Subarachnoid lavage following inadvertent intrathecal injection of tranexamic acid

Tranexamic acid (TXA) is a commonly used antifibrinolytic drug during surgical procedures to reduce blood loss. An Inadvertent intrathecal injection of TXAmay lead to serious side effects including seizures and ventricular fibrillation with reported fatalities. We report a case of an inadvertentintrathecal injection of TXAwhich occurred as a result of similarities in appearance between TXAand heavy bupivacaine ampoules. The patient had subarachnoid lavage after experiencing back pain, systemic hypertension followed by generalized tonic clonic seizures

Biochemical pattern of thyroid function test and clinical impression of thyroid disorder in a rural tertiary health institution in Nigeria

Thyroid disorders are one of the most common endocrine disorders seen globally. Diagnostic challenge may arise both clinically and biochemically because of the multiple function of thyroid hormones (THs). Request for thyroid function test (TFT s) may be based on clinical impression that may suggest thyroid dysfunction or obvious symptoms and signs that are diagnostic of hyperthyroidism or hypothyroidism. Materials and Methods: This retrospective study looks at the biochemical patterns of TFTs and the clinical impression of thyroid disorders in a rural tertiary institution. Information extracted from the laboratory register includes indication for the test, the hospital number, the gender, the age, and the THs assayed. The corresponding biochemical pattern of the TFT result was established. Results: A total of 297 requests were submitted for TH assay; 34 were excluded from the present study because there were no clinical information. There were 239 females and 24 males giving a female-to-male ratio of 9.9:1. Majority of the requests (36.5%) were for goiters, followed by gynecological disorders (20.9%) and clinical thyroid disorders (17.9%). About 46% (45.8%) of the goiter cases were biochemically euthyroid, whereas 13.5% were biochemically primary hyperthyroid. Among the 47 cases of thyroid disorders by the physician's clinical impression, 27.7% were euthyroid, 17% were biochemically hyperthyroid, and 10.6% were hypothyroid. Of the 55 gynecological disorders assessed, only 7.3% show biochemical evidence of TH alteration with 56.4% being euthyroid. About 47% (46.6%) of those that did routine medical examination had altered TH level that includes hyperthyroidism and hypothyroidism. Conclusion: Goiter is the most prevalent thyroid disorder in this environment. Biochemical pattern of thyroid function test in our environment was mostly euthyroid despites clinical features suggestive of thyroid disorders

Methods Employed in the Prevention and Treatment of Malaria among Pregnant Women in a Riverine Community in Bayelsa State; Nigeria

Background: Malaria remains a major public health problem in Nigeria and is the most common cause of hospital attendance in all age groups of which children and pregnant women are the major risk groups; therefore this study was designed to explore various methods of prevention and treatment of malaria among pregnant women in riverine community in Bayelsa State.Method: A descriptive survey with a sample size of 120 respondents. Data were collected using questionnaire and SPSS version 20 was used for data analysis.Results: The finding of the study revealed that majority of the respondents were within 16-25; with a minimum age of 16; maximum age of 45 and a mean of 30. More than half of the respondents agreed that malaria can be transmitted to the fetus and can lead to intrauterine fetal death. Majority uses insecticide treated nets (ITNs); snapper; insecticide spray; window and door net in preventing malaria; while a good number of the respondent claimed to use drug when they have malaria; most of which were prescribed.Conclusion: Majority of the respondents employed good practices in the prevention and treatment of malaria. However; some of the respondents still use crude methods that are detrimental to health. Therefore; it was recommended that community awareness and enlightenment programmes should be put in place in order to eradicate the crude methods that are harmful; as well as promote the good methods used in the prevention and treatment of malaria

Antibiotic Resistance Profile and Phenotypic Detection of Beta-Lactamase-producers among Gram-negative Bacteria Isolated from the Gut of Household Cockroaches in and around University of Ibadan

Background: Cockroaches are carriers of numerous microorganisms. However, there is paucity of information on their role as potential reservoir for beta-lactamase producers.Objectives: This research determined the antibiotics susceptibility profile of Beta-lactamase producing Gram-negative bacteria isolated from the gut of household cockroaches in selected locations in and around University of Ibadan, Oyo state.Materials and Methods: Thirty Cockroaches from different locations in and around University of Ibadan were collected between June 2015 and March, 2016, and their intestinal homogenates cultured on different selective media for the isolation of bacteria. The isolates were identified using a combination of biochemical tests and 16S rRNA sequencing. Antibiotic susceptibility testing was done using the disc-diffusion technique and phenotypic detection of extended-spectrum beta-lactamase (ESBL), AmpC-beta-lactamase (AmpC) and Metallo-beta-lactamase (MBL) production was done using double-disc synergy, cefoxitin/cloxacillin and imipenem/EDTA double-disc methods respectively.Results: A total number of 58 bacteria belonging to nine genera; Pseudomonas, Proteus, Klebsiella, Salmonella, Enterobacter, Escherichia, Serratia, Shigella and Raoultella were isolated. Higher percentage of the isolates exhibited resistance to erythromycin (90%), azithromycin (87.5%), amoxicillin (84.5%), ampicillin (74.1%), amoxicillin-clavulanic acid (74.1%), cefoxitin (67.2%) and chloramphenicol (54%), while lower percentage showed resistance to aztreonam (25%), ertapenem (13%), cefotaxime (8.6%), ceftazidime (10.3%), cefepime (5.2%), ciprofloxacin (3.5%), gentamicin (5.2%) and imipenem (0%). MDR phenotype was recorded among 82% of the isolates, 17.2% were positive for ESBL, 12% for AmpC and 13.8% for MBL production.Conclusion: This study identified household cockroaches Periplaneta americana, as a potential reservoir for MDR and beta-lactamase-producing isolates

The Impact of Seat-belts in Limiting the Severity of Injuries in Patients Presenting to a University Hospital in the Developing World

Road traffic injuries are major public health problems and a leading cause of death and injury around the world. Approximately 1.2 million people are killed each year in road crashes worldwide; with up to 50 million more injured. Over 95 of these deaths and injuries occur in the low- and middle-income countries of the world. The aim of this study is to evaluate the impact of the use of seat-belts in reducing the severity of injuries from road traffic crashes and to determine the compliance and awareness of the importance of the use of seat-belts among Nigerian motorists. Patients and Methods: The injury patterns and outcome of care in 140 patients who were seen at the emergency department of our tertiary hospital were evaluated. Initial care and resuscitation was carried out on all patients using the advanced trauma life support protocol. Results: A total of 81 (57) patients used seat-belts; while 59 (42.1) did not. Nineteen (13.6) patients died as a result of their injuries; 4 (21.1) of these had used seat-belts; while 15 (79) had not ( P = 0.001). The mortality rate of 79 for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists. for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists

Effect of Glucose Contents of Selected Soft Drinks on Plasma Glucose Level of Adolescent Healthy Nigerian Subjects

Soft drink is a carbonated water; flavoured and sweetened with either sugar or sweetener. The resulting glucose solution in the human body is the key source of energy. Positive associations between soft drinks consumption and incidence of diabetes have been postulated. Thus; it is the aim of this study to show the effects of casual soft drinks consumption on glucose level of healthy Nigerian individuals in fasting and 2 hours post-prandial. A total of 350 apparently healthy individuals were recruited for this study. 115 subjects (Group A) were given a bottle of Coca-Cola (Coke) each; another 115 (Group B) subjects were given a bottle of Bitter Lemon (Krest) each while the remaining 120 subjects (Group C) were given 75g of D-glucose in 300mL of distilled water. Glucose tolerance test (GTT) was performed on all the subjects and the curve of glucose concentration plotted against time of sample collection. GTT graph of group A and B shows a flat curve of enhanced GTT while group C shows a normal GTT response graph. The result however; indicates that casual consumption of soft drinks did not predispose to development of diabetes as it has no significant effect on plasma glucose and renal threshold concentration of apparently healthy individuals

Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients

BACKGROUND:The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV-related oral lesions in paediatric Nigerian patients on HAART with those not on HAART.MATERIALS AND METHODS: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross-sectional study over a 2-year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P-value of <0.05 was considered significant.RESULTS:A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0%) had at least one oral lesion, 43 (41.0%) had multiple lesion. The most common lesion was oral candidiasis (79.1%). The angular cheilitis (43.8%) variant was most frequent. The mean CD4 counts were 1138 cells/mm(3), 913 cells/mm(3) and 629 cells/mm(3) for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56-1.02; P=0.03), pseudomembranous candidiasis (OR=0.71; 95% CI=0.54-0.94; P=0.024) and HIV-gingivitis (OR=0.59; 95% CI=0.46-0.75; P=0.001). HAART had some beneficial but insignificant effect on development of HIV-periodonttitis (OR=0.60; 95% CI=0.51-0.70; P=0.09). The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31-5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0.62-2.06).CONCLUSION: HIV-related Oral lesions are frequently seen in HIV-infected Nigerian children. Paediatric patients receiving HAART had significantly lower prevalence of oral lesions, particularly oral candidiasis and HIV-gingivitis

Attitude of nurses towards the care of elderly patients in selected health centres in Ilorin Metropolis, Kwara State, Nigeria

Ageing is one of the national phenomena common to all races globally. Elderly individuals are always seen as giving increased burden on families and societies because most of them are incapable of performing their activities of daily living independently. This study investigates the attitude of nurses towards the care of the elderly patients either at home and work environments and especially in a selected health centres in Ilorin Metropolis; Kwara State; Nigeria. Sixty nurses were conveniently sampled for the study and the result showed differences in the nurses' attitudes in the care of the elderly; these differences were premised on their knowledge; gender; religion; age and experience in the profession. It is therefore recommended that there is an urgent need for Nursing and Midwifery Council of Nigeria to introduce and design a curriculum for Gerontological nursing as a specialty course in Nursing Education to better the knowledge and care of the aged by the nurses

Sociocultural factors affecting mental health service delivery in neuropsychiatric hospital, Port Harcourt, Rivers State, Nigeria

The study was conducted to find out the socio-cultural factors affecting the delivery of mental health services in Neuropsychiatric Hospital; Port Harcourt. Mental health care providers encounter in everyday practice a diversity in socio-cultural beliefs and practices of their consumers which quite often serve as barriers to their effective and efficient service delivery. 50 mental health care roviders participated in the study; five hypotheses were tested using chi-square measure at the significance level of 0.05. The results showed that all the variables were significant indicating that socio-cultural factors affect the service delivery of mental health care providers. Hence; it is hereby recommended that clinicians must be well vast in the cultural diversities; to be culturally responsive to the needs of their consumers and be aware of their own cultures in order to provide culturally relevant services to their clients/patients and their relations

Antibiotic Susceptibility Pattern and Beta-lactamase Production in Isolates of Staphylococcus aureus from Recurrent Furunculosis in Southwestern; Nigeria

Furuculosis is a skin infection caused by Staphylococcus aureus. It is characterised by honey crusted 'cropped' latent boil with potential to recur in a susceptible host. Isolates of S.aureus obtained from both hospitalised and non-hospitalised patients with furuncles in Southwest; Nigeria were characterised in relation to their resistance to commonly used antimicrobial agents. Exudates of 'cropped-boils' from one hundred and forty (140) individuals consisting of forty (40) hospitalised and one hundred (100) non-hospitalised cases of recurrent furunculosis were screened for S. aureus. One hundred and two (102) were positive for the organism by conventional biochemical tests. Detection of ?-Iactamase was determined by cell-suspension iodometric method. Of the 102 isolates; 30(29.4) strains possessed ?-lactamase and the minimum inhibitory concentration (MIC) of selected antibiotics was in the range of 3.95- 250?g/ml. The multiple drug resistance as evident in high MICs of the antibiotics tested could probably be due to abuse/misuse of antibiotics resulting in recurrence of furuncles in the patients

Effect of instructions about the method of urine collection and storage on the isolation rate of urinary bacteria in children

A study of 65 children (29males and 36females) and aged between four weeks and 15years with significant bacteriuria was undertaking over a six month period to determine the effects of instruction received about the methods of urine collection and storage on the prevalence of urinary tract infection. The commonest clinical presentation was fever (64.6). Only 22(35.4) of the patients had specific symptoms suggestive of urinary tract infections. The instructions about urine collection were given to 48(73.8) care givers. This instruction was given by the attending doctors (84). Despite the explanation; 15(23.1) of the patients collected the urine samples wrongly and 44(67.7) stored the samples for longer than one hour. Significant bacteriuria was more prevalent in 74.2of patients who submitted their urine samples more than one hour after collection. Communication skill is important and should be emphasized in the trainings of health workers in procedure on the patients

Childhood diabetes mellitus in Kano, North West, Nigeria

There is paucity of literature on childhood diabetes mellitus from developing countries and especially North west Nigeria and this has made it pertinent for documentation of the features of the disease in a major regional referral centre. The study was designed to describe the clinical presentation and outcome of childhood diabetes mellitus. Retrospective review of hospital records of paediatric patients managed for diabetes at Aminu Kano Teaching Hospital; Kano. Nigeria between January 1999 and December 2006. The age; sex; presenting features; complications; laboratory features and outcome of the patients were retrieved from the hospital records. During the years under review eleven out of 3;585 admissions were managed for Type 1 diabetes mellitus giving a prevalence rate of 3.1/1000. Male to female ratio was 1:0.6. The mean age at presentation was 10 4.5years most of the patients (72.7) belonged to the lower socio-economic classes IV and V. The duration of symptoms ranged from 6 58days with a mean of 24 22.8days. The patients presentedwith urinary tract infections (36.4); malaria (27.3) and recurrent boils (18.2). Three (27.3) of the patients had polyuria and polydypsia while only one (91) patient had polyphagia and weight loss. The mean random blood glucose on admission was 28.5 7.9mmo/L (16.9 39.2mmo/L) Four patient presented with diabetic Keloacidosis. Two patients (18.2) were discharged against medical advice while 1(9.1) patient died. Childhood Diabetes Mellitus; remains relatively uncommon in Nigeria

Prevalence of Schizophrenia among Patients Admitted into Neuro-Psychiatric Hospital

This study; a retrospective one that was conducted to assess the prevalence of schizophrenia among patients admitted into Neuro-Psychiatric Hospital; Rumuigbo; Port-Harcourt; Rivers State; Nigeria between January 2005 and December 2009. The method used to collect the required data was assessing all the case files of the patients at the Medical Records Department with the assistance of the Chief Medical Records Officer-in-charge. The prevalence was investigated in relation to gender; age range; level of education; occupation and marital status. The study revealed that on the average 58.19 of the patients admitted between the study period were Schizophrenic patients. It is therefore recommended that urgent national survey be conducted to determine the prevalence of all psychiatric disorders as the results will guide both the health policy makers and providers in effective and efficient planning and administration of health of the country either in the prevention; early detection and management of mental disorders in Nigeria as high prevalence is a grave threat to the dividend of our democracy

Prevalence of Schistosoma haematobium Infection in a Neglected Community, South Western Nigeria

Purpose: Schistosomiasis ranks second to malaria among parasitic diseases of socio-economic and public health importance. In Nigeria; urinary schistosomiasis caused by Schistosoma haematobium is endemic. This study aimed at producing an accurate data on the prevalence of urinary schistosomiasis in Apojula; a neglected community located around Oyan Dam; southwest Nigeria; using parasitological and molecular techniques. Methods: Parasitological examinations were carried out on urine samples from 63 participants whose ages ranged between 7 and 63 years. Matched blood and urine samples were also screened for S. hematobium infection by polymerase chain reaction (PCR) amplification of the schistosome Dra1 repeat. Results: of the 63 participants; 33 (52.4) were positive for heamaturia while 6 (9.5) had S. haematobium ova in their urine. PCR amplification of S. haematobium Dra1 repeat from their urine and blood samples showed that 59 (93.65) and 62 (98.4) were infected respectively. Conclusion: There was a high prevalence of S. haematobium infection as detected by PCR amplification of schistosome Dra1 repeat from the urine and blood samples of the study participants. In addition; the PCR was able to detect schistosome infection in cases otherwise shown to be negative by parasitological examinations thereby making them also to receive chemotherapy

Urinary tract infection in children with nephrotic syndrome in Kano, Nigeria

Background: Nephrotic syndrome is a common childhood renal disorder; the prevalence of Urinary tract infection (UTI) in these patients is high. The increased prevalence of UTI are due to immunoglobulin loss; defective T cell function; presence of ascites and relative malnutrition. Objective: The study is to evaluate the prevalence of UTI ; its etiological agents; antibiotics; sensitivity pattern and the outcome in children with nephrotic syndrome. Methods: A prospective study of all patients with diagnosis of nephrotic syndrome from January 2003 to December 2006. Urine specimen were routinely obtained by clean catch method following careful preparation urethral orifices. The specimens were processed immediately. Five millimeters (5mml) loopful of the sample were inoculated on a blood agar and CLED agar plates. Identification of the organism to species level was by using stokes disc diffusion technique. Results : Forty two patients were studied. The mean age and SEM for males was 8.2 + 0.5 years and females with 7.9 + 0.8years. The age range was two to fifteen years UTI was caused predominantly by Staphylococcus aureus in 67.9; Klebsiella species (17.9) and Pseudomonas (14.2). There was high invitro resistance of these organisms to nalidixic acid and ampicillin but sensitive to cefotaxime; ceftriazone and ciprofloxacin. Conclusion: It is recommend that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate

Mosquito larval habitats and public health implications in Abeokuta, Ogun State, Nigeria

Abstract: The larval habitats of mosquitoes were investigated in Abeokuta, Nigeria in order to determine the breeding sites of the existing mosquito fauna and its possible public health implications on the residents of the City. The habitats were sampled between August 2005 and July 2006 using plastic dippers and a pipette. The habitats were grouped as ground pools/ponds, gutters/open drains, tyres, domestic containers and treeholes/ leaf axils. Ten species of mosquitoes were encountered in the fi ve habitats namely Mansonia africana, M. uniformis, Culex quinquefasciatus, Aedes aegypti, Ae. albopictus, Ae. vittatus, Cx tigripes, Anopheles gambiae s.l., An. funestus and Eretmapodite clnysogaster. Ae. aegypti bred in all the habitats sampled while Cx quinquefasciatus bred in four habitats except tree holes/leaf axils. An. gambiae s.l and Ae. albopictus occurred in three habitats while other species bred only in one or two habitats. Ground pools and domestic containers recorded the highest number of species followed by gutters/open drains. Tree holes/leaf axils was the least preferred habitat with the lowest number of species occurrence. However, statistical analysis revealed non-signifi-cant difference in species occurrence in the fi ve habitats. The availability of the habitats to support the breeding of Aedes, Culex and Anopheles, which are known vectors of urban yellow fever, lymphatic fi lariasis and malaria suggest that the residents of Abeokuta City are at risk of mosquito-borne diseases. It is important that residents of the City are enlighten on the environmental factors that contribute to mosquito breeding and that the Government should institute proper sanitation measures to reduce mosquito breeding sites

A Seven - Year Review of Accidental Kerosene Poisoning in Children at Aminu Kano Teaching Hospital

Background: Accidental ingestion of kerosene is a potential source of morbidity and mortality in children. The objectives of the study are to determine to magnitude of the problem and proffer feasible solutions to reduce the frequency of occurrence. Methodology: The medical records of all cases of kerosene poisoning admitted into Paediatric Medical Ward and Emergency Paediatric Unit were identified and relevant data extracted and analysed. Results: Kerosene poisoning constituted 55 (1.2) of cases of all paediatric admissions within the period (Jan 1999 Dec 2005). The study showed that children 4 months to 8 years were affected with peak age of 18 months. Thirty-four (61.8) of the cases were aged below 2 years which conforms to findings in earlier studies in Nigeria. Main clinical feature was cough with difficulty in breathing in 52 (94.5) of cases. Others features noted were central nervous system involvement (14.5); vomiting (20); and fever 16 (29.1). There were 3 deaths giving the mortality of 5.5. Conclusion: The study has revealed that kerosene poisoning is a significant cause of morbidity and mortality. Government policies that will enhance the standard of living of people and education of parents/care givers are the identified imperatives for reduction of the problem

Honey : a Reservoir for Microorganisms and an Inhibitory Agent for Microbes

Background: Honey is an ancient remedy for the treatment of infected wounds; which has recently been 'rediscovered' by the medical profession.The use to which honey is put in medical care is increasing daily with many authors pointing out its importance and role in wound care.There have been reports that honey contains many microorganisms including bacteria and fungi. Objective:The aim of this paper is to highlight the various uses; organisms commonly found in honey; how the organisms arrived in the honey and their effects on wounds and wound care.Would the presence of these organisms not constitute a limiting factor to the use of honey in wound management? This is what this review aims to answer Methods:A literature search was done on honey using pubmed; google; local books and journals. Relevant journals were extracted and discussed with emphasis on the antimicrobial properties as well as microbial content of honey and the implications of these. Results:The production of honey as well as the storing process account for the presence of microorganisims. Most of these organisms are said to be in inactive forms as they can hardly survive in honey because of its several properties including hygroscopicity; hyperosmolarity; acidity; peroxide content; antibiotic activities etc. However there is a need for caution in the use of honey in wound management. Con- clusion: We suggest that wounds to be treated with honey should be investigated i.e with a swab for the microorganisms present on the wound and their sensitivity to the honey before commencing honey treatment.This will help in carefully selecting wounds that might do well with honey treatment not withstanding other properties of honey that aid wound healing