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CASE REPORTS
Infected huge prolapsed polypoidal fibroid: Issues of neglect and delayed access to surgical treatment
Fadimatu Bakari, Moroof Suleman Omobayowa, Adebiyi G Adesiyun, Hajaratu Umar Sulayman, Nkeiruka Ameh, Hauwa Umar Shuaib
July-December 2016, 1(2):56-59
DOI:10.4103/archms.archms_5_17  
Gravitational pull and subtle uterine contractions on huge polypoidal submucous uterine fibroid may dilate the cervix and prolapse into the vagina. Such prolapsed fibroid can either be removed through the vaginal route if it is connected with a long stalk or through an abdominal route if it has a broad base or if it is coexisting with multiple uterine fibroids. We present two cases of grand multiparous women with huge prolapsed submucous fibroids where neglect led to presentation with life-threatening infection and bleeding.
  6,024 7 -
ORIGINAL ARTICLES
Knowledge, attitude and perception of pregnancy danger signs among women of childbearing age in samaru community Northwestern Nigeria: Results from a cross-sectional survey
Muawiyyah Babale Sufiyan, Nasirudeen Adam, Ahmed Ayuba Umar, Jimoh Mohammed Ibrahim, Suleiman Saidu Bashir, Gerida Birukila
July-December 2016, 1(2):24-29
DOI:10.4103/archms.archms_3_17  
Context: The birth of a baby is a major reason for celebration worldwide. Yet, in most countries of the world, pregnancy and childbirth is a perilous journey. In Kaduna State, Northwestern Nigeria, the estimated maternal mortality ratio figure is 1025/100,000 live births. Despite the higher rates of maternal deaths, there is no empirical evidence on women's knowledge, perception, and attitudes toward pregnancy danger signs in Kaduna State. Aims: To determine the knowledge, attitude, and perception of pregnancy danger signs among women of childbearing age (15–49 years) in Samaru community Sabon-Gari Local Government Area in Kaduna State. Settings and Design: A community-based descriptive, cross-sectional study was conducted among 185 women of reproductive age group. Subjects and Methods: Participants were randomly selected using a multistage sampling technique. Pretested structured interviewer administered questionnaire was used for data collection. The completed questionnaires were cleaned, coded, the data entered into a computer and SPSS version 20.0 was used for analysis. Statistical Analysis Used: Frequency, percentage, and descriptive summaries were used to describe the study variable using univariate analysis, while bivariate analysis was carried out to test for a relationship between categorical variables. Results: Only 4.9% of the respondents had good knowledge about danger signs in pregnancy while 3.8% of them have good attitude and one in ten respondents only (10.3%) has good perception of pregnancy danger signs. Conclusions: Our findings show that majority of women in childbearing age have poor knowledge, attitude, and perception on danger signs of pregnancy. Hence, the need to train and involve them on pregnancy dangers signs to curb the unnecessary deaths occurring during such period.
  5,421 9 -
Knowledge, attitudes, and practices of household water purification among caregivers of under-five children in biye community, Kaduna State
Jimoh M Ibrahim, Muawiyyah B Sufiyan, Abdulhakeem A Olorukooba, Abdulrazaq A Gobir, Hadiza Adam, Lawal Amadu
July-December 2016, 1(2):35-41
DOI:10.4103/archms.archms_1_17  
Background: Water is one of the basic needs for survival, and potable water is essential for good health. Contaminated drinking water is a major health hazard in developing countries, and water-related diseases are a significant contributor to the global burden of illness. Thus, for populations without reliable access to safe drinking water, household water treatment provides a means of improving water quality and preventing disease. This study aimed to assess the knowledge, attitudes, and practices of household water purification among caregivers of under-five children in Biye community. Methodology: This was a descriptive cross-sectional study. A multi-stage sampling technique was used to recruit 142 caregivers of under-five children who were randomly selected. Data were collected using a semi-structured questionnaire and analyzed using IBM SPSS. Chi-square was used to test associations. The level of significance was set at <0.05. Results: Majority (63.4%) of respondents used unprotected well, and only 26.1% used protected well as a source of water. Only 12% of respondents had good knowledge. However, the majority of respondents (63.4%) had a positive attitude toward household water purification. Boiling was the most common (79.6%) method of water purification respondents are aware of and only about a third (32.4%) currently practiced household water purification. Conclusion: Majority of the respondents had poor knowledge and practice of household water purification. However, significant proportion of the respondents had a positive attitude toward household water purification. The local government authority should embark on the mass campaign on the importance and methods of household water purification in rural communities.
  4,983 11 -
CASE REPORTS
Cervical adenoma malignum: Diagnostic dilemma of a rare form of cervical cancer
Fadimatu Bakari, Oluseyi Bamidele Folagbade, Hajaratu Umar-Sulayman, Solomon Avidime, Garba Dahiru Waziri, Nkeiruka Ameh, Adebiyi Gbadebo Adesiyun
July-December 2016, 1(2):50-52
DOI:10.4103/archms.archms_6_17  
Adenoma malignum of the cervix is a rare variant of Adenocarcinoma of the uterine cervix. Its overall incidence rate is low. We report a case of a 51-year-old married multipara who presented with a 4-year history of recurrent, heavy, prolonged menstrual flow, postcoital bleeding, and passage of mucoid vaginal discharge. Pelvic examination revealed a bulky, firm, endophytic cervical mass with ulcerative areas. Ultrasonography showed features of multiple uterine fibroids. Cervical smear cytology and histology of cervical punch biopsy did not show evidence of malignancy. The patient subsequently had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a purportedly benign pathology of the cervix. Diagnosis of cervical adenoma malignum was made from the surgical specimen postoperatively.
  4,862 7 -
EDITORIAL
Is illegal migration on the rise among Nigerians? A wake-up call!
Istifanus A Joshua, Jerry G Makama
July-December 2017, 2(2):35-37
DOI:10.4103/archms.archms_12_18  
  3,454 9 -
ORIGINAL ARTICLES
Assessment of tetanus toxoid coverage among women of reproductive age in Kwarbai, Zaria
Zainab Kwaru Muhammad-Idris, Adamu Usman Shehu, Fadila Maryam Isa
July-December 2017, 2(2):48-54
DOI:10.4103/archms.archms_43_17  
Context: The World Health Organization 2013 estimates revealed 49,000 newborns died from neonatal tetanus (NT), a 94% reduction from the late 1980s. Over 24 countries, including Nigeria, have still not reached maternal and NT elimination status. Aims: The aims of the study were to assess knowledge and determine the extent of tetanus toxoid (TT) coverage among women of reproductive age in Kwarbai, Zaria, challenged by effects of tetanus and inadequate vaccination. Settings and Design: Kwarbai is essentially an agrarian, trading, and blacksmithing Hausa Muslim-dominated community with rich culture exhibited in its creations, festivals, and local events that bring together people from all over to socialize and share information. Subjects and Methods: The cross-sectional descriptive study was conducted between December 2014 and January 2015. Semi-structured, interviewer and self-administered questionnaires were used to obtain data on reported findings. Statistical Analysis Used: Statistical Package for the Social Sciences software SPSS® version 20 was used. Descriptive statistic measures presented as tables and graphs. Chi-square was applied for the comparison of proportions and associations between categorical variables. Results: Respondents' median age was 27 years, Hausa/Fulani (99%), Muslims (100%), married (82%), have more than four children (25%), and half attained tertiary education (54%). Women, 20–34 years, received more than one dose with education as major determinant of immunization uptake. Although level of TT knowledge is high, very few received the recommended five doses. Misconceptions linked to perceived benefits of the vaccine, route of administration, being a contraceptive and religion were some of the factors that reported to hinder respondents' uptake of the TT vaccine. Unavailability/short supply (81.8%) identified as reason for not receiving vaccine at health facilities. Conclusions: Despite high knowledge, completion of recommended doses of TT vaccine was not guaranteed due to stock-outs coupled with detrimental cultural and religious beliefs.
  3,250 13 -
Knowledge of occupational hazards and use of preventive measures among bakery workers in Kaduna North Local Government Area, Kaduna State, Nigeria
Istifanus Anekoson Joshua, Ibrahim Abubakar, Abdulrazaq Abubakar Gobir, Awawu Grace Nmadu, Chinedu John Camillus Igboanusi, Mary Ojoneme Onoja-Alexander, Farouk Adiri, Timothy Choji Bot, Wazi I-Joshua, Adamu U Shehu
July-December 2017, 2(2):78-83
DOI:10.4103/archms.archms_39_17  
Background: Workers in bakeries face many hazards in their work environment, and these hazards have the potential to cause injury or illness. The study assessed the knowledge of occupational hazards and the use of preventive measures among bakery workers in Kaduna North Local Government Area of Kaduna State. Materials and Method: The cross-sectional descriptive study was carried out in January 2017. The data collection tools were 258 pretested semi-structured interviewer-administered questionnaires and observational checklist. The collected data were manually cleaned, checked for completeness; entered into SPSS software version 20.0 and analyzed. The results were presented as tables and charts. Results: Majority (77%) were within the age bracket of 15–30 years with a mean age of 23 ± 2.1 years, 63% of males and 37% had secondary education with different job descriptions. The mean working experience was 5 years with only 14% and 2% of the workers having had training on prevention of workplace hazards and the use of fire extinguisher, respectively. The workers had poor awareness of occupational hazards such as tightness on the chest (30%), skin reactions/allergy (16%) and falls (17%) but with better awareness of burns (46%), cuts (37%) and hearing problems from excess noise (40.0%) among others. The most encountered symptoms/problems by workers were a muscular problem (72%), recurrent catarrh (65%), tightness on the chest (54%), recurrent cough (54%) and sneezing (52%) and symptoms of asthma among others. Apron, hand gloves and face masks were the commonly used protective devices by the workers and only 19% of the bakeries had functional first aid boxes. Burning was the most common method of solid waste disposal (52%). Conclusion: The workers had poor to average awareness of some occupational hazards with some encountering some problems as a result of their work. The use of personal protective devices such as apron, hand gloves and face masks were encouraging. However, the availability of functional first aid box and training on the use of fire extinguishers were major problems. There is a need for continuous training of the workers on prevention of workplace hazards, use of fire extinguisher and provision of basic functional first aid box among others in the workplace.
  2,286 9 -
Depression among students of a Nigerian University: Prevalence and academic correlates
Aisha Dabana, Abdulrazaq A Gobir
January-June 2018, 3(1):6-10
DOI:10.4103/archms.archms_5_18  
Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. It is extremely prevalent among university students and is a widespread problem globally. This study was conducted to determine the prevalence of depression and the academic factors that are associated with it among students of Ahmadu Bello University (ABU), Zaria, Nigeria. Methodology: This was a cross-sectional study conducted among 127 undergraduate students of ABU. Data were collected using a structured, self-administered Patient Health Questionnaire-9 (PHQ-9) and were analyzed using IBM-Statistical Software for Social Sciences, version 20.0. Results: Majority of the respondents (58.2%) had depression, with 37.0%, 15.7%, 3.9%, and 1.6% having mild, moderate, moderately-severe, and severe depression, respectively, according to the PHQ-9 scoring system, using a cutoff score of 5. There was no statistically significant association between depression and academic performance of respondents (P = 0.360) nor with interest (or lack thereof) in the course of study (P = 0.266). Conclusion: Depression, at different levels of severity, was noted among respondents. More screening and counseling services should be made easily accessible to students in the study area. Further research on nonacademic factors that could predispose to depression is recommended. This will aid in formulating policies for prevention and control of depression in the study area.
  2,201 8 -
CASE REPORTS
Malrotation with midgut volvulus and bowel gangrene in a 45-year-old man
Stephen Akau Kache, Danjuma Sale, Nuhu Yusuf, Jerry Godfrey Makama
January-June 2017, 2(1):29-31
DOI:10.4103/archms.archms_2_16  
Midgut volvulus due to intestinal malrotation is a rare occurrence in adult life. Malrotation is a congenital, developmental anomaly that results from an arrest of the physiological rotation of the gut through 270°. It is often thought that complications due to it, present themselves early during childhood and rarely occur among adults. However, a few cases have occurred and have been reported among adults. When it does occur in adults, it is often associated with catastrophic consequences. We present the case of a 45-year-old man with malrotation resulting in midgut volvulus. Our patient is a 45-year-old man, who presented with sudden onset of colicky abdominal pain and abdominal swelling of 24 h duration. He had been having recurrent abdominal pain since childhood. Physical examination revealed a patient in shock with markedly distended abdomen and anterior abdominal wall edema. Plain abdominal X-ray showed multiple air-fluid levels with thickened bowel outline. A diagnosis of intestinal obstruction was made. The patient was fully resuscitated and planned for emergency exploratory laparotomy under general anesthesia. Intraoperative findings revealed a 360° clockwise rotation of the small bowel around the mesenteric pedicle of the superior mesenteric artery and vein including about 350 cm of bowel gangrene. Resection and anastomosis were done. The early postoperative period was uneventful. However, he had anastomotic dehiscence on the 5th postoperative day and had to be reoperated but sadly he died 24 h later due to complications of anesthesia. Nonspecific recurrent abdominal complaints in adults of any age should raise suspicion of the possibility of a midgut malrotation or malfixation with or without intermittent volvulus. This case highlights the importance of early diagnosis and treatment.
  1,838 7 -
ORIGINAL ARTICLES
Knowledge and perception of patients with sickle-cell disease about primary care providers in Zaria, North-West Nigeria
Abdulaziz Hassan, Sani Awwalu, Lucky Okpetu, Aliyu Dahiru Waziri
January-June 2017, 2(1):12-15
DOI:10.4103/archms.archms_16_17  
Background: Sickle-cell disease (SCD) is a common disorder worldwide, affecting 2% of the Nigerian population. Patients with SCD require emergency care, especially during crises. However, specialists are scarce in hospitals in most towns and cities of Nigeria. Effective primary care may be life-saving where there are no specialists. Objectives: To determine the knowledge, perception, and attitude of patients with SCD toward primary care in Zaria. Materials and Methods: It was a researcher-administered questionnaire-based cross-sectional study of patients attending the adult SCD clinic of Ahmadu Bello University Teaching Hospital, Zaria. Results: There were 78 respondents including 55 (70.5%) females and 23 (29.5%) males. The median and interquartile range age of respondents was 22 (7) years. Most respondents have attained secondary (58.1%) and tertiary (35.5%) levels of education. Fifty-six (71.8%) respondents have visited a primary care facility in the past. While 24/76 (31.6%) respondents felt that the nonspecialist doctor was the major primary care provider, 8/76 (10.5%) each felt that the community health officer and the chemists were the primary care providers. Bone pain (26, 66.7%) was the main reason for seeking primary care. However, 8 (14.3%) respondents felt that services were poor and 4 (7.1%) felt that services were excellent at primary care centers. Conclusion: SCD patients have a fair understanding of primary care; however, there is low patronage and poor perception about the quality of care provided by the primary care providers.
  1,563 16 -
Intermaxillary fixation (IMF) Screws in minimally displaced mandibular fractures: A case control study
B Suresh Babu, Irfan Ali, S Ravi Raja Kumar, Mahaboob Shaik, Sagar A Naidu, Abdul Qahar Qureshi, Abhinav Kumar, Abhishek Singh Nayyar
July-December 2017, 2(2):43-47
DOI:10.4103/archms.archms_27_17  
Context: Numerous methods have been used for obtaining intermaxillary fixation (IMF) in the treatment of mandibular fractures. Conventional methods such as arch bars and eyelet wires have been the most common methods for achieving IMF, but they have their own disadvantages. During the last two decades, IMF using intraoral, self-tapping IMF screws have been introduced for the treatment of minimally displaced fractures of the mandible. The present case control study evaluated the efficacy and associated complications of self-tapping IMF screws in the treatment of minimally displaced mandibular fractures. Materials and Methods: A total of twenty patients of minimally displaced mandibular fractures were divided into two groups and were treated with open and closed reduction methods using self-tapping IMF screws to evaluate the efficacy of IMF screws and associated complications. Results: The most common complications encountered were pain and edema in almost all patients. In Group I treated with open reduction, damage to the roots of teeth occurred in two patients, which later became nonvital after 6 weeks, while in Group II treated with closed reduction, two patients were seen with tissue overgrowth and screw loosening. In one case, postoperative malocclusion was also observed in Group I. Conclusion: Use of self-tapping IMF screws for IMF is a valid alternative to conventional methods in the treatment of minimally displaced mandibular fractures. Iatrogenic injury to roots of the teeth is the most important complication of the IMF screws but that can be minimized and/or overcome by a careful evaluation and treatment planning of the cases.
  1,538 9 -
Prevalence of hyperprolactinemia among infertile patients with menstrual abnormalities and/or galactorrhea at a University Teaching Hospital, North West Nigeria
Tajudeen Akande, Adebiyi Gbadebo Adesiyun, Sambo Aliyu, Abdullahi Randawa
July-December 2017, 2(2):55-59
DOI:10.4103/archms.archms_26_17  
Objective: Hyperprolactinemia may be associated with galactorrhea, menstrual abnormalities, and infertility. When diagnosed and appropriate treatment instituted, there may be early relief of these symptoms and pregnancy rate may increase. This study determined the prevalence of hyperprolactinemia among infertile patients with menstrual abnormalities and/or galactorrhea. Patients and Methods: A cross-sectional study of women attending the infertility clinic who had galactorrhea and/or menstrual abnormalities. Menstrual abnormalities for this study refer to those with oligomenorrhea and amenorrhea. Results: Out of the 207 women studied, 75 of them have hyperprolactinemia, giving a prevalence of 36.2%. Galactorrhea has higher sensitivity (68%), a higher positive predictive value (39.5%), and a higher negative predictive value (69.3%) when compared with menstrual abnormalities which had sensitivity of 44%, positive predictive value of 29.7%, and negative predictive value of 56.3%, respectively. They, however, have the same specificity of 40.9%. Conclusion: The prevalence of hyperprolactinemia is high in this study. Galactorrhea is a better clinical indicator of hyperprolactinemia when compared with menstrual abnormalities.
  1,451 9 -
A quantitative survey on potential barriers to the use of modern contraception among married women of high parity attending an antenatal clinic in Kaduna, Northern Nigeria
Amina Mohammed-Durosinlorun, Zainab Mohammed Idris, Joel Adze, Stephen Bature, Caleb Mohammed, Mathew Taingson, Amina Abubakar, Solomon Avidime, Lydia Airede, Polite Onwuafua
July-December 2016, 1(2):30-34
DOI:10.4103/archms.archms_4_17  
Background: Nigeria has high maternal mortality ratios, and women of high parity are at higher risk of obstetric complications. Understanding barriers to the uptake of contraception is thus important. Methodology: A cross-sectional quantitative survey was done at the antenatal and postnatal clinics of Barau Dikko Teaching Hospital between September and December 2015. Questionnaires were administered to 400 married consenting women of high parity (five or more deliveries). The questionnaire extracted general and demographic information, history of contraception, and possible barriers to contraceptive uptake. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 22. Descriptive analysis was done using frequencies, percentages, and cross-tabulation. Chi-square test was used as a test of association where relevant, and P< 0.05 was considered statistically significant. Results: About 353 questionnaires were retrieved; respondents were mainly aged between 30 and 39 years, educated up to secondary level, Hausa and Muslims, and homemakers or traders. Women had a mean parity of 7 deliveries and highest, 15. There was high level of awareness of contraception, adequate spousal communication, and approval but a perception of high risk and side effects with contraceptive use. Conclusion: Fear of side effects was a major barrier to contraceptive use. However, a window of opportunity exists because they would be willing to use contraception in future. Hence, specific and individualized contraceptive counseling and patient selection is needed, as well as further education of women.
  1,334 10 -
EDITORIAL
Is acute appendicitis still the most common abdominal surgical emergency
Jerry Godfrey Makama
January-June 2017, 2(1):1-2
DOI:10.4103/archms.archms_40_17  
  1,323 7 -
ORIGINAL ARTICLES
Social characteristics and risk factors for diseases among internally displaced persons: A study of stefano's foundation camp in Jos, Nigeria
Istifanus A Joshua, Benjamin David Biji, Abdulrazak Abdullahi Gobir, Alhaji A Aliyu, Audu Onyemocho, Awawu Grace Nmadu, Jerry Godfrey Makama, Mathew Bobai, Abimbola G Olayemi, Kashini Andrew
July-December 2016, 1(2):42-49
DOI:10.4103/archms.archms_17_17  
Background: Nigeria like the rest of the world is exposed to a wide range of natural and human-induced disasters such as flood, plane crash, communal clashes, and postelection violence and recently, insurgency from Boko Haram. Most of these disasters have led to population displacement and its consequences. This study assessed the social characteristics and risk factors for diseases among the internally displaced persons (IDPs) at Stefano's foundation camp in Jos, Nigeria. Methodology: The study was a cross-sectional descriptive in nature carried out on March 1–30, 2015. The data were collected using 312 interviewer-administered questionnaire, key informant interview, and participant's observation and analysis was performed using SPSS version 20.0. Results: Majority (85%) of the respondents were within the age bracket of 18–49 years, 61% of females, 39% had no formal education, 53% of farmers by profession among others, 96% and 4% of them were displaced as a result of the insurgency in Borno and Adamawa States, respectively and had stayed in the camp for 3 months (43.8%). There was report of several morbidities and one case of mortality from malaria, diarrhea, and cholera due to inadequate water supply, poor refuse, and fecal disposal and the presence of disease vectors in the camp and a case of death of a 6-year-old child from malaria. Majority (83%) of the IDPs obtained medical treatment at the ill-equipped camp clinic. Conclusion: This study showed that the IDPs were faced with so many challenges and the nongovernmental organization has been rendering assistance. There is a need for all relevant stakeholders to key in to make life meaningful to this vulnerable group.
  1,321 7 -
CASE REPORTS
Lipoma of the falciform ligament of the liver as a rare cause of chronic epigastric pain: A case report and review of literature
Jerry Godfrey Makama, Stephen Akau Kache, Nuhu Yusuf, Danjuma Sale, Sila Tokan Baduku
July-December 2016, 1(2):53-55
DOI:10.4103/archms.archms_1_16  
Pathologic conditions of the falciform ligament of the liver are rare. Only a few cases have been reported. We are reporting a case of chronic epigastric pain due to lipoma of the falciform ligament. Case report and discussion of the relevant literature is presented. A 38-year-old woman presented to the emergency room with a 5-day history of an exacerbated epigastric pain which has been on and off for 3 years. She was wrongly diagnosed to have peptic ulcer disease and has been on anti-ulcer regime for close to 6 months without improvement of symptoms. On physical examination, she was in painful distress, though generally preserved the tenderness in the epigastrium was accompanied by mild local rebound tenderness. Hence, it was difficult to properly delineate the abdominal mass in the epigastrium. Laboratory data done at this occasion and in the past were normal. Plain abdominal X-ray, contrast studies, and esophagogastroduodenoscopy findings were essentially normal. Only abdominal ultrasound revealed a suspected well-defined hypodense area located dorsally to the rectus muscles. Although the computed tomography and magnetic resonance imaging were not done due to logistics and financial constrain the patient presented with haven moved from one clinic to another receiving anti-ulcer regimen. A diagnosis of intra-abdominal mass was made, and the patient subsequently had an exploratory laparotomy. The findings at open operation through an upper midline abdominal incision were a moderate size lipoma of the ligament of the liver which was removed. Postoperative period and recovery was uneventful. Histology revealed well-differentiated adipocytes arranged in the nest with essentially benign features. The patient was discharged home and has remained hailed and hearty for 6 months of surgery. Tension due to lipoma of the falciform ligament of the liver is a rare cause of intractable epigastric pain associated with a diagnostic dilemma.
  1,277 7 -
ORIGINAL ARTICLES
A comparative analysis of the awareness and practice of periodic health examination among workers of public and private establishments in Zaria, Northwestern Nigeria
Sunday Asuke, Jesubunmi Mary Babatunde, Muhammed Sani Ibrahim
July-December 2017, 2(2):38-42
DOI:10.4103/archms.archms_50_17  
Introduction: Periodic health examination (PHE) serves as a medium through which the workpeople receive recommended interventions to help them remain in a state of fitness throughout their period of employment. This study comparatively analyzed the awareness and practice of PHE among workers in public and private establishments in Zaria, Kaduna State, Northwestern Nigeria. Materials and Methods: A cross-sectional, descriptive study was carried out among 115 workers in private and 140 in public establishments in Zaria town, selected through a multi-stage sampling technique. Data were collected using a structured, self-administered questionnaire containing close-ended questions. Data were analyzed using SPSS version 17.0. Results: The mean age of the workers was 34.04 ± 9.65 years in private and 40.94 ± 8.99 years in public establishments. Majority of the workers in public 106 (93.0%) and private 125 (89.3%) were aware of PHE, but only 42.0% in private and 44.3% in public establishments had a good practice. Conclusion: The awareness of PHE among workers in both public and private establishments in Zaria was high; however, the practice was generally poor. There is the need for an intervention study among the establishments that will help translate such high awareness into practice for their benefit.
  1,211 9 -
Pattern of anterior segment eye disorders in diabetic patients attending Aminu Kano Teaching Hospital, Kano, Nigeria
Anas Lawan, Lawan Abdu, Victoria Pam
July-December 2016, 1(2):19-23
DOI:10.4103/archms.archms_3_16  
Background: The aim of the study is to determine the pattern, frequency, and types of anterior segment disorders in diabetic patients attending the outpatient specialist Diabetes Clinic of Aminu Kano Teaching Hospital (AKTH), Kano. Patients and Methods: This was a descriptive cross-sectional study of diabetic patients in AKTH over a 1-year period. Sample size was estimated using Fisher's formula, and systematic sampling was done to ensure proper randomization of patients that fulfilled the study criteria. Information obtained included patients' bio-data, height, weight, fasting blood sugar (FBS), type and duration of diabetes, associated comorbidities; visual acuity and anterior segment were examined using slit lamp biomicroscopy. Results: A total of 390 patients were examined during the study. There were 166 (42.6%) males and 224 (57.4%) females (M:F ratio = 1:1.35). Mean age was 54.81 ± 12.21 years. Seventy-four (18.97%) patients had type I disease, while 316 (81.03%) patients had type II disease. The mean presenting FBS was 9.52 mmol/L ± standard deviation 4.22, with a wide range of 3.4–24.8 mmol/L. Four patients were bilaterally blind, while ten were unilaterally blind from cataract and glaucoma. Myopia and myopic astigmatism were the most observed refractive errors though not statistically associated with high FBS (×2 = 1.00 P = 0.3165). Chronic blepharitis was the main lid finding and found to be related to high FBS (×2 = 38.68 P< 0.000001). Ocular surface findings included pterygia (3.85%), pinguecula (2.56%), dry eyes (2.31%), and combination of these. Bilateral rubeosis iridis and iris atrophy were found in 8 (2.1%) and 6 (1.5%) patients, respectively. Lens opacities varied in location and visual significance. Nuclear sclerosis was the most common lens disorder while posterior subcapsular cataract was the second predominant type observed and was associated with disease duration >10 years (×2 = 11.48, P = 0.0007039). Conclusion: Anterior segment eye disorders in diabetic patients could be clinically significant and yet unreported by the patient. These may cause low vision and blindness similar to nondiabetic population. The screening protocol in the study location should include routine eye examination.
  1,123 11 -
Is 5 IU bolus of oxytocin as effective as 10 IU bolus for control of bleeding during cesarean section under spinal anesthesia?
Musa M Yusuf, Elizabeth Ogboli Nwasor, Rabiu I Mohammed
January-June 2017, 2(1):7-11
DOI:10.4103/archms.archms_32_17  
Aim and Objectives: We sought to compare the hemodynamic effects of 5 international unit (IU) and 10 IU of intravenous (IV) boluses of oxytocin and their efficacy in reducing blood loss during cesarean section and also to determine the incidence of postoperative nausea and vomiting (PONV) and postdural puncture headache (PDPH). Patients and Methods: One hundred and ten parturients of American Society of Anesthesiologists' I and II scheduled for cesarean section under spinal anesthesia were randomized into two groups. Group A (n = 55) received 5 IU IV bolus of oxytocin and Group B (n = 55) received 10 IU IV bolus of oxytocin after delivery. Ten milliliters per kilogram of 0.9% saline was administered to both groups as volume preload. Subarachnoid block was performed with size 24G spinal needles at L2/L3 or L3/L4 intervertebral space with the patients in sitting position. Two milliliters of 0.5% heavy bupivacaine was administered slowly intrathecally. Following delivery of the baby, IV boluses of 5 IU (Group A) or 10 IU (Group B) of oxytocin were administered slowly, and recording of heart rate, systolic, diastolic, and mean arterial blood pressure was done every minute for 5 min after bolus injection. IV infusion of 30 IU of oxytocin in 500 ml of 0.9% saline (60 mU/ml) at a rate of 125 ml/h was continued in both groups till the end of surgery. Estimated blood loss (EBL) was assessed by visual estimation. Patients were monitored continuously until 24 h after surgery to evaluate PDPH and PONV. Results: There were no statistically significant differences in the EBL between the two groups. There was no significant rise in heart rate and no significant decrease in mean arterial blood pressure in Group A compared to Group B. The incidence of PDPH and PONV was also comparable in both groups. Conclusion: Five IU of IV bolus of oxytocin is as effective as 10 IU of IV bolus in reducing blood loss during cesarean section.
  1,057 7 -
Prevalence of obesity and outcome of weight loss on reproduction: A study among women attending infertility clinic in Zaria, Northern Nigeria
Yakubu Aliyu, Adebiyi Gbadebo Adesiyun, Solomon Avidime, Abdullahi Jibril Randawa
January-June 2017, 2(1):3-6
DOI:10.4103/archms.archms_25_17  
Objective: Obesity is rising in the developing countries because of changing life style, and this has its burden on fertility and its management. This study determined the prevalence of obesity and clinical correlation of obesity with menstrual abnormalities, as well as the rate of spontaneous conception among obese infertile women on nonsurgical weight loss therapy. Methodology: A cross-sectional longitudinal study was done among women that presented with infertility to the gynecology clinic. The main outcomes measured were percentage of infertile women that are obese, menstrual pattern of these women, and spontaneous conception among obese infertile women following weight loss therapy. Results: Of the 205 patients, 68 (33.2%) were found to be obese; there was a significant association between obesity and abnormal menstrual pattern (P = 0.0002). Oligomenorrhea and hypomenorrhea were also found to be significantly associated with obesity (P = 0.009 and P = 0.022, respectively). Following average of 12-month follow up, spontaneous conception among obese infertile women while on weight loss therapy was 21.1%. Conclusion: The prevalence of obesity was high with a significant association between obesity and menstrual abnormalities. Weight loss among obese infertile women led to improvement in spontaneous conception.
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Cardiovascular risk factors among geriatric Nigerians in a primary care clinic of a tertiary hospital in Southeastern Nigeria
Gabriel Uche Pascal Iloh, Okechukwu Kalu Iro, Peace Ifeoma Collins
January-June 2018, 3(1):11-18
DOI:10.4103/archms.archms_14_17  
Background: Cardiovascular (CV) risk factors tend to aggregate in geriatric population with variable distribution. These risk factors may act as alert signals for proactive geriatric CV health programs. This study was aimed at determining the frequencies of CV risk factors among geriatric Nigerians in a primary care clinic of a tertiary hospital in Southeastern Nigeria. Patients and Methods: This was a cross-sectional study carried out on 280 geriatric Nigerians at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Geriatric Nigerians aged 60 years and above were screened for risk factors of CV disease. The data collected included sociodemographic variables and metabolic, dietary, and behavioral risk factors using a structured, pretested, and researcher-administered questionnaire. Results: The top five most common CV risk factors were physical inactivity (67.1%), inadequate fruit consumption (65.7%), hypertension (48.2%), abdominal obesity (47.9%), and dyslipidemia (36.8%). Others were general obesity (31.1%), inadequate vegetable consumption (22.5%), diabetes mellitus (15.7%), habitual use of alcoholic beverages (9.0%), habitual use of snuff (3.9%), and nonhabitual smoking of cigarettes (2.8%). Conclusion: This study has demonstrated that the risk factors of CV disease exist among geriatric Nigerians in primary care, with five most frequent being physical inactivity, inadequate fruit consumption, hypertension, abdominal obesity, and dyslipidemia. Screening geriatric Nigerians for modifiable CV risk factors should be integrated into geriatric primary care in the study area.
  1,012 8 -
Reproductive health decision-making among adolescents in public secondary schools in Zaria, North-Western, Nigeria
Muhammed Sani Ibrahim, Shadrach A Adamu, Musa Yakubu, Sulaiman S Bashir
January-June 2017, 2(1):16-19
DOI:10.4103/archms.archms_22_17  
Introduction: Risky sexual behavior among adolescents is a major contributory factor to adolescent morbidity. This is mainly because during adolescence, cognitive, and psychological maturity coupled with increased need for autonomy translates into a greater desire for independent decision-making. The study assessed reproductive health decision-making and its sociodemographic determinants among adolescent senior secondary school students. Methods: This was a cross-sectional study involving 384 adolescent senior secondary school students selected through multi-stage sampling. Data were collected through a self-administered questionnaire and analyzed using IBM SPSS Statistics version 20 and results are presented in tables and charts. Results: Mean age of the respondents was 17.5 ± 1.3 years, and 170 (44.6%) were <18 years old. Reproductive health decision-making was good in 116 (30.1%). If they were sexually abused, 187 (48.4%) said that they would report first to their parents. Reproductive health decision-making showed statistically significant association with gender (P = 0.04), and class of the study (P < 0.0001), but not with age (P = 0.24), ethnicity (P = 0.86), religion (P = 0.16), and marital status (P = 0.99). Conclusion: Reproductive health decision was generally poor, and it was influenced by gender and class of the study. Therefore, Government should consider ways of improving reproductive health decision-making among the secondary school students, possibly by including it in their school curriculum. Future studies should identify locally applicable interventions to promote parent–child connectedness for improving reproductive health decision-making among adolescents.
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Does implementation of preanesthesia assessment clinics improve surgical patients care in Nigeria?
Saidu Yusuf Yakubu
January-June 2017, 2(1):20-23
DOI:10.4103/archms.archms_10_17  
Introduction: Preanesthesia assessment of patients is a major component of the perioperative care of surgical patients. The benefits of outpatient preoperative assessment clinics (PAC) were recognized over 67 years ago. However, these clinics are not used in Nigeria as part of surgical care. Search of the literature did not reveal any hospital in Nigeria that operates PAC, and therefore, its implementation in this country is still in process. This may not be unconnected with scarce financial, material, and human resources. Materials and Methods: This study was a questionnaire survey of the views of anesthetists, surgeons, and hospital administrators in some Nigerian Federal Teaching Hospitals on the usefulness and limitations of PAC. Structured questionnaires were sent to surgeons, anesthetists and Chairmen, Medical Advisory Committees in the selected Hospitalsand the results were analyzed. Results: Respondents indicated the benefits of preanesthesia assessment clinics as decrease in the incidence of surgery delays and cancelations, shorter lengths of hospital stay, improvement in the logistics of preoperative preparation, improved patient knowledge of anesthesia, and preoperative care as well as the role of the anesthetist in surgical care. Limiting factors to successful preanesthesia clinics were lack of cooperation from anesthetists and surgeons, other medical specialists, lack of supporting staff, finance, and appropriate office space. Conclusions: Preanesthesia assessment clinic increases the overall efficiency of the period of stay of the surgical patient in the hospital. Its benefits outweigh its disadvantages, and its successful implementation requires effort, time, money, and close collaboration with hospital administrators.
  947 11 -
Analgesic and anti-inflammatory effects of resveratrol in rat models of pain: Any role in clinical pain management?
Elizabeth O Ogboli Nwasor, Ahmed-Sherif Isa, Emeka John Dingwoke, Abdullahi Hussein Umar
January-June 2018, 3(1):19-23
DOI:10.4103/archms.archms_54_17  
Background: Resveratrol (RSV) is a biomolecule that has been demonstrated in numerous studies to possess therapeutic potentials with multiple targets. Despite the reported low bioavailability, it could exhibit novel role in clinical pain management. Objective: To investigate the systemic analgesic and anti-inflammatory effects of RSV in comparison to diclofenac and etoricoxib. Materials and Methods: Following institutional ethics approval, the study was conducted in the physiology research laboratory. The animals (42 male Wistar rats) used were divided into seven groups (n = 6) in separate cages. Chemical pain was evaluated using formalin-induced nociception test. Statistical analysis was done using analysis of variance and Kruskal–Wallis statistical tests. Results: There is a significant change in nociceptive score in the early phase; however, no significant changes in the late phase in the formalin test. Anti-inflammatory studies showed that RSV 50 mg/kg has a significantly potent anti-inflammatory effect when compared to control, but similar in activity to etoricoxib. Tumor necrosis factor alpha and interleukin-2 concentration did not significantly differ between the groups. Conclusion: RSV may elicit its analgesic actions by inhibiting the direct activation of nociceptors. It may be suggested that systemic RSV at a dose of 50 mg/kg in Wistar rats significantly reduces inflammation comparable to etoricoxib, but possibly less potent than diclofenac. Thus, RSV may be useful in the management of acute and chronic pain with significant inflammatory components. Further broad based human clinical studies on the analgesic and anti-inflammatory properties of resveratrol are required to confirm its potential role in clinical pain management.
  885 10 -
Integrated nutritional intervention among mothers of under-five children in two rural communities of Kaduna State, Nigeria: Its effects on maternal practice of exclusive breast feeding and children's nutritional status
MO Onoja-Alexander, SH Idris, AA Gobir, AD Onoja, C. J. C. Igboanusi, AA Olorukoba, AA Aliyu, CL Ejembi
July-December 2017, 2(2):60-66
DOI:10.4103/archms.archms_5_16  
Introduction: The World Health Organization recommends that infants should be exclusively breastfed to achieve optimal growth, development, and health. Nonexclusive breastfeeding (EBF) causes infant malnutrition which is widespread in most developing countries and accounts for 11% of global disease burden. The aim of the study was to determine the effect of integrated nutritional intervention on maternal knowledge, practice of exclusive breastfeeding, and nutritional status of under-five children in two rural communities of Kaduna State, Nigeria. Materials and Methods: The study employed a quasi-experimental design, carried out between November 2014 and June 2015 with baseline, intervention, and postintervention phases in two rural communities of Kaduna State, Nigeria (Dangaiya (Sabon Gari Local Government Area [LGA] and Kufena [Zaria LGA] communities). The intervention was conducted among 167 mother/child pairs independently selected from the study and control areas through a multistage sampling technique. Data were collected using interviewer-administered questionnaire at baseline and 6 months after intervention from both communities. Weights and heights/length of recruited children were measured. Data were analyzed using SPSS statistics software version 20.0. (IBM). Results: The result indicated that malnutrition exists among under-five children in the study area. Postintervention, mothers of the children in the study community had better knowledge of EBF (P = 0.001), duration of EBF (P = 0.001), and recommended total breastfeeding duration (P = 0.001). The change in the malnutrition status of the children was not statistically significant (P > 0.05). Conclusion: In this study, nutritional education of mothers only had positive impact on their level of knowledge of EBF but not on their practice; therefore, there is a need for the Kaduna State Ministry of Health and Local Government Authorities to put in place prolonged (>4 weeks) integrated nutritional interventions with emphasis on correct exclusive breastfeeding practices to improve the level of malnutrition in the state.
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