Afrimedic Journal <p><strong>The <em>Afrimedic Journal</em> (AJ)</strong> is a semi-annual, multidisciplinary medical journal published by the Association of Resident Doctors, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. The purpose of this journal is to promote clinical and academic excellence in basic and clinical medical sciences as well as dentistry.</p> <p>We consider any original work that advances or illuminates medical science or practice. Contributions may be in the form of review articles, original articles, case reports, short communications and letters to the editor. The AJ will also publish articles on socio-economic, political and legal matters related to medical practice; conference and workshop reports and medical news.</p> <p>The journal allows free access to its contents. Therefore, authors are required to pay a token charge for processing and publication of manuscripts including color reproduction of photographs. All submissions are subject to peer review by the Editorial Board and by expert reviewers in appropriate specialties.</p> <p>Other pages related to this journal:&nbsp;<a title="" href="" target="_blank" rel="noopener"></a></p> en-US <p>On acceptance, the copyright of a manuscript will be vested in the journal and publisher. Articles published in Afrimedic journal are distributed under the terms of the Creative Commons Attribution License which allows for unrestricted use, distribution and reproduction in any medium, for any non-commercial purpose, subject to proper citation of the original work.</p> (Dr. Agbanu Chiemezie) (Eugene Akanegbu) Tue, 23 Nov 2021 05:49:22 +0000 OJS 60 Research collaboration - a panacea for the advancement of global health.pdf <p><strong>Background:</strong> Research involves the<br>investigation of either pre-existing or<br>new concepts to provide answers to<br>questions or modify existing concepts.<br>Results of researches lead to innovation.<br>There is constant research in global<br>health as medicine is not static.<br>Research collaboration is necessary for<br>global health as it helps to eradicate<br>bias.<br><strong>Method:</strong> This is a review article on<br>research collaboration as a tool for the<br>advancement of global health. A<br>literature search was done using Google<br>Scholar, Medline and PubMed.<br><strong>Conclusion:</strong> Research collaboration<br>should be encouraged especially as it<br>promotes the acquisition of funding and<br>obtaining of research grants. It enables<br>the tackling of Research questions in<br>global health that are enigmatic and it<br>also facilitates the building of capacity.<br><strong>Key Words:</strong> Global Health, Research<br>Collaboration, Research Grant, Research<br>Questions</p> Y.B Dabota Copyright (c) 2021 Fri, 15 Jan 2021 00:00:00 +0000 Ectopic pregnancy in a teaching hospital in south eastern nigeria.pdf <p><strong>Background</strong>: Ectopic Pregnancy still remains a deadly gynaecological emergency. It has been linked with increased maternal morbidity and mortality in early pregnancy especially in Sub-Saharan Africa.</p> <p><strong>Objectives</strong>: To determine the incidence, common risk factors, clinical presentations, treatment modalities and maternal outcome of ectopic pregnancies that presented in Nnamdi Azikiwe University Teaching Hospital over a five year period (January 2014 to December 2018)</p> N.P Obiegbu, A.C Obiegbu Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 00:00:00 +0000 Efficacy of single dose ciprofloxacin versus ceftriaxone in the prevention of prostate biopsy related infection.pdf <p><strong>Background:</strong> Prostate cancer is a major health concern world over, being the second most common neoplasm in men and the sixth commonest cause of cancer related death in the entire world. Trans-rectal ultrasound guided prostate biopsy is the gold standard technique for prostate cancer diagnosis. Prostate biopsy is associated with risk of urinary tract infection.</p> <p>Objective: This study aims to compare efficacy of ciprofloxacin with that of ceftriaxone in reducing post-prostate biopsy infection.</p> <p>&nbsp;</p> C. Odo, E.N Afogu, E.S.I Ugwuidu, T.U Mbaeri, E.A Obiesie, U.U Ogbobe, U.U Nnadozie, O.V Onyebum Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 00:00:00 +0000 Prevalence and patterns of post menopausal bleeding at the nnamdi azikiwe university teaching hospital nnewi nigeria - a 5 .pdf <p><strong>BACKGROUND</strong><br><strong>OBJECTIVES</strong><br>To determine the prevalence and<br>patterns of postmenopausal bleeding.<br>Materials and methods:<br>This was a retrospective study<br>conducted on all the cases of<br>postmenopausal bleeding managed at<br>Nnamdi Azikiwe University Teaching<br>Hospital Nnewi between 1st January<br>2014 and 31st December 2018. Data<br>was obtained from the case notes<br>retrieved from the medical records<br>department and from gynecological<br>ward and clinic registers. The<br>information obtained included age,<br>parity, year since menopause, history of<br>hypertension and diabetes mellitus,<br>time of onset of postmenopausal<br>bleeding, duration of bleeding, bleeding<br>frequency, and subjective measurement<br>of bleeding and histological diagnosis.<br>Data analysis was done using SPSS<br>version 21.<br><strong>Results</strong>:<br>Out of the 1640 gynaecological<br>admissions, 53 were for<br>postmenopausal bleeding, giving a<br>prevalence of 3.2% for postmenopausal<br>bleeding. A total of 46 out of the 53<br>case files were retrieved from medical,<br>and were used for further analysis.<br>Twenty-two (47.8%) were found in<br>women between the ages of 55 to<br>65years. The majority of the cases<br>58.7% were found amongst the<br>grandmultipara. Majority (82.6%) of the<br>documented cases, were found in<br>women who have been menopausal for<br>at least 12 months and only one case<br>was reported in women menopausal for<br>less than 12 months. History of<br>hypertension and diabetes mellitus were<br>found in 11 (23.9%) and 7 (15.2%) of the<br>women respectively. PMB was first<br>noticed at least 6 months<br>postmenopausal in 24 (52.3%).<br>Recurrent PMB was experienced by 38<br>(82.6 %) of the women in the study<br>while 3 (6.5%) presented with a single<br>episode. Subjective estimation of<br>bleeding revealed that 20 (43.5%) of the<br>patients used in the study had either<br>slight or heavy bleeding. Histological<br>diagnosis showed that squamous cell<br>carcinoma of the cervix and other<br>histological types of cervical<br>malignancies accounted for 12 (26.1%)<br>and 7 (15.2%) of all histological<br>diagnoses, respectively.<br><strong>Conclusion</strong>:<br>In conclusion, PMB is a common<br>gynecological presentation in our<br>environment. It is closely associated<br>with diabetes mellitus and hypertension<br>with the leading cause in our climes<br>being cervical malignancy which is<br>largely preventable. Therefore, health<br>policies should be targeted towards<br>medical education, lifestyle</p> G.C Ikpeze, I.K Nwaeju, N.D Adinma, K.E Obi, O.Z Ikpeze Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 03:35:42 +0000 Intractable haematuria secondary to pedunculated median lobe of the prostate - a diagnostic dilemma.pdf <p>Benign prostatic hyperplasia is a common disease in the ageing male. Obstructive solitary and pedunculated<br>intra-vesical enlargement arising from the median lobe of the prostate is rare. The enlarged median lobe, juts into the bladder base, and occasionally occludes the internal urethral opening during voiding (ball valve effect). The clinical diagnosis can be difficult, as digital rectal examination and ultrasonography can be inconclusive. Intractable haematuria associated with benign prostatic obstruction (BPO) is a urological emergency necessitating emergency surgical intervention. We report a 54 year old man, who presented with a 3 year history of worsening severe lower urinary tract symptoms (LUTS) that culminated in<br>intractable haematuria of 7 days duration and acute urinary retention. Digital rectal examination revealed a flat prostatic fossa with no nodules. PSA was 11.7ng/ml. Ultrasonography revealed a huge prostate with a prominent median lobe (grade-3 IPP) and a post void residual of 176mls. He underwent emergency open transvesical prostatectomy with good surgical outcome.</p> E.A Obiesie, AME Nwofor, SO Obiesie, C. Odo, AO Odili, CK Oranusi, TU Mbaeri, ME Chiemaka, C Otene, D Orakwe, C Azie, C Eze, UV Nwadi, FE Menkiti, OO Mbonu Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 03:36:20 +0000 Right posterior diaphragmatic hernia with omphalocele management challenges and benefit of multidisciplinary and multi-inst.pdf <p>Right posterior congenital<br>diaphragmatic hernias (CDH) with<br>liver herniations pose a huge<br>management challenge to the<br>paediatric surgeons world over. Its<br>association with anterior abdominal<br>wall defects portends a poorer<br>prognosis.<br>We report a case of a day- old male<br>referred to our centre with<br>breathlessness, anterior abdominal<br>wall defect and persistent poor<br>oxygen saturation. Clinical and<br>imaging evaluations aided the<br>diagnosis of a right posterior<br>congenital diaphragmatic hernia with<br>omphalocele and divarication of recti.<br>Due to dearth of resources, a<br>multidisciplinary team of paediatric<br>surgeons, cardiothoracic surgeon,<br>paediatricians and an intensivist were<br>assembled and care was undertaken<br>in two centres to complement in<br>manpower and facility deficiencies.<br>This in so many ways mitigated<br>against likely management<br>difficulties, morbidities and even<br>mortality.</p> <p>CONCLUSION; Right congenital<br>diaphragmatic hernias (CDH) in a<br>resource constrained environment<br>can be successfully managed with<br>good clinical and multicentre<br>collaborations.</p> J.O Ugwu, K.C Etukokwu, M P Ufoegbunam, C.A Ugwunne, N.O Ugwu Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 03:35:08 +0000 Turn down distal femoral autograft in proximal tibia defect reconstruction - a case report.pdf <p>Giant cell tumor, a benign growth with<br>aggressive attributes with potential for<br>both local invasion and recurrence often<br>affects the proximal tibia with<br>attendant bone expansion, destruction<br>and invasion of the articular margin. I<br>present a 42 year old woman who came<br>in with a history of a two year old mass<br>involving the right proximal tibia, and a<br>week history of bleeding from an<br>incision scar on the proximal tibia. X-ray<br>/ histopathological findings revealed an<br>aggressive giant cell tumor with a<br>breach of the posterior cortex of the<br>proximal tibia. The patient was<br>counselled for surgery, and<br>subsequently had a resection of the<br>entire proximal tibia in the first surgery;<br>and a turn down autograft of the distal<br>femur with arthrodesis of the knee joint<br>done in the second surgery. On follow<br>up for one year, there were no signs of<br>tumor recurrence and patient could<br>ambulate comfortably with a walking<br>stick.</p> H.O Obiegbu Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 03:34:21 +0000 Burnt out benign splenic cyst mimicking intra-abdominal malignancy - case report and review of literature.pdf <p>The spleen performs important immunological function. Benign cysts, neoplasms and abscesses are identifiable cystic lesions of the spleen. Splenic cysts are very rare, and consist of Type 1 (parasitic) and Type 11 (non-parasitic) cysts. Very few cases of huge splenic cysts have been reported in literature. The most common symptoms are due to pressure effects on contiguous organs, causing pain, abdominal swelling and change in bowel habit. Management of these splenic cysts is<br>controversial. Indications for surgical intervention, include symptomatic or large diameter cysts (&gt;5cm). We report a 57 year old lady with an 18 year history of recurrent left abdominal pain, progressive weight loss, easy satiety, and recurrent low grade fever. She neither had change in bowel habit, nor haematuria. There<br>was no history of abdominal trauma. On physical examination, there was a left hypochondriac swelling, extending to the midline of the abdomen. She has been transfusedseverally in the past on account of recurrent anaemia. Ultrasound revealed multiple well circumscribed oval and rounded cysts of the spleen. Her haemoglobin level at presentation was 6g/dl. She had neutrophilia. She subsequently underwent total splenectomy with good surgical outcome.</p> E.A Obiesie, A.O Okoye, C Odo, I.O Duruewuru, M.C Agbanu, S.O Obiesie, S.C Abone, F.E Menkiti, K.E Obi, O.I Anokwulu Copyright (c) 2021 Afrimedic Journal Tue, 23 Nov 2021 03:32:47 +0000