African
Journals Online
Global Journal of Medical Sciences
Volume. 2 Number.1 2003
Abstracts
Bacterial
meningitis in adults at the University of Calabar Teaching Hospital.
A5-year retrospective study 1993-97
E.J
.Peters, K.K. Immananagha, E.E. Philip Ephraim and I.A. Ibanga
Department
of Medicine University of Calabar, Calabar
Federal
Medical Center Yenogoa
ABSTRACT
A
retrospective study of cases of adult Bacterial meningitis managed at
the University of Calabar Teaching Hospital Calabar over a 5 –Year
period (1993-97) was carried out to determine the Clinical
presentation, morbidity and the management outcomes during the survey
period. A total of 68 patients whose case records were found intact
were selected for the study. The case records of these patients were
reviewed for clinical features on presentation, the initial results of
investigations mainly lumber puncture and cerebrospinal fluid analysis
and nature of culprit organism. The management outcome of each patient
was also noted.
The
study reveled that forty one out of 66 patients recovered fully from
the illness after treatment, nineteen patients died and six patients
left against medical advice. The predicator of morbidity and mortality
were (a) late presentation with altered levels of consciousness or
outright coma; (b) early presentation while fully conscious and (c)
inadequate/ inappropriate medication prior to arrived in hospital.
Mortality rate was higher among patients who received inadequate
antibiotics, presented late for treatment; and in those presenting
with altered level of consciousness. The mortality rate was 59 and 52%
respectively. The values for each category were statistically
significant when compared with mortality rates of patients who
presented very early for treatment, had adequate doses of antibiotics,
and were fully conscious on arrival and during treatment, p<0.05.
The
common complications associated with adult bacterial meningitis were
septicemia, aspiration pneumonia and cranial nerve palsies. Bacterial
meningitis still remains an important cause of morbidity and mortality
in this environment. Adequate therapeutic coverage, health education,
and immunization where available, are required to control the scourge
of this disease.
Key
Words: Adult
Meningitis, Calabar.
Association
of multiple intestinal parasitosis and some specific parasites with
Human Immuno Deficiency Virus sero-positive status in Calabar.
S.M.
Udo, C.I. Mboto, M.E. Eja and E.E. Ekanem
Department
of Microbiology University of Calabar, P.M.B. 1115, Calabar, Nigeria.
School
of Medical Laboratory Sciences, University of Calabar Teaching
Hospital, P.M.B. 1278, Calabar, Nigeria.
ABSTRACT
The
association between intestinal parasites with Human Immunodeficiency
virus (HIV) seropositive status in Calabar was evaluated using fresh
stool samples collected from 175 HIV seropositive subjects. Samples
were collected from both male and female subjects with age range of
1-70 years (mean, 35 years) and examined macroscopically for
consistency, presence of blood, mucus and adult worms. Microscopic
examination was carried out using direct smear method in saline and
iodine. Stool concentration was by ether shake technique and modified
Ziehl Neelsen method was used for the detection of Crptosporidium spp.
In all, eight different parasites were detected from both groups of
subjects. Hiv seropositive subjects had a higher parasite load (4.33
+_ 0.24). Odds ratios associating Crptosporidium spp. Giardia
Lambia and Strongyloides Stercoralis with HIV seropositive status
were 106.9 (95%Cl 4. 11-5.22), 24.0 (95%Cl 2.61-3.25) and 22.1 (95%Cl
2.25-3.68) respectively. Infections involving four or more parasites
were exclusive to the HIV seropositive subjects and was significantly
associated (p<0.001) with HIV seropositive status. Parasitic
infections may be employed for the presumptive diagnosis of HIV
infections where clinical syndromes are inapparent especially in the
rural settings where HIV test kits may not be available but microscopy
is possible.
Key
words: Multiple
Parasitosis, Calabar, Nigeria, HIV Seropositive.
The
role of institutional factors in maternal mortality from obstructed
labour
E.J.
Udoma, A.D. Ekanem, M.E. John and A.I. Ekanem
Department
of Obstetrics and Gynaecology, University of Calabar.
Department
of Public Health, University of Calabar.
Department
of Anaesthesiology, University of Calabar.
ABSTRACT
We
conducted a ten-year review of maternal mortality from obstructed
labour in University of Calabar Teaching Hospital (UCTH), between
January 1st 1990 and December 31st 1999. The aim
was to examine the role of Institutional factors in maternal mortality
arising from this condition. The review showed that a total of 702
patients were managed as a result of obstructed labour giving an
incidence of 3.7%. Fifty-five patients died giving a case fatality
rate (CFR) of 7.8%. Fifty-one (92.7%) of the patients who died were
not booked, thirty-four (61%) were brought from spiritual churches,
while 17(31%) were from the traditional birth attendants’ (TBAs)
homes.
Four
(7.2%) were booked cases who were earlier scheduled for elective
caesarean section but defaulted and reported late in labour with
ruptured uterus. All patients were in social classes IV and V.
Although 48 (47.3%) of these patients were seen by doctors within one
hour of admission, only 6(10.9%) had initial assessment by senior
doctors. Five (9.1%) had surgery within two hours of admission,
21(38.2%) had surgery in four hours of admission whereas 29(52.7%) had
surgery after four hours of admission. The probable causes of maternal
deaths were haemorrhage 24(43.6%), septicemia 5(27.3%), post operative
shock 8(14.5%) renal failure 5(9.1%) anaesthetic deaths 3(5.5%). The
twenty-four patients who died from haemorrhage had no blood
transfusion. Nine of the patients who died from septicemia had no
antibiotics before surgery. Anaesthetic deaths were seen in those who
were managed by junior residents in conjunction with the anaesthetic
nursing staff. Suggestions are offered on how to improve the quality
of services provided by our hospitals with the aim of reducing
maternal mortality from it.
Keywords:
Maternal mortality, Obstructed Labour, Institutional factors
Distributors
of urinary schistosomiasis among high school students in Otukwang,
Obudu, Cross River State of Nigeria
O.E.
Okon and N. Umeche
Department
of Zoology, University of Calabar. Nigeria.
Department
of Applied Biology, Ebonyi State University, Nigeria.
ABSTRACT
Investigation
on the 200 high school children in Otukwang community. Obudu, Cross
River State, Nigeria showed an overall prevalence of 91% with peak
prevalence in children between 9-12years old. There was a higher
intensity of infection in females than males (t-test, P< 0.05) in
Otukwang community. Mean heamaturia was found to correlate positively
with the mean ova/10m1 of urine. In general, factors responsible for
infection included absence of pipe-borne water, presence of infected Bulinus
globosus in freshwater bodies and frequent contact of children
with cercaria infected waters.
Key
Words:
Urinary
Schistosomiasis, Distribution, Student, Otukwang Community, Cross
River State.
Prevalence
of common visual problems among primary school children in Calabar
Municipality, Nigeria
N. C. Osuchukwu
Department of
Public Health, Faculty of Laboratory and Allied Health Sciences,
College of Medical Sciences, University of Calabar, Calabar
ABSTRACT
A
study to determine the prevalence, types and degree of severity of
ametropia, hyperopia, myopia and astigmatism among 956 primary school
children from 10 selected schools in Calabar, Nigeria was conducted.
Pre-tested questionnaires were administered by two ophthalmic nurses.
Penlight examination, Hirschberg’s test, fundoscopy with a direct
ophthalmoscope without and when necessary, with pupillary dilation
were performed by one optometrist. All subjects whose visual acuity
were less than 6/6 in any eye, all who have at one time in their lives
been given corrective glasses for error of refraction were refracted.
When all cases of ametropia were considered, a prevalence of 14.9% was
found. Hypermetropia predominated (7.8%), followed by myopia (3.6%)
and astigmatism (3.5%). Ninety percent of the children with vision
less than 6/6 in any eye could have their vision improved by
refractive complications and disability. A total of 62.4% of these
children with visual disability could have their functional vision in
class improved without glasses by being moved to the front row in
class.
KEYWORDS:
Ametropia,
Primary School Children, Calabar, Nigeria
Comparative
studies of the nutritional indices of rural and urban school age
children in Umuahia
Ujah, A. O. and Maisie
H. Etukudo
Department
of Chemical Pathology, College. of Med. Sciences University of
Calabar, Calabar – Nigeria.
ABSTRACT
Malnutrition
is a major health problem among young children in third World
countries. In the present study, a comparative assessment of the
nutritional indices of rural and urban school children in Umuahia
North Local Government Area of Abia State, Nigeria was undertaken by
assessing both anthropometric and biochemical parameters of these
children. A total of one hundred and forty three (143) subjects were
used for the study .
Seventy one (71)
children were from the rural school and seventy two (72) from the
urban school with age range of 6-13 years . The anthropometric
measurements examined
Included mid –upper
–arm circumference , chest circumference , weight and height.
Results showed that there were no significant differences in the
anthropometric measurements (p > 0.05) between the two groups
studied. The biochemical parameters assayed were total cholesterol,
total proteins, albumin and globulin. There were also no significant
differences in the biochemical parameters assayed when the two groups
were compared. These findings probably suggest that malnutrition
between the age range of 6-13 years is rare among primary school
children in rural and urban Umuahia.
Key Words:
Malnutrition, Antrhropometric measurements, biochemical, indices.
Aetiologic
agents of Tinea pedis among diabetics and non diabetics in
Calabar, Nigeria
Udo
S. M.,* Oguoma C. C.,* Akpata L. E. ** and Epoke J.**
*
Departments of Biological Sciences University of Calabar, Calabar,
Nigeria
**
Medical Microbiology & Parasitology, University of Calabar,
Nigeria.
ABSTRACT
A total of 30 diabetic
and 36 non- diabetic controls aged between 20-79 years were examined
for tinea pedis using
standard microscopic and cultural procedures. The prevalence rates of tinea
pedis were 8 (26.7%) and 4 (11.1%) among diabetics and
non-diabetics respectively. Trichophyton
mentagrophytes var interdigitale was the most prevalent fungal
species isolated in this study. Candida
albicans was isolated from only diabetic subjects that had
symptoms of tinea pedis. This
suggests that diabetes mellitus may be a risk factor for tinea
pedis caused by Candida
albicans.There was a higher infection rate in diabetics aged
between 40-79 years of age when compared with non- diabetic controls,
where tinea pedis was only
found among the younger age groups range. There was a significant
difference in the infection rates among male and female diabetic
subjects (p < 0.05) It is concluded that diabetes mellitus may be a
predisposing factor to tinea
pedis caused by Candida
albicans but not by dermatophytes.
Key words:
Aetiology, Diabetics mellitus, Dermatophytes, Tinea
pedis.
Assessment
of the effect of plasma total protein and albumin levels of malaria
patients on Plasmodium falciparum sensitivity to chloroquine
1
J E . Okokon and 2 J O. Akpan
1
Department of Pharmacology and Toxicology, Faculty of Pharmacy,
University of Uyo, Uyo.
2
Department of Pharmacology, University of Calabar, Calabar.
ABSTRACT
The WHO in-vivo seven day test was employed in the assessment of the
possible effect of plasma total protein and albumin levels of adult
malaria patients on Plasmodium
falciparum sensitivity to chloroquine in Calabar in 2000. Thirty
adult malaria patients were involved in the study. Plasma total
protein and albumin levels of the patients were determined before and
after treatment with 25mg Choroquine base per kilogram body weight
(C25). Clinical and parasitological evaluations were performed. The
pretreatment as well as post treatment levels of these proteins for
sensitive and resistant infections were not significantly different.
The concentration of total chloroquine in the erythrocytes and whole
blood were also independent of the protein levels of the patients in
both sensitive and resistant cases. Thus demonstrating that the levels
of these proteins play no role in the treatment outcomes.
Key Words: Total
Protein, Albumin, Plasmodium Falciparum, Chloroquine Sensitivity.
Comparative
in-vitro effects of some anti-malaria drugs on human
erythrocyte glutathione-s-transferase (EC. 2.5.1.18) activity
*A.A.
Uwakwe and I. +N. Ononiwu
*Department
of Biochemistry, University of Port Harcourt
+Department
of Pharmacology, University of Port Harcourt
ABSTRACT
The
in-vitro effects of the anti-malaria drugs chloroquine,
camoquine (amodiaquine), mefloquine (lariam), quinine, halfan
(halofantrine) and fansidar (sulfadoxine + pyrimethamine), on human
erythrocyte gluatathione-S-transferase (GST) activity was
spectrophotometrically investigated at 37°C,
pH6.5 and at milligram percent (mg%) concentrations (0.10mg%, 0.20mg%,
0.40mg%, 0.60mg %, 0.80mg% and 1.00mg%) of the drugs.
Quinine
and its congeners, chloroquine, camoguine (4-amino quinoline) and
mefloquine, were all observed to significantly (P<0.001) increase
the activity of human erythrocyte glutathione-S-transferase in a
concentration dependent manner and according to the order: chloroquine
> quinine > mefloquine> camoquine. For instance at 1.00mg%
concentration of the drugs, human erythrocyte GST activity was
increased by 13.97, 8.98 7.98 and 6.98 folds in the presence of
chloroquine, quinine, mefloquine and camoquine respectively.
Halfan
(halofantrine) and fansidar (non-quinoline antimalarials) produced no
significant change in the activity of human erythrocyte GST at the
various concentrations tested. The activation of this enzyme by
quinine and its derivatives could point to a possibility of these
drugs to raise the oxidant stress of the red cells in the course of
their therapeutic actions.
Key
Words:
Malaria, Chloroquine, Camoquine, Halfan, Quinine, Fansidar,
Mefloquine, Erythrocytes, Glutathione-S-transferase.
Comparative
pharmacognostic and antimicrobial studies on leaves of two varieties
of Heinsia crinita
Kola, K. Ajibesin,
Bennamin, J. Ekpo and Danladi, N.Bala
Department
of Pharmacognosy & Traditional Medicine, Faculty of Pharmacy,
University of Uyo, Akwa Ibom State, Nigeria.
ABSTRACT
Heinsia crinita
(Rubiaceae) is classified as dark and white varieties in Akwa Ibom
State, though the two varieties appear macroscopically
indistinguishable. However, microscopical examination of the leaves of
the two varieties was executed by adopting standard microscopic
methods like surface preparation, transverse section and powder
clearing to reveal some discrepancies in stomatal types,
occurrence
of vascular bundles and presence and absence of sclereids. The
stomatal number, stomatal index and palisade ratio showed disparate
values for both varieties. The total ash, sulphated ash and acid
insoluble ash values also gave disparity to further distinguish the
two varieties and ostensibly justify their classification as dark and
white varieties. This finding will aid proper identification and
collection. In vitro
antimicrobical assay using agar gel-diffusion method was also carried
out on the leaves of the two varieties to determine differences in
their antimicrobial activities: Dark variety showed both antibacterial
and anti fungal activities while the white variety yielded only the
antibacterial activity.
KEY
WORDS: Heinsia
crinita, dark and white varieties, antimicrobial activities,
Pharmacognostic studies.
Effect
of nicotinic acid on Haemoglobin-S (Hbs) gelation and osmotic
fragility of Hbs erythrocytes
*A.
A. Uwakwe and E. N. Onyeike.
Department
of Biochemistry, University of Port Harcourt P.M.B. 5323, Port
Harcourt.
ABSTRACT
Various concentrations
(1.00, 1.25, 1.67, 2.50, 5.00 and 10mM) of nicotinic acid were tested
for their possible effects on HbS gelation (polymerization) and
osmotic fragility rate of HbS erythrocytes. The results indicated an
inhibition of HbS gelation by nicotinic acid in a
concentration-dependent manner. For instance, at concentrations of 1mM
and 10mM nicotinic acid, HbS gelation was reduced by 8.93% and 21.43%
respectively, after a 10 minute incubation.
Similarly,
a significant (P<0.05) reduction in HbS erythrocyte fragility was
observed in the presence of the vitamin. The reduction in HbS
erythrocyte fragility was also concentration-dependent. For instance,
at saline concentration of 0.3% and at nicotinic acid concentrations
of 1mM and 10mM, HbS erythrocyte haemolysis was reduced by 18.48% and
50.00% respectively. Nicotinic acid could therefore be considered a
necessary and beneficial factor in the diet of sickle cell patients.
Key
words: Nicotinic
acid, Haemoglobin S, Gelation, Osmotic Fragility, Erythrocytes
Complication
amoebic liver abscess still a significant health problem in the
tropics: 3 clinical case reports
Dr.
E. J. Peters, A. U. Etiuma D. U. Eduwem *V. O. Ansa
Department
of Medicine University of Calabar Teaching Hospital, Calabar. Nigeria
Department
of Surgery, University of Calabar Teaching Hospital Calabar, Nigeria
Department
of Radiology University of Calabar Teaching Hospital Calabar, Nigeria
ABSTRACT
Amoebic
liver abscess still poses a serious clinical problem in tropical
countries. Here we describe three complicated cases to illustrate the
magnitude this disease condition could assume in the tropics. Limited
access to health facilities as well as poverty and ignorance result in
patients presenting late, often with complications, which compounds
the problem of differential diagnoses. The need for improved sanitary
conditions, and qualitative health care delivery in the tropics to
positively alter the epidemiology of this disease becomes more
imperative.
KEY WORDS:
Amoebic liver abscess,
complications, tropics.
Anaemia
in children attending the General Hospital Ogoja, Cross River State-
Nigeria
P.
M. Ogan
Department
of Paediatrics, College of Medical Sciences, University of Calabar.
Calabar, Nigeria.
ABSTRACT
This
study was carried out in a General Hospital setting, in a semi urban
area to screen children for anaemia. All children who attended the
General Hospital, Ogoja during the nine months study period had
haemoglobin and haematocrit levels done on them. This was irrespective
of the disease entities for which the attendance were made. The
haemoglobin levels were obtained using the Haemoglobinometer while the
packet cell volume values were obtained using the microhaemotocrit
method. 175 children, aged 4 months to 10 Years were in involved in
the study 64% of the children were found to be anaemic and 98 (87.5%)
were five year old or below. It is recommended that children attending
any health facility for whatever illness should be screened for
anaemia.
Key words: Childhood
Anaemia, Ogoja, Cross River State-Nigeria.
The
search for an effective medical care service for Nigeria
Rev.
Dr. Solomon U. Ezenibe
Department
of Sociology University of Calabar, Nigeria
ABSTRACT
Although not always
well appreciated by the general public, medical service in Nigeria
consists of two main braches or divisions - a Public Health Division
which deals with social and preventive medicine and a medical Division
which deals with curative medicine. The level and efficiency of the
Public Health Service reflects the level of development of a country.
By that parameter, Nigeria is very much under-developed. No town in
Nigeria is wholly serviced by a Central Sewage System. Most of our
towns have open gutters and drainages. The Refuse disposal system is
poor. In spite of the need for a shift in emphasis, this paper will
center on effective organization of curative medical services in
Nigeria. Some of the key issues discussed are: the problems of our
hospitals, over centralization of hospital management, relationship of
management Boards to Ministry of Health, sharing of responsibility for
the Medical Care Services, Finance and manpower development. The paper
emphasizes that these days, there is a need to pay more attention to
the integrated nature of our health care and the complimentarity of
both divisions – medical/Public Health to ensure a national health.
It ends with a conclusion and recommendations.
Key Words:
Medicine, Public, Health,
Hospital and Preventive
|