Colonoscopy in Zaria: Indications and findings.

Background: Colonoscopy is an important procedure in the management of colorectal diseases. During a colonoscopy, one can visualize the mucosa of the large bowel and perform therapeutic procedures. Aim: The aim of this study is to review the indications and findings of colonoscopy in our center. Data on age, gender, indications, and findings at endoscopy were extracted from the endoscopy unit register. Patients and Methods: The study is a retrospective descriptive one and included all patients who underwent colonoscopy between June 2017 to December 2019 at the endoscopy unit of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Data on age, gender, indications, and findings at endoscopy were extracted from the endoscopy unit register. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) statistical software version 20. Results: One hundred and twenty-five patients had a colonoscopy during the period under review with a male to female ratio of 1.9:1. The age range of the patients was 3 to 85 years and the mean age was 46.7 ± 16.7 The most common indications for colonoscopy in our center were lower gastrointestinal bleeding (40 (32%)), followed by suspected colonic tumors (37 (29.6%)), and hemorrhoids (18 (14.4%)). The commonest findings were hemorrhoids (50 (40%)), colonic tumors (25 (20%)), and colitis (21 (16.8%)). Conclusion: A colonoscopy is an effective tool in the management of colorectal diseases. Lower gastrointestinal bleeding was the commonest indication for colonoscopy in our center and hemorrhoids and colorectal tumors were the commonest findings.

Appraisal of trimester-specific fetal heart rate and its role in gestational age prediction.

INTRODUCTION: The aim of this study was to evaluate and report normal sonographic FHR values among low-risk singleton women across the three trimesters of pregnancy and determine FHR role in gestational age prediction. METHOD: A prospective cross-sectional study of 2727 low-risk singleton pregnant women was undertaken. FHR measurements were obtained by a consultant radiologist and three experienced sonographers using transabdominal approach from January 2019 to December 2020. Two FHR measurements were taken for each participant. The fetal lie and presentation were also documented in the first trimester. Data were analysed using SPSS version 24 (IBM, Armonk, NY, USA). RESULT: The maternal mean ± SD age was 25.8 ± 6.5 years and mean FHR for first, second and third trimesters were 151 ± 16, 145 ± 6 and 125±6 bpm respectively. The mean ± SD gestational age were 10 ± 2, 19 ± 3 and 34 ± 2 weeks for the first, second and third trimester respectively. Using ANOVA, there were statistically significant differences in FHR across the three trimesters (p ≤ 0.05). A positive correlation existed between maternal age and FHR (r = 0.57, p ≤ 0.05). CONCLUSION: This study has established normal values for FHR in first, second and third trimester respectively. Referring physicians, radiologists, sonographers, obstetricians and gynaecologists may consider FHR of (135-167) bpm (139-151) bpm and (119-131) bpm as normal FHR ranges for the first, second and third trimester respectively. This study has also revealed the possibility of gestational age prediction using FHR with the equation [Gestational Age = 87.8 - (0.47) FHR]. IMPLICATIONS FOR PRACTICE: This paper provides the most up-to-date sonographic FHR recommendations for fetal management. More importantly, findings from this study also suggests that ultrasound practitioners can use FHR measurements as a reliable alternative for fetal dating.

Demographic profile and endoscopic findings among patients with upper gastrointestinal bleeding in Ahmadu Bello University Teaching Hospital, Zaria, North-Western Nigeria.

BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common medical emergency that can result in significant morbidity and mortality. AIM: The aim of this study was to determine the demographic profile and etiology of UGIB in patients seen at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, North-Western Nigeria. SUBJECTS AND METHODS: This descriptive retrospective study was carried out at the Gastroenterology Unit of ABUTH Zaria. Data of patients referred for upper gastrointestinal endoscopy with UGIB from June 2017 to December 2019 were extracted from the endoscopy register and analyzed. RESULTS: One hundred and forty-four patients had upper gastrointestinal (UGI) endoscopy done for UGIB during the period under review. Of these, 105 (72.9%) were males while 39 (27.1%) were females with male-to-female ratio of 2.7:1. The mean age of the patients was 43.5 ± 17.3 and their age ranges from 11 to 89 years. The modal age group was 40-49 years. The most common cause of UGIB was esophageal varices (67 [46.5%]) followed by erosive mucosal diseases: gastritis/duodenitis 43 (29.9%), esophagitis 12 (8.3%). Less common causes were peptic ulcer disease (PUD) in five (3.5%) patients, gastric tumor in two (1.4%), hiatus hernia in one (0.7%), and portal hypertensive gastropathy in one (0.7%). Thirteen patients (9.0%) had normal findings. CONCLUSION: Esophageal varices are the most common cause of UGIB among our patients and middle-aged male patients were the most commonly affected group.

Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017.

BACKGROUND: The OPV 3 coverage for Kaduna State, 12-23 months old children was 34.4%. The low OPV 3 coverage, due mainly to weak demand for routine antigens and the need to rapidly boost population immunity against the disabling Wild Polio Virus (WPV), led the Global Polio Eradication Initiatives (GPEI) to increase supplemental OPV campaigns in Kaduna State, despite the huge cost and great burden on personnel. The OPV campaigns, especially in high risk (low vaccine uptake, <80% OPV 3 coverage and high vaccines refusal rate) states of northern Nigeria with poliovirus transmission has resulted in overestimated denominators or target population, as the highest ever vaccinated is used to set OPV campaign targets. METHODS: We utilized a cross-sectional study that assessed the impacts and possible solutions to the challenges of overestimated denominators in immunization services planning, delivery and performance evaluation in Kaduna State, Nigeria. We used both descriptive and quantitative approaches. We enumerated households and obtained the target populations for routine immunization (<1 year), polio campaign (<5 years) and acute flaccid paralysis surveillance (<15 years). RESULTS: We found a significant difference in mean scores between the micro-planning and supplemental vaccination data on a number of <5 years (M = 102967, SD = 62405, micro-planning compared to M = 157716, SD = 72212, supplemental vaccination, p < 0.05). We also found a significant difference in mean scores between the micro-planning and projected census data on a number of <1 year (M = 26128, SD = 16828, micro-planning compared to M = 14154, SD = 4894, census, p < 0.05). CONCLUSION: Periodic household-based micro-planning, aided with the use of technology for validation remains a useful tool in addressing gaps in immunization planning, delivery and performance evaluation in developing countries, such as Nigeria with overestimated denominators.

Seroprevalence of horse (Equus caballus) brucellosis on the Mambilla plateau of Taraba State, Nigeria.

A cross-sectional study was conducted on the seroprevalence of horse brucellosis using the Rose Bengal Plate Test (RBPT) and Serum Agglutination Test (SAT) on the Mambilla plateau of Taraba state, Nigeria where horses are reared under a free range management system on cattle farms. The objectives of the study were to determine the prevalence of brucella antibodies in horses as well as the distribution of the infection according to sex and age. A total of 100 horses were sampled, 25 each from four locations where horses were concentrated on the plateau: Gembu, Nguroje, Dorofi, and Mayo Ndaga. Sixty-two of the horses were males, and 38 were females. Eighty of the horses were adults, while 20 were young. All horses were reared under a free range management system together with cattle. The overall seroprevalence rate was 16 (16%) according to the RBPT and 6 (6%) according to the SAT. The seroprevalence rates were 19.40% (12/62) according to the RBPT and 6.50% (4/62) according to the SAT in the males and 10.50% (4/38) according to the RBPT and 5.30% (2/38) according to the SAT in the females. The prevalence was highest in Nguroje (8/25, 32%) followed by Gembu (5/25, 20%), Dorofi (3/25, 12%) and Mayo Ndaga (0%). Adult horses showed a seroprevalence of 18.8% (n=15) according to the RBPT and 7.5% (n=1) according to the SAT. Young horses had a seroprevalence rate of only 5% (n=1) according to the RBPT and 0% (n=0) according to the SAT. There was no statistically significance association with location, sex, and age (P>0.05). From this result, it can be concluded that brucellosis in horses on the Mambilla plateau of Taraba state, Nigeria was essentially a disease of adult horses and more prevalent in male horses than female horses. Further studies need to be conducted to determine the disease status in lowland areas of the state where horses are reared on zero grazing or are tethered and also to determine the involvement of other species and humans.

The impact of religion and culture on diabetes care in Nigeria

This study aimed to relate the psychosocial effects of religion and culture with the awareness; knowledge and attitude of Nigerians regarding diabetes preven-tion and care. Data was collected from a sample of 1500 individuals in communities where secondary and tertiary health care centres are situated from 12/02/2012 to 25/03/2012. The study population in-cluded a higher proportion of females (65%); with the majority between 19 and 29 years old (56%). Most were unemployed (67%) or in the teaching profession (24%). Over half (58%) respondents were Christian; while 41% were Muslim; and 1% were traditional worshippers. Over 25% believed that diabetes was due to witchcraft or a punishment from God. Also; 28% believed that diabetes was caused by an infection; and 16% and 10% believed diabetes could be caused by witchcraft or by God; respectively. Nearly all (90%) believed that diabetes was potentially fatal. We conclude that many diabetic patients have inadequate knowledge about the causes of diabetes and its complications

Sarcomas in Nigerian Children in Jos North Central Nigeria.

BACKGROUND: There is a growing concern about childhood sarcomas, with recent studies suggesting an increase in the frequency of childhood sarcomas in sub-Saharan Africa. This study was carried out to determine the pattern of childhood sarcomas in Jos, North Central Nigeria and to compare the data obtained with other previous related studies. METHODS: Review of the Jos University Teaching Hospital cancer registry from January 2001 to December 2010. Data of all children (0-15 years) in the data base were retrieved for analysis. RESULTS: Two hundred and ten histological diagnosis of malignancies were made in children over the period, with 81 cases (39%) being childhood Sarcomas. The sarcomas occurred predominantly in males (54%) with male/female ratio of 2:1. The minimum age was 2 months and the maximum age was 15 years. Soft tissue sarcoma (STS) was the most predominant group which accounted for 73 cases (90%) of all sarcomas seen. Rhabdomyosarcoma (RMS) was the most common STS, it accounted for 65 cases (89%) of the STS and 80% of all the sarcomas. This is followed by Kaposi Sarcoma (KS) accounting for 6.9% of STS. There were 8 cases of Osteosarcoma which accounted for 10% of all the sarcomas. Embryonal RMS predominated in the very young children while all other sarcomas affected the older children. Extremities were the sites of predilection for most of the sarcomas (36%). Seventeen (17) cases of the RMS were of superior prognostic group, 34 (54%) were of intermediate prognostic group while 24 cases (37%) were of poor prognostic group. CONCLUSION: Childhood sarcomas are common in our environment and RMS is the single most common sarcoma while the non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) are rare.

Pattern of urological malignancies seen at Federal Medical Centre Gombe North Eastern Nigeria.

BACKGROUND: The incidence of urological malignancies is on the increase globally like most other malignant tumours. There is generally poor documentation of urological malignancies in Nigeria attested to by the paucity of literature on this subject matter. This study was carried out to document the pattern and distribution of urological malignancies seen at Federal Medical Centre, Gombe, North Eastern Nigeria. MATERIALS AND METHODS: This was a retrospective analysis of all pathologically proven urological malignancies seen at this centre from January 2000 to December 2007. All records of patients with the diagnosis of urological malignancies were retrieved from the histopathology registers, operation registers and patients' case notes. The patients' biodata including their ages, sex and tumour site were extracted and analysed. RESULTS: A total of 118 cases of urological malignancies were recorded during the 8 years under review. Ninety-nine (83.9%) ocurred in males while the remaining 19 (16.1%) were in females giving a male: female ratio of 5:1. Children comprised of nine 9 (7.6%) and adults 109 (92.4%) of the population. The organ specific frequency of occurrence of the tumour in descending order comprised of prostate 63 (53.4%) bladder 33 (28.0%), kidney 17 (14.4%), testes 3 (2.5.%) penis 2 (1.7%) ureter and urethra (0%). CONCLUSION: We concluded that prostate, urinary bladder and renal carcinomas are the three most common urological malignancies in North Eastern Nigeria.

Porocephalosis due to encysted Armillifer nymph presenting as an acute abdominal emergency: case report and review of literature.

A rare case of porocephalosis infection presenting with an acute abdominal emergency in a 60 year old Nigerian is presented. The characteristic radiologic appearance of Armillifer nymph is described, and clinical findings which may be caused by this parasite are reviewed. A brief review of the epidemiology of porocephalosis is also included.

Abdominal tuberculosis in surgical practice in northern Nigeria.

BACKGROUND: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV, tuberculosis has become a major public health problem particularly in developing countries. METHODS: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria--Nigeria, between January 1975 to December 2006. RESULTS: There were 68 males and 49 females, aged 12-70 years (mean 28.6 yrs 11 yrs). While paroxysmal dry cough was present in about 20 patients, abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14%). The findings at Surgery in 66 patients are presented in fig. 2. Multiple deposits on the peritoneum and omentum were the commonest findings (48.7% and 26.2%) respectively CONCLUSION: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol.

Abdominal Tuberculosis in Surgical Practice in Northern Nigeria

Background: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV; tuberculosis has become a major public health problem particularly in developing countries. Methods: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria - Nigeria; between January1975 to December 2006. Results: There were 68 males and 49 females; aged 12-70 years (mean 28.6yrs 11yrs). While paroxysmal dry cough was present in about 20 patients; abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14). The findings at Surgery in 66 patients are presented in fig.2. Multiple deposits on the peritoneum and momentum were the commonest findings (48.7and 26.2) respectively. Conclusion: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol

Awareness of occupational hazards and utilization of safety measures among welders in Kaduna metropolis, northern Nigeria.

BACKGROUND: Welders are exposed to a variety of occupational hazards with untoward health effects. However, little is known of welders' awareness of health hazards and their adherence to safety precautions in developing countries. This study assessed the awareness of occupational hazards and adherence to safety measures among welders in Kaduna metropolis in northern Nigeria. METHODS: A structured questionnaire was administered on a cross-section of 330 welders in Kaduna metropolis in northern Nigeria. Information was sought on their socio-demographic characteristics, their awareness of occupational hazards and adherence to safety measures. RESULTS: All welders were males with a mean age of 35.7 +/- 8.4 years. The illiteracy rate was 7.6%. Overall, 257 (77.9%) of the welders were aware of one or more workplace hazards. This was positively influenced by educational attainment, age, nature of training and work experience. Of the 330 respondents, 282 (85.3%) had experienced one or more work-related accidents in the preceding year. The most common injuries sustained were cut/injuries to the hands and fingers (38.0%), back/waist pain (19%), arc eye injuries/foreign bodies (17.0%), burns (14.0%), hearing impairment (7.0%), fractures (4.0%) and amputation (1.0%). Only 113 (34.2%) welders used one or more types of protective device with eye goggles (60.9%), hand gloves (50.3%) and boots (34.5%) being more frequently used. Regular use of safety device, shorter working hours and increasing experience were protective of occupational accidents. CONCLUSIONS: The level of awareness of occupational hazards was high with sub optimal utilization of protective measures against the hazards. There is therefore need for health and safety education of these workers for health and increased productivity.

Changes in HIV/AIDS/STI knowledge, attitudes, and behaviours among the youth in Port Loko, Sierra Leone.

Sierra Leone suffered from 11 years of civil war (1991-2002) resulting in tens of thousands of deaths and mutilations and massive population displacement. In 2001, ARC International, Sierra Leone, conducted a baseline survey of 244 female youth and 293 male youth on knowledge, attitudes, and behaviours around HIV/AIDS and STIs in Port Loko. In 2003, following 2 years of HIV prevention activities, a comparable post-intervention survey of 250 female and 299 male youth was performed. Comparison of baseline and post-intervention results showed that HIV/AIDS knowledge increased dramatically among both groups, with those able to name three effective means of avoiding AIDS increasing from 4% to 36% among female youth, and 4% to 45% among male youth. Reported condom use at last sex increased among female youth from 16% to 46% and among male youth from 16% to 37%. These results demonstrate that, despite the challenges inherent in a post-conflict country, good quality AIDS prevention programmes can be successful.

Malignant melanoma: a review.

The incidence of malignant melanoma the most malignant of all skin neoplasms, has doubled within the last 10 years. Exposure to high intensity sunlight, racial susceptibility, hormonal status, age, environmental factors as well as injury have all been shown to play a role individually or synergistically in the activation of the melanocytic oncogen. Controversies still exist in which factors actually determine prognosis, in patients with advanced malignant melanoma. Management has remained even more controversial, with surgical excision, with or without lymphadenectomy, radiotherapy, chemotherapy, laser therapy and more recently immunotherapy and intra-arterial neutron thermal capture therapy, having their proponents and opponents.

Fournier's gangrene in neonates and infants.

BACKGROUND: Fournier's gangrene is uncommon in childhood and little is known about the disease in this age group. METHOD: A retrospective review was carried out of neonates and infants treated for Fournier's gangrene over a period of 16 years. RESULTS: Twelve neonates and infants aged 5 days-3 months (median 3 weeks) were treated in our hospital. The precipitating cause was omphalitis in 7 babies, strangulated inguinal hernia in 2 and in 3 babies there was no identifiable cause. Gram-negative bacteria were cultured in 3 patients, but in most the culture was sterile. Treatment consisted of debridement of devitalised tissue and administration of broad-spectrum antibiotics. Primary closure was achieved in 1 baby and secondary closure in 2 others. In 7 babies the wound contracted rapidly and healed. There was no mortality. CONCLUSION: Fournier's gangrene in neonates and infants in our environment is largely preventable. Early debridement and appropriate antibiotics give good results.