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ORIGINAL RESEARCH REPORTS
Maternal knowledge, attitude and compliance regarding immunization of under five children in Primary Health Care centres in Ikorodu Local Government Area, Lagos State
Oluwatoyosi Adetola Adefolalu, Oluchi Joan Kanma-Okafor, Mobolanle Rashidat Balogun
January-March 2019, 16(1):7-14
DOI:10.4103/jcls.jcls_55_18  
Introduction: Immunization is one of the most successful and cost-effective public health interventions, saving the lives of 3 million children annually. One-third of the deaths among under-fives are preventable by vaccines. This study aimed to assess the knowledge, attitude, and compliance of mothers regarding immunization of under-five children in Ikorodu Local Government Area, Lagos State. Subjects and Methods: A cross-sectional descriptive study was carried out among 250 mothers of under-five children at health centers in Ikorodu selected by multistage sampling. An interviewer-administered questionnaire was used as the survey tool. Data were analyzed using Expanded Program on Immunization – Info Version 7.1.1.14. P < 0.05 was considered statistically significant. Results: All respondents were aware of immunization, more than half (72%) of them had good knowledge about the immunization of under-five children, all the mothers (100%) had a positive attitude toward immunization and a majority (86.4%) of the respondents had fully immunized their children. There was a statistically significant association between the mother's age, occupation, level of education, nature of the family and the level knowledge of the respondents. There was also a statistically significant association between the mothers' age and occupation and their compliance with the immunization of their children. Conclusion: Most mothers had good knowledge, a positive attitude and good practice towards immunization. Maternal age, education, and hence their occupation were important factors for good knowledge and practice towards childhood immunization. The education of women, thus delaying marriage, remains a key factor in ensuring child survival through immunization.
  10,762 798 -
Knowledge, attitude, and practice of abortion among female students of two public senior secondary schools in Lagos Mainland Local Government Area, Lagos State
Abdul-Hakeem O Abiola, Oluwabunmi A Oke, Mobolanle R Balogun, Foluke A Olatona, Maymunah A Adegbesan-Omilabu
April-June 2016, 13(2):82-87
DOI:10.4103/2408-7408.179682  
Background: Unsafe abortion is a public health concern because of its dire reproductive health consequences and impact on maternal morbidity and mortality. Tackling this problem will go a long way toward achieving one of the Millennium Developmental Goals, which aim to reduce overall maternal mortality by two-thirds by the year 2015. The aim of this study was to determine the knowledge, attitude, and practice of abortion and the factors associated with it among female students of two public senior secondary schools in Mainland Local Government Area, Lagos state. Materials and Methods: This was designed as a cross-sectional, descriptive study. The multistage sampling method was used to select 210 respondents. Data were collected with self-administered questionnaires and analyzed using the EPI Info software. The questionnaire was divided into four sections: the sociodemographic characteristics of the respondents, knowledge about abortion, attitudes toward abortion, and the practice of abortion. The responses to the knowledge and attitude questions were scored and graded as good (≥50%) and poor (<50%). Results: The response rate was 98%. The mean age of the respondents was 15.6 ΁ 1.3 years. The majority (83.3%) of the respondents had good knowledge of abortion; almost all (99.2%) demonstrated poor attitude toward abortion; and only a few (2%) had ever had an abortion. There was a statistically significant association between the ages of the respondents and their knowledge of abortion (P = 0.004) as well as their attitude toward abortion (P = 0.03). Conclusion: The respondents showed good knowledge of abortion, poor attitude toward abortion, and a low of practice of abortion. There is, therefore, a need to improve and sustain the existing knowledge and attitudes toward abortion so as to reduce the practice of abortion among students of the two schools.
  8,581 726 1
Knowledge, attitude, and practices of emergency health workers toward emergency preparedness and management in two hospitals in Lagos
Babajide A Adenekan, Mobolanle R Balogun, Victor Inem
January-March 2016, 13(1):23-28
DOI:10.4103/1595-9587.175483  
Background and Objective: The Emergency Department is of significance and is the vital entry points of patients into the healthcare facility of the hospital all around the world. This study aims to assess the knowledge, attitude and practices of emergency personnel at two tertiary hospitals in Lagos as regards emergency management and preparedness. Aims: This study aims to assess the knowledge, attitude, and practices of emergency personnel at two tertiary hospitals in Lagos with regard to emergency management and preparedness. Settings and Design: This was a descriptive, cross-sectional study. Materials and Methods: A convenient recruitment was made of eligible and consenting individuals at both hospitals until the required sample size was reached. Statistical Analysis Used: The data obtained were analyzed using Epi Info statistical software version 3.5.1. Results: The majority (93.2%) of the participants were clinicians. It was discovered that less than half or 98 (47.8%) of the participants had good knowledge of emergency preparedness and planning, 76 (37.1%) had a fair knowledge, while 31 (15.1%) had poor knowledge. The respondents' attitude toward emergency preparedness was generally positive, as most of them, that is, 191 (93.2%) believed that they needed to know about emergency planning. Only a minority, that is, 72 (35.1%) of the respondents knew that emergency drills are done in their respective hospitals. Conclusions: There was an overall deficiency in the respondents' knowledge of emergency preparedness. Their attitude was good and acceptable, but their practices in terms of the frequency of emergency drills and the frequency of regularly updating the emergency plans were grossly inadequate.
  6,706 685 2
Knowledge and consumption of fruits and vegetables among secondary school students of Obele Community Junior High School, Surulere, Lagos State, Nigeria
Oluwakanyinsola Ojuolape Silva, Olayinka O Ayankogbe, Tinuola O Odugbemi
April-June 2017, 14(2):68-73
DOI:10.4103/jcls.jcls_60_16  
Background: The incidence of noncommunicable diseases (NCDs) is increasing in developing countries, largely due to lifestyle and dietary changes. Adolescents are a nutritionally vulnerable age group; however, poor eating habits are often observed in adolescents. It has been observed that individuals who develop healthy eating habits early on in life are more likely to maintain them into adulthood and have a reduced risk of developing NCDs. This study aimed to assess the knowledge and consumption pattern of fruits and vegetables among junior secondary school students. Materials and Methods: This was a cross-sectional descriptive study of 220 respondents selected using a multistage sampling technique. An interviewer-administered questionnaire was used to collect data, which was analyzed using Epi Info Version 7 statistical software. Results obtained were presented with the use of frequency tables. Results: Results from this study revealed that 84.99% of the respondents displayed good knowledge of the nutritional and health values of fruits and vegetables; however, the consumption of fruits and vegetables was appropriate in only 5.48% of the respondents, having five portions of fruits and vegetables daily. Parental intake, encouragement, and supervision as well as availability and accessibility to fruits and vegetables at home were motivators for appropriate consumption. Conclusion: This study has revealed that the students of Obele Community Junior High School, Surulere, have good knowledge of the nutritional and health values of fruits and vegetables. However, the students have inappropriate daily consumption, as their consumption falls below the World Health Organization recommended five portions daily. Efforts should be made by the students themselves, the family, the School, all and sundry in the community to effect change soonest, so that these adolescents maintain healthy eating habits into adulthood, and hence prevent the occurrence of nutrition-related NCDs later on in life.
  6,231 637 1
CASE REPORTS
Multiple scrotal epidermal cysts: A rare case report
Kavita Mardi
January-June 2014, 11(1):20-21
DOI:10.4103/1595-9587.137246  
Multiple epidermal cysts over the scrotum is a rare condition and requires excision if infected or cosmetically unacceptable. Grossly enlarged or infected cysts require total excision of the scrotal wall followed by the coverage of bare testes. We are reporting a case of multiple epidermal cysts on the scrotum. Total excision of scrotal wall followed by the fascio cutaneous flap coverage was done in this case.
  6,267 275 1
Neurolipoma: A rare entity
Banyameen Iqbal, Tushar Kambale, Iqra Mushtaq
July-December 2014, 11(2):55-56
DOI:10.4103/1595-9587.146505  
A lipoma is a common type of benign tumor and a neurolipoma is one of its variants. It is also referred to as neural fibrolipoma, fibrolipomatous hamartoma, intramural lipoma, and lipomatosis of nerve. The most common sites of presentation are the volar aspects of the hands, wrists, and forearms of young persons. The median nerve is most commonly involved. Lower-extremity cases are extremely rare. We report here a rare case involving the median nerve without any skeletal deformity occurring in a male patient. It usually presents with swelling associated with pain and tenderness.
  5,096 235 -
ORIGINAL RESEARCH REPORTS
Knowledge of chemotherapy and occupational safety measures among nurses in oncology units
Sylvia E Nwagbo, Rose Ekama Ilesanmi, Beatrice M Ohaeri, Abimbola O Oluwatosin
July-September 2017, 14(3):131-137
DOI:10.4103/jcls.jcls_88_16  
Background: The mutagenic and teratogenic effects of chemotherapeutic agents from repeated exposure during care are well documented. Nurses are among the healthcare professionals who constantly handle these agents, therefore their knowledge and pattern of occupational safety is a concern. This study sought to determine knowledge of chemotherapy and occupational safety measures of nurses in oncology units in the University College hospital, Ibadan. Materials and Methods: A cross sectional descriptive study design, based on Protection Motivation theory was conducted among 100 purposively selected nurses from oncology unit of the hospital. Data were collected using a 54-item validated questionnaire. Descriptive and inferential statistics at 0.05 level of significance was used. Results: Respondents were within 35.4 ± 5.1 years. More than half of the respondents had over 3 years practice in the oncology unit (mean 2.62, ± 1.1). Knowledge of chemotherapy among the cohort was high; mean 13.9 ± 2.2, 70 % understood the use of gloves and gowns as part of safety guidelines. On handling patients' clothes, only 57% understood that such should not be washed by hand or with other clothes. Cumulatively, 79.2% of the respondents knew about the safety guidelines, 4.7% had no knowledge while 16.1% were not sure of the correct guidelines for administering chemotherapy. Respondents' level of education was significantly associated with knowledge of chemotherapy, P<0.05; practice score was also significantly associated with respondents' cadre; P<0.05. Conclusion: Periodic and consistent update of nurses' knowledge supported by policies to enforce guidelines implementation is recommended.
  4,688 503 -
National health insurance scheme: Are the artisans benefitting in Lagos state, Nigeria?
Princess C Campbell, Omowumi M Owoka, Tinuola O Odugbemi
July-September 2016, 13(3):122-131
DOI:10.4103/2468-6859.185249  
Background: Health insurance (HI) can serve as a vital risk protection for families and small businesses and also increase access to priority health services. This study determined the knowledge, attitude of artisans toward HI as well as their health-seeking pattern and willingness to join the HI scheme. Methodology: This descriptive cross-sectional survey used a multistage sampling technique to recruit 260 participants, using self-designed, pretested, interviewer-administered questionnaire. Data were analyzed using Epi-info version 7.0. Chi-square test, Fisher's exact test, and logistic regression were used for associations; the level of significance was set at 5%. Results: The respondents were predominantly male, i.e., 195 (75.0%), with a mean age of 32.36 + 6.20 years and mean income of N 29,000 + 5798.5 ($1 ~ N 161). Majority of the respondents, i.e., 226 (86.9%) were not aware of HI. The overall knowledge was poor (6.5%) and the main source of information was through radio/television (41.2%). Nearly, half of the respondents (33 out of 67) identified the concept of HI as a pool of contributors' fund for only healthcare service. A high proportion of the respondents (27 out of 34) were aware of the benefits of HI, although majority, i.e., 27 (79.4%) identified access to medication as the benefit. The majority of the respondents, i.e., 228 (87.7%) expressed negative attitude toward the scheme; however, 76.5% were willing to join the HI scheme. Conclusion: The artisans had low awareness/poor knowledge of HI which translated to a negative attitude toward the scheme. There is need for an aggressive stakeholders' enlightenment campaign for increasing coverage.
  4,740 320 -
CASE REPORTS
Submandibular vascular hamartoma with phleboliths mimicking sialolithiasis
Sharad Ramdas, Anita Ramdas, Moses M Ambroise, Renu G'Boy Varghese
July-December 2014, 11(2):52-54
DOI:10.4103/1595-9587.146504  
The differential diagnoses of radiopacities in the orofacial region include sialoliths, calcified lymph nodes, tuberculous nodes, and uncommon phleboliths. We report a case of a 37-year-old lady with intermittent unilateral left-sided submandibular swelling caused by a vascular hamartoma with phleboliths, which was initially diagnosed as submandibular sialolithiasis.
  4,825 233 -
ORIGINAL RESEARCH REPORTS
Anthropometry of children with cerebral palsy at the Lagos University Teaching Hospital
Titilayo Olubunmi Adekoje, Mike Nwachukwu Ibeabuchi, Foluso Ebun Afolabi Lesi
July-September 2016, 13(3):96-104
DOI:10.4103/2468-6859.185245  
Background: Cerebral palsy (CP) is one the most common causes of disability among children in developing countries and is often associated with poor growth. The assessment of growth and nutrition of children is an important aspect of health monitoring and is one of the determinants of child survival. Aim: To assess the nutritional status of children with CP as seen in Lagos University Teaching Hospital (LUTH). Subjects and Methods: A prospective case-control study was conducted on children with CP attending the weekly pediatric neurology clinic of the LUTH between April 2005 and March 2006. Controls were apparently healthy children being followed up at the children's out-patient clinic of LUTH for acute illness that had resolved. Anthropometric measurements of weight, length/height, mid-upper arm circumference, and skinfold thickness were taken according to the protocols recommended by the International Society of the Advancement of Kinanthropometry. Statistical Analysis: EPI-INFO (version 6.04) was used for analysis. Chi-square test was used to determine associations. Student's t-test was used to compare means of patients and matched controls. Probability P < 0.05 were taken as statistically significant. Results: The controls had higher weight than the patients with mean weight (standard deviation) of 13.7 (4.8) kg, and 12.0 (4.5) kg, respectively (P = 0.01). There were also statistically significant differences in the subscapular and biceps skinfold measurements between the patient and control groups (P = 0.00004 and 0.000008), respectively. Twenty-four (25.8%) and 5 (5.4%) of the patients had moderate and severe undernutrition compared to 6 (6.1%) and none, respectively, in the control group (P = 0.00005). Conclusion: Children with CP had significantly lower mean anthropometric parameters and were more malnourished compared with the control group of children matched for age, sex, and social class.
  4,609 432 1
Analysis of physiotherapy documentation of patients' records and discharge plans in a tertiary hospital
Olajide A Olawale, Ashiyat K Akodu, Emilia A Tabeson
July-December 2015, 12(2):85-89
DOI:10.4103/1595-9587.169687  
Background and Objective: Accurate documentation promotes continuity of care and facilitates dissemination of information concerning the patient to all members of the health care team. This study was designed to analyze the pattern of physiotherapy documentation of the patients' records and discharge plans in a tertiary hospital in Lagos, Nigeria. Materials and Methods: A total of 503 case files from the four units of the Physiotherapy Department of the hospital were examined for accuracy of records. The D-Catch instrument was used to quantify the accuracy of record structure, admission data, physiotherapy examination, physiotherapy diagnosis, patients' prognoses based on the plan of care, physiotherapy intervention, progress and outcome evaluation, legibility, and discharge/discontinuation plan. Results: “Accuracy of legibility” domain had the highest accuracy score: 401 (79.72%) case files had an accuracy score of 4. The domain “accuracy of the discharge/discontinuation summary” had the lowest accuracy score: 502 (99.80%) case files had an accuracy score of 1. Conclusion: Documentation of the plan of care made in the hospital for the period of this study did not fully conform to the guidelines of the World Confederation for Physical Therapy (WCPT). The accuracy of physiotherapy documentation needs to be improved in order to promote optimal continuity of care, improve efficiency and quality of care, and recognize patients' needs. Implementation and use of electronically produced documentation might help physiotherapists to organize their notes more accurately.
  4,551 395 1
CASE REPORTS
A rare case of ganglion cyst of sternoclavicular joint diagnosed and treated by fine-needle aspiration cytology
Divya Sethi, Sangeeta Lamba, Barkha Gupta, Mitali Swain
October-December 2017, 14(4):204-206
DOI:10.4103/jcls.jcls_57_17  
Ganglion cyst although a common swelling observed near joints of hands and feet, it is extremely rare in the sternoclavicular joint. Diagnosis is usually based on clinical examination, radiological investigations, or fine-needle aspiration cytology (FNAC). We hereby report a case of an 8-year-old girl who presented to the surgical outpatient department with a nontender, nonerythematous swelling over the right sternoclavicular joint for 3 months. Ultrasonography revealed a cystic swelling measuring 0.4 cm × 0.3 cm × 0.3 cm. The diagnosis of ganglion cyst was finally confirmed on FNAC. The aspiration acted both as diagnostic and therapeutic modality thus avoiding surgery. The patient is under follow-up for the chance of recurrence.
  4,704 189 -
ORIGINAL RESEARCH REPORTS
Critical incidents and near misses during anesthesia: A prospective audit
Pamela Onorame Agbamu, Ifeyinwa Dorothy Menkiti, Esohe Ivie Ohuoba, Ibironke Desalu
January-March 2017, 14(1):18-24
DOI:10.4103/2468-6859.199170  
Background: A critical incident is any preventable mishap associated with the administration of anesthesia and which leads to or could have led to an undesirable patients' outcome. Patients' safety can be improved by learning from reported critical incidents and near misses. Materials and Methods: All perioperative critical incidents (excluding obstetrics) occurring over 5 months were voluntarily documented in a pro forma. Age of patient, urgency of surgery, grade of anesthetist, and patients' outcome was noted. Results: Seventy-three critical incidents were recorded in 42 patients (incidence 6.1% of 1188 procedures) with complete recovery in 88.1% (n = 37) and mortality in 11.9% (n = 5). The highest incidents occurred during elective procedures (71.4%), which were all supervised by consultants, and in patients aged 0–10 years (40.1%). Critical incident categories documented were cardiovascular (41.1%), respiratory (23.25%), vascular access (15.1%), airway/intubation (6.85%), equipment errors (6.85%), difficult/failed regional technique (4.11%), and others (2.74%). The monitors available were: pulse oximetry (100%), precordial stethoscope (90.5%), sphygmomanometer (90.5%), capnography (54.8%), electrocardiogram (31%), and temperature (14.3%). The most probable cause of critical incident was patient factor (38.7%) followed by human error (22.5%). Equipment error, pharmacological factor, and surgical factor accounted for 12.9%. Conclusion: Critical incidents can occur in the hands of the highly skilled and even in the presence of adequate monitoring. Protocols should be put in place to avoid errors. Critical incident reporting must be encouraged to improve patients' safety and reduce morbidity and mortality.
  4,367 512 -
CASE REPORTS
Fournier's gangrene and perianal abscess: Is there a common denominator?
Ajibola Emmanuel Jeje, Bolaji O Mofikoya, Abisola E Oliyide
January-March 2017, 14(1):53-55
DOI:10.4103/2468-6859.199166  
Fourniers gangrene is a genital catastrophe with significant morbidity and mortality. We present a 57 year old patient with fournier's gangrene and perianal abscess. He had serial debridements with daily bedside dressing and secondary closure of the scrotal defect. Further evaluation during the course of treatment revealed diabetes mellitus. We conclude that aggressive multidisciplinary treatment will improve outcome and that the existence of fournier's gangrene coexisting perianal abscess could alert the clinician to the possibility of underlying diabetes mellitus - A common denominator.
  4,449 261 -
ORIGINAL RESEARCH REPORTS
Choosing an appropriate Plastibell size for infant circumcision
Abdulrasheed A Nasir, Kayode T Bamigbola, Lukman O Abdur-Rahman, James O Adeniran
July-September 2018, 15(3):123-125
DOI:10.4103/jcls.jcls_90_17  
Background: The Plastibell technique is the most frequently used device due to its perceived “ease of use” by all categories of practitioners including nonqualified people like barbers and technicians. Nonetheless, Plastibell technique for circumcision is not without its problems. We aim to describe a simple and objective technique of choosing an appropriate Plastibell size for Plastibell circumcision. Technique and Methods: The circumference of the glans penis (C) is measured at the level of the glanular ridge. The diameter of the glans corresponding to the Plastibell size is determined using the formula πD = C. The glans diameter (D) equals 0.32C. This technique was used to choose Plastibell size for 25 consecutive infants in a pilot study. Results: The median age of the infants was 21 days. The median circumference of the glans was 4.1 cm, and the median size of the Plastibell used was 1.3. The median time taken by the device to fall off spontaneously after circumcision was 4 days. There was no complication recorded. Conclusions: This objective method of choosing the appropriate Plastibell size is easy and safe. It has the potential to reduce the complications of Plastibell circumcision.
  3,925 189 -
Hypoxic-ischemic encephalopathy and the Apgar scoring system: The experience in a resource-limited setting
Ibrahim Aliyu, Teslim O Lawal, Ben Onankpa
January-March 2018, 15(1):18-21
DOI:10.4103/jcls.jcls_102_17  
Introduction: Virginia Apgar developed the Apgar scoring which has shown relevance in assessing the general well-being of the newborn at delivery and also determining the response and effectiveness of resuscitation. This includes the 1st, 5th, and even the 10th and 20th min scores. However, the first and fifth scores have been severally used in defining perinatal asphyxia. This study, therefore, seeks to assess the performance of Apgar scoring in a resource-limited setting in determining hypoxic-ischemic encephalopathy (HIE). Materials and Methods: This was a retrospective study. The medical records of 142 admitted newborns with a diagnosis of perinatal asphyxia were reviewed over a 1-year period. Results: There were 86 males and 56 females with perinatal asphyxia and a male-to-female ratio of 1.5:1. Most cases had a 1 min Apgar score in the range of 4–5 (62.0%), whereas using the 5th min Apgar score, majority of the cases had scores of 6 and more. Sixty-five cases (45.8%) had HIE, whereas Stage 1 HIE was the most recorded form of encephalopathy. The 1st min Apgar scoring showed that most cases with a score of 4–5 had Stage 1 HIE, whereas all the nine cases with Stage 3 HIE had a score of 0–3 (Fisher's exact test = 132.074; P = 0.00); furthermore, most cases with Stage 1 HIE had a 5 min score of 6 and above, but all the cases with Stage 3 HIE had a score between 4 and 5 (Fisher's exact test = 49.024; P = 0.00). Conclusion: The Apgar score still remains an important tool in neonatal resuscitation and monitoring; asphyxiated neonates need to be actively and effectively resuscitated.
  3,775 294 -
ABSTRACTS
Abstracts and poster presentations of the faculty of clinical sciences conference and gathering, 2017

April-June 2018, 15(2):69-95
DOI:10.4103/2468-6859.232815  
  3,759 264 -
ORIGINAL RESEARCH REPORTS
Healthseeking preferences of residents of Mushin LGA, Lagos: A survey of preferences for provision of maternal and child health services
AA Roberts, MR Balogun, AO Sekoni, VA Inem, OO Odukoya
January-June 2015, 12(1):9-13
DOI:10.4103/1595-9587.160759  
Introduction: Attendance at antenatal clinics, skilled care at delivery and timely access to postnatal care, immunization, and treatment in case of illness are essential to reducing adverse health outcomes in the community. This survey was conducted to identify the demographic and community members' preferences for health service facility for maternal and child care within the Mushin local government area (LGA). Materials and Methods: This descriptive cross-sectional survey was done among household residents in Mushin, Lagos to determine the healthcare provider preferences of residents for maternal and child services, severe and nonsevere illnesses in adults and children, as well as cases of behavioral illnesses. Results: The survey showed that a third (33%) of respondents expressed a preference for doctors in public health facilities for antenatal care and delivery. For severe childhood illnesses, the preference was for doctors in either private (45.1%) or public (44.1%) health facilities rather than nonphysicians. Regarding severe adult illnesses or behavioral illnesses, respondents preferred doctors in government facilities (48.1% and 59.9%, respectively). The educational level of household heads was positively associated with preference for maternal and child services in accredited health facilities and this association was statistically significant at P < 0.05. Conclusion and Recommendations: In view of the proximity of a tertiary health facility in Mushin LGA, the authors recommend further research into the decision-making dynamics within households in terms of preferences for healthcare provision.
  3,632 213 -
Uterine rupture at Lagos University Teaching Hospital
Omololu Adegbola, Adesumbo Kanyinsola Odeseye
January-March 2017, 14(1):13-17
DOI:10.4103/2468-6859.199163  
Background: Uterine rupture remains a major life-threatening obstetric disaster encountered in many developing countries and is associated with a high maternal and perinatal mortality and morbidity. Objectives: The objective of this study was to determine the incidence, associated risk factors, trend, clinical presentation, management as well as maternal and fetal outcome of uterine rupture at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Materials and Methods: This was a retrospective study of patients with uterine rupture at the LUTH, Idi-Araba, Lagos, Nigeria, from June 1, 2005 to May 31, 2013. The case records of patients in this period were retrieved from the medical health records department. The relevant data of sociodemographic characteristics, clinical presentation, management as well as maternal and perinatal outcome were collated using a structured questionnaire. Results: Of the 13,138 deliveries during the study period, there were eighty cases of uterine rupture giving a hospital incidence of 6.1/1000 deliveries. Patients with parities of 1 (28.36%) and 2 (38.81%) were identified to be at higher risk of uterine rupture. Previous caesarean section (46.28%), obstructed labor (26.87%), and injudicious use of oxytocin (16.42%) were the common associated factors. Rupture along previous anterior scar was the most common site affected in 32.84%; repair with bilateral tubal ligation was the surgical procedure in most of the cases (47.76%). The case fatality rate for ruptured uterus was 11.94% for the mothers and the perinatal mortality rate of 791/1000 babies. Conclusion: Uterine rupture is a major cause of maternal and perinatal death in Lagos, Nigeria.
  3,420 362 2
A comparative study of the effects of infrared radiation and warm-up exercises in the management of DOMS
Ayoola I Aiyegbusi, Adebimpe J Aturu, Adegoke M Akinfeleye
April-June 2016, 13(2):77-81
DOI:10.4103/2408-7408.179681  
Introduction: Delayed onset muscle soreness (DOMS) is associated with temporary morbidity as a result of pain, soreness, and reduced muscular performance that affects the overall performance of the individual. Several interventional modalities have been studied without a conclusive evidence of efficacy. Objective: This study was carried out as part of a continuous attempt to find an effective and quick relief for DOMS. The study investigated the comparative effects of warm-up exercises and infrared radiation in ameliorating the symptoms associated with DOMS. Materials and Methods: Sixty volunteer subjects between the age of 16 years and 35 years had DOMS induced in the left biceps brachii muscle. They were randomized into three groups with 20 subjects in each group. The groups were allocated as follows: Group A as control that received no treatment, Group B had a bout of warm-up exercises consisting of 10 sets of maximal elbow flexion and extension after which DOMS was experimentally induced, and Group C had infrared radiation for 20 min  after which DOMS was experimentally induced. Assessment for muscle soreness, pain, and joint range of motion (ROM) was carried out immediately after inducing DOMS and it was repeated 24 h and 48 h later using the Numerical Pain Rating Scale (NPRS), deep palpation (DP), and goniometry, respectively. Results: The infrared group (Group C) had significantly lower scores on NPRS and DP throughout the 3 days compared with the control while the significant effects of warm-up exercises were seen from day 2. There was, however, no significant difference (P > 0.05) in the range of movement (ROM) scores. Compared with warm-up exercises (Group B), infrared resulted in significantly lower NPRS and DP scores and greater ROM only on day 1. Conclusion: Infrared radiation (IRR) is effective in ameliorating the symptoms of DOMS immediately after treatment on day 1 while the effect of warm-up exercises is seen 24 h later. IRR, thus, has a better effect than warm-up exercises in ameliorating the symptoms associated with DOMS.
  3,363 367 -
Clinical pattern of psoriasis in patients seen at a tertiary hospital in Nigeria
Olusola Ayanlowo, Ayesha Akinkugbe
July-September 2016, 13(3):137-142
DOI:10.4103/2468-6859.185251  
Background and Objectives: Psoriasis is a chronic, papulosquamous disorder of the skin with variable morphology, characterized by periods of remission and reactivity. Psoriasis is less common in the tropics and in dark-skinned persons. Prevalence in West Africans has been noted to be similar to that of the African-Americans suggesting a similarity in genetic ancestry. This study aimed to describe the clinical characteristics of psoriasis and precipitating factors in Nigerian patients. Materials and Methods: This is a retrospective study of all dermatology patients with features of psoriasis who attended the dermatology outpatient clinic of the hospital between January 2007 and May 2012. Data were obtained from the patients' clinic notes and protocol for psoriasis, which documented patients' demographic data, clinical presentations, and precipitating factors. Results: Psoriasis was found in 1.13% (124/11,015) of the study population. There was a male preponderance with a male to female ratio of 1.34:1. The majority of patients seen were in the fourth decade of life. Stress, alcohol, and drugs were the most reported predisposing factors to psoriasis. All types of psoriasis were found, and plaque psoriasis was the most common. Conclusion: This study confirms the increasing frequency of psoriasis among dermatology patients in Nigeria, which may either be due to an increased proficiency in diagnosing the condition by physicians or increase prevalence of environmental factors. The current trend in the management of psoriasis is focused on treating the inflammatory process as well as managing the modifiable environmental triggers.
  3,359 267 1
Pattern of complications and comorbidities among diabetic patients in a tertiary healthcare center in Nigeria
Oluwatosin O Kayode, Oluwakemi O Odukoya, Ifedayo A Odeniyi, Oluwarotimi B Olopade, Olufemi A Fasanmade
January-June 2015, 12(1):29-35
DOI:10.4103/1595-9587.160765  
Background: The prevalence of diabetes mellitus (DM) among Nigerian adults is increasing. Besides the well-recognized microvascular complications of diabetes, there is also a growing epidemic of macrovascular complications. Patients with diabetes may not only have diabetes-related complications but may also have nondiabetes-related comorbidities. Aim: To determine the pattern of chronic diabetic complications and coexisting morbidities in patients attending the diabetic outpatient clinic of a tertiary health care center in Nigeria and the factors associated with the presence of complications. Materials and Methods: This was a cross-sectional descriptive survey carried out among patients attending the follow-up diabetic clinic of a tertiary health care center in Nigeria over a 3-month period. A systematic random sampling method was used and 422 eligible patients were selected and interviewed using pretested interviewer-administered questionnaires, after written informed consent was obtained. Data were analyzed using  Epi Info statistical package version 3.5.1. developed by Centers for Disease Control and Prevention (CDC) in Atlanta Georgia (USA). Results: Of the 422 patients interviewed, 400 (247 females and 153 males) had complete data for analysis. Eighty-eight patients had comorbidities, and the commonest was hypertension in 63 (71.6%). Out of the 61 patients who had complications, the majority, that is, 39 (63.9%) had eye complications. Factors significantly associated with the presence of diabetic complications were the duration of diabetes, marital status, and the presence of diabetic comorbidities. Conclusion: The frequency of diabetic complications and comorbidities is quite high in the patients studied. There is a need to improve the standard of care of patients and to ensure optimal blood glucose control. This will go a long way in reducing the frequency of complications and comorbidities.
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Liver function tests in Nigerian women with severe preeclampsia
Ifeoma C Udenze, Adesina P Arikawe, Elaine C Azinge, Ephraim U Egbuagha
January-June 2014, 11(1):7-11
DOI:10.4103/1595-9587.137241  
Background: Preeclampsia is a common complication of pregnancy with high maternal and perinatal morbidity and mortality. The new American College of Obstetricians and Gynecologists (ACOG) guideline now includes elevation of liver enzymes as a criterion for the diagnosis of preeclampsia. Objectives: The objectives of this study is to compare liver function tests in preeclampsia and normotensive pregnancy and determine their relationship with systolic and diastolic blood pressure, plasma creatinine, and uric acid levels in Nigerian women with severe preeclampsia. Materials and Methods: This was a case-control study of 46 women with severe preeclampsia and 21 pregnant women as controls. These women attended the Antenatal Clinic at the Lagos University Teaching Hospital, Lagos where women were consecutively recruited. Results: There was a statistically significant difference in the systolic blood pressure (P = 0.002), diastolic blood pressure (P = 0.004), plasma creatinine (P = 0.007), uric acid (P = 0.0001), plasma albumin (P = 0.029), alkaline phosphatase (ALP) (P = 0.0001), aspartate aminotransferase (AST) (P = 0.0001), γ-glutamyl transferase (GGT) (P = 0.035), and unconjugated bilirubin (P = 0.023) between the group with severe preeclampsia and the normotensive pregnancy control group. Alanine aminotransferase (ALT) was however not significantly elevated. AST elevation was the most common anomaly in severe preeclampsia occurring in 54.3% of cases. There was no association between systolic and diastolic blood pressure, plasma creatinine, and uric acid in severe preeclampsia with and without abnormal liver function tests. Conclusion: Elevation of AST, ALP, GGT, and unconjugated bilirubin are common in Nigerian women with severe preeclampsia but may not all be of liver origin. These parameters were also not associated with indices of disease severity. The use of liver enzyme concentrations as adjuncts in preeclampsia diagnosis should be applied with caution in Nigerian women with preeclampsia.
  3,245 292 -
EDITORIAL COMMENTS
Autism in Nigeria: A call for action
Foluso E.A. Lesi, Joseph D Adeyemi, Olatunji F Aina, Yewande O Oshodi, Charles S Umeh, Andrew T Olagunju, Wellington Oyibo
July-December 2014, 11(2):33-34
DOI:10.4103/1595-9587.146494  
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ORIGINAL RESEARCH REPORTS
Comparative evaluation of the efficacy of closed pocket debridement with diode laser and periodontal open flap debridement: A clinical and microbiologic study
Khushboo Deshmukh, Devanand Shetty, Arvind Shetty, Suresh Babu Jandrajupalli, Swarnalatha Chandolu, Ruparani Bodduru, Abhishek Singh Nayyar
July-September 2018, 15(3):113-122
DOI:10.4103/jcls.jcls_72_16  
Context: Different techniques are used for periodontal therapy, viz. scaling and root planing, subgingival curettage, gingivectomy, and full- or split-thickness flap procedures with or without osseous recontouring. Most of the said periodontal surgeries are invasive and associated with pain and secondary discomfort, thus leading to a quest for newer techniques such as laser-assisted closed pocket debridement techniques for periodontal therapy. The present study was designed to compare the efficacy of closed pocket debridement with diode laser and periodontal open flap debridement as assessed by clinical and microbiological parameters. Materials and Methods: Twenty patients in an age range of 20–54 years and with pocket depth of ≥5 mm and ≤7 mm were included in the study. The plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and colony forming units (CFUs) of the periodontal pathogens namely Porphyromonas gingivalis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and streptococci were compared in patients undergoing closed pocket debridement with diode laser (Group I) against open flap debridement (Group II) at baseline and after 3 months of the procedure. Results: There was a statistically significant difference between the PD reduction in Group I and Group II (P = 0.02), with Group II showing greater reduction in PD. Furthermore, the mean value of CFUs after 3 months of the procedures in Group I was significantly less as compared to Group II. Conclusion: The laser-treated group (Group I) was found to be better in terms of decrease in clinical PD as compared to Group II. The bactericidal effect of the diode laser was, also, clearly evident by a greater reduction of CFUs of periodontal pathogens in Group I as compared to Group II.
  3,139 319 -
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