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ORIGINAL ARTICLES
Pattern and factors associated with hemoglobin genotype testing among children attending a University Teaching Hospital in Lagos, Nigeria
Samuel Olufemi Akodu, Elizabeth Aruma Disu, Olisamedua Fidelis Njokanma
January-June 2015, 13(1):16-20
DOI:10.4103/1118-4647.158708  
Background: Sickle cell disorders are chronic debilitating genetic disorders affecting the red cells. Sickle cell disorders were originally found in the tropics and subtropics but are now common worldwide due to migration of people from tropical to temperate zones. Objective: The objective was to describe pattern and factors associated with hemoglobin (Hb) genotype testing among children attending a University Teaching Hospital in Lagos, Nigeria. Methodology: The study was conducted at the General Children Outpatient Clinics of Lagos State University Teaching Hospital, Ikeja, Lagos in South west Nigeria. It is a cross-sectional study using research administered questionnaire to obtain information from caregivers. Results: A total of 202 subjects aged 6 months to 15 years were conveniently recruited. Overall, the Hb genotype uptake rate was 17.8%. The overall prevalence of Hb disorders was 25.8%. One-ninth of the subjects with known Hb genotype status at commencement of the study had their Hb genotype status confirmed before the age of 1 year. First birth order and upper social stratum were significantly associated with younger age at Hb genotype uptake. Conclusion: Fewer children had Hb genotype uptake during infancy and this underscores the need for early Hb genotype testing of infants. This screening can be during the prenatal, neonatal or at most in infancy during immunization, and infant welfare clinics visit.
  8,565 304 -
Misuse of mobile phone conversation while driving: Driver distraction a major public health problem
Abdulbari Bener, Funda Çatan, Erkut Bolat, Erol Yildirim, David Crundall
July-December 2016, 14(2):17-22
DOI:10.4103/1118-4647.187900  
Aim: The aim of the present study is to determine the frequency of mobile phone use while driving and associated factors in a sample of road traffic among Turkish drivers in Istanbul. Design: This is a cross-sectional study design. Subjects and Methods: The study included a representative sample of 1200 drivers. However, 891 drivers agreed to participate and completed the driver behavior questionnaire (DBQ). Methods: The Manchester DBQ was used to measure the aggressive and aberrant driving behaviors causing accidents in terms of sociodemographics, driving attitudes, and behaviors, adherence to traffic laws, and mobile phone use. Results: The present study expressed that the frequency of mobile phone use while driving was very high among Turkish drivers who were involved with traffic crashes. There was a significant difference found between mobile phone users and nonusers while driving in age group (P < 0.01), education (P < 0.001), occupation (P < 0.001), seat belt use (P < 0.001), vehicle type (P < 0.001), and excessive speed (P < 0.001). Furthermore, attempting to overtake, missing give way signal, and turning right/left nearly hitting other car were reported as errors. For lapses, there was no significant association found between correct and incorrect parking for drivers in all of the DBQ items. The data showed that the drivers reported higher mean scores of violations such as driving close to the car to go faster, running a red light, disregarding speed limit at night or early in the morning. Conclusion: Together, the results provide important insights into mobile phone use and its related factors among Turkish drivers. The type of vehicle, excessive speeding, occupational status, educational level, age group, seat belt use, and crossing a red light were statistically significant associated with mobile phone use among drivers who were involved in the road crashes. When drivers use a mobile phone, there is an increased likelihood of the road accidents that result in injury. There is no doubt that hands-free phone use while driving may not minimize the risk totally. In fact, advancing technology will increase mobile phone use in motor vehicles so it may cause more crashes and fatalities.
  2,767 2,954 1
Prevalence and risk factors of bacterial vaginosis in a cohort of women seeking child spacing services in nigeria
Nyengidiki Kennedy Tamunomie, Goddy Bassey
July-December 2015, 13(2):35-39
DOI:10.4103/1118-4647.170150  
Background: The sustenance of reproductive potential of patients seeking contraceptive options is essential. The risk of bacterial vaginosis is increased by the choice of contraceptive options, which may affect postcontraception fertility. Objective: To determine the prevalence and risk factors of bacterial vaginosis in a cohort of women seeking child spacing services. Materials and Methods: A cross-sectional prospective study of women seeking fertility regulation services was conducted in a tertiary health facility in Nigeria between March and September 2014. Interviews were conducted to collect data on sociodemographic characteristics, characteristics of vaginal discharge, and sexual practices engaged by these women. Bacterial vaginosis was diagnosed using the Amsel criteria. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to assess the predisposing factors. Results: One-hundred seventy-eight clients were recruited. Bacterial vaginosis was noted in 7.87% of these women. Patients had increased risk of bacterial vaginosis when they were of low socioeconomic class (OR 8.17; 95% CI 2.30–29.81), used vaginal drying agents (OR 9.70; 95% CI 2.35–46.15), had an early sexual debut (OR 9.56; 95% CI 2 54–38.92), a history of previous sexually transmitted infections (OR 21.39; 95% CI 4.99–105.30), and practiced vaginal douching (OR 19.23; 95% CI 3.82–130.43). Conclusion: The prevalence of bacterial vaginosis in this cohort raises the need for a high index of clinical suspicion in patients seeking fertility regulation services in the presence of notable risk factors. Avoidance of contraceptive methods that may increase the risk of bacterial vaginosis and the need for treatment to maintain reproductive potentials is advised.
  2,015 3,126 -
CASE REPORTS
The danger of failure to recognize injury in cervical spine X-ray for trauma
Biodun Ogungbo, Olatunde Olawoye, Mary Idowu, Caleb Sabo Bishop
July-December 2016, 14(2):38-41
DOI:10.4103/1118-4647.189752  
We present a female with an acute traumatic fracture dislocation of the cervical spine. She sustained bilateral facetal dislocation at the C7/T1 junction without neurological deficit. This was not diagnosed on initial X-rays of the cervical spine. We highlight the danger of this failure and conducting dynamic X-rays in such a situation. The patient presented after 4 months and was operated upon safely with anterior/posterior fixation across the fracture site. She remains neurologically intact.
  4,780 177 -
ORIGINAL ARTICLES
Evaluation of effects of artemether + lumefantrine (artemisinin-based combination therapy) on women's reproductive cycle using Creighton Model Fertilitycare System and NaProTECHNOLOGY
Francis Achebe
July-December 2017, 15(2):31-41
DOI:10.4103/NJGP.NJGP_14_16  
Background: Malaria is prevalent in Nigeria, and artemether + lumefantrine (artemisinin-based combination therapy [ACT]) is drug of choice in treatment of uncomplicated cases. ACT is contraindicated in early pregnancy. They release-free radicals that can compromise female fertility. Infertility and its associated complications such as miscarriages, abnormal gestation, and unstable marriages seem to be on the increase. This study aims at evaluating the effect of ACT on female fertility. The significance of this research is to draw the attention of fertility care givers to this possible cause of infertility and fertility challenges. Subjects and Methods: Creighton Model FertilityCare System and NaProTECHNOLOGY are simply technologies that can be used to assess female fertility. They are used in this study to assess the effect of ACT administered at different stages of menstrual cycles of three selected fertile adult females. The results are interpreted on the background of standard Creighton model chart. Results: This study has shown that ACT has a significant fertility deteriorating effect on the women. It caused ovulation defect and diagnosed as partial rupture syndrome in the very cycle of use and in the first cycle after use. It also significantly reduced cervical mucus production and significantly reduced luteal phase progesterone production with an associated significant increase of luteal phase estrogen production. Conclusion: ACT use as antimalarial may be a possible cause of infertility and fertility challenges in women.
  4,704 229 -
Factors associated with the use of traditional birth attendants in Nigeria: A secondary analysis of 2013 Nigeria national demography and health survey
Joseph Odirichukwu Ugboaja, Charlotte Blanche Oguejiofor, Emmanuel Okwudili Oranu, Anthony Osita Igwegbe
July-December 2018, 16(2):45-52
DOI:10.4103/NJGP.NJGP_27_17  
Background: A large number of women in Africa deliver without skilled birth attendants with profound consequences for maternal and perinatal outcomes. This study evaluated the factors associated with traditional birth attendants in Nigeria. Methodology: We conducted a weighted analysis of data from the 2013 Nigeria Demographic and Health Survey that included women aged 15–49 years using STATA software, version 12.0 SE (Stata Corporation, TX, USA) to investigate the factors associated with the utilization of traditional birth attendants in Nigeria using logistic regression models. The result was presented in odds ratio and 95% confidence interval (CI). Results: The rate of delivery with Ttaditional birth attendants among the respondents was 23.4% (n = 7,267), and this was significantly associated with low maternal education (adjusted odds ratio [aOR]: 1.75;95% CI: 1.49–2.06), rural residence (aOR: 1.3 95% CI: 1.12–1.51), poor family wealth index (aOR: 1.29; 95% CI: 1.09–1.54), unemployed status (aOR: 3.01; 95% CI: 1.50–6.03), and having >5 living children (aOR: 1.23; 95% CI: 1.06–1.44). Factors that significantly reduced the rate include age category 35–44 years (aOR: 0.82; 95% CI: 0.69–0.98), having visited a health facility in the past 12 months (aOR: 0.86; 95% CI: 0.76–0.98), and watching television at once a week (aOR: 0.75; 95% CI: 0.64–0.88). Conclusion: The risk factors for delivery with traditional birth attendants in Nigeria include low maternal education, large family size, rural residence, and noninvolvement of women in decision about their health care while exposure to media and contact with a health facility reduced the risk. Women empowerment through education and employment may reduce the rate of use of traditional birth attendants at delivery.
  4,424 361 -
A five year review of ovarian cancer at a tertiary institution in Lagos, South-West, Nigeria
Kehinde Sharafadeen Okunade, Halima Okunola, Adeyemi A Okunowo, Rose Ihuoma Anorlu
July-December 2016, 14(2):23-27
DOI:10.4103/1118-4647.187901  
Background: Ovarian cancer constituted 7% of gynecological malignancies seen in Lagos, Nigeria and was the second most common cause of death among women in Lagos, Nigeria. Objectives: The aim is to determine the prevalence of ovarian cancer and characteristics of patients with ovarian cancer at a Tertiary Institution in Lagos. Patients and Methods: This was a retrospective review of all the patients with histologically confirmed ovarian cancer admitted to the gynecological ward of the hospital over a period of 5 years. Relevant information was extracted from the ward register and patients medical case records. Data were analyzed using Epi-info statistical software package and results were then presented in tables and chart. Results: Fifty cases of ovarian cancer were admitted during the period under review. This constituted 1.7% of the gynecological admission cases and 8.2% of the gynecological malignancies managed in the hospital during the study. It was the second most common gynecological malignancy. The mean age of the ovarian cancer patients was 45.7 ± 4.3 years with the majority of the patients (58%) being premenopausal, 34% being nulliparous and only 16% having one or more risk factors. The abdominal swelling was the most common presenting symptom with 80% of the patients presenting with advanced disease. Epithelial ovarian cancer was the most common histological variant. The most common treatment modality was surgery and chemotherapy. The patient default rate was 64%. Conclusion: Ovarian cancer cases are on the increase. Failure of optimal management is worsened by the delay in presentation and poor compliance to treatment with high patients' default rate.
  2,934 1,338 -
Polycystic ovarian syndrome: Analysis of management outcomes among infertile women at a public health institution in nigeria
LO Omokanye, OA Ibiwoye-Jaiyeola, A. W. O. Olatinwo, IF Abdul, KA Durowade, SA Biliaminu
July-December 2015, 13(2):44-48
DOI:10.4103/1118-4647.170152  
Background: Infertility remains an issue of concern especially to the female partner who bears the brunt of the stigma attributed to the disease in this environment. Among the identified etiological factors for infertility, polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age that impact on ovulation and conception. Aims and Objectives: The objective of this study was to determine pregnancy outcome following the various modalities of management of PCOS at the University of Ilorin Teaching Hospital (UITH). Materials and Methods: This is a nonrandomized (nonblinded) clinical trial of five therapeutic options for infertile women with PCOS from the Assisted Reproductive Technology (ART) Clinic and Gynaecology Clinic of UITH between January 1, 2011 and December 31, 2013. Results: Of 624 infertile women who presented at ART and general gynecology clinic of UITH, 76 met the Rotterdam criteria for PCOS, giving a prevalence rate of 12.2%. The patients aged 20–44 years with a mean age of 31.5 years. Most 49 (64.5%) of the patients were nulliparous, and more than half (56.6%) belong to the middle social class. Thirty-four (44.8%) were obese while 22 (28.9%) were overweight. Of the various management options, 48.7% had laparoscopic ovarian drilling; other treatment options offered were the use of clomiphene citrate (CC) alone, CC with metformin, weight reduction, and gonadotropin. Patients were followed-up within 6–12 months (mean 5.5 ± 1.2 months) following the initial treatment for evidence of laboratory/clinical pregnancy. An overall pregnancy rate of 46.0% was recorded. However, a total of 13 (17.1%) were lost to follow-up. The highest pregnancy rate (75%) was reported in women managed with CC alone (P = 0.229). Conclusion: PCOS occurs commonly in reproductive age and management outcomes are promising in Nigeria. CC, metformin, and laparoscopic ovarian drilling are of great benefit. Further studies on PCOS in low resource countries are needed.
  3,098 554 -
EDITORIAL
Diagnosing and treating Malaria in Nigeria. Unitaid project defeat - Change of guard at the editorial desk of the Nigerian journal of general practice
Jide Onyekwelu
July-December 2014, 12(2):8-12
Full text not available  [PDF]
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ORIGINAL ARTICLES
Traditional bone setters' gangrene: An avoidable catastrophe, 8 years retrospective review in a private orthopedic and trauma center in South-East Nigeria
Agu Thaddeus Chika, Jide Onyekwelu
January-June 2016, 14(1):1-5
DOI:10.4103/1118-4647.177496  
Background: Traditional bone setters apply tight splints on the limbs of patients in their practice settings. Most of the times, these tight splints will result in compartment syndrome and when they are not recognized on time, they will deteriorate into gangrene. Design: This is a retrospective study covering a period between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east of Nigeria. Results: A total of ten patients out of sixty seven patients had amputations on account of traditional bone setters' gangrene constituting 14.9%. All of the patients with bone setters' gangrene had two stage amputations. One of the patients refused amputation and he was referred to another centre. There was zero mortality. Conclusion: Traditional bone setters' gangrene is an avoidable orthopaedic disaster that is common in our environment. Genuine efforts should be made by all the stakeholders to reduce and possibly to eliminate this catastrophe.
  2,689 285 -
An evaluation of the characteristics of patients with gestational choriocarcinoma in south-south, nigeria
TK Nyengidiki, G Bassey
July-December 2015, 13(2):40-43
DOI:10.4103/1118-4647.170149  
Background: Gestational trophoblastic diseases have been generally associated with the good outcome, especially in developed countries where early presentation and diagnosis is the norm. Objective: This study seeks to determine the characteristics of patients with gestational choriocarcinoma at the University of Port Harcourt Teaching Hospital(UPTH), Nigeria. Methods: This was a retrospective study of women who were treated for gestational choriocarcinoma at the UPTH over a 5-year period from January 1, 2008 to December 31, 2012. Results: Atotal of 13 cases of gestational choriocarcinoma were treated in UPTH during the study period, and there were 16,720 deliveries giving a prevalence of 0.8/1000 deliveries. The majority of patients (76.9%) were of low socioeconomic class. 92.3% of patients presented with amenorrhea for 28 weeks. Histological examination of tissues extracted from previous miscarriages was not performed in 100% of patients. Eighty percent of all mortalities were associated with antecedent pregnancies being miscarriages. All patients managed were lost to follow-up within 32 weeks. Conclusion: Gestational choriocarcinoma in Port Harcourt is associated with high mortality. Most patients with choriocarcinoma were of low socioeconomic class, presented late with lack of histological examination of previously extracted products of conception. Most of the patients were lost to follow-up within 32 weeks.
  1,680 1,224 -
Hypertension prevalence and body mass index correlates among patients with diabetes mellitus in Oghara, Nigeria
Anizor Chinedu, Azinge Nicholas
January-June 2015, 13(1):12-15
DOI:10.4103/1118-4647.158707  
Background: Hypertension and abnormal body mass index (BMI) are a cause of increased morbidity and mortality in patients with diabetes mellitus (DM). The aim of this study is to determine the prevalence of hypertension with correlates to BMI among patients with DM seen in a tertiary hospital in Oghara, Delta State. Materials and Methods: Two hundred and forty-four diabetic subjects were retrospectively evaluated at the Endocrinology Clinic of the Delta State University Teaching Hospital, Oghara, Nigeria. Data obtained from medical records included presence of hypertension confirmed by presence of elevated blood pressure >140/90 mmHg on two consecutive clinic visits or known hypertensive on medications, age, sex, type of diabetes, weight and height with computation of BMI. Results: The prevalence of hypertension among the diabetic patients was 57.4%. Eighty-two males (58.5%) were hypertensive compared with 58 (41.5%) in female subjects. The prevalence of hypertension was higher in overweight and obese diabetic subjects than in normal weight subjects and also higher in type 2 diabetic patients compared to type 1, which were both statistically significant (P < 0.05). Conclusion: Hypertension is a common co-morbidity arising diabetic patients in this study. The focus must be on health education, lifestyle modification and adherence to anti-hypertensive therapy to control hypertension in diabetic patients.
  2,566 331 2
Antihypertensive prescription patterns of nonspecialist general practitioners in Lagos, Nigeria
Babawale Taslim Bello, Cashmir Ezenwa Amadi, Christiana Oluwatoyin Amira, Amam Chinyere Mbakwem
January-June 2016, 14(1):6-10
DOI:10.4103/1118-4647.177530  
Context: Concerns have been expressed about the antihypertensive prescription patterns of nonspecialist physicians who care for the majority of patients with hypertension in developing countries. Aims: The aim of the study was to assess the antihypertensive prescription pattern of nonspecialist general medical practitioners in Lagos, Nigeria. Settings and Design: This was a cross-sectional survey carried out among nonspecialist general medical practitioners within Lagos State, Nigeria. Subjects and Methods: A total of 132 doctors completed questionnaires about their demographics, duration and location of practice, and antihypertensive prescription patterns. Statistical Analysis Used: Continuous variables are presented as means or medians while categorical variables are presented as percentages. Comparison between means was done using the Student's t-test, while comparison between percentages was carried out using Chi-square test. Results: Majority (61.2%) considered thiazide diuretics their first choice antihypertensive. The most frequently prescribed antihypertensives were calcium channel blockers (CCBs) (88.6%), thiazide diuretics (85.6%), and angiotensin converting enzyme inhibitors (ACEIs) (84.8%). These were also the most frequently combined with the CCB-thiazide diuretic combination being the most frequently prescribed (81.1%) followed by the ACEIs - thiazide diuretic combination (65.9%). The most frequently considered factors when prescribing antihypertensive medications were side effects of the medications (92.4%), additional benefits beyond blood pressure (BP) lowering (90.9%), patients' BP at the time of presentation (89.4%), dosage frequency of the drug (87.9%), and available scientific evidence for efficacy in lowering BP (87.1%). Conclusions: The antihypertensive prescription pattern of nonspecialist physicians practicing in Lagos aligns with current hypertension treatment guidelines.
  2,368 252 -
Assessment of level of adherence to antiretroviral therapy among human immune deficiency virus/acquired immune deficiency syndrome patients at Imo State University Teaching Hospital, Orlu, Nigeria
HN Chineke, Prosper O.U. Adogu, KA Uwakwe, MU Ewuzie
January-June 2015, 13(1):21-25
DOI:10.4103/1118-4647.158709  
Background: Antiretroviral therapy (ART) is not a cure for human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS), but rather it is used for optimal suppression of the viral load to an undetectable serum level, hence it remains a palliative measure to improve the quality of life and longevity by impeding the rate of disease progression. Objective: The objective was to evaluate the level of adherence, the prevailing contributory factors to adherence as well as nonadherence of HIV/AIDS patients to ART at Imo State University Teaching Hospital (IMSUTH), Orlu, Nigeria. Methodology: A descriptive cross-sectional study of HIV/AIDS patients receiving anti-retroviral drugs at IMSUTH, Orlu. It was carried out using interviewer - administered questionnaire involving 400 respondents. The collected data was analyzed manually using electronic calculator and results were presented in frequency tables. Results: The result showed a high level of adherence of HIV/AIDS patients to anti-retroviral drugs as 383 (96.2%) were adherent, while 15 (3.8%) were not adherent. Some reasons given for nonadherence to treatment were self-discouragement, toxicity of the drugs especially skin rashes, attitude of health workers, stigma, and distance to the hospital hence they may not be able to access their medications as and at when due. Conclusion: There is a significant high level of adherence of HIV/AIDS patients to ART at IMSUTH, Orlu, probably due to their high level of formal education as majority of the respondents 333 (83.0%) achieved at least a secondary level of education.
  2,164 263 -
A study of postural variation in peak expiratory flow rates in healthy adult female subjects in South India
Jenny Jayapal
January-June 2016, 14(1):11-13
DOI:10.4103/1118-4647.177531  
Background: Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR shows postural variation that follows a specific pattern in asthmatics and healthy individuals has been identified. Adequate data are not available for the postural variation in normal individuals, who are students in professional courses, and had a sedentary lifestyle. Lung volumes in normal subjects were significantly higher in a standing position. Others have reported that in healthy subjects spirometric indices were higher in the standing in comparison with the sitting position whereas other studies have reported no differences between spirometric values obtained in lying, sitting, and standing positions. Hence, this study is undertaken to study the postural variation in PEFR in healthy adult female subjects in South India. Methods: PEFR was recorded in 50 adult healthy female students aged 18-23 years and studying in professional courses (MBBS, BDS, Nursing, and MSc). Mini wright's peak flow meter was used to measure the PEFR. Three readings were taken PEFR in standing and lying posture. Best of three recordings is taken as the final value. Results: PEFR is decreased in lying posture compared to standing posture in subjects studied, and the quantum of difference was noted. Conclusion: In postural changes, PEFR measurements significantly differ based on whether the measurements are taken in the standing or in the lying posture in healthy participants. The effect of posture may be of importance in recording PEFR and changing to a better posture may be especially useful for those patients with weak expiration.
  2,171 243 -
Etiological pattern, clinical presentation, and management challenges of proptosis in a tertiary hospital in South West Nigeria
TO Otulana, OA Sogebi, HA Ajibode, OT Bodunde, OO Onabolu
July-December 2016, 14(2):28-32
DOI:10.4103/1118-4647.189746  
Background: The etiology of proptosis is diverse ranging from orbital problem to infiltrative disease and spread from contiguous sites including nasopharynx, paranasal sinuses, and sometimes distant structures. It can also be part of systemic illness affecting multiple tissues and organs. Aim: This study aims to determine the demographic pattern and etiology of proptosis in a tertiary health facility in South Western Nigeria and to discuss the management challenges. Methods: This is a clinic-based retrospective descriptive analysis of all patients that presented with proptosis at the Eye Clinic of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun state, Nigeria, over a 13-year period from 2000 to 2012. The hospital records of patients was used which was analyzed using Statistical package for Social sciences version 15. Results: A total of 175 cases of proptosis out of 15,266 new cases gave a hospital prevalence of 1.2%. The average age of the 138 patients analyzed was 37.8 years with a male to female ratio of 1:1. Children constituted 27.5%. Eighty-one (58.7%) patients presented within 1 month of onset of proptosis. Twenty-three (16.7%) had bilateral proptosis. Half of the studied population was secondary to orbital inflammation. The common causes of proptosis were infective 38.4%, mass/tumor 18.8%, noninfective inflammation 13%, and sinonasal diseases 10.9%. Eight (5.8%) were mucocele of paranasal sinuses. Thyroid-related eye disease and proptosis of vascular etiology were common in females. Computerized tomographic scan of the orbit and/or sinus/cranium was done in 11.4% of the patients. Thirty-seven (26.8%) patients defaulted. Conclusion: Infective process is the most common cause of proptosis from orbital cellulitis. Majority were unilateral with no sex predilection. Proptosis due to thyroid eye disease and vascular abnormality were found mostly in females. The management challenges were poor record keeping and inadequate personnel. Despite the threat to life and vision posed by some etiology of proptosis, a large number of the patients were unable to fund investigation and treatment while others defaulted from the facility.
  2,109 223 -
CASE REPORTS
Giant lipomas. A report of two cases
CD Emegoakor, CN Echezona, ME Onwukamuche, HO Nzeakor
July-December 2017, 15(2):46-49
DOI:10.4103/NJGP.NJGP_17_16  
Lipomas can be found in any region of the body and are the most common benign tumors of the adipose tissue. Giant lipomas have been reported to be any lipoma more than 10 cm in size along its widest diameter or more than 10 g in weight. Here we present two case reports of otherwise healthy patients who presented with unusually large tumors at different points in the same facility. Hence, it was needed to report our findings: A 27-year-old man with a 3-year history of a huge right gluteal swelling; A 56-year-old man with a 30-year history of a right lower limb mass. Physical examination and relevant radiological investigations were conducted to characterize and ascertain the extent of the two masses. They were excised surgically and underwent histology to confirm diagnosis. Despite the availability of improved health services, giant lipomas still exist.
  2,191 95 1
ORIGINAL ARTICLES
Effects of hypertension on left ventricular wall size in Nigerians from the Owerri heart study
Philip Chidi Njemanze, Josephine Njemanze, Cynthia Akuazaoku, Stella Nzeji, Chinwe Clara Ofoegbu, Ozioma Maduka, Adaeze A-Ojiaku
July-December 2014, 12(2):18-23
Background and Purpose - The rising prevalence of hypertension in Nigerians may account for the increase in rate of cardiac diseases, most often associated with left ventricular hypertrophy (LVH), an end-point measure of cardiac end-organ damage. The study cohort drawn from the Owerri Heart Study (OHS) were examined to determine the left ventricular posterior wall thickness (LVPWT) at the different levels of blood pressure according to the classification of the Seventh Joint National Committee (JNC 7) report. = Methods - One hundred and eighty consecutive patients including 108 men and 72 women of mean age 53.2+14years, were clinically evaluated by measurements of systolic (SBP) and diastolic (DBP) blood pressure using mercury sphygmomanometer. The blood pressures were classified according to the JNC 7 report. The LVH was determined by measurement of left ventricular posterior wall thickness (LVPWT) using twodimensional(2-D) Color Flow Echocardiography, Results - Patients with normal blood pressure (SBP = 114.7±11.7 mmHg, DBP = 69.4+3 mmHg) were n=17, the LVPWT = 14.1±2.2mm. Patients with Pre-hypertension (SBP = 133.8+18.5 mmHg, DBP = 80.1+0.85 mmHg) were n = 33, LVPWT = 15.4+2.74mm. Patients with Stage 1 hypertension (SBP = 144±13.9 mmHg, DBP = 90.1+0.9 mmHg) were n = 59, LVPWT = 15.2+2.6mm. Patients with Stage 2 hypertension (SBP = 159.6+20.6 mmHg. DBP = 106.7±10.4 mmHg) were n=71, LVPWT = 16.67+3.5mm. Analysis of variance (AN0VAJ revealed significant differences in SBP F(3, 176) = 37.68,p< 0.0001, DBP F(3,176) = 217.7,p<0.0001,andLVPWr/F(3,176) = 4.66,p< 0.01. Conclusion - The LVPWT at prehypertension did not differ significantly [p> 0.05) with the LVPWT of normatensives, hypertension Stage 1 and Stage 2. This may suggest that the distinction of prehypertension may include patients with blunted nocturnal fall in BP defined as 'non-dippers' that has been associated with increase in left ventricular mass index. This may suggest that, patients with prehypertension should be eval uated for LVH and if present, there should be no delay in early therapeutic intervention with antihypertensive drugs along lifestyle modification.
[ABSTRACT]   Full text not available  [PDF]
  816 1,378 -
Predictive value of institutional impact factor as an indirect measure of maternal mortality in Nigeria: A systematic review
Philip C Njemanze, Iheanyichukwu O Okoro
January-June 2015, 13(1):3-11
DOI:10.4103/1118-4647.158706  
Background: This study developed a novel measure termed as an institutional impact factor (IIF), which was used for predicting the trends of maternal mortality ratio (MMR) resulting from poor management of the health system. Methods: A total of 3518 publications from Nigeria in PubMed from 1975 to 2005, were used to obtain IIF for each institution studied. The study periods compared, were period A (1975-1989), period B (1990-2004), and period C (1990-2005). Results: The public health sector period A mean ± standard error (SE) IIF was 1.423 ± 0.09, and dropped significantly in period B, to IIF of 0.704 ± 0.024, P < 0.001. Conversely, in period A, the mean ± SE MMR, was 508.8 ± 115.7/100,000 live births, and rose significantly in period B to MMR of 1895.5 ± 363.7/100,000 live births, P < 0.05. The linear regression model suggested a negative correlation between IIF and MMR. The overall, F (1,18) =15.5, P < 0.001, R2 was 0.463, BETA coefficient was − 0.68, P < 0.0001. The intercept 2957.6 was significant, P < 0.0001. We predicted that the Millennium Development Goals 5 required a 75% drop in MMR to 127/100,000 live births, and IIF rise to 1.69, in 2015. Conclusion: The IIF may be a health metric index for monitoring efficiency of the health workforce.
  1,980 204 -
CASE REPORTS
Atypical presentations of hiatal hernia in two pediatric patients
Mohemmed Ajij, Shambhavi , Shalu Gupta
January-June 2017, 15(1):10-12
DOI:10.4103/1118-4647.201051  
Hiatal hernia is an uncommon condition in children. Its symptoms can vary markedly from none to life-threatening condition, thereby making its diagnosis challenging. We reported two different cases, first a 15-month-old child presenting with respiratory distress, second a 7-year-old boy presenting with resistant iron deficiency anemia. Surgical management was done in both cases, following which both of them improved. To the best of our knowledge, this is the first case report of hiatus hernia in children in this region, with such contrasting presentation. A stepwise and methodical approach to the patients led to early diagnosis.
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ORIGINAL ARTICLES
Assessing the influence of mass media on contraceptive use in Nigeria: A secondary analysis of 2013 Nigerian national demographic and health survey
Joseph Odirichukwu Ugboaja, Charlotte Blanche Oguejiofor, Emmanuel Okwudili Oranu, Anthony Osita Igwegbe
July-December 2018, 16(2):39-44
DOI:10.4103/NJGP.NJGP_25_17  
Background: The low contraceptive use in Africa has been severally linked to ignorance and misconceptions. Media platforms provide potential avenues for addressing these misconceptions. This study is aimed at evaluating the influence of media exposure on contraceptive use among Nigerian women. Materials and Methods: We conducted a weighted analysis of data from the 2013 Nigerian Demographic and Health Survey that included 38,948 women aged 15–19 years using STATA software, version 12.0 SE (Stata Corporation, TX, USA) to investigate the influence of media exposure on contraceptive use among Nigerian women using logistic regression models. The result was presented in odds ratio (OR) and 95% confidence interval (CI). Results: The contraceptive use among the respondents was 14.88%, comprising mainly of modern methods (64.2%; n = 3006). After controlling for age, educational status, religion, wealth status, and other potential confounding variables, the use of contraceptives was significantly associated with reading newspapers for at least once a week (OR = 1.16; 95% CI = 1.03–1.32), listening to radio for at least once a week (OR = 1.16; 95% CI = 1.01–1.32), and watching television for at least once a week (OR = 1.39; 95% CI = 1.20–1.61). There was an improvement in the odds in favor of contraceptive use among the women when the frequency of media exposure was increased to at least once a week. Conclusion: Contraceptive use among women in Nigeria is positively influenced by exposure to media which improves with increasing frequency of exposure. This finding provides a potential opportunity for improving contraceptive utilization in the country using the various mass media platforms.
  1,764 271 -
PERSPECTIVE
Ebola Virus Disease (EVD)
Ifeoina Anne Njellta, Chukwudi Uchenna Njelita
July-December 2014, 12(2):13-17
Full text not available  [PDF]
  511 1,386 -
CASE REPORT
That grossly enlarged abdomen is an unusual huge mesenteric cyst after all: case report and literature review
Thaddeus Chika Agu, Mary S Chukwu, Mary Philomena Ikeanusi
July-December 2015, 13(2):49-51
DOI:10.4103/1118-4647.170151  
We report a case of a married lady living with her husband for 8 years, who in the past 5 years developed an enlarging abdomen, which neighbors and in-laws thought was pregnancy but later turned out to be a huge mesenteric cyst. Arriving at a diagnosis by clinical methods and available tools with certainty failed and the inability to afford the state of the art diagnostic tools caused the surgeon to revert to exploratory laparotomy.
  1,704 184 -
Management of an extruded ventriculoperitoneal catheter coming through the umbilicus
Biodun Ogungbo, Olatunde Olawoye, Joy Ugochukwu Akudo, Peter Ebang
January-June 2016, 14(1):14-16
DOI:10.4103/1118-4647.177534  
Ventriculoperitoneal shunts are useful devices for treatment of hydrocephalus. Although effective, historically, the probability of shunt dysfunction is pretty high throughout the life. Migration of a ventriculoperitoneal shunt catheter is a rare but well-recognised complication in hydrocephalus treatment. Perforation into different organs or through natural or artificial orifices has been described. A 5-month-old baby presented to hospital with extrusion of her abdominal catheter through the umbilicus. This occurred spontaneously 2 months following placement of a ventriculoperitoneal shunt for hydrocephalus. This is the first report of this unusual complication in Abuja, Nigeria.
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CASE REPORTS
Benign migratory glossitis with scrotal tongue
Karthik Shunmugavelu
January-June 2017, 15(1):13-14
DOI:10.4103/1118-4647.201053  
Benign migratory glossitis (BMG), also known as geographic tongue, consists of migrating, painless white lesions of different sizes on the dorsum of the tongue. These areas are devoid of papillae. BMG may occur in a sole manner or in combination with scrotal tongue. In case of scrotal tongue, also known as fissured tongue, food particles may get accumulated in the deep fissures resulting in irritation of the tongue. This scientific article is a case report regarding a 20-year-old man who presented with a combination of BMG and scrotal tongue.
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