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   2012| July-September  | Volume 19 | Issue 3  
    Online since November 16, 2015

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Nigerian National Health Insurance Scheme (NHIS): An overview
DC Obalum, F Fiberesima
July-September 2012, 19(3):167-174
Full text not available  [PDF]
  1,400 259 -
A review of obesity and orthopaedic surgery: The critical issues
DC Obalum, F Fiberesima, SU Eyesan, CN Ogo, C Nzew, M Mijinyawa
July-September 2012, 19(3):175-180
Obesity is a growing concern in the health community because of the morbidities associated with it. There is a higher occurrence of many orthopaedic conditions among obese individuals than their non-obese counter parts. Obesity also worsens the progression of many of these orthopaedic conditions. have shown that obesity may have negative impact on bone metabolism and may be implicated in the pathophysiology of some orthopaedic conditions like osteoporosis, fractures, osteoarthritis and many soft tissue ailments by both reduction in bone mass and elaboration of proinflammatory cytokines. These contribute to preponderance of musculoskeletal co-morbidities among obese patients. peri-operative issues which include increased cardiopulmonary risks, issues of special equipment, instrumentation, surgical approach, patients' positioning and adjustments in medication should be acknowledged and meticulously addressed in operative management of orthopaedic conditions in obese patients. Surgeries in obese patients are fraught with operative challenges and post-operative complications than in the non-obese and a good knowledge of the critical issues in surgical management of obese patients is necessary to facilitate decision making as well as rendering of effective and efficient orthopaedic care.
[ABSTRACT]   Full text not available  [PDF]
  1,326 114 -
Prevalence of ventricular arrhythmias and heart rate variability pattern in chronic heart failure
GT Lasisi, AP Adebola, OS Ogah, FA Daniel
July-September 2012, 19(3):157-162
Aims and Objectives: This study was carried out to determine the prevalence of ventricular arrhythmias and heart rate variability pattern in patients on treatment for chronic heart failure. Patients and methods: Twenty four hour ambulatory electrocardiograms were recorded in 60 patients with chronic heart failure and echocardiography left ventricular ejection fraction of less than 45%.Sixty age and sex- matched individuals with no obvious evidence of underlying cardiac disease were also evaluated for comparison. Results: Premature ventricular complexes (PVCs) were evident in all subjects being infrequent [ < 30 PVCs per hour], in 21 (35%) and frequent [ > 30 PVCs per hour] in 39 (65%).Multiform extra systoles were recorded in 44 (73.3%) subjects, ventricular couplets in 50 (83.4%), and non-sustained ventricular tachycardia (NSVT) in 28 (46.7%) of the 60 subjects. Among the controls, PVCs were seen in 27(45%) and were all infrequent. None of the controls had multiform extra systole, ventricular couplets or NSVT. Significant inverse relationships were found between ejection fraction and PVC per h ( P-value < 0.001), ventricular couplet per 24h (P-value < 0.001) and NSVT per hour (P-value 0.002). Time domain heart rate variability measures i.eMean Standard Deviation of Normal to Normal RR Interval (SDNN), mean Percentage of Adjacent NN Intervals in a 24 hour recording which differ by at least 50ms (pNN550) , mean Root Mean Square Successive Difference in RR Interval (rMSSD) were significantly lower in the subjects compared to the controls. The corresponding P-values were <0.001, < 0.001, < 0.001 respectively. A significant positive correlation was found between EF and SDNN ( P-value <0.001), pNN50 (P-value 0.044) and rMSSD (P-value < 0.001). Conclusion: This study showed that ambulant out patients with chronic heart failure, have significantly higher prevalence of ventricular arrhythmias and narrow heart rate variability compared to healthy individuals of comparable age and gender.
[ABSTRACT]   Full text not available  [PDF]
  1,301 119 -
Detection of Prostate Cancer: Comparison of cancer detection rates of Sextant and Extended Ten-core Biopsy Protocols
RW Ojewola, KH Tijani, EA Jeje, CC Anunobi, MA Ogunjimi, EV Ezenwa, OS Ogundiniyi
July-September 2012, 19(3):137-142
Aims and Objectives : To compare the cancer detection rates of sextant and ten- core biopsy protocol amongst patients being evaluated for prostate cancer. Patients and methods : This is a prospective study involving 125 men with suspicion of prostate cancer. They all had an extended 10-core transrectal digitally-guided prostatic biopsy using Tru-Cut needle. Indications for biopsy were presence of one or more of the following: elevated Prostate Specific Antigen (PSA), abnormal Digital Rectal Examination (DRE) findings and abnormal prostate scan. Sextant biopsies were collected first, followed by four lateral biopsies in all patients. Both groups of specimen were kept and analyz\sed separately by the same pathologist. The cancer detection rates of sextant and extended (combination of sextant and lateral) 10-core biopsy protocols were determined and compared. Pearson's Chi square and McNemar tests at two degrees of freedom with level of significance set at 0.05 ( P<0.005) were used to determine the statistical significance. Results : The overall cancer detection rate of 10-core prostate biopsy was 48.8%. Of all positive biopsies, the sextant biopsy protocol detected 52 cancers (85.2%) while the lateral biopsy protocol detected 58 cases (95.1%). Three (3) cancers were detected by the sextant protocol only while the lateral protocol detected nine (9) cancers where sextant technique was negative for malignancy. Ten-core extended protocol showed a statistically significant increase of 14.8% over the traditional sextant. (P =0.046). The overall complication rate of ten-core biopsy was 26.4% and the procedure was well tolerated in most patients. Conclusion : We conclude that a ten-core prostate biopsy protocol significantly improves cancer detection and should be considered as the optimum biopsy protocol.
[ABSTRACT]   Full text not available  [PDF]
  1,262 116 -
Preparation of platelet-rich plasma from small volume of whole blood - A simplified approach
OK Ogundipe, VI Ugboko, FJ Owotade, B Paul-Odo, AB Afariogun
July-September 2012, 19(3):133-136
Aim and objectives : Platelet-rich plasma (PRP) is frequently used to enhance wound healing in numerous surgical applications. There are many methods of preparation of PRP. The present report describes a laboratory technique which is rapid, simple and inexpensive for preparing PRP from small volume of whole blood. Materials and methods : Whole blood was drawn from 30 patients undergoing oral and maxillofacial surgery. PRP was prepared by the modified open system. Platelet counts for whole blood and PRP were determined using a cell counter. Results : The data from 30 patients aged 20 to 33 years, with a mean of 24.4 (+/ - 3.3) and male : female ratio of 1:1.1, were analysed. The platelet count in PRP was 3,157,667 +/- 984,380 while that in whole blood was 268,667 (+/- 64,678) platelets /cubic ml, reflecting an 11-fold increase in platelet concentration. No effect of gender or ageing on platelet count was observed. Conclusion : This study demonstrates a simple, rapid and inexpensive technique that is useful in obtaining platelets concentrated approximately 11-fold.
[ABSTRACT]   Full text not available  [PDF]
  1,226 126 -
The efficacy of 10gram intramuscular loading dose of MgSO 4 in severe preeclampsia/ eclampsia at a tertiary referral centre in Northwest Nigeria
BO Okusanya, KKD Garba, HM Ibrahim
July-September 2012, 19(3):143-148
Aims and Objectives : The efficacy of 10g intramuscular loading dose of magnesium sulphate in women with severe preeclampsia/eclampsia was assessed at a tertiary health centre for potential use at primary health level. Subjects and Methods: Intramuscular 10g loading dose and 14g loading dose of Pritchard were compared in women with severe preeclampsia/eclampsia. Primary outcome measures were the occurrence of fits in women with severe preeclampsia, further fits in those with eclampsia and maternal death. Other outcome measures were mode of delivery and severe birth asphyxia at 5 minutes of life. Results: One hundred and three women were enrolled; 54 and 49 women had 10g and 14g loading dose respectively. No significant convulsions (p= 0.1424) occurred in women with severe preeclampsia who had 10g intramuscular loading dose and repeat convulsion was averted in 93% of women with eclampsia. 10g loading dose did not increase the likelihood of caesarean section in women with preeclampsia (p=0.2832) or eclampsia (p=0.9112). The mean Apgar score at 5 minutes of life of neonates whose mothers had 10g and 14g loading dose for preeclampsia was 8 and 8.46 respectively, and 8.9 and 8.8 respectively for eclampsia. There was no statistically significant difference in maternal death between the two groups for severe preeclampsia (p= 0.2020) and eclampsia (p=0.3496). Conclusion: This study suggests a potential use of intramuscular 10 gram loading dose of MgSO4 at the primary health care level in Nigeria.
[ABSTRACT]   Full text not available  [PDF]
  1,215 135 -
Ruptured uterus and bowel injury from manual removal of placenta: A case report
Oluwarotimi I Akinola, Adetokunbo O Fabamwo, Bolaji Oludara, R Adeyanju Akinola, Yusuf A Oshodi, Samuel K Adebayo
July-September 2012, 19(3):181-183
Background : Retained placenta is a significant cause of maternal mortality and morbidity throughout the developing world. 'Though, intestinal injury may arise as a complication of induced abortion following instrumentation through the genital tract, the involvement of the large bowel in complicated manual removal of placenta is a very rare occurrence' Case report : We present the case of a 28 year-old Para 3+0, 3 alive woman who had attempted manual removal of placenta in a basic emergency obstetric care facility that resulted in lower uterine segment rupture with evisceration of bowels through the laceration outside the introitus. She subsequently had right hemi- colectomy with ileo-transverse anastomosis and repair of uterine rupture with bilateral tubal ligation. Conclusion : This case highlights the risk of exposing parturients to inexperienced attendants at delivery and emphasises the need for intensification of manpower training to attain the 5th MDG enunciated by the United Nations.
[ABSTRACT]   Full text not available  [PDF]
  1,228 110 -
Socio-demographic and obstetric determinants of gestational age at booking at the University of Benin Teaching Hospital: A descriptive survey
EJ Enabudoso, E Obhielo
July-September 2012, 19(3):149-152
Aims and objectives: This study evaluated the determinants and socio- demographic and obstetric characteristics of the gestational age at booking for antenatal care at the University of Benin Teaching Hospital, Benin City. Patients and methods : A prospective cross-sectional analytical survey, using a pretested semi-structured anonymous questionnaire was carried out at the antenatal clinic of the University of Benin Teaching Hospital, Benin City. The participants were women who presented for booking with sure date of last menstrual period, between October and December, 2010. Results : There were 484 respondents with mean age of 30 ± 4.5 years and median parity of 1. The modal and median gestational age at booking was 20 weeks and 18 weeks respectively. Percentage booking in the first, second and third trimesters was 14.9, 54.3 and 30.8 respectively. There was multiple booking in 90.7% of respondents in the previous pregnancy. Frequent strike actions and distance factors were the main reasons reported for multiple bookings. Nulliparity, previous perinatal death and absence of prior booking were significantly associated with early booking. Conclusion : Late and multiple booking for antenatal care is still prevalent in our environment. Nulliparity and previous foetal loss influence earlier booking. Missed opportunities for counseling and resource wastage is highlighted.
[ABSTRACT]   Full text not available  [PDF]
  1,211 106 -
Incidence of hepatotoxicity of highly active Antiretroviral Therapy in a Tertiary Health Centre in Nigeria.
RA Ugiagbe, AO Malu, BJ Bojuwoye, AN Onunu
July-September 2012, 19(3):127-132
Aims and objectives: The aim of this study was to determine the incidence of hepatotoxicity of HAART in HIV infected patients in a tertiary health centre in Nigeria. Materials and Methods: This study was carried out on HIV patients on HAART attending infectious disease clinic, gastroenterology clinic or admitted into the medical wards of University of Benin Teaching Hospital. HAART-naive HIV patients were used as controls. A clinical evaluation and relevant laboratory investigations were done. Hepatotoxicity was defined using a standardised toxicity grade scale. Results: A total of 84 cases and 42 controls were studied. The mean ages were 35.2± 9.9years and 35.5±9.0 years for the cases and the controls respectively. Over 70% of the study population and controls were females. The overall incidence of hepatotoxicity was 17.9% and severe hepatotoxicity occurred in 10.7% of the patients. Alcohol use and being underweight were independent risk factors for hepatotoxicity. Conclusion: This prospective study clearly shows that there was appreciable hepatotoxicity associated with HAART in the study patients as found in other parts of the world. There is a need for regular monitoring of liver function in these patients because of the risk of hepatotoxicity.
[ABSTRACT]   Full text not available  [PDF]
  1,200 114 -
High sensitive C-reactive protein (HsCRP) as a cardiovascular risk factor in hypertensive Nigerians
JO Idemudia, ES Idogun
July-September 2012, 19(3):163-166
Aims and objectives: The objective of this study is to determine the effect of plasma high sensitivity C-reactive protein (HsCRP) levels on hypertensive and apparently healthy normotensive Nigerians in the management of hypertension. This is a preliminary study; a study involving larger numbers of normotensives and hypertensives is in progress. Subjects and methods: Plasma C-reactive protein level was determined in 150 hypertensive patients mean age 46.8±8.2 years and 30 apparently healthy normotensive individuals mean age 38.8 ±13.2years using the enzyme linked immunosorbent assay (ELISA) technique. Results: The hypertensive subjects had significantly higher body mass index (BMI) (p-value < 0.05) than the normotensive subjects (BMI=28.34±4.40kg/m2 Vs. 25.79±2.91kg/m2). The hypertensive subjects also had significantly higher C- reactive protein values (0.18±0.1mg/dL Vs 0.08±0.04 mg/dL) (p-value < 0.0001). Among the hypertensive subjects, there was no significant difference in the level of C-reactive protein between the males and the females (0.17±0.10 mg/dL Vs 0.20±0.09 mg/dL). In the hypertensive patients, CRP positively correlated with atherogenic index (r = 0.551, p < 0.05) and coronary heart disease (CHD) risk (r = 0.589, p < 0.05). However, in normotensive patients, CRP was positively correlated with atherogenic index (r = 0.492, p < 0.01) but negatively correlated with CHD risk (r = -0.475, p < 0.01). Conclusion: These results show that the plasma concentrations of HsCRP in hypertensive subjects were significantly higher than those of the normotensive subjects and HsCRP positively correlated with atherogenic index and CHD risk in hypertensive Nigerians.
[ABSTRACT]   Full text not available  [PDF]
  1,179 109 -
Blindness and visual impairment in Remo, Ogun State, Nigeria: A hospital-based study
TO Otulana
July-September 2012, 19(3):153-156
Full text not available  [PDF]
  1,010 103 -