Helicobacter pylori infection in Nigerians with dyspepsia.

BACKGROUND: Helicobacter pylori is the most common chronic bacterial infection, and a significant aetiological factor in acid peptic diseases and gastric cancer. Dyspepsia is a common gastrointestinal disorder, and the most common indication for gastroscopy. Detection of this organism during endoscopy has become standard clinical practice. We determine the prevalence of H. pylori infection among dyspeptic patients using serology and histology. METHODS: Patients with dyspepsia underwent gastroscopy, and biopsies were taken from the antral portions of their stomach and processed. Their serum samples were tested for H. pylori infection using ELISA to detect anti-bodies. RESULTS: One hundred and twenty-five patients, comprising 49 (39.2%) males and 76 (60.8%) females were studied. A prevalence rate of 93.6% for H. pylori was found by serology while a rate of 80.0% was found by histology. CONCLUSION: There is a high prevalence of H. pylori infection in patients with dyspepsia; and a high percentage of detection by serological and histological tests.

Attitude towards psychiatric treatment and referral pattern in the University of Maiduguri Teaching Hospital - a preliminary report.

OBJECTIVE: There is a paucity of literature on consultation-liaison psychiatry, in northern Nigeria. This study aimed to determine both the pattern of psychiatric referrals, and the attitudes of doctors toward the treatment of mental disorders in a teaching hospital, in northeast Nigeria. METHOD: In this cross-sectional survey, we used a modified version of the self-rated Kumar 12-item questionnaire and a basic socio-demographic questionnaire to assess a non-random convenient sample of 100 postgraduate resident doctors (with a response rate of 70%) from the University of Maiduguri Teaching Hospital (UMTH). We subjected the data obtained to descriptive statistical analysis, using EPI info (2003), to report averages. RESULTS: A relatively low percentage (57.1%) of doctors acknowledged treating patients with mental disorders in their practice, with a higher proportion acknowledging referral (75%). Nearly one in five (17.6%) of the respondents were unaware that patients with functional illness could have psychological disorders. We found more awareness for psychotherapy (44.1%) than other non-pharmacological treatment interventions, while 10.3% were ignorant of non-pharmacological forms of treatment for psychological problems. CONCLUSION: Although this is a preliminary report, the research reported here demonstrated that doctors in the teaching hospital concerned recognized the need for psychiatric consultation and referral. It is difficult to draw further conclusions because of the limitations of this study.

Helicobacter pylori indyspeptic Nigerians.

BACKGROUND: Dyspepsia is a common gastrointestinal disorder, and is the most common indication for upper gastrointestinal endoscopy. Helicobacter pylori is a significant aetiological factor in acid peptic diseases and gastric cancer. Detection of this organism during upper gastrointestinal endoscopy has become standard clinical practice. Data is scanty from North-Eastern Nigeria on the subject. OBJECTIVES: To determine the prevalence of Helicobacter pylori among dyspeptic patients, and alsoto find out the association of H. pylori and degree of activity in chronic gastritis. METHODS: This is a hospital-based cross sectional study which was carried out at the Endoscopy unit of Federal Medical Centre, Yola and Histopathology unit, University of Maiduguri Teaching Hospital, Maiduguri from November, 2006 to May, 2010. Patients with dyspepsia who underwent upper gastrointestinal endoscopy as part of their work-up, also had endoscopic biopsies taken from the antral portions of their stomach. The biopsy specimens were fixed in 10% formalin and transported from Yola to Maiduguri by courier for processing. RESULTS: Three hundred and forty-nine patients comprising 152(43.6%) males and 197(56.4%) females with dyspepsia had upper gastrointestinal endoscopy. Their age ranged between 14 and 103 years with a median of 44.1 years. A prevalence rate of 56.7% for Helicobacter pylori was found.Helicobacter pylori associated with severe activity accounted for 80.3%; moderate activity- 57.5%; mild activity - 20% and normal gastric mucosa- 9.1%. CONCLUSION: There is a high prevalence of Helicobacter pylori among patients with dyspepsia, and a strong association between H. pylori and chronic gastritis with severe activity.

Spectrum of endoscopic findings in Nigerians with dyspepsia.

BACKGROUND: Dyspepsia is a common gastrointestinal disorder originating from the gastroduodenal region, and is the most common indication for upper gastrointestinal tract endoscopy. There are differing information on the commonest endoscopic findings in patients with dyspepsia from Nigeria. OBJECTIVE: The aim of this study was to determine the spectrum of endoscopic findings in patients with dyspepsia. PATIENTS AND METHODS: This is a hospital-based prospective study carried out at the Endoscopy Unit of Federal Medical Centre, Yola from November, 2006 to May, 2010. Patients with clinical features of dyspepsia who underwent upper gastrointestinal tract endoscopy as part of their workup were recruited. Their biodata, history and duration of dyspepsia were noted on a proforma. The spectrum of endoscopic findings was also noted. RESULTS: A total of 259 patients with dyspepsia had upper gastrointestinal tract endoscopy. Ninety-nine (38.2%) were males while 160 (61.8%) were females, giving a male to female ratio of 1:1.6. Clinically significant endoscopic findings were seen in 241 (93.1%) patients while gastroduodenitis was the commonest finding. One hundred and two (39.4%) patients had two endoscopic findings, and 7 (2.7%) had three findings. CONCLUSION: Majority of patients with dyspepsia had clinically significant endoscopic findings. Gastroduodenitis was the commonest endoscopic finding.

Aluminium-induced liver and testicular damage: effects of Piliostigma thonningii methanolic leaf extract.

BACKGROUND: Aluminium is believed to be non toxic and easily eliminated from the body, a belief which encourages its use in daily life. However, several studies have reported its hepatotoxicity and testicular derangement in animals and humans. OBJECTIVE: The protective potential of Piliostigma thonningii (250 mg/kg of body weight) methanolic leaf extract on aluminium-induced hepatotoxic and testicular damage in Wister rats was studied. METHODS: Toxicity was induced in experimental animals via oral route using 0.5 mg of AlCl3 per kg of body weight (b.w). The toxicant and the plant extract were administered with the aid of gastric intubator for a period of 35 days at 24h interval. Thirty male Wistar rats (mean weight, 207 +/- 11.01g) were randomly assigned to three groups: a control group treated with 0:5 ml of olive oil (vehicle for the extract) and 1 ml of saline (vehicle for the toxicant), a second group treated with 0.5 mg of AlCl3 (toxicant) per kg bwt and a third group treated with 0.5 mg of AlCl3 and 250 mg of P. thonningii extract per kg b.w. The serum activities of liver enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) along with sperm function indices (sperm count, sperm motility, live/dead sperm ratio and total morphological abnormalities) were assessed in the animals. RESULTS: AlCl3 ingestion caused a decrease in mean gain in body weight, % sperm motility, sperm count and live/dead sperm ratio as well as significant (P < 0.05) increase in absolute weight of the liver, total sperm abnormalities, ALT, AST and ALP activities as compared to the control rats. The toxicant, however did not cause any significant (p < 0.05) change in absolute and relative weights of the testis and caudal epididymis of rats as compared to the control rats. Co-treatment of rats with P. thonningii leaf extract apparently subverted the induced-changes. Though, rats co-treated with the extract do not show visible signs of protection against AlCl3-induced sperm damage, serum activities of ALT, AST and ALP were significantly decreased following oral intake of the extract. CONCLUSION: Data of the study suggest that AlCl3 exposure particularly through oral route at a dose of (0.5 mg/kg b.w) is toxic and capable of inducing liver damage and testicular dysfunction in animals and possibly humans. Interestingly, Piliostigma thonningii extract (methanolic) at a dose of 250 mg/kg b.wt) was effective in protecting rats from liver damage induced by the toxicant.

Millennium development goals-knowledge and attainability as perceived by doctors: a case study.

OBJECTIVE: To audit the knowledge of doctors and evaluate their disposition toward the attainment of the Millennium Development Goals (MDGs). MATERIALS AND METHODS: Semi-structured questionnaires requesting information about knowledge of the acronym "MDGs" were administered on willing doctors at three tertiary health centers: University of Ilorin Teaching Hospital, Federal Medical Centre, Bida, and Federal Medical Centre, Yola. Data were analyzed using frequency tables and simple statistical methods. RESULTS: One hundred and eighty-three doctors participated in the study, comprising 65 (35.5%) from Bida, 18 (9.8%) from Yola, and 100 (54.7%) from Ilorin, with a male to female ratio of 2:1 (P < 0.05). Thirty-nine respondents (21.3%) had no fore kowledge of MDG (P < 0.05). Only 77 (42.1%) of the respondents who had fore knowledge of "MDG" knew the number of goals to be eight (P < 0.05). Among those who had fore knowledge of MDG, only 34 comprising 15 (10.4%, Bida), 1 (0.7%, Yola), and 18 (12.5%, Ilorin) could correctly list a minimum of four of the MDGs (P < 0.05). Only 12 (8.3%) of the respondents believed that the MDGs are very achievable. CONCLUSION: There is an absolute need for more elaborate publicity on the MDGs among doctors as they are key players if attaining the MDGs is to be a reality.

Diabetic foot care: self reported knowledge and practice among patients attending three tertiary hospital in Nigeria.

BACKGROUND: Diabetes Mellitus (DM) foot complications are a leading cause of mortality in developing countries and the prevalence of diabetes is expected to increase in the next decades in these countries. The aim of this study was to determine the knowledge and practice of foot care among diabetes patients attending three tertiary hospitals in Nigeria. METHODS: This is a cross-sectional study carried out from November 2009 to April 2010. Pre-tested structured questionnaires were administered by medical officers to diabetes patients. The outcome variables were knowledge and practice regarding foot care. The knowledge and practice scores were classified as good if score ≥70%, satisfactory if score was 50-69% and poor if score was < 50%. RESULTS: Of 352 diabetes patients, 30.1% had good knowledge and 10.2 % had good practice of DM foot care. Majority (78.4%) of patients with poor practice had poor knowledge of foot care. With regard to knowledge, 68.8% were unaware of the first thing to do when they found redness/bleeding between their toes and 61.4% were unaware of the importance of inspecting the inside of the footwear for objects. Poor foot practices include; 89.2% not receiving advice when they bought footwear and 88.6% failing to get appropriate size footwear. Illiteracy and low socioeconomic status were significantly associated with poor knowledge and practice of foot care. CONCLUSION: This study has highlighted the gaps in the knowledge and practice of foot care in DM patients and underscores the need for an educational programme to reduce of diabetic foot complication.

Hepatitis B virus infection amongst pregnant women in North-eastern Nigeria- a call for action.

BACKGROUND: It is well known that Hepatitis B virus infection is endemic in Nigeria. Even though studies have been carried out on Hepatitis B virus infection in different parts of Nigeria, and in different sub-groups of individuals, information regarding the prevalence of Hepatitis B virus infection in pregnant women is scanty especially from the North-eastern region of Nigeria. We therefore determined the seroprevalence of Hepatitis B surface antigen (HBsAg) amongst pregnant women in North Eastern Nigeria. MATERIALS AND METHODS: A hospital-based cross-sectional study was carried out. The setting was the ante-natal clinic of the Federal Medical Centre, Yola, Nigeria. The duration of the study was from July 2008 to December 2008. Two hundred and thirty-one consecutively recruited pregnant women were screened for Hepatitis B surface antigen. Positive samples were re-tested using ELISA to eliminate false positives. Their biodata were obtained using a questionnaire to establish the presence of possible risk factors such as blood transfusion, surgery, etc. Written informed consent was obtained from each woman. RESULTS: Out of the 231 pregnant women tested, nineteen of them were seropositive for Hepatitis B virus infection giving an infection rate of 8.2%. Women in the age group 25-29 years had the highest HBV infection rate. CONCLUSION: This study confirms a high seroprevalence of Hepatitis B virus infect ion amongst pregnant women. It is recommended that pregnant women should be routinely screened for Hepatitis B virus infection as part of antenatal care services.

Management and health issues in women with epilepsy - a review.

Although epilepsy affects men and women equally, there are special implications for women, especially during their childbearing years, and particularly when pregnancy is contemplated. This review summarisesthe complexity and multifaceted nature of health issues affecting women with epilepsy (WWE) in general and epilepsy in women beyond childbearing age. The female sex hormones and their cyclic as well as age-related variations certainly influence seizure activity and epilepsy in women. Catamenial epilepsy is a multifaceted neuroendocrine condition in which seizures are clustered around specific points in the menstrual cycle, most often around perimenstrual or periovulatory period. There are special concerns for women of child bearing years with regard to contraception, pregnancy and teratogenicity that should be considered during counseling and selection of appropriate treatment.Although the majority of pregnant WWE experience normal pregnancies and deliveries, their children have a higher risk of birth defects. Individualised treatment coupling antiepileptic drug use (AED) and the specific phase of impact of the reproductive cycle must be considered in treatment selection. As the number of available treatment options for epilepsy increases, the optimal goal for the general practitioner is to work as a team with obstetricians and gynaecologists, and neurologists in an effort to ensure the best treatment of WWE

Hepatitis B Virus Infection amongst Pregnant Women in North-Eastern Nigeria- A Call for Action

Background: It is well known that Hepatitis B virus infection is endemic in Nigeria. Even though studies have been carried out on Hepatitis B virus infection in different parts of Nigeria; and in different sub-groups of individuals; information regarding the prevalence of Hepatitis B virus infection in pregnant women is scanty especially from the North-eastern region of Nigeria. We therefore determined the seroprevalence of Hepatitis B surface antigen (HBsAg) amongst pregnant women in North Eastern Nigeria. Materials and Methods: A hospital-based cross-sectional study was carried out. The setting was the ante-natal clinic of the Federal Medical Centre; Yola; Nigeria. The duration of the study was from July 2008 to December 2008. Two hundred and thirty-one consecutively recruited pregnant women were screened for Hepatitis B surface antigen. Positive samples were re-tested using ELISA to eliminate false positives. Their biodata were obtained using a questionnaire to establish the presence of possible risk factors such as blood transfusion; surgery; etc. Written informed consent was obtained from each woman. Results: Out of the 231 pregnant women tested; nineteen of them were seropositive for Hepatitis B virus infection giving an infection rate of 8.2. Women in the age group 25-29 years had the highest HBV infection rate. Conclusion: This study confirms a high seroprevalence of Hepatitis B virus infect ion amongst pregnant women. It is recommended that pregnant women should be routinely screened for Hepatitis B virus infection as part of antenatal care services

Hepatitis B Virus Infection amongst Pregnant Women in North-Eastern Nigeria- a Call for Action

Background: It is well known that Hepatitis B virus infection is endemic in Nigeria. Even though studies have been carried out on Hepatitis B virus infection in different parts of Nigeria; and in different sub-groups of individuals; information regarding the prevalence of Hepatitis B virus infection in pregnant women is scanty especially from the North-eastern region of Nigeria. We therefore determined the seroprevalence of Hepatitis B surface antigen (HBsAg) amongst pregnant women in North Eastern Nigeria. Materials and Methods: A hospital-based cross-sectional study was carried out. The setting was the ante-natal clinic of the Federal Medical Centre; Yola; Nigeria. The duration of the study was from July 2008 to December 2008. Two hundred and thirty-one consecutively recruited pregnant women were screened for Hepatitis B surface antigen. Positive samples were re-tested using ELISA to eliminate false positives. Their biodata were obtained using a questionnaire to establish the presence of possible risk factors such as blood transfusion; surgery; etc. Written informed consent was obtained from each woman. Results: Out of the 231 pregnant women tested; nineteen of them were seropositive for Hepatitis B virus infection giving an infection rate of 8.2. Women in the age group 25-29 years had the highest HBV infection rate. Conclusion: This study confirms a high seroprevalence of Hepatitis B virus infect ion amongst pregnant women. It is recommended that pregnant women should be routinely screened for Hepatitis B virus infection as part of antenatal care services

Non-motor symptoms of Parkinson's disease: diagnosis and management.

BACKGROUND: Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health, quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for many PD patients. METHODS: Literature search was performed using the reference databases Medline, Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms', Parkinson's disease, olfaction and constipation. Papers discovered by this search were reviewed, as were references cited therein. RESULTS: Contrary to common perception, many NMS of PD occur early in PD and some may even predate the diagnosis of PD that is based on motor signs. These include olfactory deficit, sleep problems such as rapid eye movement behaviour disorder, constipation and the more recently described male erectile dysfunction. CONCLUSION: There is compelling evidence that non-motor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoL of their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated.

Current management of Parkinson's disease.

Although Parkinson's disease (PD) is still incurable, a large number of different treatments have become available to improve the quality of life and physical and psychological morbidity, and its early treatment is of prime importance. This article reviews the current situation of PD. This review was based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. The subject headings and keywords used were Parkinson's disease and therapeutic advances. Only articles written in English were included.The management of PD has evolved rapidly over the last 10 years with the advent of new drugs and new classes of drugs, but the currently available treatment methods are all symptomatic ones. However, some of these may have marginal disease-modifying effects. Progress in manufacture of newer drugs has markedly improved the treatment of early PD; however, the management of advanced Parkinson's symptoms remains a challenge. Currently no treatment has been proven to slow the progression of PD. Although symptomatic therapy can provide benefit for many years, PD will eventually result in significant morbidity.

Smokeless tobacco use in adult Nigerian population.

OBJECTIVES: The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. METHODS: Across-sectional survey of 1776 adults in Yola, North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and data collection. RESULTS: Out of 1776 interviewed respondents, 133 (7.49%) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8%). Fifteen (0.9%) chewed tobacco while only 2(0.1%) both chewed and snuffed tobacco. Social acceptance (21.8%) was the major reason for using smokeless tobacco. Males, 5 th and 6 th decades of life, poor education, lower socioeconomic class, Margi, Hausa and Fulani tribes were the determinants of smokeless tobacco use. About 89.5% of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. CONCLUSION: Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking.

Smokeless Tobacco Use in Adult Nigerian Population

The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Across-sectional survey of 1776 adults inYola; North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and data collection. Out of 1776 interviewed respondents; 133 (7.49) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8). Fifteen (0.9) chewed tobacco while only 2(0.1) both chewed and snuffed tobacco. Social acceptance (21.8) was the major reason for using smokeless tobacco. Males; 5th and 6th decades of life; poor education; lower socioeconomic class; Margi; Hausa and Fulani tribes were the determinants of smokeless tobacco use.About 89.5of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking

Non-Motor Symptoms of Parkinson's Disease: Diagnosis and Management

Bacground: Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health; quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for manyPDpatients. Methods:Literature search was performed using the reference databases Medline; Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms'; Parkinson's disease; olfaction and constipation. Papers discovered by this search were reviewed; as were references cited therein. Results: Contrary to common perception; many NMS of PD occur early in PD and some may even predate thediagnosis of PD that is based on motor signs. These include olfactory deficit; sleep problems such as rapid eye movement behaviour disorder; constipation and the more recently described male erectile dysfunctionThere is compelling evidence that nonmotor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoLof their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated

Non-Motor Symptoms of Parkinson's Disease: Diagnosis and Management

Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health; quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for manyPDpatients. Literature search was performed using the reference databases Medline; Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms'; Parkinson's disease; olfaction and constipation. Papers discovered by this search were reviewed; as were references cited therein. Contrary to common perception; many NMS of PD occur early in PD and some may even predate the diagnosis of PD that is based on motor signs. These include olfactory deficit; sleep problems such as rapid eye movement behaviour disorder; constipation and the more recently described male erectile dysfunction.There is compelling evidence that nonmotor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoLof their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated

Pulmonary manifestations of ankylosing spondylitis treated as pulmonary tuberculosis: a case report and review of literature.

A 45 year old trader presented with history of persistent productive cough, progressively increasing dyspnoea, malaise and fever of 6 months prior to presentations. He also complained of severe lower backache and stiffness that radiated to both legs of 5 years duration. Chest radiograph revealed left apical fibrosis, coarse, linear shadows with cavities. There was also super infection with aspergilloma in the left apical region. The sputum AAFB was negative. Despite the fact that the patient complained of lower backache and stiffness, the plain radiograph of the affected spine was not requested for by the attending physician. Rather, the patient was commenced on antituberculous therapy based on pulmonary changes on chest radiograph. But after completing the treatment (nine months regimen), there were no improvement in patient's clinical conditions and pulmonary changes on repeated chest radiograph. The plain radiographs of the lumbosacral spine, pelvis and both hips were suggested by the author (Radiologist) who reviewed the patient's chest radiographs. The radiographs of the lumbosacral spine, as well as pelvis and both hips showed features of ankylosing spondylitis with pulmonary complication. His treatment was later reviewed based on the above new findings. This report highlights the fact that pulmonary manifestation in ankylosing spondylitis, a rare entity in our environment can present the same pattern as pulmonary tuberculosis which is far more common in this environment. A high index of suspicion will enhance early proper diagnosis.

Delirium: issues in diagnosis and management.

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognized and treated by physicians. Literature searches were conducted using MEDLINE with the following keywords/ phrases: delirium, acute confusion and management. Additional articles identified by hand-searching in major journals of medicine and psychiatry, and a review of references cited within these sources supplemented the search. In this article, the available published literature regarding the diagnosis, prevention and treatment of delirium is systematically reviewed. Prevention and treatment strategies do not need to be complex or expensive but require well-coordinated interventions from multiple disciplines, including nursing, psychiatry, neurology and primary care, as well as the cooperation and significant effort of family and friends. Atypical antipsychotic agents offer some advantages over haloperidol and in a limited number of studies appear safe and effective for delirium.