African
Journals On-line
Journal of College of Medicine
Volume 8, Number 1, June 2003
ABSTRACTS
Assisted
Reproduction Techniques (Art): The State of the Art in Nigeria
Joseph
I. Ikechebelu. MBBS, FWACS,FICS
Department
of Obstetrics and Gynaecology, College of Health Sciences, Nnamdi Azikiwe
University, Nnewi Campus, P.M.B. 5001, Nnewi, Nigeria
Correspondence:
Dr. J.I. Ikechebelu. Dept. of Obstetrics and Gynaecology, College of Health
Sciences, Nnamdi Azikiwe University, Nnewi Campus
Background: Infertility
has become a social stigma in our environment because of the erroneous belief
that a childless marriage is a failed marriage. This has placed a lot of
marriages under pressure. Therefore any solution to infertility is a welcome
relief. This is where Assisted Reproduction Techniques (ART) belongs.
Aim:
To present an overview of ART and review the state of the practice in Nigeria
highlighting the benefits, limitations and the future of the ART.
Findings:
ART has grown from its humble beginning with IUI and IVF & ET in only one
centre in Nigeria to more advanced techniques like ICSI and TESE in 3 notable
centres. ICSI has enjoyed a better pregnancy rate than even the conventional
IVF because of high male infertility in Nigeria. High cost of procedure, lack
of skilled personnel and poor infrastructures are the major obstacles to the
growth of ART in Nigeria. However, the coming of more centres has led to a
price reduction and partnership with foreign centres has also provided the
needed skill and experience. The joy of an infertile couple having a child of
their own remains a driving force for ART is Nigeria and any success is a
reduction in the infertility scourge.
Conclusion:
ART has therefore brought a ray of hope for the infertile couple. It is
becoming more available and affordable in Nigeria with improving success rate.
It should not be condemned entirely as it can be a last resort for some infertile
couple who can afford it.
Key words:
Assisted Reproduction Techniques, Benefits and Limitations, Nigeria.
Review:
Vegetarianism- Food as
Medicine and A way of Life
Chima Oji Md. DDS.
Department of Oral and
Maxillofacial Surgery, University of Nigeria Teaching Hospital, Enugu
Correspondence
to: Chima Oji,44 Park Avenue GRA, P.O.Box 3265, Enugu-Nigeria. E-mail: [email protected]
This short review highlights the beneficial and adverse effects of
vegetarian diets in various medical conditions, and the relationships between
vegetarian diets and morality. It is becoming increasingly important to
recognize that both values and scientific issues come into play in evaluating
data on diet. An inverse association has been reported between nut, fruit,
vegetable and fibre consumption, and the risk of coronary heart disease. An
inverse association between fruit and vegetable consumption and stroke has been
suggested. There is an inverse association between dietary fibre intake and
incidence of colon and breast cancer as well as prevalence of colonic
diverticula and gallstones. There are few adverse effects, mainly increased
intestinal gas production and a small risk of vitamin B12
deficiency. The link between food and mood has been established by hundreds of
scientific studies. Many of them show that vegetarian diets positively
influence depression, anxiety, anger, violence, lethargy, and cravings.
Key words: Vegetarianism,
Medical viewpoint, Ethical reasons.
Urolithiasis
in Pregnancy – A Clinical Review
Emmanuel O Abara, FRCS (C), FACS
Richmond Hill Urology Practice and Prostate Institute,
Ontario, Canada
Correspondence to: Dr. E.O. Abara, Suite 204,
10168 Yonge Street, Richmond Hill, Ontario L4C 1T6, Canada E-mail: [email protected]
Urolithiasis in not rare in women of childbearing
age, however, its occurrence in pregnancy is uncommon. The clinical
presentation may not be straightforward, as there are a variety of obstetrical
and surgical problems that qualify as part of the differential diagnosis. This
can lead to delay in the treatment, which in turn can threaten the pregnancy
and lead to renal impairment.
Iron and Cancer: A Review
P.M. Ofordile1MSc, FIMLS; P.U.Achukwu1 MSc;
AIMLS, A.A Ngokere2, FIMLS A.A Ofodile3 MSc, MD
Department of Medical Laboratory Sciences1,Morbid Anatomy2,Radiation
Medicine3, College of Medicine, University of Nigeria, Enugu Campus,
Enugu Nigeria.
Correspondence to: P.M. Ofordile Department of Medical Laboratory
Sciences
College of Medicine, University of Nigeria, Enugu Campus.
Iron overload constitutes a
major health problem worldwide, and deserves attention. This review covers a
few of the proliferating literature ranging from mechanisms of its
carcinogenesis, iron-withholding defense system and its attendant risks, to
suggestions of prevention and control.
Key Words: Iron, Cancer,
Peroxyl radicals, haemochromatosis, neoplastic cells.
Should we really be
promoting home or community-based malaria treatment? Insights from a study in
Southeast Nigeria on the treatment of child-hood malaria
O.E Onwujekwe (MBBS, PhD)1, C Akahara (MBBS, FWACP)2,
B.S.C Uzochukwu (BMBCH, MPH,FWACP)2 and E.N Shu (MSc, PhD)1
1Health Policy Research Unit, Department of
Pharmacology and Therapeutics, College of Medicine, University of Nigeria
Enugu, Nigeria
2Department of Community Medicine, College of
Medicine, University of Nigeria Enugu
Corresponding to: Dr.
O.E. Onwujekwe, Health Policy Research Unit, Department of Pharmacology
and Therapeutics, College of Medicine, University of Nigeria Enugu Campus.
Email: [email protected]
Aim:To determine
household’s practices in utilization of home treatment for childhood malaria
and explore their implications for improving prompt appropriate care in
communities.
Methods: Questionnaires
were administered to women from randomly selected households with previous
month history of childhood malaria in four villages. Focus groups discussions
were also held with groups of men and women in each village.
Results: A total of
28/94(29.8%) of the households had drugs in their homes at the time the child
had “malaria” and 40 (42.6%) had to buy the drugs from outside. However, 26
(27.7%) first took the child to a health facility for treatment. Only 53.2%
cases were confirmed to be malaria, but 47.8% of the treatments given contained
anti-malaria and 31.2% drugs like antibiotics.
Conclusion: Home treatment
can lead to inappropriate drug consumption. It is necessary to compare the
cost-effectiveness of alternative means of bringing treatment nearer the home
and community –based health workers can help to surmount the problems with home
treatment.
Keywords:Malaria, Home
treatment, Community–based, Appropriate treatment.
Use of substance and non-prescription drugs by pregnant Nigerian Women
1John
E.N. Okonkwo FMCOG, FACOG; 2R. Uwakwe FMPsych
1Department of Obsetrics and Gynaecology, 2Department
of Psychiatry, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria
Correspondence
to: John E.N. Okonkwo, P.O.Box 8282, Enugu, Nigeria
Objective: To evaluate the problems of alcohol, other substance
and non- prescription drugs use during pregnancy.
Methods: The study was
carried out at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
Participants who were recruited during the study period, consisted of 1160
alternate pregnant patients who registered at the antenatal clinic from January
1999 to December 2001. They were administered the psychoactive substance
screener section of the ICD – 10 symptom checklist (WHO, 1994); the
self-reporting questionnaire (SRQ – 24 Harding et al, 1980) and the health
questionnaire (Sheila Blume, 1996).
Results: Thirty percent of the women admitted to use of non-
prescription drugs. Vitamins were the most commonly abused (41.4%) followed by
analgesics (33.4%), kola nuts (25.7%), laxatives (10.6%), and antacids (8.9%)
Alcohol was consumed by 43.7%. Whereas 16.7% found alcohol not helpful in
feeling better or relaxed when they are depressed or nervous, 27.1% found it
helpful. The incidence of drinking alcohol was higher (50%) among the 35 and
above year age group, followed by the 30-34 year age group with 37.5%. Only
2.9% admitted to using tobacco.
Conclusion: Alcohol consumption in pregnancy appears to be
higher in the older pregnant Nigerians. The implications of use in early
pregnancy and during labour are highlighted.
Key Words: Non-prescription
drugs, Substance use, Pregnant Women, Nigeria
Tracheobronchial
Foreign Bodies In Nierian Children: Clinical Profile And A Teachnique Of
Administering Anaesthesia During Rigid Bronchoscopic Removal
*B. C. Ezeanuolue, FMCORL, ** K. L.A Izuora,
FWACS, ** H. A. Ezike, FMCA
Department of *Otolaryngology and
**Anaesthesia, University of Nigeria Teaching Hospital Enugu-Nigeria
Correspondence
to: Dr. B.C Ezeanolue, Department of Otolaryngology, University of Nigeria
Teaching Hospital, Enugu- Nigeria
Aim: To highlight the
clinical profile of foreign body aspiration in children seen in a clinic in
Enugu and the technique of rigid bronchoscopic removal of these foreign bodies
under general anaesthesia.
Method: The study was retrospective. The anaesthetic pre-medication was to give
intravenous atropine 0.01mg/kg body weight. Anaesthesia was induced wih
intravenous dose of ketamine 2.0mg/kg and midazolam 0.1mg/kg body weight, and
followed with a bolus dose of suxamethonum 1mg/kg. An appropriate sized rigid
respiratory bronchoscope assembly was inserted into the trachea. Patient was
ventilated manually and bronchoscopic removal of foreign body done.
Results: They were 19 males and 11 females, with an average age of 1.6years.
Groundnut was the most commonly recovered foreign body in 19(63%) patients. The
right main bronchus was the commonest site of impaction in 10(33%) patients. No
foreign body was recovered in 4(13.3%) patients. Two patients (6.6%) died from
severe acute pulmonary oedema.
Conclusion: Foreign body aspiration is a persistent life-threatening problem among
Nigerian children. We recommend that children below the age of 4 years should
not be fed whole groundnuts.
Key words: Anesthesia, Foreign body aspiration, Tracheo-bronchial tree.
Phacomorphic Glaucoma in
Gambians
Chimdi M. Chuka-Okosa MSc;
F.W.A.C.S.
Department of Ophthalmology,
University of Nigeria Teaching Hospital, Enugu
Correspondence
to: Chimdi Chuka-Okosa Dept of Ophthalmology, U.N.T.H. Enugu
Aims: (i) To assess the uptake
of cataract surgical services in the Gambia in a simple way, using the
incidence of Phacomorphic glaucoma.
(ii) To review the cases of phacomophic glaucoma seen in the Gambia
over a one-year period.
(iii) To update us on the systematic approach to the treatment of early
phacomorphic glaucoma.
Report: Four cases of
phacomorphic glaucoma (with no previous history or signs of trauma, uveitis or
any other ocular or systematic pathology that could explain the development of
the glaucoma apart from cataract) seen over a one-year period in Royal Victoria
Hospital, Banjul, the tertiary unit of the Gambian Eye Care Programme, were
identified and analysed for age, sex, symptoms/signs, duration and treatment.
There were 3 females and 1 male
aged between 50 and 71 years. All but one presented with pain and blurred
vision of≤3 week duration. Visual
acuity at presentation was ≤PL in all patients and all remained blind
(visual acuity <3/60) even after surgery.
Conclusions: i. Generally, the
uptake of cataract surgical services in the Gambia is good. ii. In spite of the
effectiveness of the cataract surgical services of the Gambian Eye Care
programme, those in dire need of cataract surgery have not come in contact with
the available services.
Key words: Phacomorphic
glaucoma; lens intumescence.
Inverted Papilloma of the Nose and Paranasal Sinuses.
*Nnennia
Mgbor FMCORL, **Wilson I.B. Onuigbo FRC Path.
*Department
of Otorhinolaryngology, University of Nigeria, Enugu Campus; **Medical
Foundation and Clinic, Enugu
Correspondence to: Dr. N. Mgbor, Department of
Otorhinolaryngology, University of Nigeria, Enugu Campus
Background: There has been some difficulty
distinguishing inverted papilloma (IP) of the nose and paranasal sinuses from
other nasal tumors. Confusion exists because IP are uncommon tumors, mimic
nasal polyps and nasal malignant growths and also vary in growth from
transformation into malignancy.
Method: Histologies of a series of inverted
papilloma of the nose and paranasal sinuses within a period of 12 years (1985 –
1997), were evaluated. Cases were analysed using the following morphological
criteria: clinical finding, localization, bony changes, duration of growth,
recurrences and pathologic sections.
Results: There were 22 patients, aged between
35 and 80 year (N = 22; 11 Males, 11 females), with histologically proven
inverted papilloma
Treatment options were simple excision, polypectomy,
Lateral Rhinotomy, Caldwell-luc and Hemimaxillectomy. Recurrence was a common
feature.
Conclusion: Radical aggressive surgery with a
close follow up is advocated to avoid recurrence or possible transformation
into malignancy.
Keywords: Inverted papilloma, Nose and
Paranasal Sinuses, Features.
Sub-chorionic Haematoma: Has
it a prognostic relevance in Pregnancy Outcome?
*Arthur C Ikeme FRCOG,
FWACS, **Hyginus U Ezegwui MBBS, FWACS and ***S.O. Mgbor, FWACS
*Department of Obstetrics
& Gynaecoloy, University of Nigeria Teaching Hospital, Enugu
**Federal Medical Centre
Abakaliki, Ebonyi and ***Department of Radiology UNTH Enugu
Correspondence Dr. H U
Ezegwui Department of Obstetrics and Gynaecology, University of Nigeria
Teaching Hosptial, Enugu e-mail [email protected]
Aim: To evaluate the significance of sub-chorionic haematoma found in
patients with first trimester vaginal bleeding , on pregnancy outcome.
Method:
This is a prospective study. Five hundred and thirty six patients with first
trimester bleeding had abdomino – pelvic ultrasound. Forty-seven patients had
sonographic evidence of subchorionic haematoma. The pregnancy was followed up
in the forty – seven patients.
Result: Spontaneous
abortion occurred in 13 patients (27.7%) premature labour in 12 patients (25.5)
and spontaneous term vaginal birth in 22 patients (46.8). There was no
sonographic evidence of ectopic pregnancy and trophoblastic disease.
Conclusion: Majority of the patients who had sub-chorionic haematoma had a normal
term pregnancy. However if the subchorionic haematoma was extensive and
associated with passage of dark blood clots per vaginam the prognosis for the
fetus was poor.
Key words:
First trimester bleeding, sub-chorionic haematoma, pregnancy outcome.
Cost Implication of
Abdominal wound Dehiscence in Obstetric Patients at UNTH Enugu, 1990 – 1999
Aniebue
U.U. (F.W.A.C.S)
Department
of Obstetrics & Gynaecology UNTH, Enugu
Correspondence to: Dr. U.U.
Aniebue, Department of Obstetrics & Gynaecology, University of Nigeria
Teaching Hospital, P.M.B. 1129, Enugu
Aim: To
evaluate the magnitude of cost involved in treating abdominal wound dehiscence
in obstetric patients at the University of Nigeria Teaching Hospital (U.N.T.H)
Enugu and estimate the impact of such costs on parturients.
Methods:A
retrospective case – note based audit was carried out in obstetric patients who
developed abdominal wound dehiscence in UNTH Enugu between January 1990 and
December 1999. Direct and indirect costs were estimated and their impact
analysed.
Results: Fifty-six
cases of abdominal wound dehiscence occurred in 2460 caesarean sections and 48
laparotomies resulting in a prevalence of 2.2%. Seven (12.5%) complete
abdominal wound dehiscence and 49 (87.5%) partial abdominal wound dehiscence
were recorded. The mean age of affected women was 27±4.3 years. Their parity
ranged from 0-6. Most of the women (69.6%) were is social classes 4 and 5.
Their mean duration of hospitalisation was 26.7±11.8 days. In 57.1%, the
surgeries were done as emergency and in 30.4%, they were booked. The estimated
total cost of treatment in the affected parturients was 1,172,089 Naira. Except
for 2 women in social class 1, the rest needed 2-6 times their monthly income
to offset the cost of treatment. Treatment costs were significantly higher in
unbooked women than their booked counterparts (p<0.05); 73.1% of direct
costs were incurred in women who did not have either pre-or intra –operative
antibiotics.
Conclusion:
Prolonged hospitalisation, high cost of treatment, and prolonged job loss,
which might lead to aversion to obstetric operations and hospital delivery,
were evident. The consequence is a self- perpetuating cycle of high costs and
increased morbidity. It is expected that with the mass mobilization of our
parturients to good antenatal care and safe delivery, the cost of obstetric
services in our centre will reduce.
Key words: Cost
implication, Wound dehiscence, Obstetrics.
Attitude of University of Nigeria Medical Students to Community
Medicine
C.N.Onwasigwe FWACP, FMCPH
Department of Community
Medicine, University of Nigeria,Enugu Campus
Correspondence to: Dr(Mrs.) C.N. Onwasigwe, Department of Community
Medicine, UNTH, Enugu
Aims: A study was carried out
among 136 final year medical students of University of Nigeria Enugu Campus, to
verify their attitude to Community Medicine as well as selection of the course
for future specialization.
Methods: The study was a cross sectional descriptive one involving all final
year medical students of the College of Medicine, University of Nigeria Enugu
Campus, graduating in the year 2000.
Results: The study showed that the
students had a fairly good attitude towards Community Medicine. However, only a
minority of the students 16(11.8%) ranked it first when compared with the other
clinical courses. A total of 24 (17.7%) of the students chose the course as
their area of future specialization. There was no statistically significant
difference between the male and female students in their opinions.
Conclusion: It is recommended that some
new innovative methods would be employed to increase the students’ interest in
the discipline, particularly the aspect of Primary Health Care which is the
mainstay of the country’s health care delivery system.
Key Words: Medical
students, Community Medicine, attitude, specialization.
Socio-Demographic and Clinical features of Adolescents Attending an
Out-Patient Psychiatric Clinic of a Nigerian University Teaching Hospital
F.E.
Okwaraji
Department of Psychological
Medicine, University of Nigeria Teaching Hospital, Enugu
Correspondence to:
F.E. Okwaraji, Department of Psychological Medicine, U.N.T.H., Enugu
Aim:To find out the socio-demographic and clinical features
of adolescent who attended the outpatient psychiatric clinic of the University
of Nigeria Teaching Hospital Enugu over a five-year period (1995 – 1999)
Method:Case notes of all
the patients who attended this clinic for this five-year period were extracted
from the medical records department of the hospital and examined. The case
notes of all the adolescents who attended the clinic were then isolated from
the lot and studied.
Results: Out of a total
of 3277 patients seen in this clinic for this period, 583 were found to be
adolescent representing a period prevalences of 17.8%; 60.2% of the adolescents
were students. The average age of the adolescents was 14.5years, 31.2% of the
adolescents presented with schizophrenic symptoms followed by substance abuse,
which recorded 20% of attendance. There were 62.6% males and 37.3% females
giving a male: female ratio of approximately 2:1.
Conclusion: In view of large
number of adolescent who attended the out-patient psychiatric clinic of this
hospital, it was concluded that government should lay more emphasis on the
improvement of the mental health status of adolescents by creating an enabling
socio-economic environment through better youth employment and educational
opportunities as well as counseling in schools among others.
Key words:
Socio-demographic, Adolescents, Psychiatric Out-patient Clinic.
Healthy Environment for
Children: The Nigerian Situation
Margaret
N. Aghaji
Department of Community Medicine, University of Nigeria Teaching
Hospital, Enugu
Correspondence to: Dr. M.N. Aghaji, Department of Community Medicine,
UNTH, Enugu
Background: The theme for the World Health Day 2003 is “Healthy
Environment for Children”. As a follow-up action, this article reviews the
state of the environment in Nigeria and the health indices for the Nigerian
child.
Methods: Information was extracted from records and survey
reports published by government units, scientific publications, newspapers and
the internet.
Results: The basic environmental risks from inadequate water
supply, sanitation, food hygiene and poor housing, are still uncontrolled in
Nigeria. Emerging risks from the social environment and industrialization are
increasing, and the overall health indices for the Nigerian child is poor.
Conclusion: A concerted action plan to improve the Nigerian
environment for children should be drawn by a government appointed task force
for implementation by the government, community groups and non-governmental
organizations.
Key Words: Environment, Nigeria, Children.
Fasting Blood Glucose Levels
in Different Haemoglobin Genotypes and Blood Groups
*F.E. Ejezie, F.E and **E.A.
Onwusi
*Department of Medical
Biochemistry, University of Nigeria, Enugu Campus. **School of Medical
Laboratory Technology, University of Nigeria Teaching Hospital, Enugu
Correspondence
to: F.E. Ejezie, Dept. of Med. Biochemistry, UNEC
Objective: To determine the
fasting blood glucose levels in different hemoglobin genotypes and blood
groups.
Subjects and Methods: One hundred and
ninety (190) apparently healthy individuals, selected from the students of the
School of Medical Laboratory Technology, University of Nigeria Teaching
Hospital, Enugu, were used in the investigation. Blood for glucose estimation
was collected in fluoride oxalate bottles while EDTA bottles were used for the
collection of blood for hemoglobin genotype and ABO blood group determination.
Fasting blood glucose levels were determined by the Glucose Oxidase method,
hemoglobin genotype by Electrophoresis method and the ABO blood groups by the
Slide method.
Results: The mean fasting
blood glucose concentrations in the different blood groups (O,A,B and AB) were
70.6± 13.6mgldl, 73.6±12.8mgldl, 74.1± 11.9mg/dl and 80.2±7.8mgldl
respectively. For the different Hb genotypes (HBAA, HBAS, HBSC and HBSS) the
following mean fasting blood glucose levels were
obtained respectively: 71.9±8.Omg/dl 73.4±7.4mgldl, 94.7±6.Imgldl and
94.6±5.9mgldl. There was a significant difference between the mean fasting
blood glucose concentrations of blood groups O,A,B and AB (P<0.005).A
comparison of the mean fasting blood glucose levels in the Hb genotypes HBAA,
HBAS, HBSC, and UBSS also showed a significant difference (P<0.0001).
Conclusion: The results show that Hb
genotypes HBSC, UBSS have higher fasting blood glucose concentrations than HBAA
and HBAS. Fasting blood glucose levels are also higher in blood group AB than
blood groups O,A and B. Thus, there is a correlation between fasting blood
glucose, hemoglobin genotypes and ABO-blood groups.
Key words: Blood glucose
levels, hemoglobin genotypes, ABO-blood groups.
Faecal Pollution of Well Water in Enugu Metropolis
N.F. Onyemelukwe, I.S.I. Ogbu, U.N. Atuenyi
Department
of Medical Laboratory Sciences, Faculty of Health Sciences and Technology,
College of Medicine, University of Nigeria, Enugu Campus
Correspondence
to: Dr. N.F. Onyemelukwe Department of Medical Laboratory Sciences, University
of Nigeria, Enugu Campus
Purpose
of Study: We analyzed well water samples from 4
zones, Abakpa, Obiagu, Ogui and Trans-Ekulu, in Enugu Metropolis for evidence
of fecal pollution.
Basic Procedure: Five wells were located in each zone by the multistage sampling procedure
and water samples were taken aseptically using Gallenkamp apparatus, 100ml
volumes were filtered and the filter membranes cultured in duplicate on freshly
–prepared MacConkey agar plates and incubated for 24 hours at 370C
and 440C. Colonies were counted and identified using morphological
and biochemical characteristics. All lactose-fermenters (LF) growing and giving
typical biochemical test results at both temperatures were regarded as
Escherichia coil and as evidence of fecal pollution of sample.
Results: All, except one sterile sample (9.5%) showed growth of LF at 370C.
AT 440C, growth was recorded in 2 samples each (40%) from Abakpa,
Obiagu, and Ogui and all samples (100%) from Trans-Ekulu. The mean LF counts
per 500ml well water sample at 370C and 440C respectively
were Abakpa 296, 26; Obiagu 338, 316; Ogui 192, 46; Trans-Ekulu 176, 176.
Bacterial counts did not correlate with the structural features of the wells.
Conclusion: Leakage from drainage pipes, human and animal activities were thought to
be the factors in the fecal contamination of Enugu well water. Prompt
replacement of damaged drainage structures, hygienic siting and use of Enugu
artesian wells are measures that may help decontaminate the water and make it
safe for human use.
Key Words: Well water; fecal pollution, Escherichia coli.
A Report of Clinical Trial
Conducted on Toto Ointment and Soap
*C.O. Alebiosu
FWACP; **A. Ogunledun MSc; ***D.S. Ogunleye PhD.
*Department of Medicine , **
Department of Pathology, *** Department of Pharmaceutical/ Medical Chemistry,
Ogun State University Teaching Hospital, Sagamu
Correspondence
to: Dr. C.O. Alebiosu, Department of Medicine, Ogun State University Teaching
Hospital, Sagamu, Nigeria
Aim: The efficacy of Toto ointment and soap on common skin disorders
was tested.
Methods: A cohort of Nigerians with common skin conditions
such as fungal and bacteria skin infections, scabies, acne vulgaris and
dandruff were selected and followed for a period of twelve weeks. The study is
a comparative, prospective, blinded, observational study. Following a placebo
run in / wash out period, patients were given either a Toto ointment, or
soap or a combination of these, or sulfur ointment alone. Cure rate, adverse
drug effects and acceptability of the products were assessed.
Result: Out of the 595
patients selected for the study with common skin diseases, 446 (74.9%) had
fungal infections while 64 (10.8%) had scabies infections. Forty-seven (7.9%),
thirty-six (6.1%) and 2 (0.3%) patients had bacterial skin infections, acne
vulgaris and dandruff respectively. At the end of treatment period, 92 (71.3%)
of 129 patients with fungal skin infections and 41 (87.2%) out of 47 patients
with scabies were successfully treated with Toto ointment. Although few
patients were seen with bacterial skin infections during the study period, the
patients showed good response to the ointment, the soap or a combination of the
two.
Overall, the combination of Toto ointment and soap gave a
better clinical success rate on all diseases when compared to sulfur ointment
alone. The study has shown the efficacy and tolerability of Toto
products (skin ointment and soap) in the management of common skin disorder.
Conclusion:Toto ointment and soap
are particularly efficacious in the management of common skin conditions such
as fungal and bacteria skin infections, scabies, acne vulgaris and dandruff.
Key
words: Toto products,
Clinical Trial, Common Dermatoses.
Accidental Injuries to the
Urinary Bladder: Enugu Experience.
Aloy E. Aghaji and Fred O.
Ugwumba
Urology Unit, Department of
Surgery, University of Nigeria
Teaching Hospital, Enugu
Correspondence
to: Aloy Aghaji, Urology Unit, Department of Surgery, U.N.T.H. Enugu
Aim: To study the
aetiology, mode of presentation and treatment outcome of accidental bladder
injuries in Enugu.
Patients and Methods: All patients who
were admitted alive to two health institutions in Enugu metropolis –
University of Nigeria Teaching Hospital and JAMA Urological Clinic, between
January 1993 and December 2002 (10years) were included. Records of all these
patients were studied.
Results: One hundred and twenty five
(125) patients were seen during the study period. The age range was 14-76 years
(mean 34.5years). Sixty-six (52.8%) were male while 59 (47.2%) were female.
External trauma accounted for majority of cases in males (80.3%) with blunt
trauma accounting for 83.0% of these. Iatrogenic injuries accounted for
majority of cases in female (6.8.0%) with gynaecological injuries accounting
for 85.0% of these. Spontaneous bladder rupture occurred in 8(6.4%) patients
and all were intraperitoneal. All the patients were seen within 48hours of the
offending injury. Diagnosis was made clinically in most instances. A few
patients had intravenous urography (IVU) cystography or abdominal ultrasound.
After resuscitation, repair of the bladder was in two layers with urethral
catheter drainage of the bladder and wound drainage. One of the patients with
spontaneous rupture died 72 hours post-operatively. All the other patients
survived.
Conclusion:Accidental injury
to the bladder is not uncommon. Open
gynaecological procedures are the commonest cause in females, while
blunt
trauma is the commonest in males. Diagnosis can be made clinically and
prompt intervention is life saving.
Key words: Urinary Bladder,
Accidental Injuries, Enugu.
Genesis of Gynaecomastia
Wilson I. B. Onuigbo,
FRCP(Glasgow), FRCPath
Medical Foundation and Clinic, Enugu, Nigeria
Correspondence to: Prof. Wilson I. B. Onuigbo, Medical Foundation and
Clinic, 8 Nsukka Lane, P. O. Box 1792, Enugu, Nigeria 400001
Aim: To study the genesis of gynaecomastia using cases of it personally
documented among the Igbos of Nigeria.
Methods: A 30-year
histopathology data pool containing gynaecomastia cases was studied with
special reference to surname, names(s), age, hospital, town, clinician,
provisional diagnosis, symptoms, and signs which were submitted in Request
Forms to me.
Results: The youngest
patient was aged 11 years and the oldest 83 years, the average age being 35.8
years. There were two peaks in the 21-30 and 41-50 age groups. Unilateral
involvement occurred in 82.1%, no side preponderating clearly. During the three
decades of study, there was an increasing trend that probably indicates cancer
awareness among the population. The patients appear to welcome surgical
excision, since they travel early and to long distances for attention in cosmopolitan
and missionary hospitals.
Conclusion: Male breast
problems feature in surgical practice among the Igbos of Nigeria, the spectrum
of the disease being of considerable interest epidemiologically.
Key Words: Gynaecomastia,
Genesis, Igbos.
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