Sahel Medical Journal

Perception and predictors of insecticide-treated net use in a rural Northern Nigerian community

Z Iliyasu, A Umar, G Aminu, S Jahun

Background: Sub-Saharan Africa carries a high burden of malaria. Despite evidence of the effectiveness of insecticide treated nets (ITNs), utilization rates are still low.
Methods: We assessed community perception of malaria and determinants of ITN use among 158 households in rural northern Nigeria using interviewer administered structured questionnaires.
Results: Nearly all respondents 157(99.4%) were familiar with the term “malaria” and attributed it to mosquito bite. Other mentioned causes of malaria included unclean environment (74%), heat (7%), overwork (1.9%), and contaminated water (0.6%). The symptoms mentioned included fever (95%), headache (52.5%), body weakness (41.1%) and vomiting (25.9%). Most respondents (84.0%) were aware of ITNs but only 34.8% used them. Willingness to buy at current market price, health workers as
source of information and the use of mosquito coils were significant predictors of ITN use.

Conclusion: High awareness of ITNs did not translate into its utilization. Public health education in malaria including free ITN use should be delivered by health workers.

Primary childhood head and neck neoplasms: An 8-year histopathological review in a teaching hospital

AP Igbe, WO Akhiwu

Background: Although infectious diseases remain the leading cause of death among children in our environment, neoplastic diseases have emerged as important cause of childhood morbidity and mortality.
Method: A retrospective review of neoplastic lesions of the head and neck region histologically diagnosed at University of Benin Teaching Hospital (UBTH) in children aged 0-14years between 2002 and 2009 was carried out with the aim of determining their incidence and histological patterns.
Results: A total of 266 neoplasms were diagnosed in this age group during the period out of which123(46.2%) were located in the head and neck region. Seventy two cases (58.5%) were malignant while 51 (41.5%) were benign. Lymphoma was the commonest histological type of malignant tumour (51%) with Burkitt’s lymphoma being the predominant subtype. The commonest benign tumours were haemangioma and neurofibroma each of which accounted for 8 cases (15.7%). The commonest sites for
these lesions were jaw, eye and adnexa, soft tissues, peripheral nerves, and lymph nodes.
Conclusion: It is concluded that Burkitt’s lymphoma remains the commonest childhood head and neck malignancy in the study population. The oral sites constituted about 40% of the tumours studied.

Effect of physical activity on body water in sedentary young underweight and obese women

H Nasim

Background: The purpose of this study is to examine the effect of a walking exercise on body water among sedentary obese and thin women.
Methods: Forty young untrained girls between the age of 20 and 25 years (obese, BMI>30: N=20 and thin, BMI <20: N=20) volunteered to participate in this study. Participants were randomly assigned to two
exercise (obese=10, thin=10) and two control (obese=10, thin=10) groups matched for BMI. DXA was used to measure each subject's body water, percentage body fat and lean mass. Serum estrogen level by radioimmunoassay (RIA) was assessed. Each walking session was 30 min long at intensity corresponding to 50-75% of maximal age adjusted heart rate and 3 days per week for 2 months.
Results: Percent body fat and lean mass were affected positively by exercise programme (p< 0.001). Significant change was observed in serum estrogen and body water in both exercise groups (p<0.05).
Conclusion: This study demonstrated that 30 minutes walking exercise improved adaptation of body fluids in both obese and thin sedentary women.

Clinical profile and outcome of adult tetanus in Kano

LF Owolabi, I Aliyu, M Nagoda, AG Habib

Introduction: Though tetanus is rare in the developed countries of the world, it remains a major public health hazard in the developing world like Nigeria despite availability of inexpensive vaccine. We undertook a 6-year study of all tetanus cases managed at two tertiary centres in Kano.
Methodology: Demographic and clinical data of all adult tetanus patients managed at Aminu Kano Teaching Hospital and Murtala Muhammad Specialist Hospital, Kano between January 2004 to December 2009 were collected and analyzed.
Results: A total of 146 patients were admitted in the two facilities out of which complete data was obtained from 126 patients. All patients had generalised tetanus. There were 93 (73.8%) males and 33 (26.2%) females. Their age ranges between 17 and 62 years; mean (35.2 ± 1.3) years. Majority of the patients were in the age bracket of 21 – 30 years with most (50.8%) being farmers. The most common portal of entry was leg wound while portal of entry was not identifiable in 37 (29.4%) patients. Incubation period was less than 48 hours in 46 (51.7%) and period of onset was less than 48 hours in 64 (50.8%) patients. Aspiration pneumonitis and laryngospasm were documented complications in 12 (9.5%) and 26 (20.6%) of the patients, respectively. The overall mortality rate was 46%.
Conclusion: Tetanus remains an important disease with substantial mortality in Kano. The males and farmers are most frequently affected. The overall mortality rate was 46% with the value being highest
among severe (87.2%) and the very severe (92.3%) cases.

QT interval prolongation in patients with hypertensive heart disease

KM Karaye

Background: The study assessed the prevalence of QT interval prolongation and identified its associated factors
Methods: The study was cross-sectional in design. Subjects confirmed on echocardiography to have HHD were recruited consecutively from 3 echocardiography laboratories in the Kano City, Nigeria, over 7 months. Prolonged QTc was defined as QTc > 440 ms in males and > 460 ms in females, or more than 500ms in both sexes in the presence of complete bundle branch block. A p-value of <0.05 was considered statistically significant.
Results: A total of 113 patients were recruited consecutively, and 32 of them (28.3%) had prolonged QTc, while the remaining 81 (71.7%) had normal QTc. Patients with prolonged QTc had significantly higher prevalence of moderate-severe dyspnoea and peripheral oedema, higher mean heart rate, shorter PR interval, larger left atrium and left ventricle (LV), worse LV systolic and diastolic functions, and higher prevalence of eccentric LV geometric pattern.
Conclusion: This study demonstrated high prevalence of prolonged QTc in patients with hypertensive heart disease. Affected patients had significantly higher prevalence of several factors associated with increased morbidity and mortality. Assessment of QTc is recommended for risk stratification in patients with HHD.

Histopathological pattern of breast carcinoma in different age groups

MA Misauno, AM Dauda, EO Ojo, A Abdulwahab-Ahmed

Background: Breast cancers tend to be more aggressive in younger patients and some histopathological types like medullary, mucinous and tubular variants have a better prognosis. This study describes the histopathologic pattern and tumour grade of breast carcinoma in younger patients.
Methods: This was a retrospective analysis of all consecutive breast cancer specimens submitted to the histopathology department of Federal Medical Centre Gombe during the study period. The data was analyzed with EPI Info 2002 using simple means and percentages.
Results: A total of 167 cases of breast carcinoma in 164 females were reviewed with three patients having bilateral disease. The age range of the study population was 22-75 years with a mean age of 44 +/-11.7 years. One hundred and twenty seven patients (76%) were aged less than 50 years while the rest were above 50 years. A total of 133 tumours were invasive ductal carcinomas, 107(80.45%) of which were in the premenopausal age group and 26(19.55%) in post menopausal age. One hundred and six patients (63.5%) had low grade tumours (grades 1 and 2) while 61(36.5%) had high grade tumours (Grades III and IV tumours). Forty three (70.5%) of these high grade tumours were seen in
premenopausal age group. Eleven patients had invasive lobular carcinoma of which 4(36.4%) were premenopausal while 7(63.6%) were post menopausal.
Conclusion: It is concluded that younger patients tended to frequently have aggressive and high grade disease.

Attitude of final year medical students towards community medicine in Ahmadu Bello University, Zaria, Nigeria

T Dahiru, SH Idris, AA Aliyu, J Ilyas

Background: Several studies were conducted in the past in Nigerian Universities to determine undergraduate medical students’ attitudes, aspirations and career preference but none was conducted in Ahmadu Bello University (ABU), Zaria. This study was undertaken to determine final year medical students’ attitudes toward Community Medicine.
Methodology: The study was cross-sectional and descriptive in design. A total of 94 graduating medical students during the 2006/2007 academic session were invited to participate in the study. All the 94 students were given self-administered structured and closed-ended questionnaire. We collected information on socio-demographic characteristics of the respondents, general and specific attitudes towards Community Medicine (CM), class attendance in Community Medicine, and choice of CM as a
field for future specialization.

Result: Seventy-two students (76.7%) have made up their minds to specialize in a chosen field of Medicine while fourteen (14.4%) were undecided. Thirty-five (48.69%) students said they could specialize in CM while 19(26.4%) cannot. Of the clinical discipline for possible specialization in the future by the whole class, 32(34.0%) respondents declared to specialize in Obstetrics & Gynecology, 18(19.1%) in Community Medicine 11 (11.7%) in surgery.

Conclusion: Our finding demonstrated that final year medical student favorably perceived community medicine as a future career.

A five-year review of uterine fibroids at the university of Uyo Teaching Hospital, Nigeria

AM Abasiattai, NM Utuk, EJ Udoma

Background: Uterine fibroids are benign tumours that arise from myometrial smooth muscle cells. They are the most common tumours found in humans and are particularly common in Negros. We determined
the prevalence modes of presentation and treatment modalities of uterine fibroid at the University of Uyo Teaching Hospital, Uyo, Nigeria.
Methods: The case notes of all patients with uterine fibroids over a 4-year period were studied.
Results: Uterine fibroids accounted for 7.1% of gynaecological admissions and 21.2% of major gynaecological surgeries. The patients’ age ranged from 21 to 55 years with modal age group being 31-40 years (38.8%). Majority of the patients were of low parity (75.4%). The most common presenting complaints were abdominal swelling (25.5%) and infertility (21.4%). Myomectomy was the most common surgical procedure performed (77.6%) and the most common post operative complications were anaemia (21.4%) and pyrexia (18.4%).
Conclusion: Uterine fibroids are common in our environment. The patients are predominantly of low parity and myomectomy is the most common surgical procedure performed.

The effect of aerobic exercise on some diabetic risk factors in obese women

H Nasim

Background: Exercise has been shown to prevent and delay onset of diabetes. The purpose of the present study is to examine the effect of walking exercise in reducing some diabetic risk factors in sedentary obese women.
Methods: Eighteen untrained obese (BMI>30) women aged 19-25 years volunteer took part in the research. They were randomly divided into two groups (Control: n=9, Exercise: n=9). At first and after 8 weeks lipid profiles and anthropometric variables were measured. Then the experimental group started exercise program that consisted of 30 minutes walk with intensity of %50- %75 of maximal heart rate. There were 3 sessions in a week for 2 months. The data were analysed by unpaired- t-test at the level of p<0.05.
Result: The results of this study showed that walking exercise positively changed diabetic risk factors variables in obese women (p<0.05).
Conclusion: This study demonstrated that diabetic risk factor can be reduced by a program of regular physical activity in young obese women.