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Sahel Medical Journal

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Volume 5 No.4 October – December 2002
Abstracts

The Megascrotum Syndrome: The Sokoto Experience

I O Ntia and M Moin

Department of Surgery, Usmanu Danfodio University of Teaching Hospital, 

P.M.B. 2370 Sokoto, Nigeria

Summary

Giant scrotal swellings still occur in the rural areas of developing countries like ours. The normal scrotum is about ½ -¾ the size of the clenched fist and hangs 6 to 8cm blow the pubic arch.

36 patients with large scrotal swellings were electively treated by scrotal reduction and reconstruction over a 5-year period. 15 scrotal swellings attained giant size. 16 were hydroceles, 15 hernias and 5 scrotal lymphoedema. Associated pathology included bilharziasis, filariasis, tuberculosis and non-specific chronic infections. The aim of the surgery was to reduce the scrotum to the size of the clenched fist enclosing at least one viable testis. There were 9 cases of significant wound infection. All the patients were satisfied with the results and there was no death. The megascrotum causes compression atrophy of the testis and raises testicular temperature above normal. It is associated with testicular dysfunction, testicular atrophy, oligospermia and infertility.

In addition to vigorous treatment of any associated pathology, surgery should aim at reducing the megascrotum to normal size

 

 

Patients’ Perception on Communication Between Patients and Doctors in a Teaching Hospital

T M Akande, FMCPH

University of Ilorin Teaching Hospital P.M.B. 1459 Ilorin, Kwara State, Nigeria

Summary

This cross-sectional survey of a study was conducted to determine the extent of communication between doctors and their patients, and the determinant factors.

A total of 297 randomly selected patients were interviewed.  About two-third (65.5%) responded that they knew the diagnosis or nature of their ailment. Less than half (42.2%) of those interviewed felt they received adequate information about the nature of their ailment from the health workers and about half (54.9%) felt doctors spent enough time to explain this to them. Educational level of patients tends to influence communication. This study confirmed communication gap between patients and health care providers.

 

 

Prevalence of Yersinia enterocolitica Among Diarrhoeal Patients Attending University of Benin Teaching Hospital Benin City, Nigeria

*A I Omoigberale, FWACPaed and **P O Abiodun, Facharzt, FWACPaed.

Department of Child Health University of Benin Teaching Hospital, PMB 1111 Benin City, Edo State, Nigeria.

Summary

OBJECTIVE: This study was undertaken to determine the prevalence of Yersinia enterocolitica among diarrhoeal patients attending University of Benin Teaching Hospital. Diarrhoeal is still a major cause of morbidity and mortality in Nigeria due to lack of clean portable water, and poor personal and environmental hygiene among majority of Nigerians.

DESIGN: A cross-sectional study of the patients presenting with diarrhoea to the hospital was done.

SETTING: The study was carried out in both children and adults presenting with diarrhoea at the University of Benin Teaching Hospital, Benin City from June to December, 2001.

SUBJECTS: A total of 215 patients were prospectively admitted into the study. This consisted of 95 males and 120 females. These were 139 children and 78 adults. Samples taken from them were subjected to cold temperature enrichment at 40C and subsequently subcultured in Deoxycholate citrate agar (DCA) and MacConkey agar  (MCA) plates and incubated at 250C and 370C. Microscopy, culture and biochemical tests were done on all the samples. The sources of drinking water of the patients were determined and the literacy status of the 78 adults amongst them was also noted.

RESULTS: 47 (21.9%) of the 215 patients were positive for Yersinia enterocolitica. The highest prevalence of 32.8% was recorded among children age 1-9 years. There was a strong association between sources of drinking water and prevalence of Yersinia enterocolitica. The prevalence was also found to be high among illiterate and semi illiterate adults. Sex did not play any positive role in the infections (x2, p>0.05)

CONCLUSION: In addition to rotavirus and bacteria such as Shigellae, Yersinia enterocolitica has been found to be responsible for gastroenteritis which is still a major cause of morbidity and mortality among majority of Nigerians. It is recommended that provision of clean portable water for drinking and addressing the poverty status of the populace by the various tiers of governments would go a long way to reducing morbidity and mortality associated with gastroenteritis.

KEY WORDS: Prevalence, Yersinia enterocolitica, portable drinking water, Agar

 

 

Epidemiological Investigation of Kerosene Burn Tragedy in Ilorin, Kwara State, Nigeria

O I Musa FMCPH,  I M Akande FMCPH, and M J Saka MB,BS

Department of Epidemiology & Community Health, University of Ilorin Teaching Hospital, P.M.B. 1459 Ilorin, Kwara State, Nigeria

Summary

About three-quarters’ of all burn-related deaths follow kerosene accidents and house fire. The cause and the risk of burn injury are influenced by age, economic status, occupation and environmental circumstances leading to the injury. This report provides epidemiological facts concerning recent kerosene tragedy reported in Ilorin in which 12(18.5%) deaths out of 65 cases of burns investigated was recorded while 12(23%) of the remaining 53 cases receiving treatment were at risk of death due to severe burns they sustained. Although careless use of kerosene in fire lighting practices by the victims was a major risk factor identified, adulteration of the product poses a great danger to its use for demits purposes. Public enlightenment on safe fire lighting and cautious use of Kerosene are recommended.

 

 

The Pattern of Association of Urethral Stricture with Benign Prostatic Hyperplasia in Nigerians

IO Ntia,  and A A Dikko

Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto. Nigeria

Summary

The records of all patients treated for Being Prostatic Hyperplasia (BPH) with urethral stricture between January 1991 to December 2000 in the Urology Unit of Usmanu Danfodiyo University Teaching Hospital, (U.D.U.T.H.), Sokoto were reviewed.

69 patients with this association were studied. The mean age was 62.5 years, range 50-88. All the patients presented with urine retention which was relieved by suprapublic catheter drainage. Diagnosis was confirmed by cystourethrography, panendoscopy and urethral calibration. Treatment was by synchronous open prostatectomy and urethral dilatation in 61 patients. 8 patients were treated by internal optical urthrotomy and transurthral resection of the prostate. Post operatively, satisfactory urine flow was the rule. 6 patients required intermittent urethral dilatation during the first year. Strictures in these patients were mild, simple and adequately treaded by regeneration procedures. Severe complicated strictures were not associated with BPH.

This association tends to occur in 10-12% of BPH patients. This approach to management can be undertaken by surgeons who have average skill in general urologial procedure.

 

 

The Relationship Between Socio-Demographic Factors and Severity of Visual Field Loss in Glaucoma Patients at Initial Presentation In Benin-City, Nigeria

* AE Omoti, FWACS, MJ Waziri-Erameh, FWACS, AI Osahon, FWACS

Department of Ophthalmology University of Benin Teaching Hospital, P.M.B. 1111 Benin- City, Nigeria

Summary

Late presentation continues to be a major problem of patients with primary open angle glaucoma. The aim of this study is to determine the socio-demographic factors, which affect the severity of visual field loss at initial presentation.

A prospective study of 154 new patients with a diagnosis of primary open angle glaucoma seen between January 1997 and August 1998 at the University of Benin Teaching Hospital, Nigeria were analyzed in the context of gender, marital status, religion geographical abode, education status, occupation and monthly income. The patients were examined using the Bjerrum screen.

The mean age was 52.73 years (SD+ 15.98) and the male to female ratio was 2.1:1. Eighty-seven patients (56.5%) presented late with visual field constricted to less than 100 of fixation. Gender, marital status, religions and geographical abode did not significantly affect the severity of visual field loss at presentation. There was a significant difference with occupation (P>0.05), educational status (P>0.05) and with monthly income (P>0.01). Patients in the higher socioeconomic classes, those who had tertiary level of education and those in the higher monthly income groups presented earlier than those in the lower socioeconomic classes, those with lower educational status and those in the lower monthly income groups respectively.

Economic empowerment, poverty alleviation and improvement in educational status can reduce the problem of late presentation.

KEY WORDS:Factors, severity, field loss, glaucoma.

 

 

An Assessment of the Availability and Utilization of Toilet Facilities at Alanamu Ward, Ilorin, Kwara State, Nigeria.

R A Olawoye,MPH.

Ministry of Health, Ilorin, Nigeria

and

 A O Awoyemi, FMCPH.

Department of Epidemiology & Community Health

University of Ilorin, Ilorin Nigeri

Summary

The study assessed the availability of toilet facilities in Alanamu Ward of Ilorin, the capital city of Kwara State of Nigeria. It also critically appraised the utilization of the toilets and factors affecting both availability and utilization. Heads of households or their representatives in 112 houses selected by systematic random sampling were interviewed.

One hundred and ten of the questionnaires were found suitable for analysis. Results obtained showed that people in Alanamu use other methods beside the toilet for defaecation and excreta disposal. These other methods include refuse dumping sites, bush at backyard of houses, bowls and the surroundings.

Factors such as accessibility, education, culture and socio-economy have strong influence on toilet availability and utilization in Alanamu.

Recommendations were made in order to improve latrine conditions and excreta disposal generally. There is also an urgent need for further research, particularly, KAP survey of people on excreta disposal and its health implications.

 

 

Haemangioma of the Maxilarysnus – Case Report.

F.O. Ogisi, FRCS (Ed.)

ENT Unit Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria

Summary

Haemangiomas arising in the paranasal sinuses are very rare and there have been relatively few reports in the literature. We report here a case of maxillary sinus haeamangioma presenting initially as recurrent epistaxis of unexplained origin; the actual pathology was evident at surgery

KEY WORDS: haemangioma; sinuses; epistaxis.