Annals of Nigerian Medicine

Lassa fever: Unveiling the misery of the Nigerian Health Worker

Aisha Mustapha — 2018-02-19

No Abstract

Assessment of the incidence of diarrhea in children under 5 years at the Institute of Child Health, Banzazzau, Zaria

Ifeoma Bernadette Ucheh — 2018-02-19

Introduction: This study was carried out to assess the incidence of diarrhoea in children under five years at the catchment community of Institute of Child Health (ICH), Banzazzau, Zaria, affiliated to Ahmadu Bello University Teaching Hospital Zaria.

Aims: The study aim was to assess the incidence of diarrhoea amongst children under five years at the Institute of child health Banzazzau between January 2013 and December 2014.

Settings and Design: The study was a retrospective study of the incidence of diarrhoea amongst children under five years at the Institute.

Materials and Methods: The materials used for this survey include medical records, questionnaires, weighing scale and a metre rule. Hospital records of children presented with diarrhoea were reviewed to assess the occurrence of diarrhoea among under five. A total of 2,400 hospital records of children under 5 years over a period of 24 months (January 2013- December 2014) who attended the clinic were reviewed.

Statistical Analysis Used: Data was analysed using SPSS, version 20.0 and anthropometric data was analysed using the WHO Anthro Software Package 2011.

Results: The socio-demography of children seen in the hospital records showed a preponderance of male children over females that presented with diarrhoea (55.4%) and children within the aged 12-23 months had the most diarrhoeal cases (36.8%).

Conclusions: Diarrheal disease assessed in under five years in the study area occurred more in male children who are between the ages of 12 to 23 months.

Keywords: Diarrhoea, Children, Under five

A study of clinical and etiological profile of community‑acquired pneumonia with special reference to atypical pneumonia

T.C. Nagesh Kumar — 2018-02-19

Background: Pneumonia is a leading cause of morbidity and mortality, especially in developing countries. The cause of community‑acquired pneumonia (CAP) is often difficult to establish. The most effective methods, especially for the diagnosis of atypical pathogens, are often invasive and may not always be justified. We studied the clinical and etiological profile of CAP, especially with regards to pathogens causing atypical pneumonia.

Aims and Objectives: The aim is to study the clinical profile and etiological agents in patients suffering from CAP in our hospital and to detect proportion of atypical pathogens among these CAP patients.

Methodology: From September 2012 to September 2014, 122 patients were diagnosed as having CAP and were included in this study. After sputum, blood culture, and serological evaluation, they were grouped as having typical and atypical pneumonia. Chi‑square test was used as statistical method to compare between these two groups.

Results: Of 122 patients, 40.2% of patients were found to have typical organisms and 20.5% had atypical organisms causing pneumonia. The common etiological agents were Streptococcus pneumoniae (15.6%) and Klebsiella pneumoniae (8.2%) among typical pneumonia and Mycoplasma pneumoniae (7.4%) and Legionella pneumophila (5.7%) among atypical pneumonia cases.

Conclusions: It is difficult to differentiate these causative agents by clinical features alone. Hence, appropriate serological, sputum, and blood culture should be carried out for early diagnosis, prompt treatment and also to reduce complications.

Keywords: Community‑acquired pneumonia, etiology, indirect immunofluorescence, typical and atypical pathogens

Prevalence and characteristics of the metabolic syndrome in patients with chronic pancreatitis

K.V.S. Hari Kumar — 2018-02-19

Objective: Chronic pancreatitis (CP) and metabolic syndrome (MS) share a bidirectional cause and effect relation. We investigated the prevalence and characteristics of MS in patients with CP and compared the same between alcoholic CP and tropical CP (TCP).

Materials and Methods: In this cross‑sectional, observational study, we included serial patients of CP presented to our hospital. We excluded CP patients with other known systemic disorders, long‑term intake of drugs that could affect the lipids and also excluded patients with features of exocrine deficiency. The study population is grouped as alcoholic CP (Group 1; n = 65) and TCP (Group 2; n = 37). A fasting blood sample was checked for all the biochemical parameters, and MS was defined as per the Asian modification of the National Cholesterol Education Program Adult Treatment Panel III definition. The results were analyzed by appropriate statistical methods.

Results: The study participants (85 male and 17 female) had a mean age 40.8 ± 12.6 years, CP duration 3.7 ± 4.7 year, and body mass index of 22.5 ± 3.2 kg/m². A total of 27 (26%) out of 102 patients had the presence of the MS, which was similar in frequency between both the groups (P = 0.0991). Hyperglycemia and low high‑density lipoprotein cholesterol (HDL‑C) were the common features in alcoholic CP, whereas TCP patents showed hyperglycemia, abdominal obesity, and low HDL‑C. None of the participants had all the five components, and seven patients had no features of the MS.

Conclusion: MS is seen in a quarter of patients with CP, and the prevalence is same irrespective of the underlying etiology.

Keywords: Alcohol, chronic pancreatitis, diabetes, hypertension, metabolic syndrome

Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor‑2 status of breast cancers in women visiting the Jos University Teaching Hospital

Innocent Emmanuel — 2018-02-19

Introduction: Breast cancer remains the most common malignancy in women and the leading cause of morbidity and mortality in this gender. The disease in the indigenous African woman is associated with an inherent aggressive biology and worst clinical outcome. As the malignancy is a heterogeneous entity, each case must be individually categorized for efficient therapy. Current clinical practice employs the use of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), as biomarkers to appropriately select patients that would benefit from targeted therapy against these major molecular pathways of the disease. This study aims at establishing the ER, PR, and HER2 status of breast cancer in women visiting the Jos University Teaching Hospital.

Materials and Methods: All histologically confirmed cases of breast cancer at the Jos University Teaching Hospital, between January 1, 2010, and December 31, 2012, with sufficient clinical records, were subjected to immunohistochemistry for the ER, PR, and HER2 status.

Results: A total of 96 cases of female breast cancers were histologically diagnosed during the period of the study. Sixty‑three (65.6%) cases met the inclusion criteria. The predominant histological type was invasive carcinoma (no special type) accounting for 54 (85.7%) cases. Scarf Bloom Richardson Grade 1, 2, and 3 for the cancer cases were: 18 (28.6%), 29 (46.0%), and 16 (25.4%), respectively. The rate of ER, PR, and HER2 positivity were 36.5%, 28.6%, and 33.3%, respectively. There were 26 (41.3%) triple‑negative cases.

Conclusion: The study shows a relatively low rate of hormone‑receptor positivity, and higher HER2 positivity of breast cancers in our locality, which may be responsible for poor prognosis in our patients.

Keywords: Breast, cancer, estrogen, human epidermal growth factor receptor 2, Jos, progesterone, receptor

Determinants of depression among medical students in two medical schools from South East Nigeria: A screening test

Chinawa Awoere Tamunosiki — 2018-02-19

Objectives: This study aims to assess the susceptibility of depression among clinical students from two medical schools from South East Nigeria, using a screening test questionnaire.

Methods: A total of 352 clinical medical students from two universities were enrolled by simple random sampling. A pretested self‑administered depression questionnaire was used to evaluate degrees of depression among the participants.

Result: Out of the 352 students studied, 14 (4%) of the students are susceptible to moderate to severe depression while none are susceptible to mild depression.
Among the students, gender and age were not significantly associated with depression (χ² = 2.896; P = 0.089). Socioeconomic class of the students was not significantly associated with depression (χ² = 2.186; P = 0.335).

Conclusion: A relatively low number of medical students are susceptible to depression. Depression among medical students is unaffected by gender, age, and socioeconomic class.

Keywords: Depression, depression questionnaire, medical student, Nigeria