African
Journals On-line
Journal of College of Medicine
Volume 7, Number 2, December 2002
ABSTRACTS
Vitamin A: The Expanding Spectrum of uses
Ebele F. Ugochukwu
Department of Paediatrics Nnamdi Azikiwe University
Teaching Hospital Nnewi, Anambra State, Nigeria.
Correspondence to: Dr Ebele F. Ugochukwu, Dept. of
Paediatrics Nnamdi Azikiwe University Teching Hospital Nnewi.
Background: Vitamin A is a naturally occurring fat
– soluble vitamin, whose main physiologic role is that of
maintenance of integrity of epithelial cells of the body. This
study reviews the functions, sources and varying clinical uses of
vitamin A.
Methods: Data were collected from MEDLINE searches,
Cochrane Controlled Trials and other relevant journals.
References are cited.
Results: Vitamin A has utility value in virtually all
branches of medicine Ophathalmology, Immunology, Paediatrics,
Obstetrics, Dermatology, Cardiology, Oncology and therapy of
infectious diseases.
Conclusions: Attention is drawn to the need for vitamin
A supplementation and fortification of foods to avert deficiency.
Key words: Vitamin A, fortification, supplementation,
deficiency.
Plasma Ascorbic Acid Concentration and some Haematological
Parameters in Homozygous Sickle Cell Disease in Enugu Metropolis
*S.O. Ureme , **F.E. Ejezie , #I.G. Maduka , +G.I. Ibegbulam
and +K.E. Nwanne
Departments of *Medical Lab. Sciences, **Medical
Biochemistry, #Chemical Pathology and +Haematology/Immunology,
College of Medicine, University of Nigeria, Enugu Campus.
Correspondence to: F.E. Ejezie , Dept. of Medical
Biochemistry U.N.E.C.
Aim: To determine the plasma ascorbic acid
concentration, haematocrit, reticulocyte count and blood cell
morphology in homozygous sickle cell disease in Enugu metropolis.
Materals and Methods: Forty known sickle cell anaemia
patients (HbSS) and ten non-sicklers (HbAA) were used as tests
and controls respectively. In both cases, whole blood samples
were collected in EDTA bottles. Plasma ascorbic acid
concentration was determined by Roe and Kenther method while
haematological parameters were by the method of Dacie and Lewis.
Results: The mean results obtained in sicklers were:
ascorbic acid 0.60± 0.13mmol/L; reticulocyte 5.7 ±2.3%;
haemotocrit 0.19 ±0.33L/L. In steady state, the following
results were obtained: ascorbic acid 0.32 ± 0.14 mmol/L;
reticulocytes 6.5 ± 2.2%, haematocrit 0.21 ±0.05 L/L. The mean
results for vasoocclusive crisis state were: ascorbic acid 0.35
±0.15mmol/L; reticulocyte 6.0±3.0%; haematocrit 0.39 ± 0.14
L/L. The results for the control subjects were ascorbic acid 1.42
±0.70mmol/L; reticulocyte 21.±1.7%; haematocrit 0.39±0.14L/L.
The blood cell morphology in sicklers showed moderate to marked
anisocytosis, poikilocytosis, hypochromia, polychromasia, target
cells and normoblastosis. The blood cells in control were
normocytic and normochromic. Ascorbic acid, Reticulocyte and
Haematocrit levels showed significant difference (p<0.05)
each, when sicklers were compared with controls. However, steady
and crisis states showed no significant difference (p>0.05)
Conclusion: The results suggest that ascorbic acid
concentration in plasma of sicklers in Enugu metropolis is lower
than normal subjects, while vaso-occulsive sickling crisis does
not appear to change the concentration in sickle cell disease.
The results also show that haematological changes occur in sickle
cell disease.
Key words: Ascorbic acid, sickle cell disease,
Haematological parameters.
Susceptibility Pattern of Nasopharyngeal Isolates of
Streptococcus Pneumoniae among Nursery School Children in Enugu,
Nigeria
*N.F.Onyemelukwe, Ph.D, # M.E. Ohanu, FNMCPath, and + Ada
Nwokocha, FMC (PAED) *Department of Medical Lab. Sciences,
#Department of Medical Microbiology, +Department of Paediatrics,
College of Medicine, University of Nigeria, Enugu Campus
Correspondence to: Dr. M.E. Ohanu, Dept of Medical
Microbiology UNTH, Enugu.
Aims: To determine the rate of nasopharyngeal
colonization of Streptococcus pneumoniae among nursery school
children in Enugu urban and to determine their antibiotic
susceptibility pattern particularly the penicillin resistant
strains.
Methods: Specimens were collected from the nasopharynx
of 385 apparently healthy children aged between 12 to 36months
with cotton tipped flexible metal applicator. The swabs were
immediately inoculated on to blood agar plates. The plates were
incubated at 37oC for 24-48 hours under 5% carbon
dioxide. Organisms were identified and confirmed as S.
pneumoniae according to Facklam and Washington technique.
Antibiogram was carried out with penicillin by the oxacillin disc
diffusion method and also to erythromycin chloramphenicol and
cephalosporin using Muellur – Hinton agar.
Results: S. Pneumoniae was isolated from 64 (16.6%)
children; 29% colonization rate observed in 141 malnourished
children was significantly greater (p<0.05) than the rate of
9.5% from the 244 children that were well nourished. Nine (14%)
of the 64 isolates of S. Pneumoniae were resistant to penicillin
and 2 of these were also found to be resistant to erythromycin,
chloramphenicol and cephalosporin.
Conclusion: A good proportion of apparently healthy
children in Enugu are nasopharyngeal carriers of beta
–lactam drug resistant strains of S. Pneumoniae especially
in the malnourished group and mainly in the age group 12-24
months. This observation calls for a careful re-evaluation of the
management of infections due to this organism that hitherto was
well managed with penicillin and related drugs. There is need for
constant monitoring of the antibiotic sensitivity patterns of S.
Pneumoniae strains from patients in this community.
Key words:Streptococcus Pneumoniae, carriage, drug
resistance
The Prevalence of Enterhaemorrhagic Escherichia Coli in
children Presenting with Diarrhoea at University of Benin
Teaching Hospital, Benin, Nigeria
*A.I. Omoigberale #M. Okolie and #M. Ajieh
*Department of Child Health and #School of Medical
Laboratory Sciences, University of Benin Teaching Hospital, Benin
City.
Correspondence to: Dr. A.I. Omoigberale , Department of
Child Health University of Benin Teaching Hospital
, P.M.B. 1111, Benin City, Nigeria. E-mail [email protected]
[email protected]
Objective: To determine the prevalence of
enterohaemorrhagic Escherichia coli (EHEC), the pathogenicity of
other strains of Escherichia coli and other organisms in children
presenting with and without diarrhoea in the hospital.
Subjects and Methods: A total of 247 stool samples
collected from children aged 1 month to 7 years, made up of
children with diarrlhoea (90) and children without diarrhoea
(157), were screened for the presence of enterohaemorrhagic
Escherichia coli (EHEC). Microscopy, culture and biochemical
tests were done on all stool samples for the presence of EHEC and
other enteric pathogens and for the presence of parasites.
Results: Out of the 247 stools tested, 103 (41.7%) were
infected with pathogenic organisms. No protozoan parasite was
isolated. Out of the 90 children with diarrhoea and the 157
children without diarrhoea, 64 (71.1%) and 39 (24.8%) (X2
= 2.462; P<0.05) were infected with pathogenic organisms,
respectively. The pathogenic organisms which included other
strains of Escherichia coli which were not typed had the
highest prevalence (87.4%) as against staphylococcus aureus
(11.7%) and candida species (0.9%). (X2 3.342;
P<0.05). However No EHEC, shigellae and salmonella species
were isolated. A moderately significant association was found
between the ages of children and E coli. Infection, with children
below 4 years of age, having the highest prevalence (X2
2.632, P< 0.05). There was an inverse relationship, the
younger children had more pathogenic infections than the older
children. No statistical significance was found between the sexes
and E Coli infection (X2 =0.432; P>0.05) and also
between the sources of water supply and E. coil infection (X2
= 0.502; P>0.05)
Conclusion: This study which was specifically carried
out to determine the prevalence of EHEC in diarrhoea children
recorded a zero prevalence. However in the course of the study
other strains of E. coli and other organisms were isolated as
reported in the study. This suggests therefore that EHEC is not a
common cause of watery diarrhoea in children. We suggest that
further work be done using bloody stool samples and stool samples
from children with renal failure. Perhaps its prevalence may be
higher as EHEC is thought to be strongly associated with bloody diarrhoea and children with haemolytic
uraemia syndrome.
Key words: Enterohaemorrhagic Escherichia Coli (EHEC),
Diarrhoea, Aetiopathogenesis, Children.
Prevalence of HIV Infections/ AIDS Among E.N.T. Patients at
the U.N.T.H., Enugu
*Nnennia Mgbor, M.D, FA ORL and # Godfrey
Okafor, Ph.D
*Department of Otorhinolaryngology and #Department
ofHaematology and Immunology, College of Medicine, University of
Nigeria, Enugu Campus.
Correspondence to: Dr. Nnennia Mgbor Dept. of E.N.T.
College of Medicine University of Nigeria Enugu, Nigeria., Fax
234 – 42-459718, e-mail [email protected]
Aim: To asses the prevalence of HIV/AIDS among E.N.T.
patients at U.N.T.H. Enugu.
Patients and Methods: Records of 224 patients who
attended the E.N.T. Clinic for surgery between May 1995 and April
1998 were retrospectively evaluated. The prevalence, spectrum,
and characteristics of head and neck complications of the AIDS
patients were evaluated.
Results: Out of 224 patients, 12 (5.4%) were HIV
seropositive, with a male/female ratio of 1: 0.7. They were aged
between the second and fifth decade with highest incidence in the
age group 21 – 30 years. Transmission was by heterosexual
relationships. Patients were neither drug abusers nor homosexuals
and there were equal numbers of single and married patients.
Businessmen were the highest occupational group (50%), followed
by students, civil servant and hoteliers at 16.6% each. Patients
presented with varied multiple symptomatology; productive cough 5
(50%), neoplasm 5(42%), catarrh 4 (33.3%), fever 3 (25%), sore
– throat 3 (25%), cervical lymphadenopathy 3 (25%),
dysphonia 3 (25%).
Conclusion: Although the above symptoms are common in
everyday otolaryngology practice, there should be awareness that
AIDS could present in a similar way.
Key Words: Acquired Immune Deficiency
Syndrome(AIDS),Otolarynagology, Manifestations, Varying,
Symptomatology.
HIV/AIDS Awareness Among Post-primary Students.
Chika Josephine Ifedili (PhD)
Institute of continuing education, Benin City.
Correspondence to: Dr(Mrs) C.J. Ifedili, Institutu of
Continuing Education, Benin City, Nigeria. E-Mail: [email protected]
Aim: To examine the rate of awareness of HIV/AIDS among
post-primary school students in Edo State of Nigeria.
Method: A stratified random sample of 4000 students
participated in the study. The instrument used in collecting the
data titled HIV/AIDS Awareness Inventory (HAAI) was tested and
the Pearson product moment correlation was 0,73. The final
Spearman-Brown formula yielded 0.85, which showed that the
instrument was reliable. The z-test and ANOVA were the
statistical methods used.
Results: The major findings were that: 68% of male
students as opposed to 81% of female students agreed that disease
could be transmitted only through sexual intercourse, 97% of the
students agreed that the disease carrier could easily be
identified by sickly lean look, 93% of the female students who
have had sexual intercourse agreed that their partners did not
use condom and 72% of the students have never had sexual
intercourse while 87% were found not to be sexually active.
Conclusion: The awareness of HIV/AIDS is very low
inspite of all the efforts already put in by both the government
and non-governmental agencies. The parents, teachers,
politicians, community and religious leaders and the mass media,
should intensify the awareness of the disease at the grass root
level.
Key Words: HIV/AIDS, Awareness, Post-primary students,
Nigeria.
Long Steel Wire Penetrating Through The Upper Aerodigestive
Tract In A Home Accident- A Case Report.
B.C Ezeanolue
Department of Otorhinolaryngology. University of Nigeria
Teaching Hospital Enugu.
Correspondence to Dr. B.C Ezeanolue, Department of
Otolaryngology, UNTH Enugu.
Presented, is a case report of a long and slender steel wire
penetrating and embedding in the upper aerodigestive tract of a
65-year-old man in a rare home accident. The upturned end of the
wire in the pharynx prevented it from being pulled out, despite
the fact that about 50cm of it was protruding from the mouth to
the outside. The challenging task of removing it was made simple
and safe by using an open surgical approach that directly
accessed the upturned end of the wire.
The rarity of such event, the age of the patient, the type of
the foreign body, the injuries suffered and the challenges it
posed in its management were discussed.
Keywords: Home accident, foreign body, aerodigestive tract,
surgery.
Design and Construction of Strain Gauge Interface Pressure
Transducer for Measurement of Static and Dynamic Interface
Pressure Applied by Pressure Garments and its Relationship to
Deep Vein Thrombosis
G.C. Okoye, M.B.,B.S., Ph.D.,
Bioengineering Unit, University of Strathclyde, Glasgow UK.
Correspondence to: Dr. G.C. Okoye, Dept. of Medical
Rehabilitation, Faculty of Health Science and Technology, College
of Medicine, University of Nigeria, Enugu Campus. Nigeria.
Many prophylactic and therapeutic devices used in orthopaedics
and rehabilitation medicine apply both static and dynamic
pressure on the skin of the body. Oftentimes, the pressure
applied by these devices may not be ascertained and when the
external compressing pressure is known, the actual or interface
pressure may not be a reflection of the externally applied
pressure. This transducer can be routinely used clinically to
ensure that various devices in clinical practice apply adequate
and safe pressures.
Key words: Interface pressure, Strain gauge transducer, deep
vein thrombosis.
Knowledge, Beliefs, and Practices of Malaria Preventive
Measures Amongst Pregnant Women in Enugu
*P.N. Aniebue ,*C.O. Akpala, *C.N. Onwasigwe **U.U. Aniebue.
*Department of community medicine, ** Department of
Obstetrics & Gynaecology, University of Nigeria Enugu Campus.
Correspondence to:Dr (Mrs.) P.N. Aniebue, Dept. of
Community Medicine, UNTH, Enugu. Aim: To determine the
knowledge, beliefs and practices towards malaria amongst pregnant
women in Enugu.
Method: A cross sectional survey of 300 consecutive
pregnant women attending the antenatal clinics of University of
Nigeria Teaching Hospital Enugu was carried out. The survey
instrument was a questionnaire with questions covering various
aspects of malaria including causes, prevention and treatment
practices.
Results: One hundred and thirty two (53.1%) of the
pregnant women had correct knowledge of the aetiology of malaria
while 103 (41.3%) still attributed the aetiology of malaria to
other factors including excessive ingestion of oil, overexposure
to sunlight, bite of cockroach, witches and poisoned food.
Knowledge of the causes of malaria was directly proportional to
the educational attainment of the women. Most respondents showed
correct knowledge concerning symptoms of malaria and fever was
the most acknowledged symptom; 234 (94.0%) believed malaria could
be prevented and knowledge and practice of malaria preventive
measures were also high. The major determinants of choice of
preventive measures adopted by the women were perceived
reliability 178 (71.2%) and ease of administration 76 (30.4).
Treatment choices of malaria amongst the women were oral drugs
123 (49.4%), injections 116 (46.6%) herbs 5 (2.0%) and
unspecified 5(2.0%). In the event of an attack of malaria 160
(64.3%) of the pregnant women would visit a doctor, 44.7 (17.7%)
would engage in home treatment with drugs mainly analgesics and
antimalarials, while the rest would resort to either treatment
with herbs, visit to chemists or resorted to prayers.
Conclusion: The study has demonstrated a fair knowledge
of causes of malaria and its preventive measures. However a few
grey areas have been identified. The belief in other causes of
malaria apart from mosquitoes as widely held by the women could
cause a diversion of attention to preventive measures from
mosquito bites. Sustained health education especially to less
educated women is strongly advocated to enhance to knowledge of
malaria and practice of preventive measures.
Key Words: Knowledge. Belief, Practices, Malria
Prevention, Pregnant Women.
Ilioinguinal and Genitofemoral Entrapment Neuralgia.
Experience in 8 cases and a review of the literature
Emeka Nwose MBBS, Ph.D.
Niger Foundation Hospital, Enugu.
Correspondence to: Dr Emeka Nwose,
Niger Foundation Hospital, 5 Presidential Close, P.O. Box 4206,
Enugu.
Background: Chronic residual neuralgia may occur after
operation in the lower abdomen as a result of surgical handling
or suture compression of the sensory nerves. Pain in the inguinal
region is the usual mode of presentation and if the pain
persists, accurate identification of the nerve involved, and
treatment is recommended.
Materials and Methods: Experience with 8 patients in
the last 3 years with chronic residual neuralgia after
appendectomy and herniorrhaphy is presented. Six of the patients
had Ilioinguinal and 2 had genitofemoral neuralgia. The six
patients with illioinguinal neuralgia had neurectomy.
Results: Five of the six patients who underwent
neurectomy for illoinguinal neuralgia had complete pain relief
while one of them required a further genitofemoral blockage for
coexisting genitofemoral neuralgia.
Conclusions: Nerve entrapment is a rare complications
of operations in the lower abdomen. When the diagnosis is made by
a multidisciplinary approach, a neurectomy is frequently
successful in relieving severe pain and paresthesia without
serious morbidity.
Key words: Entrapment neuralgia, diagnosis, and
treatment.
Cautionary case of Double Carcinoma Presenting as Acute Abdominal Pain
G.E. Njeze, * S.O. Mgbor, ** W.I.B. Onuigbo
University of Nigeria Teaching Hospital, Enugu, ** National
Orthopaedic Hospital Enugu
Correspondence to: Dr G.E. Njeze, Department Surgery,
University of Nigeria Teaching Hospital Enugu
Primary malignant neoplasms have been of great interest for a
long time. A historical review mentioned the commoner
combinations of organs and exemplified with primary cancer of the
urinary bladder being associated with that of the uterine cervix,
bowel, pharynx or prostate. The present study reports its
association with the gall bladder. The rarity value of this
combination is enhanced by the vesical growth being an
adenocarcinoma which is itself a rare type in this organ.
Key words: Gall bladder, Urinary bladder, Concomitant
carcinoma, Historical perspectives, case report.
Orbito-Ocular Tumours In Nigerian Children
E.N. Onwasigwe
Ophthalmology Department, University of Nigeria Teaching
Hospital, Enugu, Nigeria.
Correspondence to: Dr. E.N. Onwasigwe, Department of
Ophthalmology, U.N.TH, Enugu
Aim: An analysis of orbito –ocular
tumours in Enugu, Nigeria.
Patients and Methods: This is a retrospective analysis
of patients seen at the University of Nigeria Teaching Hospital,
Enugu, between January 1990 and December 1999. The information
sought included demographic data, presenting symptoms, diagnosis,
mode of treatment and histological pattern.
Results: Of the 134 patients enrolled for the study, 51
of them (38.1%) had retinoblastoma. This was considered the
highest presenting orbito-ocular tumour in children. Other
conditions included neurofibromatosis, dermolipoma,
chalazion,haemangioma, rhabdom- yosarcoma, pseudotumour, dermoid
cyst, Burkitt's lymphoma, liposarcoma, lipoma and onchocercal
nodule. About 70% of the patients presented at five years and
below. Patients with intraocular tumours were 38.0% of total,
followed by orbital tumours (34.0%), eye lid tumours (18.%) and
conjunctival tumours (10.0%). Intraocular tumours ranged highest
because retinoblastoma contributed to the highest number of cases
and is primarily intraocular.
Conclusion: This study has brought to light the many
aspect of orbito-ocular tumours in Nigerian children and also
highlighted the many problems caused by inadequate facilities for
diagnosis and management.
Key words: Orbito-ocular tumours, children,
retinoblastoma, tumour sites.
Teenage Pregnancy: Knowledge and Attitude of Adolescents
in Southeast Nigeria.
* Christian C. Ibeh. MBBS, FNMCP and #Joseph I. Ikechebelu
FWACS, FICS
*Department of community Medicine and # Obstetrics And
Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi,
Anambra State, Nigeria.
Correspondence C.C.Ibeh, Department of Community
Medicine, College of Health Sciences, Nnamdi Azikiwe University,
P.M.B. 5001, Nnewi Nigeria.
Aim: A cross –sectional study carried out in Awka,
Anambra State, Nigeria to determine the perception of adolescents
to teenage pregnancy.
Subject and Method: Four secondary schools were
randomly selected for the conduct of the survey. One hundred and
thirty (130) students in the senior secondary classes were
randomly selected in each of the chosen school giving a total of
520 subjects. Trained interviewers were used to administer
structured questionnaires to the students.
Results: The result revealed a high level of awareness
of teenage pregnancy amongst the adolescents (71.8%); 5.1% (16)
of the girls and 8.1% (15) of the boys reported having been
involved in teenage pregnancy. Over 92% (444) of the respondents
showed disapproval to it while 4.4% (21) were indifferent and 3.5
(17) consider it acceptable. Substantial proportions of the
students 29.8% (143) do not know how to avoid teenage pregnancy.
Contraception is not the favoured option but rather abstinence.
Abortion is low on the line of action subjects will take if they
fall victim to unintended pregnancy.
Conclusion: It is advocated that an urgent action be
taken by policy makers to reduce the prevalence of teenage
pregnancy to save the youths from undue hardship imposed on them
by unintended pregnancy and also check the spread of AIDS.
Adolescents should be encouraged to use contraceptives if they
cannot abstain from sex before marriage.
Key Words: Teenage Pregnancy, Knowledge. Attitude,
Adolescents.
Family Planning Attitude and Practice Amongst Male Doctors
in Enugu, Eastern Nigeria
H.E. Onah and H.U. Ezegwui
Department of Obstetrics and Gynaecology University of
Nigeria Teaching Hospital,
Enugu, Nigeria.
Correspondence to: Dr. H.E. Onah, Department of
Obstetrics and Gynaecology, University of Nigeria Teaching
Hospital, Enugu, Nigeria. E-mail: [email protected]
Objective: To determine the disposition of medical
personnel to contraception in Enugu, Eastern Nigeria.
Methods: A questionnaire survey of the contraceptive
attitude and practice of 386 male doctors practicing in Enugu and
a comparison of these with those of a previous study of the
general male population in Enugu.
Results: 73% of the male doctors compared to 90% of the
general male population in Enugu approved of male contraception.
62.7% of the male doctors compared to 78% of the general male
population used a contraceptive method. The main contraceptive
methods used by the respondents were condoms (43.9%), periodic
abstinence (34.7%) and coitus interruptus (6.5%) while more of
the general male population and their consorts used the more
effective artificial means of contraception – the
intrauterine contraceptive device, hormonal contraceptives and
spermicides . The major reasons proffered for the contraceptive
choice were prevention of sexually transmitted diseases in the
case of condoms and reduced side effects in the case of the
natural methods. Although 55.7% of the respondents favoured
adolescent contraceptive use, 22.8% of these would not allow
their adolescent children access to contraception. 75.6% of the
respondents were against legalization of abortion as a back-up
for contraceptive failure mainly on religious grounds and because
it will increase promiscuity.
Conclusion: Although medical personnel in Nigeria have
the potential to enhance not only contraceptive knowledge but
also its acceptance amongst clients, they themselves are less
favourably disposed to contraception than the general population.
Family planning programmes in Nigeria and other developing
countries need to recognize this limitation. Doctors, therefore,
also need to be encouraged to use contraceptives.
Key Words Family Planning, Attitude, practice, doctors,
Enugu..
A comparative Study of Maternal Mortality in Teritary and
Secondary Health Care Centres in Enugu, Southeast Nigeria
*Ijeoma O. Ehiemere M Comm. Health, FWACN and #Ethel Anyaeji
,BSc. Hons. RM,
*Department of Nursing Sciences, University of Nigeria,
Enugu Campus, #Maternity Unit, University of Nigeria Teaching
Hospital, Enugu.
Correspondence to: Ijeoma Ehiemere, Department of
Nursing Sciences, U.N.E.C.
Aim: To compare the maternal mortality rates at the
tertiary hospital (UNTH) and two secondary health institutions
(Mother of Christ and Colliery Hospitals) in Enugu Metropolis for
a five-year period 1995 – 1999.
Patients and Methods: A retrospective study of 11,415
deliveries in the three hospitals was undertaken for the
five-year review period. Maternal deaths as recorded in these
hospitals were reviewed. Information sought included total number
of deliveries for the period under review, booking status of
patients, parity and mode of delivery as well as causes of
maternal death. Doctor –patients ratio and Nurse
–midwives/patient ratio in the three hospitals were equally
included in information sought. Descriptive and parametric
statistics were used where necessary to compare similarities and
differences observed and explanations offered.
Results: Maternal Mortality Rate (MMR) was found to be
higher at UNTH, 1,738 per 100,000 births than the combined total
from mother of Christ 407 and Colliery 560 (967 per 100,000
births). Higher maternal deaths were found among grand
multiparous women (6 children and above) in the three hospitals.
Similarly, there was also high maternal mortality among unbooked
patients in the three hospitals. UNTH was better staffed in terms
of doctor- patients ratio and nurse/midwives-patient ratio than
the other two secondary level hospitals. Analysis of variance
(ANOVA) of the maternal mortality ratio at 95% confidence level
yielded a value of 0.086 as against a theoretical value of 3.88.
Conclusion: It is therefore conclued that it is not the
type of institutions that is the sole determinant of material
outcome as parity, booking status, mode of delivery and the time
and state at which the patient reaches the final referral centre
are contributory factors.
Key words: Comparative Study, Maternal Mortality,
Hospital.
The Use and Abuse of Psychoactive substances by Students of
A Rural Secondary School In Enugu Nigeria
K.O.B. Okonkwo and P.O. Ezeani
Department of Psychological Medicine, University of Nigeria
Teaching Hospital Enugu.
Correspondence to: Dr. K.O.B. Okonkwo, Dept. of
Psychological, UNTH, Enugu
Aim: To delineate the problem of the use of
psychoactive substances in a rural secondary school.
Method: Using a self – report questionnaire a
random sample of students of a rural secondary school in Enugu
State in Nigeria was studies to find the prevalence and the
pattern of use of psychoactive substances.
Results: A life time prevalence of the use of
substances of 76.3 percent was obtained. Eighty one percent of
the boys as against 67.8% of girls have ever used drugs and this
was statistically significant (P<0.05). In the daily use of
these substances (as also the “ever” use) alcohol
topped the list; closely followed by caffeine.
Conclusion: It is pertinent to mention the observation
of the absence of the use of Amphetamine, Cocaine, Opiodis and
Hallucinogens in our study population. However, the need for
immediate action to check this level of drug is highlighted and
the need for health education in all schools is stressed.
Key words: Drug abuse, rural school, prevention.
INJECTION PRACTICES IN ENUGU, NIGERIA
Margaret N. Aghaji
Department of Community Medicine, University of Nigeria
Teaching Hospital, Enugu.
Correspondence to :Dr.M.N.Aghaji, Depatment of Community
Medicine,U.N.T.H, Enugu
Aim: To determine the pattern of injection use and
reasons for its use in formal health facilities.
Materials and methods: This study was carried out in
1999 in Enugu, an urban city in Nigeria. Using a stratified
random sampling method 204 patients and 25 prescribers from 20
registered health facilities were selected for the study.
Information was collected using both self and interviewer
administered questionnaires with verifications from medical
records.
Results: Parental drugs were prescribed for 106(52.0%)
patients and injectables prescribed significantly more for
patients in the health centers 42(93.3%) N=45 followed by private
hospitals 56(51.4%) N=109 and least in tertiary/secondary health
facilities 8(16.0%) N=50. (X2=56.8, DF=2,
p-value=0.00) When the patients' were disaggregated by the
prescribers' qualifications the injection habit of specialists
(N=58) and general practitioners (N=92) were the same (approx.
38% each) while that of primary health workers remained
significantly high at (90.7%, N=54). (X2=44.3, DF=2,
p=0.00) And out of a total of 769 drugs prescribed, 207(26.9%)
were injectables. Of the 207 injectables prescribed; analgesics
were 54(26.1%) with dipyrone 47; antimalarials were 44(21.3%)and
all were chloroquine; vitamins/haematinics were 41(19.8%) with
Vitamin B complex 35 and antibiotics were 38(18.4%) with
penicillins 21.
The major reasons given by the prescribers for the injections
were to, quicken the onset of drug action 51(48.1%), satisfy
patients 21(19.8%) and when other formulations are not available
16(15.1%). The indications for the injections were justified for
only 20( 9.6%) drugs. Only 26(12.7%) patients requested an
injection. Most patients 154(75.5 %) did not make any specific
drug request because 108 patients felt that it was the
prescribers' duty. About 141(69.1%) patients knew that injection
can cause an adverse effect while 27 (13.2%) patients believe
injections have no disadvantages.
Conclusion: The rate of unjustified injection use
within the formal health sector in Enugu is very high though
patients demand for injections is low. Educational interventions
aimed at primary health care providers and private medical
practitioners should be organized urgently in this setting to
curb the rate of injection use.
Key words: injectables, drug prescription, Nigeria
Audit of Unbooked Post- Anaesthesia Admissions To Intensive
Care Unit in Enugu, igeria
Patrick U. Nze FWACS
Department of Anaesthesia, University of Nigeria Teaching
Hospital Enugu.
Correspondence to: Dr. P.U.N. Nze, Dept. of Anaesthesia,
U.N.T.H., Enugu
Aim: To determine whether unbooked admissions were
predictable, or whether there were any preventable anaesthetic
factors responsible for intensive care unit (ICU) admission.
Materials and Methods: The admissions to the Intensive
Care Unit (ICU) of the University of Nigeria Teaching Hospital,
Enugu for the period June, 1998 to end of August 1999 were
reviewed. Data were collected from medical records, especially
anaesthetic records. The anaesthetic chart records the source of
the admission, whether post-operative admissions are booked or
unbooked, patient age, mortality, details of therapies (including
medications, monitoring lines, management of fluids) airway
problems, cardiac disease, respiratory failure renal impairment
and infection.
Result: Three thousand operations were performed during
the study period. There were 150 admissions to the ICU from the
operating theatre, with 9(6%) unbooked. Of the unbooked
admissions, 6(67%) were considered predictable and 4 (44%) had
preventable features.
Conclusion: There were predictable and unpredictable
admissions with or without preventable features.
Key Words: Anaesthesia, Intensive Care, Audit.
Contribution of low Birth –Weight and Very Low Birth
Weight Infants to Perinatal Mortality at the University of
Nigeria Teaching Hospital, Enugu – Nigeria
G.N. Adimora MB:BS, FMC (Paed).
Department of Paediatrics College of Medicine, University
of Nigeria, Enugu Campus
Correspondence: Dr. G.N. Adimora, Dept of Paediatrics,
U.N.T.H. Enugu.
Objective: To determine the association between low and
very low birth weight infants and perinatal mortality at the
University of Nigeria Teaching Hospital, Enugu.
Methods: A retrospective study of the hospital records
in the labour ward and the Newborn Special Care Unit (N.B.S.C.U),
of the UNTH was carried out for the years 1992 –1997. The
babies enlisted in the study were those that weighed under 2.5kg,
subdivided into the low birth weight (LBW) infants, weighing
1.5-2. 49kg; and very low birth weight (VLBW) infants, weighing
0.5- 1.499kg. The birth weights among these age groups were then
compared with the general figures for all the births. Figures
obtained were analysed by simple statistical methods.
Results: A total of 6376 babies were delivered in the UNTH
during the period under study. Out of this number 784 (12.296%),
weighed below 2.5kg. Of this number 283 were VLBW and 501 LBW.
The perinatal mortality rate (PMR), for the LBW ranged from 294.8
per 1000 to 397 per 1000, the highest mortality rate being
recorded for the year 1995. The annual PMR for the VLBW ranged
between 516.6 per 1000 to 878.7 per 1000, the highest mortality
rate being recorded for the year 1997. Although the 784 total
number obtained for the LBW and VLBW babies was only 12.29% of
the total births in the hospital, the mortality rate among this
age group is very high especially in the VLBW infants
(717.3/1000)
Conclusion: The contribution of LBW and VLBW babies to
the PMR in UNTH is high. When considered separately, the PMR
among them is extremely high. Delivery, monitoring and treatment
procedures of pre-term infants need to be improved.
Key Words: Birth Weight, Perinatal Mortality, UNTH.
Tropical plants in health care delivery in Nigeria: Contributions of some members of Compositae (Asteraceae)
J.C Okafor FLS, FFAN, PhD
Fame Agricultural Center No. 3 Kingsway Road, Enugu.
Correspondence to: Prof. J.C. Okafor, Fame Agricultural
Center, 3 Kingsway Road, P.O. Box 3856, Enugu. E-mail:
[email protected]
Aim: To identify, review and highlight the
contributions of some species of Compositae to health care
of the Nigerian populace, especially in rural setting.
Methods: Information is derived mainly from ethno
botanical surveys conducted over time by the author, in
Southeastern Nigeria. The information is corroborated by
experienced traditional medicine practitioners who are members of
the Association for Scientific Identification, Conservation and
Utilization of Medicinal Plants of Nigeria (ASICUMPON) Enugu.
Reference is made also to Useful Plants of West Tropical Africa.
Results:Twenty-two species are discussed, indicating
their medical value in treating several ailments and conditions.
The spectrum of ailments is indeed wide including diabetes,
insomnia, skin problems, fertility and impotence, malaria, ulcer,
sexually transmitted diseases, cough, worms, sores, poison
antidote, among others. Method of preparation and administration
include infusions, decoctions, maceration and pounding, drying
and steam baths.
Conclusions: The abundance of species and variety of
ailments treated justify further research on the contributions of
Compositae in Nigeria.
Key words: Tropical plants, Health care, Nigeria.
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