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   2003| April-June  | Volume 10 | Issue 2  
    Online since December 14, 2015

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Prosthetic parameters among dental patients in Ile-Ife, Nigeria
AO Olusile, EO Ogunbodede, AO Oginni
April-June 2003, 10(2):88-91
The purpose of this study was to determine the Rest Vertical Dimension (RVD), Occlusal Vertical Dimension (OVD), Freeway Space (FWS) and their importance in the fabrication of dental prostheses. These prosthetic parameters were determined in 310 dentate patients attending the Dental Hospital of the Obafemi Awolowo University Teaching Hospitals' Complex Ile-Ife. The MMO was obtained by measuring inter-incisal distance. RVD and OVD were derived using Willis gauge. The FWS was taken as 'RVD minus OVD'. Of the 310 attendees, twenty-seven (8.7%) were denture wearers. There was no statistically significant difference between the genders with regards to the use of dentures (P = 0.17). The mean values (+/- standard deviation) for MMO was found to be 50.5 +/- 7.9 mm (range 18.0 to 70.0 mm). The RVD was 73.0 +/- 8.4 mm (range 50.0 to 94.0 mm) and OVD was 69.8 +/- 8.2 mm (range 47.0 t 92.0 mm). The mean FWS was 3.3 +/- 1.4 mm (range 1 to 9 mm). Following the loss of most of the posterior teeth or in a state of complete edentulism, the face profile appears squashed and the vertical dimensions are altered. To provide an efficient and functional prosthesis, the facial dimensions have to be restored to or near pre-edentulous state. The establishment of values for these facial dimensions in given population will assist in the provision of satisfactory prosthesis.
[ABSTRACT]   Full text not available   
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Perianal abscess and fistula in children in Zaria
EA Ameh
April-June 2003, 10(2):107-109
Perianal abscess (PAA) and fistula-in-ano (FIA) are not uncommon in children, but reports from tropical Africa are uncommon. In a period of 17 years, 17 children aged 12 years and below were treated for these conditions in Zaria, Nigeria. There were 14 boys and 3 girls, aged 4 months-12 years (median 3 years), Eight had PAA (median age 3 years), 5 ischiorectal abscess (median age 5 years) and 4 FIA (median age 10 months). FIA followed pull through for anorectal malformation in 2 patients and in one it was preceded by PAA. PAA was associated with chronic fissure-in-ano in one patient and uncontrolled diabetes mellitus in one. One 16-month girl with an ischiorectal abscess developed severe perineal necrotising fascitis and separation and retraction of the anorectum. Escherichia coli was cultured in 2 patients with abscesses and staphylococcus aureus in another 2. Culture was sterile in 7 patients with abscesses. Treatment was by adequate incision and drainage for abscesses. Fistulectomy was the treatment for FIA, but in one patient a diversion colostomy was performed in addition as the fistula was a high one. The child who developed necrotising fascitis had debridement and diversion colostomy. FIA recurred in one patient necessitating repeat fistulectomy. Although the number of patients is small, perianal sepsis appears to be less common in our environment compared to developed countries. Some differences are highlighted.
[ABSTRACT]   Full text not available   
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Abruptio placenta following sexual intercourse: case report
ME Aziken
April-June 2003, 10(2):113-114
This is a case of Abruptio Placenta resulting from sexual intercourse. Pelvic Examination revealed active bleeding per vaginam. The pregnancy resulted into intra-uterine foetus death. The foetus membranes were ruptured and labour progressed. A still born male baby was delivered.
[ABSTRACT]   Full text not available   
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HIV seroprevalence in emergency department patients: Lagos University Teaching Hospital, Lagos, 1999
OA Esan, AS Akanmu, I Akinsete
April-June 2003, 10(2):71-75
The emergency department patients represent a cross-section of the entire population and values of HIV seroprevalence in them have been used to assess the general trends of HIV surveillance in other countries. The objectives of this study is to determine 1. Whether seroprevalence of HIV antibodies in patients attending emergency departments could serve as a marker of prevalence of HIV antibody in the general population. 2. The degree of clinical suspicion or knowledge of the medical personnel to the status o the HIV seropositive patients is also evaluated. A total of 312 emergency department patients of Lagos University Teaching Hospital (LUTH) had their blood samples screened for antibodies against Human Immunodeficiency Virus (HIV) types I and II by ELISA based techniques: Immunocomb II HIV I & II Bispot Kits. Repeatedly reactive samples were confirmed by another ELISA based technique using Immunocomb I & II Combfirm kits. The attending medical doctor was asked whether there was any suspicion or knowledge that the patient being attended to, was HIV seropositive. The seroprevalence of HIV antibodies was 5.77% with no significant difference in sex incidence. The age groups 20-29 and 30-39 years were most affected. The seropositive nature of affected patients was unsuspected by medical personnel in 55.56% of the HIV antibodies seropositive patients. The Federal Ministry of Health in 2000, estimated the National prevalence rate of HIV to have been 5.4% in 1998. This figure is comparable to that obtained in this study and revalidates the fact that emergency department patients may be used for disease surveillance in the population. The seropositive status of majority of the HIV positive patients was unsuspected by the attending medical personnel. Thus, strict adherence to universal safety precautions is essential for all medical personnel. Post exposure prophylaxis should be made readily accessible to all medical personnel.
[ABSTRACT]   Full text not available   
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Ventricular arrhythmias: Q-T prolongation and left ventricular hypertrophy in adult Nigerians with hypertensive heart disease
OG Opadijo, AB Omotoso, MA Araoye
April-June 2003, 10(2):76-78
Seventy adult Nigerians with hypertensive heart disease (HHD) and 68 healthy controls were studied for ventricular arrhythmias (VA). The roles of QT prolongation and left ventricular hypertrophy in these arrhythmias were received. The mean age of the study population was 49.9 +/- 6.0 years. 14 (20.0%) patients had cardiac arrhythmias with 3 patients having premature ventricular contractions (PVC). Ten (14.3%) cases had QTc prolongation out of which 1 patient had PVC. Some factors that were found to be associated with QT prolongation in HHD include: left ventricular hypertrophy, persistently elevated systolic blood pressure and female gender. There was a positive correlation between left ventricular hypertrophy and QTc prolongation and also between QTc prolongation and frequency of ventricular arrhythmias.
[ABSTRACT]   Full text not available   
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Diabetic retinopathy: management update
SN Nwosu
April-June 2003, 10(2):115-120
The objective of the study is to review the current knowledge and management of diabetic retinopathy. Current information from multi-centre controlled clinical trials and epidemiological studies in different parts of the world were used to review the epidemiology, pathophysiology, classification, clinical features and management of diabetic retinopathy. Diabetes mellitus affects all ocular tissues. Retinopathy, its most devastating ocular complication, presents with similar clinical picture in both types 1 and 2 diabetes. In Nigeria, diabetic retinopathy has an incidence of 33%; accounts for 16.7% of retinal diseases and leads to bilateral blindness in 22.2% of diabetics. Its incidence depends on both the duration of diabetes and the level of glycaemic control. Hypertension, dyslipaemia, hyperglycaemia and cigarette smoking aggravate retinopathy and adversely affect its response to treatment. Strict blood sugar control delays the onset of retinopathy and retards the progression of established disease. Timely laser and vitrectomy surgeries obviate severe visual loss in diabetic retinopathy. The role of medical therapy for diabetic retinopathy is still experimental. Diabetes occurs worldwide; diabetic retinopathy is increasing in incidence. Developed countries have clear guidelines on the care of diabetes and its complications. The need for similar guidelines in Nigeria is urgent.
[ABSTRACT]   Full text not available   
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Malignant tumours of the nasopharynx at Jos University Teaching Hospital, Nigeria
OB da Lilly-Tariah, AO Somefun
April-June 2003, 10(2):99-102
A retrospective epidemiological study of 55 patients who had been histologically diagnosed as having nasopharyngeal malignancy was undertaken at the Jos University Teaching Hospital in the period from December 1988 to November 1998. Jos is at the heart of the middle belt of Nigeria and is made up of peoples of various tribes and religions. The aim of this study was to evaluate the epidemiological factors, clinical presentation, histological pattern and treatment outcome in the patients during the study period. Fewer females were affected than males with a ratio of 1:1.6. Age range was 35-82 years with an average age of 42.19 years. Most of the well documented predisposing factors were absent in this series and the role of smoking and alcohol is unclear. Squamous cell carcinoma (72.7%) was the commonest epithelial malignancy with the incidence of the well differentiated type (WHO type 1) being as high as 34.5%. Rhabdomyosarcoma (14.8%) was the commonest sarcoma. Neck swelling 70.9%, Nasal stuffiness 41.8%, epistaxis 34.5% and pharyngeal mass 25.5% were the commonest symptoms. Treatment and follow-up were unsatisfactory as patients could not afford the cost of radiotherapy and anti-cancer drugs.
[ABSTRACT]   Full text not available   
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Clinical and management factors related to outcome in neonatal tetanus
CN Okoromah, FE Lesi, MT Egri-Okwaji, E Iroha
April-June 2003, 10(2):92-95
Although tetanus is a well-recognised, well-described, preventable and eradicable infection, it continues to ravage the lives of children in developing countries, especially among neonates. A cross-sectional review of cases of neonatal tetanus seen in LUTH was carried out retrospectively. Thirty-nine (39) cases were studied, comprising 26 (63.4%) males and 15 (36.6%) females, giving a male: female ratio of 1.6:1. Case fatality rate was 10.3%, thirty-five (89.7%) cases survived, of which nine (23.8%) survived with complications. Clinical factors that influence outcome were: a short interval between onset and presentation (p = 0.03), low tetanus score below 6.0 (p = 0.002), hyperpyrexia (p = 0.0001), heart failure (p = 0.035), cyanosis (p = 0.008) and crepitations (p = 0.003). Although several management factors were associated with mortality, these failed to meet statistical significance (p > 0.05). In this study, clinical factors, including presentation interval, were the principal determinants of outcome. The need for intensification and sustenance of preventive measures, early recognition and presentation, prompt treatment as well as improved care are emphasised. We recommend periodic audit of patient clinical data towards improving quality of care.
[ABSTRACT]   Full text not available   
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Hepatitis C virus infection in patients with sickle cell anaemia at the Lagos University Hospital
OA Lesi, MO Kehinde
April-June 2003, 10(2):79-83
The objective of this studies is to determine the frequency of antibodies to Hepatitis C virus (anti-HCV), (2) assess the role of blood transfusion in transmission of infection, and (3) evaluate the clinical implication of anti-HCV sero-positivity in patients with Sickle cell anaemia (SCA). Two hundred and seventy-eight (278) patients with SCA were evaluated by questionnaire interviews for risk factors, clinical examination and serum testing for anti-HCV using a third generation ELISA kit. The overall anti-HCV prevalence was 5.0% (14/278). Anti-HCV was positive in 7% (5/76) of never transfused compared with 5% (9/202) of previously transfused sicklers. (p = 0.5). Clinically, splenomegaly alone or in combination with hepatomegaly was associated with a positive anti-HCV (p = 0.04 and 0.01 respectively). Anti-HCV was detected in 5% of adult patients with Sickle cell anaemia, especially in patients with persistent splenomegaly alone or in combination with hepatomegaly. Blood transfusion did not appear to be the major route of HCV transmission.
[ABSTRACT]   Full text not available   
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Comparative study of salt taste threshold of hypertensives, their normotensive relatives and non-relatives
SO Olayemi, AF Mabadeje
April-June 2003, 10(2):96-98
The role of salt in the genesis of hypertension has been well documented. Earlier studies have demonstrated higher salt taste threshold among hypertensives compared to normotensives. The aim of this study is to compare the salt taste thresholds of normotensive relatives of hypertensive patients with those of normotensives without family history of hypertension. Twenty-one hypertensives, 52 first degree relatives of these hypertensives and 99 normotensives without family history of hypertension were studied. They were made to taste different concentrations of solution from distilled water to 280 mmol of saline. The results showed that hypertensives had higher salt taste thresholds--detection (p < 0.0001), recognition (p < 0.0001) and maximum tolerable threshold (p < 0.05)--compared with normotensive relatives. The normotensive relatives of hypertensive patients in turn had higher salt taste thresholds--detection (p < 0.01), recognition (p < 0.0001) and maximum tolerable threshold (p < 0.001)--compared with normotensive controls; they also had significantly higher mean arterial pressure (p < 0.001). Health education with intervention directed at the hypertensives and their first degree normotensive relatives to willfully modify their desire and appetite for salt is of paramount importance.
[ABSTRACT]   Full text not available   
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Prevalence of cryptosporidium infection among undernourished children in Jos, Central Nigeria
EB Banwat, DZ Egah, BA Onile, IA Angyo, ES Audu
April-June 2003, 10(2):84-87
This prospective study aimed at determining the prevalence data of Cryptosporidium infection in undernourished children, its seasonality and its relative frequency in diarrhoeic stool in Jos, Central Nigeria. One hundred and seventy each of undernourished and well nourished children aged 0-5 years were recruited into the study. Stool samples and clinical data were obtained using questionnaires. Results were analysed using Chi-square test. The prevalence of the infection was found to be 4.8% and all infections occurred in diarrhoeic stool. No infection with this pathogen was recorded in the well-nourished group. There was a defined seasonality of the infection. The high prevalence suggests the importance of introducing routine screening of this group of patients for cryptosporidium infection to facilitate their management.
[ABSTRACT]   Full text not available   
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Two vaginal deliveries after a classical caesarean section--case reports
AB Ande, O Onofowokan, GC Njoku
April-June 2003, 10(2):110-112
It is standard practice to offer a parturient who has had a classical Caesarean section an elective repeat Caesarean section due to the fear of uterine rupture. The strong aversion of our women to operative delivery does not allow an appreciable number to avail themselves of hospital delivery even after Caesarean section. We report the case of a booked patient who had a classical Caesarean section but defaulted in two subsequent pregnancies to have vaginal deliveries in a private hospital. We therefore suggest a more liberal attitude to allowing attempt at vaginal delivery as an informed decision in well-equipped facilities capable of easy and prompt resort to appropriate intervention.
[ABSTRACT]   Full text not available   
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Helicobacter pylori: pathogen and symbiont
AE Ani, AO Malu
April-June 2003, 10(2):121-124
There are puzzles in defining the exact role of Helicobacter pylori infection in humans. The bacterium, which is associated with human disease of the upper gastrointestinal tract, may otherwise exist as a commensal with probable symbiotic association in some human hosts. Although virulence associated genes have been detected in some strains which explain their pathogenicity, their pathogenic effect and subsequent clinical manifestations seem to vary in different human populations or geographical locations. Some human hosts remain predominantly asymptomatic in spite of the "virulent" H. pylori strain(s) they harbour. There are probable benefits of H. pylori colonisation of the human gastric mucosa. Thus the recommendation of eradication therapy in patients with known peptic ulcer disease may be more advantageous than the "test and treat policy", which suggests treatment of uninvestigated dyspeptic patients, who may not have any lesions.
[ABSTRACT]   Full text not available   
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Prognostic factors in the management outcome of carcinoma of the larynx in Lagos
OA Somefun, CC Nwawolo, PA Okeowo, SB Alabi, FB Abdul-Kareem, AA Banjo, SO Elesha
April-June 2003, 10(2):103-106
This is a retrospective analysis on the prognostic factors in the management outcome of clinically and histologically diagnosed carcinoma of larynx seen in Lagos University Teaching Hospital between 1996-1999. Various prognostic factors have been documented as determinants on the probable outcome of carcinoma of the larynx, such as duration of symptoms, smoking, medical status of the patient, degree of differentiation, size and site of tumour and presence of cervical lymph node. Thirty-six patients between 1996-1999 were reviewed, with a male to female ratio of 11:1, and peak age group of occurrence in 50-59 years, majority (86.12%) of which were non-smokers who presented in varied degrees of airway obstruction necessitating pre-treatment tracheostomy in 70% of the patients with more than 50% presenting within 3-6 months of onset of initial symptom. The tumours were staged clinically and histology revealed well differentiated T3 glottic tumour without any clinically palpable neck node in more than 50% of the patients which should predict a better outcome. But the interplay of many prognostic variables like pre-treatment tracheostomy and its attendant complications, supposed biological aggressive tumour in a non-smoker, coupled with treatment biased by patients, high costs of treatment, logistics and poor follow up compliance, resulted in poor outcome of our management.
[ABSTRACT]   Full text not available   
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Autogenous arteriovenous fistulas for haemodialysis: a review
JA Akoh, S Dutta
April-June 2003, 10(2):125-130
The last 40 years has witnessed revolutionary changes in vascular access provision for haemodialysis. Autogenous arteriovenous (AV) fistula is the best access modality and should be considered first when planning vascular access. Education is required to ensure preservation of the cephalic veins in patients at potential risk for the development of end stage renal disease (ESRD). The best access procedure should be performed first and the AV fistula allowed to mature before use. Autogenous AV fistula have a cumulative patency of 85-90% and 60-85% at 1 and 3 years respectively. Increased use of preoperative imaging and the use of autogenous vein are essential to improved long-term results.
[ABSTRACT]   Full text not available   
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