Orient Journal of Medicine https://www.ajol.info/index.php/ojm <p>The <em>Orient Journal of Medicine</em> is a Nigerian journal publishing articles in clinical or laboratory medical sciences.</p><p>Other websits related to this journal: <a title="http://www.orientjom.com/" href="http://www.orientjom.com/" target="_blank">http://www.orientjom.com/</a></p> Nigerian Medical Association of Anambra en-US Orient Journal of Medicine 1115-0521 Editorial: Mass Emigration of Nigerian Medical Workers and Attainment of Sustainable Development Goal (SDG) 3 https://www.ajol.info/index.php/ojm/article/view/214466 <p>No Abstract.</p> Okechukwu H. Ekwunife Copyright (c) 2021-09-15 2021-09-15 33 3-4 iv vi Treatment Outcome of Retained Placenta at The University of Port Harcourt Teaching Hospital: A Five-Year Review https://www.ajol.info/index.php/ojm/article/view/214467 <p><strong>Background:</strong> Retained placenta is one of the major causes of primary and secondary post-partum haemorrhage and is associated with increased risk of maternal morbidity and mortality.<br><strong>Objective:</strong> To determine the prevalence, evaluate the risk factor, clinical presentation and treatment outcome of retained placenta in the University of Port Harcourt Teaching Hospital (UPTH).<br><strong>Methodology:</strong> This was a retrospective study from January 1st, 2014 to December 31st, 2018. Relevant information were retrieved from patients’ clinical records and analysed using statistical package for social science (SPSS) version 25.<br><strong>Result:</strong> The prevalence of retained placenta was 0.98%. forty-six out of 50 patients (92.0%) with retained placenta had unsupervised home deliveries which accounted for majority of the risk factors. Thirty-nine (78.0%) patients presented with snapped umbilical cord, 24 (48.0%) patients with active vaginal bleeding and seven (14.0%) patients were in circulatory shock at presentation. Manual removal of placenta was carried out for all patients as the major mode of management while 21 (42.0%) patients had concomitant oxytocin administration. Thirty (60%) patients had primary postpartum haemorrhage. Twenty-six (52%) patients had anaemia at presentation while 6 (12%) and 2 (4%) patients had puerperal sepsis and genital tract lacerations, respectively. No maternal mortality from retained placenta was recorded within the study period.<br><strong>Conclusion:</strong> Retained placenta is essentially a disease of the unbooked patient and can lead to dire consequences. The utilization of antenatal care, skilled birth attendance and the provision of emergency obstetric care services can reduce the adverse effects of retained placenta.<br><br></p> Goddy Bassey Victor Abel Copyright (c) 2021-09-15 2021-09-15 33 3-4 73 79 Expression of Ki 67 in Malignant and Premalignant Cervical Lesions in Nigerian Women https://www.ajol.info/index.php/ojm/article/view/214468 <p><strong>Background</strong>: Cervical cancer, though preceded by treatable premalignant lesions, ranks second among all cancers in Nigerian women. The proliferative marker ‘Ki-67’ is useful immunohistochemically to enhance the diagnosis of cervical dysplastic lesions, reducing inter-and intra-observer variability. This study is aimed at evaluating the role of Ki-67 expression in cervical dysplastic lesions as a diagnostic and prognostic tool.<br><strong>Methodology</strong>: We applied Ki-67 immunohistochemical staining on 142 cervical biopsies from the archives of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi in Anambra state, a federal teaching hospital. Ki-67stains nuclei of proliferating cells, and was expressed as Ki-67 scores and labeling index (LI). LI was calculated as the number of positive cells per 100 dysplastic cervical epithelial cells while Ki-67 score was given based on levels of positive staining per third of epithelial thickness. The data analysis was done using the IBM SPSS Statistics (Statistical Product and Service Solutions) software version 20.0, and the result presented with tables where relevant.<br><strong>Results:</strong> LI and Ki-67 score increased with increasing dysplasia. There was disagreement between IHC (immunohistochemistry) enhanced and morphologic diagnosis in 9 (6.33%) cases. Ki-67 IHC significantly enhanced the diagnosis of CIN (Cervical intraepithelial neoplasm) and carcinomas (x2 =0.001, P&lt;0.05). Both premalignant and malignant cervical lesions were more common in fifth and sixth decades.<br><strong>Conclusion</strong>: Ki-67 IHC is a veritable diagnostic and prognostic marker, reducing inter-and intra-observer variability in the diagnosis of cervical dysplastic lesions.</p> Amalachukwu O. Ike Felix E. Menkiti Anthony A. Ngokere Copyright (c) 2021-09-15 2021-09-15 33 3-4 78 87 Variation in The Antimicrobial Potency of Honey Samples from Different Sources https://www.ajol.info/index.php/ojm/article/view/214469 <p><strong>Background:</strong> Honey has been used for different purposes including management of wounds for centuries. Reports of considerable variations in the antimicrobial potency of honey samples from different sources exists but we found none from our sub-region. This comparative study tested the antibacterial activities of honey from five different sources in South-East Nigeria.<br><strong>Methodology:</strong> The study involved 23 isolates from surgical wounds. Honey samples from five different sources were procured from the farmers. In-vitro antibacterial activity using dilution technique was done with the five honey samples and standard antibiotic susceptibility tests as control. The results were analysed by simple statistical methods and compared.<br><strong>Results:</strong> All the honey samples inhibited the growth of isolates at neat concentration (without dilution) but their antimicrobial activities diminished as the samples were diluted. Honey samples from <em>Chorophora</em> excels (Iroko tree) and <em>Pentachlethra macrophyla</em> (oil bean tree) inhibited Proteus species at neat concentration only. Honey from rock inhibited methicillin resistant <em>staphylococcus aureus</em> (MRSA) at neat concentration only but honey&nbsp; from <em>Anarechadium occidentale</em> (Cashew tree) did same from a dilution of 1:2 and below<em>. Escherichia coli, </em><em>Pseudomonas species, Klebsiella species </em>and<em> Proteus</em> were susceptible to Ciprofloxacin (used as quality control).<br><strong>Conclusion:</strong> This work shows that antibacterial activity of honey differs according to sources. Honeys from <em>Anarchadium occidentale</em> (cashew) and <em>Vitex doniana</em> (“uchakiri or eli-eli”) have higher efficacy in wound&nbsp; management than honeys from other sources in South-East Nigeria</p> Titus O. Chukwuanukwu Obasikwe N. Uba Comfort N. Akujobi Rebecca C. Chukwuanukwu Evaristus E. Afiadigwe Simon N. Ushie Copyright (c) 2021-09-15 2021-09-15 33 3-4 88 94 Characteristics and Blood Pressure Profile of Goitre Patients in A Tertiary Hospital in South-West Nigeria https://www.ajol.info/index.php/ojm/article/view/214470 <p><strong>Background:</strong> Goitre remains endemic in iodine deficient areas of the world despite widespread introduction of iodine fortified food. In Nigeria, it is the second most common condition in endocrinology clinic. There is a therefore a need to document the blood pressure profile and clinical characteristics of this condition.<br><strong>Objective:</strong> This study assessed the clinical characteristics, biochemical and blood pressure profile of patients with goitre in the study area and assessed their knowledge and practice of preventive measures against goitre.<br><strong>Methodology:</strong> A comparative study of 103 adults with goitres and 103 healthy controls. An interviewer administered questionnaire was used and venous blood samples were obtained for analyses. Variables of interest included socio-demographic, anthropometric, thyroid function, and blood pressure.<br><strong>Results:</strong> The mean age of the goitre group was 46.92 ± 13.85 years with 86.4% carrying the swelling for up to 5 years. Anthropometric parameters, social habits, knowledge, and practice of the preventive role of iodized salt were similar between the goitre and control&nbsp; groups. Forty-six percent of the goitrous subjects were hyperthyroid. Weight and BMI were significantly higher among the hypothyroid subgroup (p&lt;0.001), with subjects in the hyperthyroid subgroup having significantly higher pulse rate and systolic blood pressure&nbsp; (p&lt;0.001). The hypothyroid subgroup had significantly higher diastolic blood pressure and lower pulse pressure (p&lt; 0.001).<br><strong>Conclusion</strong>: This study concluded that patients with hyperthyroidism and hypothyroidism were more likely to have elevated systolic and diastolic blood pressure, respectively. Routine cardiovascular status check is therefore important in goitrous patients.</p> Adeola O. Ajibare Adekunle Adeyemo Akinwumi O. Olakanmi Emmanuel Y. Fagbemiro Ayoola S. Odeyemi Suraj A. Ogunyemi Rasaaq A. Adebayo Babatope A. Kolawole Michael O. Balogun Copyright (c) 2021-09-15 2021-09-15 33 3-4 95 104 Use of Face Mask as a COVID-19 Preventive Measure Among Household Heads in Enugu Nigeria https://www.ajol.info/index.php/ojm/article/view/214471 <p><strong>Background</strong>: Corona virus disease 2019 (COVID-19) is a highly infectious disease that can be transmitted from person to person through the respiratory droplets from an infected person and contacts. It is scientifically proven that covering mouth and nose with face mask prevents the spread of respiratory droplets produced by coughing and sneezing from an infected individual.<br><strong>Objective</strong>: To evaluate the ownership and use of face mask as preventive practices against COVID-19 as well as factors affecting its use among adults in Enugu.<br><strong>Methodology:</strong> We conducted a community-based cross-sectional study among 320 heads of households selected by multi-stage sampling technique in Enugu metropolis, Enugu state, Nigeria. We collected information on ownership and use of face mask from 4th to 15th May 2020. Data entry and analysis were done using IBM Statistical Package for Social Sciences statistical software version 25. The proportion of household heads who own and used face mask was estimated and the factors associated with its use was explored using Chi square test at 5% level of significance.<br><strong>Results</strong>: One hundred and six (33.1%) heads of households have and use face mask; 272 (85.0%) were planning to own a face mask and 309 (96.6%) were aware of government directive to use face mask. Overall, 314 (98.1%) of the heads of households were willing to wear face mask if it is available. Ownership and use of face mask was more among females (38.8%) compared to males (28.0%, p =0.04).<br><strong>Conclusion:</strong> Majority of respondents did not own or use a face mask but were willing to use one if made available. We therefore recommend that more efforts should be geared towards educating and sensitizing the public, particularly household heads, since they can play a role in ensuring that other family members adhere to the COVID-19 preventive measures.</p> Elizabeth U. Nwonwu Edmund N. Ossai Chukwuma D. Umeokonkwo Ituma B. Ituma Ifeyinwa C. Akamike Joel U. Okenwa Copyright (c) 2021-09-15 2021-09-15 33 3-4 105 111 Simultaneous Bladder and Uterine Rupture Secondary to Poor Management of Labour by A Traditional Birth Attendant: A Case Report https://www.ajol.info/index.php/ojm/article/view/214472 <p>Nigeria has one of the highest maternal morbidity and mortality globally. Poor health seeking behaviour and lack of adequate training among most Traditional Birth Attendants (TBA) are major contributors to our poor health indices. Uterine rupture is a major obstetric complication with significant morbidity and mortality. Uterine rupture occurring simultaneously with bladder rupture is rare. A major risk factor in our environment is failure to recognise high risk pregnancies as well as unsupervised labour. We report a case of an unbooked 34-year-old G5P4+0 trader at 39 weeks’ gestation who was referred from a traditional birth attendant with simultaneous bladder and uterine rupture.</p> Mojeed O. Momoh Christopher C. Affusim Tijani I.A. Oseni Neba F. Fuh Bolanle T. Adewuyi Caleb U. Adebayo Copyright (c) 2021-09-15 2021-09-15 33 3-4 112 116 Community Acquired Pyogenic Liver Abscess Caused by A Nosocomial Organism: A Case Report https://www.ajol.info/index.php/ojm/article/view/214473 <p>Pyogenic liver abscess (PLA) is a potentially life-threatening disease affecting patients in many parts of the world, especially Asia and the other third world countries, Nigeria inclusive. Knowing the aetiology of PLA, where possible, plays a significant role in the successful treatment of the patients. Recently, the prevalence of Klebsiella pneumonia induced PLA (KP-PLA) has become an emerging public health challenge all over the world, however, other rare organisms are also implicated as shown in our case report. Acinetobacter baumannii is a multi-drug resistant nosocomial organism that may also be responsible for some cases of community acquired infections as seen in this index case.</p> Shirley N. Chukwurah Simon N. Ushie Felix E. Ezenekwe Ejeye O. Ugwunze Chinyelu U. Ufoaroh Nkechi P. Maduekwe Copyright (c) 2021-09-15 2021-09-15 33 3-4 117 122 <i>Gossypiboma</i> Mimicking Intra-abdominal Tumour https://www.ajol.info/index.php/ojm/article/view/214474 <p><em>Gossypiboma</em> is a rare, preventable and under-reported pseudo-tumour complication following surgery. It has serious medicolegal consequences. It poses a diagnostic dilemma due to non-specific clinical and radiologic features. We therefore report a case of <em>gossypiboma</em> in a 31-year old woman following a midnight emergency caesarean operation, to highlight the risk in our environment, the implications and the need for a high index of suspicion in postsurgical patients.<br><br></p> Felix E. Menkiti Emmanuel A. Obiesie Igwebuike V. Onyiaorah Chidiadi Ochiabuto Pius I.S. Okafor Copyright (c) 2021-09-15 2021-09-15 33 3-4 123 126