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   2001| January-March  | Volume 8 | Issue 1  
    Online since November 29, 2015

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Knowledge and management of malaria in under five children by primary health care workers in Ibadan South-east local government area.
OI Fawole, MO Onadeko
January-March 2001, 8(1):1-6
The results of a survey of the knowledge and management practices of 61 health workers in five primary health care facilities in Ibadan South-east LGA are presented. In addition, 30 health workers were observed as they managed children with fever and the parasite status of 92 children diagnosed to have malaria was determined. Results revealed that 62(67.4%) children had the malaria parasite. Knowledge of some basic concepts was fairly adequate as the majority 46(75.4%) knew the cause of malaria. Treatment practices were poor as only 34(55.7010) and 39(63.9%) health workers respectively prescribed chloroquine and paracetamol correctly. Observation revealed that history taking and physical examinations were rudimentary. Scores out of 100 on correct prescriptions of chloroquine and paracetamol were 60.1 and 76.8 respectively. There is an urgent need for periodic education programmes, especially for health workers with many years of experience to help them maintain clinical skills and refresh their knowledge.
[ABSTRACT]   Full text not available   
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Spinal tuberculosis: A 15 year review at OAUTHC Ile-Ife
IC Ikem, EA Bamgboye, AA Olasinde
January-March 2001, 8(1):22-25
A review of the hospital records over 15 years was made. The objective of the study was to describe the clinical presentation, management and outcome of spinal tuberculosis. Thirty-four patients were studied. There were 15(44.16%) males and 19 (55. 9%) females. Their age range was 2-80 years with mean (+/- SD) of 25.28 +/- 22.33 years. The occupations most commonly affected are Students (44.1%), Pre-school Children (17.6%) and Traders (14.7%). Back pain (100%), weight loss (47.1%), paraparesis (47.1%), kyphotic spinal deformity (32.4%) and night sweats (29.4%) were common features. Only 26.5% patients had active pulmonary tuberculosis. All the vertebral segments were involved. The Lumbar spine was the most involved vertebral segment in 50% patients. Using the Westergren method the mean (+/- SD) Erythrocyte Sedimentation Rate (ESR) mm/hour at the initial diagnosis was 83.58 +/- 31.11 mm/hour whereas three months after the commencement of antituberculosis chemotherapy it was 30.06 +/- 11.96 mm/hour. All the patients were given multiple antituberculosis drugs therapy and spinal traction. Spinal support was offered when the patients became ambulant. At the end of two years follow-up, 94.1% patients were alive, while 5.9% patients died during the course of treatment due to overwhelming sepsis. Among the patients that were alive, 14.7% still had persistence of their neurological deficit ie. paraparesis. Ten percent of the patients were mobilised on crutches while 5.96% were confined to wheelchair. This study shows that in tuberculosis endemic areas, symptom of back pain especially in the younger age group should be thoroughly investigated as this group constituted the largest affected population.
[ABSTRACT]   Full text not available   
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Giant congenital pigmented naevus with unusual presentation and early malignant transformation in a Nigerian infant: Case report and review of the literature
H Ammed, UH Pindiga, CU Onuora, A Abimiku, AA Dikko
January-March 2001, 8(1):26-31
A six month-old female infant with a giant congenital pigmented naevus isreported because of the rarity and unusual presentation and early malignanttransformation. It was the first case to be documented in our centre. There wasan extensive giant, darkly pigmented naevus of the "bathing trunk" distributionnoted at birth, associated with multiple darkly pigmented smaller naevi scatteredover the trunk and limbs. Bv the third month of life large pigmented lesion beganto demonstrate small papillomatous projections studding the entire surface and atage six months nodular and warty excrescences appeared including a largepedunculated spherical mass attached to the anal verge. The labia majora becameanatomically disfigured by these nodular, warty lesions of various sizesassociated with the large pigmented hairy naevus. Histological examination of theexcised large perianal and vulvar nodules showed the typical picture of anintradermal naevus consistent with giant congenital pigmented (melanocytic)naevus. The deeper portions of the lesion showed features of malignanttransformation. The rapidity of evolution of the lesions including histologicfeatures of early malignant transformation and the gross disfiguring of thegenitalia and perineum are uncommon presentation of this melanocytic naevus. Inview of the early malignant transformation immediate surgical treatment wasindicated. Unfortunately the patient was lost to follow-up. The case report iscomplimented with a review of the literature.
[ABSTRACT]   Full text not available   
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Comparison of three subtypes of depression
GT Okulate, HT Oladapo, A Osibogun
January-March 2001, 8(1):41-45
The objective of the study is to identify socio-demographic variables and clinical characteristics which distinguish between three subtypes of depression. In a prospective manner, 227 patients meeting ICD-10 criteria for depression were grouped into 3 subtypes--unipolar depression without psychosis, unipolar depression with psychosis and bipolar disorder depression. Using a structured questionnaire, socio-demographic and clinical variables obtained from the patients were compared in the 3 subtypes. Bipolar disorder patients were more likely to have first episode of illness before age 30 years. Psychotic depression patients were most likely to have positive family history of mental disorder and to have attempted suicide previously. Depressed females were less educated and more likely to be married. Early age at onset of depression requires more public awareness on recognition of depression particularly in the economically productive group. Further studies are required especially in community samples to further confirm these findings.
[ABSTRACT]   Full text not available   
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Hypothalamic neuropeptide Y mRNA in pregnant, lactating and suckling rats
MO Ajala, OO Oladipo, OA Afonja
January-March 2001, 8(1):16-21
Blood glucose, plasma insulin and luteinizing hormone levels were studied in pregnant wistra rats and those in early and late stages of lactation. NPY mRNA was also measured in whole hypothalamic tissue of these rats which were either fed ad libitum or food deprived to 80% of the relative controls. When fed ad libitum, hypothalamic NPY mRNA was not significantly elevated in the pregnant rats (111 +/- 2.1%). By the 5th and 4th days of lactation the mRNA had increased progressively (141 +/- 4.7% of control, p<0.01; 186 +/- 9%, p<0.001) respectively. Blood glucose levels were unchanged in pregnancy and lactation, however, insulin levels dropped significantly by the ]4th day of lactation (control 322.3 +/- 3.2; lactating 298.6 +/- 4.8 pmol/l; p<0.05). Luteinizing hormone was significantly reduced in the lactating rats (control 2.2 +/- 0.21, lactating 0.81 +/- 0.2 ng/ml;p<0.05). In food restriction, NPY mRNA was increased moderately in the non-pregnant state and enormously in late lactation (non-pregnant 157 +/- 21%, lactating 333 +/- 35%, p<0.001). In a lactation, blood glucose was unchanged while plasma insulin and LH were reduced to 20% and 50% of controls respectively (insulin: control 110.3 +/- 2.0; lactating 18.3 pmol/l; LH. control 1.3 +/- 0.1; lactating 0.59 +/- 0.4 ng/ml p<0.01). Orexigenic effect of hypothalamic NPY is possibly responsible for the hyperphagia in lactating. Food restriction and lactation had additive lowering effect on plasma insulin but an additive increase on hypothalamic NPYmRNA. NPY message may be partially responsible for the anovulatory effect of lactation.
[ABSTRACT]   Full text not available   
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Evaluation of nucleolar organizer regions in tumours of the jaw bones
OC Afolabi, O Odukoya, G Arole, AF Banjo
January-March 2001, 8(1):7-11
Nucleolar organizer regions [NORS] are loops of DNA that transcribe to ribosomal RNA. They can be visualized as intranuclear black dots by histochemical staining with a colloid silver solution. Silver stained nucleolar proteins (AgNORs) were counted in a variety of jaw bone tumours. In osteosarcomas, the number of AgNORs was also quantified before and after chemotherapy. Malignant bone tumour cells possessed more than five small AgNORs (5.54 +/- 0.44). Nuclei of benign jaw bone tumour cells had less than three (2. 97 +/-0.61). A significant difference in the number of AgNORs between osteosarcoma before chemotherapy (5.76 +/- 0.50) and after chemotherapy (3.89 +/- 1.65) was observed. (P < 0.05). The number ofAgNORs in recurrent osteosarcoma, recurrent ameloblastic carcinoma and recurrent chondrosarcoma was much higher than in their respective primary lesion but without statistical significant difference. The results of the present study indicate that the AGNOR count might help in determining malignancy, evaluating the effect of chemotherapy, and deciding the prognosis.
[ABSTRACT]   Full text not available   
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Maternal mortality at Sagamu, Nigeria--a ten year review (1988 - 1997)
AO Olatunji, AO Sule-Odu
January-March 2001, 8(1):12-15
A review of maternal deaths at the Ogun State University Teaching Hospital, Sagamu, Nigeria over a 10 year period is presented. During the period, there were 92 maternal deaths, those from abortion and ectopic pregnancy inclusive. The total deliveries were 5423 giving a maternal mortality ratio of 1700 per 100,000. Ruptured uterus was the most common cause followed by eclampsia, postpartum haemorrhage and complications of abortion in that order. Unbooked patients constituted about one third of the total (29. 1 %). Primipara and grandmultipara were the most at risk of maternal death and the risk of dying following operative delivery was six times that of vaginal delivery. Easy access to affordable antenatal care, good blood transfusion services, more widespread use of contraceptives and training of traditional birth attendants would help reduce the risk of maternal death.
[ABSTRACT]   Full text not available   
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Outcome of primary closure of incised acute soft-tissue abscesses
ST Edino, CH Ihezue, PO Obekpa
January-March 2001, 8(1):32-36
One hundred and six patients with acute soft tissue abscesses were involved in the study at the Accident and Emergency unit of Jos University Teaching Hospital (JUTH) from June, 1996 to April, 1997. The objective of the study was to assess the outcome of primary closure in the treatment of acute soft tissue abscesses using the healing rate, cost effectiveness, quality of scars and postoperative complications as parameters. The patients were divided into two groups: group A for primary closure, and group B for the conventional method. There was a statistically significant difference (P<0.05) in the healing time for study group A (6.96 +/-123.56) compared with control group B. Similarly group A was more cost effective (Total cost = N406 +/-123.56) compared with control group B (Total cost = N580.47 +/- 174.24). The difference was statistically significant (P < O. 05). Ninety one percent of the primary closure group had cosmetically acceptable scars compared with only 9.3% in group B. This difference was significant statistically (p<0.05). Complications were low in the two methods of treatment. However two patients (4.4%) in group A developed re-accumulation of pus and wound dehiscence. The results of this study show that primary closure after incision of an acute soft tissue abscess heals faster with cosmetically better scars, and it is more cost effective, than simple incision and drainage followed by daily dressing.
[ABSTRACT]   Full text not available   
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Hysterectomies in Nigerians: Histopathological analysis of cases seen in Ile-Ife
KA Adelusola, SO Ogunniyi
January-March 2001, 8(1):37-40
To review retrospectively hysterectomy specimens sent to the histopathological department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria in order to document the histopathological findings and relate these with the age of patients. The records of patients with hysterectomy specimens sent to the histopathological laboratory within a period of 10 years were studied. Some of the histological slides were reviewed. The diagnosis of uterovaginal prolapse was based on clinical as well as pathological findings. Three hundred and thirty hysterectomy specimens seen over the study period of 10 years were studied. Women aged 40-49 years accounted for the highest number of cases, Hysterectomy was most often performed for leiomyoma (48%). followed by uterovaginal prolapse (17%). In women over the age of 70 years hysterectomy was most often performed for uterovaginal prolapse. Complication of pregnancy still accounted for a high percentage of hysterectomy (11%) Most were ante-partum and post partum haemorrhages as well as septic abortion in young women Ten of the specimens were normal both grossly and microscopically. Six of these were removed for suspected leiomyoma. The peak age incidence for women with leiomyoma who had hysterectomy corresponds with the overall peak age for women who had Hysterectomy. Leiomyoma was the commonest finding in hysterectomy specimens. However, clinicians should ensure that the condition is accurately diagnosed in all cases to avoid removal of a normal uterus.
[ABSTRACT]   Full text not available   
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Learning and evaluation in medical education
KE Nkanginieme, N Eke
January-March 2001, 8(1):46-51
An educational experience is a complex event, which involves four distinct common places: learner, curriculum, milieu and teacher. Medical education is a unique form of educational experience. The learner is almost always an adult. The teacher is not necessarily trained to teach. Because of rapid changes in knowledge it is very dynamic. Life-long learning and evaluation are mandatory, for the student as well as the medical practitioner. This communication highlights some issues concerning learning and evaluation, as applicable to medical education, including the concept of learning by objectives, learning approaches, study strategies, learning methods; the purposes of evaluation, self-evaluation and common assessment methods. This is intended to create some awareness, in the medical student, resident or medical teacher of the need to begin to learn how to learn and demystify evaluation.
[ABSTRACT]   Full text not available   
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