The comparison of intelligence quotients of atopic and nonatopic children in ibadan, Nigeria.

BACKGROUND: Atopy-related illnesses such as atopic dermatitis and asthma are chronic illnesses, and children suffering from such illnesses are subjected to frequent absenteeism from school. Studies have shown that the performance of children with asthma was comparable to their healthy counterparts despite their absenteeism at school, in contrast to findings in other chronic illnesses like epilepsy. AIM: In the present study, we investigated the association between atopy and intelligence quotient (IQ) scores in a group of Nigerian children in Ibadan, a city in southwestern Nigeria. MATERIALS AND METHODS: This is a cross-sectional study of children in an urban elementary school. Questionnaires to ascertain the presence of atopy-associated conditions such as hay fever, atopic dermatitis, asthma, allergic rhinitis, and allergic conjunctivitis were administered to the parents of 128 pupils in the 3(rd) to 6(th) grades of elementary school. Based on the responses to the questionnaire, pupils were categorized as being atopic and nonatopic. All the pupils underwent the Standard Progressive Matrices IQ test. The IQ scores were then compared among these two groups of children. RESULTS: Out of the children studied, 26.6% were found to have atopy and after adjusting for factors such as age and sex, the IQ scores in this atopic group were not found to be statistically different from the scores in the nonatopic group (r = 2.122872, P = 0.009). CONCLUSION: IQ scores were not statistically significantly different for children with and without atopy. Thus, the presence of atopy does not appear to be associated with low IQ scores and hence, may not be related to poor school performance.

Liver enzymes in Nigerians with lichen planus.

INTRODUCTION: Lichen planus has been reported in association with liver diseases. Clinical signs such as jaundice may not be reliable indicator of ongoing inflammation or the presence of an ongoing liver disease. Liver function test in spite of its variability may serve as a more reliable indicator of liver disease. The objective of this study is to assess the discriminant power of liver enzymes with lichen planus and control. METHODS: Sixty Nigerians with lichen planus (LP group) and 30 patients with other dermatoses control group A) and 30 apparently normal individual (control group B) had their liver enzymes assayed using the automated Hitachi 70 auto-analyzer. RESULT: There was no a statistically significant difference in the level of liver enzymes between the LP group and controls. CONCLUSION: Liver enzymes in Nigerian with lichenplanus are generally within normal limits and are comparable to individuals without lichen planus.

A 12-year review of cases of adult tetanus managed at the University College Hospital, Ibadan, Nigeria.

In this review, hospital case records of 202 adult tetanus managed between January 1990 and December 2001 in a tertiary institution in Southwestern Nigeria were reviewed. The mean age of the patients was 36.1+/-17.8 years with male:female ratio of 2.2:1 and an overall mortality rate of 64%. Patients with unfavourable outcomes spent 4.5+/-0.41 days compared with 16.6+/-1.2 days by those who survived. Factors associated with poor prognosis are age >60 years (P=0.029), incubation period <7 days (P=0.007), period of onset <48 h (P=0.0001), tachycardia with pulse rate >120/min (P=0.001) and spasm (P=0.002). Gender (P=0.11), post-injury vaccination (P=0.48) and types of antibiotics administered (P=0.49) were not significantly associated with increased mortality. The three most common complications were aspiration pneumonitis, sepsis and urinary bladder obstruction while complications with highest mortality (100%) were sepsis and cardiac arrest.

Clinicopathological study of neurofibromatosis type 1: an experience in Nigeria.

BACKGROUND: Neurofibromatosis type 1 (NF1) is the commonest single gene autosomal dominant disorder, and its diagnosis is usually composed of a set of clinical criteria. Histological examination of skin lesions is often neglected. This study was designed to evaluate the clinical and pathologic pattern of NF1 among Nigerians and to emphasize the place of histological examination. METHODS: A retrospective case study of 98 clinically diagnosed NF1 patients whose dermal mass lesions (neurofibromas) were excised and processed for histological diagnosis over a period of 22 years (1980-2001) at the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. RESULTS: There were 98 patients: 60 males and 38 females (ratio 3 : 2) aged 1-99 (mean +/- S.D. = 3.4 +/- 1.7) years. All patients had neurofibromas, which were benign in 95 patients (96.9%) and malignant in three (3.1%) patients, while 94 (96%) patients had cafe-au-lait spots. Benign neurofibromas were clinically cutaneous [50 (51%)], subcutaneous [37 (37.8%)] and plexiform [8 (8.2%)]. Site distribution of the neurofibromas included the extremities (50%), trunk (20.4%), head and neck (19.4%), and multiple sites (10.2%). Three patients presenting with neurofibosarcomas were aged 4, 23 and 27 years, respectively. Their deaths were responsible for the mortality rate of 3.1% recorded in this study. CONCLUSIONS: In our setting, NF1 is more common among males, with the highest density of neurofibromas covering the extremities.

Hepatitis B virus in Nigerians with lichen planus.

BACKGROUND: [corrected] Lichen planus had been reported as one of the cutaneous manifestations of Hepatitis B virus (HBV) in the literature. The prevalence of HBV among Nigerians with lichen planus has not been documented in the literature despite the high prevalence of HBV in the community, and the reports of a possible relationship between lichen planus and HBV from this centre and from other regions. The aim of this study was to determine the prevalence of HBsAg amongst Nigerians with lichen planus. METHOD: Sixty Nigerians with lichen planus (LP group) and 30 patients with other dermatoses not reportedly associated with HBV (control group A) and 30 apparently normal subjects (control group B) were screened for the presence of HBsAg by second generation ELISA. RESULTS: Nine (15%) of the 60 LP group, 2 (6.2%) of the 30 control group A and 2 (6.2%) of the 30 control group B were HBsAg seropositive. CONCLUSION: This study found a higher prevalence of HBsAg in patients with lichen planus when compared with patients with other cutaneous dermatoses and apparently normal individuals. Although a causal relationship between HBV has not been established from this study, this report reiterates the importance of screening patients with lichen planus for the presence of HBV and instituting therapy in those found positive.

Retrospective analysis of typhoid fever in a tropical tertiary health facility.

A retrospective analysis of cases diagnosed as typhoid fever over a ten-year period at the University College Hospital, Ibadan, Nigeria was carried out to assess the presentation pattern, laboratory investigation, mortality and mode of therapy. Incidence was of typhoid fever was highest in the dry months of the year. The mean age of survivors and the dead are 25.7 and 21.9 years respectively. Most of the patients presented with fever, abdominal pains and other gastrointestinal symptoms such as vomiting, constipation and diarrhoea. There was no specific temperature pattern but pulse rate > or = 120/minute was significantly associated with mortality. The commonest complication was intestinal perforation followed by haemorrhage with septic shock playing a prominent role in mortality. Mortality rate of 22.2% was recorded which is not significantly different from the 24% recorded at the same centre over three decades ago and most of them died within nine days of admission with 50% dying within 3 days. Most patients were scantily investigated with poor yield on blood, stool and urine cultures. Widal's test was not a favoured investigation and was not helpful in diagnosis. Chloramphenicol was the drug of choice as monotherapy, while metronidazole and gentamicin were used in cases of gut perforation. It is concluded that typhoid fever is still a major health concern in the tropics and efforts need to be geared up to combat this preventable scourge by improvement in basic necessities of life such as potable water, hygienic food in addition to health education.

Hepatitis C virus and lichen planus in Nigerians: any relationship?

BACKGROUND: The association of lichen planus with Hepatitis C virus (HCV) has been widely reported in the literature. No such association, however, has been reported amongst black Africans in whom HCV is thought to be endemic. Lichen planus is a frequently encountered dermatosis in this racial group as well. The aim of this study was to determine the prevalence of anti-HCV amongst Nigerians with lichen planus. METHODS: Fifty-seven Nigerians with lichen planus (LP group) and 24 patients with other dermatoses not reportedly associated with HCV (control group A) and 24 apparently normal subjects (control group B) were screened for the presence of anti-HCV by second generation ELISA. RESULTS: Nine (15.8%) of the 57 LP group, 6 (25%) of the 24 control group A and none out of the 24 control group B were seropositive for anti-HCV. CONCLUSION: The prevalence of anti-HCV amongst Nigerian with lichen planus is lower than amongst patients with other dermatoses not associated with HCV but higher than amongst apparently normal control. It would appear that the prevalence of HCV is high in Nigeria and not necessarily in lichen planus as a specific entity.

Lichen planus following hepatitis B vaccination in an African girl.

Lichen planus is a papulosquamous disorder with distinctive clinical features. Until now the aetiology has been largely unknown, however, several postulations have been proposed. The immunopathogenic basis has been most favoured. We report a case of a 13-year-old girl who presented with Lichen planus after receiving the second dose of hepatitis B virus (HBV) vaccination. This report, similar to earlier reports, appears to support the immunopathogenic basis of Lichen planus.