Tropical Journal of Medical Research

Research Irresponsibility and Misconduct: Predisposing Factors and Consequences

2023-09-16T16:00:43-05:00

Scientific misconduct can have serious consequences, such as avoidable disease or human loss as a result of erroneous information in the literature or the ongoing citation of retracted work. When current research or effort is based on previous, questionable, or fraudulent research, it can waste resources—both human and financial. The research careers of those who participate in misconduct may suffer as a result of article retractions and reputational consequences. Lack of appropriate training and skills, insufficient supervision or mentoring of the researcher, insufficient information, professional pressures, the researcher's personal psychology, and bureaucracy are all risk factors for research misconduct. The repercussions of research misconduct include dismissal from duty, imprisonment, suicide, failure to gain promotions, loss of editorships, dwindling research grants, graduate students unwillingness to join a research group, and early retirement. Academics should make every effort to prevent it.

A Review of the Management of Paediatric Brain Tumours

2022-11-13T00:22:55-06:00

Background: Brain tumours are the second commonest tumours in children, and are associated with high mortality rate. A large number of these brain tumours are undiagnosed, until they increase to considerable size, due to the expansible nature of the skull in infants, and the capacity of the developing brain to compensate for neurological deficits. Most have non-specific neurological features. Magnetic resonance imaging (MRI) scan is the radiological investigation of choice. The management of paediatric brain tumours entails multidisciplinary measures. Objectives: This is aimed at a general review of the management of paediatric brain tumours. Materials and methods: This study involved a review of existing literature using several search engines, such as Google scholar, Hinari, Scopus, Pubmed and other research tools. The search word was 'paediatric brain tumour, and also another search was the addition of 'Nigeria' to the earlier search words. Results: A total of 59 articles were seen which discussed childhood brain tumours, but 39 articles addressed paediatric brain tumours. Each was thoroughly reviewed and used in the framework of this manuscript. Conclusion: Paediatric brain tumours are heterogenous group of tumours, and presents with varied clinical features and most requires a multimodal approach of treatment.

Defect Reconstruction Post En Bloc Excision of Aggressive Giant Cell Tumor of the Distal Radius: A Report on Two Cases

2022-07-20T22:15:50-05:00

Giant cell tumor (GCT) though benign, represents a locally aggressive neoplasm characterized by proliferation of mononuclear cells, bone destruction and a high rate of recurrence. Management of aggressive GCT of the distal radius and reconstruction of resultant defect after excision remains a challenge. This is a report on two cases presenting with aggressive GCT of the distal radius with bone destruction and cortical breach of the distal radius. Both cases required an enbloc excision of the distal radius with a tumor free margin of 3cm, and subsequent reconstruction of the defect with a non-vascularized fibula graft and radiocarpal arthrodesis using a T-plate. Union was achieved in both cases. There were no reported infections, fractures or recurrence within the follow up period. Defect reconstruction of the distal radius following enbloc excision of the distal radius leads to satisfactory outcomes.

Giant Prostate with Persistent Haematuria Presenting as an Emergency: A Case Report Highlighting Management Challenges in a Resource Limited-Setting

2023-04-01T18:48:09-05:00

In benign prostatic hyperplasia, prostate size has not been correlated with presence or severity of symptoms. However, giant prostate weighing more than 200g is usually associated with symptoms especially significant haematuria. This can pose management challenge in emergency situation where resources are limited. We report a case of 500g prostate enlargement presenting as an emergency with recalcitrant haematuria. We highlighted the management challenges in a resource-limited setting and also reviewed relevant literature.

Primary Bilateral Multiple Ovarian Leiomyomata in a Patient with Gorlin-Goltz Syndrome: Would Intraoperative Frozen Section Have Prevented Surgical Menopause?

2023-06-12T15:04:40-05:00

Benign ovarian tumours are a diagnostic criterion for Gorlin-Goltz syndrome (GGS), especially when bilateral. We report this rare case of bilateral multiple ovarian fibroids that posed a diagnostic dilemma in a patient with Gorlin-Goltz syndrome. She is a 31-year-old nullipara, primarily infertile, referred with a 13-year history of lower abdominal swelling, a 22-week size pelvic mass, which was hard and slightly mobile, with no ascites. Tumour markers were normal. Abdominopelvic CT revealed multiple small bowel calcifications likely metastatic. Intraoperative findings were those of bilateral huge, extremely hard, craggy, multi-lobulated ovarian tumour measuring 28cmx12cm on the right and 20cmx10cm on the left. No grossly normal ovarian tissue identified. The appearance and consistency of the tumour raised a suspicion for malignancy. As there was no facility for intraoperative frozen section and patient was not consented for hysterectomy, bilateral salpingo-oophorectomy was done following second and third opinions. Histology revealed bilateral ovarian leiomyomata. During follow up, she was discovered to have major and minor criteria for Gorlin-Goltz syndrome. Patient is currently on hormone replacement therapy for menopausal symptoms and regular with follow up.

Prevalence of Hypertension and Relationship with Anthropometric Indices in Urban Dwellers in Kwara State, Nigeria

2022-11-12T22:54:15-06:00

Background: Hypertension is a growing public health concern with a rising prevalence and associated clinical outcomes, particularly in Nigeria. The association of hypertension with anthropometric indices is insufficiently described in Nigeria. Objectives: We aim to determine the prevalence of hypertension and its relationship with anthropometric indices. Materials and Methods: This is a cross-sectional study of adults in seven urban communities in Kwara State, Nigeria. The study was done during World Kidney Day over a seven year period (2007-2015). Blood pressure, body mass index, waist circumference, and hip circumference were measured. Hypertension was defined as blood pressure ≥ 140/90mmHg. Results: One thousand five hundred and six adults were recruited, with a mean age of 44 ± 14 years, and a female preponderance (55%). The prevalence of hypertension was 30%, (30.2%) in males and (29.8% in females). Hypertension correlates significantly with age (r = 0.416, P = 0.001), BMI (r = 0.301, P = 0.001), hip circumference (r = 0.219, P = 0.001), waist-hip ratio (r = 0.225, P = 0.005), and waist circumference (r = 0.063, P = 0.045). The identified predictors of hypertension were; waist circumference had about 17% increased risk for hypertension (OR = 1.169, CI = 1.021 – 1.340, P = 0.024), body mass index, 11% (OR = 1.113, CI = 1.059–1.170, P = 0.001), and age 5% (OR = 1.052, CI = 1.034 – 1.070, P = 0.001).Conclusion:The prevalence of hypertension is high in urban population of Kwara State, and is similar in men and women, but it increases with age, high body mass index, and waist circumference.

Aetiology and Outcome of Obstetric- Related Acute Kidney Injury in Benue State University Teaching Hospital, Makurdi, Nigeria: A Three year Review

2022-11-01T15:15:51-05:00

Background: Obstetric (Pregnancy related) Acute Kidney Injury is a global health problem associated with significant fetal and maternal morbidity and mortality. Acute Kidney Injury in pregnancy is usually due to obstetric complications such as septic abortion, abruptio placental, uterine haemorrhage, intrauterine fetal death, puerperal sepsis and preeclampsia-eclampsia. Several studies conducted across the world revealed variations in the aetiology of pregnancy related Acute Kidney Injury. Objectives: This study aimed to determine the common aetiologies and outcome of patients with Obstetric Acute Kidney Injury treated in Benue State University Teaching Hospital Makurdi over a 3 year period. Methods: This was a three (3) year retrospective study of 21 patients with Obstetric Acute Kidney Injury. The socio-demographic information, aetiology, treatment and outcome of treatment were extracted from patients hospital records. Results: The mean age of the study population was 29.3±5.23. Common causes of obstetric Acute Kidney Injury were postpartum haemorrhage, puerperal sepsis, pre-eclampsia – eclampsia. and post-abortal sepsis. Twelve (12)(57.1%) were managed conservatively, while nine 9 (42.9%) had haemodialysis. Six (6) (28.57%) died while fifteen 15 (71.4%) recovered. Conclusion: Obstetric-related Acute Kidney Injury is a common cause of maternal and fetal morbidity and mortality in our environment. Postpartum haemorrhage and sepsis were the commonest cause of obstetric Acute Kidney Injury. The mortality is high owing mainly to late presentation. Early presentation, early diagnosis and treatment as well as making haemodialysis affordable are key to improving outcomes of patients with Obstetric- related Acute kidney injury.

Epidemiological Pattern and Outcome of Surgically Treated Cranial and Intracranial Suppurative Lesions in a Public Tertiary Health Institution in Anambra: A 13-Year Experience

2022-08-13T18:26:38-05:00

Background: The improvement and increasing availability of diagnostic and treatment armamentarium has continued to improve the outcome of cranial and intracranial abscesses. Over the years, the epidemiological pattern, aetiology and outcome varied with regions. Objective: We present here the patterns and outcome of management of these lesions in a tertiary health institution in Anambra State, Nigeria. Materials and methods: This is a retrospective study involving patients managed for cranial and intracranial suppurative lesions between 2007 and 2020. Demographic data, aetiology, presenting symptoms, site of lesions, surgery done and outcome were collected and analysed with simple descriptive statistical tools like mean, median, standard deviation as well as charts and tables. Ethical clearance was obtained. Results: There were 1432 neurosurgical procedures done in the period, 43 of which were cranial and intracranial abscesses accounting for 3.0% (43/1432). Male preponderance (30/43) was observed. Most of the patients were below 5 years (12/43). For the entire cranial and intracranial lesions, frontal lobe was the most common lobe affected anatomic area (19/43). More than one lobe was affected in 58.1% (25/43) of cases. Craniectomy was the most common surgery done. Average length of hospital stay was 6.3±4.2 weeks. Recently, the number of cases treated per year is on the increase. Four mortalities were recorded. Conclusion: Young males are more affected. Frontal lobe is the most affected anatomic region. Near 10% mortality was recorded. Increasing cases are being witnessed in the facility hence there is a need for improved capacity to manage the emerging trend.

Pattern of HIV, Hepatitis B and Hepatitis C Viral Infections among Pterygium Patients in Onitsha, Nigeria

2022-09-01T19:01:00-05:00

Background: Human immunodeficiency virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are avoidable diseases that have remained serious global health issues. This is because of serious morbidity and mortality that result from these diseases. Objectives: To determine the pattern of HIV, HBV and HCV infections among pterygium patients in Southeast Nigeria. Materials and Method: This was a retrospective cross sectional study of patients that underwent pterygium surgeries at City of Refuge specialist eye clinic in Onitsha, Nigeria, between March 2021 and February 2022. Case files of patients were retrieved, and relevant data like sociodemographics and HIV, HBV and HCV serostatus were collected. Data obtained were analyzed using the Statistical Package for Social Sciences (version 23.0; SPSS Inc., Chicago, IL). Statistical significance was set at p˂0.05. Results: Data collected from 227 participants who met inclusion criteria were analyzed. The mean age of the participants was 54.1±13.63 years. The overall prevalence of HBV, HCV and HIV among pterygium patients was 0.44% (1/227, 95%CI=0.01-2.45), 1.76% (4/227, 95%CI=0.48-4.51) and 16.74% (38/227, 95%CI=11.85-22.98) respectively. The prevalence of HBV and HCV were not influenced by age or gender while the prevalence of HIV was influenced by age (p=0.002). Conclusion: The prevalence of HBV, HCV, and HIV are high among pterygium patients in south-east Nigeria. Professional support regarding universal precautions and prevention approaches should be recommended among health care providers in ophthalmology practice.

Epidemiological Studies of Malaria in Gboko Metropolis, Gboko Local Government Area of Benue State, Nigeria

2023-02-04T10:50:43-06:00

Background: Malaria remains a significant parasitic disease of public health importance in the world due to the morbidity and mortality associated with the disease. Objectives: We carried out an epidemiological study of malaria in Gboko metropolis in Gboko Local Government Area of Benue State, North - Central Nigeria, to determine the malaria prevalence, risk factors, and perceptions of malaria eradication among patients attending hospital clinics between the months of April and June, 2021. Materials and Methods: We used Rapid Diagnostic Test (RDT), thin blood and thick blood film microscopy for the parasitological investigations of the blood samples of four hundred and fifteen (415) hospital patients. Also, structured questionnaire was administered to the same individuals to obtain information on malaria management practices of the people. Chi-square test P<0.05 was used to check for relationships between prevalence of malaria and other parameters in the study. Results: The prevalence rate for both sampling methods used were found to be (55.7%) 231/415 and all (100%) were parasitic infections of Plasmodium falciparum. There was significant difference (p<0.05) in both the prevalence by age and hospital. The intensity of malaria infection showed that 45.9% (106/231) had moderate infection with no significant difference. The administration of questionnaire in the study shows that the respondents in Gboko demonstrated a good knowledge of malaria. Conclusion: Malaria public enlightenment efforts should be intensified to make malaria elimination not just possible but also achievable in Gboko Metropolis, Gboko Local Government Area of Benue State, Nigeria.

Awareness, Attitude, and Anxiety of Radiographers in the Management of COVID-19 Patients in a Nigerian Population

2022-12-25T16:16:56-06:00

Background: Healthcare workers which included radiographers are extremely strained during the course of any pandemic because of their role as key players in response to a pandemic. Imaging, especially chest radiograph and computed tomography (CT) have emerged as key components of COVID-19 patient investigation and management pathways. Objectives: This study assessed the Awareness, attitude and anxiety of medical radiographers in the management of COVID-19 patients. Materials and Methods: Forty-four (44) practicing radiographers in government and private hospitals and diagnositic centers within Anambra State participated in the study. A validated questionnaire designed according to the objectives and developed based on, awareness, attitude and anxiety of radiographers in management of COVID-19 patient was used. Only those that were properly filled were used in the final data analysis. The data were analyzed using Microsoft's™ Statistical Package for Social Sciences (SPSS) version 20. Results: This showed that 29 respondents (65.91%) are highly aware of COVID-19 infection, 14 (31.85%) were aware, and 0 (0.00%) are not aware. Their attitude toward attending to COVID-19 patients showed that 31.82% (14) gladly accepted, 22.73% (10) said that they will resign and leave the profession, 29.55% (13) would do it grudgingly, while 15.91% (7) stated other reasons for attending to COVID-19 patients. The anxiety revealed that there is the possibility of getting a COVID-19 infection, to which 54.55% (24) strongly agreed, 40.91% (18) agreed, and 2.27% (1) strongly disagreed. Conclusion: Radiographers are aware of COVID-19 infection, and the majority show a poor attitude and high anxiety level in attending to infected patients.

Serum Adiponectin and its Relationship with Insulin Resistance in Nigerian Children

2023-08-08T18:24:14-05:00

Background: Adiponectin, an excellent insulin sensitizer, holds immense potential in the management of Type 2 diabetes mellitus (T2DM) and other non-communicable diseases (NCDs). Despite insulin resistance being a known risk factor for NCDs, the precise association between adiponectin and insulin resistance in Nigerian children remains largely unexplored. Objectives: To examine the association between serum adiponectin and insulin resistance among Nigerian children. Materials and Methods: 172 primary school children aged 4-12 years were randomly enrolled in this study. Anthropometric measurements, including body mass index (BMI) and waist circumference, were recorded. Serum adiponectin levels, fasting blood glucose, and insulin levels were measured. Insulin resistance was assessed using HOMA-IR and FGIR. Results: Mean adiponectin levels were higher in females compared to males (p = 0.23). Insulin resistance was observed in 5.2% of children using HOMA-IR and in 1.7% using FGIR. Following adjustment for age, gender and BMI, a unit increase in adiponectin was associated with decreased odds of insulin resistance (OR: 0.956; 95% CI: 0.722-1.266). Increased adiposity was significantly associated with insulin resistance. Conclusion: This study offers significant contributions to our understanding of the association between serum adiponectin levels and insulin resistance in Nigerian children and explores the potential role of adiponectin in the management of T2DM and other NCDs. The insights gained from this study hold promise in informing targeted interventions and shaping future management strategies for NCDs in African populations.

Morbidity Pattern and Illness Variances among the Elderly seen in General Outpatient Department of Comprehensive Health Centre, Ukpo, South East Nigeria

2022-10-04T19:10:34-05:00

Background: The elderly constitute the fastest-growing age group globally, with a significant increase occurring in developing countries. They develop health deterioration due to increased incidence of chronic diseases, which leads to morbidity that poses challenges and burdens to the healthcare system. Objectives: This study sought to assess the morbidity pattern among elderly patients seen in the General Outpatient Department (GOPD) of a comprehensive health centre, Ukpo, in Anambra, South East, Nigeria. Materials and Methods: This was a retrospective review of data from medical records of 140 elderly patients who visited the facility from January 1st 2016 to December 31st 2020. Information obtained included age, occupational status, place of domicile, and diagnosis. Data were analysed using the SPSS version 20 software package. Results: Out of 140 elderly patients seen within the study period, females accounted for 72.90%, and only 14.29% of the geriatric morbidity were due to communicable diseases, predominantly Malaria (14.3%). Their mean age and standard deviation was 75.6 ± 5.7 years. Diseases like Hypertension (37.1%) and Arthritis (23.6%) were the most common non-communicable diseases. Chi-square analysis showed a strong relationship between age and distribution of morbidities among the elderly population of this study (p<0.001). Conclusion: Non-communicable diseases like Hypertension, Arthritis, and Cataract were common in the elderly population of this study. There is a need to provide facilities to cater to the health needs of this special population.

Effectiveness of Anthracycline Based Neoadjuvant Chemotherapy in Tumour Size Reduction in Pre-Menopausal Women with Locally Advanced Breast Cancer

2023-04-01T18:54:25-05:00

Background: Neo-adjuvant chemotherapy (NAC) has been demonstrated as a helpful strategy and the standard of care in the multimodal management of locally advanced breast cancer. Objectives: This study aims to evaluate the effectiveness of anthracycline-based neoadjuvant chemotherapy in down-staging locally advanced breast cancer in pre-menopausal women. Materials and Methods: The size of the primary breast tumor was measured initially, after each course of chemotherapy, and three weeks after the 4th course of NAC. Four courses of the regimen: cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) were given every three weeks. Medication response was evaluated using a modification of the RECIST methodology. The data were analyzed using the SPSS statistical software version 23.0. (Statistical Package for Social Sciences SPSS Inc.). Results: Only 49 patients were able to complete the four courses of neoadjuvant chemotherapy. The age of the study population ranged from 24 to 54 (40.92±7.98) years. The pre-chemotherapy sizes of the breast masses ranged from 3.0-25.0 (9.70±4.33) cm. The mean size of the breast masses after 1st to 4th course were:8.26±4.13cm, 6.72±4.32cm, 6.09±4.97cm, and 5.79±5.35cm respectively. The size reduction was significant, with Spearman's correlation coefficients Sr values of 0.869, 0.667, 0.619, and 0.599 from 1st to 4th course. Nine (18.4%) of the 49 patients have achieved clinical complete response (cCR) after 4 courses of NAC. Conclusion: Neoadjuvant chemotherapy using combined cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) was found to be very effective in the management of locally advanced breast cancer in premenopausal women.

A Radiology Perspective: The Effectiveness of Safety Devices in Patients with Traumatic Head Injury at NAUTH, Nnewi

2023-04-19T00:46:14-05:00

Background: Road traffic accidents in Nigeria remain the leading cause of head injuries. The use of helmets, seat belts, and car seats for young children has been advocated to reduce the severity of traumatic head injury (TBI) but the implementation of these gadgets is yet to come into full effect. Objectives: We aim to determine the association between the use of safety devices with the Glasgow coma scale (GCS) and Rotterdam CT score in patients with TBI. Materials and Methods: A total of 170 participants with a traumatic brain injury (TBI) were recruited. A quick GCS examination, and a brain computed tomography (CT) scan was done. Results: A total of 137(80.6%) participants had abnormal CT findings while 33(19.4%) had normal CT findings. 58 participants did not use safety helmets and 14 had a Rotterdam score of 1. All 14 participants who used safety helmets had a Rotterdam score of 1. Rotterdam score of 2-3 was seen in 16(27.6%) participants who did not use safety helmets. The Rotterdam score of 4-6 was recorded in 30(31.7%) participants in patients without safety gear. There was a statistically significant correlation between the use of safety devices and the severity of head injury (assessed by GCS and Rotterdam score) in MCRTA and MVRTA (p < 0.001). A greater proportion without safety devices had severe head injuries. Conclusion: With the use of safety devices, the severity of traumatic head injuries was less.

Uterine Artery Doppler Indices in the Second and Third Trimester in Women with Normal Singleton Pregnancy

2023-04-29T03:39:15-05:00

Background: The maternal mortality rate has declined since 1990 but many women still die from pregnancy-related causes and during childbirth, especially in developing countries like Nigeria. Doppler ultrasound has a non-invasive, accurate method of evaluating the uterine arteries and it reflects any changes in placental perfusion through the Doppler velocimetry. Objectives: To determine the pulsatility index (PI), resistivity index (RI), end-diastolic velocity (EDV), peak systolic velocity (PSV), and systolic/ diastolic ratio (S/D) of the right and left uterine arteries in the second and third trimesters of a normal singleton gestation. Materials and Methods: A study of 176 singleton pregnancies of patients 18yrs and above taken at 21-25 weeks and 31-35 weeks gestation for each patient. Blood pressure and urine protein were checked at each visit. Results: The right and left uterine arteries respectively in the second trimester; PI - 1.01+/-0.26, 1.03+/-0.27, RI - 0.598+/-0.07, 0.606+/-0.09, PSV - 88.33+/-44.70, 92.60+/-50.56, EDV - 38.46+/-22.01, 41.35+/-26.94, S/D - 2.43+/-0.58, 2.44+/-0.59. The right and left uterine arteries respectively in the third trimester; PI - 0.89+/-0.22, 0.88+/-0.21, RI - 0.55+/-0.07, 0.54+/-0.06, PSV - 106.69+/-57.66, 139.83+/-56.33, EDV - 50.14+/-23.91, 66.99+/-28.30, S/D - 2.15+/-0.49, 2.14+/-0.37. A statistically significant difference in the parameters from the second to the third trimester, an increase in the PSV and EDV value, and a decrease in the PI, RI, and S/D values. Conclusion: A valuable regional nomogram for singleton gestation has been established with which to compare Doppler indices values in high-risk pregnancies.

Outcome of Preliminary Total Hip and Knee Arthroplasty Surgeries in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria: A Retrospective Study

2023-05-12T18:55:11-05:00

Background: Total joint replacement is a major orthopaedic procedure. The aim is to alleviate pain, improve function, and correct disability in a diseased joint thereby improving health-related quality of life of the individual. Objectives: To review the outcome of total knee and hip replacement surgeries in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. Materials and Methods: This is a retrospective analytic study on the outcome of total hip and knee joint replacement surgeries done from 2015 to 2019, at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. Relevant information, including pre and post-operative assessment scores, was obtained from the case files of patients. The data was analyzed using Statistical Package for Social Sciences SPSS version 20. Results: Twenty-three primary total joint replacements were done in 20 patients within the period studied. There were 5 males and 15 females giving a male-to-female ratio of 1:3. Mean age of the patients was 64.0 + 9.1 years, ranging from 15 years to 82 years. The indication for surgery in all the cases was severe osteoarthritis with deformities in 65% of cases. The mean duration of illness before intervention was 6 + 4 years ranging from 1 to 15 years. Short-term knee score improved from a mean of 24 to 45, while hip score improved from a mean of 54 to 95. Conclusion: The short-term results suggest a successful outcome with minimal complications. Total joint replacement was found to improve the clinical symptoms the patients presented with.

Sonographic Determination of Thyroid Gland Volume among Pregnant Women Attending Murtala Muhammad Specialist Hospital Kano, Nigeria

2023-05-16T15:46:40-05:00

Background: In Kano state, there is a lack of documented thyroid volume data for pregnant women using ultrasound, potentially leading to misdiagnosis of goitre caused by thyroid gland enlargement during pregnancy. Objectives: This study aimed to determine the thyroid gland volume of pregnant women at Murtala Muhammad Specialist Hospital (MMSH) using ultrasound. Materials and Methods: The study took place at MMSH Kano from January 2021 to January 2023, with 300 pregnant women and 100 controls. Ultrasound scans were performed using a Toshiba TA321 Ultrasound machine. Thyroid lobe volume was calculated with the formula A × B × C × 0.479. Statistical analysis used SPSS version 21.0, employing ANOVA and independent t-tests for comparisons, and Pearson's coefficient correlation for relationships.Results: The total thyroid volume for non-gravid and gravid participants in the first, second, and third trimesters was 8.45±1.55 cm3, 7.38±2.37 cm3, 9.01±3.31 cm3, and 9.37±3.57 cm3, respectively. Significant differences were observed in demographic variables and thyroid volumes, except for age and height. There was no significant difference in right thyroid volume (RTV) and total thyroid volume (TTV) between the control and pregnant groups. However, a significant difference was found in left thyroid volume (LTV) between the groups. A moderate positive correlation was observed between TTV and weight, BMI, and BSA, while a weak positive correlation was seen with age and height. Conclusion: This study determined the thyroid gland volume in pregnant patients in Kano state, showing a progressive increase with advancing trimesters.

A Mixed-Method Study of Mental Health Practices and Policy among practitioners in Southern Nigeria

2023-06-16T04:55:51-05:00

Background: The Community Mental Health Model (CMHM) is suggested by the World Health Organization as appropriate for the effective delivery of mental health care. However, the state of Nigeria's mental health care is precarious. This is particularly traceable to the lack of awareness, stigmatization, inadequate or poor services, as well as ineffective government policies. Objectives: The goal of this study was to investigate mental health practices and policy implementation among mental healthcare practitioners in Southern Nigeria. Materials and Methods: The mixed-method research leveraged on quantitative and qualitative data which used a total population and purposive sampling respectively. Data collection was via a researcher-administered questionnaire, and in-depth interviews. Results: Data analysis using SPSS Version 20 and NVivo 12 revealed that the mental healthcare model in the study area is a combination of out-patient, in-patient, and CMHM. Participants showed a good level of awareness of CMHM. They also identified barriers to mental healthcare, including stigmatization and financial constraints. While most participants acknowledged the adoption of the Nigerian mental health policy of 2013, its implementation was notably inadequate. Conclusion: A strong necessity to reform Nigeria's existing mental health care with a proper policy guide is imperative in this study. This will tilt the nation towards international standards and global best practices, and guarantee the most efficient and effective mental health service delivery to the Nigerian people.

A Retrospective Study on Gender-Related Differences in Clinical Events of Sickle Cell Disease: A Single Centre Experience

2023-05-12T19:01:02-05:00

Background: Sickle cell disease (SCD) is a genetic disorder, prevalent in Sub-Saharan Africa, especially in Nigeria with a high rate of mortality and morbidity due to poor socioeconomic structure amongst other factors. Devising risk stratification through inexpensive means may serve as an important tool for early detection and management of complications of SCD. Objective: To determine the impact of gender on the clinical events amongst children living with SCD. Materials and Methods: This was a retrospective study carried out at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra, Nigeria. Medical notes were obtained from medical records department. Data on demographic variables, weight, full blood count result, blood transfusions history, hospital admissions and complications were obtained. p value of < 0.05 was considered statistically significant. Results: 45 cases were reviewed, of which 23 (51.1%) were males and 22 (48.9%) were females with a mean age of 9.8±3.9 years. The mean haemoglobin concentration, WBC, neutrophil, lymphocyte, and platelet counts of the study group were 9.94± 4.58 g/dl, 13.86 ±8.15x109/l, 6.71± 4.37x 109/l, 6.79±4.51 x109/. There was no statistically significant relationship with gender (p values: 0.457, 0.495, 0.893, 0.319, 0.137 respectively. The frequency of vaso-occlusive crisis and chronic leg ulcers were more in males, although this was not statistically significant (p=0.291, 0.699 respectively). Females were shown to have more cases of osteomyelitis but this was not statistically significant (p=0.459). Conclusion: We found no statistically significant relationship between gender and clinical events in SCD patients, although other studies reported otherwise. A larger, multicentre study is recommended.

Health-Related Quality of Life of Obese Patients Presenting at the General Outpatient Clinic of a Tertiary Hospital in South-Eastern Nigeria

2023-05-12T18:04:13-05:00

Background: Obesity and overweight are linked to more deaths than underweight. It is associated with reduced quality of life and poor mental health outcomes. Together with its associated comorbidities, obesity produces a significant reduction in health-related quality of life (HRQoL). While it is known that obesity decreases HRQoL in people, little information regarding the quality of life in obese patients in this environment is available. Objectives: The study sought to determine the quality of life of obese individuals presenting to the General outpatient clinic. Materials and Methods: A cross-sectional descriptive survey was conducted at the General Out-patient Clinic of Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria among obese patients. Data was collected using a pre-tested interviewer-administered questionnaire and the SF-36 form to assess their HRQoL. Results were analyzed using SPSS V25. Results: The mean age of respondents was 46.9 years. The mean body mass index (BMI) was 36.4 with a significant difference in the mean physical and mental component scores among the different BMI classes. Males had higher physical component scores than females. Age, occupation, marital status, and parity were significant predictors of HRQoL. Conclusion: The decline in quality of life increases as the BMI increases. There is a need to involve the various components of quality of life domains that are affected in the management of obesity. A therapeutic approach with an emphasis on increasing the quality of life in physical, emotional, and mental domains will likely facilitate easier weight loss.

Improved Fertility Potential of Ethanolic Leaf Extracts of Petroselinum Crispum

2023-07-11T18:10:28-05:00

Background: Parsley (Petroselinum crispum) is a bright green biennial plant in temperate climates and it is an annual herb in tropical and subtropical areas. Objectives: This work was aimed at evaluating the effect of the ethanolic leaf extract of parsley (P. crispum) on the histology of the ovaries and the reproductive hormone (oestrogen). Materials and Methods: A total of fifteen (15) adult female Wistar rats were used, they were divided into three groups each comprising of five rats. The groupings were as follows: Group A (Normal Control), Group B (825mg/kg per body weight of parsley leaves ethanolic extract), Group C (1,650mg/kg per body weight of parsley leaves ethanolic extract). The extract was administered through orogastric tube daily for 28 days after which the animals were sacrificed using chloroform. The ovaries were excised and processed histologically using Hematoxylin and Eosin stains and blood was collected for oestrogen hormone assay. Results: There were no signs of toxicity on body weight and there were no significant changes in the cytoarchitecture of the ovary of low dose group. However, in the high dose group, administered 1,650mg/kg bw of the extract results showed a significant increase in the oestrogen level of the animals and fatty infiltration in the ovarian cytoplasm. Conclusion: Ethanolic leaf extracts of Petroselinum crispum has the potential of improving fertility through its action on estrogen hormone levels, at high doses.

Risk Factors for Hepatitis B Virus Transmission among Adolescents in Secondary Schools in Onitsha, South-Eastern Nigeria

2023-05-12T18:13:08-05:00

Background: Hepatitis B virus (HBV) infection is a highly contagious disease of public health importance which is hyperendemic in Nigeria. Horizontal transmission is a major route of spread and adolescents are susceptible because of their high-risk behaviours. Objectives: The risk factors for hepatitis B virus transmission among apparently healthy adolescents in secondary school in Onitsha were determined. Materials and Methods: This was a cross-sectional descriptive study among adolescents in secondary schools in Onitsha using a multi-staged sampling technique. Enzyme-linked immunosorbent assay (ELISA) was used for qualitative detection of Hepatitis B surface antigen (HBsAg) in the serum samples. Risk factors for transmission of HBV were obtained through semi-structured questionnaires. Simple descriptive statistics, chi-square and odds ratio were determined using the statistical package for the social sciences (SPSS 20). Results: In the study group the following variables were significantly associated with the risk of HBV transmission: blood transfusion (p<0.001), sexual activity (p<0.001), sharing of personal items (p<0.001), use of illicit drugs (p=0.003), contact with a person with jaundice (p=0.012), tattoo/scarification (p=0.005) and ear piercing (p=0.045). Conclusion: The observed risk factors enhance horizontal transmission of HBV among these adolescents and contribute to the existing high prevalence of HBV infection in Nigeria. Targeted health education through school health programs is crucial to enable the study area meet up with the World Health Organization's target of 90% reduction in new cases of HBV infection by 2030.

Clinical Profile of Scabies: A Cross-Sectional Study in a Southeastern Nigerian Hospital

2023-07-02T17:43:07-05:00

Background: Scabies is a common skin infestation caused by ectoparasite, Sarcoptes scabei var. hominis. The disease is ubiquitous and affects all age groups. It is spread by direct or indirect contact with an infected person or via fomites. Clinical features frequently vary necessitating occasional missed diagnoses. A knowledge of the diverse clinical patterns will improve diagnostic accuracy, especially in atypical presentations. Objectives: To evaluate the clinical profile of scabies in patients presenting to the dermatology clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria. Materials and Methods: It was a cross-sectional study and was conducted from January to December 2019. All patients diagnosed with scabies during the study period were recruited. The diagnosis was clinical. The clinical features and patient characteristics were documented. Results: A total number of 96 patients were enrolled. Two-thirds were males while a third were females. The frequently affected sites were the buttocks, genitals, ankles, and wrists. The commonest presenting features were itching, papules, scales, and nodules. Papular scabies were the most common type of scabies seen. Conclusion: Papular scabies remain the most common type of scabies. Many cases are often misdiagnosed. Self-medication with triple action creams was a popular practice among our patients, a practice which may mask the typical presentation of the symptoms (itch) and signs (Scabies incognito)