Prevalence of Silent Gallstones on Ultrasound in a Nigerian Population.

BACKGROUND: Gallstones detected incidentally during imaging are termed 'silent' or asymptomatic gallstones and they account for 80% of all gallstones. About 1-2% of patients with silent gallstones develop symptoms yearly; however, determining those who will develop symptoms is a major challenge. Ultrasonography is the most sensitive and specific method of detecting gallstones with an accuracy greater than 95%. The study aims to determine the prevalence of ultrasound-diagnosed silent gallstones in a Nigerian population and to determine its association with age and gender. METHODS: This was a retrospective analysis of abdominal ultrasound scans performed at the Radiology department of a tertiary institution between January 2013 and December 2015. Data retrieved included age, sex, and sonographic findings. Data analysis was done by simple proportions and percentages using the Statistical Package for Social Sciences version 20.0 software. RESULTS: Two thousand, one hundred and thirty-eight patients had abdominal ultrasound scans for various reasons during the study period. These included 915 males and 1223 females. Incidental findings of gallstones were observed in 52 patients, giving a prevalence of 2.4%. The prevalence of gallstones increased with age (p=0.051) with the highest prevalence seen in the 5th decade. Gallstones prevalence was higher in females with a male-to-female ratio of 1:3.5. CONCLUSION: The prevalence of silent gallstones is low in our environment, but given the complications that may arise, follow-up for early detection of complications in the patients is therefore strongly recommended.

CONTEXTE: Les calculs biliaires détectés fortuitement lors de l'imagerie sont appelés calculs biliaires "silencieux" ou asymptomatiques et représentent 80% de tous les calculs biliaires. Environ 1 à 2 % des patients atteints de calculs biliaires silencieux développent des symptômes chaque année ; cependant, déterminer ceux qui développeront des symptômes est un défi majeur. L'échographie est la méthode la plus sensible et la plus spécifique pour détecter les calculs biliaires avec une précision supérieure à 95 %. L'étude vise à déterminer la prévalence des calculs biliaires silencieux diagnostiqués par échographie dans une population nigériane et à déterminer son association avec l'âge et le sexe. MÉTHODES: Il s'agit d'une analyse rétrospective des échographies abdominales réalisées au service de radiologie d'un établissement tertiaire entre janvier 2013 et décembre 2015. Les données récupérées comprenaient l'âge, le sexe et les résultats échographiques. L'analyse des données a été faite par proportions et pourcentages simples à l'aide du logiciel Statistical Package for Social Sciences version 20.0. RÉSULTATS: Deux mille cent trente-huit patients ont subi une échographie abdominale pour diverses raisons au cours de la période d'étude. Il s'agissait de 915 hommes et de 1223 femmes. Des calculs biliaires ont été observés chez 52 patients, soit une prévalence de 2,4 %. La prévalence des calculs biliaires augmente avec l'âge (p=0,051), la prévalence la plus élevée étant observée au cours de la cinquième décennie. La prévalence des calculs biliaires était plus élevée chez les femmes avec un ratio homme/femme de 1:3,5. CONCLUSION: La prévalence des calculs biliaires silencieux est faible dans notre environnement, mais compte tenu des complications qui peuvent survenir, un suivi pour la détection précoce des complications chez les patients est donc fortement recommandé. Mots-clés: Calculs biliaires silencieux, Échographie, Nigérian.

RETROSPECTIVE EVALUATION OF MRI PATTERN OF GLIOBLASTOMA IN A TERTIARY HOSPITAL IN NIGERIA.

Introduction: Malignant gliomas, especially glioblastomas, are among the most aggressive and devastating of cancers, commonly producing profound progressive disability and leading to death in most cases. Conventional magnetic resonance (MR) imaging with gadolinium-based contrast agents is the most widely established and most useful tool in the characterization of cerebral tumors including Glioblastomas. This study aims to describe the imaging characteristics of Glioblastoma in African patients using conventional MR imaging. Methodology: This was a retrospective cross-sectional study carried out at a Nigerian tertiary hospital. The demographic data, MR images and reports of patients with imaging and histological diagnosis of Glioblastoma between January 2003 and September 2017 were retrieved and reviewed. All the recorded data were analyzed using simple proportion and descriptive statistics with the Statistical Package for Social Sciences (SPSS) version 20.0 software for Windows. Results: One hundred and twenty-two (122) patients had brain tumors during the review period, out of which 14 (11.5%) had histologically confirmed glioblastoma. The male- to -female ratio was 2.5 to 1.0. The age ranged between 14 and 72 years with a mean age of 49.6 years SD ±16.3. Twelve (85.7%) patients had solitary tumors and 2 (14.3%) had multiple tumors. Six (42.9%) were found on the right hemisphere only, 5 (35.7%) were found on the left hemisphere while 3 (21.4%) traversed both hemispheres. All tumors showed inhomogeneous enhancement and significant midline shift to the contra-lateral side of greater than 3mm. Only 1 (7.1%) tumor showed evidence of intra-tumoral bleed detected on T2* sequence. Conclusion: Glioblastoma is a known aggressive brain tumor with unique MR imaging characteristics. While midline shift is typical, intra-tumoral bleeding may be an uncommon finding at presentation in our center.

Parasitological, serological, and molecular survey of trypanosomosis (Surra) in camels slaughtered in northwestern Nigeria.

Surra is a parasitic disease caused by Trypanosoma evansi and transmitted non-cyclically by biting flies. The disease significantly affects the health, productivity, and market value of camels thereby constituting a major constraint to food safety, security, and economy. This is the first study on the prevalence of surra in northwestern Nigeria, using a range of diagnostic tests along the parasitological-serological-molecular continuum hence, emphasizing it as a major enzootic risk for camels in Nigeria. In this cross-sectional study, 600 blood samples were collected from camels at major abattoirs in northwestern Nigeria and evaluated for the prevalence of T. evansi using parasitological (Giemsa staining), serological (CATT/T. evansi), and molecular (VSG-PCR and sequencing) methods. The overall prevalence of surra recorded in this study was 5.3%, 11.5%, and 22.5% using Giemsa-stained blood smears, CATT/T. evansi, and VSG-PCR respectively. However, higher prevalence rates at 6.0%, 13.7%, and 26.7% by Giemsa-stained blood smears, CATT/T. evansi, and VSG-PCR were recorded in Katsina State compared with results from Kano State. A significantly (p < 0.05) higher prevalence by VSG-PCR was observed when compared with both parasitological and serological methods used. Although age and body condition scores were associated (p < 0.05) with surra prevalence in sampled camels, no seasonal association (p > 0.05) was recorded. Sequencing of the VSG region of Trypanosoma spp. Further confirmed the presence of T. evansi as the aetiological agent of surra from the sampled camels. Findings from this study call for the implementation of adequate control measures aimed at reducing the impact of T. evansi infections on camel production in Nigeria.

Optimization of the adsorption of total organic carbon from produced water using functionalized multi-walled carbon nanotubes.

This study investigated the removal of Total Organic Carbon (TOC) from produced water by batch adsorption process using adsorbents developed from Multi-Walled Carbon Nanotubes (MWCNTs). The MWCNTs, synthesized by catalytic chemical vapour deposition method using kaolin-supported tri-metallic (iron-cobalt-nickel) catalyst were purified by H2SO4/HNO3 and then functionalized with 1-pyrenebutanoic acid N-hydroxyl succinimidyl ester (PSE). The raw, purified and functionalized MWCNTs were characterized by High Resolution Scanning Electron Microscopy (HRSEM), High Resolution Transmission Electron Microscopy (HRTEM), Brunauer-Emmett-Teller (BET) and Fourier Transform Infrared Spectroscopy (FTIR). In the results, HRSEM/HRTEM revealed the structure, purity and also confirmed the attachment of the PSE molecule onto the nano-adsorbent(s). The BET surface areas of MWCNTs, PMWCNTs and FMWCNTs were 970.17, 869.25 and 831.80 m2/g, respectively while the FTIR established the existence of surface functional groups. The functionalized MWCNTs (FMWCNTs) nano-adsorbent showed superior performance efficiency (93.6%) than the purified MWCNTs (PMWCNTs) (79.2%) as examined under the same batch adsorption condition: 0.02 g adsorbent dosage, 10-90 min contact time and 30 °C solution temperature probably, due the improved wettability resulted from incorporation of PSE. Subsequently, Central Composite Design (CCD) was applied to optimize the process parameters for the sorption of TOC onto FMWCNTs. The CCD in the response surface methodology predicted 260 mg/g adsorption capacity of FMWCNTs in the removal of TOC at the optimum condition of 49.70 min contact time, 34.81 °C solution temperature, and 0.02 g adsorbent dosage. The kinetics data were best described by pseudo-second-order model and thermodynamic parameters suggested that the process was feasible, spontaneous and exothermic. It can be inferred from the various analysis conducted that the developed FMWCNTs nano-adsorbent is effective for removal of TOC from oil-produced water and may be explored for removal of organic contaminants from other industrial wastewater.

Evaluating Ultrasound Determined Thyroid Volume as a Predictor of Newborn Thyroid Hormone Function.

BACKGROUND AND OBJECTIVES: Congenital hypo-thyroidism is a cause of intellectual and developmental disabilities in the newborn. Early screening and prompt treatment can prevent the devastating outcomes of congenital hypothyroidism. The disease burden of congenital hypothyroidism in Nigeria is higher than in many parts of the world. Using ultrasound, the authors sought to determine the normal mean thyroid gland volume in newborns and establish the thyroid gland volume as a predictor of thyroid hormone function in the newborn. METHODS: This was a descriptive cross-sectional study. Healthy newborns had their length and weight measured, thyroid ultrasound scan performed, and a blood sample taken for thyroid-stimulating hormone values. RESULTS: The mean total thyroid volume was 0.51cm3 ± 0.25. The thyroid volume of the right lobe (mean volume= 0.27cm3 ± 0.13) was significantly larger than the volume of the left lobe (mean volume =0.24cm3 ± 0.12) (p<0.001). The thyroid-stimulating hormone (TSH) values ranged from 1.36µIU/ml to 35.03µIU/ml with a mean value of 7.73µIU/ml ± 7.04. There was no significant correlation between the thyroid volumes and the TSH of the newborns. CONCLUSION: This study determined the mean thyroid volume in newborns. There was no significant correlation between the thyroid volumes and the TSH values of the newborns implying that the thyroid gland volume is not a reliable predictor of thyroid hormone function. Newborn, Ultrasound.

Green corrosion inhibition and adsorption characteristics of Luffa cylindrica leaf extract on mild steel in hydrochloric acid environment.

The corrosion inhibition of Luffa cylindrica Leaf Extract (LCLE) was investigated using gravimetric, depth of attack and surface analysis techniques. Effect of inhibitor concentrations (0.50-1.00 g/l), temperatures (30-60 °C) and immersion time (4-12 h) was studied on the Inhibition Efficiency (IE) of the extract on Mild Steel (MS) immersed in a 0.5 M HCl solution. The constituents of the proposed inhibitor were identified by using a GC-MS. The media solutions and adsorbed film on MS were characterized using FTIR Spectrophotometer. SEM microgram and surface tester were applied for studying surface morphology and depth of attack profile. The optimum IE of 87.89% was obtained. The LCLE adsorption on MS followed Langmuir isotherm and pseudo-second-order adsorption kinetics. Activation energy (28.71 kJ/mol), entropy (- 0.15 kJ/mol. K), average enthalpy (-28.00 kJ/mol) and Gibbs free energy (-11.43 kJ/mol) obtained at optimum condition indicate exothermic process and physical adsorption mechanism. The result obtained in this study compared well with many reported green inhibitors for MS corrosion.

REFRACTIVE ERRORS AMONG CHILDREN ATTENDING A TERTIARY EYE FACILITY IN IBADAN, NIGERIA: HIGHLIGHTING THE NEED FOR SCHOOL EYE HEALTH PROGRAMS.

BACKGROUND: It is estimated that 19 million children aged below 15 years are visually impaired globally. Twelve million of these are due to uncorrected refractive errors. The aim of this study was to describe the pattern of refractive errors seen in children attending the eye clinic of the University College Hospital, Ibadan, Nigeria. METHODS: A descriptive retrospective study of children with refractive errors seen between January 2011 and December 2012 was conducted. Information on the age, sex, type of refractive error, degree of error (spherical equivalent), presenting complaint, previous spectacle use and return for follow-up visit were retrieved and analyzed using SPSS version 20. RESULTS: Three hundred and sixty-six children diagnosed with refractive errors accounted for 34.6% of all children seen. Of these, 267 (73%) records were successfully retrieved. The mean age was 10.58 (± 3.14) years, with 156 (58.5%) aged between 11 and 15 years. The male to female ratio was 1:2. The commonest refractive error was myopia, found in 124 (23.2%) of 534 eyes followed by simple myopic astigmatism and compound myopic astigmatism found in 117 (21.9%) and 111 (20.8%) eyes respectively. Majority, 229 (85.8%) had never worn spectacles previously and only 80(30%) children returned for a follow up visit. CONCLUSION: Refractive errors constitute a common diagnosis among children seen in our tertiary eye facility. Late presentation and poor follow up among our patients are a cause for concern. Public enlightenment, health education and school eye programs are recommended to reverse this trend.

Cohort event monitoring of patients treated for uncomplicated malaria with artemisinin-based combination therapies in selected hospitals and community pharmacies in Nigeria.

AIMS AND OBJECTIVES: The study was designed with the broad objective of determining the safety profile of artemisinin-based combination therapies amongst Nigerian population. PATIENTS AND METHODS: This was a cohort event monitoring (CEM) programme involving monitoring adverse events (AEs) in malaria patients treated with either artemether-lumefantrine (AL) or artesunate-amodiaquine (AA) in healthcare facilities in Nigeria. The study involved continuous enrolment of patients with malaria and treated with either AL or AA at the various sites until a total cohort of 600 patients were enrolled at each site. Patients were monitored from the onset of therapy, and on days 3 and 7 from the first day of treatment to identify AEs that may occur. RESULTS: A total of 6102 AEs were recorded in 10,259 patients monitored during the programme. Of 4896 patients who received AA, 4233 (86.5%) patients reported at least one AE while 1869 (34.8%) AEs out of 5363 patients who received AL were reported (P = 0.010). The predominant incidence of each specific AE reported in each group among the patients who received AA and AL includes body weakness 30.8%/7.5%, dizziness 10.3%/3.9%, restlessness 5.02/1.12%, vomiting 3.5/1.03% and drowsiness 3.1/1.5% for AA and AL, respectively. There were more AEs among patients with co-morbid conditions and patients in the younger age groups (9-<15 years), P = 0.000. CONCLUSIONS: Various types of AEs were seen and documented during the CEM programme. The findings suggested that the AA/AL monitored during this programme was generally safe and remarkably well tolerated among the Nigerian populations.

Bi-lobed Perirectal Epidermoid Cyst: An Unusual Cause of Hematochezia in a Middle-aged Woman.

Perirectal epidermoid cysts are congenital cysts originating from the ectodermal germ cell layer of the hind gut. Their presenting symptoms are most often nonspecific and distinguishing them from other presacral developmental cysts often present a diagnostic and therapeutic dilemma. We present a 58-year-old woman who presented with chronic dyschezia and hematochezia of a few days duration and no prior colonoscopies. Initial blood work and tumor markers were unremarkable. Pelvic magnetic resonance imaging (MRI) showed a 7.5 cm × 5 cm × 6 cm homogenous bi-lobed cystic mass in the pelvis adherent to the left lateral wall of the rectum and posteriorly to the sacrum with a displacement of the rectum anteriorly and to the right. There was no pelvic sidewall adenopathy or free fluid in the pelvis. Preoperative colonoscopy showed rectal compression with no rectal involvement of the mass. The cyst was successfully resected posteriorly via the trans-sacrococcygeal approach. An intraoperative proctosigmoidoscopy confirmed an intact rectum. The patient remains recurrence-free 1 year postsurgical resection.

Comparative periodontal status of human immunodeficiency virus-positive patients and controls in a dedicated human immunodeficiency virus clinic in Nigeria.

BACKGROUND: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub-Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of HIV-seropositive patients with that of HIV-seronegative persons using the community periodontal index (CPI). METHODOLOGY: This was a comparative study of the periodontal status of 110 HIV-positive subjects and 110 age and gender-matched HIV-negative controls attending a dedicated HIV Clinic in a Teaching Hospital in Lagos, Nigeria. The CPI and simplified oral hygiene index score were used in the periodontal examination. Highest CPI scores and percentages of CPI sextants assessed the prevalence and severity of chronic periodontitis respectively. Logistic regression was used in adjusting demographic differences in the study population. P ≤ 0.05 was considered as significant. RESULTS: A significant proportion of the HIV-positive patients 61 (55.5%) and the HIV-negative controls 53 (48.7%) had shallow pockets (4-5 mm) (CPI code 3). The prevalence of deep pockets (≥ 6mm) (CPI code 4) was higher among HIV-positive patients 9 (8.2%) than the controls 4 (3.5%) (P = 0.079). HIV-positive patients had a greater percentage of CPI codes 3, 4 and fewer CPI code 0 sextants than controls (P = 0.000). Both groups had comparable oral hygiene status (P = 0.209). Using a logistic regression analysis, HIV-positive status and lower education accounted for the greater severity of chronic periodontitis. CONCLUSION: HIV-seropositive patients had more severe chronic periodontitis than the HIV-seronegative controls, which was independent of lower education.

Use of complementary medicines among HIV-infected children in Lagos, Nigeria.

BACKGROUND: Complementary medicine (CM) use is common among children with chronic illnesses such as epilepsy and asthma. Lack of data on the profile of CM use among children with human immunodeficiency virus (HIV) infection necessitated this study. METHODS: Parents or caregivers of HIV-infected children attending the paediatric HIV-clinic in a teaching hospital in Lagos, Nigeria, were randomly selected and interviewed with a semi-structured (open- and close-ended) questionnaire. Clinical details of the patients were extracted from their case files. RESULTS: A total of 187 parents/caregivers were interviewed. Most of the parents/caregivers (181; 96.8%) have used CMs for their children. Mind-body interventions (181; 36.6%) and biological products (179; 36.2%) were frequently used. Relatives, friends and neighbours influenced CM use in 37.1% of the children. CMs were used mostly to treat weight loss (79; 43.7%), cold (40; 22.1%), and fever (39; 21.6%). CONCLUSION: CM use is common among HIV-infected children in Lagos.

Rational use of medicines: assessing progress using primary health centres in Shomolu local government area of Lagos, Nigeria.

BACKGROUND/OBJECTIVE: Medicines (drugs) are a critical component in the prevention and treatment of diseases. Their rational use is important to maximize their benefits and prevent undesirable effects. This study was conducted to assess progress with rational use of medicines at primary care level using recommended indicators. METHODS: The cross-sectional descriptive study was conducted in four primary health centres in Somolu Local Government Area (LGA) of Lagos State, Nigeria. It employed retrospective and prospective data collection methods. From the four centres, prescription notes of 600 clinical encounters spanning one year were analyzed for prescribing indicators and a checklist was administered for facility indicators. RESULTS: For the 600 clinical encounters studied, 2802 drugs were prescribed. The mean number of drugs per encounter was 4.7 ± 2.1; 75.6% of drugs were prescribed by generic name; prescriptions containing at least an antibiotic averaged 48.5%, while those with at least an injection prescribed were 21%. Of all the drugs prescribed, 83.2% were from the National Essential Drugs List (NEDL). On the average, 86.5% of key essential drugs were available in the health centres but none of the centres had a copy of the NEDL or drug formulary. There were wide variations in some of the indicators across the four facilities. CONCLUSION: The study showed progress in some indicators when compared with previous studies but gaps still exist. We recommend training on rational use of medicines for health workers in the facilities and distribution of copies of NEDL to all the facilities.

Body mass index and asthma severity in a population of Nigerian asthmatics.

BACKGROUND: Asthma and obesity have considerable impact on public health. There is increase prevalence of both conditions worldwide. This study was undertaken to determine the prevalence of obesity among asthma patients as well as determine the effect of body mass index (BMI) on asthma severity and pulmonary functions. METHODS: The study was conducted at the asthma clinic of the medical outpatient of Lagos State University Teaching Hospital, Ikeja. Ethical clearance was obtained from the hospital's research and ethics committee. Non probability sampling method was used with consecutive asthma patients diagnosed by the respiratory physicians according to NHLBI guideline recruited into the study. The weight, height and pulmonary function tests were carried out using standard methods. Acarefully designed interviewer administered questionnaire were used to collect information on the socio demographic characteristics of the patient, asthma symptoms, control use of rescue medications and emergency visits. RESULTS: One hundred and fifty eight (158) asthma patients participated in the study. There were 63 (39.9%) males and 95 (60.1%) females. The prevalence of obesity was 53.8%. The mean age of respondents was 46.48 +/- 17.16 years. Age, educational level and employment status were related to the body mass index while gender and duration of asthma were not. There was no difference in the severity of asthma and utilization of emergency services across the BMI categories. The obese asthmatics generally recorded lower lung function volumes compared with the non-obese asthmatic groups. CONCLUSION: Prevalence of obesity is high among the asthmatics studied. There is no difference in asthma severity across the BMI categories. Pulmonary functions are lower in obese asthmatics.

Biosorption equilibrium, kinetic and thermodynamic modelling of naphthalene removal from aqueous solution onto modified spent tea leaves.

The object of this study was to investigate the feasibility of using modified spent tea leaves to remove naphthalene from its aqueous solution under batch mode. The effects on the removal process of physical factors, such as initial naphthalene concentration, contact time, biosorbent dosage, pH and temperature, have been evaluated. The equilibrium biosorption data were analyzed by the Langmuir, Freundlich, Temkin and Dubinin-Radushkevich (D-R) adsorption isotherm models. These models provided a good fit to the experimental data, but the Langmuir isotherm model provided the best correlation (R2 = 0.993) to the experimental data. The biosorption kinetic data of naphthalene were analyzed by pseudo-first-order, pseudo-second-order and intra-particle diffusion and surface mass transfer kinetic models. These four kinetic models fitted the biosorption kinetic data well, but the pseudo-first-order kinetic model gave the best fit. The activation energy (E(a)) was found to be 15.89 kJ per mole and the thermodynamic properties of the biosorption process, such as the Gibbs free energy, enthalpy and the entropic change of biosorption, were also evaluated. It was established that the biosorption process was spontaneous, feasible and endothermic in nature.

Medication administration errors among paediatric nurses in Lagos public hospitals: an opinion survey.

OBJECTIVE: There is paucity of data on paediatric medicine administration error (MAE) in developing countries. This study aimed to investigate the experience of MAEs among paediatric nurses working in public hospitals in Lagos, Nigeria. DESIGN: A confidential, self-reporting questionnaire was the instrument for the study. SETTING: Public hospitals in Lagos, Nigeria with established paediatric services and departments. PARTICIPANTS: Paediatric nurses. METHODS: The questionnaire was administered to 75 nurses working in public hospitals in Lagos to obtain information on the experience of medication errors during their entire career, as well as to know their views on the nature of MAEs and the contributing factors. RESULTS: Fifty nurses responded to give a response rate of 66.7%. All the participants were females with a mean ± s.d age of 35.3 ± 10.7 years. Thirty two (64%) had committed at least one medication error over the course of their career. Wrong dose error (24; 48%) and wrong timing of medicine administration (20; 40%) were the MAEs frequently committed by the participants. The consequences of the errors included shock (23; 46%), restlessness (21; 42%), disorientation (11; 22%), and respiratory depression (10; 20%). Increased workload (26; 52%) and not double checking medicine doses (12; 24%) were the major factors the nurses perceived to be contributing to MAEs. Only 15(30%) nurses had reported MAEs to their superiors. Fear of intimidation, retribution or being punished (11; 22%) and lack of policies in place to report errors (13; 26%) were the two major barriers to reporting MAEs. Half (50%) of the nurses indicated that policies were available in their work places to prevent medication errors. CONCLUSIONS: Medication administration errors were frequently committed by the participants and resulted in some inconsequential effects, morbidity and deaths. Appropriate measures should be implemented to prevent future occurrences of MAEs.

Awareness and knowledge of glaucoma among workers in a Nigerian tertiary health care institution.

PURPOSE: The aim of this study reports the level of awareness and knowledge of glaucoma among selected health care personnel at a health institution in southwestern Nigeria. MATERIALS AND METHODS: Health personnel at the Federal Medical Centre, Owo, Nigeria, a tertiary health care institution were stratified into a clinical and an administrative directorate. One-hundred twenty participants were selected from each directorate by a random sampling technique. A structured questionnaire was used to collect sociodemographic data and data on the level of knowledge and awareness of glaucoma. Statistical analyses included the independent t-test and Pearson's chi-square test for categorical variables. Statistical significance was indicated by P < 0.05. RESULTS: From the target population of 240 participants, 216 (98 males; 118 females) completed the questionnaire. The mean age of the participants was 35.07 ± 07 years. A total of 148 (68.6%) participants had heard of glaucoma comprising all participants from the clinical directorate and 28 participants from the administrative directorate. There was no statistically significant difference between the clinical and administrative directorates about the knowledge of the aspect of vision that is first affected by glaucoma, the painless nature of glaucoma among most Africans and the irreversible nature of glaucoma-related blindness (P > 0.05, all comparisons). CONCLUSION: There is the need to update the knowledge base of these workers if they are to be useful in propagating information of the irreversible blindness that could arise from delay in glaucoma diagnosis and treatment.

Colonoscopy practice in lagos, Nigeria: a report of an audit.

Background. Colonoscopy effectiveness depends on the quality of the examination. Community-based report of quality of colonoscopy practice in a developing country will help in determining standard and also serve as a stimulus for improvement in service. Aim. To review the quality of colonoscopy practice and document pattern of colonic disease including polyp detection rate in Lagos, Nigeria. Method. A protocol that captured the patients' demographics, indication, and some quality indices of colonoscopy was developed and sent to all the identified colonoscopy units in Lagos to complete for all procedures performed between January 2011 and June 2012. All data were collated and analyzed. The quality indices studied were compared with guideline standard. Results. Twelve colonoscopy centers were identified but only nine centers responded. The gastroenterologist/endoscopists were physicians (3) and surgeons (5). Six hundred and seven colonoscopy procedures were performed during this period (M : F = 333 : 179) while the sex was not disclosed in 95 subjects. The examination indications were lower GI bleeding (24.2%), altered bowel habits (9.2%), lower abdominal pain (9.1%), screening for CRC (4.3%) and unspecified (46.8%). Conscious sedation was generally used while bowel preparation (good in 81.4%) was done with low residue diet and stimulant laxatives. Caecal intubation rate was 81.2%. Common endoscopic findings were haemorrhoids (43.2%), polyps/masses (13.4%), diverticulosis (11.1%), and no abnormality (23.4%). Polyp was detected in 6.8% of cases. Conclusion. Colonoscopy utilization is low, and the quality of practice is suboptimal; although limited resources could partly explain this, however it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence.

Clustering of hypertension, diabetes mellitus and dyslipidemia in a Nigerian population: a cross sectional study.

OBJECTIVE: The clustering of cardiovascular risk factors and diseases has grievous implications on overall morbidity and mortality. There is however relative paucity of this information among the Nigerian population. This study was aimed at defining the prevalence of the clustering of hypertension (HT), diabetes mellitus (DM) and dyslipidemia (DYSL) in a Nigerian teaching hospital outpatient clinics population. SUBJECTS AND METHODS: A cross sectional study of patients managed at the hypertension and diabetes clinics of the Lagos State University Teaching Hospital, Nigeria between January and December 2008. The baseline demographic characteristics, blood pressures, blood sugars and fasting lipid profiles were obtained retrospectively from hospital records. Using the standard criteria for the diagnosis of HT, DM and DYSL, the prevalence of these conditions and their respective clusters were determined. RESULTS: A total of 506 patients were seen over this period, male; 234 (46.2%), female; 272(53.8%) with mean age of 57.35 (1.28) years. The prevalence of HT, DM and DYSL were 85%, 39.5% and 58.9% respectively. Concurrent HT and DYSL was the most prevalent cluster found in 146 patients (28.9%), followed by the clustering of the three co-morbidities of HT, DM and DYSL in 124 patients (24.5%).Other clusters were DM+HT; 49 (9.7%), DM+DYSL;13 (2.6%). 41.2% of the population had the clustering of at least two co-morbidities and about a quarter had the three conditions coexisting. CONCLUSION: There is a significant burden of the cardiovascular risk factors occurring in clusters in the Nigerian population studied. This calls for purposeful measures to control these risk factors.

The knowledge, perceptions and practice of pharmacovigilance amongst community pharmacists in Lagos state, south west Nigeria.

PURPOSE: Community Pharmacists both have an important responsibility in monitoring the ongoing safety of medicines and are widely accessible to do it. This study aims to investigate the knowledge, perceptions and practice of Pharmacovigilance amongst community pharmacists in Lagos State, South West Nigeria METHODS: A cross-sectional observational survey was used in this study. A multistage random sampling technique was employed in the selection of 420 community pharmacies in Lagos. RESULTS: About 55% of respondents have ever heard of the word 'Pharmacovigilance' out of which less than half (representing only 18% of all respondents) could define the term 'Pharmacovigilance'. Forty percent of the respondents stated that patients reported ADRs to them at least once a month, and 20% reported to the relevant authorities. However only 3% of respondents actually reported an ADR to the National Pharmacovigilance Centre. The most important reason for poor reporting was lack of knowledge about how to report ADRs (44.6%).Meanwhile, 90% of respondents believed that the role of the pharmacists in ADR reporting was important. Most community pharmacists were willing to practice pharmacovigilance if they were trained. CONCLUSION: Community pharmacists in Lagos had poor knowledge about pharmacovigilance. Reporting rate was also poor. There is an urgent need for educational programs to train pharmacists about pharmacovigilance and ADR reporting.

African traditional medication and keloid formation in herpes zoster ophthalmicus.

Keloid scar complicating herpes zoster ophthalmicus (HZO) has not been much reported among Africans despite the African population having dark skin. We report on a middle-aged Nigerian with HZO who developed keloid scar following use of traditional herbs to the herpetic rashes. A 52-year-old immune-competent Nigerian male presented with a 2-week history of vesicular rashes involving the left side of the forehead down to the tip of the nose. He initially presented to an African traditional healer who had advised application of various herbs to the lesion. When he presented to the eye clinic, he was treated for the associated uveitis with significant improvement. The cicatricial skin change gradually became raised with clinical appearance of keloid at 1 year of follow-up. Cicatricial skin changes in HZO are not unusual, but keloid formation among Africans has not been much described. Late presentation, use of traditional herbs some of which have corrosive effect and secondary bacterial infection are the possible factors that may encourage such abnormal wound healing. The myth associated with HZO in the local African setting as well as the fact that African traditional healers are still widely accepted among most African communities may play a role in increasing the risk of keloid formation among our population following HZO infection.