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   2020| January-April  | Volume 14 | Issue 1  
    Online since April 30, 2020

 
 
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ORIGINAL ARTICLES
Measurement of thoracic and lumbar pedicle dimensions in Nigerians using computed tomography
Olakunle Badmus, Patricia Ogbe, Omodele A Olowoyeye, Adewole Akinsulire, Olubukola Omidiji
January-April 2020, 14(1):12-18
DOI:10.4103/phmj.phmj_17_19  
Background: Pedicle screws are often used to stabilise the spine. They afford the benefit of a three-column control of the spine. The technique of pedicle screw insertion is familiar and has a well-documented safety profile during lumbar and thoracic spinal surgery. However, complications such as cerebrospinal fluid leakage due to pedicle screw misplacement, neurological irritation and pedicle penetration may occur. Therefore, knowledge of the dimensions of spinal pedicles is necessary for the fixation of pedicular screws to avoid possible complications. Aims: The aim of this study was to determine the maximal diameter and axial length of thoracic and lumbar pedicles in a homogenous African population using computed tomography (CT). This would establish normative data on the average size of pedicle screws that would be required during the surgery, hence maximising pull-out strength while reducing the possibility of revision of the pedicle screw placement. Methods: It is a retrospective study where the transverse pedicle width, axial pedicle length and sagittal pedicle width of T1–L5 were measured on 100 patients; 50 males, 50 females with normal spinal architecture using a 128-slice Toshiba CT scanner. Results: The mean axial length in the thoracic and lumbar vertebrae ranged from 31.76 ± 2.92 mm (T1) to 43.02 ± 3.32 mm (T12) and from 45.07 ± 2.40 mm (L5) to 46.32 ± 2.28 mm (L3), respectively. The mean TPW at the thoracic and lumbar vertebrae ranged from 4.53 ± 0.69 (T4) to 7.78 ± 1.31 mm (T12) and from 6.81 ± 1.25 mm (L1) to 12.95 ± 1.49 mm (L5), respectively. The mean sagittal diameter of thoracic and lumbar vertebrae ranged from 5.78 ± 1.07 mm (T1) to 10.98 ± 1.37 (T12) and from 9.51 ± 1.31 mm (L2) to 9.78 ± 1.61 (L4), respectively. Conclusion: The dimensions of thoracic and lumbar pedicles measured in this study vary with those obtained from other populations. This strengthens the case for customising the existing range of spinal pedicle screws according to local population characteristics.
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Knowledge, pattern and determinants of the use of skin-lightening creams among University Undergraduates in Southwestern Nigeria
Wasiu Olalekan Adebimpe, Olubukunola Omobuwa, Demilade Ibirongbe, Adeola Efuntoye
January-April 2020, 14(1):6-11
DOI:10.4103/phmj.phmj_11_19  
Background: Fair skin has been associated with beauty and sexual attraction. Aggressive marketing of skin-lightening products to unsuspecting members of the general population continues despite their numerous side effects. Aim: This study assessed the knowledge and pattern of the use of skin-lightening creams (SLCs) among undergraduates in Osun State, Southwestern Nigeria. Methods: This is a descriptive, cross-sectional study among University undergraduates. Three hundred undergraduates were selected using multistage sampling method. The research instrument used was a semi-structured, self-administered, pretested questionnaire. Data were analysed using the SPSS version 23.0 software. Results: The mean age of the students was 21.0 (±3.4) years. Most (283, i.e., 94.3%) of the students were aware of SLCs, with the Internet being the most common source of information. About 69.0% had good knowledge, while 67.0% had a poor attitude towards the use of SLC. Eighty-one (27.0%) respondents knew that SLC had side effects, 114 (38.0%) had ever used SLC, 69 (60.5%) still use SLC now, while 45 (39.5%) have stopped. Among those who had ever used, 108 (94.7%) said that they knew the chemical ingredient in SLC, 34 (29.8%) usually checked the label before use, 108 (94.7%) usually obtained SLC products from the supermarkets/shops. Predictors of the use of SLC in this study were female and age older than 19 years. Conclusion: Good knowledge but poor attitude characterised the significant proportion of SLC users under the study, and this underscored the need for improved public awareness in this regard and targeting this young, vulnerable population.
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Prevalence and pattern of beta-haemolytic streptococcal throat infections among primary school children in a rural community in rivers state
Woroma Wonodi
January-April 2020, 14(1):23-30
DOI:10.4103/phmj.phmj_23_19  
Background: Group A beta-haemolytic Streptococcus (GABHS) remains a major cause of morbidity and mortality in humans where it causes symptomatic pharyngitis and the non-suppurative sequelae of acute rheumatic fever and post-streptococcal acute glomerulonephritis. Regional evaluation of streptococcal throat infections may be helpful in disease surveillance. The aim of this study was to evaluate the prevalence and pattern of GABHS throat infections among primary school children in a rural community in Rivers State, Nigeria. Methodology: This cross-sectional study was carried out between May and July 2015 in Emohua local government area of Rivers State, Nigeria. Pupils were recruited using a multistaged random sampling technique. Throat swabs obtained were cultured using sheep blood and sent for microscopy and Lancefield grouping. Results: A total of 456 pupils aged 6–12 years were recruited, of which 54 (11.8%) had a positive throat culture of beta-haemolytic Streptococcus (BHS). The isolates were Lancefield Groups B (23; 42.6%), A (18; 33.3%), D (9; 19.6%), C (3; 5.6%) and F (1; 1.8%). No Group G BHS was isolated. Age, sex, socioeconomic class, classroom and household overcrowding did not significantly influence the prevalence of BHS throat infections. Conclusion: The prevalence of BHS throat infections in this rural community was similar to that in the urban areas in Nigeria. There was no significant difference between the prevalence of BHS in symptomatic and asymptomatic pupils.
  3,928 279 -
Prevalence and possible aetiological factors of acne keloidalis nuchae in South–South Nigeria
Bolaji Otike-Odibi, Dasetima Altraide, Stella-Maris Egboh
January-April 2020, 14(1):3-5
DOI:10.4103/phmj.phmj_10_19  
Background: Acne keloidalis nuchae (AKN) is a scarring folliculitis found predominantly among men of African descent. It could present as pustules, papules or keloidal eruptions usually at the occiput of the scalp and has been associated with certain aetiological factors. Aim: The aim of the study was to determine the prevalence and possible aetiological factors of AKN in the University of Port Harcourt Teaching Hospital (UPTH). Methods: It was a 3-year retrospective study conducted in the Dermatology Clinic of the UPTH, from 2014 to 2017, where folders of patients who were diagnosed with AKN by dermatologist were retrieved and reviewed. Results: The prevalence of AKN was 1.7%. Male patients were predominantly affected with a male-to-female ratio of 21:1. The age range of the cases was from 18 to 51 years, with a mean ± standard deviation of 27.31 ± 7.01. Majority of the subjects had a history of clean-shaven hair (80.6%). Other possible predisposing factors were friction from collars (48.4%) and shaving of the hairline at the occiput during haircuts (64.5%). Conclusion: Despite the low prevalence of AKN, its social impact is glaring; therefore, more emphasis should be laid on the aetiological factors and management to improve the quality of life of the affected patients.
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Changing pattern of adult external abdominal hernias in Zaria
Peter Pase Abur, Muhammad Daniyan, Stanley Emeka Nwabuoku, Lazarus M D. Yusufu, Vincent I Odigie
January-April 2020, 14(1):19-22
DOI:10.4103/phmj.phmj_22_19  
Background: External abdominal hernias are very common diseases encountered in surgical practice. A previous report from this centre 21 years ago documented the pattern of adult external abdominal hernias. However, there is an observed changing pattern. The aim of the study was to document the changing pattern, mode of presentation, treatment and outcome. Methods: It was a 5-year prospective study from January 2011 to December 2015. Adult patients with external abdominal hernia at our institution were studied. Information documented included patients' sociodemographic information, type of hernia, mode of presentation, treatment and outcome. Results: Six hundred and thirty-seven out of 4,083 patients with general surgical cases had external abdominal hernias (15.6%), with a male:female ratio of 3.1:1. The types of hernia were inguinal (451 [70.8%]), umbilical (83 [13.0%]), incisional (54 [8.5%]), epigastric (31 [4.9%]), femoral (14 [2.2%]) and others (4 [0.6%]). The common modes of presentation for inguinal hernias were simple (364 [80.7%]) and strangulated (42 [9.3%]). The most common mode of treatment for inguinal hernias was modified Bassini (265 [58.8%]). The common post-operative morbidities for groin hernias were wound infection (18 [3.9%]) and acute urinary retention (10 [2.2%]). The 3-year recurrence rate for groin hernias was 14 (3.0%). Mortality was three (0.5%) patients. Conclusion: The pattern of external abdominal hernias in our institution has changed with the descending order of occurrence as follows: inguinal, umbilical, incisional, epigastric and femoral. This is in contrast to previous reports where femoral was the second most common. Modified Bassini was the preferred method of repair of inguinal hernia due to its simplicity.
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EDITORIAL
Port Harcourt Medical Journal valedictory editorial
Ndubuisi Eke
January-April 2020, 14(1):1-2
DOI:10.4103/0795-3038.283673  
  3,644 344 -