Ocular biometry using computed tomography: a study in Benin, Nigeria.

AIMS AND OBJECTIVES The aim was to determine CT measured ocular biometry in Mid-Western Nigeria which may be employed on other Nigerians and Black Africans. PATIENTS AND METHODS The ocular images of 200 patients that had normal cranial CT scans without ocular abnormality or complaints were retrospectively retrieved and analysed. The CT scans were done at the University of Benin Teaching Hospital. The axial length and width were obtained at the maximum mid-axial images and analysed using SPSS version 17 for measures of central tendency and correlations between variables (level of significance set at 0.05). RESULTS The mean axial length was 21.4mm (right) and 21.6mm (left) while the width was 21.6mm (for right and left). The ocular biometry was larger in the left eye than the right, and also in males than females. The axial length and width increased with advancing age. CONCLUSION CT ocular biometry can be performed on previous cranial CT scans done for other reasons. The dimensions in this study may be used as a local normogram.

Measurement of normal ocular volume by the use of computed tomography.

BACKGROUND: Reduction or increase in ocular volume may indicate ocular pathology. Unfortunately the reference values utilized for ocular volume had been that of non-Africans. It is therefore pertinent to have a reference value of normal for Africans. OBJECTIVE: To document the computer tomography (CT) scan measured ocular volume in Benin City, which may serve as a reference for African. MATERIALS AND METHODS: The ocular volume of 200 consecutive 'normal' patients (400 eyes) who had CT scan done (using Somatom AR.T, CT scanner, and Siemens) was calculated. The dimensions were obtained at mid-ocular axial slices with maximum anterior-posterior dimension and maximum size of the eye lens. RESULT: The mean (mean ± 2 SD) ocular volume for both eyes was 5282.23 mm 3 ± 1755.13 mm 3 (right eye was 5264.26 mm 3 ± 1781.12 mm 3 ; left eye was 5300.20 mm 3 ± 1771.57 mm 3 ). The mean ocular volumes was different for either eyeball and sex (in males the right eye was 5289.80 mm 3 , left eye was 5224.31 mm 3 ; while in females the right eye was 5338.18 mm 3 , left eye was 5240.79 mm 3 ). Ocular volume correlated with the patients' ages P = 0.006 for the right eye, P = 0.008 for the left eye and P = 0.006 for total eyeball volume. CONCLUSION: Ocular volume correlated positively with the age of the patients to about 50 years after which some reduction was observed. We noted that males had slightly larger eyeballs in comparison to females, although not at statistical significant level.

An audit of 3859 preadmission chest radiographs of apparently healthy students in a Nigerian Tertiary Institution.

BACKGROUND: Chest radiographs are routinely requested as part of the medical screening process prior to admission to institutions. Literature on the yield of such an exercise is sparse especially in the Nigerian setting. This study was therefore carried out to assess the usefulness of routine chest radiography for students at the time of admission. MATERIALS AND METHODS: This was a prospective study of 3859 chest X-rays taken at the department of radiology, University of Benin Teaching Hospital for one admission screening for the 2008/2009 academic year. The age and sex of the subjects were also recorded. The heart, lung fields and bony thorax were examined for any abnormality. RESULTS: Out of the 3859 pre-admission chest radiographs studied, there were 1951 males or 50.56% and 1908 females or 49.44% subjects. The mean age for males was 21.15±3. CONCLUSION: This study has shown that pre-admission routine chest radiography in asymptomatic patients remains a relevant screening tool for medical fitness during admissions into institutions. However because of dangers of exposure to ionizing radiation, we advise that a detailed medical history and physical examination be done to restrict its use to only those subjects with signs and symptoms suggestive of disease.

Ultrasonographic ocular diameters in Nigerians.

BACKGROUND: There is little information on the biometric ultrasonography of the eyeball, especially in Africans. The eyeball diameters form the basis for the calculation of the intraocular lens power and diagnosis of axial hypermetropia and myopia OBJECTIVE: To determine the ocular diameters of healthy Nigerian eyes. METHODS: Measurements of the eyeball in volunteers were taken on the B-mode image using a Medison's Sonoace 1500 ultrasound machine using a 6.5 MHz curvi-linear transducer placed over the closed eyelid. The vertical, horizontal and axial diameters of the eyes of healthy subjects were recorded. The age and sex of the subjects were also recorded. RESULTS: Four hundred eyes of 200 subjects comprising 125 females (62%) and 75 (38%) males (38%) were studied. The age range was 3-92 years with an overall mean age of 41.48 +/- 23.26 years for both sexes. The mean axial eyeball diameter for the entire study population was 21.7 +/- 0.16 mm. There was a gradual increase in all eyeball diameters with age. The highest value for eyeball diameter (22.5 +/- 0.18 mm) was recorded for the elderly age group. The (SD) mean eyeball diameters for males were slightly higher than that for the females; mean for males, 21.8 +/- 0.13 mm, 95% CI = 21.781-21.819, vs females, 21.6 +/- 0.14 mm, 95% CI = 21.581-21.619. However, the difference was not statistically significant (p = 0.409). CONCLUSIONS: The eyeball diameters found in this sample of Nigerians are lower than the dimensions reported in Caucasians. These values may be used as reference values for normal African eyes.

Prenatal Ultrasound Diagnosis of Discordant Occipital Encephalocele in Multiple Pregnancy - A Case Report

Background: Pre-natal sonographic examination is the primary modality of imaging in pregnancy which allows direct; real-time assessment of the fetus; and accurate diagnosis of congenital anomalies. One such anomaly is encephalocele. Case Report:The case of a 38 year old gravida 14; Para 13+1 with a diagnosis of discordant encephalocele multiple (twin) pregnancy made during routine sonographic examination is presented. One twin showed showed an occipital skull defect in association with a sonolucent area with ll-defined margins continuous with the fetal scalp. There were no other associated anomalies. Conclusion:Caution must be taken when performing a pre-natal sonographic examination to rule out congenital anomalies. This is important for the management of the pregnancies

Job satisfaction and psychological health of doctors at the University of Benin Teaching Hospital.

BACKGROUND: Studies on job satisfaction and health have mainly been carried out among Caucasian populations. Similar studies are lacking in Nigeria. AIM: To investigate the level of job satisfaction and its relationship to psychological disorder amongst Nigerian doctors. METHODS: All 190 doctors at the University of Benin Teaching Hospital were invited to participate in a cross-sectional study. The respondents completed two self-administered questionnaires, a specifically designed (25-item) questionnaire and a standard instrument--the General Health Questionnaire (GHQ 28). RESULTS: One hundred and fifty-two doctors responded, giving a response rate of 80%. Twenty-one (14%) doctors had a GHQ score of 4 and above, and were at increased likelihood of having a psychological disorder. Fifty-four per cent were either very dissatisfied or dissatisfied with their jobs, while 30% were very satisfied or satisfied with their jobs. The proportion of doctors with GHQ scores of 4 or above increased with the level of dissatisfaction although this was not statistically significant. The crude odds ratio of psychological disorder (GHQ score 4 and above) in dissatisfied respondents compared to satisfied respondents was 2.2 (95% confidence interval = 0.6-8.4). The odds ratio remained non-significant after controlling for the presence of adolescent children, stress outside work and length of service. CONCLUSION: This study showed a high rate of job dissatisfaction among Nigerian doctors compared to their European and North American counterparts. The reason for this is not altogether obvious. Further research is needed to determine the causes of job dissatisfaction amongst Nigerian doctors.

Towards malaria control: the knowledge of health care providers about mosquito and malaria transmission.

OBJECTIVE: To find out how much health care providers know about the transmission of malaria and the vector. DESIGN: A cross sectional study was carried out using a predesigned questionnaire which was self administered by the student to collect the necessary information for analysis. Live samples of mosquito larvae, drawn larva and adults were provided for the subjects to identify to assess their knowledge. SETTING: The University of Benin Teaching Hospital and the School of Health Technology. SUBJECTS: 254 randomly selected Community Health Officers in training at the University of Benin Teaching Hospital and the School of Health Technology in Benin City, Edo State, Nigeria. MAIN OUTCOME MEASURES: Many of the students had no knowledge of the subject. The School's authorities were encouraged to include field practicals in their curriculum to improve the students' knowledge on mosquitoes and malaria transmission. RESULTS: Only (26.8%) and (18.1%) of the subjects could identify both drawn and live larvae respectively while (25.2%) identified the adult mosquito correctly. All the respondents knew that the mosquito transmits diseases but quite a few knew the diseases transmitted included malaria (55.3%), yellow fever (16.0%) and elephantiasis (10.7%) respectively. CONCLUSION: The knowledge of the students on the biology of mosquitoes and their role as the malaria vector was poor. The education of the subject on this important endemic disease is advocated to improve the quality of life of citizens and promote the primary Health Care Programme in Nigeria.

Towards malaria control in Nigeria: a qualitative study on the population of mosquitoes.

Malaria is still highly prevalent in many tropical countries and this disease can only survive in areas where mosquitoes and infected human populations are high. Relevant information on the species of mosquitoes, their habitats and their population are important in planning preventative strategies in the control of malaria, hence this study. Mosquito species and their habitats were investigated in both high and low density areas of Benin City, Edo State, Nigeria. The results showed that Culex pipiens fatigans, Aedes aegypti, Aedes albopictus, Anopheles gambiae and Culex trigripes were the commonest mosquitoes found in Benin City. Among the habitats studied, containers and gutters had the highest population of mosquitoes. The serious public health implications of these various species of mosquitoes is the possibility of outbreaks of infectious diseases like yellow fever, dengue, which some of these mosquitoes are known to transmit. Malaria, though endemic, is also important because of its associated high morbidity and mortality rates. This study provides some useful information on the habitats and species of mosquitoes found in Benin City. Follow-up studies are being carried out by the authors on quantitative studies on the population of these species of mosquitoes, the dissolved elements present in the different habitats that could promote or inhibit the breeding of mosquitoes, and KAP surveys on mosquitoes and malaria among the Benin populace. It is hoped that such comprehensive data would be very useful in planning effective preventative strategies in the control of malaria in Benin City.

Knowledge, attitude and practice towards AIDS among civil servants in Nigeria.

A study about knowledge, attitude and practice (KAP) towards AIDS was carried out amongst 340 randomly selected workers in Benin City in Nigeria using self-administered questionnaires. Three hundred and thirty (97.1%) of the workers were aware of the existence of AIDS but only 50 (14.7%) had the correct knowledge of the aetiology of AIDS, and of these 29 (8.5%) had tertiary education. Generally there was a good knowledge of the different routes of transmission except for the erroneous belief by a high number, 125 (36.8%) and 129 (37.9%) that it could be transmitted through sharing of utensils and causal kissing respectively. The attitude to AIDS sufferers is poor and 156 (45.9%) actually think they should be ostracized. Twenty-one (6.2%) of the respondents still keep multiple sexual partners while 142 (41.8%) would willingly use the condom for safer sex. There is therefore the need for an intensive and effective health education campaign to combat this deadly disease in the country.

PIP: A KAP survey conducted among 341 government workers in Benin City, Nigeria, revealed a need for intensive health education to prevent the further spread of acquired immunodeficiency syndrome (AIDS). 111 civil servants were female and 229 were male; the age range was 20-54 years. Although 330 (97.1%) were aware of AIDS, only 67 (19.7%) had correct knowledge of the etiology of the disease. Common misconceptions were that the AIDS virus could be transmitted through sharing food utensils, casual kissing, and casual contact. Moreover, 93 (27.4%) believed that some people have natural immunity against infection with human immunodeficiency virus (HIV) and 25 (7.4%) thought that AIDS was curable. 164 (48.2%) were aware that condoms help prevent HIV transmission and 142 (41.8%) expressed a willingness to use condoms. 156 (45.9%) of civil servants felt that persons with AIDS should be ostracized. Although workers with a tertiary education tended to be somewhat more knowledge about AIDS than their less-educated counterparts, this trend was neither significant nor consistent.

Anaemia in pregnancy.

Four hundred and thirty-five pregnant women attending the antenatal clinic at the University of Benin Teaching Hospital (UBTH) were investigated. The ages of the women ranged from 16-42 years with an average haemoglobin level of 10.52 gms%. The prevalence rate of anaemia among these antenatals was 20.7% and 2.8% had severe anaemia. This shows that anaemia is still a problem in Nigeria. Mothers in the age groups 10-19 years and 30-39 years constituted higher percentages of anaemic cases compared to the other age groups. The percentages of the pregnant women who were anaemic were also higher in social-classes IV and V contributing 27.6% and 21.9% respectively. One hundred and eight (49.4%) of the pregnant women booked for antenatal care during the 3rd trimester and the percentage of anaemia was highest in this group 54 (28.4%). About half of the mothers who were para 5+ were anaemic. Nutrition education components of the antenatal care should be intensified. In this regard, mothers should be encouraged to participate actively in income generating activities to improve their economic and nutritional status. Also, during the health education activities in the clinics, the importance of family planning and early bookings for antenatal care need to be stressed.

Schistosoma haematobium in rural school children in Nigeria.

A survey of Schistosoma haematobium infection was carried out in 722 rural school children in Emu, Edo State of Nigeria. The ages of the children ranged from 5-19 years with those between the age-group 10-14 years constituting the highest percentage 317 (43.9%). There were more males 383 (53.0%) than females 339 (47.0%) in the study population. Urine analysis of these children showed that 254 (35.2%) of them were excreting Schistosoma haematobium ova and of these 196 (27.2%) had haematuria. The prevalence of the disease was highest in the younger children with 43.1% for haematuria and 55.3% for S. haematobium ova among the age-group 5-9 years. The corresponding figures were 21.4% and 24.7% for age-group 10-14 years and 14.9% and 27.7% for 15-19 years old children. The sex-specific prevalences of haematuria and Schistosoma haematobium ova were higher for females than for the males.

A simple colorimetric quantification of flavonoids in the flowers of Lonchocarpus cyanescens genus: Lonchocarpus.

As part of a continuing study of the Nigerian flora a chemical analysis of the flavonoids of some plants of the family Papilionaceae prominent in traditional medicine was undertaken. The flowers of the selected plants were extracted and the flavonoids were detected and identified by standard methods. In any such biochemical/chemotaxonomic study where a sizeable number of plants are analysed and in which small differences in type and quantity of each sample are critical, a fast and accurate method of determining the composition becomes paramount. In this work, the determination of the concentration of each flavonoid as a factor of absorbance on a simple single cell photoelectric colorimeter (Seagull Electric Institute Model-1) is reported. The results obtained for Lonchocarpus cyanescens genus Lonchocarpus were consistently satisfactory, sensitive and economical compared with the standard thin layer procedure. As far as the authors know, this is the first report of this method in flavonoid work.

Preliminary phytochemical, pharmacological and antibacterial studies of the alkaloidal extracts of the leaves of Synclisia scabrida Miers.

Preliminary phytochemical investigation of the leaves of Synclisia scabrida indicated the presence of two alkaloids in the water extracts and five alkaloids in the ethanol extracts. The alkaloidal fraction obtained from the cold ethanol extract furnished on column-chromatography, a homogeneous amorphous solid which has been designated as alkaloid C. Alkaloid C showed positive test for alkaloids. The UV and IR spectra and colour reactions of alkaloid C indicated that the compound may be a phenolic bisbenzylisoquinoline alkaloid. All the extracts delayed the onset and shortened the duration of apomorphine-induced stereotyped behaviour in chicks. In addition, 40 mg kg-1 i.p. of the ethanolic extract induced catalepsy in rats. The cold water extract (CWE) synchronized the EEG of the hyperstriatum, optic tectum and the reticular formation while the EMG activity was slightly enhanced. The hot ethanol alkaloidal extract (HEE) inhibited the growth of Pseudomonas aeruginosa and Staphylococcus aureus. The minimum inhibitory concentration of HEE on Pseudomonas aeruginosa strains I and II were 5 and 2.5 micrograms/ml while for Staphylococcus aureus strains I and II were 5 and 10 micrograms/ml, respectively. Up to 1 g kg-1 i.p. of the extract failed to induce any lethal effect in chicks and rats. These effects of the leaf extracts of Synclisia scabrida Miers support some of the local uses of the plant by traditional medical practitioners.

Morbidity and mortality patterns among malnourished children in Benin City, Nigeria.

A morbidity and mortality survey was carried out amongst 196 malnourished children attending the Nutrition Unit, Ministry of Health, Owina Street, Benin City, Nigeria, between January 1971 and December 1973 (morbidity) and also between October 1974 and March 1975 (mortality). Gastrointestinal disorders (77, 39.3%) and measles (67, 34.2%) predominated in both morbidity and mortality patterns. In all, 30 (15.3%) of these children died, and kwashiorkor contributed 14 (46.7%) of this total. The age group of the majority of the sick and dead children was 1-2 years, which is within the traditional weaning age of Nigerian children. Immunization of children and their mothers at appropriate times, coupled with sound nutrition and health education to their mothers, will go a long way towards ensuring the good health and welfare of our children.

PIP: A morbidity and mortality survey was carried out among 196 malnourished children attending the Nutrition Unit, Ministry of Health, Owina Street, Benin City, Nigeria between January 1971 and December 1973 (morbidity) and also between October 1974 and March 1975 (mortality). Gastrointestinal disorders (77, 39.3%) and measles (67, 34.2%) predominated in both morbidity and mortality patterns. Kwashiorkor in 74 children (37.8%) was the most frequent malnourished condition. Of the 196 malnourished children, 30 (15.3%) died. Kwashiorkor had higher overall mortality and case fatality rates than the other 2 nutritional disorders. Of the 74 kwashiorkok cases, 14 died--a case fatality rate of 18.9%, and a mortality rate of 46.7% of the total deaths. The correspoding case fatality rates for marasmus and undernutrition were 13.6% and 12.7%. Malnutrition associated with respiratory diseases and measles had higher case fatality rates than the other morbid conditions. 75 (38.3%) were 1-2 years; 67 (34.2%) were less than 1; 46 (23.5%) were 2-3; and 8 (4.1%) were 3 or over. The corresponding deaths for these age groups were 14, 9, 6, and u respectively. Malnourished children in the 1-2 year age group had the highest case fatality rate (18.7%). This age group is within the traditional weaning age in Nigeria.

Pharmacological effects of Synclisia scabrida alkaloid B on some isolated muscle preparations.

Alkaloid B reversibly blocked the responses of rat diaphragm to electrically induced stimulations via the phrenic nerve. The alkaloid had no effect on the responses of the diaphragm elicited by direct electrical stimulation. The responses of frog rectus abdominis muscle to acetylcholine were inhibited by alkaloid B. Alkaloid B reversibly antagonised the responses of rabbit duodenum to exogenously applied acetylcholine. The contractile effect of oxytocin on rat uterus was specifically inhibited by alkaloid B. The effects of alkaloid B on isolated muscle preparations were concentration-dependent. However, the effect of dopamine and noradrenaline on rat vas deferens was not altered by alkaloid B.

Pregnancy among schoolgirls in Nigeria.

A study was made of 127 cases of schoolgirls with pregnancy-related problems who were admitted into three of the major hospitals in Benin City, Nigeria, over a 10-month period. The findings suggest that schoolgirl pregnancy in Benin City is found chiefly among teenage girls during the early years of secondary school. Lack of experience in family life and knowledge about contraceptive methods, coupled with poor parental control, are the major factors that put the young adolescent at risk of unwanted pregnancy. School drop-out and complications of illegally induced abortion are the most frequent and worst consequences of schoolgirl pregnancies. The provision of formal education on family life and effective and easily accessible family planning methods for the adolescent population are suggested as a means to reduce the rate of schoolgirl pregnancy.

PIP: A study was made of 127 schoolgirls with pregnancy-related problems who were admitted into 3 of the major hospitals in Benin City, Nigeria over a 10-month period. The findings suggest that schoolgirl pregnancy in Benin City is found chiefly among teenage girls during their early years in secondary school. Lack of experience in family life and knowledge of contraceptive methods, coupled with poor parental control, are the major factors which place the young adolescent at risk for unwanted pregnancy. School dropout and complications of illegally induced abortion are the most frequent and worst consequences of schoolgirl pregnancy. The provision for formal education on family life and effective and easily accessible family planning methods for the adolescent population are suggested as a means to reduce the rate of schoolgirl pregnancy.