Research Journal of Health Sciences

An Unusual presentation of Cutaneous Sarcoidosis in a Nigerian: A case report

H. Sani — 2024-08-12

Background: Sarcoidosis is an idiopathic disorder which present with different manifestation. This is an unusual case of cutaneous sarcoidosis with extensive polymorphic lesions on the skin as the only organ involved.

Case Report: Mrs. A.O, a 28 year old house-wife presented with a one year history of progressive itchy, reddish, raised skin rashes for one year. Lesions were initially localized to the chest and limbs but subsequently involved the whole body including the palms and soles. No history of fever or weight loss. On examination, she had generalized erythematous, annular and arcuate plaques with areas of active edges involving the whole body including the palms and soles. Healed lesions were atrophic and hyperpigmented (Figure 1). No mucosal involvement. Her chest radiograph, FBC, ESR, LFT, serum Calcium, ACE levels (20U/L) and ECG were normal, while her Mantoux and Gene expert test was negative. Biopsy of the lesion showed dermal infiltrates, composed of epithelioid histocytes disposed in nodules as well as multinucleated giant cells of langhans and foreign body types features consistent with cutaneous annular sarcoidosis (Figure 3 and 4). She was placed on systemic steroids followed by topical steroids and made significant improvement. (figure 2)

Conclusion: Sarcoidosis is not common in our environment and cutaneous manifestation as the sole presentation is even rarer. We report one such case with skin as the sole organ affected and equally of interest is the extensive nature of the lesions observed.

Screening for chronic kidney disease among health workers in a tertiary hospital in North Central Nigeria

A. Bello — 2024-08-12

Background: Screening adults for chronic kidney disease and managing those identified has been advocated as one of the means of limiting the burden of the disease. The renal study team of Federal Medical Centre, Bida decided to screen health workers in the hospital for chronic kidney disease as part of activities marking the world kidney day.

Methods: A purposive cross-sectional study involving 262 health workers; using self -administered questionnaire was carried out after adequate publicity. Chronic kidney disease was defined according to KDIGO. Data obtained were analyzed with SPSS version 21.2

Results: Chronic kidney disease defined as eGFR <60mls/ min/1.73m was seen in 19 (7.25%) of the respondents. Also 79 (30.15%) had eGFR spanning within 2 60 – 89mls/min/1.73m . Marital status and recurrent body swelling were significantly associated with chronic kidney disease (p= 0.018 and 0.045 respectively). Marital status was the only predictor of chronic kidney disease in the population (p=0.047, Exp B= 0.166, CI= 0.028 – 0.976).

Conclusion: We advocate that comprehensive renal function test should be included in pre-employment medical screening test in the country.

Prevention of post-anaesthetic shivering under subarachnoid block for lower limb surgeries: A randomised controlled study comparing nefopam and tramadol

R.O. Shoyemi — 2024-08-12

Objectives: Shivering is one of the frequent, undesirable and unpleasant effects of spinal anaesthesia that can be prevented by several means including, pharmacological and non-pharmacological methods.

Methods: Patients between 18 and 65 years were randomly assigned into two groups (A or B). Group A patients received intravenous 0.3mg/kg nefopam while Group B patients received intravenous 0.5mg/kg tramadol just before the institution of subarachnoid block. The parameters assessed were: the incidence of post-spinal anaesthetic shivering, its' severity, and the side-effects of the two drugs. Changes in haemodynamic parameters, temperature, peripheral arterial oxygen saturation and temperature were also evaluated.

Results: Thirty- four patients (100%) in group A and twenty-eight patients (82.35%) in group B, were shivering-free. Thus, only six patients (17.65%) in Group B shivered intra-operatively; p= 0.025, which is statistically significant. The severity of post-anaesthetic shivering was assessed to be grade 2 in three patients (8.82%), while it was grade 1 in the remaining three patients (8.82%). Four patients experienced nausea in group B, but none in group A; p = 0.114 No episode of vomiting was observed in both groups.

Conclusion: Nefopam is better than tramadol for the prevention of intraoperative shivering under spinal anaesthesia.

Geo-Biochemical properties of peroxidase extracted from Cola nitida At the Ninth Year of Planting

O.A. Adefila — 2024-08-12

Background: This study reports the biochemical properties of plant peroxidase from white cultivars of Cola nitida for sustained biotechnological applications.

Methods: Peroxidase was extracted from Cola nitida, in 20 mM sodium phosphate buffer pH 7.0 containing 10% glycerol, 1% PEG, , 0.015% citric acid, 0.010% L-Cysteine and 0.010% ascorbic acid Buffer C). The extracted peroxide was subjected to a step wise purification stages which separated it into two peaks. The native molecular weight was determined for the major peak to be 21 ± 1.16 kDa while the subunit was estimated to be 15.5 ± 2.1 kDa.

Results: Optimum pH and temperature was studied to be 4.0 and 40^oC respectively. Further studies required investigating several methods of immobilization on the nine years harvested Cola nitida in order to enhance its biotechnological applications.

Conclusion: However, this study was able to establish that Cola nitida is a strong alternative to the commonly purchased horseradish peroxidase.

Platelet count can be used to determine the severity of oesophageal varices

K.C. Okonkwo — 2024-08-12

Introduction: Variceal haemorrhage is one of the most devastating consequences of portal hypertension. The risk of bleeding increases with severity of varices. It is important to see if there are parameters that can noninvasively predict severity of varices as endoscopy has some limitations.

Aims and Objectives: This study sought to determine if platelet count can be used to determine the severity of oesophageal varices in a low resource setting.

Methodology: This was a descriptive cross-sectional study, in which 79 patients with chronic liver disease and upper gastrointestinal endoscopy diagnosed varices were recruited consecutively to participate in the study. Blood sample for platelet count was taken from each patient. A proforma was used to document the demographic parameters as well as grade of varices and platelet count. The ability of platelet count to determine severity of oesophageal varices was assessed. Test of association between platelet count groups and grades of varices was carried out using the Chi-Square Test. Test of correlation between platelet count and grades of varices was carried out using the Spearman's coefficient.

Result: A total of 79 subjects were recruited into the study. Test of correlation between platelet count and grades of varices was statistically significant (ñ value: -0.783; p value: 0.001. There was a statistically significant difference in the median platelet count and grade of varices (p=<0.0001).

Conclusion: Platelet count, a simple, cheap and available investigation, can be used as a non-invasive predictor of severity of varices in resource poor settings with limited endoscopy services.

Trichoscopy findings of normal scalp and hair in blacks - A community survey

E. Otrofanowei — 2024-08-12

Background: Trichoscopic features of scalp and hair diseases have been described in Caucasians, Asians, Hispanics, and Black Americans but few reported in Nigerians. A survey of trichoscopic findings on disease-free scalp and hair of Black Africans becomes relevant and forms a comparative basis for establishing findings in a diseased state.
Objective: To examine the scalp and hair of Nigerians in a semi-urban community with no scalp and/or hair disease and document trichoscopy findings.
Method: A cross-sectional descriptive survey of 307 individuals at a semiurban market in Lagos where the scalp and hair of all participants were reviewed clinically and using DermLite® dermscope by dermatologists. Demographic data, clinical and trichoscopic findings of participants with no scalp or hair disease were documented using a pre-designed questionnaire. Data was analysed using IBM SPSS version 22. Ethical approval was sought and obtained from the Lagos State University Teaching Hospital (LREC/06/10/1297).
Result: 96 (31.3%) participants had normal hair M:F ratio of 1.1:1.0 . Those aged between 35 – 39 years and <25 years age bracket was 18.8% and 15.6% respectively. White dots were seen in (95; 99%), white dots with regular distribution (93; 96.9%), preserved honeycomb pattern in (92; 95.8%) and peripilar casts in 14; 14.6% of partcipants.
Conclusion: Trichoscopic findings of normal scalp and hair in Black Africans include regular white dots and preserved honeycomb appearance. Peripilar casts and scales may also be seen in Africans without hair or scalp disease.

Indications and outcomes of induction of labour among induced women in a tertiary hospital in Southwest Nigeria: a five-year review

M. Ayinde — 2024-08-12

Background: Induction of labour (IOL) is a common obstetric practice worldwide when the continuation of pregnancy poses a threat to the well-being of the mother or fetus.

Objectives: This study assessed the indications and outcome of labour induction among induced women in a tertiary hospital in Southwest Nigeria.

Method: A5-year review of records of all clients that had induction of labour at the facility between January 1, 2012, and December 31, 2016, was conducted, ® and analysis was done using IBM SPSSversion 23. Results were presented in tables and charts using frequencies and percentages. Chisquare test was used to assess for association between sociodemographic/obstetrics characteristics and the mode of delivery, with significance level(á) set at 0.05.

Results: A total of 286 women were induced during the period, with 79.0% successfully achieving vaginal delivery. Postdate pregnancy was the commonest 88 (30.6%) indication for IOL, and majority of 233 (81.5%) of the women had no complications.

Conclusion: The major indication for IOLin this study was postdate pregnancy, and the study observed a high success rate among women who had IOL, with very few reports of complications in both the mother and fetus.

The predictors of ownership and utilization of Long-Lasting Insecticidal Nets among caregivers of under-five children in Ekiti State, South-West, Nigeria

O.P. Oluyide — 2024-08-12

Background - Malaria is a life-threatening disease associated with a high level of morbidity and mortality in sub-Saharan Africa especially among children under five years of age. Long-lasting insecticidal Nets (LLINs) ownership and utilization are some of the proven interventions to reduce the burden of the disease. This paper aims to assess and compare the predictors of ownership and utilization of LLINs among caregivers of under-five children living in urban and rural settlements in Ekiti State, Nigeria. - This was a cross- sectional comparative study among 800 under-five caregivers. A multistage sampling technique selected 400 caregivers each from urban and rural settlements. Data were analyzed using Statistical Product and Service Solution (SPSS) IBM version 23. Univariate analysis was conducted to summarize the data and inferential statistics were generated using chisquare and binary logistic regression at 95%CI. The results showed much lower ownership rates in urban (32.3%) than the rural (33.0%). The predictor of ownership of LLINs among respondents in urban settlements was, obtaining their information about LLINs from health workers, friends as sources of information, awareness, good knowledge, and having positive attitudes about LLINs. Utilization is better in the rural (78.0%) compared to the urban (61.2%). The predictor of utilization of LLINs in urban settlements was having positive attitudes towards LLINs while the predictors of the utilization of LLINs in rural were the number of under-five children with caregivers and positive attitude to LLINs.

Conclusion –Ownership of LLINs in both settlements was very low and lagged in urban. The utilization was however higher but also lagged in urban. However, it has not reached the 80% proposed by the National Malaria Control Programme. It is therefore recommended that the Government and partners sustain the free distribution of LLINs throughout the year in the communities to improve ownership and Social and Behavioral Change Communication (SBCC) intervention is necessary to improve utilization.

Pattern of co-morbidities in chronic kidney disease patients on haemodialysis in Delta State, Nigeria: a retrospective study

A.B. Odonmeta — 2024-08-12

Background: Chronic kidney disease is regarded as a significant cause of mortality and morbidity in this current century, with a prevalence rate ranging between 1.6% and 12.4% in Nigeria.

Objective: To identify the prevalence rates of the various co-morbidities in CKD patients undergoing haemodialysis in a private centre in Delta State, Nigeria.

Methods: This study is a 6-year retrospective study, which reviewed all records of chronic kidney disease patients who visited the private centre in Delta State from 2016 – 2021. The variables accessible and retrieved from the registry were: age, sex, and co-morbid conditions. Data obtained were entered and analysed using Microsoft Excel. Descriptive statistics were used to present the results.

Result: Of the 7490 patients who received care for chronic kidney disease within the period under review, 1940 patients had 7262 sessions of haemodialysis and were included in the study. The mean age of patients was 50.36±17.16. About 1222(63.7%) are males while 718(36.3%) are females. The prevalence rate of the various co-morbid conditions identified were: hypertension (96.1%), diabetes (67%), HIV (14.4%), Hepatitis C (8.8%), Hepatitis B (6.9%), and obesity (5.2%).

Conclusion: Majority of CKD patients present with various co-morbid conditions, with the most frequently occurring condition being hypertension. It is recommended that CKD patients should be evaluated for other conditions with increased likelihood of occurrence.