[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Helicobacter pylori (H. pylori) has been well noted as a causative agent of many diseases in the gastrointestinal (GI) tract notably, gastritis, peptic ulcer disease, and gastric adenocarcinoma. Determining the burden and the risk factors for acquiring this infection may be crucial to containing it and its sequelae in Kano, Nigeria. Methodology: The study was cross-sectional in design. Questionnaires were administered in dyspeptic patients to obtain the relevant clinical, and sociodemographic data. Upper GI endoscopy was performed in the patients, and gastric biopsy specimens were taken and sent to the histopathology laboratory for assessment and H. pylori identification. Results: Of the 306 participants, 136 (44.4%) were males, while 170 (55.6%) were females, with male: female ratio of 1:1.3. The ages of the participants ranged from 18 to 84 years with a mean of 41.2 ± 15.3 years. Of the 306 samples, 250 (81.7%) were positive for H. pylori. This gives H. pylori prevalence of 81.7%. Only 4 (1.3%) of the participants belonged to the higher social class, out of which 25% had positive H. pylori, while 230 (75.2%) participants belonged to the lower socioeconomic class with 87.8% H. pylori prevalence. The lower social class had a significant association (P < 0.0001) with increased H. pylori infection. A total of 290 subjects (94.8%) shared a room with three or more other siblings in childhood, out of which 233 (80.3%) had H. pylori. Only 80 subjects (26.1%) used pipe-borne water in childhood, while 226 (73.9%) sourced their water from either well, pond or stream during childhood. Conclusion: This study showed a high prevalence of H. pylori in Kano, and low socioeconomic status, unclean water source, overcrowding, and cigarette smoking were significant risk factors for H. pylori infection.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Aim: To assess the knowledge of cardiopulmonary resuscitation (CPR) among clinical medical students of the University of Port-Harcourt. Materials and Methods: A cross-sectional study on the knowledge of CPR among clinical medical students (4 ^th -6 ^th year classes) of the University of Port Harcourt. The data collected were analyzed using the Epi info version 7 statistical packages and Chi-square test was used to compare proportions with P < 0.05 considered significant. Results: Two hundred and forty-five questionnaires were distributed with 177 (72.2%) duly filled. The male to female ratio was 1.5:1, the age range was 19-40 years with a mean of 24.50 ΁ 2.79 years. The 6 ^th year class had 109 (61.6%) respondents, 5 ^th year had 49 (27.7%) and 4 ^th year had 19 (10.7%). Forty-six (26.0%) of students had some form of CPR training and 11 (6.2%) admitted having performed CPR. Of the 46 students that had CPR training, 39 (84.8%) did so because it was given to them at some point in their medical training, while 7 (15.5%) acquired the training due to personal interest. One hundred and two (74.6%) students scored <50%, while 45 (25.4%) scored >50%. The number of students scoring >50% increased with increasing class level (P < 0.001). Students with some prior training in CPR (50.0%) scored above average compared to the students without CPR training (16.8%) (P < 0.001). Conclusion: There is a need to periodically and constantly organize CPR for the medical students and incorporating the training in their medical curriculum to enhance better understanding of the procedure.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

This is a retrospective study of salivary gland tumor (SGT) specimens seen at the University of Benin Teaching Hospital (UBTH) over a 20-year period. It is aimed at determining the epidemiological pattern of these tumors. The materials for this study that consisted of available slides and paraffin-embedded blocks of all SGT specimens received during the study period were evaluated. Data on age, sex, anatomical sites and histologic diagnosis were obtained from the departmental surgical records. Data analysis was done using SPSS version 16.0. SGTs are very rare, accounting for 0.32% of specimens received in the UBTH. The female to male ratio was 1:1.3, and the ratio of benign to malignant tumors was 1.8:1. The mean ages for benign and malignant tumors were 37.0 and 43.5 years, respectively. The peak age for benign SGTs was in the 3 ^rd decade, while malignant tumors showed a peak in the 6 ^th decade. The parotid gland was most commonly affected (57%). Overall, pleomorphic adenoma was the most common SGT seen, accounting for 53.2% of all the cases. Adenoid cystic carcinoma was the most frequently encountered malignant SGT (10.1%). The epidemiological pattern of SGT in the study populace is similar to those of other African-based studies but differ slightly from those of the Caucasians.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The prevalence of transfusion-transmissible infections (TTIs) is influenced by certain blood donor characteristics. Aim: To study the epidemiology of TTIs among blood donors in a Nigerian Tertiary Hospital. Materials and Methods: Sociodemographic data and other donor information were retrieved from the donor register. The rapid test results for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV), syphilis (venereal disease research laboratory), and human immunodeficiency virus (by determine and Stat-Pack test kits) as well as P24 antigen assays were also retrieved from the register. Chi-square statistics was used to compare the prevalence rates of TTIs among donor groups, the level of significance was set at P < 0.05. Results: The highest prevalence of TTIs was recorded for HBsAg and HCV (2.0% (29/1419) and 2.0% (28/1419) respectively), among all donors, it was nil for syphilis (0%). Commercial donors recorded the highest percent prevalence of all TTIs while voluntary donors had the least. Traders and students had a higher prevalence of TTIs among the occupational groups while laborers and the unemployed recorded the least. Blood Group A Rhesus D positive donors recorded the highest prevalence of TTIs while blood Groups A and B Rhesus D negative and AB Rhesus D positive donors recorded the least. There were no significant differences in the prevalence rates of TTIs compared by donor type, gender and occupational groups (P > 0.05). Conclusion: Donor type, occupation and blood group appear to indicate higher TTI carriage rate among our blood donor set.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Several international studies suggest that medical school training is associated with high levels of stress. Although stress is peculiar to the medical profession, it is rarely given the desired attention, especially in resource-constrained settings. This study was therefore conducted to determine the prevalence of stress stressors, coping strategies of medical students in the University of Calabar, Nigeria. Materials and Methods: A cross-sectional descriptive survey of 451 medical students was conducted on available classes during the study period. A semi-structured self-administered questionnaire was used to elicit information from respondents. Data were summarized using proportions, and Chi-square test was used to explore associations between categorical variables. Level of significance was set at P < 0.05. Results: Majority (94.2%), of undergraduate medical trainees perceived the training as stressful. The major stressors identified were excessive academic work load (82.3%), inadequate holidays (76.4%), and insufficient time for recreation (76.2%). Feeling depressed, sleeping problems and anxiety were the most common effects of stress reported by the respondents. The coping strategies adopted by the students were mainly positive. Perceived stress was significantly associated with being in the clinical level of study, residing on campus and a higher monthly allowance (P < 0.05). Conclusion: Majority of the students interviewed perceived their training as stressful. There is, therefore, an urgent need for medical educators to introduce of stress management courses or programs into the curriculum.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Upper gastrointestinal complaints are common, and the underlying diseases range from simple to very serious pathologies. Upper gastrointestinal endoscopy helps in the proper diagnosis and the appropriate management of the underlying lesions. Aim: To determine the indications for and the findings at upper gastrointestinal endoscopy in a private Tertiary Hospital in South-Eastern, Nigeria. Materials and Methods: A retrospective cohort study of adults who had an upper gastrointestinal endoscopy between March 2011 and August 2012 at the study hospital was carried out. Their medical records were reviewed to evaluate the indications and outcomes of the endoscopy. Results: A total of 211 patients' records were reviewed. Males constituted 49.5% of the patients while females constituted 50.5% giving a male:female ratio of approximately 1:1. Their ages ranged from 18 to 92 years with a mean of 52.5 years. The commonest indications for the procedure were dyspepsia occurring in 129 (61.1%) followed by gastrointestinal bleeding 39 (18.5%). The commonest endoscopic diagnosis was gastritis which was found in 161 (76.3%) patients. Peptic ulcer was diagnosed in 29 patients (13.7%) and gastroesophageal varices in 5 patients (2.4%). Of 39 patients with an indication of upper gastrointestinal bleeding, peptic ulcers occurred in 18 (42.1%) while varices were seen in 5 (12.8%). Conclusion: The commonest indication for upper gastrointestinal endoscopy in the studied Tertiary Hospital in South-Eastern Nigeria is dyspepsia while the commonest endoscopic diagnosis is gastritis. Furthermore, peptic ulcers are seen more commonly than gastro-oesophageal varices in patients presenting with upper gastrointestinal bleeding in this population.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Contraceptives are methods or devices used to prevent pregnancy. In Nigeria, the contraceptive prevalence was reported at 15% in 2013. Aims: This study aimed to determine the pattern of contraceptive use and sociodemographic characteristics of the users of family planning services in a teaching hospital in Lagos. Subjects and Methods: This was a descriptive, retrospective study of women who sought contraceptive services at the family planning clinic over a 3-year period. Relevant information was extracted from the case records of these women. Data were analyzed using Epi Info statistical package for Windows. Results: A total of 594 women opted to use a form of contraception in the study, within an age range of 15–52 years and with mean age of 34.3 ± 4.2 years. Fifty-four percent (54%) of the women users belonged to the Yoruba tribe and 89.4% were of the Christian faith. Married women accounted for 97.6% of the users, with the majority (68.9%) having parity of 2–4. Majority (77.6%) of the women had at least a tertiary level of education, with 46.1% of them involved in a form of skilled occupation. Nurses were the commonest source of referrals (42.9%). A larger proportion of the women (46.3%) preferred Jadelle implant while the least used method is Norplant (0.5%). Conclusion: Equipping medical personnel with the information and skills needed to meet the increasing demand for family planning services is necessary to avert the needless increase in the incidence of unwanted pregnancies, unsafe abortion, and their sequelae.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Oncology nurses are posed with issues that are potential sources of stress to them. Aim: To identify the potential sources of stress in cancer care for Nigerian oncology nurses. Materials and Methods: This was a descriptive cross-sectional study involving nurses working in the oncology units of three selected Nigerian teaching hospitals. Consenting oncology nurses were recruited. The tool for data collection was a self-administered structured questionnaire. Result: Eighty-six (86) nurses participated. High workload (mean = 5.34 ± 0.59), taking care of critically ill patients (mean = 5.12 ± 0.78), strict organizational rules (mean = 5.05 ± 0.66), lack of organizational support (mean = 4.91 ± 0.87), and challenges of caring for dying patients (mean = 4.66 ± 0.97) were the major potential sources of stress perceived by oncology nurses. Conclusion: A number of stress-generating situations have been identified, and appropriate strategies and interventional programs are needed to address them.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Context: Leprosy still continues to be an important public health problem. Aims: The present study was undertaken to study the histopathological features of leprosy in skin biopsies and to categorize them into various types based on microscopy, bacterial index of granuloma and to correlate with clinical presentations whenever possible. Materials and Methods: Skin biopsies after adequate fixation in 10% of formalin, were routinely processed and paraffin embedded sections of 5 μ thickness were stained with H and E and fite -faraco stain and were studied microscopically. Results: A total of 200 skin biopsies were obtained from patients with an age range of 7 -85 years, majority were in 3 ^rd decade, with male to female ratio of 2.6:1. Borderline tuberculoid was the most common type of leprosy (72.5%). Most common clinical feature was loss of sensation. Atrophic epidermis and grenz zone was more common in lepromatous leprosy and borderline leprosy. There were 6 biopsies with lepra reaction, 4 (66.6%) were of type 1 and 2 (33.3%) were of type 2 reactions. Majority of biopsies were of paucibacillary type (77%) and rest (23%) were of multibacillary type, clinicopathological correlation was observed in 150 biopsies (75%). Conclusions: For accurate diagnosis, correlation of clinical and histopathological features along with bacterial index appears to be more useful than considering any of the single parameters alone.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Context: The children emergency room (CHER) in Federal Teaching Hospital Abakaliki (FETHA) is one of the units o pediatrics department specialized in meeting the unique needs of children during medical emergencies. A description of the pattern and outcome of its admissions and factors that may contribute to their outcome will help proffer solutions in health care planning with regards emergency care in Abakaliki. Aims: To determine the pattern and outcome of CHER admissions at Federal Teaching Hospital Abakaliki (FETHA). Materials and Methods : A retrospective study of CHER admissions from 1 ^st of January to 31 ^st of December 2012. The Nurses book of statistics and case notes of patients in the CHER of FETHA Ebonyi state, a multi-specialty, children's referral, tertiary health hospital in Ebonyi State were used. Statistical analysis used: Descriptive analysis using SPSS version 20 (IBM statistics). Results: Over the period, 1022 patients were seen with a mean age of 1.9 + 2.6 years. Males were 58.8%, 41.2% were females. The most common diagnosis was diarrheal disease (36.1%) followed by malaria (16.2%) and pneumonias (11.7%). A mortality of 10% was recorded while 66.6% were discharged home, 3.8% discharged against medical advice while 19.6% were transferred to other units in the ward. Majority of deaths were in infancy (57.8%), more in males (69.6%), and from diarrheal disease (43.1%). Conclusions: There is a high mortality ratio of patients at CHER in our setting, attributable mainly to preventable causes like diarrhea. This raises concerns that parental education on health promoting and preventive measures may be low.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Refractory epilepsy is common in practice of neurology. When associated with hemiparesis and hemiatrophy a possibility of Dyke-Davidoff-Masson syndrome (DDMS) could be considered and imaging helps in confirmation. We present a case report of a 10-year-old female who presented with seizures, right-sided hemiparesis, hemiatrophy of the right side of the body, and mental retardation. Magnetic resonance imaging (MRI) brain revealed characteristic features diagnostic of congenital type of cerebral hemiatrophy or DDMS. Few case reports are described in literature highlighting crossed cerebellar diaschisis an imaging finding associated with the syndrome on MRI. The associated MRI findings of the syndrome are described.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Cardiovascular disease (CVD) is an increasingly important cause of morbidity and mortality worldwide. Combination of risk factors for CVD can be seen in the metabolic syndrome (MS), which can be computed to get an assessment of an individual's risk for future cardiovascular events. Aims: We aimed to determine the Framingham risk assessment of MS patients at the Lagos University Teaching Hospital, Nigeria. Materials and Methods: This was a cross-sectional study of newly diagnosed patients with MS using the International Diabetes Federation criteria. Anthropometry and clinical data were obtained, and fasting blood glucose and lipid concentrations were also determined. Framingham risk assessment was calculated and categorized as <10%: low risk, 10–20%: intermediate risk, and >20%: high risk for future CVD. Results: There were 120 patients (females 82, males 38) with mean ages of 52 ± 13.5 years and 54 ± 14.2 years, respectively (P = 0.46). Framingham risk assessment showed 56 (47%) patients comprising of 42 females and 14 males had low risk; 31 (26%) patients comprising of 24 females and 7 males had intermediate risk while 32 (27%) patients comprising of 16 females and 16 males had high risk for CVD. The risk assessment significantly correlated with age, systolic blood pressure, and total and high-density lipoprotein-cholesterol (P < 0.05). Conclusion: Majority of the males had high 10-year risk for CVD while most of the females had low risk. Men may need to intensify strategies to reduce modifiable risk factors for CVD.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Low- birthweight (LBW) is the single most powerful predictor of mortality in the first few months of life, especially in most developing countries. The physiologic hypercholesterolemia of later pregnancy suggests an adaptive function for pregnancy maintenance or fetal growth. Decreased levels of maternal total cholesterol have been reported in association with intrauterine growth restriction. Aim: The aim of this study is to assess the association between low maternal serum cholesterol during early pregnancy and LBW in term neonates. Patients and Methods: This was a prospective cohort study in which eligible participants were enrolled at the gestational age of 14–20 weeks over a period of 12 months. Blood samples were taken to measure the total serum cholesterol concentrations, and the sera were then analyzed enzymatically by the cholesterol oxidase: p-aminophenazone method. Association between low maternal serum cholesterol and LBW was tested by using Chi-square. All significances are reported at P < 0.05. Results: The present study showed an incidence of 13.4% for delivery of LBW babies in the low-risk study patients. LBW was 2.05 times more common with low total maternal cholesterol than with normal midrange maternal cholesterol levels (21.1% vs. 10.3%, P = 0.039). Conclusion: We can infer from the study that the low maternal serum cholesterol is associated with LBW in term neonates. We can, therefore, recommend that the concept of an optimal range for maternal serum cholesterol during pregnancy may have merit and pregnant women should be encouraged to follow a healthy, balanced diet, and ensure regular antenatal visit to their health-care provider.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Due to lack of treated water supply in major cities and settlements in Anambra state, Nigeria, majority of the population obtain potable water directly from boreholes, streams, sachet, harvested rain, and well water sources. Lead-laden potable water may be a major cause of mortality and morbidity in Anambra state, Nigeria. Objective: This study was conducted to determine the presence of lead in potable water sources in Anambra state, Nigeria. Materials and Methods: Water samples were systematically collected from 81 water sampling sites in different senatorial zones of the state. Lead was estimated in the water samples using Varian AA240 atomic absorption spectrophotometer. Results: The mean levels of lead in the water samples in all the senatorial zones of the state were higher than the maximum contaminant limit (0.01 mg/L) set by the World Health Organization (WHO). The mean level of lead in harvested rain, sachet, and stream waters (0.34 ± 0.23, 0.37 ± 0.08, and 0.23 ± 0.06 mg/L, respectively) was higher in Anambra South senatorial zone compared to the WHO maximum contaminant limit. Furthermore, Anambra South has higher (P < 0.001) mean lead level compared to the North and Central senatorial zones. Conclusion: This study reveals significantly high lead levels in potable water sources in Anambra state, Nigeria. The water samples should be well treated to remove this harmful toxic heavy metal which is very dangerous to health.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Context: Pregnant women in resource-scarce countries are vulnerable to helminthic infestation. Aims and Objectives: to document the prevalence and pattern of soil-transmitted helminthic infestation among booked expectant mothers in this region. Materials and Methods: This was a descriptive cross sectional study. Pregnant women who were counseled and consented to the study were randomly recruited at the booking clinic. They were interviewed and had their blood and stool specimens collected for laboratory analysis. Data was analysed using epi info statistical package version 3.4.1. Result: One hundred and thirty one (32.4%) stool samples out of the four hundred and four samples yielded positive results. The helminth species isolated included Ascaris lumbricoides, Hookworm, Trichuris trichuria, Strongyloides stercoralis and Enterobius vermicularis. Ascaris lumbricoides (65.6%) was the most prevalent. Two women (1.5%) had mixed infections. Though the intensity of infection was generally low. Conclusion: Antenartal clinic attendees in Abakaliki have some degree of helminthic infestation, routine deworming during the prenatal period is advocated.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Dental amalgam has been in use for a very long time in the field of restorative dentistry as an intracoronal restorative material. Despite its long usage, there have been reports about adverse health effects arising from the exposure to minute mercury released from amalgam to the dentists if not properly handled. Aim: The aim was to find out the compliance of Nigerian dentists with recommendations on mercury hygiene practices. Materials and Methods: A cross-sectional study using self-administered questionnaire consisting of three parts was conducted among registered dentists. The first part of the questionnaire sought demographic characteristics of respondents while second part assessed measures taken by the caregiver himself while working with amalgam and the last part assessed measures taken to control and prevent mercury contamination within the clinical setup. Result: There was total compliance with the use of gloves when working with amalgam among the participants. However, the house officers had the highest tendency of always wearing face mask and protective clothing followed by specialist in training. There was a statistically significant difference in the tendency to always wear face mask (χ² = 21.37, P = 0.00) and protective clothing (χ² = 24.77, P = 0.00) as against occasional and never wearing them, among the different categories of dentists. Compliance with the use of rubber dam and alternative source of air was found to be generally poor among the professionals studied. More than two-third of all dentists studied never used the two preventive measures. About 78% never used rubber dam when working with amalgam. The method of handling excess mercury was found to be more appropriate among the respondents in the teaching hospitals and poorest among those in private set-up. Furthermore, a great majority (87.5%) of those working in private clinics had never heard of mercury vapor monitoring. Conclusion: It was noted that some of the standard mercury hygiene practices such as the use of rubber dam, high volume suction, and water cooling when removing or polishing amalgam restorations were not followed properly.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Amblyopia causes impairment of visual acuity, depth perception, and contrast sensitivity and this leads to loss of binocular single vision. Objectives: This study was conducted to determine the prevalence and types of amblyopia among primary school pupils in Benin City, Edo State, Nigeria. Materials and Methods: This was a cross-sectional study. A two-stage simple random sampling technique was used to select 2,139 primary school pupils who were examined. Data were obtained using researcher-administered questionnaires and ocular examinations included visual acuity (VA) test, crowding phenomenon, cover test, Hirschberg's test, Maddox wing, and Maddox rod test. Cycloplegic refraction and dilated fundoscopy were performed after the administration of 1% tropicamide. Amblyopia was defined as best corrected VA ≤6/9 in one eye or both the eyes without ocular pathology in either eye. Results: Amblyopia was present in five students (0.23%) - two males and three females - out of whom two had unilateral and three had bilateral amblyopia. There were two cases of mixed amblyopia (both had anisometropia and strabismus with amblyopia). Anisometropic, isometropic, and meridional amblyopia were found in one pupil each. Conclusion: The prevalence of amblyopia among primary schoolchildren in Benin City, Edo State, Nigeria is lower than that reported in previous studies in African, Caucasian, and Asian populations.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Neonatal tetanus is a lethal disease which has remained an important public health problem in developing countries. The global efforts at eliminating neonatal tetanus have resulted in many nations having less than one case of neonatal tetanus per 1,000 live births per district- a goal that Nigeria is striving to achieve. Objective: To evaluate the contribution of neonatal tetanus to morbidity and mortality in the neonatal unit of Stella Obasanjo Hospital (SOH), Benin City, Nigeria. Methods: A retrospective study in which records of admissions over a six-year period (June 2008 to May 2014) were obtained from the neonatal unit records paying particular attention to cases of tetanus. Information retrieved included age, sex, duration of stay in the unit and outcome. Results: A total of 2,324 patients were admitted into the neonatal unit during the study period. Of these, 23 had tetanus, giving an overall prevalence of 1.0% and an annual incidence of four cases. All the cases were out-born. Nine (39.1%) were males while 14 (60.9%) were females giving a M: F ratio of 1: 1.6. The median and modal age at presentation was seven days (range being 2-21 days). Ten (43.8%) patients were discharged home, four (17.4%) discharged against medical advice while nine died; giving a case fatality rate of 39.1% and contributing 3.1% out of the overall mortality of 286 neonates. Conclusion: Neonatal tetanus contribute significantly to morbidity and mortality. The global efforts for disease elimination should be unrelenting. To be counted among nations that have successfully eliminated the disease, we must pay particular attention to public enlightenment.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Prolonged stay in the Intensive Care Unit (ICU) defined ≥14 days stay in the ICU is associated with increased cost, resource utilization, and could contribute to patients' morbidity and mortality. Objective: This study was designed to determine the factors that contributed to prolonged stay in ICU and its impact on patients' outcome. Materials and Methods: We conducted an 11-year retrospective, case-control study of all admissions into the ICU with emphasis on prolonged stay. Data on indications for ICU admission, clinical course, and intervention in terms of blood transfusion and mechanical ventilation were obtained and analyzed. Others were duration of stay in the ICU and patients' outcome. Results: A total of 1,661 patients were admitted into the ICU during the study period, out of which only 90 patients had prolonged stay constituting 5.4%. Mortality rate among patients with prolonged stay was 37.8%. Neurosurgery and cardiothoracic units had more patients with prolonged stay, 38.6% and 18.2% patients, respectively. Blood transfusion and the indication for ICU admission contributed significantly to prolonged stay. Conclusion: The ICU exerts great physical, material, psychological, and social toll on the patients, institution, and society. Indication for ICU admission/severity of illness and blood transfusion were identified factors associated with prolonged stay in the ICU. Age, sex, and mechanical ventilation did not have any significant impact on duration stay.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objective: The aim was to study the incidence, microbiological profile and early outcomes in elderly (age >60 years) patients of ventilator associated pneumonia (VAP) admitted to Intensive Care Unit (ICU) of a Tertiary Care Hospital in Uttarakhand. Materials and Methods: Elderly patients (age >60 years) admitted to ICU who developed VAP were enrolled in the study from December 2011 to December 2012 .Their endotracheal secretions were collected and processed as per standard microbiological methods, and the results analyzed along with the early outcomes in terms of in ICU mortality of the patients. Retrospective analysis of records was also done during this period of one year to find out the incidence of VAP among elderly patients. Results: Incidence of VAP was 45.21% among elderly patients on mechanical ventilation (MV) and Gram-negative organisms were the most common etiological organisms. Mortality among elderly patients with VAP was similar to that in young. Conclusions: A higher incidence of VAP was seen among elderly patients subjected to MV though larger studies are needed. Microbiological profile of VAP among elderly and young is similar.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Teething is an important developmental milestone in young children. Mothers attribute several symptoms to teething and their beliefs in turn affect their behavior towards the healthcare of children during the period of tooth eruption. This study assessed maternal beliefs and behaviors towards teething in young children in Benin City, Nigeria. Methods: A descriptive cross-sectional study was carried out among mothers who brought their babies to Well Baby Clinics in three health facilities in Benin City, Nigeria. The tool for data collection was a structured researcher-administered questionnaire. Data were analyzed using SPSS version 16.0. Results: Mothers of 420 children (mean age 16.2 ± 8.6 months) participated in the study. Over two-third 302 (71.7%) believed that infant teething is associated with various symptoms. The commonest symptoms reported were fever 258 (85.7%) and diarrhea 241 (80.0%) while the least was redness of the gums, 2 (0.7%). A greater proportion of respondents, 224 (74.4%), 186 (61.8%) and 184 (61.1%) managed teething discomfort with teething syrups, tepid sponging and teething toys respectively. More than half of the respondents 263 (54.3%) and 162 (56.3%) gave analgesics to relieve fever and oral rehydration solution (ORS) for diarrhea attributed to the teething process respectively. Conclusion: Mothers' beliefs encourage the use of "teething" as a ready explanation for childhood diseases. They utilize analgesics, ORS, teething syrup and herbal medications to relieve perceived teething symptoms. The misconception about teething can be corrected through health education of mothers when they access health facilities. The mass media may also be employed to reach a larger audience.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Sickle Cell Anemia (SCA) is an inherited disorder which is associated with significant morbidity and mortality. Early recognition as well as prompt and effective management of the morbidities seen in SCA is key to the survival of patients with the disease. Objective: To determine the morbidity profile and outcome of patients with sickle cell anemia (SCA) admitted into an Emergency Pediatric Unit (EPU) of a tertiary health center in Nigeria. Methods: A retrospective study in which records of admissions of children with SCA over a two-year period (June 2011 to May 2013) were obtained from the EPU records. Information retrieved included age, sex, diagnosis and outcome as far as the unit is concerned. Results: One hundred and forty-seven children, 11.9% of the total (1,234 patients) EPU admission, aged between six months and 18 years (mean age being 84.76 ± 57.24 months) were studied. Male: female ratio was 1.3: 1. Vaso-occlusive (53.2%), hyper-hemolytic (37.6%) and acute sequestration crises (9.2%) were noted but no case of aplastic crisis was seen. Among infections, Malaria (56.2%), Sepsis (15.6%) and pneumonia (12.5%) were the major cases documented. Two (50-0%) patients died of acute sequestration crisis, one (25.0%) of meningitis and another (25.0%) of hyper-hemolytic crisis with severe anemia. Mortality rate was 2.7%. Conclusion/ Recommendation: SCA admissions in our EPU are mainly due to vaso-occlusive crises and infections. Acute sequestration crisis was the leading cause of death followed by meningitis and hyper-hemolytic crisis. Prompt and effective transfusion services, the use of pneumococcal conjugate vaccine as well as judicious use of appropriate antibiotics will augment the chances of survival in these children.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Anemia is one of the important clinical significance in sickle cell disease, and a major clinical consequence of glucose-6-phosphate dehydrogenase (G6PD) deficiency is hemolytic anemia. The aim of this study is to compare the enzyme activity in sickle cell patients (SS) and normal hemoglobin (Hb) (AA) individuals. Patients and Methods: A total of 100 hundred samples comprised of 50 sickle cell patients as test subjects and 50 Hb AA individuals were used as controls. Each of the blood sample collected was screened immediately for G6PD deficiency using the methemoglobin reduction test and Randox kit. Results obtained were subjected to statistical analysis using paired t-test. Result: Glucose-6-phosphate dehydrogenase deficiency was found to be significantly higher in test subjects (P < 0.01) when compared with the control subjects. It was also shown that G6PD levels tend to increase with increase in age though this increase was not significant (P > 0.05). There was no significant difference in G6PD levels between males and females sickle cell patients (P > 0.05). Conclusion: These results, therefore, suggests that G6PD enzyme activity is much more reduced in the sickle cell patient who may contribute to making them prone to hemolytic anemia when compared to normal individuals.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: In chronic obstructive pulmonary disease (COPD) patients, left ventricular (LV) systolic dysfunction is rare. Objectives: To evaluate the prevalence of LV systolic or diastolic dysfunction in patients with COPD. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital for a period of 2 years from January 2012 to December 2013. These patients underwent physical examination and standard two-dimensional (2D) echocardiographic views, and peak flow velocity of early diastolic filling [early filling velocity (E-Max)], peak flow velocity of late atrial filling [atrial filling velocity (A-Max)], and early flow velocity peak/late flow velocity peak [early to late (E/A)] ratio were measured according to the criteria of the American Society of Echocardiography. Statistical analysis was carried out using SPSS software. Results: A total of 102 patients diagnosed with COPD as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines were enrolled. Of the 102 COPD patients, the maximal A-Max increased and E-Max decreased in 76 patients (74.5%) (P < 0.001). The early flow velocity peak/late flow velocity peak (E/A) ratio also markedly decreased in these 76 patients (P < 0.001) indicating LV dysfunction. The atrial contribution to total left diastolic filling increased in patients with COPD. This was also observed in COPD patients with normal pulmonary artery pressure (PAP) (P < 0.001). Grade IV COPD (P - 0.000), the duration of illness (P < 0.001), and smoking >10 packs for years (P < 0.001) were the risk factors that were associated with the development of LV diastolic dysfunction in COPD patients. Conclusion: The prevalence of LV diastolic dysfunction was 74.5%. As the severity of COPD increased, the risk of LV diastolic dysfunction increased. The screening of severe COPD patients for LV function might improve the outcome.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]