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EDITORIAL
Medical outreach activities, a means to an end
Ndubuisi Eke
September-December 2016, 10(3):85-85
DOI:10.4103/0795-3038.197758  
  619 1,704 -
ORIGINAL ARTICLES
Assessment of workplace hazards in mortuaries in Port Harcourt, Nigeria
Kingsley E Douglas, SS Peterside
September-December 2016, 10(3):102-110
DOI:10.4103/0795-3038.197752  
Background: Mortuary workers face various hazards in course of carrying out their duties. These hazards may be ignored by employers and employees alike. Identifying these hazards in time before they become risks that cause accidents and even death is recognized mode of prevention and control. This study was to assess the workplace hazards in mortuaries located in Port Harcourt City Area. Methods: Following ethical approval, this descriptive cross-sectional study recruited 100 eligible respondents from private and public mortuaries, respectively, balloted for from six known and registered mortuaries in Port Harcourt city. Respondents answered pre-tested, close-ended, structured, self-administered questionnaires which probed sociodemographics, occupational history, knowledge and behaviour towards hazards encountered while at the workplace. There was also an adapted checklist used for the walk-through survey of the study sites' identification and quantification of hazards. Data obtained were analysed and presented using descriptive and analytical statistical tools. Results: The study had mostly male (95%) respondents with only 15% having acquired tertiary education. The majority (94%) of the hazards respondents were exposed to were mechanical slips, trips and falls. The majority (93%) of respondents had safety training on the hazards associated with the mortuary, while 11% used personal protective equipment (PPE) always. Conclusion: Hazards abound in mortuaries in Port Harcourt City even though most workers had received training on hazards and hazards prevention. There was also a poor use of PPE. It is recommended that health education, provision, enforcement and monitoring of the use of PPE be intensified among this group of workers.
  2,107 186 -
Oral health status, knowledge of dental caries aetiology, and dental clinic attendance: A comparison of secondary school students in the rural and urban areas of Lagos
Modupeoluwa Omotunde Soroye, Cyril Ilemobade Adegbulugbe
May-August 2016, 10(2):42-49
DOI:10.4103/0795-3038.189451  
Background: Dental caries is painful, expensive to treat and can harm nutrition and overall health. Good oral hygiene, regular utilization of dental health facilities, dietary habits and knowledge of determinants of dental caries play important role in the prevalence of dental caries among school children. Tooth loss, sequelae to untreated dental caries is higher among urban school children than their rural counterparts. Aim: To compare and determine the oral health status and investigate dental clinic attendance and knowledge of students in rural and urban secondary schools in Lagos on the aetiology of dental caries. Methods: Using stratified and proportionate to size sampling techniques, a random sample of 598 students aged 12-26years from rural and urban local government areas were examined for dental caries and gingivitis. Questionnaires were administered to elicit information on frequency of consumption of refined sugar, parents' educational status, knowledge of dental caries aetiology and dental clinic attendance. The decayed, missing and filled tooth index (DMFT) was measured according to the WHO caries diagnostic criteria for epidemiological studies and the clinical oral hygiene status measured with the gingival index (GI) of Loe and Silness, Plague index and the Simplified Oral Hygiene Index. Results: There was a statistically significant difference between urban and rural students in caries experience in permanent teeth (mean DMFT = 0.26 in urban areas; 0.11 in rural areas), More of the parents of students in the urban schools are educated than those in rural schools. The decayed (D) and missing (M) components were higher in the rural area, indicating a high level of restorative treatment need among the students in rural area. The urban participants had better oral hygiene and the gingival index was higher among rural students. Dental clinic attendance was higher among the urban participants than the rural participants. Conclusion: The students in urban secondary schools had better oral health status and make use of dental facilities more than their rural counterparts. The knowledge of aetiology of dental caries is poor among both the rural and urban school students.
  1,424 151 -
Microbiological assessment of indoor air quality at different sites of a tertiary hospital in South-South Nigeria
Kenneth Emuren, Best Ordinioha
May-August 2016, 10(2):79-84
DOI:10.4103/0795-3038.189459  
Background: The risk of nosocomial infection is increasing due to the increasing number of patients with immune depression. Good ventilation is one of the methods used to reduce the ambient air levels of the causative agents, but this is rarely observed in Nigeria as hospital designs used to shut out the inclement weather in temperate countries are copied without many modifications, and without adequate provisions to constantly power the mechanical ventilation mechanisms. This study tested the microbiological air quality at different areas of the University of Port Harcourt Teaching Hospital to ascertain the levels of airborne bacteria and fungi in the ambient air. Methods: The study was carried out in July 2015 in randomly selected inpatient wards, outpatient clinics, and clinical laboratories of the hospital. The assessment was carried out by exposing Petri dishes containing the appropriate culture media for about 30 min at a convenient place in each of the nine study sites. Thereafter, the plates were covered and immediately transferred to the laboratory for incubation at 37°C, for 24-48 h, for bacteria; and at room temperature, for 5-7 days, for fungi. The number and types of bacteria and fungi in the cultures were determined at the end of the incubation period. Results: There were detectable bacteria and fungi in the ambient air of all the study sites. The mean bacterial count ranged from 9.5 colony forming unit per cubic meter (CFU/m 3 ) in the urology ward to 199.33 in the HIV clinic, with a mean of 80.0 CFU/m 3 , while the mean fungal count ranged from 10.5 CFU/m 3 in the surgery outpatient clinic (SOC) to 23.5 in the Anatomical Pathology Laboratory (APL), with a mean of 16.9 CFU/m 3 . Staphylococcus and Streptococcus were the most common bacteria in the SOC; Klebsiella was predominant in the immunization clinic; Escherichia coli were the most common in the APL, while bacillus was most frequently isolated in the gynecology ward. The fungi cultured from the study sites include Aspergillus, Penicillium, Fusarium, Trichophyton, Candida, and Rhizopus. Unlike the bacteria count, the fungal count increased in all the study sites at the end of the working day. Conclusion: The number and types of bacteria and fungi cultured from the study sites have the potential to cause ill health. Corrective actions are therefore needed.
  1,254 175 -
CASE REPORTS
Stromal tumour of the ileum: An unusual cause of massive gastrointestinal bleeding
OS Omorogbe, AA Iloh, OG Egigba, OC Osime
January-April 2017, 11(1):45-48
DOI:10.4103/phmj.phmj_19_16  
Background: Gastrointestinal stromal tumour are rare gastrointestinal tumour that probably originate from the interstitial cells of Cajal and 95% express a specific molecular marker. They occur most commonly in the stomach (60%) followed by the small intestine (30%) and may present with gastrointestinal bleeding. Case Report: A 40year old man presented with passage of frank blood per rectum with associated haemodynamic instability necessitating several units of blood transfusion. Following adequate resuscitation, lower and upper GI endoscopy done were negative and subsequently had emergency laparotomy for continued gastrointestinal bleeding. We found a bleeding ileal tumour which was resected. Histopathology confirmed gastrointestinal stromal tumour. Conclusion: small bowel stromal tumour rarely and unusually presents with massive lower GI bleeding. Diagnosis may be delayed due to inaccessibility of the small bowel to routine upper and lower GI endoscopy. Mesenteric angiography, radionuclide RBC, capsule endoscopy, push enteroscopy depending on the fitness of the patient, may aid diagnosis. Prompt surgical resection and adjuvant imatinib therapy for malignant variants is the treatment of choice.
  1,322 64 -
ORIGINAL ARTICLES
Pattern of cerebrospinal fluid analysis in children above the neonatal age as seen at the University of Port Harcourt Teaching Hospital
Awopeju Abimbola Temitayo Oluwajenyo, Yaguo-Ide Lucy Eberechukwu
September-December 2016, 10(3):86-90
DOI:10.4103/0795-3038.197755  
Background: Bacterial meningitis is a potent cause of morbidity and mortality in the paediatric age group. The aim of this study was to review the results of analysis the cerebrospinal fluid (CSF) collected from children above the neonatal age who were suspected to be having meningitis and to also determine the susceptibility pattern of these isolates. Methods: A descriptive retrospective study of results of CSF culture reports taken from paediatric patients aged 1 month to 16 years with clinical suspicion of bacterial meningitis at the University of Port Harcourt Teaching Hospital between January 1, 2009, and December 31, 2014. The CSF samples were subjected to macroscopic examination, white blood cell count, Gram's stain and culture. Organisms isolated were characterised by standard procedure and antibiotic susceptibility testing was done according to the Clinical Laboratories Standard Institute guidelines. Data were retrieved from laboratory record books and analysed using Microsoft Excel sheet. Results are presented as tables and pie chart. Results: Five hundred and seventy-four samples were received from children who were above the neonatal age (28 days). Of these, 329 were male (57.3%), 240 were female (41.8%), while in 5 (0.9%) of the samples, the sex was not indicated. Only 10 (1.7%) samples were positive for culture. Of these, Gram-positive cocci were the most common organisms, of which Staphylococcus aureus was the most prevalent, being 7 (70%), followed by Escherichia coli (20%), while the least prevalent organism was β-haemolytic streptococci (10%). The organisms all exhibited resistance to amoxicillin-clavulanic acid. Ceftazidime exhibited 100% sensitivity against E. coli isolates. Ceftriaxone, cefotaxime and ciprofloxacin exhibited good sensitivity among all the bacteria isolates that were cultured. Conclusions: There was a low yield of bacteria in CSF culture of paediatric patients at the University of Port Harcourt. The third-generation cephalosporins are still effective in bacterial meningitis in paediatric patients.
  833 523 -
Aetiological factors and dimension of tympanic membrane perforation in Benin City, Nigeria
Johnson Ediale, Paul R. O. C Adobamen, Titus S Ibekwe
May-August 2017, 11(2):55-59
DOI:10.4103/phmj.phmj_29_17  
Background: Tympanic membrane (TM) perforation is a recognised cause of hearing loss in our environment. The integrity of the TM can be compromised by varying aetiological factors which are often preventable. TM perforation occurs in different dimensions which tend to influence the degree of hearing loss. Aim: The aim of this study is to determine the aetiological factors and dimensions of TM perforation among adolescents and adults in Benin City. Methods: This was a 1-year prospective study carried out from 1st July 2014 to 30th June 2015 at the Ear, Nose and Throat Clinic of University of Benin Teaching Hospital. Consecutive patients with TM perforation were examined using a hand-held otoscope as well as Firefly video otoscope and subsequently had an interviewer administered questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20 and ImageJ software. Results: One hundred and forty-eight patients with TM perforation in either or both ears were studied. There were 67 (45.3%) males and 81 (54.7%) females; ratio of 1:1.2. Ages ranged from 10 to 64 years, with a mean age of 34.5 ± 15.7 years. Chronic suppurative otitis media (CSOM) was the major cause of TM perforation in this study, 148 (74.0%). The small perforation was predominant, 54 (55.1%) and 48 (47%) in the right and left ears, respectively while the central anterior perforation, 93 (46.5%) occurred commonly. Conclusion: Central and small perforations were the predominant TM perforation while CSOM was the major cause of TM perforation.
  1,151 194 -
The burden of blindness and visual impairment according to age and gender: A case study of Emohua local government area, Nigeria
AA Onua, C Tobin-West, I Ojule
May-August 2016, 10(2):73-78
DOI:10.4103/0795-3038.189458  
Background: Visual impairment and blindness pose different degrees of public health and social problem among the different age groups and sex. The problems are worse in the developing countries due to ignorance and lack of adequate eye care services. Public information systems, epidemiological data, and funding for blindness programs are often lacking and have hampered comprehensive blindness control programs in the rural communities, a fact that underscores the importance of this study. Aim: To estimate the burden of blindness and visual impairment according to age and gender in Emohua local government area (LGA), Nigeria. Methods: A population-based descriptive cross-sectional study conducted between October 11, and November 29, 2014, in Emohua LGA. Three hundred and fifty-three inhabitants were recruited in the study through a multistage sampling method. Demographic data, detailed ocular examinations were recorded and analyzed using SPSS version 20. Results: The study participants were 164 males and 189 females (male:female = 1:1.2). The prevalence of bilateral blindness is 1.4% (95% confidence interval [CI]: 0.78-2.5%) and unilateral blindness 2.5% (95% CI: 1.2-3.4%). Those who had various degrees of visual impairment in both eyes constituted 6.2% (95% CI: 5.7-8.5%) and 9.1% had unilateral visual impairment (95% CI: 8.7-9.7%). Cataract was the leading cause of bilateral blindness, accounting for 60% of cases, glaucoma (20%), and corneal opacity (20%). Conclusion: Blindness and visual impairment are more common in the older age groups and female gender in Emohua LGA. Government and nongovernmental organizations should step up comprehensive eye health care programs to realize the goals of Vision 2020.
  1,180 130 -
Validity of Beck's depression inventory and alcohol use disorders identification test in Nigeria's Niger Delta region
DC Chukwujekwu, CU Okeafor, PO Onifade
May-August 2016, 10(2):50-54
DOI:10.4103/0795-3038.189453  
Background: The Beck's Depression Inventory (BDI) and Alcohol Use Disorder Identification Test (AUDIT) have been validated for use in the study of alcohol related psychiatric disorders in the developed world as well as in Western Nigeria, but not in the Niger Delta Region. Aim: To ascertain the psychometric properties of BDI and AUDIT for use in this part of the world using psychiatric out-patients at the University of Port Harcourt Teaching Hospital. Methods: Four hundred and seventy (470) subjects were enlisted into the study using systematic sampling technique. The BDI and AUDIT were administered to each of them. One hundred and eighty five (185) subjects met the criteria for the second stage viz; a score of 18 and above on the BDI and/or a score of 5 and above on the AUDIT. Diagnoses of Depression and Alcohol Use Disorder were made using the Composite International Diagnostic Interview (CIDI). The data were analyzed using the statistical package for social sciences (SPSS) version 16.0 Results: The sensitivity and specificity of the BDI were 96.3% and 58.8% respectively. The positive and negative predictive values of BDI were 86% and 85.7% respectively. Also, the sensitivity and specificity of the AUDIT were 100% and 92.1%. Furthermore, the positive and negative predictive values of the AUDIT were 85.5% and 100% respectively. Conclusion: The BDI and AUDIT have excellent psychometric properties; hence they are valid for carrying out studies on alcohol related psychiatric disorders.
  1,171 107 -
Uterine fibroids: Experience with 100 myomectomies in Orlu, South East Nigeria
VI Ndububa
September-December 2016, 10(3):124-129
DOI:10.4103/0795-3038.197753  
Background: Uterine fibroid, over the years, has remained a major gynaecological problem in Nigeria, and although various treatment modalities exist, abdominal myomectomy has remained the mainstay of treatment for those women who want to preserve their reproductive capacity. Most of them, however, present late when the fibroids are either huge or associated with complications. Aim: The aim of this study was to present experience with abdominal myomectomy vis-a-vis its outcome and also to show the symptoms at presentation. Methods: This is a study of the first hundred abdominal myomectomies carried out by the author in Imo State University Teaching Hospital and St. Damian's Catholic Mission Hospital both in Orlu, Imo state, Nigeria. The myomectomies were carried out between August 2007 and September 2013. Data were recorded in a pre-surgery-prepared pro forma administered by the author prospectively. The data were analysed using SPSS version 15 and the results presented in descriptive, tabular and graphical forms. Results: The age of the hundred women who had myomectomy ranged from 20 to 49 years. The most common symptoms these women presented with were menorrhagia (69%), abdominal mass (63%), dysmenorrhoea (33%) and infertility (33%). The sizes of the uterus on abdominal palpation ranged from not palpable (5%) to as much as 36 weeks gestation. The major myomectomy-associated complications in this study were blood transfusion rate of 86%, post-myomectomy pyrexia (44%), severe haemorrhage (25%) and post-myomectomy anaemia (24%). There was one mortality due to severe haemorrhage. Conclusion: Menorrhagia and abdominal mass are the chief symptoms of the fibroid. Severe haemorrhage still remains a major threat to successful abdominal myomectomy and efforts should be geared towards reducing this.
  1,157 103 -
Assessment of the level of some heavy metals in commonly consumed local fish species displayed for sale in Port Harcourt, Nigeria
Dornu M N-ue, Best Ordinioha
May-August 2016, 10(2):55-59
DOI:10.4103/0795-3038.189454  
Background: The incessant crude oil spillage into the water bodies of the Niger delta region of Nigeria has raised fears that the fish caught in the water bodies would be heavily contaminated with heavy metals. This study tested five commonly consumed local fish species for their lead, cadmium, mercury, and arsenic content. Methods: Samples of dark tilapia (Sarothendon gallelacus), light tilapia (Oreochronis niloticus), two-fin catfish (Clarias gariepinus), "Zeghe" (Hydrocynus forskahlii) and three-fin catfish (Auchenoglanis occidentalis) bought from three fish markets (Creek Road, Mile One and Iwofe) were used for the study. The levels of the heavy metals in the fish samples were assessed in an accredited laboratory, while the human health implications of the contaminants were determined using the relevant international regulatory standards. Results: The fish samples contained detectable levels of the assessed metals. The mean concentration of cadmium in the fish samples was 0.29mg/kg; while the mean concentration of arsenic was of 1.85mg/kg. The average concentrations of lead and mercury in the fish samples were below the regulatory limits, whereas the mean concentration of cadmium was three times the WHO permissible limit of 0.1mg/kg. The concentrations of cadmium were highest in the light tilapia, and in the fish bought from the Mile One market, and lowest in the three-fin catfish, bought from the Creek Road market. Conclusion: The levels of the assessed heavy metals were significantly less than expectation. The levels of cadmium in the samples were however high enough to cause severe adverse health effects, hence the need for a more comprehensive public health response in managing crude oil spills.
  1,120 127 -
Cardiopulmonary resuscitation skills in some Nigerian secondary school students
Adedamola Olutoyin Onyeaso, Chukwudi Ochi Onyeaso
May-August 2016, 10(2):60-65
DOI:10.4103/0795-3038.189455  
Background: While many countries of the world have incorporated the teaching of cardiopulmonary resuscitation (CPR) into their schools curricula, there has been little or no effort made towards this in Nigeria. The aim of this study was to find out whether exposure of some Nigerian secondary school children to the conventional CPR would result in significant change in their CPR skills immediately after the training. Methods: It was a quasi-experimental study design carried out in 2012 with participants drawn from both private and public secondary schools in Obio / Akpor Local Government Area in Port Harcourt City, Rivers State, Nigeria. The initial cohort (stage I) involved 400 participants from senior secondary school 1 and 2 (SS1) and SS2) when their baseline CPR skills were assessed and immediately after the CPR training (stage II) when the participants dropped to 347 [189 (54.5%) females; 158 (45.5%) males]. They were exposed to both class room teachings and the practical hands-on sessions using manikins in line with the American Heart Association (AHA) guidelines. The data was analyzed using ANOVA and t-test. Results: Although the participants had virtually no CPR skills at the beginning, they gained very substantially immediately after the training which was found statistically significant (P < 0.05). They showed much enthusiasm in the training with high percentage of them indicating willingness not only to provide bystander CPR to their relatives but to strangers and trauma victims. Over 98% of them wanted CPR to be formally taught in Nigerian secondary schools. Conclusions: The CPR skills of the Nigerian students improved statistically with many ready to offer bystander CPR. It was recommended that CPR training programme should be incorporated into the curriculum of secondary school education in Nigeria.
  1,096 113 -
Blood pressure, blood sugar and gingival crevicular fluid volume in adult females with malocclusion in Benin City, Nigeria
Idia Nibokun Ize-Iyamu, Agnes O Umoh
May-August 2017, 11(2):72-78
DOI:10.4103/phmj.phmj_18_16  
Background: The gingival crevicular fluid (GCF) may be a valuable adjunct in the initial diagnosis and assessment of the severity of periodontal disease in patients with hypertension and diabetes. The GCF volume may be used to monitor and plan appropriate dental treatment and prevent progression of disease in adult patients with malocclusion who have hypertension or diabetes. Aim: The aim of this study is to determine the volume and correlation between blood pressure, blood sugar and GCF volume in adult females with malocclusion in Benin City, Nigeria. Methods: A total of 152 fasting women aged 26–65 years were divided into two groups as follows: Group 1: Malocclusion; n = 82 (54%) (crowding - 41, spacing – 39 and anterior open bite - 2) and Group 2: Normal occlusion; n = 70 (46%). Blood pressure and blood sugar values were obtained and the GCF volume measured. Correlations between age, gender, probing depth, malocclusion, blood pressure, blood sugar and GCF volume were determined using the Statistical Package for Social Sciences (version 16) software. Significant values of P < 0.05 were applied. Results: The highest GCF volume in the total sample studied was 2.17 μL in 1.3% and the most prevalent was seen in 0.62 μL in 42.8%. GCF volumes of 0.93 μL were most prevalent in crowding in 14.6% and in 0.62 μL in spacing in 9.9%. Furthermore, a GCF volume of 0.62 μL was highest in blood pressure of 121/89 mmHg in 9.9% and blood sugar levels of 80–120 mg/dl in 25% of subjects, respectively. Malocclusion (crowding, spacing and anterior open bite) exhibited a higher number 45.1% in GCF volume of 0.62 μL. There was, however, no significant relationship between blood pressure, blood sugar and GCF volume (P > 0.05) in both the malocclusion and control groups. There was also a statistically significant difference between GCF volume and pocket depth (P < 0.01). Conclusion: This study revealed that blood pressure and blood sugar levels in adult females with malocclusion do not affect GCF volume. A positive correlation, however, exists between GCF volume, pocket depth and oral hygiene in Benin City.
  1,027 131 -
Knowledge, practice and attitude of breast self, clinical breast and mammographic examinations amongst medical doctors in Bayelsa State
DO Allagoa, SC Uwaezuoke, EL Kotingo
January-April 2017, 11(1):26-33
DOI:10.4103/phmj.phmj_11_17  
Background: Breast cancer is the most common cancer in women both in the developed and less developed world. Regular self, clinical and mammographic examination of the breast according to internationally acceptable guidelines can result in early detection of cancer in asymptomatic women thereby reducing morbidity and mortality related to the disease. Aim: The aim of this study is to assess the knowledge, practice and attitude of breast examinations and breast cancer amongst medical doctors in Bayelsa State to achieve the desired reduction in mortality. Methods: This is a descriptive cross-sectional study of Doctors in Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State carried out between September 1, and October 1, 2015. A structured self-administered questionnaire was designed and used to collect information from 216 medical doctors. The data were processed using SPSS Windows version 20. Summary statistics, sample frequencies and crossed tabulations were then computed. Results: Of the 176 respondents, none had a low level of knowledge; 58 (33.0%) showed moderate level of knowledge, whereas 118 (67.0%) showed a high level of knowledge. Only 55.7% of doctors had performed breast self-examination (BSE), 16.5% clinical breast examination (CBE) and 4% mammography. However, when it was coned-down to only female doctors, it was found that whereas 54 (85.7%) of our female respondents practiced BSE, only 15 (23.8%) had CBE, and only 2 (3.2%) had done screening mammography. Majority (92.6%) believed that breast cancer can be cured if detected early, with 100% opted to seeing a doctor. Conclusion: Convincing majority of medical doctors in our study had excellent knowledge about BSE, CBE and mammography as screening modalities, respectively, for breast cancer. Attitude towards breast cancer treatment was also positive. However, their practice levels were quite poor.
  1,011 110 -
A study of the effect of frequency of tooth brushing on the prevalence of inflammatory periodontal diseases
Osagie Akhionbare, Patrick I Ojehanon
September-December 2016, 10(3):119-123
DOI:10.4103/0795-3038.197750  
Background: The use toothbrush and paste are the most common means of oral prophylaxis in Nigeria and how the frequency of this prophylaxis affects the prevalence of periodontal disease has not been fully ascertained. Aim: This study aims to assess if frequency of self-oral hygiene prophylaxis in a day, using the toothbrush and paste, had any relationship on the prevalence of inflammatory periodontal diseases, using the community periodontal index of treatment needs (CPITN). Methods: A cross-sectional study of 894 subjects (428 males and 466 females), who reported for the first time at the Dental Centre, of the University of Benin Teaching Hospital, Benin City, Nigeria, were examined. Only those that used toothbrush and paste once or twice daily, as the only oral hygiene method and were 18 years and above of age, were selected and investigated. Results: 58.3% of the entire subjects surveyed and 63.1% of male subjects indicated twice-daily oral prophylaxis when compared to 53.9% of female subjects. There was a statistical significant difference in the distribution of subjects with respect to occupation, between the two groups. This difference was most marked among the professional subgroup as compared to other subgroups. There was a statistical significant difference in the prevalence of periodontal diseases as indicated by CPITN scores. The group that performed oral prophylaxis twice daily had a higher proportion of those with CPITN codes 0 and 1 whereas codes 3 and 4 were more predominant with the group that perform oral prophylaxis once daily. Conclusion: The distribution of CPITN scores had a relationship with the frequency of daily oral hygiene practices. In view of the results of this study, it is suggested that some form of preventive oral hygiene programs be embarked on where emphasis is placed on regular and higher frequency of tooth brushing.
  1,009 111 -
Evaluation of antimalarial drugs usage according to WHO prescribing indicators in a tertiary health facility in Maiduguri, Northeastern Nigeria
Phillip Samuel Maryah, Ballah Akawu Denue, Nasiru Yakubu Ikunaiye, Roseline I Aderemi-Williams, Cecilia B Akawu
May-August 2017, 11(2):67-71
DOI:10.4103/phmj.phmj_7_17  
Background: The high morbidity and mortality associated with malaria especially in sub-Saharan Africa such as Nigeria calls for prompt preventive and curative measures including adherence to standard treatment guideline. Aim: To assess the level of adherence with the five defined WHO prescribing key indicators. Methods: This was a retrospective evaluation of the performance of antimalarial drugs prescribing practice among clinicians from January to December 2014. It was done through a set of drug prescribing indicators developed by WHO and the International Network of Rational Use of Drugs (INRUD). Results: Of the 385 patients prescription randomly generated from the record of 12,477 patients in this descriptive study, a total of 143 (37.1%) had antimalarial prescription(s) with no gender variation. The evaluation of the studied antimalarial drug prescriptions through defined WHO prescribing indicators revealed an average number of drugs per encounter of 3.9, with 37.4% of the prescriptions written in generic names. All the antimalarial drugs were prescribed from the National Drug Formulary, with injectable form constituting 4.7%. Conclusion: This study shows suboptimal compliance with WHO prescribing indicators with respect to average number of antimalarial per encounter and prescription in generic names. The proportion of antimalarials prescription in injectable form falls within the WHO acceptable limit of ≤10%. All antimalarial drug prescriptions in this study were from essential drug list. We, therefore, recommend rational antimalarial drug prescription in conformity with WHO/INRUD core drug prescribing indicators.
  951 162 -
ARTICLES
A five - year review of gestational trophoblastic diseases in Port Harcourt, Nigeria
TK Nyengidiki, G Bassey, NM Inimgba, NC Orazulike, C Amadi
January-April 2016, 10(1):18-24
DOI:10.4103/0795-3038.179443  
Background:  Gestational Trophoblastic Diseases (GTD) are a spectrum of inter-related but histologically distinct tumours originating from the placenta with good prognosis when diagnosed early.
Aim:  To determine the prevalence, clinical presentations, management of gestational trophoblastic disease at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Methods:  A retrospective analysis of women treated for gestational trophoblastic disease from 1st January 2008 to 31 st  December 2012. The information from patients records: age, occupation, educational level, husband's occupation, parity, presenting symptoms, uterine size, mode of treatment and management options were collated and analysed. The Chi-square test was used to compare categorical variables with a p value of ≤  0.05 as significant.
Results:  A total of 38 cases of GTD were treated with a prevalence of 2.3 per 1,000 deliveries. The mean age and parity were 31 ±  6.3 years and 2 ±  1.6 respectively. Maternal age less than 35 years and low socioeconomic status were significantly associated with GTD (p=0.0000). The mean gestational age at presentation was 16.24 ±  5.4 weeks. The commonest clinical presentation was amenorrhoea in 100% of patients. Twenty-five(65.8%) cases of hydatidiform mole and 13(34.2%) cases of choriocarcinoma were observed. Twenty-two (57.9%) patients had suction evacuation only for hydatidiform mole, 3(7.9.%) had suction evacuation and cytotoxic therapy for hydatidiform mole and subsequent persistent trophoblastic disease while 8(21.1%) had chemotherapy for choriocarcinoma. Five patients with advanced choriocarcinoma did not receive definitive treatment before demise. Twenty (52.6%)defaulted in their follow up schedule.
Conclusion:  There is high prevalence of GTD in Port Harcourt with high mortality among patients with malignancy. Most of the patients defaulted in their follow up; thus there is a need for education and sensitization of the populace on GTD, as well as proper counseling of patients treated on the benefits of follow up visits.
[ABSTRACT]   Full text not available  [PDF]
  968 137 -
ORIGINAL ARTICLES
Pure tone audiometric findings in patients on second-line treatment for multidrug-resistant tuberculosis
Matilda Uju Ibekwe, Chibuike Nwosu
September-December 2016, 10(3):97-101
DOI:10.4103/0795-3038.197748  
Background: The need for second-line antitubercular medication has been on the increase due to the emergence of multidrug-resistant strain tuberculosis (MDR-TB) in our environment. Aim: This study was to assess the effect of second-line antitubercular medication on hearing in patients with MDR-TB. Patients and Methods: This is a prospective study of all the patients admitted to the MDR-TB center of the University of Port Harcourt Teaching Hospital between January and May 2013. All patients had pure tone audiometry done before and 3 months after commencement of second-line antitubercular medications. The second-line regimen used includes kanamycin, levofloxacin, cycloserine, pyrazinamide, and pyridoxine. Results: The study had a total of 28 patients. There were 14 males and 14 females. The age range was between 18 and 68 years. Different degrees of high-frequency sensorineural hearing loss (SNHL) were seen in 14 patients after 3 months' therapy. There were 13 bilateral and 1 unilateral hearing impairment, 2 patients had profound SNHL. However, a good number had involvement of the speech frequencies. Conclusion: Second-line antitubercular medication appears to have a tremendous effect on hearing. This raises a public health issue since there is a growing increase in MDR-TB in our environment.
  977 117 -
Evaluation of cardiovascular risk factors in patients with chronic kidney disease
Ehimen Phyllis Odum, Esther Okiemute Udi
May-August 2017, 11(2):60-66
DOI:10.4103/phmj.phmj_15_17  
Background: Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in patients with CKD. Aim: The aim of this study is to determine the prevalence of the various cardiovascular risk factors in CKD patients and compare with that of healthy controls. Methods: A case-controlled study. The study sample included 94 diagnosed CKD patients above the age of 18 years without symptoms of cardiac disease and 70 controls. Fasting plasma glucose, lipid profile, creatinine, albumin, glomerular filtration rate and urinary albumin-creatinine ratio were estimated in participants. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The cardiovascular risk factors found in CKD patients versus controls were hypertension (62.7% vs. 11.4%), diabetes (13.8% vs. 7.1%), dyslipidaemia (50.0% vs. 31.4%), obesity (14.9% vs. 20.0%), hypoalbuminaemia (19.1% vs. 0%), microalbuminuria (55.3% vs. 20.0%) and macroalbuminuria (21.3% vs. 0%). However, only the prevalences of hypertension (P < 0.001), hypertriglyceridaemia (P = 0.007), low high-density lipoprotein (HDL) (P = 0.050), hypoalbuminaemia (P = 0.007), microalbuminuria (P < 0.001) and macroalbuminuria (P < 0.001) were statistically significant. Patients on maintenance haemodialysis had higher prevalence of hypertension (P = 0.018) and hypoalbuminaemia (P = 0.001) than pre-dialysis patients. Conclusion: Prevalences of hypertension, hypertriglyceridaemia, low HDL, hypoalbuminaemia, microalbuminuria and macroalbuminuria were significantly higher in CKD patients than in controls.
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EDITORIAL
Journal ranking and case reports
Preye Owen Fiebai
May-August 2017, 11(2):53-54
DOI:10.4103/phmj.phmj_35_17  
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ORIGINAL ARTICLES
Risk factors of intestinal parasitic infections among human immunodeficiency virus-infected patients on highly active antiretroviral therapy
FO Akinbo, PJ Anate, DB Akinbo, R Omoregie, S Okoosi, A Abdulsalami, B Isah
January-April 2017, 11(1):15-20
DOI:10.4103/phmj.phmj_5_17  
Background: Highly active antiretroviral therapy (HAART) improves immunity and reduces the occurrence of enteroparasitic infections. Aim: This study aimed to determine the prevalence and risk factors of intestinal parasitic infection among human immunodeficiency virus (HIV) patients on HAART in Kogi State, Nigeria. Methods: Blood and stool specimens were collected from 511 subjects including 411 HIV patients on HAART and 100 apparently healthy non-HIV individuals. The blood specimens were used to determine CD4 count and haemoglobin concentration, whereas the stool specimens were processed to detect intestinal parasites using standard techniques. Socio-demographic data were obtained with the aid of a questionnaire. Results: Entamoeba histolytica was the predominant parasites recovered generally and in both genders as well as being the only parasite that was associated with immunodeficiency as measured by CD4 count <200 cell/μL (P = 0.0059) HIV status was a significant risk factor for acquiring intestinal parasitic infection (odds ratio = 8.213 95% confidence interval = 1.971, 34.225; P = 0.0012). Among the other risk factors, CD4 count <200 cell/μL (P < 0.0001) and farming (P = 0.0202) were associated with intestinal parasitic infections among HIV patients on HAART. Conclusion: An overall prevalence of 14.4% of intestinal parasitic infections was observed among HIV patients on HAART in this study. Routine diagnosis of intestinal parasites among HIV patients on HAART is advocated.
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The awareness and desirability of pain relief in labour among pregnant women in Zaria
John Chukwuzitelu Ekweani, S Avidime
September-December 2016, 10(3):115-118
DOI:10.4103/0795-3038.197749  
Background: It is generally believed in third world countries that labour pains are well tolerated and so analgesia in labour is unnecessary. Studies have shown high levels of awareness but poor utilisation among parturients. This study assessed the level of awareness, desirability and barriers to the use of labour analgesia among pregnant women in Zaria. Methods: This was a prospective, cross-sectional and descriptive study carried out on 368 antenatal clinic clients at Ahmadu Bello University Teaching Hospital, Zaria, from November, 2011 to January, 2012. A semi-structured, pre-tested questionnaire was administered, and the data collected were analysed using the Statistical Package for Social Sciences software version 16. Results: The mean age of the respondents was 29.1 ± 5.5 (standard deviation) years. Majority (41.3%) were Hausas, 61% were Muslims, 56% were aware of labour analgesia and most (34.8%) got their information from nurses. The most common method of pain relief known was music and hypnosis, constituting 97.3%. Only 13.3% of the clients (49) have ever experienced any form of analgesia administered during labour and half of which got their experience overseas. About 62.5% of the clients desired pain relief in labour, but the major obstacle to its uptake was unavailability of the methods. Conclusion: Although patients are aware of labour analgesia, most have not experienced it mainly due to nonavailability of the methods. Clients need further education, and pain relief in labour should be made available in maternity centres.
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ARTICLES
Pattern of strabismus in a tertiary hospital in Nigeria: a six-year review
EA Awoyesuku, B Fiebai, AA Onua
January-April 2016, 10(1):14-17
DOI:10.4103/0795-3038.179442  
Background:  Strabismus (ocular misalignment) is frequently seen in clinical practice. Its prevalence varies in different parts of the world with no sex predilection. Stabismus is a significant cause of ocular morbidity. Esotropia is often the commonest form of presentation among children.
Aim:  To determine the frequency and clinical features of patients presenting with strabismus in the ophthalmic clinic a past 6-year period.
Methods:  This was a hospital based study of all the patients diagnosed having strabismus in University of Port Harcourt Teaching hospital between January 2007 and December 2013. The medical records of a total of 74 patients who visited the ophthalmic clinic and diagnosed as having strabismus were retrospectively reviewed and subsequently analysed using Statistical Package for Social Sciences (SPSS) version 17 computer soft ware package. Ethical clearance was obtained from the Ethics committee of the University of Port Harcourt Teaching Hospital.
Results:  A total of 12,334 case files were reviewed in this study. Five thousand one hundred and eighty-one (42%) were males and 7,153 (58%) females. A total of 74 cases had strabismus (0.6%). Twenty- three were males and 51 females (M:F=1:2.2). Twenty-eight (37.8%) had alternating squint, twenty- three (31.1%) had esotropia, twenty- one (28.4%) had exotropia and two (2.7%) had hypertropia.
Conclusion:  This study confirmed the relatively high frequency of alternating squint and esotropia in patients with strabismus.
[ABSTRACT]   Full text not available  [PDF]
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The effect of some social factors on adolescents nutritional status in an oil-rich Niger-Delta region of Nigeria
PN Tabansi, AF Adesina, IC Anochie
January-April 2016, 10(1):2-9
DOI:10.4103/0795-3038.179440  
Background:  Adolescence is the period of transition from childhood to adulthood and the second most critical period of physical growth after the first year of life. Nutritional problems may arise from poor eating habits, snacking and consumption of nutrition deficient processed foods. Some social factors have been shown to influence their nutritional status, the result of which may have detrimental health implications as they advance into adulthood.
Aim:  To determine the effect of some social factors on the nutritional status of adolescents in Port Harcourt.
Methods:  A multi-staged sampling technique was used to select 960 adolescents from eight secondary schools in Port Harcourt. Using an investigator-administered questionnaire, information on their socio-economic status, eating habits, food content and level of activity was obtained. Anthropometric measurements were taken and BMI calculated using the formula weight/height 2  (kg/m 2 ). This was then used to categorize their nutritional status. The results were analyzed using SPSS 14 and EPI Info 6.04.
Results:  Eight hundred and nineteen adolescents (85.3%) had normal weight, 61(6.4%) were underweight while 17 (1.8%) were obese. Significantly more males (8.9%) were underweight compared to females (3.8%); while females were significantly more overweight and obese than males. Consumption of snacks (17.4%), soft drinks (10%), higher social economic class (11.5%) and watching television for >3hrs a day (18.6%) were associated with overweight and obesity.
Conclusion:  Social economic status, snacking and hours spent watching television have a detrimental effect on the nutritional status of adolescents in Port Harcourt.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
The buccal groove of the lower first molar: Comparing odontometric position with anatomic nomenclature
OT Temisanren, JU Ifesanya, BA Adesina, KK Kanmodi
January-April 2017, 11(1):2-5
DOI:10.4103/phmj.phmj_6_17  
Background: The buccal groove of the lower first molar (LM1) is the reference point in the clinical classification of malocclusion based on Edward Angle's criteria, a classification of great value in orthodontic practice. The groove has been popularly named as the mid-buccal, anterior buccal, or simply as the buccal groove. This variation in nomenclature suggests that the location of the buccal groove differs in different populations. Aim: This study aimed to ascertain the exact location of the buccal groove on mandibular first molars as well as its morphological variations and possible clinical implications in this environment. Methods: The study casts were retrieved from the orthodontic units of University College Hospital, Ibadan, and Military Hospital, Lagos. Sociodemographic variables, the mesiodistal width of the LM1, number of buccal grooves, and location of the buccal groove along the mesiodistal width of the LM1 were ascertained. Data were analysed using the SPSS software version 22. Paired t-test was used to assess the relationships between quantitative variables while the Chi-square test assessed qualitative variables and the level of significance was set at P< 0.05. Results: The mean age of the patients was 15.50 ± 7.09 years. The mean mesiodistal widths of the lower right and left molars were 11.27 ± 0.78 mm and 11.41 ± 0.86 mm, respectively. Paired t-test showed that the left buccal groves were more anteriorly located than the right buccal grooves (P < 0.001). The buccal grooves were more anteriorly placed irrespective of the number of grooves present on the LM1, both left and right (P < 0.001). Conclusion: The most appropriate nomenclature for the buccal groove of the LM1 is the anterior buccal groove. Caution must be exercised in classifying individuals with uncommon buccal groove location in clinical orthodontic practice.
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