Nigerian Medical Journal

Severe respiratory acidosis-induced involuntary hyper defecation: The role of medullary caudal raphe nuclei.

2025-01-21T14:24:40+00:00

Dear Editor,
We report a case of a 9-year-old male child who presented to us with progressive quadriparesis over the
past 6 months. Clinical examination and imaging studies revealed congenital atlantoaxial dislocation. He
was thus posted for posterior fixation. Early on the morning of the surgery, the child developed sudden
bradypnea (respiratory rate – 10-12 breaths/min), tachycardia (165-170 beats/min), high blood pressure
(systolic 140 mm Hg), oxygen desaturation (SpO2 – 90-92%), and responsive only to painful stimuli
(Glasgow Coma Scale: E1V1M2). This respiratory depression was secondary to the compression of the
cervico-medullary junction and spinal cord edema

Hypophosphatemia in pregnancy: A case report

2025-01-21T09:31:29+00:00

Autosomal hypophosphatemic rickets though a rare genetic disorder can lead to significant discomfort to the
patient resulting in clinical deterioration and a poor quality of life. We describe a case of a 33-year-old woman
G2P1001 at 6 weeks of gestation with complaints of myalgia and bony pains. Keeping her history of bony pains
and fractures in mind, she was further evaluated. On evaluation, she was found to have low levels of phosphates
0.99 mg/dl (2.40-4.40) and high levels of fibroblast growth factor 23 (FGF 23) 231.70pg/ml (23.20-95.40). These
biochemical parameters were suggestive of hypophosphatemic rickets and further on gene sequencing she was
found to have autosomal dominant hypophosphatemic rickets (HR). During her follow-up visits, her checkup and
antenatal investigations were normal. Pregnancy acts as a stressor and patients with asymptomatic ADHR may
present during pregnancy for the first time with the symptoms of HR. So, a high index of suspicion is required for
patients reporting musculoskeletal pains in pregnancy. Early diagnosis can help the mother have a better pregnancy
experience. Phosphate and vitamin D supplementation during pregnancy can help these women reduce
musculoskeletal pain symptoms. Unfortunately, this patient had a spontaneous abortion in the second trimester.
The overall prevalence of ADHR is less than 1 per 1,00,000 live births. Data in pregnancy with ADHR is also
minimal due to the condition's rarity. Hence, more and more studies are required in pregnancy with this disease to
come to any conclusion and to find any association of ADHR with pregnancy outcomes. Genetic counselling and
the need for testing in newborns if symptomatic is also an essential factor to remember when coming across such
antenatal patients.

A rare case of poorly differentiated neuroendocrine carcinoma of the descending colon with regional lymph node involvement presenting in a young adult Nigerian male: A case report.

2025-01-21T09:42:18+00:00

Malignant colonic neuroendocrine tumours are rare. Even more uncommon is their occurrence in the left colon. They also
infrequently occur in males and young adults. We describe a rare case of poorly differentiated neuroendocrine carcinoma of
the descending colon in a 32-year-old male who presented with signs of intestinal obstruction. He later had exploratory
laparotomy and tumour resection with 5 cm gross tumour margins and Hartman-type colostomy and completed six cycles of
Etoposide and Carboplatin combination. He has been tumour- and symptom-free for 36 months. Even though rare,
neuroendocrine tumours should be an important differential of all colonic tumours, irrespective of the patient's age and sex,
and surgeons should have a high index of suspicion for them. Although they most commonly occur in the right colon (cecum),
they can also be found in the descending colon, where they can present with intestinal obstruction. Tumour resection with 5
cm gross tumour margins and Hartman-type colostomy can be handy. Etoposide and Carboplatin combination can improve
overall survival in complicated World Health Organization (WHO) stage 3 neuroendocrine carcinoma with regional lymph
node involvement, and generally poor prognosis, but without evidence of distant metastasis, and relatively fair performance
index. Younger patients with neuroendocrine carcinomas may benefit better from platinum-based chemotherapy.

Haemolytic anemia in a patient of chronic myeloid leukemia: an unrecognized side-effect of hydroxyurea?

2025-01-21T10:08:13+00:00

Hydroxyurea (HU) is frequently used in the treatment of various myeloproliferative neoplasms (MPN)
where it reduces cell proliferation by impairing DNA synthesis leading to decreased hematopoiesis.
Herein we report a case of a 65-year-old female who was diagnosed with Chronic myeloid leukemia and
developed severe hemolytic anemia requiring multiple packed red blood cell (RBC) transfusions while
being treated with hydroxyurea. The haemolysis persisted until discontinuation of the drug. Common
side-effects of HU like macrocytic anemia, leucopenia, and thrombocytopenia are well known but
hemolytic anemia is a rare side-effect, not well known with only a handful of cases being described in the
scientific literature so far.

Probable case of cutaneous anthrax with toxic manifestations and fatality seen in an adolescent in Sokoto, Nigeria: A postmortem review

2025-01-21T10:17:16+00:00

Background: Anthrax is a life-threatening zoonotic disease caused by Gram-positive, spore-forming bacterium Bacillus
anthracis. It manifests as a cutaneous, gastrointestinal, and respiratory disease. The cutaneous form ranges from a self-limiting
lesion to severe edematous lesions with toxemic shock. Of recent, increasing cases of anthrax have been reported in Nigeria
warranting heightened surveillance. A patient with skin lesions suggestive of cutaneous anthrax and toxic manifestations is
reviewed to emphasize the need for a high index of suspicion.
Case report: A 14-year-old boy presented with skin lesions of one month involving the hands, face, and legs, left lower limb
swelling of two weeks, fever of 10 days, and fast breathing of five days duration. There was a positive history of contact with
cattle carcasses at the abattoir. He was febrile (38.1o c), mildly pale, and mildly dehydrated, oxygen saturation was 95%. He
was tachypnoeic and tachycardic with a low-volume pulse. There was extensive left lower limb swelling, a raised necrotic
ulcer with a black surface on the calf, measuring 9cmx5cm with serosanguinous discharge, and another confluent vesicular
lesion on the anterolateral aspect of the left leg measuring 8cmx6cm. Differential diagnoses considered were cellulitis,
osteomyelitis, leishmaniasis, and malignancy.
Result, treatment & outcome: His packed cell volume was 33%, retroviral screening, and hepatitis screening were nonreactive, and erythrocyte sedimentation rate was 3mm/hr. Leg X-ray was normal. Other investigations could not be done due to financial constraints and the patient’s demise. He received intravenous (IV) fluid, IV ceftriaxone, IV metronidazole, tetanus toxoid, and antiseptic wound dressing. He succumbed to the illness 72 hours later. Anthrax was considered after the patient's demise due to the type of skin lesion and progression of the illness in line with the standard case definition.
Conclusion: Cutaneous anthrax with systemic manifestations should be considered as a probable diagnosis in patients with
typical skin lesions and toxic features.

Challenges in diagnosing advanced abdominal ectopic pregnancy in low-resource settings: A case from north western Nigeria.

2025-01-21T13:38:03+00:00

Abdominal ectopic pregnancy is a rare type of ectopic pregnancy associated with high maternal and perinatal
mortality.
We present a case of a 28-year-old now primipara who was misdiagnosed to have abruptio placentae and ruptured
uterus on two different occasions from a primary health care center but was found to have an advanced abdominal
ectopic gestation at 21 weeks gestational age. The patient was managed by exploratory laparotomy and is currently
doing well.
Abdominal ectopic pregnancy, though rare, does occur in our setting, and a high index of suspicion is necessary to
make a diagnosis. Prompt diagnosis will help in managing the patient hence reducing morbidity and mortality

Geospatial distribution, accessibility and utilization of basic emergency obstetric and new-born care in Jigawa State, Northwest Nigeria.

2025-01-17T10:33:00+00:00

Background: High maternal mortality has remained a problem, especially in developing countries. Ensuring
availability and utilization of Basic Emergency Obstetric and Newborn Care services (BEmONC) reduce maternal
morbidity and mortality. The study aimed to determine the geospatial distribution, accessibility and utilization of
BEmONC services in Jigawa State.
Methodology: A cross-sectional study was conducted using the WHO “30 by 7” cluster sampling technique and
two-stage sampling to select 630 women and 15 Primary Health Care facilities (PHCFs) respectively. The Geo
coordinates of the PHCFs and households of respondents were taken using the global positioning system (GPS) on
Android devices. Data were analysed using IBM SPSS version 25 and Arc GIS version 10.6.
Results: A dispersed distribution was observed for the BEmONC facilities in two LGAs and majority of the
respondents (71.9%) fall within 5 Km radius to a BEmONC facility. Only 27% of the respondents utilized
BEmONC services for obstetric complications. Predictors of utilization of BEmONC were living within 5 Km to
the nearest BEmONC (aOR=3.3; 95% CI=1.565 – 6.822), use of bicycle (aOR=1.930; 95% CI=1.012 – 3.679),
cars (aOR=1.838; 95% CI=1.127 – 2.998), and tricycles (aOR=1.833; 95% CI=1.017 – 3.309) as means of
transportation to PHCs.
Conclusions: A dispersed distribution and good physical accessibility to BEmONC facilities were found, however,
utilization was poor. Distance and mode of transportation were predictors of utilization of BEmONC services.
Jigawa State Government should intensify awareness campaigns to improve the utilization of BEmONC services
and provide emergency transport schemes for women with obstetric complications.

Factors associated with microalbuminuria among Children with sickle cell disease in a tertiary centre in South-South Nigeria

2025-01-17T11:08:36+00:00

Background: Microalbuminuria, an early indicator of kidney damage in Sickle Cell Disease (SCD) patients, is linked to
a heightened risk of chronic kidney disease (CKD) in adulthood. This study investigates the determinants of
microalbuminuria in paediatric SCD patients in South-South Nigeria.
Methodology: This cross-sectional study was conducted over six months at the Rivers State University Teaching
Hospital, Nigeria, involving 60 children with [HbSS genotype, SCD] in a steady state. Data collection included
demographics, past medical history, clinical measurements, and laboratory assessments of urine and blood samples.
‘Steady state’ was defined as SCD with a known 'steady state' haemoglobin level and stable clinical state for ≥ 3 months.
Microalbuminuria was defined spot urine albumin-creatinine ratio of 30mg/g to <300 mg/g.
Results: Of the 60 children recruited, 31 children (51.7%) were males. The mean age was 9.6 ± 4.3 years. The
prevalence of microalbuminuria was 16.7% (CI: 8.29 – 28.5%) and associated risk factors were hypertension (p =
0.017), use of Hydroxyurea (p = 0.008), and Ciklavit (p = 0.025), but not NSAIDs (p = 0.046). There was a significant
negative correlation (ɼ = -0.28; p = 0.032) between haemoglobin level and microalbuminuria.
Conclusion: This study provides insights into the factors associated with microalbuminuria in children with SCD in our
setting and highlights the need for early screening for markers of CKD among children with SCD. Further research is
needed to ascertain the potential benefits of addressing anaemia and reducing haemolysis in mitigating the occurrence of
microalbuminuria among children with SCD.

Otorhinological disorders among pregnant women attending the obstetric clinic at Benjamin Mkapa Hospital, Tanzania

2025-01-17T11:40:26+00:00

Background: Pregnancy leads to physiological changes primarily driven by hormones like oestrogen and
progesterone. Such changes are multi-systemic in nature including involvement of the ear, nose and throat. Such
changes impair the quality of the life of pregnant women and thus requires prompt intervention during pregnancy.
This study aimed to determine otorhinological disorders among pregnant women attending obstetric clinic at
Benjamin Mkapa Hospital.
Methodology: A hospital-based descriptive cross-sectional study was conducted at Benjamin Mkapa Hospital from June to
August 2023. A total of 246 pregnant women were recruited after consenting where data on their age, gestational age, and
otological and rhinological disorders were obtained. Otoscopic and rhinoscopic examination were done and recorded in the
data collection sheet. Data was analysed using a Statistical Package for Social Sciences (SPSS) version 23. A p-value<0.05
was statistically significant.
Results: This study recruited 246 pregnant women with majority 135(52.8%) in the 3rd trimester. Pertaining otological
disorders manifested by pregnant women, majority 39(15.9%) of them presented with hearing loss/reduced hearing ability, and
conductive hearing loss was the most common type, 19(48.7%). Regarding rhinological disorders, 47(19.1%) pregnant women
had allergic rhinitis and most of them presented with nasal obstruction 41(87.2%), nasal bleeding 12(25.5%) and pale pinkish
inferior turbinate,3(6.4%). Eighty (32.7%) pregnant women had olfactory disturbance whereby most of them had reduced
sense of smell 41(51.3%). The association between otorhinological disorders and gestational age was significant for only
allergic rhinitis and olfactory disturbance (p-value<0.05).
Conclusion: The study concludes that otorhinological disorders are common among pregnant women, with a significant
number experiencing hearing loss, allergic rhinitis, and olfactory disturbances. Specifically, allergic rhinitis and olfactory
disturbances are significantly associated with the trimesters of pregnancy, while other disorders like hearing loss, Bell’s palsy,
otitis externa, and sinusitis do not show a significant association with the pregnancy trimesters. This highlights the need for
prompt intervention to manage these conditions and improve the quality of life for pregnant women

A study to compare and correlate the effect of a yogic lifestyle on Framingham, Q RISK 3, and WHO risk scores among high-risk cardiovascular subjects

2025-01-17T11:55:49+00:00

Background: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. Yoga is a low-cost, easily accessible lifestyle modification program that holds as an approach to decreasing cardiometabolic risk factors and increasing exercise self-efficacy among high-risk subjects. This study aimed to assess the impact of the yogic lifestyle (including diet) on cardiovascular risk scores by using the Framingham (FRS), QRISK3 score, and World Health Organization (WHO) CVD risk prediction charts at baseline, three months, and six months. The present study compares and correlates FRS, QRISK3, and WHO cardiovascular risk scores.
Methodology: The experimental interventional study was conducted among the high-risk population at RUHS College of Medical Sciences and Associated Group of Hospitals, Jaipur. Framingham risk Score, QRISK3 score, and WHO CVD risk prediction charts were used as a method of measurement for the outcome of interest at baseline, three months, and six months in the study and control group. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The statistical analysis was done using advanced SPSS-22 software at significant level tests as p≤0.05, ensuring the highest level of accuracy. Data were analyzed using a one-way variance ANOVA test analysis at baseline, three, and six months. Pearson correlation analysis was done to compare different risk scores.
Results: Participants had a mean age of 48.43 ± 6.4 years. Baseline values (mean±SD) of FRS, Qrisk3, WHO were 24.59±10.15,28.59±10.11,15.71±6.07. After six months of yogic lifestyle, these values decreased significantly to 15.1±7.05, 20.09±7.08, and 13.85±4.96. The decrease in cardiovascular scores was statistically significant (p<0.0001), providing strong evidence for the effectiveness of the yogic lifestyle. Pearson correlation analysis results depict that FRS and Q risk 3 (r=0.840, p<0.0001), FRS and WHO risk chart (r=0.768, p<0.0001), Q risk3 and WHO risk chart (r=0.778, p<0.0001) have a statistically significant strong positive correlation.
Conclusion: This study's findings suggest that a 24-week yogic lifestyle intervention (including diet) significantly decreased FRS, Q RISK
3, and WHO CVD risk scores among high-risk subjects compared to the control group.

Sociodemographic and economic correlates of dialysis vintage in a resource challenged setting: A four-year prospective study in Southwest Nigeria

2025-01-17T12:12:14+00:00

Background: Dialysis vintage is largely dependent on the effectiveness of the delivered dose coupled with the extent of patient
compliance with the prescribed treatment regimen. This study assessed the determinants and correlates of dialysis vintage.
Methodology: This was a 4-year prospective, observational study. The data was collected from the dialysis and medical records, both
had the contacts of patients and relatives.
Results: A total of 314 participants (males 67.20%) with a mean age of 47.91±8.81 years underwent 2265 maintenance
haemodialysis sessions. The females were older and had more hospital admissions; (P=0.07). Approximately 32.17% of the
participants traveled at least fifty kilometers to access dialysis treatment. In a month, only 23.57% of the participants received the
minimum prescribed twelve sessions, and 24.84% received the required erythropoietin dose. The mean dialysis vintage for all
population was 9.13 ± 3.15 months, it was shorter for participants with hospitalization, (p<0.001), dialysis termination (p<0.001),
intradialytic hypotension (p<0.001), and hypertension (p<0.001), Approximately, 14.2% of the participants had health insurance
coverage, more so with the men After dialysis initiation, 6.69% of the participants were alive to the fourth year. The predictors of
dialysis vintage were income (OR-4.62, 95% CI-2.88-6.24), health insurance (OR-8.11, 95% CI-4.82-13.35), dialysis duration (OR6.38, 95% CI-2.40-9.55) and spKt/V (OR-4.24, 95% CI-0.48-5.91).
Conclusion: Dialysis vintage was short (9.13 ± 3.15 months), more so in females, poor funding, peridialysis complications, and
without health insurance. More concerted efforts from governments, multinational donor agencies, and philanthropists are needed in
health insurance coverage, particularly for kidney care to increase the dialysis vintage.

Perception of learning environment among undergraduate medical students at university of Jos using Johns Hopkins learning environment scale

2025-01-17T12:32:32+00:00

Background: The learning environment (LE) plays a crucial role in the performance and training of medical students.
Different tools have been used to assess the LE with various conclusions. However, the John Hopkins Learning Environment
Scale (JHLES) which is a relatively newer scale is more specific, less cumbersome to administer, and has a wider scope. The
study aims to assess the perception of the LE of undergraduate medical students in a Nigerian institution using the JHLES.
Methodology: This was a cross-sectional study carried out on clinical medical students of the College of Health Sciences,
University of Jos. A self-administered questionnaire containing socio-demographic data and the 28 JHLES questions was
used. Data was analysed using SPSS version 25.0. The Overall mean JHLES Score was obtained by calculating the average of
the JHLES scores attained by all participants.
Results: A total of 400 clinical medical students were enrolled and a mean JHLES Score of 77.90 (±14.03) was obtained. The
males were found to have statistically significantly higher mean JHLES scores than the females, particularly in the domain of
Faculty relationships, Academic climate, and Mentoring. The domain of “community of peers” had the highest ratings while
“mentoring” and “meaningful engagement” recorded the least scores.
Conclusion: The clinical medical students had a fair perception of their LE. The areas of strength should be encouraged while
faculty may enact programs that will improve the domains with low scores to ultimately make better the learning environment
and training of these future doctors.

Patient-related and health system factors, and experiences of women with a history of stillbirth in Port-Harcourt

2025-01-17T16:10:53+00:00

Background: Nigeria makes a substantial contribution to the global burden of stillbirths. However, data on women’s
experiences and care received at the time of stillbirth are limited. This study aimed to investigate the experiences and patientrelated and health system factors in women who had a stillbirth in a previous pregnancy in the past 15 years.
Methodology: This was a cross-sectional survey of 64 pregnant women, attending antenatal care in Port-Harcourt, who had
stillbirth in a previous pregnancy. Consenting participants were interviewed using a predesigned and pretested questionnaire.
Information on sociodemographic characteristics, pregnancy history including health-seeking behaviour in the stillbirth
pregnancy, and women’s experiences and appraisal of care provided by healthcare workers during the stillbirth event, were
collected. Data was analysed using descriptive statistics and presented as numbers, Means and Percentages in tables.
Results: Most participants (92.2%) experienced one stillbirth. The majority (71.9%) had stillbirths at 9 months gestation.
Almost all pregnancies (98.4%) were singleton, and most mothers (81.3%) reported attending antenatal care regularly. The
majority of deliveries (89.1%) occurred in healthcare facilities. Post-stillbirth, 45.3% of the mothers stayed in an open
postnatal ward, 56.3% saw their stillborn child, with 39.1% of them not seeing the baby at all, and only 4.69% saw and held
their dead baby. Over half (56.3%) found healthcare workers supportive and satisfied with their role, but (45.3%) did not
receive postnatal care or counselling. Concerning performing an autopsy, 60.9% would not have requested one.
Conclusion: Most stillbirths were term pregnancies, occurred intrapartum, and were in-facility deliveries. Delays in reporting
complications and receiving care at the hospital contributed to the stillbirths. A good proportion of the women were not shown
and did not hold their babies and were admitted to a standard postnatal ward following delivery, factors which are predictive
of increased psychological morbidity. However, most women were satisfied with the care and support they received from
healthcare workers during the delivery

Demographic and clinical characteristics of benign laryngeal lesions: Insights from a decade of experience in a tertiary hospital.

2025-01-20T08:49:57+00:00

Background: Benign laryngeal lesions, characterized by non-cancerous growths in the larynx, significantly impact voice quality and
respiratory function. These lesions, which include vocal cord polyps, nodules, papillomas, and cysts, often result from factors such as vocal abuse, viral infections, and chronic inflammation. While studies on benign laryngeal lesions are well-documented globally, data specific to Northern Nigeria remains sparse. This study aims to analyze the demographics, clinical features, treatment modalities, and outcomes of benign laryngeal lesions over a decade in a tertiary otolaryngology center in Northern Nigeria.
Methodology: A retrospective review of 176 cases of benign laryngeal lesions was conducted over 10-years (2011-2020). Data were
collected on patient demographics, clinical presentation, risk factors, lesion characteristics, and treatment outcomes. All patients underwent flexible laryngoscopy, with a subset receiving CT scans and histopathological examination. The study excluded malignant lesions.
Results: The study population comprised 123 males (69.9%) and 53 females (30.1%), with a male-to-female ratio of 2.3:1. The age range of patients was from 1.5 to 69 years, with a mean age of 34.74 years (±16.64). The most common presenting symptom was hoarseness (94.8%), and most lesions were vocal cord polyps (52.3%), followed by vocal cord nodules (34.7%) and juvenile-onset respiratory papilloma (6.8%). The glottic region was the most frequent site of lesion occurrence (94.9%). Treatment primarily involved voice rest (43.2%), direct laryngoscopy with excision (22.2%), and microlaryngeal surgery (8.0%). Treatment outcomes showed a cure rate of 40.9%, with a recurrence rate of 29.0%.
Conclusion: This study provides valuable insights into the demographic and clinical profiles of patients with benign laryngeal lesions in
Northern Nigeria. The findings indicate a predominance of vocal cord polyps, significant gender disparity, and the effectiveness of surgical interventions. These results align with regional and international data but highlight the need for more localized studies to better understand the epidemiology and management of these lesions in Northern Nigeria. Further research should explore specific risk factors and the longterm outcomes of different treatment modalities.

Analysis of HAM-D scores on cognitive functions and heart rate variability in patients with major depressive disorder

2025-01-20T09:17:32+00:00

Background: Previous research has shown that Major Depressive Disorder (MDD) is accompanied by severe
impairments in cognitive and autonomic processes, which may linger even when mood symptoms recover.
This study aimed to analyse the relationship between depression severity, as measured by the Hamilton
Depression Rating Scale (HAM-D), and how it affects heart rate variability (HRV) and cognitive function in
patients with Major Depressive Disorder (MDD).
Methodology: The cross-sectional study was conducted at RUHS College of Medical Sciences and
Associated Hospitals, Jaipur, from July 2022 to January 2023 on 90 subjects having major depressive disorder
(MDD) of either sex in the 20-40 age group using the Hamilton score for depression (HAM D), Heart Rate
Variability (HRV) measurements, and a battery of cognitive tests. Regression analyses were conducted to
examine the associations between HAM-D scores with both HRV parameters and cognitive functions.
Results: Results indicated a significant negative correlation between HAM-D scores and HRV measures with
p<0.001, suggesting that increased depression severity is associated with reduced HRV. Additionally, higher
HAM-D scores predicted poorer performance on cognitive tasks, particularly in the domains of executive
function and working memory. The coefficient of determination r2=0.724 suggests that approximately 72.4%
of the variance in the dependent variable (Hamilton rating score for depression) could be explained by the
combined cognitive function and heart rate variability parameters.
Conclusion: These findings highlight the potential utility of, emphasizing the importance of comprehensive
assessment and treatment approaches that address both the affective and cognitive aspects of depression

Causes and outcome of unconsciousness in the accident and emergency department of the university of Port Harcourt teaching hospital

2025-01-20T09:35:03+00:00

Background: Unconsciousness occurs when a patient enters a sleeplike state but cannot be aroused, and
it is not due to physiological drowsiness. It is a common presentation in the Accident and Emergency
Department (A&E), and a burden to the emergency physician especially when the cause is unknown. The
cause of coma may be trauma or non-trauma related. There is a shortage of data on the aetiology and
outcome of unconsciousness in developing countries including Nigeria.
Methodology: This cross-sectional study investigates 765 unconscious patients using convenience
sampling from September 2023 to June 2024 at the A&E of the University of Port Harcourt Teaching
Hospital. The World Health Organization emergency unit form was adapted for this study.
Results: The total population of this study is 765, 55.16% males and 44.84% females. A majority of the
cases 81.83% were not related to trauma. The commonest causes of unconsciousness were stroke,
diabetic complications & emergencies, traumatic brain injury, metastatic neoplasm, HIV AIDs related
disease and hypertensive emergency. Most of the patients 494(64.58%) died while in A&E, 116 (15.16%)
were transferred to the ward and 56 (7.58%) were discharged against medical advice.
Conclusion: Unconscious patients are a challenge in the emergency room. Stroke and diabetic
emergencies are the commonest causes of non-trauma-related aetiologies while traumatic brain injury is
the most common cause of trauma-related aetiology of unconsciousness.

Validation of siriraj stroke scoring system in the clinical differentiation of stroke sub-types in a resource-limited setting

2025-01-20T09:42:24+00:00

Background: Stroke remains one of the major non-communicable public health disease conditions with resultant
high morbidity and mortality. Neuroimaging in the form of Computed Tomography (CT) or Magnetic Resonance
Imaging (MRI) is adjudged to be the most reliable and efficient method of accurately diagnosing stroke and ruling
out differentials. However, in view of cost implication and non-availability, a clinical scoring system known as the
Siriraj Stroke Score (SSS) was developed to clinically differentiate stroke types, especially in resource-limited
settings. This study sought to validate and determine the role of Siriraj stroke score in the clinical evaluation of
patients presenting with acute stroke.
Methodology: This is a descriptive prospective study that was conducted over a one-year period. The study
populations were adult patients presenting with acute stroke in a tertiary health facility in North-Western Nigeria.
Clinical details with neuroimaging in the form of a CT scan were obtained. Data obtained was analyzed using Stata
15.
Result: Fifty-four percent (54%) of patients enrolled were males and ischaemic stroke is the commonest stroke
subtype present in 69% of patients studied. Altered levels of consciousness, headache and vomiting are important
discriminatory variables of the scoring system. The sensitivity, specificity, Positive Predictive Value (PPV),
Negative Predictive Value (NPV) and accuracy of Siriraj Stroke Score for haemorrhagic stroke is 92%, 72%, 62%,
95% and 62% respectively.
Conclusion: Siriraj Stroke Score with sensitivity greater than 90% is reliable in differentiating the stroke subtypes; the patients in the ‘grey zone’ will however require neuroimaging.

Comparison of risk factors and clinicopathological features between pre- and post-menopausal patients with breast cancer

2025-01-20T09:51:34+00:00

Background: Breast cancer is the most common cancer affecting women globally with an estimated 2.3 million new cases in
2020. In Nigeria, it constitutes about 12% of all new cancers and 25% of all cancers in women. The risk factors of breast
cancer include both non-modifiable and modifiable factors. There are clinical and biological differences between patients with
pre-menopausal and post-menopausal breast cancer. This study aims to evaluate the differences in risk factors, disease
presentation and tumour characteristics between premenopausal and postmenopausal breast cancer patients.
Methodology: This is a 2-year prospective cross-sectional study conducted at the University of Port Harcourt Teaching
Hospital between 1st January 2021 and 31st December 2022. All consecutive patients who presented with breast cancer that
was histologically confirmed and gave informed consent were included in the study. Patients were divided into two groups
which are pre-menopausal and post-menopausal based on their menopausal status. Relevant data were extracted and recorded
in a data extraction form. Analysis was done using Statistical Product and Service Solution version 26.
Results: One hundred and thirty-three patients were recruited for the study. Seventy (52.6%) of them were pre-menopausal
and 63 (47.4%) were post-menopausal. Their ages were from 19 to 78 with a mean of 46.94 ± 11.93. The peak age was 41-50
years and 30.8% of the patients were within this age range. Only late age at first pregnancy was significantly associated with
pre-menopausal breast cancer.
Conclusion: Similar risk factors and tumour characteristics with a higher prevalence of triple-negative breast cancer were
found in both groups but late age at first pregnancy occurred significantly in pre-menopausal breast cancer patients.

Prevalence and perception of disrespect and abuse during childbirth in public healthcare facilities in Lagos, Nigeria

2025-01-20T10:13:52+00:00

Background: There is increasing awareness of disrespect and abuse (DAA) during childbirth. Globally, DAA during delivery
is a common cause of suffering and violation of the human rights of birthing mothers. Respectful maternal care is necessary to
improve the quality of care and uptake of institutional delivery services to reduce maternal and perinatal morbidity and
mortality. The study aims to determine the prevalence, common forms, and perception of maternal DAA among mothers who
just gave birth and are still in the hospital.
Methodology: A cross-sectional study on 261 consenting postnatal women at four public healthcare facilities in Lagos,
Nigeria. An interviewer-administered pretested questionnaire was used to obtain data on sociodemographic characteristics and
experiences of DAA. We analysed the data using Statistical Package for Social Sciences (SPSS) version 25. Logistic
regression analysis was used to assess significant risk factors for DAA during delivery and early puerperium.
Results: The prevalence of DAA during childbirth was 82%. Perceptions of non-consented care and abandonment/neglect
were the most reported forms of DAA reported by 86.8% and 45.6% of respondents, respectively. The odds for DAA were
four times greater in women who had pregnancy complications compared to those who did not (aOR: 4.50, 95%CI: 1.50-
13.46) and doubled in women who had vaginal delivery compared to Caesarean section (aOR: 2.10, 95%CI: 1.07-4.12).
Conclusion: DAA is prevalent during childbirth in our public healthcare facilities. This goes against the proposed standard of
care where respectful maternal care is every womans right, posing a risk for reduced use of institutional delivery services.

An evaluation of asthma control using the asthma control test in patients at the university hospital, Agadir, Morocco.

2025-01-20T10:29:19+00:00

Background: Asthma is a common chronic disease, and asthma control is the major therapeutic
objective, thus ensuring a good health-related quality of life. This study aimed to evaluate the level of
asthma control in a sample of asthmatic patients followed in allergology consultation during our training
using the asthma control test (ACT) and its correlation with other parameters.
Methodology: This is a cross-sectional study of 66 asthmatic patients who were followed in
pulmonology consultation at Agadir University Hospital after completing the asthma control test
questionnaire over 6 months (June to December 2021).
Results: The age of the patients ranged from 17 to 76 years, with an average age of 41.36 +/- 13.31
years. There was a predominance of females in this sample, representing 54.5% of the patients against
45.5% of males. All patients were on inhaled corticosteroid therapy (ICS) (as monotherapy in 25.8% of
cases and in combination with a long-acting beta-2 mimetic (LABA) in 74.2% of cases). 60.6% of the
patients were from low socioeconomic levels, of which 28.8% were from rural areas. 22.7% of the
participants were illiterate. Allergic rhinitis was found in 66.6% of patients and allergic conjunctivitis in
45.5%. Active smoking was found in 16.7% of cases. Obesity was found in 10 patients (15.2% of cases).
According to the ACT, asthma was totally controlled in 37.9% of cases and partially controlled in 43.9%
of patients.
Conclusion: The level of asthma control found in this study was lower compared to other populations.
The study also showed that better ACT scores and asthma control correlated with higher socioeconomic
levels.

Gestational diabetes mellitus and feto-maternal outcomes in federal medical centre, Yenagoa, Bayelsa State-A comparative study of two diagnostic criteria

2025-01-20T10:41:18+00:00

Background: The prevalence of gestational diabetes mellitus (GDM) is dependent on the diagnostic criteria used and there is no consensus on screening methods and diagnostic criteria. The International Association for Diabetes in Pregnancy Study Group (IADPSG) recently put forward new diagnostic criteria and encourages its adoption worldwide. The aim of this study was to determine the incidence of GDM and to compare the foeto-maternal outcomes of women diagnosed with GDM in the Federal Medical Centre, Yenagoa using the WHO 1999 and IADPSG criteria.
Methodology: This was a cohort study of 340 women who were booked for antenatal care at the Federal Medical Centre, Yenagoa. Women who gave consent to participate in this study took part in a 75-gram, 2-hour oral glucose tolerance test (OGTT). The diagnosis of GDM was sought in each participant using both the WHO 1999 and the IADPSG criteria. The incidence and the foeto-maternal outcomes in women diagnosed with GDM using different criteria were compared.
Results: The incidence of GDM was 5.3% in the IADPSG (case) group and 3.8% in the WHO (control) group. This difference was not
statistically significant (p = 0.18). There was no significant difference between the groups for foetal and maternal outcomes that were
assessed. Maternal outcomes were pre-eclampsia (p = 0.48), polyhydramnios (p = 0.31), insulin therapy (p = 0.35), caesarean section (p = 0.28), genital tract laceration (p = 0.18) and instrumental vaginal delivery (p = 0.34). Foetal outcomes were birth weight ≥ 4kg (p = 0.07), neonatal jaundice (p = 0.38), hypoglycaemia (p = 0.46), birth injuries (p = 0.42) and shoulder dystocia (p = 0.23).
Conclusion: The application of the IADPSG criteria in our environment may lead to an increase in the number of women being managed for GDM without any appreciable improvement in foetal and maternal outcomes.

Assessment of COVID-19 vaccine knowledge, uptake, and factors influencing its uptake among medical students at the university of Jos

2025-01-20T10:57:54+00:00

Background: COVID-19 vaccination is crucial to containing the pandemic. COVID-19 vaccine knowledge, attitudes,
and uptake among medical students are vital, as they are future healthcare professionals expected to promote
vaccination. This study assessed the knowledge of the COVID-19 vaccine, its uptake, and associated factors among
medical students.
Methodology: A cross-sectional study was conducted among 245 medical students at the University of Jos, Nigeria.
Participants were selected using stratified random sampling. Data was collected via a self-administered questionnaire
and analysed using descriptive and inferential statistics.
Results: The median knowledge score was 8, with an interquartile range (IQR) of 3. Most participants had low
knowledge of the COVID-19 vaccine (65.7%), while a minority had high knowledge (34.3%). The overall vaccine
coverage was 20%. Gender and tribe were significantly associated with vaccine uptake. Males were more likely to
receive the vaccine than females (24.3% vs. 12.9%, p = 0.039), and participants from the Igbo tribe were less likely to
receive the vaccine than those from the Yoruba tribe (0% vs. 29.4%, p = 0.002). Additionally, being tested for COVID19 was significantly associated with vaccine uptake (p < 0.001). Factors influencing COVID-19 vaccination decisions
were access to accurate information (68.9%, p < 0.001), healthcare professionals' recommendations (31.1%, p < 0.001),
concerns about safety and side effects (26.6%, p < 0.006), self-protection (19.5%, p = 0.011), government guidelines
(39.6%, p < 0.001), vaccine availability (38.0%, p = 0.005), and the availability and convenience of vaccination centres
(33.7%, p < 0.001).
Conclusions: There was low COVID-19 vaccine knowledge and uptake among medical students. Gender, tribe, access
to information, healthcare guidance, and practical barriers influenced vaccination decisions. Targeted education and
provider involvement are needed to address hesitancy in this critical population.

Blood usage among orthopedic patients at the Rivers State university teaching hospital, Port Harcourt, Nigeria

2025-01-20T11:10:19+00:00

Background: Blood transfusion holds a significant place in the practice of surgery, including orthopaedic
surgeries. The aim of this study was to evaluate the intraoperative use of blood and blood products among
orthopaedic patients operated at the Rivers State University Teaching Hospital from January 2021 to December
2021, focusing on the demographics of patients, number and type of surgeries needing a blood transfusion, and the
number of blood transfusions.
Methodology: A retrospective observational study was carried out at the operating theatre of a referral tertiary
hospital using a designed proforma to extract data from the registers of operated orthopaedic patients.
Results: There were 168 males and 145 females who were operated on, and 43 (13.74%) of them had intraoperative blood transfusion. Patients between 41 to 50years and 51 to 60 years dominated the distribution with a
total of 20 (46.5%), out of 59 blood transfusions carried out. The surgical condition requiring the highest number
of blood transfusions was fractures (29), followed by foot gangrene (17) occasioned by diabetes mellitus and
peripheral vascular disease. Open reduction and internal fixation for fractures (18) constituted the highest single
type of surgery carried out within the study period.
Conclusion: A bimodal age distribution was observed in intraoperative blood transfusion requirements. The
orthopaedic intraoperative blood transfusion burden was 13.74%, mainly for open reduction and internal fixation
for fractures.

Comparison of papanicolaou smear tests among HIV negative and HIV positive pregnant Women on HAART at a tertiary hospital

2025-01-20T12:52:08+00:00

Background: Cervical cancer is the most common gynaecological cancer worldwide, causing morbidity and mortality, especially in
developing countries like Nigeria. It develops from premalignant lesions of the cervix. Human immune deficiency virus (HIV) increases the risk of dysplastic changes in the cervix. Pregnant HIV-positive women may be at a higher risk of having pre-invasive cervical lesions. Pregnancy presents an opportunity to screen women for premalignant lesions of the cervix using a Papanicolaou (Pap) smear, especially in an environment like ours where women of reproductive age have poor health-seeking behaviour. The objective of this study is to compare the cytological patterns of Pap smear of pregnant women who are HIV positive compared to their HIV negative counterparts at the antenatal clinic of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).
Methodology: This is a comparative cross-sectional study that involved performing Pap smears on consenting HIV-positive pregnant
women on HAART and HIV-negative pregnant women attending the antenatal clinic of AE-FUTHA. One hundred pregnant HIV-positive
women on HAART and one hundred pregnant HIV-negative women who met the inclusion criteria and gave consent were recruited into the study by consecutive sampling method. A pretested questionnaire was administered to the women. A pap smear test was carried out on each of the participants. The data was analysed using Epi info version 7.2.1. Continuous variables were presented as mean and standard deviation while categorical variables were presented as numbers and percentages. Categorical variables were analysed using Chi-square (Fisher’s exact test was also used), while means were compared using a t-test. A P-value ˂ 0.05 was considered as statistically significant.
Result: The prevalence of abnormal Pap smear among pregnant women in AEFUTHA was 14%. The prevalence among HIV-positive
pregnant women was 24% while the prevalence for HIV-negative women was 4%. This difference was statistically significant (P value was <0.001).
Conclusion: This study has demonstrated the presence of premalignant cervical lesions in pregnant women with a significantly higher
prevalence among HIV-positive pregnant women. Therefore, there is a need to incorporate Pap smear tests among routine antenatal
investigations, especially for HIV-positive pregnant women.

The hypertriglyceridemic waist phenotype is associated with an adverse cardiometabolic profile in this cohort of Nigerians

2025-01-20T13:13:14+00:00

Introduction: The hypertriglyceridemic waist (HTGW) phenotype was introduced as a means of identifying individuals at
risk of developing metabolic syndrome as well as cardiovascular diseases and diabetes. However, studies surrounding the
prevalence of the phenotype and its relationship with established markers of cardiometabolic risk, especially in the Nigerian
population, remain sparse. This study aimed to determine the prevalence of the HTGW phenotype and explore its relationship
with cardiovascular risk markers, namely Castelli Risk Indices I and II (CRI-I and CRI-II), Atherogenic Index of Plasma (AIP)
and serum triglyceride-HDL cholesterol ratio (TG/HDL).
Methodology: In this retrospective cross-sectional study, the records of 206 patients presenting at a cardiac hospital from
November 2022 to October 2023 were analysed. The HTGW phenotype was deemed present with a waist circumference of at
least 94cm in men or 80cm in women and a serum triglyceride level of 150mg/dl or more in both sexes.
Results: At-risk waist circumference was more prevalent in women (92.7% vs 77.3%; p=0.002). The prevalence of the
HTWG phenotype in the patient cohort was 29.6%, with more males than females (31.8% vs 27.1%) presenting with the
phenotype (p=0.004). Patients with the phenotype also had higher systolic blood pressure, waist circumference, body mass
index, triglycerides, AIP, and TG/HDL (all p<0.0005). The HTWG phenotype was also associated with a lower HDL and LDL
cholesterol (p<0.0005) as well as a lower CRI-II (p=0.049).
Conclusion: The HTWG phenotype correlates with an increased cardiometabolic risk among Nigerians. This finding warrants
the implementation of routine anthropometric and serum triglyceride measurements in screening programmes and hospitals for
the early detection of individuals at risk of developing cardiovascular diseases.

Prevalence and pattern of obstructive sleep apnea among undergraduate students in tertiary institutions, Kwara State, Nigeria.

2025-01-21T07:53:38+00:00

Background: Sleep is a very important physiologic process which is necessary to maintain a state of well-being.
Obstructive Sleep Apnea (OSA) is prevalent among all age groups with variations in presentation and severity. It is often
underreported, especially among young people in the Low- and Middle-Income Countries LMICs. This study assessed
the prevalence and pattern of OSA among undergraduates enrolled at tertiary Institutions in Kwara State, Nigeria using
both Epworth and Stop Bang tools.
Methodology: A campus-based study conducted among undergraduate students in Kwara state. Respondents were
selected from three tertiary institutions. A total of 1,048 eligible students were selected using a multistage sampling
technique. Epworth Sleepiness Scale (ESS) and Stop Bang Questionnaire (SBQ) were adapted and administered. Both
descriptive and inferential analyses were conducted. The level of significance was set at a p-value of <0.05 at 95%
confidence interval. Ethical approval was obtained.
Results: The mean age of respondents was 21± 2.69. More than half 634 (60.5%) of the 1048 respondents were females,
with 20 (1.9%) were married. Abnormal sleepiness was reported in 151 (14.41%) while 897 (85.59%) had normal
sleepiness using ESS. With the SBQ, 998 (95.2%) had a low risk while 46 (4.3%) had a moderate to high risk of OSA.
Religion, increasing levels of study, and presence of chronic disease, were significantly associated with abnormal
sleepiness using ESS, whereas female gender, religion, presence of chronic disease, smoking, use of sedatives and
caffeine were significantly associated with OSA using SBQ.
Conclusion: The prevalence and pattern of sleep disorder among the undergraduates showed a moderate prevalence of
sleep disorder and associated risks of OSA using the sleep disorder tools. There is a tendency to become a big burden
with an increase in age, therefore health promotion interventions are recommended early to students to create awareness
of OSA risks.

Undesirable occupants of bone marrow creating a menace: A 4.5-year audit from a tertiary care centre in Eastern India.

2025-01-21T08:13:48+00:00

Background: Bone marrow (BM) in addition to being the origin of primary hematological malignancies is also commonly involved in
metastatic solid tumors. Bone marrow examination includes aspiration and biopsy, and it is a well-known procedure not only to diagnose hematological malignancies but also for staging and prognosis of various solid tumors. The presence of metastasis in the bone marrow is of grave prognostic significance and it is imperative to rule out marrow involvement in any malignancy where curative treatment is considered. The study’s objectives were to evaluate the clinical, hematological, and biochemical characteristics of patients with BM metastases of solid tumors diagnosed by bone marrow (BM) aspiration and trephine biopsy and to find out the accuracy rate of diagnosing metastatic infiltration between bone marrow aspiration, trephine imprints, and trephine biopsy procedures.
Methodology: It was a 4.5-year retrospective hospital-based observational study where relevant clinical, biochemical, and hematological parameters including bone marrow aspirate and biopsy were analyzed and compiled from hospital medical records.
Results: The total number of BMA and trephine biopsies that came during the duration of 4.5 years were 3850 and 2980 respectively. Out of the 3850-bone marrow aspiration and 2980 trephine biopsies received in the dept of Hematology, 305 cases were referred to look for metastatic bone marrow infiltration. Out of these 305 cases, 69 cases showed the presence of metastatic deposits (12.6%). 45 patients (65.2%) were males, and 24 patients (34.7%) were females with M:F ratio of 1.8:1. Most common age group was 51-60 years (31.8%). The most common complaints were fever, body aches, weight loss, and weakness. Clinical examination revealed pallor in 38 out of 69 cases (55%) and organomegaly in 14 cases (20.2%). Microcytic hypochromic anemia (26%) was the most common finding on peripheral blood smear examination followed by pancytopenia (18.8%). The biochemical findings most commonly observed were raised LDH (60.8%), serum PSA (36.3%), and alkaline phosphatase (21.7%)
Conclusion: Trephine biopsy is a sensitive method for detecting marrow metastasis and should be done in all cases being investigated for this purpose. BMA alone may miss marrow metastases in almost half of cases. Trephine imprint cytology is more sensitive than BMA and can provide rapid diagnoses while waiting for trephine biopsy results.

Sero-prevalence of hepatitis B and C and HIV among students at the federal university of health sciences, Azare

2025-01-21T08:31:52+00:00

Background: Infection with the human immunodeficiency virus and hepatitis viruses B and C have been reported
to be endemic in some Nigeria’s institutions of higher learning. Several studies have reported varying prevalence
rates for hepatitis B and C viruses and HIV among undergraduate students in Nigerian universities.
Methodology: A cross-sectional descriptive prevalence study of hepatitis B and C viruses and HIV among
students at Federal University of Health Sciences, Azare conducted on the 2nd of December 2023. Screening for
hepatitis B and C viruses and HIV was done using standard procedures. Ethical approval was obtained in addition
to individual consent from all participants.
Results: Three hundred students with the mean age of 19.43±2.352 years were studied. 96.7% were aged 24 years
or younger; females being the majority [185, 61.7%]. The majority of the participants were in their 200 level (190,
63.3%). Ten health-related programmes were represented in the survey. Twelve participants (4%) were positive for
HBsAg; nine (75%) being males. One participant was positive for HBeAg, while only three (1%) of the
participants had evidence of prior HBV vaccination, thus giving us a window of opportunity for vaccination. None
of the participants had evidence of infection with HCV or HIV.
Conclusion: Screening students of health-related courses should be routinely done to ascertain their status to
prevent occupational exposures and transmission in the healthcare setting. Results from this survey will inform
formulation of policies that will protect our future healthcare force and safeguard the lives of patients.

Predictive value of prostate-specific antigen density on tumour grade in diagnosis of prostate cancer: A hospital-based cross-sectional study.

2025-01-21T08:45:17+00:00

Background: Prostate cancer is the most common urologic malignancy in men, it is witnessing a huge burden in developing
countries. Prostate-specific antigen has served as a tool in diagnosis and prognostication. To improve its sensitivity, Prostatespecific antigen density is being used to discriminate between benign and malignant conditions to avoid the incidence of
unnecessary biopsy. Similarly, it is important to establish the importance of Prostate-specific antigen density in
prognostication to help in treatment stratification. The aim of this study, therefore, is to assess the relationship between
Prostate-specific antigen density and tumour grade using the Gleason score.
Methodology: This study was a prospective cross-sectional study carried out between 2015-2016. It involved 191
consecutive patients who were either asymptomatic or symptomatic with elevated prostate-specific antigen (PSA)/abnormal
digital rectal examination findings or both. They had a Prostate volume assessment and digitally guided prostate biopsy.
Prostate-specific antigen density was calculated, and histopathology reports were evaluated. Data were analysed using SPSS
version 20.0. Pearson correlation coefficient and test of ANOVA were used to assess the relationship between prostatespecific- antigen and Gleason score while a scatterplot was used to determine the relationship between prostate-specific
antigen and prostate volume. The level of significance was set at p< 0.05
Results: All patients in this study were Nigerians, mean age of the study population was 68.2+ 9.4 years. The median PSA for
patients with prostate cancer was 76.9ng/ml and 14.5ng/ml for patients with benign disease, the difference was statistically
significant (p<0.001), and median prostate volume was 84.5mls while the median PSAD was 0.25. PSAD for Gleason score 2-
4,5-7,8-10 was 0.4,0.8 and1.1 respectively which was statistically significant using a test of ANOVA (p=0.001). Pearson
correlation coefficient revealed a statistically significant correlation between Prostate-specific antigen and Gleason score (r=
0.375, p=0.024). Using Fisher’s exact test there was a statistically significant difference between PSAD for benign prostatic
disease and carcinoma of the prostate, p<0.001.
Conclusion: The study revealed that Prostate-specific antigen density has a statistically significant predictive value for tumour
grade using Gleason score, however no statistically significant correlation was observed between prostate-specific antigen and
prostate volume in prostate cancer.

Attitudes and beliefs about HIV/AIDS and their relationships with sexual practices among senior secondary school students in Abakaliki, Ebonyi State, Southeast Nigeria.

2025-01-21T08:57:22+00:00

Background: Attitudes and beliefs regarding HIV among adolescents and young adults (AYA) may influence practices
that increase the risk of HIV transmission. The study aimed to determine the attitudes and beliefs regarding HIV among
senior secondary students and their sexual practices.
Methodology: It was a cross-sectional descriptive study that involved 1,200 adolescents and young adults (AYA) aged
14-24 years in senior secondary schools in Abakaliki. Information was obtained using a two-part pre-tested
questionnaire that tested attitudes and beliefs regarding HIV using a 6-item questionnaire and another part sought
information on biodata and sexual practices. The p-value of < 0.05 was statistically significant.
Results: The median (IQR) age of participants was 16.0 (9.0) years, and the majority (64.4%, 773/1,200) were females
with a male-to-female ratio of 1.0: 1.8. Seven hundred and thirty (60.8%) had positive attitudes and beliefs towards HIV.
Although 628 (52.3%) were willing to be tested for HIV, only 25.6% (307/1,200) have ever been tested for HIV. Three
hundred and fifty-five (29.6%) of them had engaged in sexual activities, of which 145 (12.1%) had multiple sexual
partners. There were significant relationships between attitude, beliefs, and age ((ꭓ 2= 39.69. p = <0.001), willingness to
test for HIV (ꭓ 2 = 10.20. p= 0.002), and having multiple sexual partners (ꭓ 2= 5.49, p= 0.019).
Conclusion: Positive attitudes and beliefs regarding HIV were high but were not reflected in their practices. Sustained
efforts toward effective HIV-related health education in schools and improved adolescent-friendly health services where
HIV screening is readily accessible are recommended.

Factors associated with the place of delivery among women in Ogun east senatorial district Nigeria: A rural-urban comparative cross-sectional study

2025-01-21T09:21:34+00:00

Background: Choosing the appropriate place for delivery has a significant impact on the outcome of
labour and childbirth. This study aimed to identify the factors associated with the place of delivery among
women in Ogun East senatorial district, Nigeria.
Methodology: Using a multistage sampling technique, a comparative cross-sectional study was
conducted among 375 women in Ogun East Senatorial District. An interviewer-administered, structured
questionnaire was used. Data were analyzed using IBM SPSS version 22.0. Statistical significance was
set at p<0.05. Relevant descriptive and inferential statistics were calculated. Results were presented in
frequency tables.
Results: More urban respondents (n=296, 78.9%) utilized health facilities as a place of delivery during
their last pregnancy than rural respondents (n=288, 76.8%). The factors associated with the place of
delivery included marital status, educational status, cost of health service, and proximity to the health
facility.
Conclusion: The findings underscore the need for public health policies that improve rural access to
affordable and nearby maternal health services, which could enhance facility-based deliveries and reduce
maternal and neonatal risks.

Circumventing the challenges of inappropriately filled radiological requests in sub-saharan Africa: experiences from an infectious disease hospital

2025-01-21T14:04:45+00:00

Radiological requests are vital communicative tools by Physicians to Radiologists. Improperly
filled radiological requests are frequently encountered in our practices as radiologists; a trend
which can negatively impact patient care. A properly filled request will prevent unwarranted
radiation exposures and improve service delivery by Radiology departments. This article amply
expresses our practice experiences (not unique to our centre alone) as they relate to poorly filled
radiological investigation requests and the practical approach we have developed and adopted
over time which has been quite helpful in addressing this age-long problem.

Fallopian tube papilloma: A systematic review of case reports

2025-01-17T08:23:10+00:00

Fallopian tube papilloma (FTP) is one of the benign lesions of the oviduct and is a rare proliferative
epithelial lesion. Low incidence and underreporting of the disease limit our knowledge of these lesions.
These lesions cause a diagnostic dilemma and need to be differentiated from several other conditions of
the fallopian tubes both benign and malignant. Fallopian tube papilloma may lead to tubal obstruction
and can be a cause of subfertility, ectopic gestation, or mass lesions in the fallopian tubes and hence
should be considered as an important differential while managing these women. A high index of
suspicion is required, and the final diagnosis can only be made after histopathological results. The
reporting of such lesions is important to know the true prevalence of these tumors and to increase our
knowledge about these benign neoplasms. This systematic review of case reports was done to enhance
knowledge regarding the etiology, natural course, complication, and recurrence of FTP. An electronic
search of Scopus, Pubmed, Embase, Web of Science, Google Scholar, and other databases was conducted
for case reports and case series published in English from inception till January 2024.

Cholera in Nigeria: A review of outbreaks, trends, contributing factors, and public health responses

2025-01-17T08:50:32+00:00

Cholera remains a significant public health challenge in Nigeria, with recurrent outbreaks exacerbated by inadequate water,
sanitation, and hygiene (WASH) infrastructure, as well as conflict and displacement. This review examines cholera outbreaks
in Nigeria from 2010 to 2024, analyzing epidemiological trends, contributing factors, and public health responses. Seasonal
peaks during periods of heavy rainfall and flooding have consistently facilitated Vibrio cholerae transmission, with Northern
regions disproportionately affected due to poor infrastructure and ongoing conflicts. Displacement into overcrowded camps
has heightened vulnerability, particularly in conflict-affected areas such as Borno and Adamawa. The outbreaks have exhibited
multiple epidemic waves within single periods, reflecting persistent transmission dynamics. Recent outbreaks have seen higher
incidence rates among children under the age of five and vulnerable populations, highlighting the need for targeted
interventions. Public health responses have focused on improving surveillance, case management, and WASH infrastructure,
with coordinated efforts from national and international agencies. Vaccination campaigns, particularly in high-risk areas, have
proven effective in controlling outbreaks. However, challenges remain, including inadequate healthcare capacity, vaccine
stockouts, and the emergence of antimicrobial-resistant Vibrio cholerae strains (serogroup O1) resistant to antibiotics such as
tetracycline, doxycycline, ampicillin, and trimethoprim-sulfamethoxazole, complicating treatment efforts. The COVID-19
pandemic further strained Nigeria’s healthcare system, underscoring the need for an integrated health system to be
strengthened to manage concurrent public health crises. This review emphasizes the importance of a multi-sectoral approach to
cholera prevention and control, addressing underlying social determinants and ensuring sustained investments in public health
infrastructure to mitigate future outbreaks.

Genetic modifiers in sickle cell disease leg ulcers: Unveiling the pathways associated with the development and, or progression of leg ulcers - A scoping review protocol

2025-01-17T09:47:50+00:00

This scoping review aims to assess the literature on genetic modifiers of leg ulcers in sickle cell disease, evaluating
available evidence, methodologies, and research gaps. A major morbidity in sickle cell disease is the development
of leg ulcers. This clinical syndrome of SCD leg ulcers (SLU) has continued to be an enigma due to its
multifactorial evolution, dearth of promising guidelines on treatment, and generally unsatisfactory response to
treatment. Underlying genetic susceptibilities for SLU may impact counselling, prognostication, risk of
development, severity as well as response to interventions. Hence the need for this scoping review. This scoping
review will collate and assess studies in English on genetic markers of SLU among all SCD age groups, genders,
races, and regions. Genetic or molecular markers to be assessed among patients with sickle cell leg ulcers included,
genetic markers of Inflammation, vasculopathy, tissue damage, oxidative stress, coagulopathy as well as genetic
predispositions that have been studied in relation to SLUs across all countries. This includes most common
biomarkers that promote development of SLU, the single nucleotide polymorphic markers (SNPs) that work
through the MAPK and SMAD signaling pathway. A PubMed search of all fields for literature published in
English using the strategy (sickle cell) AND (leg ulcer), and (sickle cell) AND (leg ulcer genetics) from 1998 to
2023 (last 25 years) will be undertaken. This will be modified, according to the inclusion criteria, as appropriate
across other databases. The other databases will include Google Scholar, web of Knowledge, Scopus, New Zealand
Science, Silver chair, Taylor and Francis+NEJM, and journals.lww.com.

The variability in pattern, presentation, and outcomes in the management of congenital corrected transposition of the great artery (ccTGA): A systematic review and meta-analysis.

2025-01-17T10:03:49+00:00

Background: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease
with varying regional reports in management approach. The meta-analysis is aimed to document various regional
differences in the pattern, presentation, and outcomes in the management of congenitally corrected transposition of
the great artery(ccTGA)
Methodology: Search engines for published articles on ccTGA were used in the meta-analysis. This includes
PubMed, Google Scholar, Web of Science, Medline, and Africa journal online. Articles published between 2001
and 2024 were recruited of which the last search was done in August 2024. Selected articles were highlighted and
screened by means of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Statistical
heterogeneity was assessed with the I
2
statistics.
Results: Fifty-one full articles were screened from the initial four hundred and eighty citations. A total of 37
studies were further excluded from the 51 studies after further screening for incomplete data, case reports, nonEnglish language reportage, and studies from autopsy findings. The resultant 14 studies were presented in
PRISMA. The statistical significance was observed as evidenced by the significance heterogeneity identified in the
selected studies.
Conclusion: The review had shown that children with ccTGA presented with varying features with some
chromosomal correlates. Management options are directed towards a high index of suspicion, early intervention,
and prompt surgical care to avert the numerous complications that follow the disease.