Ebonyi Medical Journal

Epigenetics And Fetal Alcohol Spectrum Disorders (FASD)

2013-03-11T11:27:59+00:00

No Abstract.

Intraocular pressure and visual acuity across the phases of the menstrual cycle in Nigerian women

2013-03-11T11:27:59+00:00

Context: Available literature suggests that the pattern of variation in intraocular pressure (IOP) in different phases of the menstrual cycle is inconsistent. Results from studies on the effects of oestrogen and progesterone alone or in combination, on IOP have been conflicting.
Aim: To determine the pattern of changes in IOP and visual acuity during the different phases of the menstrual cycle in healthy Nigerian women.
Method: This was a cross sectional descriptive study. One hundred women aged 20 to 35 years, with a regular 27-29 days cycle were examined during the follicular, ovulation and luteal phases of the menstrual cycle. The
women were examined for three consecutive cycles and mean values were computed.
Results: Intraocular pressure decreased in the follicular phase and rose in the luteal phase. Mean IOP during the follicular phase was 16.7 ± 1.6 mmHg. At mid-cycle, IOP was 15.0 ± 1.7 mmHg and during the luteal
phase, IOP was 16.0 ± 1.5 mmHg. The difference in mean IOP during the follicular phase and mid-cycle period was significant ( p<0.05). Also, the difference in mean IOP between ovulation and the luteal phase was
significant (p<0.05). There was no significant difference in mean visual acuity values across the different phases of the menstrual cycle, (p>0.05).
Conclusion: Intraocular pressure increases during the luteal phase of the menstrual cycle in normal female subjects, an effect that could relate to mildly impaired vision and non-compliance with contact lens wear.
Keywords: Pressure, acuity, vision, follicular, luteal.

Profile of Blindness and Low Vision at Ebonyi State University Teaching Hospital (EBSUTH) Abakaliki

2013-03-11T11:27:59+00:00

Background: Anecdotal data from EBSUTH suggest a high burden of glaucoma blindness.
Objective: To describe the causes of blindness among patients seen at the eye clinic of EBSUTH, Abakaliki.
Methodology: This is a prospective, descriptive study. The sample size consists of all consecutive new patients seen at the eye clinic over a 7- month period. The relevant data were the biodata, presenting visual
acuity (PVA) and clinical diagnosis for each patient. Data analysis was done using SPSS version 16. Analysis was by means of simple tables and pie charts showing frequencies, percentages and proportions. Relationship
between socio-demographic variables and PVA were tested using the chi squared statistic. Significance was set at p < 0.05.
Result: Out of 781 patients examined, 194(24.9%) were visually impaired. This includes 103 (13.2%) blind (PVA<3/60) and 91 (11.7%) with low vision (PVA <6/18 to 3/60), in the better eye. Age >40 yrs was 2 strongly associated with blindness (x =56.36; p=0.0001). Cataract and glaucoma accounted for 43% and 42% of blindness respectively. Causes of low vision were cataract 31%, refractive errors 24%, glaucoma 16%, pterygium 7%, Eye trauma 4%.,infective conjunctivitis 3% ,central corneal opacity 2% and others 9%.

Conclusion: Cataract and glaucoma were the commonest causes of blindness in this study population accounting for 85 % of the burden of blindness. The glaucoma blindness of 42% is higher than that obtained from similar studies in other centres. This calls for further studies to elicit the factors responsible for this.

Key Words: Blindness, low vision, visual impairment, glaucoma, Abakaliki - Nigeria

Presentation, Pattern and Outcome Of Breast Cancer In A Poor Economy: A Definition Of The Tripod Of Ignorance, Disease And Poverty

2013-03-11T11:27:59+00:00

Context: Most cases of breast cancer in developing countries present in advanced stages for several reasons.
Aims: The aim of this study was to determine the stage at which patients with breast cancer presented, evaluate reasons for late presentation and determine impact on outcome.
Methods: A six-year prospective study (2005-2010) was carried out by means of a structured questionnaire. All consenting patients of breast cancer that presented to the hospital were included in the study. Data on
clinical presentation, management and outcome of management were obtained from the case files. Data were analysed using percentages and tables.
Results: With most cases occurring in the 5 decade, there were 309 cases of breast cancer with patients in stages 3 and 4 accounting for 67%. There were only seven males. Over 22% of the patients presented after a year of noticing the symptom of breast cancer. Fear of mastectomy (24%), visit to prayer houses (18.3%), financial constraints (18.3%) and ignorance (16.3%) were the commonest reasons for late presentation. The commonest histological type was invasive ductal carcinoma (73%). Of the 206 patients that accepted mastectomy, 172 patients were in stages 3 and 4. Only 105 patients (including 18 mortalities) in stages 3 and 4 could be followed up for an average duration of one year.

Conclusion: Most patients with breast cancer present late to hospital for various reasons with attendant poor outcome. Follow up of patients is quite challenging. Health education is required to emphasise the importanceof early presentation.

Key Words: Cancer, Late, ignorance, poverty, poor outcomes.

Postpartum Depression Among Igbo Women In An Urban Mission Hospital, South East Nigeria

2013-03-11T11:27:59+00:00

Context: Postpartum depression adversely affects mothers, their newborn infants, their partners and the society. Its timely diagnosis is highly desirable.
Objective: To assess the prevalence and associated sociodemographic variables of Postpartum depression among women of Igbo Ethnic origin attending an urban mission hospital in Enugu, South East Nigeria.
Method: One hundred and eighty six women of Igbo Ethnic group attending postnatal clinic at six weeks postpartum were consecutively recruited in a descriptive cross sectional study. Postpartum depression was
assessed, using the Edinburgh Postnatal Depression Scale (EPDS).
Results: The prevalence of postpartum depression among the respondents was 30.6% at an Edinburgh Postnatal Depression scale (EPDS) cut off score of 10 and 15% when a more stringent cut off score of 13 was
used. Socioeconomic status of the respondents and depression were significantly associated, with women of lower socioeconomic status being more likely to be depressed than women of higher socioeconomic status. No significant association was found between Age or Parity and postpartum depression.
Conclusion: The study demonstrated that significant number of Igbo ethnic women attending postnatal clinic in the Urban Mission Hospital in Enugu metropolis screened positive for postpartum depression. Obstetricians
should therefore be encouraged to routinely screen women for postpartum depression during their postnatal visits. This will ensure early identification and referral of affected mothers for appropriate intervention.

Keywords: Postpartum, Depression, Igbo, Prevalence, Nigeria.

Infection control in Dental Laboratories: A survey of Nigerian dental technology students

2013-03-11T11:27:59+00:00

Context: Transmission of infection may occur in laboratory oral healthcare setting with undermined infection control.
Objective: To assess infection control knowledge and confidence in protecting self from occupational acquisition of HIV infection among Nigerian dental technology students.
Methods: This questionnaire-based cross-sectional survey of dental technology students of Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted in 2010.
Results: The infection control knowledge among the respondents in this study was high. The roles of dental technologists in infection control expressed by the respondents were use of protective wares-(74.3%),
sterilization-(39.4%), disinfection of impression-(13.1%), proper instrument handling-(9.1%) and hand washing-(4.0%). A total of 68.2% of the respondents asserted that infection can be transmitted from impression with 44.4% of them pinpointing tuberculosis as the most likely transmissible infection. The majority (87.9%) of the respondents expressed confidence in the ability to protect self from occupational HIV
acquisition. More than half (57.1%) of the respondents reported having adequate HIV-related knowledge for information delivery to the patients and public.
Conclusion: Overall the infection control knowledge and expressed confidence in the ability to protect self from occupation HIV acquisition was good in this study.

Key words: Knowledge, infection control, transmission, dental technology students.

Self-reported periodontal problems and oral hygiene practices among pregnant women in antenatal clinic in Benin City, Nigeria

2013-03-11T11:27:59+00:00

Context: Periodontal disease is prevalent among pregnant women especially those with suboptimal oral hygiene practices.
Objective: To assess the self-reported periodontal problems and oral hygiene practices among pregnant women attending the antenatal clinic, University of Benin Teaching Hospital (UBTH), Benin-City, Nigeria.
Methods: This prospective study was conducted among 300 randomly selected pregnant women attending the antenatal clinic of UBTH, Benin-City, Nigeria. Questionnaire elicited information on demography,
periodontal problems, mode and frequency of tooth cleaning, utilisation of dental healthcare services. Data was analysed using SPSS version 16.0. P<0.05 was considered statistically significant.
Results: Of the 300 respondents enrolled in the study, 288 completed the questionnaire. The majority (48.4%) were aged 25-30 years and mean age was 29.5 ± 3.57 years. Periodontal problems reported by the respondents were food packing (58.3%), gingival bleeding (23.6%), gingival swelling (21.9%), tooth mobility (4.9%), and tooth loss due to periodontal disease (3.1%). On self perceived oral health status, 137 (47.6%) assessed their oral health as good. The majority (92.7%) of the respondents used toothbrush and paste for cleaning. There existed significant association between age and oral hygiene methods (P<0.05). More than half (58.3%) and 3.1% of the respondents cleaned their teeth once-daily and use dental floss respectively. About 14.3% of the respondents had undergone scaling and polishing. About two-third (66.3%) of the respondents had never visited the dentist and 84.4% had not seen the dentist within the last 12 months.
Conclusion: Data revealed that periodontal problems and poor oral hygiene practices were prevalent among the respondents.

Keywords: Periodontal problems; oral hygiene practices; pregnant women

Health Seeking Behaviour and Access to Health Care Facilities at the Primary level in Nigeria: our experience.

2013-03-11T11:27:59+00:00

Context: Health care at the primary level is accepted as the model for delivering basic health care to low income populations especially in developing countries such as Nigeria. Despite all the efforts and strategiesadapted in Nigeria, there is still high level of morbidity and mortality from the diseases primary health care (PHC) is expected to control. The aim of this study was to determine the effect of limited knowledge and accessto primary health care services on the health-seeking behaviour of Nigerians

Methods: We carried out a multistage cross-sectional study in 10 health centres in Nigeria using qualitative and quantitative research methods. A semi-structured questionnaire was administered to the health care providers and patients while an in-depth interview was also conducted amongst the community members where the health centers were situated.

Results: Out of the 166 questionnaires distributed, 161 (97%) were returned anonymously while 32 interviews were conducted giving a total of 193 response rate. One hundred and eleven (57%) seek health care at the health centres, 121 (62.7%) patent medicine stores, 87 (45%) medicine vendors, 100 (51.8%) private clinics, 56 (29%) prayer houses, 118 (61.1%) traditional healers. The commonest reason (79.8%) for preferred choice of visit was accessibility to health care services.

Conclusion: Limited access to health care services and poor service organization of the primary health care (PHC) in Nigeria have been identified as reasons for seeking health care in an unothordox method, which often expose individual to the lure of witch doctors who claim to have cure to almost all the diseases Therefore, the PHC service organizations in Nigeria should among other things provide access to health care services and also appreciate the need for health outreach programme and communication in rural areas.

Keywords: Health care services, Accessibility, Health-seeking behavour, Nigeria.

Perforated Duodenal Ulcer: A Review Of Fourteen Consecutive Patients

2013-03-11T11:27:59+00:00

Context: Due to the dire nature of perforated peptic ulcer, fatality could occur if prompt surgical intervention is not employed. Poor prognostic factors include delay in presentation, co-morbid medical factors and preoperative shock.
Objective: To review patients of perforated peptic ulcer seen over a four-year period (2008 -2012); examining for outcomes and prognostic indices.
Methods: The available records of patients that had laparatomy for perforated peptic ulcer over the four year period at Central hospital Warri and Delta state university teaching hospital were accessed and relevant data of age, symptoms at presentation, duration of symptoms, intraoperative findings and outcome were studied.
Results: There ten male and four female patients. Their mean age of 39.9 (+15.7) years. The duration from the commencement of symptoms to surgical intervention ranged between 72 and 216 hours (three to nine
days), mean 5.1 (+1.9) days. No case was diagnosed within 48hours of occurrence. Epigastric pain, vomiting and abdominal swelling were commonest symptoms. Perforation occurred at the duodenum in ten patients while four patients had gastric perforation Chest X-ray available in five patients showed pneumoperitoneum in three patients. Omental patch closure was done in all the patients with an intrabdominal drain left in the
paracolic gutter or pelvis. Two of the patients (14.3%) developed residual intrabdominal abscesses. A singular case of omental repair leak was recorded. No incidence of reperforation was noted. Deaths occurred in four
patients (29%); three of the deaths occurring within 24 hours of intervention. The demised patients had diagnosis and intervention five days from the commencement of symptoms. Hypotension at presentation was a poor prognostic sign.

Conclusion: Presentation after 24 hours was not an adverse prognostic factor in our patients contrary to published literature. However, delay in presentation at 120 hours (five days) and preoperative hypotensionwere observed in the demised patients. The absence of a functional ventilator in the intervening centres, contributed to the mortality recorded in this series. We strongly implore that skilled anaesthesia be employed at surgery on these patients.

Key words: Perforation, duodenum, gastric, ulcer

Morphological Patterns Of Malignant Melanoma In Benin-City, South-South, Nigeria

2013-03-11T11:27:59+00:00

Context: Malignant melanoma ranked among the top 10 most common malignancies in developed countries. It remains a major skin cancer with considerable geographical, racial and ethnical variation worldwide.
Objective: The purpose of this study is to determine the frequency and morphological patterns and variants of malignant melanoma in University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.
Materials and Methods: Data of surgical biopsies from the skin received at the department of Histopathology, over a twenty-five year period (January 1982 to December 2007) were reviewed. The sources of information were surgical pathology day books, duplicates of histology cards and reports. Information derived includes socio-demographic data on age, sex, hospital numbers, clinical features and diagnosis. Corresponding slides were retrieved for histopathology examination. Skin cancers were categorized using the W.H.O classification
Results: One hundred and eight seven malignant skin biopsies were seen in the Department during the period. Of these, malignant melanoma was the most common and accounted for (32.6%). The peak age incidence was
th seen in the 5 decade with a male to female ratio of 1:1. The mean age for malignant melanoma was 52.4 ±2.2SD with an age range of 25-79 years. Of the 61 cases, majority accounting for 90.2% occurred in the leg
and foot region. Nodular melanoma constituted first majority variant accounting for 36.3%. Malignant melanoma in advanced stages IV and V was the most common constituting 81%.
Conclusion: The exact incidence of malignant melanoma in most African countries including Nigeria is unknown because most cases of malignant melanoma are unreported.

Keywords: Malignant melanoma, Histopathology, Biopsy

Occupational exposure, willingness to care and misconception about hepatitis-B virus transmission among dental surgeons in Nigeria

2013-03-11T11:27:59+00:00

Context: Hepatitis-B infection poses a significant threat to the health of dental surgeons and oral healthcare delivery worldwide.
Aim/Objective: To assess occupational exposure, willingness to care and misconceptions about hepatitis-B virus (HBV) transmission among dental surgeons in Nigeria.
Methods: This cross-sectional study was conducted among randomly selected dental surgeons in Edo and Delta States of Nigeria. Questionnaire regarding demography, knowledge about the transmission of HBV, worry about contracting the infection, comfort level in having infected colleague, willingness to treat infected patients, glove use, needlestick and sharp injuries and post-exposure prophylaxis was the tool of data collection.
Results: Misconceptions about the mode of transmission of HBV existed among the respondents and 86.0% of them used gloves regularly. Three-quarters (74.6%) and 80.7% of the respondents have received hepatitis-B
vaccine and expressed different level of worry about occupational HBV contraction respectively. The majority of the respondents expressed willingness to render emergency and routine dental care for hepatitis-B infected patients but 50.9% expressed comfort in having infected colleague. The prevalence of needlestick and sharp injuries and post-exposure prophylaxis in event of injury among the respondents were high and low respectively. The vaccinated respondents expressed more willingness to treat hepatitis-B patients, better comfort level having infected colleagues and lesser worry about occupational contraction of hepatitis-B infection than the unvaccinated respondents. Vaccinated respondents were also more likely to be regular glove users, experience needlestick and sharps injury and seek post-exposure prophylaxis.
Conclusion: Misconceptions about the mode of transmission of HBV existed among the respondents. Occupational exposure, willingness to care and worry about occupational (HBV) contraction among the
respondents were high but had non significant association with hepatitis-B vaccination status.

Key words: Occupational exposure, willingness, hepatitis-B, dental surgeons

Blood Pressure Pattern Among Young People In South-Eastern Nigeria: A Cross-Sectional Survey

2013-03-11T11:27:59+00:00

Context: Apparently healthy young people are frequently regarded as free from such chronic diseases as hypertension, but reports from many parts of the world show that both hypertension and prehypertension are prevalent among young people.
Objective: The objective of this study was to examine the pattern of blood pressure among apparently healthy young people in Abakaliki.
Methods: Cross-sectional survey of 215 subjects aged between 15 and 24 years, screened and analysed for systolic and diastolic hypertension as well as systolic and diastolic prehypertension. Reference intervals were also derived from the mean and Standard Deviation values.
Result: There is a highly significant sex difference (p=0.000) in the mean Systolic Blood Pressure (114.71±13.46mmHg for males versus 108.56±9.99mmHg for females). The prevalence of systolic hypertension was 3.3% as against 2.3% for the diastolic hypertension (using the WHO/ISH guidelines for the classification of hypertension). With the Reference Interval derived from the study the prevalence of systolic
hypertension was also 3.3% while the diastolic hypertension was 4.3%. The prevalence of systolic prehypertension was 28.8%, as against 16.3% for the diastolic prehypertension.
Conclusion: The high prevalence of systolic and diastolic prehypertension is of clinical significance because virtually all these will eventually progress to frank hypertension on follow-up. Being diagnosed early implies that early intervention with lifestyle modification will eventually reduce the prevalence of hypertension in the adults. In view of limited resources in developing countries, this will provide a more cost effective approach to
the control of hypertension in the community than the treatment of established hypertension in adult life.

Key Words: Blood pressure, pattern; Prehypertension; Hypertension; Young people.

Complications associated with intrauterine contraceptive devices at the Imo State University Teaching Hospital, Orlu, Nigeria

2013-03-11T11:27:59+00:00

Background: Intrauterine contraceptive device (IUCD) is one of the reversible methods of contraception. Its use has increased steadily worldwide. However, some women reject it based on presumed complications associated with its use.
Aim: To determine the complications reported by women, action taken on the complications and other associated factors in Orlu, Nigeria.
Method: This is a cross-sectional study of 130 women who had IUCD insertions at the family planning clinics of Imo State University Teaching Hospital as well as its urban and rural practice centres (namely Anara Health Centre and Ogbaku Comprehensive Health Centre) both in Orlu Senatorial district between May 2008 and August 2008. Structured questionnaires were administered to consecutive women on follow-up visits at the Family Planning Clinics who are on IUCD. Information regarding age, parity, complications, reported action taken after the complication, clients' awareness of the availability of intrauterine device and duration of IUCD use were included in the questionnaires.
Result: A total of 130 users were available for study. Heavy menstruation was reported by 50 (35.2%) women which was the commonest in this study; 65 (50%) did not do anything about whatever complication reported. The age range was 21-45years with a peak age group of 26-30 years. Majority of the clients 85 (65.4%) knew about IUCD from the hospital. More than half (46.2%) of the patients had between 2-5 children. The distribution of the duration of IUCD use showed that most of the clients had the IUCD for one year and less.
Conclusions: IUCD is well accepted among users who still consider the benefit of reversible contraception more than the reported complication.

Keywords: IUCD, Complications, Orlu Senatorial district.

Self-reported preparedness for medical emergencies among dentists in two hospitals in Benin City

2013-03-11T11:27:59+00:00

Context: Medical emergencies have been known to occur in dental offices and can lead to loss of life if not well managed.
Objective: The objective of this study was to assess self-reported preparedness by practicing dentists for management of medical emergencies in Benin City, Nigeria.
Methods: A self-administered questionnaire was completed by dentist in a teaching and general hospital in Benin City.
Results: Majority of respondent (86.6%) reported to have received either theoretical or practical or both training in medical emergency at undergraduate level. While only 46.7% have had training post graduation.
Only 6.7% of respondent have certification in both basic life support and advanced trauma life support, while only 20% participated in emergency drills in the last six months prior to this study. Non availability of emergency kit was reported by 43.3% of the respondent. No respondent knew of the availability of a complete emergency kit. Only adrenaline, oral glucose, diazepam, oxygen and AMBU bag were reported to be available
by 36.7%, 16.7%, 33.3%, 33.3% and 23.3% of the respondents respectively. Only 40% of the respondents felt competent to perform mouth-to-mouth resuscitation.
Conclusion: Preparedness for management of medical emergencies was found to be inadequate among the surveyed dentists. The need for improvement of the training of practicing dentists in the management of
medical emergencies at the undergraduate, postgraduate, and continuing education levels as well as the need for organization of the dental workplace to handle such emergencies cannot be overemphasized.

Keywords: Medical emergency, preparedness, Competence, Dentists

Nigerian Family Physicians' Knowledge, Attitude, Practice and Educational Needs Regarding Oral Cancer

2013-03-11T11:27:59+00:00

Introduction: Family physicians' role in disease screening and prevention may facilitate significant reduction in the prevalence, morbidity and mortality of oral cancer if properly harnessed.
Objective: To determine the Nigeria family physicians knowledge, attitude, practices and educational needs regarding oral cancer.
Materials and Methods: This cross-sectional study was conducted among family physicians attending the Society of Family Physicians of Nigeria (SOFPON) National Conference in Benin City in November, 2011 using pretested, self-administered questionnaire.
Results: Of the 100 distributed questionnaires, 80 of them were filled and returned giving 80% response rate. More than half (51.3%) of the participants attended to patients with oral health problems on the daily-weekly basis. About one-fifth (21.3%) and 70% of the participants exhibited good knowledge about risk factors and clinical features of oral cancer respectively. However only 20% of the participants provide oral examinations to patients aged more than 40 years with less than half (47.1%) of them employing both direct inspection and palpation. A total of 86.3% of the participants opined that they are not well informed about oral cancer and majority (95%) of participants expressed interest in learning about oral cancer. Participants reported varied of mode of learning the dominant preferred modes being seminars, pamphlet and posters.
Conclusion: This study revealed that family physicians attend to patients with oral problems but are not adequately informed about oral cancer. The gap in knowledge, shortcomings in practice, educational needs noted should be addressed utilizing the preferred mode of instruction reported by the participants.

Keywords: Family physician, oral cancer, knowledge, attitude, practices, educational needs.

Relationship Between Glycated Haemoglobin and Body Mass Index in a Healthy Population in Egor Local Government Area, Benin City

2013-03-11T11:27:59+00:00

Context: Glycated haemoglobin is widely used as an index of mean glycemia, a measure of risk for the development of diabetic complications and quality of diabetes care. Obesity is commonly associated with type
2 diabetes and has been shown to cause or aggravate insulin resistance.
Objective: To determine the relationship between glycated hemoglobin and body mass index in an apparently healthy population in Egor local government area, Benin City.
Methods: This is a cross sectional study involving healthy adults. Blood pressure, Height, Weight were all measured and body mass index (BMI) calculated as weight (in kilograms) divided by height (in meters squared). Glycated haemoglobin was estimated using the ion exchange chromatography method.
Result: A total of 100 healthy subjects, 50 males and 50 females, ages ranging from 18 – 65 years were included in the study. Forty-six percent of the study population had BMI within the normal range, while the
remaining subjects were either overweight (31%), obese (22%), morbidly obese (1%). BMI correlated significantly with Glycated haemoglobin (r=.330) (p < 0.05) in the study population. Correlation was stronger amongst the males (r=.456) (p< 0.05) than females, and was not statistically significant in the females (r=.319) (p> 0.05). BMI also showed a weak but significant correlation with diastolic blood pressure in the study population (r=.289) (p< 0.05).
Conclusion: Glycated haemoglobin showed a significant correlation with body mass index in the population studied, corroborating the role obesity may play in the aietiopathogenesis of diabetes mellitus type 2 in this
environment.

Key words: Glycated, haemoglobin, obesity, mass, index

Neural Tube Defects In Rural Ebonyi State, Four Cases In Three Months – Co Incidental? Case Reports

2013-03-11T11:27:59+00:00

No Abstract.

Congenital absence of unilateral tube, ovary and round ligament in a Nigerian teenager: A Case report

2013-03-11T11:27:59+00:00

No Abstract.

Transabdominal Impalement Injury by a Wooden Stake In A School Boy: A Case Report

2013-03-11T11:27:59+00:00

No Abstract.