The Indirect Victims of COVID-19: Perception of Non-COVID-19 Patients about the Effect of Closure of the Medical Outpatient Services on their Health.

BACKGROUND: In order to reduce COVID-19 transmission and protect healthcare workers, the outpatient departments (OPDs) in many hospitals worldwide were closed down in the early days of the pandemic. Patients being managed for chronic medical illnesses who subsequently suffered reduced access to healthcare have been described as "the patients left behind". AIM: The study aimed at assessing the impact of the closure of the Medical OPD in University of Ilorin Teaching Hospital (UITH) on the health and perceived well-being of patients with chronic medical illnesses. METHODS: A cross-sectional study of 180 patients with chronic medical illnesses attending the MOPD in UITH. RESULTS: Mean age of participants was 50.2±18.2years, 92 (51.1%) were male, median duration of attending MOPD was 21 months (IQR 12-36). 92 patients (51.1%) perceived a negative affectation of their well-being by the closure of MOPD. Being >50 years was associated with a perception of negative affectation of well-being (P=0.042). 140 patients (77.8%) had clinic appointments that fell within the period under review. 67(69.3%) of the 97 patients who had medical complaints during the period could not reach a doctor and this was associated with a perception of negative affectation of their wellbeing. The commonest action they took was to do nothing (28.3%), three (4.5%) resorted to herbal concoctions. 19 (29.9%) felt their complaints were urgent. CONCLUSION: Our study identifies that patients with chronic medical illness are potential victims of COVID-19 related disruption of healthcare services. Healthcare managers in Nigeria must develop alternatives such as telemedicine that sustain face-to-face medical interaction during eventualities.

CONTEXTE: Afin de réduire la transmission de la COVID-19 et protéger les travailleurs de la santé, les services ambulatoires (OPD) dans de nombreux hôpitaux dans le monde ont été fermés dans les premiers jours de l'Pandémie. Patients pris en charge pour des maladies chroniques quipar la suite souffert d'un accès réduit aux soins de santé ont été décrit comme "les patients laissés pour compte". OBJECTIF: L'étude visait à évaluer l'impact de la fermeture de l'OPD médical à l'hôpital universitaire d'Ilorin (UITH) la santé et le bien-être perçu des patients atteints de chroniquesMaladies. MÉTHODES: Une étude transversale de 180 patients atteints de chroniques maladies médicales fréquentant le MOPD à l'UITH. RÉSULTATS: L'âge moyen des participants était de 50.2 ±18.2 ans, 92 ans(51.1 %) étaient des hommes, la durée médiane de la participation au MOPD était de 21mois (IQR 12-36). 92 patients (51.1 %) ont perçu un résultat negative l'affectation de leur bien-être par la fermeture du MOPD. Être >50ans était associée à une perception d'affectation négative de bien-être (P= 0.042). 140 patients (77.8 %) avaient des rendez-vous à la clinique qui s'inscrivait dans la période considérée. 67 (69.3 %) des 97 patients qui ont eu des problèmes médicaux au cours de la période n'ont pas pu atteindre un et cela était associé à une perception d'affectation negative de leur bien-être. L'action la plus courante qu'ils ont prise était de ne rien faire (28.3%), deux (4.5%) ont eu recours à des concoctions à base de plantes. 19 (29.9 %) ont ressenti leurs plaintes étaient urgentes. CONCLUSION: Notre étude identifie que les patients atteints demaladie chronique les maladies médicales sont des victimes potentielles des perturbations liées à la COVID-19des services de santé. Les gestionnaires de soins de santé au Nigeria doivent se developper des solutions de rechange comme la télémédecine qui soutiennent la médecine en personne interaction lors d'éventualités. Mots-clés: Maladie COVID-19, Maladies chroniques, COVID-19 fermeture connexe des services médicaux ambulatoires, perception.

The Indications and Findings at Colonoscopy in a Tertiary Hospital in North-Central Nigeria: A Seven-Year Review.

BACKGROUND: Colonoscopy is an invaluable tool used in the diagnosis of colorectal diseases. It is also useful in the prevention and treatment of some of these diseases. The knowledge of the prevailing colorectal diseases is key to planning for prevention. OBJECTIVES: This study aimed at determining the spectra of indications and findings at colonoscopy in a tertiary health facility. METHODS: This was a hospital-based cross-sectional study of all patients who underwent colonoscopy between March 2013 and February 2020. The patients' biodata, indications and findings at colonoscopy were retrieved from the Endoscopy Register. RESULTS: A total of 385 colonoscopy reports were included in the analysis. The age of the patients ranged from 14 to 95 years with a mean age (standard deviation) of 55.9 (15.4) years. There were 219 (57.0%) males and 166 (43.0%) females. The commonest indication for colonoscopy was haematochezia 150 (38.9%) followed by suspected colorectal malignancy 98 (25.5%), abdominal pain 28 (7.3%), altered bowel habit 21 (5.5%), constipation 20 (5.2%), chronic diarrhoea 19 (4.9%), surveillance/ screening 16 (4.2%), occult bleeding and anal pain 7 (1.8%) each, and others 19 (4.9%). The colonoscopy findings were normal findings 116 (30.1%), haemorrhoids 127 (32.9%), colorectal polyps 70 (18.2%), diverticulosis 46 (11.9%), rectal tumour 43 (11.2%), colonic tumour 32 (8.3%), colitis 23 (5.9%), angiodysplasias 6 (1.6), others 12 (3.1%). The findings were not mutually exclusive. Our diagnostic yield was 69.9%. CONCLUSION: The commonest indication and diagnosis for colonoscopy were haematochezia and haemorrhoids respectively. Our diagnostic yield was 69.9%.

CONTEXTE: La coloscopie est un outil précieux utilisé dans le diagnostic des maladies colorectales. Il est également utile dans la prévention et le traitement de certaines de ces maladies. La connaissance des maladies colorectales prédominantes est essentielle à la planification de la prévention. OBJECTIFS: Cette étude visait à déterminer les spectres d'indications et les résultats à la coloscopie dans un établissement de santé tertiaire. MÉTHODES: Il s'agissait d'une étude transversale en milieu hospitalier portant sur tous les patients ayant subi une coloscopie entre mars 2013 et février 2020. Les données biographiques, les indications et les résultats de la coloscopie des patients ont été extraits du registre d'endoscopie. RÉSULTATS: Un total de 385 rapports de coloscopie ont été inclus dans l'analyse. L'âge des patients variait de 14 à 95 ans avec un âge moyen (écart type) de 55,9 (15,4) ans. Il y avait 219 (57,0%) hommes et 166 (43,0 %) femmes. L'indication la plus courante de la coloscopie était l'hématochézie 150 (38,9%) suivie d'une suspicion de malignité colorectale 98 (25,5%), de douleurs abdominales 28 (7,3%), d'altération des habitudes intestinales 21 (5,5%), de constipation 20 (5,2%), de diarrhée chronique 19 (4,9 %), surveillance/dépistage 16 (4,2 %), saignement occulte et douleur anale 7 (1,8 %) chacun, et autres 19 (4,9 %). Les résultats de la coloscopie étaient normaux 116 (30,1%), hémorroïdes 127 (32,9%), polypes colorectaux 70 (18,2%), diverticulose 46 (11,9%), tumeur rectale 43 (11,2%), tumeur colique 32 (8,3%), colite 23 (5,9 %), angiodysplasies 6 (1,6), autres 12 (3,1%). Les résultats n'étaient pas mutuellement exclusifs. Notre rendement diagnostique était de 69,9 %. CONCLUSION: L'indication et le diagnostic les plus courants de la coloscopie étaient respectivement l'hématochézie et les hémorroïdes. Notre rendement diagnostique était de 69,9 %. Mots clés: Maladies colorectales, coloscopie, indications, spectres, rendement diagnostique.

Cecal carcinoid tumor in a nigerian man: A case report and review of literature.

Carcinoid tumors are rare neuroendocrine tumors that have been reported in a wide range of organs but most commonly involve the gastrointestinal tract (stomach, ileum, appendix, and colon), and rarely ovary and thymus. We present a case of a 56-year-old Nigerian man with a cecal carcinoid tumor that was surgically removed. A 56-year-old Nigerian man, presented to our hospital with a year history of right-sided lower abdominal fullness, audible bowel sounds, occasional diarrhea, nausea, vomiting, and epigastric pain. There was no history of hematochezia or passage of melena stool. Colonoscopy revealed a cecal mass occupying more than two-thirds of the cecal lumen. Histology confirmed carcinoid tumor (well-differentiated neuroendocrine tumor), which was surgically removed. Carcinoid tumors are slow growing rare neuroendocrine tumors. Mortality is low if it is diagnosed early.

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.

Helicobacter pylori eradication therapy: A review of current trends.

Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

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.

Diverticulosis of the colon: a report of two cases.

BACKGROUND: Diverticula are bulging pouch-like herniations in the wall of the hollow organ anywhere in the gastrointestinal tract from the oesophagus to the colon. Diverticula are thought to occur more commonly in the colon than in any other segment of the gastrointestinal tract. It may be asymptomatic or complicated by diverticulitis (diverticular inflammation), bleeding, or perforation with peritonitis. It could be potentially life threatening. It was thought to be rare in this part of the world, but is increasingly diagnosed with the advent of modern imaging techniques and colonoscopy. Two cases of colonic diverticula discovered during colonoscopy were highlighted. CASE REPORTS: Case 1--This patient was a 79-year old traditional ruler who presented with 2 months history of progressive left- sided abdominal pain, dull in nature and sometimes colicky but non-radiating. There was no known aggravating or relieving factors. There was associated history of chronic constipation dating back to over 15 years relieved with use of laxatives. There was no diarrhoea, vomiting or haematochezia. He had no history of previous surgeries. Physical examination showed mild tenderness at the left iliac fossa. Digital rectal examination was normal. Plain abdominal x-ray and abdomino-pelvic ultrasound scan showed no abnormalities. Colonoscopy revealed multiple diverticula with diverticulitis at the descending and sigmoid colon 40 cm-60 cm from the anal verge. Case 2--This patient is a 64-year old retired military officer who presented with constipation of 5 years and rectal bleeding of 10 months. Pre-morbid bowel habit was 1-2 bowel motions per day but now once in 2 days. Constipation was characterized by recurrent passage of hard pellet-like stools. This became associated with passage of fresh blood in the stool 10 months ago, and anal pain. Volume of blood was about 5 mls per episode, and this occurred only when stool was hard. The anal pain was sometimes severe enough to prevent the patient from sitting comfortably on both buttocks. There was no weight loss or constipation alternating with diarrhoea. He had no history of any chronic medical illness. Colonoscopy revealed anal fissure, internal haemorrhoids, and multiple diverticula in the sigmoid and descending colon. Both patients are being managed conservatively with dietary advice and antibiotics, and still being followed up in the clinic. CONCLUSION: Reports of colonic diverticula with diverticulitis in this part of the world are few. This is the first report of colonic diverticulosis from Ilorin.

Angiodysplasia of the colon: a report of two cases and review of literature.

Angiodysplasias of the colon are enlarged and fragile blood vessels in the colon result in occasional loss of blood from the lower gastrointestinal tract. It may be observed incidentally at colonoscopy or patients may present with lower gastrointestinal bleeding. The objective of this case report is to highlight two cases of colonic vascular ectasia seen using a Pentax video colonoscope at the Endoscopy unit of Crescent hospital, Ilorin. The first patient is an 85-year-old man, who presented with constipation, left-sided abdominal pain, and weight loss of two weeks duration. There was no anorexia, abdominal swelling, diarrhea, or hematochezia. Abdomino-pelvic ultrasonography showed normal findings. Colonoscopy done, reaching the ileo-cecal valve and caecum, showed an area of dilated tortuous blood vessel (vascular ectasia) in the wall of the descending colon approximately 45 cm from the anal verge, with no features of bleeding. No ulcers or mass lesion was seen. Colonoscopy showed angiodysplasia of the colon. The second patient is a 30-year-old female trader who presented with two days history of massive hematochezia of about 7 episodes prior to presentation with an estimated blood loss per episode of about 300 ml. There were clinical features of shock. Packed cell volume at presentation was 14%. She was transfused with 4 units of fresh whole blood. Post stabilization, colonoscopy was done 5 days after bleeding had stopped, which revealed an area of erosion with mucosal blood clot about 27 cm from the anal verge. An area of angiodysplasia was seen. No hemorrhoids or mass lesion was seen anywhere in the colon. Angiodysplasia is an uncommon finding in Ilorin. These are the first reported cases of angiodysplasia of the colon from Ilorin, Nigeria.

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

Indications for oesophagogastroduodenoscopy in Ilorin, Nigeria--a 30 month review.

BACKGROUND: Oesophagogastroduodenoscopy is one of the most commonly performed endoscopic procedures. Properly performed, it provides valuable information in patients with upper gastrointestinal conditions. Oesophagogastroduodenoscopy is a visual examination of the upper intestinal tract using a lighted, flexible fibreoptic endoscope or videoscope. Oesophagogastroduodenoscopy is generally indicated for evaluating upper abdominal symptoms such as dysphagia or odynophagia, oesophageal reflux symptoms, gastroduodenal or oesophageal ulcer, upper tract stricture or obstruction, gastrointestinal bleeding, persistent vomiting of unknown cause etc. This study is therefore to review the indications for oesophagogastroduodenoscopy in Ilorin, Nigeria. AIM: To review the indications for oesophagogastroduodenoscopy in Ilorin, Nigeria. METHODOLOGY: A review of the indications for oesophagogastroduodenoscopy was undertaken to cover a thirty-month period from June 2006 to November 2008. The endoscopy register of the operating theatre was examined over this period. The biodata of the patients who underwent the procedure over this period was reviewed. RESULTS: A total of 206 patients had oesophagogastroduodenoscopy done on them during the period under review. 124 of the patients were males (60.2%) while 82 were females (39.8%). The indications for oesophagogastroduodenoscopy were dyspepsia, 94 patients (45.6%); upper gastrointestinal tract bleed, 54 patients (26.2%); gastric outlet obstruction, 12 patients (5.8%); gastric cancer, 11 patients (5.3%); dysphagia, 9 patients (4.3%); acute exacerbation of peptic ulcer disease, 8 patients (3.8%); gastro-oesophageal reflux disease, 7 patients (3.4%); recurrent vomiting, 3 patients (1.5%); bloody stool, 2 patients (1.0%); epigastric mass, 2 patients (1.0%); 1 patient (0.5%) each on account of excessive salivation, foreign body ingestion, ingestion of corrosive, and recurrent anaemia. CONCLUSION: The commonest indication for oesophagogastroduodenoscopy in Ilorin is dyspepsia.

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.

Histomorphology of Helicobacter pylori-associated chronic gastritis in Ilorin.

The presence or absence of Helicobacter pylori in gastric biopsies is of significant therapeutic implication. The aim of the study was to review gastric biopsies taken from dyspeptic patients in the University of Ilorin Teaching Hospital for H. pylori mucosa positivity and other parameters of chronic gastritis. Fifty-seven chronic gastritis cases were evaluated using the updated Sydney classification scheme. There were 27 males and 30 females with a mean age of 48.8 +/- 15.6 years. Chronic mononuclear inflammatory infiltrates ranging from mild, moderate to marked was seen in 15 (26.3%), 29 (50.9%) and 13 (22.8%) cases respectively. H. pylori was positive in 28 cases (49.1%) while the rest were H. pylori negative. Neutrophil activity was observed in 39 cases (68.4%). Non-atrophic gastritis was seen in 39 cases (68.4%) while atrophic gastritis ranging from mild to moderate changes was seen in 18 cases (31.6%). Intestinal metaplasia was found in 5 cases (8.8%) and it comprised of type I (3 cases) and type II (2 cases). H. pylori was the main aetiological agent responsible for chronic gastritis, commonly found in the antral mucosal biopsies and the majority presented with mild-moderate chronic inflammatory changes.

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.

Indications for Oesophagogastroduodenoscopy in Ilorin; Nigeria- a 30 Month Review

Background: Oesophagogastroduodenoscopy is one of the most commonly performed endoscopic procedures. Properly performed; it provides valuable information in patients with upper gastrointestinal conditions. Oesophagogastroduodenoscopy is a visual examination of the upper intestinal tract using a lighted; flexible fibreoptic endoscope or videoscope. Oesophagogastroduodenoscopy is generally indicated for evaluating upper abdominal symptoms such as dysphagia or odynophagia; oesophageal reflux symptoms; gastroduodenal or oesophageal ulcer; upper tract stricture or obstruction; gastrointestinal bleeding; persistent vomiting of unknown cause etc. This study is therefore to review the indications for oesophagogastroduodenoscopy in Ilorin; Nigeria. Aim: To review the indications for oesophagogastroduodenoscopy in Ilorin; Nigeria. Methodology: A review of the indications for oesophagogastroduodenoscopy was undertaken to cover a thirty-month period from June 2006 to November 2008. The endoscopy register of the operating theatre was examined over this period. The biodata of the patients who underwent the procedure over this period was reviewed. Results: A total of 206 patients had oesophagogastroduodenoscopy done on them during the period under review. 124 of the patients were males (60.2) while 82 were females (39.8). The indications for oesophagogastroduodenoscopy were dyspepsia; 94 patients (45.6); upper gastrointestinal tract bleed; 54 patients (26.2); gastric outlet obstruction; 12 patients (5.8); gastric cancer; 11 patients (5.3); dysphagia; 9 patients (4.3); acute exacerbation of peptic ulcer disease; 8 patients (3.8); gastro-oesophageal reflux disease; 7 patients (3.4); recurrent vomiting; 3 patients (1.5); bloody stool; 2 patients (1.0); epigastric mass; 2 patients(1.0); 1 patient (0.5) each on account of excessive salivation; foreign body ingestion; ingestion of corrosive; and recurrent anaemia. Conclusion: The commonest indication for oephagogastroduodenoscopy in Ilorin is dyspepsia

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