Aims and Objectives: Increased free radical production and thus oxidative stress have been implicated in the pathogenesis of metabolic syndrome. As a result there is depletion of defences against free radical damage which comprise antioxidant enzymes and vitamins like vitamins C and E, resulting in low plasma levels. This study was designed to determine if the plasma total antioxidant status and vitamins C and E levels are lower in metabolic syndrome subjects living in Port Harcourt, Nigeria compared to healthy controls. Patients and Methods: One hundred subjects between 21 and 73 years of age who satisfied the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria for metabolic syndrome were recruited into the study. One hundred controls were age- and sex-matched. After determining their blood pressure (mmHg) and waist circumference (cm), the concentrations of plasma glucose (mmol/L), lipid profile (mmol/L), total antioxidant status (TAS, mmol/L), vitamin C (΅mol/L) and vitamin E (΅mol/L) were estimated in all participants. Results: The mean plasma TAS (1.23 ΁ 0.28mmol/L), vitamin C (27.5 ΁ 7.4΅mol/L) and vitamin E (16.9 ΁ 4.9΅mol/L) of metabolic syndrome subjects were significantly lower (P=0.0001 for all) than that of controls (1.58 ΁ 0.28mmol/L, 44.3 ΁ 7.3΅mol/ L, 30.8 ΁ 6.1΅mol/L respectively). Conclusion: The TAS, vitamins C and E are reduced in metabolic syndrome subjects compared with that of controls. This may be due to increased oxidative stress resulting from an imbalance between antioxidant defences and increased free radical production.

[ABSTRACT]   Full text not available  [PDF]

Aims and objectives: This study seeks to document the biochemical manifestations of liver dysfunction in Nigerians with sickle cell anaemia with the aim of alerting physicians on the need to consider these changes in the overall management of the disease condition. Patients and Methods: Serum total proteins, albumin, bilirubin, alkaline phosphatase (ALP), alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels were estimated in 150 patients with sickle cell anaemia (HbSS) and 100 control (HbAA) subjects. Results: The serum total proteins and albumin levels were found to fall within the reference intervals in both the HbSSpatients and the controls. However, the mean bilirubin (total and conjugated) levels and the activities of alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase were significantly higher (P <0.05) in the HbSSpatients than the control subjects. Conclusion: This study demonstrated elevated levels of serum bilirubin, ALP, ALT and AST in patients with sickle cell anaemia.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives: To evaluate the Pattern of Oncologic Emergencies seen in Adult cancer patients and the treatment modalities used. Materials and methods : Between January 2004 and December 2008, a total of 1824 (M:F = 1:1.8) new patients were seen. 196 (M:F = 1:1.4) consecutive patients with histologically confirmed malignancies presenting with or having oncologic emergencies were treated and have been reviewed. Patients' folders were reviewed retrospectively with a structured pro forma. Results were analysed using Epi Info soft ware Version 3.4.1; 2007 Edition. Results : The median age was 49 years and mean age of 42 years (range, 15 - 82 years). M: F = 1:1.4. 162 patients had oncologic emergencies at presentation while 21 during treatments and 13 during follow up. At the time of diagnosis of oncologic emergency, 126 were not on any treatment, 42 patients on hormonal therapy and 28 patients were on diverse chemotherapy. All the patients presented late with 108 patients presenting with metastatic disease and 88 patients with locally advanced disease. Only 35 patients were treated within 1 week of onset of emergency. 59 patients had cervical cancer, 31 patients with breast cancer and 28 patients with prostate cancer. Tumour haemorrhage wass the commonest oncologic emergency seen in 107 patients followed by bone pain with imminent cord compression from bone metastases in 59 patients. Of 107 patients with tumour haemorrhage, 54 patients had cardiovascular collapse with 7 having acute renal failure. Similarly, of the 107 with tumour haemorrhage, 56 patients bled from cervical cancer, 12 patients from breast cancer and 8 patients from urinary bladder. 129 patients were treated with teletherapy, 31 patients had chemotherapy, 27 patients had emergency surgery and 5 patients had chemoradiation. Oncologic emergencies were corrected in 126 patients. Conclusion : Tumour haemorrhage is the commonest oncologic emergency in this environment and teletherapy is the commonest therapy used. More radiotherapy centres are needed for prompt treatment and their usefulness in managing emergencies should be made known. Oncologic emergencies are commonly seen in metastatic and locally advanced disease.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives: This study aimed at determining the frequencies and pattern of congenital heart lesions among patients who had echocardiographic scan for various cardiovascular-related complaints at the University of Ilorin Teaching Hospital, Nigeria. Patients and Methods: All patients referred for echocardiography between May 2004 and April 2007 for various cardiovascular complaints were reviewed. Patients diagnosed with congenital heart disease were selected and analysed for frequencies of lesions, sex ratio and mean age. Results: Seventy-six patients with a diagnosis of congenital heart disease were reviewed. Ventricular septal defect was the commonest lesion; seen in 27.6% of patients followed by atrial septal defect (21.1%), patent ductus arteriosus (13.1%) and tetralogy of Fallot (11.8%). Others were dextrocardia with situs inversus (6.6%) and bicuspid aortic valve (2.6%). Conclusion: The distribution of congenital heart lesions is similar to that reported from other parts of the world except for higher frequency of atrial septal defect and lower incidence of bicuspid aortic valve. There has been an improvement in diagnosis of CHD in the middle belt of Nigeria due to availability of echocardiographic imaging facility even though most patients have no access to surgical correction.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives: Lower gastrointestinal (LGI) diseases are the leading causes of morbidity and mortality worldwide. Colonoscopy holds an important place in screening, diagnosing and treatment of these conditions. In Nigeria, as in many other developing countries, the facility for performing colonoscopy is rarely available. This prospective report seeks to evaluate the demographic data of patients presenting for colonoscopy, the pattern and validity of referral diagnosis versus colonoscopy findings in Ile-Ife, Nigeria. Subjects and Methods: All patients who had colonoscopy procedure done in the Endoscopy Unit of Obafemi Awolowo University Teaching Hospital Complex between January 2007 and December 2011 were included in the study. Results: During the study period, colonoscopy was carried out in 320 patients. One hundred and eighty two (56.9%) were males, while 138 (43.1%) were females. The median age was 59.5 years. Their ages ranged from 2-87 years. The most common indications were lower gastrointestinal bleeding and change in bowel habit which together accounted for 79.0%. No abnormality was seen in 93(29.1%) patients. Abnormal endoscopic findings included 66(20.6%) patients who had haemorrhoids, 50(15.6%) cases colorectal cancer, 33 (10.3%) patients had benign polyps and (30 (9.4%) patients had diverticular disease. Other findings were colitis, inflammatory bowel disease, rectovaginal fistula, vascular ectasia and extra luminal compression. Haemorrhoids, diverticulosis and polyps were the most common findings in patients presenting with lower gastrointestinal bleeding Conclusion: This present report showed that colonoscopy is a cheap, safe and effective method of investigating lower gastrointestinal disease in Ile-Ife, Nigeria. When the indication is based on symptoms, the diagnostic yield could be as high as 90%. The common causes of lower gastrointestinal bleeding in Ile-Ife, Nigeria include haemorrhoids, diverticulosis and polyps.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives : Pathologic effects of environmental factors on smooth muscle cells (SMCs) near the air/blood interface have been difficult to study because it is impossible to dissect blood vessels and bronchi down to their alveolar terminals. SMCs derived from explants of lung terminal parenchyma were examined in order to detect any effect of chronic hypoxia on their growth profiles. Subjects and Methods : Lungs were obtained from sheep kept at 12, 470 ft altitude, PaO2 ~60 Torr for ~4 months and from age matched control sheep kept at sea level. SMC were allowed to migrate from terminal lung parenchyma. Monolayer growth profiles were studied by using tritiated thymidine incorporation as indicator of DNA synthesis. Results : The normal growth pattern, typified by intrapulmonary 7th generation vein SMCs, showed a peak at 72h and mean peak tritiated thymidine incorporation (counts per minute, cpm) of 2829.46±294.24. Fifteen SMC lines were obtained from hypoxic sheep lungs compared to control sheep which generated three lines. According to peaks and mean incorporated cpm, hypoxic cells showed five distinct growth profiles: normal, subprolific, prolific, retarded, and senescent. Mean peak cpm incorporated by subprolific and prolific cells were: 4480.80±240.22 and 7775.42±475.77 cpm. The normal cells incorporated 507.04, 1386.33, 936.08, and -944.29 cpm in the 1st, 2nd, 3rd and 4th 24h-periods respectively while the retarded cells incorporated 403.70, 491.7, 53.08, and -124.08 cpm, and the senescent cells incorporated 26.71, 7.04, 7.83, and -0.42 cpm respectively. Apoptotic cells were also derived from hypoxic tissues. Conclusion : This report indicates an origin of pulmonary pathology, the SMC's near the air/blood interface.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives : The study investigated some co-morbidities, and age, gender and occupational distribution of stroke survivors seen in the Physiotherapy clinic of University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria; A 3-year retrospective study (January, 2008 to December, 2010). Patients and Methods : A total of 236 case notes of stroke survivors referred to the Physiotherapy clinic within the period of study were obtained and reviewed. Results : Majority (50.8%) of the stroke survivors were hypertensive, type 2 diabetes mellitus accounted for 14.8%, HIV 11.4%, chronic renal and heart diseases constituted 8.1% and 3.8% respectively. Those with hperlipidaemia and obesity comprised 3.0% each, and not specified encompassed 5.1%. One hundred and forty-one (59.7%) of the cases seen were males and 95 (40.3%) were females. The average age of the male and female patients were 56.0 ± 15.8 and 49.8 ± 18.8 years respectively. Housewives (31.8%) constituted the highest occupational groups while students (5.9%) were the least. Conclusion : The most common co-morbidities found among the stroke survivors were hypertension (50.8%), diabetes mellitus (14.8%) and HIV (11.4%). Majority of the stroke survivors were at their peak age when they are most economically relevant and productive (below 60 years). This suggests that the disability resulting from stroke will have a great negative impact on quality of life and socio-economic lives of these patients as well as a burden on the society. To alleviate this impact and lessen the societal burden of the disease, the public should be well educated and informed on the importance of seeking prompt and appropriate health care services.

[ABSTRACT]   Full text not available  [PDF]

Aims and objectives : To objectively assess the visual acuity of commercial motor drivers (CMD) in 3 Local Government Areas (LGA) of Ogun State of Nigeria in order to determine their eligibility to drive. Subjects and methods : The visual acuities of CMDs in 3 LGAS of Ogun state in Nigeria (selected using a multistage sampling technique) were tested with Snellens acuity charts and the eyes examined with bright pen torches and ophthamoscopes. Visual acuity 6/12 or better in the worse eye was taken as adequate to obtain a driving license. The drivers with worse visual acuities were further examined to find the cause of decreased vision. Results : The visual acuities of 524 drivers were determined and analyzed. Their ages ranged from 19-66 years with a mean of 46.8 ΁7.2 years. Two hundred and twenty (41.9%) of the drivers were between 40 and 49 years old. Four hundred and four (77.1%) did not have any form of eye test prior to this study. Four hundred and sixty three drivers (88.4%) were eligible to drive while 61 drivers (11.6%) were not eligible. Decreased visual acuity was caused by refractive error in 22(36.1%), cataract in 19(31.2%), glaucoma in 12(19.7%), corneal scar in 5(8.2%) and posterior segment lesions in 3(4.9%). Conclusion : Objective assessment of vision should be an essential component of licensure. Middle aged and elderly drivers are prone to age related ocular diseases and require reassessment of visual status every 3 years when licenses are renewed.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives : The objective of this paper is to emphasise the importance of detailed history, thorough physical examination and the need to expose undergraduates to basic Otorhinolaryngological skills of clinical examination as a way of overcoming the diagnostic challenges of foreign body in the throat. Patients and Methods : The case was an 8-year old boy who presented with 1-year history of impacted stump of toothbrush in his throat following a fall. With a high index of suspicion, his throat was examined under bright illumination and a foreign body brought into view by tongue depression was found impacted in his left tonsillar fossa. He was subsequently taken to the operating room for removal under General Anaesthesia. Results : Intra-operatively, the stump of a toothbrush measuring 4.8cm in length was confirmed and removed (Figs 1 & 2). The procedure was uneventful. Conclusion : Foreign body in the throat could pose diagnostic challenge. Detailed history and thorough physical examination are essential to clinch a diagnosis. Early referral in doubtful cases goes a long way to reduce morbidity and mortality associated with delayed removal.

[ABSTRACT]   Full text not available  [PDF]

Aims and Objectives: Gestational choriocarcinoma is a malignant form of gestational trophoblastic disease with a highly aggressive biologic behavior and responds well to chemotherapy. The objective of this study is to analyse the various histological features of this neoplasm as seen in Ahmadu Bello University Teaching hospital, ( ABUTH ) Zaria, determine its incidence, and compare with other studies. Materials and methods: The bench registers were used to retrieve the request forms, slides, and tissue blocks. The slides were all stained with standard haematoxylin and Eosin. The histological criteria published by Gehrig and van Lee was used to diagnose the tumours and grading of the cases from grade I to III. Results: Forty three cases were studied and these formed 4.9% of all products of conception and 37.7% of all gestational trophoblastic diseases. The peak age of incidence was in the third and fourth decades of life with vaginal bleeding as the leading mode of presentation. Extensive histopathological analysis and grading revealed haemorrhage, necrosis diamorphic appearance and pleomorphism as the most frequent features. Conclusion: Gestational choriocarcinoma is a common problem in Zaria, North- Western Nigeria with an incidence of 1 in 1039 deliveries. Haemorrhage, necrosis, diamorphic appearance and pleomorphism were the most frequent histological features. Health education and early detection are of paramount importance in reducing morbidity and mortality.

[ABSTRACT]   Full text not available  [PDF]

Full text not available  [PDF]