Case report of bullous pemphigoid in a 65 year old woman

The unique thing about this case is that it is the first reported case of bullous pemphigoid in the elderly that has been clinically diagnosed with histologic findings highly suggestive of this blistering disorder although an immunofluorescence could not be done due to unavailability in the centre. Patient was managed successfully and discharged home with improvement on subsequent hospital visits. This case report shows how diagnosis of an immunobullous disease was made and managed in a resource poor setting. A descriptive summary of 65-year old black Nigerian woman with bullous pemphigoid covering history, physical examination and management. The main diagnosis was bullous pemphigoid in a recently diagnosed type 2 diabetic. Patient was placed on corticosteroids as well as immunosuppressive agents and diabetes was managed with subcutaneous insulin and oral hypoglycemics with appropriate wound care. Patient showed remarkable improvement after management and was discharged home with subsequent follow up in the clinics. Bullous Pemphigoid (BP) can be diagnosed clinically with a high index of suspicion with the aid of skin biopsy and histology, and can be managed successfully even in a resource poor centre where immunofluorescence facilities are lacking.

An exploratory study of stigma and discrimination among people living with HIV/ AIDS in Abuja Municipal Area Council, Nigeria

This study examined the magnitude of HIV/AIDS stigma and discrimination among people living with HIV/AIDS (PLWHA) in Abuja Municipal Area Council (AMAC). A descriptive cross-sectional study was conducted using both qualitative and quantitative methods to survey 100 PLWHA resident in AMAC-FCT. Participants were selected through a combination of two-stage and systematic random sampling technique using a table of random numbers. A 40-item structured questionnaire adapted from the HIV Stigma Scale and a semi-structured focus group discussion (FGD) guide were used to collect data. Quantitative data were coded and entered SPSS statistical software. Frequency tables were generated, and data subjected to descriptive and inferential statistics. Cross tabulations examined pattern of associations between respondent's characteristics while qualitative findings utilized content analysis along five specific themes to demonstrate the way HIV/AIDS stigma manifested among respondents. Participation was 100% and HIV/AIDS stigma prevalence was high at 67%, with mean age 33.01years (SD±5.94years) for respondents. Findings confirmed rejection of PLWHA by sexual partners, family members and friends, dismissal from work, decrease in the quality of health care services and sometimes outright denial of services. A high correlation was found between the scales and subscales of the HIV Stigma Scale with all correlation values reaching statistical significance (p =0.01). Regret for disclosure of status and ending social interaction by PLWHA was reported as consequences of disclosure and potential hindrance for disclosure which will encourage ongoing transmission of the virus. Our study provides evidence on stigma and discrimination of PLWHA in AMAC, FCT-Abuja in the face of limited evidence to drive HIV prevention interventions. Further studies should investigate other predictors and reasons for stigma and discrimination among this population

Awareness, acceptability and barriers to the utilization of modern methods of family planning among women attending antenatal clinic in Bayero University, Kano

Background: Contraceptive prevalence rate (CPR) is generally very low in Nigeria, but particularly lowest in northern Nigeria. Barriers to access and utilization have been variously studied, but there is need to consider specific contexts. Objective: The aim of this study is to determine the level of awareness, acceptability, and barriers to the utilization of modern methods of family planning in Bayero University, Kano, North-west, Nigeria. Methodology: This was a cross-sectional study conducted at the antenatal section of BUK staff clinic, among 152 pregnant women between May and October 2013. Ethical approval and informed consent were obtained. Descriptive statistics was used to report categorical variables. Results: Awareness of modern methods of contraception was high (86.18%) and the majority (86.19%) knew at least one method of family planning. The commonest methods known by the respondents were: Oral contraceptive pills (39.47%), injectables (22.37%) and condom (14.47%). Out of the152 respondents, 77(50.66%) accepted the use of modern methods of family planning and 39(25.65%) out of these number had ever used at least one method, while 38(25.00%) did not. Fear of side effects (42.11%), desire for more children (15.79%), and lack of awareness (13.82%), religious prohibition (10.53%) and opposition by male partners (7.89%) constituted the major barriers to the utilization of modern methods of family planning. Conclusion: The level of awareness was found to be high but acceptability and utilization were low, this is due to the existing barriers to utilization of modern methods of family planning. Effort should be made to allay the fear of side effects and to educate women on the implication of frequent childbirth

Nutritional Practices and Taboos among Pregnant Women Attending Antenatal Care at General Hospital in Kano; Northwest Nigeria

Background: Food taboos among rural women have been identified as one of the factors contributing to maternal undernutrition in pregnancy. Aim: The aim of this study was to explore some of the taboos and nutritional practices among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu LGA; Kano; Nigeria. Subjects and Methods: This was a cross-sectional study involving 220 pregnant women. Interviewer-administered structured questionnaire was used to interview the respondents; which showed various sociodemographic information; cultural nutritional processes; taboos of the community; and a 24 h food recall. The ages; parities; and gestational ages of the women were collated. Descriptive statistics was used. Data were analyzed using SPSS statistical software Version 17.0 (SPSS Inc.; Chicago; IL; USA). Association between sociodemographic factors and nutritional practices and taboos was determined using Chi-square test and P 0.05 was considered statistically significant. Results: At the end of the study; 200 participants (91%) gave complete information. Most of the women; 70% (140/200) were in the 20-39 years age range with mean (standard deviation [SD]) age of 23.7 (6.1) years; mostly uneducated; 70% (140/200); and unemployed; 51% (102/200). Most of the women did a child spacing of 12-24 months; 62% (124/200) with mean (SD) child spacing interval of 26.32 (10.19) months. Gestational age at booking was mostly 13-26 weeks; 48% (96/200) with an average of 26.60 (8.01). Most of the women had 1-4 children; 54.5% (109/200) with mean (SD) of 2.47 (2.50). Most of the women agreed that they had adequate intake of oil; 86% (172/200); meat/fish; 92% (194/200); fruit/vegetables 56% (112/200); and had 3 meals/day 80% (152/200); and did not practice pica 83% (166/200). All of the women; 100% (200/200) believe that women should eat more during pregnancy in order to have healthy babies. They were mostly supported by their husbands; 53% (106/200) and less likely by the community; 34% (17/200). The nutritional practices and taboos of the women showed a statistically significant association with age; parity; and support received from husband and community (P 0.05). Educational status is not associated with their nutritional practices and taboos. Conclusion: Although sociocultural indices of the respondents were poor; their intake of good nutrition and abstinence from nutrition taboos were satisfactory. Further studies are intended to objectively study the nutritional practices/taboos in pregnancy

Abnormal findings on dipstick urinalysis of out-patient with malaria in Abakaliki, Nigeria.

Background & objectives: Malaria, one of the major health challenges of the tropics affecting about 500 million people, particularly the children and pregnant women have been associated with changes in urine compositions. The present study was undertaken to document the urinary abnormalities in malaria patients based on malaria species and the level of malaria parasitaemia. Methods: Febrile patients (n = 365) with positive Giemsa-stained blood films for malaria recruited from Outpatient Department of Ebonyi State University Teaching Hospital, Abakaliki participated in the study. Patients were classified into two categories (+ and ++) based on parasite density. Apparently healthy individuals (n = 81), without malaria parasite on both thick and thin films of comparable age and gender acted as control group. Urine sample (10 ml) was collected from each participant and analysed using standard laboratory methods and techniques. Results: Seventy-four (20.3%) of the patients had Plasmodium falciparum malaria. Although all the urine parameters were higher in the malarial patients in comparison to the control, only bilirubinuria and urobilinogenuria were statistically significant (p <0.05). Also, bilirubinuria, urobilinogenuria, haematuria and proteinuria were significantly (p <0.05) higher in P. falciparum infection than in infections with other malaria species, but only in P. falciparum infection, bilirubinuria and urobilinogenuria were significantly (p <0.05) higher at higher parasitaemia. Conclusion: Even though positive blood film for malaria parasite remains the gold standard for the diagnosis of malaria, urinary abnormalities, such as bilirubinuria, urobilinogenuria, proteinuria and haematuria may aid in identifying patients with severe malaria parasitaemia, especially the falciparum malaria.