 0.81). Obesity and increasing age were the major risk factors for DM among the suburban population. Conclusion: DM is common in suburban areas of Northwest Nigeria. We recommend increased awareness of the epidemic potential of this public health problem even in suburban areas.
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Prevalence and sociodemographic correlates of obesity and overweight in a rural and urban community of Delta State, Nigeria
Ejiroghene Martha Umuerri, Christiana Omotola Ayandele, Godson Ugwoke Eze
October-December 2017, 20(4):173-178
DOI:10.4103/1118-8561.230258  
Introduction: Urbanization has been linked to increasing prevalence of obesity. Objective: To determine the rural–urban differences in the prevalence and sociodemographic correlates of obesity/overweight. Materials and Methods: A cross-sectional, descriptive study of adults in Jesse (rural) and Warri (urban). Weight and height were measured, and body mass index (BMI) was calculated. Results: A total of 866 respondents, 44.0% (rural) and 56.0% (urban) with a male: female ratio of 1:1 and 1:1.5; mean age (± standard deviation [SD]) was 47.1 (±19.0) years and 38.9 (±12.2) years, and mean BMI (±SD) was 22.64 (±3.52) kg/m2 and 24.89 (±5.14) kg for rural and urban populations, respectively. The overall prevalence of obesity and overweight was 10.9% and 20.9%, respectively, with urban (15.7% and 23.9%) being higher than rural (4.7% and 17.1%).Female respondents in both settings had a higher prevalence rate of overweight of 26.5% versus 19.9% (urban) and 17.3% versus 16.8% (rural) for females and males, respectively. The prevalence of obesity is highest among middle-aged (40–64 years) respondents in both settings. The difference in high BMI (≥25 kg/m2) between urban and rural setting in this age group was statistically significant (Chi-square [χ2] = 22.055, df = 1, P < 0.001). The urban–rural differences in the association between educational status and prevalence of obesity and overweight was significant (≤primary: χ2 = 18.970, df = 1, P < 0.001; secondary: χ2 = 9.064, df = 1, P = 0.003). Conclusion: The prevalence of obesity and overweight is high, being higher in the urban population. Obesity and overweight are more prevalent among females and middle-aged persons in both settings. The odds of having high BMI (≥25kg/m2) are highest among urban dwellers with a lower level of education.
  4 8,222 553
REVIEW ARTICLE
Renal cell carcinoma in Nigeria: A systematic review
Akinfenwa Taoheed Atanda, Muhammad Sanusi Haruna
October-December 2017, 20(4):137-142
DOI:10.4103/smj.smj_67_16  
Literature on renal cell carcinoma (RCC) in Nigeria is characterized by lacunae in several important areas with resultant incomprehensiveness of data. This requires a review of the literature so as to streamline the data. Using internet search engines, data were extracted from a total of twelve studies reported in peer reviewed journals between 2000 and 2015 from various states of Nigeria including Kano. These were subsequently collated, analyzed, and then compared with those from other parts of the world. There is relatively low incidence rate of 0.3/100,000 population; slight male preponderance and affectation of younger age groups with average age at diagnosis of 45 ± 4 years. Significant smoking history, exposure to industrial dye, family history, and HIV associated immunodeficiency are major risk factors of RCC in Nigeria. A significant number of cases presented with triad of loin pain, hematuria, and loin mass; advanced disease and bulky tumors of up to 3.8 kg and 56 cm. The predominant histological subtypes were clear cell carcinoma 60%–85.7% and papillary carcinoma 23.8%–46.2%. In general, there has been poor overall outcome for RCC bearing patients in the country. RCC in Nigeria is characterized by earlier age at onset and poor outcome, thus necessitating more aggressive case identification at early stages so as to improve prognosis.
  4 5,752 1,276
ORIGINAL ARTICLES
Cardiovascular disease risk profile in Nigerian school children
Christopher Sabo Yilgwan, Hyacinth Iduh Hyacinth, Olukemi Omowumi Ige, Ibrahim Ishaya Abok, Gavou Yilgwan, Collins John, Christian O Isichei, Selina N Okolo, Fidelia Bode-Thomas
October-December 2017, 20(4):143-148
DOI:10.4103/1118-8561.230260  
Background: Cardiovascular disease (CVD) is a major cause of death among adults worldwide. It is acknowledged that its risk factors have their roots in childhood. The present study evaluated CVD risk factors in primary school children in a Nigerian peri-urban setting. Methodology: This cross-sectional study was carried out in two primary schools in Jos South local government area, Plateau State, Nigeria. The 241 children studied were chosen using a systematic random sampling technique to select the children from each school. Pretested questionnaire was used to elicit the information on family characteristics and individual characteristics while standard anthropometric and laboratory procedures were used in evaluating the CVD risk factors. Results: Overall, 137 (56.8%) were females (M:F = 0.76), 151 (62.7%) were from the middle class, 59 (24.5%) from lower class while 31 (12.9%) were from the upper class. The overall prevalence of at least one cardiovascular risk factor was 54%. Sedentary lifestyle was the most common CVD risk factor in 32.4% of subjects followed by obesity (13.7%), adverse CVD event in family (11.6%), high low-density cholesterol (10.3%), high total cholesterol (TC) (9.1%), and hypertension (9.1% combine, 7.1% diastolic, and 5.8% systolic). Linear regression analysis showed that body mass index (BMI) for age (β = 0.41, P < 0.001), systolic blood pressure (BP) (β = 0.94, P = 0.03), diastolic BP (β =1.26, P = 0.01), and TC (β = 0.07, P = 0.04) significantly rise with age. BMI for age (P = 0.02) was significantly higher in female subjects compared with their male counterparts. Conclusions: From the findings of the present study, interventions related to modifiable risk factors, such as encouragement of physical exercise and sports in schools, healthy and prudent diet, and weight control programs should be undertaken early in life so as to help control the development of and the epidemic of CVD in later life.
  3 5,544 413
Stroke admissions in Kubwa General Hospital: A 30-month review
Osaze Ojo, Chukwuebuka Udo Onyegiri
October-December 2017, 20(4):155-159
DOI:10.4103/smj.smj_9_17  
Background: Stroke is a common neurological disorder that contributes significantly to the morbidity and mortality of medical admissions. Objectives: To review the types, risk factors, hemispheric involvement, and outcomes of admitted stroke patients in Kubwa General Hospital, Abuja, Nigeria. Subjects and Methods: We carried out a retrospective study of patients who had a clinical diagnosis of stroke in Kubwa General Hospital, Abuja, Nigeria, between January 2013 and June 2015. Results: A total of 60 patients who had stroke were admitted during this period, accounting for 4.25% of medical admissions. Men and women accounted for 68.3% and 31.7%, respectively, with a male-to-female ratio of 2:1. Their mean age was 54.9 ± 13.5 years while the median age was 52.5 years. The mean hospital stay for these patients was 8.4 ± 5.5 days. Ischemic stroke occurred more frequently (65%) compared with hemorrhagic stroke (35%). Hypertension (65%), alcohol (25%), previous stroke (18.3%), diabetes mellitus, and hypercholesterolemia (18.3%) were the common identifiable risk factors for stroke. Ten patients (16.7%) had two risk factors for stroke, whereas 8 patients (13.3%) had three risk factors for stroke. The mean systolic and diastolic blood pressures on admission were 171.5 ± 41.6 mmHg and 103.3 ± 24.0 mmHg, respectively. The left hemisphere (53.3%) was more often affected than the right hemisphere in these patients. Majority of the patients (48.3%) were discharged following improvement while the case fatality was 11.7%. Conclusion: Stroke is not uncommon as a cause of medical admission in Kubwa General Hospital. Ischemic stroke occurred more commonly and the left hemisphere was more often involved compared with the right hemisphere. Hypertension was the most common risk factor for stroke in these patients.
  3 6,836 354
Dental caries experience in primary school pupils in Port Harcourt, Nigeria
Joycelyn Odegua Eigbobo, Grace Alade
October-December 2017, 20(4):179-186
DOI:10.4103/smj.smj_70_15  
Aim: This study aimed to investigate the prevalence and pattern of dental caries in children in public and private primary schools in Port Harcourt, Nigeria. Materials and Methods: This was a comparative cross-sectional study carried out among children in two private and two public primary schools in Obio/Akpor local government area. Information was obtained from the school records and parents by means of structured questionnaires. The dentition status was obtained with the aid of sterile instruments in an upright chair under natural light. Data collected were analyzed using SPSS version 20. Results: There were 200 (46.5%) males and 230 (53.5%) females, with a mean age of 7.6 (±2.7) years. The prevalence of dental caries was 12.6%; the private school pupils had a prevalence of 10.2% while that of the public school pupils was 15%. Forty-five (13.1%) pupils had a decayed, missing, filled teeth of primary dentition (dmft) >0; 17 (37.8%) were private school pupils. They had a mean dmft index of 0.25 (±0.76); the private school pupils had a lower mean dmft. The mean decayed, missing, filled teeth of permanent dentition (DMFT) index was 0.05 (±0.33); the difference between private and public schools was not statistically significant (P = 0.50). Untreated dental caries was 84.2% and 94.3% of permanent and primary dentitions, respectively. Conclusion: Dental caries is not a common problem in this study population; the mean dmft/DMFT values were very low. However, the prevalence of dental caries was higher among children attending public schools. There was a high prevalence of untreated caries.
  3 5,479 328
CASE REPORT
Tongue tuberculosis: A rare entity
Ajay Kumar Verma, Ambarish Joshi, Amritesh Ranjan Mishra, Anubhuti Singh, Malti Kumari, Surya Kant
October-December 2017, 20(4):202-204
DOI:10.4103/smj.smj_64_16  
Tuberculosis (TB) of tongue is a very rare extrapulmonary manifestation of TB. A number of different pathologies can mimic this condition, and so TB is often overlooked. Diagnosis requires a high index of suspicion and a prompt clinicohistopathological examination. We report a case of tongue TB which occurred probably because of the habit of brushing teeth with neem twigs (Azadirachta indica).
  1 4,493 222
ORIGINAL ARTICLES
An autopsy review of abdominal injuries resulting from road traffic accidents: The Ile-Ife experience
Olaejirinde Olaniyi Olaofe, William Olufemi Odesanmi, Kayode Adebowale Adelusola, Akinwumi Oluwole Komolafe, Donatus Sabageh
October-December 2017, 20(4):187-191
DOI:10.4103/1118-8561.230262  
Background: Road traffic accidents (RTAs) are a leading cause of blunt force trauma to the abdomen. They remain an important cause of death globally and especially in Nigeria. Aims: The aim was to review the autopsy findings of victims with abdominal injuries following RTAs. Subjects and Methods: The autopsy records and case notes of victims of RTAs fatalities who sustained abdominal injuries over a 10-year period were reviewed. This was carried out at a tertiary health institution in Sub-Saharan Africa. Statistical Analysis Used: Statistical Package for Social Sciences version 15.0. Results: Seventy-six cases were reviewed. The male to female ratio was 4.1:1. The mean age of the victims was 34.2 years while the age range was from 4 to 85 years. The 30–40-year age group accounted for 34.2% of cases. About 53.9% of the victims died at the accident scene, whereas 34.2% died while on hospital admission. About 42.1%, 32.9%, and 21.1% of the victims were passengers, drivers, and pedestrians, respectively. The spleen was injured in 67.1% of cases while the liver and intestines were injured in 22.4% and 15.8% of cases, respectively. Death was due to the combined effects of multiple injuries in 67.1% of cases, whereas 26.3% of victims died as a result of severe hypovolemia. Conclusions: Abdominal injuries in RTAs fatalities are more common in males and the most productive young adult population. The spleen is the most frequently injured intra-abdominal organ. The majority of deaths in this group of patients are due to the combined effects of multiple injuries in various body structure. Rapid management of patients with abdominal injuries is essential and particular consideration must be placed on those injuries involving other body parts.
  - 5,290 270
Assessment of direct causes and costs of medical admissions in Bingham University Teaching Hospital – Jos, Nigeria
Peter U Bassi, Modupe Builders, Egua Maxwel Osaronowen, Chinonye Anuli Maduagwuna, Abdulmumini A Ibrahim, Musa Dankyau
October-December 2017, 20(4):192-201
DOI:10.4103/smj.smj_24_17  
Background: As health-care costs continue to rise and the population ages, an individual Nigerian continues to experience financial hardship in settling medical bills, especially when health insurance schemes are still far from reality for most Nigerians, making health-care financing burdensome in Nigeria like many developing countries. This has made out-of-pocket expenditure the most common form of health-care financing. Aims: This study assessed the average costs, duration, and causes of inpatient admission so as to know the direct costs associated with medical care for proper health-care planning. Settings and Design: This was a pilot study of a prospective cohort design whereby all patients were admitted to medical wards during the study period. Materials and Methods: Cost analysis was performed from the societal perspective, but included only direct medical care cost for this analysis. Patients input charts and pharmacy dispensing charts of all patients admitted to medical wards between May and July 2015 were reviewed. All costs were in local currency (Naira) using the average exchange rates proposed by Central Bank of Nigeria for June 2015. Statistical sAnalysis Used: Statistical analysis was carried out using SPSS version 20. Results: A total of 293 out of 320 patients met inclusion criteria and were assessed. Female patients admitted during the study period had an overall higher mean cost of care ₦84, 303.94 ± 6860.56 (95% confidence interval [CI]: 68,991.65–96,103.27) compared to male patients ₦68, 601.59 ± 57,178.37 (95% CI: 59,081.51–78,121.67) (P < 0.102). Civil servants had higher mean overall costs of care ₦90, 961.70 ± 105,175.62 (95% CI: 65,883.46–116,039.94) (P < 0.203). Conclusions: The higher prevalence of female patients with higher mean cost of inpatient care in this study suggests that Jos females may be more health conscious than their male counterparts. Overall mean cost of inpatient care stay was not proportional to the length of stay, suggesting early discharge from hospital did not necessarily eliminate the cost of patient management.
  - 6,437 284
Incidence and risk factors of cervical dysplasia among human immune deficiency virus positive and human immune deficiency virus negative women at Aminu Kano Teaching Hospital
Zakari Muhammad, Iman Haruna Usman, Zainab Ahmed Datti, Attah Rapheal Avidime, Shuaibu Adavuruku Danjuma, Atanda Akinfenwa Taoheed, Aisha Abdullahi Suleiman
October-December 2017, 20(4):160-167
DOI:10.4103/smj.smj_34_17  
Background: HIV infection is a risk factor for cervical cancer and both diseases are prevalent in Nigeria. HIV positive women are at greater risk of cervical dysplasia than HIV negative women which may be as a result of immunosupression, hence adding more burdens to their already worsening health condition. It has become relevant to screen these women early and refer for appropriate and effective therapeutic intervention. Objective: To compare the incidence and risk factors of cervical dysplasia among HIV positive and HIV negative women at Aminu Kano Teaching Hospital, Kano. Methods: This was a comparative cross sectional studyl, which involved HIV positive women attending HIV clinic and HIV negative women attending the gynecological clinic at Aminu Kano Teaching Hospital. A cohort of 150 consenting HIV- positive women not on HAART and 150 HIV- negative women, selected by systematic random sampling were sent for Pap smear examination. On the same day blood samples were taken from antecubital vein and sent for both CD4 count and viral load among the HIV positive group. A pretested questionnaire was administered to the women of both groups on same day to determine the presence or absence of risk factors of cervical dysplasia in them. The results obtained were recorded using proforma and analyses of risk factors of cervical dysplasia was done using Chi square test and Fisher exact test to compare variables between those with normal and abnormal smears and student t test to determine the relationship of lesions with CD4count and viral load among the HIV positive women. Results: The incidence of cervical dysplasia among HIV- positive women was 49 (32.7%) and was significantly higher than 12(8%) found among the HIV- negative. Age ≥ 35years and parity ≥5, early coitarche, multiple sexual partners, low-socioeconomic status, cigarette smoking did confer some risk of dysplasia however. This study also showed that among the HIV positive group, CD4 count was inversely associated with risk of cervical dysplasia and women with a CD4 count <500 cells/mm3 were at greater risk of cervical dysplasia compared with women with CD4counts>500 cells/mm3. Conclusion: It Ais important to carryout cervical smear screening for HIV-positive women, especially those with a CD4 count<500 at first contact.
  - 4,689 294
Health-related quality of life of people living with HIV/AIDS accessing care in a tertiary health-care center in North West Nigeria
Mansur Olayinka Raji, Hamidu M Liman, Ismail A Raji, Aminu Umar Kaoje
October-December 2017, 20(4):149-154
DOI:10.4103/1118-8561.230261  
Background: Worldwide, human immunodeficiency virus (HIV) continues to be a major public health issue. The vast majority of people living with HIV/AIDS (PLWHA) resides in low- and middle-income countries, such as Nigeria, and they suffer the impact of the disease with serious effect on their health-related quality of life (HRQoL). Aim: This study aimed at assessing the HRQoL of PLWHA attending retroviral clinic of a tertiary health care center. Methodology: The study was conducted at the retroviral clinic of a tertiary health institution, having about 4500 clients. PLWHA were recruited into the study using systematic sampling technique. The instrument of data collection was modified from the World Health Organization QoL HIV bref questionnaire. The questionnaires were analyzed with IBM software package version 20. Results: The overall domain scores for the respondents were; physical domain 62.8 ± 16.3; psychological domain 57.7 ± 15.8; social relationship domain 55.6 ± 17.5; environmental domain 59.2 ± 12.1; while the overall QoL and general health of all the respondents were 65 ± 21.8. The overall QoL and general health status of respondent were only significantly positively correlated with place of residence (P = 0.01). Respondents' perception of their current illness was negatively correlated with physical (r = −0.483), psychological (r = −0.393), social relationship (r = −0.397), environment (r = −0.329), and overall QoL scores (r = −0.530). Conclusion: Generally, the mean QoL domain scores for the respondents were high (>50). Very low QoL scores were seen in the social domain, suggesting that more social interventions are required in this population.
  - 4,386 365
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