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   2010| January-March  | Volume 19 | Issue 1  
    Online since December 3, 2020

 
 
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MEDICAL EDUCATION
Multiple Choice Questions in Morbid Anatomy

January-March 2010, 19(1):115-117
Full text not available  [PDF]
  162 20 -
ORIGINAL ARTICLES
Management of Eclampsia at AKTH: Before and After Magnesium Sulphate

January-March 2010, 19(1):104-107
Background: Eclampsia contributes significantly to maternal and perinatal morbidity and mortality in Nigeria. The world Health Organisation recommended Magnesium Sulphate as the most effective, safe and low cost drug for the treatment of eclamptic seizures and for prophylaxis in severe pre-eclamptic. This study is aimed to evaluate the effect of the introduction of magnesium sulphate for the management of eclamptic seizures on maternal and fetal indices in Aminu Kano Teaching Hospital [AKTH], Kano. Methods: A retrospective study of all patients who presented with eclampsia in AKTH, Kano. The study period included 3 years prior to introduction of magnesium sulphate [January 2002- December 2004] and 3 years after its introduction [January 2005 – December 2007]. Results: During the study period, the prevalence of eclampsia was 1.02% [1: 97 deliveries]. Sixty six [50.5%] of the patients were aged 19 and below. Approximately 62% of the patients were primigravida and 87% were unbooked. Thirty eight [29%] were treated with diazepam while ninety three [71%] were treated with magnesium sulphate. 39.4% of those treated with diazepam died compared to 15% of those treated with magnesium sulphate. Approximately ninety percent of those that died had no antenatal care. Overall perinatal mortality rate in this study was 312 per 1000 births [41]. 368.4 per 1000 births among those treated with diazepam and 296.7 per 1000 births in the magnesium sulphate group. Approximately nine percent of those treated with magnesium sulphate develop toxicity [85.5% renal and 12% respiratory] Conclusion: This study is in support of the findings that magnesium sulphate is superior to diazepam in the reduction of maternal morbidity and mortality.
[ABSTRACT]   Full text not available  [PDF]
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Haemoglobin Genotypes: A Prevalence Study and Implications for Reproductive Health in Uyo, Nigeria

January-March 2010, 19(1):36-41
Background: Haemoglobinopathies are among the most common genetic disorders worldwide, inherited as autosomal recessive disorders from healthy-carrier parents. The most common are the sickle cell disorders and the thalassaemias, occurring in people of African, Asian, South European and Middle Eastern descent. The University of Uyo Teaching hospital (UUTH), Uyo, Akwa Ibom state, Nigeria is a tertiary health institution providing the health needs of the host and neighbouring states in South-south and South East Nigeria. There is currently paucity of data on the haemoglobin genotype distribution in Akwa Ibom state, hence the need for this study, considering its importance in medical diagnosis, patient management, genetic information and counselling. Methods: This is a retrospective study. Registers and results of all haemoglobin genotype investigations carried out in the department of Haematology, University of Uyo Teaching Hospital, Uyo between January, 2003 and December, 2007 were extracted, reviewed and analyzed using simple percentages. Results: Eight thousand and ninety seven Haemoglobin genotype tests carried out over a five year period were analysed: 6376 (78.7%) of these were HbAA, 1580 (19.6%) HbAS, 121 (1.5%) HbSS, while HbAC and SC accounted for 16 (0.2%) and 4 (0.04%) respectively. The ratios of Hb AA to Hb AS, HbAA to HbSS and HbAA to HbAC were 4:1,52:1 and 400:1 respectively. Of the 8097 subjects, 6723(83.0%) were females, 1152 (14.2%) were males. Among the females, 4.8% of HbSS and HbSc were in children under 15 years while only 0.3% were in those 15–44 years. Conclusion: While HbAA is the predominant genotype in our environment, there is also a significant number of the abnormal haemoglobin genes. With many children with sickle cell disease now surviving to adulthood due to advances in medicine, a larger number of women with sickle cell disease in pregnancy with all the attendant challenges it poses should be expected in our environment. It is necessary therefore, to keep abreast with developments in the area of its management in order to cope with the challenges.
[ABSTRACT]   Full text not available  [PDF]
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Experience in the Use of Epidural Anaesthesia

January-March 2010, 19(1):31-35
Background: Epidural anaesthesia is applicable for a wide range of surgical procedures and offers distinct advantages over general and spinal anaesthesia. It is however underutilised in our environment. We report a one year experience in the use of this technique. Our objective is to describe a one year experience in the use of epidural anaesthesia with emphasis on the scope and safety in our institution. Method: A retrospective study of all patients that had epidural anaesthesia over a one year period for different procedures. Case notes and anaesthetic records were studied and analysed using EPI info 3.2.1. software. Results: Thirty two patients had epidural anaesthesia over the period. Majority (18 cases) were caesarean sections (56.3%). There were 9 general surgical cases (28.1%), four gynaecologic (12.0%) and one orthopaedic (3.1%) cases. Of the five complications observed (15.6%), only two could be traced to the technique of anaesthesia and the lone mortality (3.1%) was unconnected. Conclusion: We conclude that epidural anaesthesia is applicable to a wide range of procedures within and across disciplines in our practice and is both easy to perform and safe.
[ABSTRACT]   Full text not available  [PDF]
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A -Five Year Review of the Complications of Progestogen only Injectable Contraceptive at the University of Port-Harcourt Teaching Hospital

January-March 2010, 19(1):87-95
Background: The injectable progestogen only contraceptive is a widely accepted method of contraception in our environment and very little has been reported on its complications in our environment. The aim of the study was to highlight the complications associated with use of Injectable Medroxyprogesterone Acetate and Norethisterone Enanthate in clients at the University of Port- Harcourt Teaching Hospital, Port-Harcourt, South- South Nigeria Methods: It was a - 5 year retrospective study of the clients who accepted and used progestogen only injectable contraceptives (depot medroxyprogesterone acetate and noerthistherone enantate) at the family planning units of the University of Port Harcourt Teaching Hospital between 1st January 2000 and 31st December 2004. The case files of these clients were retrieved their data extracted. The information included the clients sociodemographic characteristics, the types doses of of injectable contraceptives received and the side effects reported at the follow up visits. The data was coded and entered into a data bank and analysed using SPSS for windows 11.0 version. Results: Seven hundred and seventy seven (777) injectable contraceptive acceptors out of the 1720 contraceptive acceptors during the study period. This accounted for 45.17% of the new acceptors over the 5 years period, making the injectable contraceptives the most commonly used method of birth control in UPTH. Five hundred and five (505) clients took depot medroxyprogesterone acetate (DMPA) while 272 used norethesterone enanthate (NE-ET). The mean age of the injectable contraceptive users was 31.31±5.5 years and the mean parity was 5.5±2.5 deliveries. The users reported multiple side effects with 579 episodes. Secondary amenorrhea was the commonest side effect occurring in 350 (45.34%) clients. Others were hypertension in 17 (2.94%) and metabolic disturbances in 14 (2.41%). Conclusion: Injectable progestogen only contraceptive is associated with multiple side effects, with secondary amenorrhoea being the most common. The contraceptive failure rate of this method in our women is low.
[ABSTRACT]   Full text not available  [PDF]
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Pelvic Types as Seen in a Tropical Setting

January-March 2010, 19(1):42-45
Background: Cephalo pelvic disproportion is still the leading indication for caesarean section in many developing countries and the contribution of pelvic typology may play some role in this regard. Our objective is to determine the proportion of pelvic types as seen in a tropical setting. Method: A retrospective review of preliminary films of hysterosalpingography of 400 women who underwent the study between January 2000 and December 2007 was reviewed to determine the pelvic typology. Result: Of the 400 films reviewed, 361 (90.3%) were gynaecoid, 36 (9%) were android and 3 (0.8%) were andropoid. There was no platypelloid pelvis seen in the films reviewed and a mixed type pattern was not observed in this study. Conclusion: The proportion of pure gynaecoid pelvis seen in this review is about the highest reported in the literature.
[ABSTRACT]   Full text not available  [PDF]
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REVIEW ARTICLES
Oxidative Stress Following Traumatic Brain Injury: Enhancement of Endogenous Antioxidant Defence Systems and the Promise of Improved Outcome

January-March 2010, 19(1):14-21
Background: Management of brain injury can pose enormous challenges to the health team. There are many studies aimed at discovering or developing pharmacotherapeutic agents targeted at improving outcome of head-injured patients. This paper reviews the role of oxidative stress in neuronal loss following traumatic brain injury and presents experimental and clinical evidence of the role of exogenous antioxidants as neuroprotectants. Method: We reviewed published literature on reactive oxygen species and their role in experimental and clinical brain injuries in journals and the Internet using Yahoo and Google search engines. Results: Traumatic brain injury causes massive production of reactive oxygen species with resultant oxidative stress. In experimental brain injury, exogenous antioxidants are useful in limiting oxidative damage. Results with clinical brain injury are however more varied. Conclusion: Oxidative stress due to excessive generation of reactive oxygen species with consequent impairment of endogenous antioxidant defence mechanisms plays a significant role in the secondary events leading to neuronal death. Enhancement of the defence mechanisms through the use of exogenous antioxidants may be neuroprotective, especially if the agents can penetrate cell membranes, are able to cross the blood-brain barrier and if they are administered within the neuroprotective time window.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Prevalence of Anaemia in HIV-Infected Children at the University of Abuja Teaching Hospital, Gwagwalada

January-March 2010, 19(1):50-57
Background: Use of highly active antiretroviral therapy (HAART) has remained the only regimen potent enough to reduce viral replication in HIV-infected individuals. Its combination with co-trimoxazole has also been recommended in those with CD4% of less than 15%. The use of HAART containing zidovudine (ZDV) in combination with co-trimoxazole carries the risk of anaemia in already anaemic predisposed individuals from HIV infections, opportunistic infections, parasitic infestations, sickle cell anaemia, and malnutrition. The aim of the study is to document the effect of use of combination of HAART containing ZDV with co-trimoxazole in haemoglobin profile of HIV-infected children after one year of its administration at the University of Abuja Teaching Hospital (UATH), Gwagwalada. It is also aimed at comparing the result obtained with those on stavudine containing HAART with co-trimoxazole. Method: A two year prospective study of HIV- infected children on treatment with HAART in combination with co-trimoxazole, and attending the paediatric outpatient special treatment clinic (POSTC) for HIV infected children at the UATH, Gwagwalada from November 2006 to October 2008, was carried out to determine effect of these drug combinations in the haemoglobin profile of infected children. Three monthly PCV level was carried out using haematocrit centrifuge and reader. Results: A total of 173 patients were started on HAART during the first year recruitment period, 90 (52.0%) were males, while 83 (48.0%) females, giving a male to female ratio of 1.1:1. One hundred and seventeen (67.7%) of patients were on ZDV containing HAART, while 56 (32.3%) were on stavudine containing combination. All patients were started on co-trimoxazole prophylaxis with the exception of 6 (3.5%) patients because of drug reaction. The mean PCV of patients on ZDV containing combination with co- trimoxazole decreased from 30.2 ± 5.5% to 29.0 ± 2.3%, with a net decrease of 1.2% after one year treatment, those on stavudine containing combination with co-trimoxazole instead showed an increased from initial PCV of 28.3± 4.2% to 34.2 ± 3.0% with a net increase of 5.9% after the same duration of treatment, (p>0.05). While patients on ZDV combination alone without co-trimoxazole prophylaxis had a minimal decrease of 0.9% in their PCV level after one year treatment, those on stavudine combination alone without any prophylaxis instead showed an increase of 6.8% in their PCV after the same duration of treatment. Conclusion: A combination of HAART containing ZDV plus co-trimoxazole carries risk of anaemia than that of stavudine containing combination with co-trimoxazole. Such combination should therefore not be given to anaemic patients. Regular check in PCV of patients on HAART combination with ZDV and additional co-trimoxazole prophylaxis is required for early detection of significant drop in PCV level.
[ABSTRACT]   Full text not available  [PDF]
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Outcome of Management of Non-Gonococcal Septic Arthritis at National Orthopaedic Hospital, Enugu, Nigeria

January-March 2010, 19(1):69-76
Background: Septic arthritis is an acute bacterial infection of a synovial joint. It is an orthopaedic emergency that can lead to morbidity or mortality if not properly treated. The fundamental issues in the management of septic arthritis include the duration of antibiotic therapy, the mode of joint drainage and the role of physiotherapy. There is paucity of local data on septic arthritis in Nigeria. The study was carried out at the National Orthopaedic Hospital, Enugu; a regional trauma and orthopaedic center with wide catchments area covering at least three geopolitical zones of Nigeria. The objective of the study is to describe the pattern and distribution of non-gonococcal septic arthritis, the causative organisms, and the outcome of management of this condition at Enugu, Nigeria and make recommendations on the antibiotic therapy. Method: A retrospective study of all the patients that presented at the National Orthopaedic Hospital Enugu with Non-gonococcal septic arthritis between January 1997 and December, 2006 was done. The patient's case notes were retrieved from the Medical Record Department. Information extracted and analyzed included demographic data, joints affected, cultured organisms, antibiotic sensitivity pattern, duration of parenteral and oral antibiotics therapy, complications and follow-up period. Patients with incomplete records, immune-compromised patients and those with subjacent osteomyelitis were excluded from thestudy. Result: Forty-three patients were seen within the period and 40 had analyzable data. The age range was 1 month to 39 years, with a mean age of 10.2 years. Twenty-one patients (52.5%) were males and 19 (47.5%) were females. The hip joint was the most commonly affected (47.5%). Staphylococcus aureus was the most common organism (50%), followed by Coliforms (42.5%). Most patients (75%) had parenteral antibiotics for 3-5 days, while 77.5% of patients received oral antibiotics for 2-4 weeks. All the patients had arthrotomy and joint irrigation within 48 hours of admission. Complications were recorded in 11 patients (27.5%). Fixed flexion deformity was the commonest complication (17.5%). No mortality was recorded. Conclusion: Septic arthritis is an orthopaedic emergency. Early diagnosis and prompt treatment with appropriate antibiotics and surgical drainage are the keys to a successful outcome. In our environment (Enugu), the coliforms are competing favourably with staphylococcus aureus as causative agents of septic arthritis. Short term parenteral antibiotics of 3–5 days seems to be as effective as the 1–2 weeks therapy in the non-immune compromised patients and in cases not complicated by juxtarticular osteomyelitis or presence of prosthetic implants.
[ABSTRACT]   Full text not available  [PDF]
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The Remarkable Beneficial Effect of Adding Oral Simvastatin to Topical Betamethasone for Treatment of Psoriasis: A Double-blind, Randomized, Placebo-controlled Study

January-March 2010, 19(1):58-61
Background: Psoriasis is a common chronic inflammatory disease with unpredictable prognosis. Given the immunomodulatory effects of statins, the present study was conducted to determine whether the addition of orally administered simvastatin to the topical betamethasone, a standard antipsoriatic treatment, can produce a more powerful therapeutic response against this clinical conundrum. Method: In a double-blind study, 30 patients with plaque type psoriasis were randomly divided into two equal treatment groups. Group 1 received oral simvastatin (40 mg/d) plus topical steroid (50% betamethasone in petrolatum) for 8 weeks and group 2 received oral placebo plus the same topical steroid for the same time period. Psoriasis Area and Severity Index (PASI) score was checked before and at the end of the treatment period. Results: PASI score decreased significantly in both groups, but the decline of PASI score was more significant in patients who received simvastatin (Mann-Whitney test; P-value=0.001). No side effect or any laboratory abnormality was detected in patients. Conclusion: Our work, which is the first double-blind, randomized, placebo-controlled study on this subject, shows that oral simvastatin enhances the therapeutic effect of topical steroids against psoriasis. The increased risk of cardiovascular accidents in psoriatic patients and the protective effect of statins against cardiovascular disease further encourages their use in the treatment of this clinical conundrum.
[ABSTRACT]   Full text not available  [PDF]
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The Role of Adenoidal Obstruction in the Pathogenesis of Otitis Media with Effusion in Nigerian Children

January-March 2010, 19(1):62-68
Background: Although adenoidectomy is generally applied in the treatment of otitis media with effusion (OME), there is still much debate about the role of adenoid in the pathogenesis of OME. The purpose of this study is to determine the incidence of OME in children with obstructive adenoid disease in comparison with normal control, and the degree of nasopharyngeal obstruction by adenoid as it relates to the development of OME in Nigerian children. Method: Controlled, prospective clinical study was carried out. Diagnosis of OME was made with finding of type B tympanogram on tympanometry evaluation. The incidence of OME among adenoidal patients was compared with its incidence in normal control. The degree of nasopharyngeal obstruction among the adenoidal subjects was evaluated with an adenoidal-nasopharyngeal ratio parameter obtained from soft tissue radiograph of nasopharynx, and was related to the results of tympanometric evaluation of the adenoidal subjects. Results: The incidence of OME was significantly higher in the adenoidal children than the normal control (p < 0.001). The risk of OME was more than 7 times as more among adenoidal group than among the non-adenoidal control. Gross nasopharyngeal obstruction was significantly associated with type B tympanogram (p= 0.002). The diagnosis of OME correlated significantly with the degree of nasopharyngeal obstruction (r=0.32; p = 0.002). Conclusion: Our study found adenoid obstruction as a significant risk factor for OME in children. The risk of OME increases with the increasing degree of nasopharyngeal obstruction.
[ABSTRACT]   Full text not available  [PDF]
  62 23 -
Self-Medication Profile of Dental Patients in Ondo State, Nigeria

January-March 2010, 19(1):96-103
Background: The practice of selfmedication has been extensively researched but there is dearth of information about its modality among dental patients in developing countries. Hence, this study was designed to determine the proportion of dental patients who practice, medications employed and the reasons for resorting to self medication in general dental populations in Ondo State, Nigeria and to make appropriate recommendations. Methods: This study was conducted between June 2007 and June 2008 at the Federal Medical Centre, Owo and State Specialist Hospital, Akure, Ondo State, Nigeria. Five hundred and thirty six consenting respondents were selected by multistage sampling technique and interviewed with the aid of semi structured questionnaire. Results: Almost half of the respondents (42% or n=225) admitted to self medication while the majority (58%) did not practice it. Drugs utilized are usually singly (56.4%) rather than in combination (43.6%), commonly analgesics (50.1%) and antibiotics (30.4%), with the majority (45.8%) using the medications for at least one week. The reasons cited by respondents for self medication were their perception that they know what to do and it saves time and money. Conclusion: A sizable majority of the respondents admitted to self-medication usually with analgesics. Adequate health education of the populace on the use and misuse of analgesics needs to be mounted, while dental services should be made readily available and affordable so that self medication among dental patients can be reduced to the barest minimum.
[ABSTRACT]   Full text not available  [PDF]
  56 27 -
Effect of low intensity continuous training programme on serum uric acid in the non pharmacological management of hypertension: A randomized controlled trial

January-March 2010, 19(1):77-86
Background: Elevated serum uric acid (SUA) is considered to be positively associated with cardiovascular event risk factor in hypertension. Also, the positive role of exercise in the management of Hypertension has been well and long established. However the relationship between SUA level and hypertensive management particularly in non pharmacological technique is ambiguous and unclear. Therefore the purpose of the present study was to determine the effect of continuous low intensity training programme on SUA level and cardiovascular parameters in male subjects with hypertension. Method: Two hundred and seventeen male patients with mild to moderate (systolic blood pressure [SBP] between 140-180 & diastolic blood pressure [DBP] between 90-109 mmHg) essential hypertension were age matched and grouped into continuous and control groups. The continuous (n=112; 58.63 ± 7.22 years) group involved in an 8 weeks interval training (35-9% HR max reserve) programme of between 45 minutes to 60 minutes, while age-matched controls hypertensive (n=105; 58.27± 6.24 years) group remain sedentary during this period. Cardiovascular parameters (SBP, DBP & VO2max) and SUA were assessed. Students’t and Pearson correlation tests were used in data analysis. Results: Findings of the study revealed significant effect of interval training programme on VO2 max, SBP, and DBP and SUA concentration at p< 0.05 and changes in VO2max negatively correlated with SUA (r=-.266)at p<0.05. Conclusion: it was concluded that low intensity continuous training programme is an effective non- pharmacological management and may prevent cardiovascular event through the down regulation of SUA in hypertension.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Bronchopulmonary Dysplasia in a Premature Infant Case Report and Literature Review

January-March 2010, 19(1):108-111
Background: Bronchopulmonary dysplasia is an important cause of morbidity and mortality in premature infants. The aim of this study is to present a premature, extremely low birth weight infant with bronchopulmonary dysplasia. Method: A review of the case records of a child with recurrent respiratory distress and the relevant literature. Results: A preterm, extremely low birth weight baby (birth weight was 0.8 Kg), delivered by emergency caesarian section for previous caesarian section and prolonged rupture of fetal membranes at 27 weeks gestational age. She had spontaneous breathing at birth (APGAR scores were 8 in one minute and 10 in 5 minutes). She developed respiratory distress with cyanosis and became oxygen dependent from the second week of life. Examination revealed severe dyspnoea with grunting respiration, tachypnoea, cyanosis and crackles in the lung fields. Chest X-ray showed hyperinflation, right lower zone patchy consolidation with obliteration of the costophrenic angle. Echocardiography was however normal. She was successively managed with intermittent oxygen, dexamethasone, salbutamol and antibiotics (ceftriaxone). She was nursed in the incubator for 3 months. There was no episode of apneic attack throughout admission. She responded to treatment and was discharged home on intermittent oxygen therapy and nebulisation. The weight on discharge was 1.6kg. At 6 months of age, she is still having recurrent respiratory distress and supplemental oxygen at home. She is regular to follow up with recurrent episodes of wheeze requiring admissions. Conclusion: Bronchopulmonary dysplasia should be suspected in a premature extremely low birth weight infant with early recurrent respiratory distress.
[ABSTRACT]   Full text not available  [PDF]
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REVIEW ARTICLES
Malaria Vaccine: The Pros and Cons

January-March 2010, 19(1):8-13
Background: Malaria is an important parasitic disease of humans caused by infection with a parasite of the genus Plasmodium and transmitted by female anopheles. Infection caused by P. falciparum is the most serious of all the other species (P. ovale, P. vivaxand P. malariae) especially in terms of morbidity and mortality hence the reason why most of the research has been focussed on this species. The disease affects up to about 40 per cent of the world's population with around 300-500 million people currently infected and mainly in the tropics. It has a high morbidity and mortality especially in resource-poor tropical and subtropical regions with an economic fall of about US$ 12 billion annually in Africa alone. Method: relevant literatures were reviewed from medical journals, library search and internet source. Other relevant websites like PATH, Malaria Vaccine Initiative and Global Fund were also visited to source for information. The key words employed were: malaria, vaccine, anopheles mosquito, insecticide treated bed-nets, pyrethroids and Plasmodium. Results: several studies have underscored the need to develop an effective human malaria vaccine for the control and possible eradication of malaria across the globe with the view to reduce the morbidity and mortality associated with the disease, improve on the social and economic losses and also protect those at risk. Conclusion: It is very obvious that the need for effective human malaria vaccine is not only to serve those living in malaria endemic regions but also the non-immune travellers especially those travelling to malaria endemic areas; this would offer cost effective means of preventing the disease, reducing the morbidity and mortality associated with it in addition to closing the gap left by other control measures. It is very obvious that there is no single control measure known to be effective in the control of malaria, hence the need for combination of more than one method with the aim of achieving synergy in the total control and possible eradication of the disease. It suffices to say that despite the use of combination of more than one method (e.g. drugs treating patients, breaking the life cycle of the vector mosquito using larvicides, clearing swamps and other mosquito breeding sites), no much progress was made towards achieving this goal, hence the renewed interest especially with regards to vaccine development.
[ABSTRACT]   Full text not available  [PDF]
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Laparoscopic General Surgery – The Journey So Far

January-March 2010, 19(1):22-30
Background: Laparoscopic surgery has evolved in a relatively short time to become a popular and integral part of the surgical armamentarium. An overview of developments which have taken place since its inception is presented. Methods: The PubMed database was searched for all English language literature. Further references were obtained through cross-referencing the bibliography cited in each work and using books from the authors’collection. Conclusion: Laparoscopic surgery has developed rapidly, initially from a basically diagnostic procedure to a therapeutic one which is currently challenging time-honoured traditional methods of surgery. Technological advancements and enthusiasm as well as the desire for scar less surgery appear to be poised to push even further the frontiers of this discipline.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Risk Factors for Placenta Praevia in Jos, North Central Nigeria

January-March 2010, 19(1):46-49
Background: Placenta praevia, a major cause of obstetric haemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on risk factors for placenta praevia have been published, data obtained from the sub-Saharan Africa remains scanty. Our objective is to describe the spectrum of risk factors for placenta praevia in Jos, North Central Nigeria. Methods: This was a retrospective cohort study of 96 women delivered form January, 1999 to December, 2002 at Jos University Teaching Hospital, Jos, Nigeria. Data on total number of deliveries, maternal age, parity, and past obstetrics history and abortion were carefully extracted from medical records and analyzed using the Epi Info 3.4.1 (CDC, Atlanta, Georgia). Results: The prevalence of placenta praevia was 0.89%. Previous uterine evacuation was documented in 35.4% of cases, while previous caesarean section scar occurred in 5.2% of cases. About half (44.8%) of the cases had no known risk factor. Conclusion: Uterine scaring following abortion management is an important risk factor for placenta praevia. However, majority of patients with placenta praevia in this work have no identifiable risk factor.
[ABSTRACT]   Full text not available  [PDF]
  56 13 -
EDITORIAL
Mental Health and Employment

January-March 2010, 19(1):5-7
Full text not available  [PDF]
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CASE REPORTS
Disseminated Cutaneous Leishmaniasis in HIV positive patient - A Case Report

January-March 2010, 19(1):112-114
Disseminated cutaneous leishmaniasis and HIV dual-infection is seldom reported. Leishmaniasis and HIV co-infection may intensify the immune defect and is the chief reason for atypical presentation and widespread progression of cutaneous leishmaniasis and its defiance to conventional therapy. Here we report a 38-year-old HIV-positive lady who presented with a 6-month history of a progressive papule and nodular eruptions of leishmaniasis on face, trunk and extremities that was recalcitrant to treatment.
[ABSTRACT]   Full text not available  [PDF]
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