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  Citation statistics : Table of Contents
   2016| September-December  | Volume 10 | Issue 3  
    Online since January 6, 2017

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Uterine fibroids: Experience with 100 myomectomies in Orlu, South East Nigeria
VI Ndububa
September-December 2016, 10(3):124-129
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.
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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
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.
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Huge cervical fibroid
John Chukwuzitelu Ekweani, OA Oguntayo, A. O. D. Kolawale, MS Zayyan
September-December 2016, 10(3):135-138
Fibroids in the cervical region of the uterus are uncommon because of the rarity of smooth muscles. The aim of the study was to present this rare finding in our centre and to show our management and the challenges encountered. We present a 45-year-old multipara who before the presentation had 6-year history of abnormal vaginal bleeding and was previously managed in a peripheral hospital. Physical examination suggested a large cervical fibroid and a hydronephrosis on the right displayed on intravenous urogram. She had total abdominal hysterectomy with the urologist who repaired an inadvertent ureteric injury and inserted a stent. It was removed after 6 weeks, and she was discharged with no further complications. Management of such patients should involve other disciplines after careful evaluation has been carried out.
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Medical outreach activities, a means to an end
Ndubuisi Eke
September-December 2016, 10(3):85-85
  - 1,878 3,210
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
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.
  - 2,777 1,950
Health implications of chemicals found in the drinking water supply of members of an urban community in Rivers State, South–South Nigeria
Samuel Chindah, Best Ordinioha
September-December 2016, 10(3):91-96
Background: Efforts at improving access to drinking water almost always concentrate on increasing quantity, with little attention given to the quality of water. There is, however, increasing evidence of the significant contributions of chemicals found in drinking water on health. This study tested the drinking water supply of Rumuola, a suburb of Port Harcourt, for possible chemical contamination. It also ascertained the human health implications of the detected contaminants in the water samples. Methods: A cross-sectional, analytical study design was used. Water samples were collected from water facilities that serve most members of the community and analysed in an accredited laboratory, for nitrate, fluoride, calcium, arsenic, lead and iron, using atomic absorption spectrophotometer. A checklist was also used to assess a 30 m radius of each of the water facilities, for possible sources of contamination. An impact assessment was also carried out to ascertain the health implications of the contaminants identified in the water samples. Results: Samples from eight water facilities were tested. All the samples contain detectable concentrations of iron, lead, nitrate, fluoride and calcium. The mean concentration of fluoride in the water samples was 0.01 mg/L; that of nitrate was 38.78 mg/L; the mean concentration of iron was 1.05 mg/L, those of lead and calcium were 0.094 and1 mg/L, respectively; while arsenic was not detected in any of the samples. The mean concentration of iron in the water samples can provide 12%–26% of the recommended daily allowance; while the mean concentration of lead of the samples is more than nine times the WHO permissible limit. Conclusion: The concentrations of the assessed chemicals in the water supply can supply some percentage of the recommended daily intake while others can pose some adverse health effects.
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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
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.
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Phaeochromocytoma: Is it that uncommon?
JM Adotey, NJ Jebbin, A Dodiyi-Manuel, AC Onwuchekwa
September-December 2016, 10(3):130-134
Background: Phaeochromocytoma has been described as a rare condition in the literature. Aim: This study aims to present cases of phaeochromocytoma seen at the University of Port Harcourt Teaching Hospital (UPTH) over a period of 6 years (2003–2008). Methods: All patients that presented with phaeochromocytoma within the study period were included in the study. Data were collected from hospital records and presented as case series. Results: Five cases of phaeochromocytoma seen at the UPTH between 2003 and 2008 form the subject of the retrospective report. There were three males and two females, and their ages were 40, 28, 23, 37 and 11, respectively. Four of the resected specimen were benign in histology while one was malignant. Mortality was recorded in only one patient. Conclusion: Having seen five cases of a condition that is reported as rare within a period of 5 years raises the question as to whether phaeochromocytoma is as rare as is generally recorded.
  - 1,996 142
Assessment of workplace hazards in mortuaries in Port Harcourt, Nigeria
Kingsley E Douglas, SS Peterside
September-December 2016, 10(3):102-110
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.
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A modified method of dartos flap coverage of neourethra in the repair of hypospadias and urethrocutaneous fistula
Abdulwahab A Ajape, Sulyman A Kuranga
September-December 2016, 10(3):111-114
Background: Hypospadias is a common congenital anomaly and its repair has been characterised by constant evolution. Urethrocutaneous fistula (UCF) formation remained the most common complication of hypospadias repair the occurrence of which precludes one of the goals of hypospadias surgery. Aim: To assess the modification of interposing layer of dartos flap coverage in hypospadias and UCF repairs in the prevention of UCF. Materials and Methods: In this retrospective review, 11 cases of hypospadias and UCF were repaired with our modification of dartos flap interposition from January 2010 to December 2013. The medical records were retrospectively reviewed to determine the clinical presentation, the age at surgery, the position of meatus and UCF, history of previous repair and the surgical outcomes. Results: The ages range from 1 to 25 years with a mean age of 8.36 years. Eight patients had repair of hypospadias, two patients had repair of post-circumcision UCF and a patient had repair of congenital UCF (CUCF). All the patients with hypospadias had tabularised incised plate urethroplasty except two of them who had staged repair with buccal mucosa graft reconstruction. Those with post-circumcision UCF and CUCF had incised plate plus simple closure. All the patients had our modified interposing layer of dartos flap incorporated. The outcomes were satisfactory in nine patients, one patient had glanular dehiscence and another one had complete dehiscence of the wound. Conclusion: This modification of dartos flap interposition can be added to the various surgical armamentariums in the management of these patients.
  - 2,110 172
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
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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