Authors:CC Ilechukwu, UE Ebenebe, CF Ubajaka, AL Ilika, OF Emelumadu, SA Nwabueze Abstract: Background: Diabetes mellitus is a widespread and devastating disease. Diabetes is associated with several mechanisms of tissue damage, one of which is oxidative stress. Oxidative stress and oxidative damage to tissues are common end points to chronic diseases such as atherosclerosis, diabetes and cardiovascular diseases. Oxidative stress plays an important role in the pathogenesis of and the complications of diabetes. Hyperglycaemia results in overproduction of oxygen free radicals which contributes to the progression of diabetes. Objective: This review aims at determining the role of oxidative stress in diabetes and diabetic complications. Method: Relevant literatures were reviewed from medical journals, library search, Pub Med search, Google search and other internet search engines (Google Scholar, Hinarii, Ask.com) from 1987 to 2011. Results: Several studies demonstrated that oxidative stress plays a role in the progression of diabetes and also in the development and progression of diabetic complications. Conclusion: Increasing evidence has implicated a role for oxidative stress in progression of diabetes and diabetes associated complications. Antioxidant therapy has been effective in management of diabetes and diabetic complications. In addition, physical exercise and insulin therapy can also improve diabetes through the reduction of oxidative stress.Keywords: Oxidative stress, free radicals, antioxidants, diabetes, diabetic complications. PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:FO Edegbe, CO Okani, GO Ogun, EE Akang Abstract: Background: There is a significant lack of studies of germ cell neoplasms in the paediatric age group from Nigeria and other parts of Africa. Objectives: The aim of this study was to determine the histological pattern of paediatric germ cell tumours in Ibadan, Nigeria. Method: This is a retrospective study of cases of germ cell neoplasms histologically diagnosed at the Department of Pathology, University College Hospital (UCH), Ibadan between January 1988 and December 2007 among children aged 0-14 years. Haematoxylin and eosin stained slides were reviewed and where necessary, the paraffin blocks were recut and stained. The World Health Organization Histological Classification of paediatric germ cell tumours of 2004 was used in this study. Result: Paediatric germ cell tumours comprised 0.05% of all surgical pathology specimens in the study period. There were 10 (25.6%) male and 29 (73.4%) female patients, giving a male to female gender ratio of 1:2.9. Extragonadal germ cell tumours constituted 25 (64.1%) and gonadal germ cell tumours 14 (35.9%) cases. Benign neoplasms accounted for 26 (66.7%) and malignant neoplasms accounted for 13 (33.3%) cases. Thirty-one (79.5%) of the 39 cases were teratomas, 7 (17.9%) were yolk sac tumours and one (2.6%) was a mixed germ cell tumour. The most common sites were the ovary (33.3%), sacrococcygeal region (20.5%) and neck (10.3%). There was a bimodal age distribution, with a first peak in infancy and a second peak between >5-10 years of age. Conclusion: In view of the paucity of studies on germ cell tumours from Nigeria and other parts of Africa, further studies of this unique group of neoplasms are required in order to validate the findings of this study.Keywords: Germ cell tumours, Children, Pathology, Nigeria. PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:CB Duru, KA Uwakwe, KC Diwe, CC Nnebue, S Onah, HN Chineke, C Abejega Abstract: Background: Human Immunodeficiency Syndrome and tuberculosis are among the leading causes of death from infectious diseases worldwide. The resurgence of tuberculosis in children is partly attributed to the coexisting burden of human immunodeficiency virus infection, which is most pronounced in sub Saharan Africa. Aim: To determine the prevalence and pattern of HIV/TB co-infection among HIV positive children attending clinics at Imo State University Teaching Hospital. Method: This is a retrospective review of HIV/AIDS children attending HIV clinics at Imo State University Teaching Hospital, Orlu, Imo State, Nigeria from January, 2011- December, 2012. Results: Of the total of 128 HIV infected children reviewed during the 24 months period, 16(12.5%) were coinfected with tuberculosis, (95% CI, 10.7% - 14.3%). Among these 16 patients, TB co-infection was diagnosed before commencement of ART in 93.7% of them. Majority of the TB cases (87.5%) presented with pulmonary TB amongst whom only 25.0% were sputum positive. The factors found to affect TB development significantly were stage of HIV disease (p=0.000) and CD4 count level (P=0.021) of patients. The factor with the highest influence on TB development was the clinical stage of HIV disease (Odds ratio =6.013) and that of least influence was sex of patient (Odds ratio= 0.8319). Conclusion: The study revealed a moderately high TB/HIV co-infection rate. Low CD4 count level below 200cell/ml and late clinical stages of HIV disease contribute significantly to the development of TB disease.Key Words: HIV/AIDS, tuberculosis, co-infection, children. PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:HA Efegbere, AE Anyabolu, AN Onyeyili, EK Efegbere, N Sani-Gwarzo, A Omoniyi, RC Okonkwo, OP Eze, MU Oguwuike, EH Enemuo, PO Adogu, AL Ilika, AO Igwegbe, IC Oyeka Abstract: Background: Determinants for non-compliance to antituberculosis treatment range from a poor correlation between patient and programme needs and priorities among other socio-economic factors. Objectives: This is to assess determinants of treatment outcome of public private mix tuberculosis control programme in South-Eastern Nigeria. Methods: A retrospective cohort study design using Multivariate Logistic Regression to analyze secondary data set (2007-2010) of patients to assess determinants of TBDirectly Observed Treatment Short course Treatment outcomes in public and private facilities in Anambra State. Results: A total of 2,018 patients (1,899 patients in public health facilities and 119 in private health facilities) were reviewed. The mean ages in public and private facilities were 34.0±4.2 years and 32±3.7 years. Males were 60.0% (1100 patients) and 75%(90 patients) at public and private health facilities respectively. Cure rates of 37.6%(714 patients) and 48.7%(61patients);Defaulter rates of 28.2%(532 patients) and 7.6%(9 patients); Interruption rates of 3.9%(74 patients) and 0%(0 patients); Transfer-out rates of 3.2%(61 patients) and 1.7% (2 patients);Failure rates of 1.9%(36 patients) and 0.8%(1 patient);Death rates of 4.1%(78 patients) and 0.8%(1 patient); and treatment completion rates of 19.7%(375 patients) and 6.7%(8 patients) were found at public and private health facilities respectively. Conclusion: Determinants that affected treatment outcome for public facilities were year, HIV status of patients, category of treatment, sex and age of patients. The determinant for private facilities was only year. Future research should focus on identifying factors that influence health seeking behaviour to accessing care in private facilities.Key words: Tuberculosis, Determinants, Treatments Outcome, Public-Private Mix. PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:AY Isah, JA Adaji, GO Akaba, OP Oluwole Abstract: Background: Papinicolaou smear has been established as a cost effective screening method for Carcinoma of the cervix and had been used with celebrated successes in developed societies. Its utilization has remained abysmally low in Africa with attendant alarming rate of overt advanced cancer among her female population. Recent government public outreach programs abound and there is need to evaluate the effectiveness of these campaigns on the outcome of smear results with a view of future adjustment in outreach strategy. Objectives: To review the results of Pap smears conducted in University of Abuja Teaching Hospital with a view of documenting the prevalence of positive smears among the study population. Materials and Method: A three year retrospective study of Pap smears that were carried out at the University of Abuja Teaching Hospital between January 1, 2010 and December 31, 2012. The records of the patients were retrieved from medical record Department and analysed for age of the patient, parity, educational status, marital status, findings on vaginal examination, indication for pap smear and Pap smear results. The results were presented and discussed using simple percentages. Results: One thousand two hundred and seventy four (1274) women had cervical smears during the study period. Ninety eight percent of patients were having their cervical screening for the first time at the mean age of 39.13±9.7 years. Positive Pap smear result was obtained in 39.5% of symptomatic and 24.4% of asymptomatic patients while Negative smears were recorded in 63.8% of the patients. Human Papilloma Virus (HPV) changes occurred in 5.7%, while atypical cells of undetermined significance (ASCUS) were observed in 4.9% of the patients. Low grade squamous intraepithelial lesions (LSIL) were the commonest cervical smear abnormality observed in 9.6% of the patients. Conclusion: The mean age at first screening remain high with corresponding high rate of abnormal smear in both symptomatic and asymptomatic patients. The provider initiated counseling and testing is encouraged for early identification and treatment of precancerous lesions of Carcinoma of Cervix. Development and strict adherence of a National guideline for free routine screening of all women of reproductive life may increase the uptake.Key words: Cervical cancer, Screening, Pap smear, Utilization. PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:C Okeudo, BU Ezem, EC Ojiyi, FC Anolue, EI Dike Abstract: Background: Anaemia is the most commonly encountered haematological abnormality in human immunodeficiency virus (HIV) positive patients with estimates climbing as high as 95% depending on clinical settings. The twin effects of HIV infection and anaemia in pregnancy is associated with adverse maternal and perinatal outcomes. Objective: To determine the prevalence of anaemia among HIV positive pregnant women at booking at Orlu, South-East Nigeria. Methods: A retrospective analysis of the case records of women who were screened for Human Immunedeficiency Virus and anaemia at the Imo State University Teaching Hospital from 1st March 2008 to 28th February 2010 was done. Data on age, parity, educational status, marital status, haemoglobin concentration and retroviral status were collected and analyzed using SPSS version 13. Results: Nine hundred and twenty one pregnant women were screened at booking within the study period. The age range of the women was 8-39years with a mean age of 28.22 ± 5.04years. One hundred and six (11.5%) of the women tested and were confirmed positive to HIV 1 & 2 antibodies. Anaemia was significantly higher among HIV positive pregnant women than in HIV negative pregnant women (75.5% vs 57.9%; P=0.001). Seventy seven point three percent (75/97) of women ≤ 20 years were anaemic. This was shown to be significant (P=0. 000). Three hundred and thirty three (69.2%) of the women that had only secondary education were significantly (P=0.000} more anaemic than those that had postsecondary education. Conclusion: There was a high prevalence of anaemia among HIV positive pregnant women at booking at the Imo State University Teaching Hospital (IMSUTH, Orlu. Anaemia was also more significant in younger age (≤20years} and lesser educated women (only secondary .school}Key Words: Anaemia, HIV, Pregnancy, Booking, Orlu PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:CB Duru, NO Eke, CO Ifeadike, KC Diwe, KA Uwakwe, BO Nwosu, HN Chineke Abstract: Background: Antenatal care is an evidence based intervention that improves maternal and perinatal outcome. Assessment and re-assessment of its utilization by rural and urban women in Nigeria is necessary for planning healthcare programmes and interventions. Aim: This study aims to assess urban – rural differences in antenatal care services utilization among women in South-East Nigeria and factors that influence such. Methodology: This is a cross-sectional study carried out among women of reproductive age in Anambra State, South-East Nigeria. Participants were selected using multistage sampling technique. Data was collected using pre-tested, semi-structured questionnaires which were interviewer-administered. Data obtained was analyzed using SPSS version 17. Tests of significance were done using Chi square test and student T test at 95% confidence intervals. Results: Six hundred women were included in the study; 300 respectively, from urban and rural settings. The mean age of respondents was 33.9+2.7 years. The average month at booking was higher in the rural areas (5.2 months) when compared to the urban (4.4) months, with more respondents in the urban areas booking earlier (P=0.000). More respondents in the urban, 140 (50.8%), attended ANC up to 4 times when compared to their rural counterparts, 102(37.0%) (p= 0.000). Women in the urban areas were more likely to have deliveries supervised by skilled birth attendants (p= 0.000). The estimated cost of antenatal care was higher in the urban areas than the rural (p= 0.000). Satisfaction received from antenatal and delivery services was also higher in the urban settings (p= 0.000). Conclusion: Rural-urban differences exist in the utilization of antenatal care services, with a higher proportion of urban women utilizing these services. Increased health education of women, especially in the rural areas, is advocated.Key Words: Antenatal utilization, Rural, Urban, Women, Nigeria. PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
Authors:AO Eguvbe, N Akpede, NE Arua Abstract: Background: Breast cancer is the most commonly diagnosed cancer among women worldwide and the most common among African women. The WHO, recent global cancer statistics indicate a rising global incidence of breast cancer in populations of the developing countries that previously enjoyed a low incidence of the disease. Early detection through mammogram, clinical breast examination (CBE), and breast self examination (BSE) is critical to reducing breast cancer related morbidity and mortality. Objectives: To assess the knowledge, awareness, perception and behavior of female healthcare workers in Oshimili South LGA of Delta State towards breast cancer and its screening. Methods: A cross-sectional descriptive study done from January to March 2014. Multistage sampling technique was used in the selection of the LGA and study participants. Data was collected using a semi-structured questionnaire and were analyzed using SPSS version 17. Results: A total of 424 female healthcare workers were interviewed. The mean age was 35.4 years and ranged from 21 to 58 years. A total of 406 respondents (97.1%) were aware of breast cancer; 340(81.3%) practice breast self examination (BSE); 117(41.9%) knew about breast mammography. The commonest source of information about breast cancer was from fellow healthcare workers (45.3%), followed by school (16.5%), and newspaper (14.8%). Conclusion: The study shows a high level of awareness of breast cancer and BSE but a low level of awareness of breast mammography. The level of awareness of breast cancer, the practice of BSE and awareness of breast mammography were all found to increase with increase in age of respondents. The married respondents were more aware of breast cancer and also of breast mammography. Higher educational level was not found to increase awareness of breast cancer, practice of BSE and knowledge of breast mammography.Key words: Breast cancer, knowledge, screening PubDate: 2014-10-31 Issue No:Vol. 5, No. 1 (2014)
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