Annals of African Medicine
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  Citation statistics : Table of Contents
   2007| March  | Volume 6 | Issue 1  
    Online since October 10, 2009

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Bilateral transverse facial cleft as an isolated deformity: Case report
VI Akinmoladun, FJ Owotade, AO Afolabi
March 2007, 6(1):39-40
DOI:10.4103/1596-3519.55730  PMID:18240492
Transverse facial clefts are rare deformities, these mostly occur as part of syndromes such as facial dysostosis and branchial arch syndrome. This is a report of a case of isolated, asyndromic bilateral facial cleft seen at a semi-urban specialist hospital. Congenital facial defects remain sources of mental and social stress to the families. Infanticide, perhaps a thing of the past in the developed world may still be practiced in cases of congenital deformities in the developing countries, hence the need for early involvement of social workers and clinical psychologist in management.
  11 3,995 68
Intestinal parasitism, potable water availability and methods of sewage disposal in three communities in benue state, Nigeria: A survey
GTA Jombo, DZ Egah, JT Akosu
March 2007, 6(1):17-21
DOI:10.4103/1596-3519.55736  PMID:18240486
Background : To assess the level of parasite burden in a village community and the predisposing factors. Methods : Two hundred subjects each were recruited from three communities- Tyogbenda, Jato-Aka and Adikpo during an episode of free medical outreach. A simple random sampling method was adopted and a questionnaire was interviewer administered on relevant aspects of basic hygiene such as- sources of water supply, methods of domestic sewage disposal and frequency of hand washing. Stool samples were collected and tested and findings analysed using appropriate statistical methods, p values < 0.05 were considered significant. Results : The prevalence of intestinal parasites in Tyogbenda, Jato-Aka and Adikpo communities was found to be 71.5%, 65.5% and 40.5% respectively. Ascaris lumbricoides was the commonest parasite in the three centres (34.5%, 28.5% and 19.0% respectively for Tyogbenda, Jato-Aka and Adikpo communities). Other parasites identified were- Entamoeba histolytica, Entamoeba coli, Hookworm, Enterobius vermicularis, Strongyloides stercoralis, Schistosoma mansoni and Trichuris trichura. Multiple parasitic infestation was common in the communities where quality of water supply and methods of sewage disposal facilities were below standard. Conclusion : The prevalence of intestinal parasitism is still high in Nigerian rural communities. The present resolve by the federal ministry of water resources to supply potable water to all Nigerian rural communities should be sustained. Furthermore, a health education program should be properly constituted and integrated into the present primary health care policy for the country.
  11 5,081 90
Surgical hand scrub: Lots of water wasted
A Ahmed
March 2007, 6(1):31-33
DOI:10.4103/1596-3519.55733  PMID:18240489
Background : Surgical hand scrub (SHS) is an important antisepsis measure before participating in surgical operation. It reduces the risk of microbial contamination of the surgical wound by skin flora. SHS is usually performed in a scrub sink with taps that have hand operated handles. During the scrub process large volume of water is wasted. The aim of this study was to determine the volume of water used during SHS in comparison to the actual volume necessary. Method : Unknown to them various cadreof the operation team were timed during their first scrubbing of the day for scheduled operations. Duration of scrubbing (ST) and that during which the hands were being washed with flowing water (WT) were recorded. The amount of water flowing through the tap per minute was also recorded. Using the mean ST, WT and water flow per minute the total volume of water used during scrubbing and that necessary to wash the hand were calculated. Results : Overall, the ST ranged between 3 and 7 minutes with a mean of 4.8 ± 0.5 SD minutes. Mean WT was 1.4 ± 0.4 SD minutes. The mean water flow was 4,217mls per minutes. The volume of water used per scrubbing was 20.2 litres while only 5.9 litres was used for washing the hands. Between January and December 2002, the volume of water used for scrubbing was 200,283 litres while only 58,498.5 litres (29.2%) was necessary. Conclusion : Plenty water is wasted during SHS. Reducing the amount of water flowing unused would provide cost saving to the hospital. The use of taps operated with foot pedal would reduce the waste.
  10 4,657 90
Prevalence of refractive error and attitude to spectacle use among drivers of public institutions in Ibadan, Nigeria
CO Bekibele, OI Fawole, AE Bamgboye, LV Adekunle, R Ajayi, AM Baiyeroju
March 2007, 6(1):26-30
DOI:10.4103/1596-3519.55734  PMID:18240488
Background : High rate of motor vehicle accidents have been associated with poor vision. Studies on drivers from elsewhere other than health institutions have found abnormal visual acuities. The aim of this study is todetermine prevalence of refractive errors and the attitude to spectacle wear among drivers of public institutions studied. Methods : A cross sectional population study of all 99 motor vehicle drivers from the College of Medicine, University of Ibadan and University College Hospital (UCH) Ibadan between December 2003 and January 2004. Results :The ninety-nine motor vehicle drivers in the study comprised of 67 (67.7%) from the College of Medicine, and 32 (32.3%) from the UCH. All were males, aged 38 to 60 years, mean 50.1 + (SD= 4.8 years). Proportion of drivers with refractive errors was 16.7% (95% CI, 16.6-16.8) but only 56.3% of these wear glasses while driving (others did not including 3 out 4 who were bilaterally visually impaired without glasses). Relative frequency of RTA among drivers was 16.2%, the risk was marginally higher among drivers with refractive error (OR 1.2, 95% CI: 0.4-3.7). The commonest refractive error was simple hypermetropia present in 15 eyes. Hypermetropia was associated with increasing age of drivers (p<0.05). Majority (97.7%) of the drivers were presbyopic but only 32 (32.3%) were current wearers of spectacles. Conclusion : Refractive errors were present in 16.7% of drivers studied. But 43.8% of these (3 out 4 of whom were bilaterally visually impaired without glasses) do not wear corrective lenses while driving. There is need for periodic visual screening exercise and eye health education on drivers.
  8 5,474 68
Chemical eye injuries: Presentation and management difficulties
FG Adepoju, A Adeboye, IA Adigun
March 2007, 6(1):7-11
DOI:10.4103/1596-3519.55738  PMID:18240484
Background/Purpose : To review the pattern of presentation and management difficulty of patients with ocular chemical burns. Method : Retrospective study of all patients with ocular burns seen over 8-year period (March 1998- April 2006) in the eye clinic as well as the plastic and reconstructive surgery unit of our hospital. Case files were retrieved and relevant information extracted and analyzed. Results : There were a total of 23 patients (n=33 eyes) seen in the period under review consisting of 19 males and 4 females. The age ranged from 6-52 years with mean age of 31.87years. The chemical injuries were accidental in 73.9% of the cases and of these 76.5% were work related. The remaining 26.1% resulting from assault were bilateral and led to blindness in all the patients. Main injurious agents were acid and alkali. Conclusion : Major cause of chemical injury was work related; although blindness and disability occurred more in the cases of assault. Occupational health issues need a revisit, preparedness of health institutions to take adequate care of people with ocular burns is presently poor.
  8 5,516 133
Experiences in management of Pott's paraplegia and paraparesis in medical wards of Usmanu Danfodiyo university teaching hospital, Sokoto, Nigeria
CH Njoku, MA Makusidi, EO Ezunu
March 2007, 6(1):22-25
DOI:10.4103/1596-3519.55735  PMID:18240487
Background : Pott's disease refers to spinal tuberculosis, which commonly leads to a gradual onset of neurological deficit that are difficult to diagnose at the early stage. Method: The study was a combination of retrospective and prospective study. Information was obtained using a predesigned protocol. Diagnosis was based on clinical features and plain spinal x-ray. Anti-tuberculous therapy was instituted in all patients for a minimum of 18 months. Monitoring of neurological status was done weekly. Results: There were 92 patients made up of 71 males (77.2%) and 21 females (22.8%) with a male: female ratios of 3.4:1. 53.3% were paraplegic while 46.7% were paraparetic. The age group 31-40 years was the most affected. 43.5% of the patients were farmers who formed the majority. Back pain, weight loss, paraplegia and paraparesis in that order were the common clinical features. 25% of the patients recovered full use of their lower limbs at the end of the study. Thoracic spine and lumbar spine were equally involved (41.5% respectively) while thoraco-lumbar spine was involved in 15.1% of patients. Cervical spine was only involved in 1.9% of the patients. Conclusion: Effective management of spinal tuberculosis should be a teamwork involving the physician, orthopedic surgeon, neurosurgeon as well as the radiologist. The rural populace needs to be educated to prevent late complications and ensure better prognosis.
  7 4,907 91
Ovarian pregnancy presenting as ovarian tumour: Report of 2 cases
MOA Samaila, AG Adesiyun, LMD Yusufu
March 2007, 6(1):36-38
We present 2 cases of ovarian masses diagnosed as tumours but turned out to be pregnancy. Ovarian pregnancy, a form of ectopic gestation has a distinct pathology though it can be a source of diagnostic difficulty clinically and intraoperatively. A total of 71 ectopic pregnancies were seen in the department from January 2001 to December 2005, of these only two were ovarian ectopics. Both patients were nulliparous and presented with lower abdominal pains, abdominal masses and menstrual irregularity. They both had laparotomy and total right salpingo-oophorectomy. Grossly, the ovaries were enlarged, grey tan and globular. Focal ruptures in the wall of the ovaries showed protruding fetal parts. Microscopy showed chorionic villi within and in continuity with ovarian stroma and corpus luteum. They were both diagnosed ovarian ectopics. A good knowledge and understanding of the gross pathology, combination of imaging studies and high index of suspicion should help in making an intra-operative diagnosis.
  3 2,214 51
Triplet gestation: Clinical outcome of 14 cases
AG Adesiyun, E Eseigbe
March 2007, 6(1):12-16
DOI:10.4103/1596-3519.55737  PMID:18240485
Background / Objective : To determine maternal complications and fetal outcome of triplet gestations. Method : Retrospective study of pregnant women with triplet gestation managed in 10 years. Results : Fourteen women were managed with triplet gestation, of these, (71.4%) were booked for antenatal care and four (28.6%) were unbooked. The mean age of the women was 31.3 years. The age range was between twenty seven years and thirty nine years. The mean gestational age at diagnosis for the booked women was 18.6 weeks. Of the fourteen patients, ten (71.4%) had spontaneous conception, three (21.4%) followed ovulation induction and one (7.2%) resulted from invitro fertilization and embryo transfer. Two (14.3%) patients had cervical cerclage based on their past obstetric history and assessment of the cervix. Six (42.9%) patients were hospitalized and treated for preeclampsia 3 patients, spontaneous abortion 1 patient and cervical incompetence 2 patients. Eleven (78.6%) patients had preterm birth. The mean gestational age at delivery was 33.4 weeks. Of the thirteen deliveries, nine (69.2%) had caesarean section and four (30.8%) delivered per vaginam. A total of thirty nine babies were delivered, thirty four (87.2%) babies survived and five (12.8%) died. Perinatal mortality was 11.9% and the "take home" baby rate was 81%. Conclusion : Antenatal care with initiation of specialized prenatal care and planned delivery in triplet gestation improves fetal outcome.
  2 3,080 64
Cervical cancer in HIV seropositive patients
SA Adewuyi
March 2007, 6(1):41-42
DOI:10.4103/1596-3519.55729  PMID:18240493
  - 2,447 36
Patent ductus arteriosus in adults: Surgical experience in Ivory-Coast
H Yangni-Angate, G Ayegnon, C Meneas, FL Diby, Y Yapobi
March 2007, 6(1):34-35
DOI:10.4103/1596-3519.55732  PMID:18240490
Background : Patent ductus arteriosus surgery is well documented. Hospital Mortality has reduced to almost 0%. Yet, with adults, this surgical cure is likely to be difficult and require some technical skills Method : A retrospective study of surgical procedures and results after surgery of patent ductus arteriosus (PDA) in adults. Results : Since 1978 to 2000 we have reported 16 operated cases. The average age was 22.5 years. There was female predominance with a sex ratio of 2.3/1. All patent ductus arteriosus had been confirmed by two dimensional echocardiography (2D echocardiography) and cardiac catheterization. All hemodynamic types of Nadas classification were observed. Double or triple ligation supported on Teflon felt was the most frequent technique used (69%). This technique gave good results in view of the absence of hospital mortality and only 1 case of recanalisation after a long follow up of all patients from 1 - 7 years (mean 5 years). Conclusion :Double or triple ligation on Teflon felt according to Wright technique is a good technique.
  - 2,820 42
Management of asthma in adults: Current trends and future directions
AK Bello, CH Njoku
March 2007, 6(1):1-6
DOI:10.4103/1596-3519.55739  PMID:18240483
Bronchial asthma has witnessed a significant increase in its prevalence in the past decade. Considerable morbidity and significant mortality has been associated with it and this has been matched by increased scientific research into new methods of therapy to supplement or replace the traditionally known treatment modalities. A search for old and new literature on asthma management in adults necessitated forage in the library for old works and an internet search into relevant websites to download several works on asthma from which those relevant to this article were selected. Evidences supporting current asthma therapies including some non-pharmacological measures of intervention and alternative approaches were highlighted. Some novel interventions that may be useful in the future management of asthma were discussed. Some novel therapeutic agents acting on specific components of the inflammatory pathways in asthma are emerging. The future management of asthma may involve the use of these newer agents in combination with more established therapies. For successful management of asthma, patient's education and involvement are essential.
  - 7,277 108