Context Tobacco smoking is the second major cause of death and the fourth most common risk factor for many diseases worldwide. Health care workers should in addition to promoting smoking prevention and cessation strategies, also serve as role models and advocates in the fight against smoking. Objectives. This study aims to assess the prevalence of and attitude towards tobacco smoking among primary health care workers in Kumbotso Local Government Area (LGA). Methodology With the aid of a semi-structured questionnaire, a cross sectional survey was carried out among 240 primary health care workers selected by simple random sampling from a list of all the health workers in the LGA. Results esults An overall ever smoked prevalence of 39.6% was recorded. Most (87.5%) of the health workers were indifferent to smoking and more male health workers did smoke. Conclusion There was a high smoking prevalence rate observed especially among the male health workers which suggest that they should be targeted with smoking prevention and cessation activities so that they can serve as role models to the general public in the global fight to reduce smoking and its consequences worldwide. Key words: Smoking, Prevalence, Health Workers, MDGs, Smoking Cessation, Prevention.
Context Inadequate bed spaces have continued to be a challenge to the in-patient management of the severely mentally ill in developing countries. This has to be considered in management of the mentally ill. Aims and objective This study aims to determine the socio-demographic characteristics, the prevalent psychiatric diagnoses and the age and gender distributions of the diagnosis in patients admitted in the psychiatric ward of Ebonyi state university teaching hospital Abakaliki. Methods A retrospective review was done on case notes of all patients admitted into the psychiatric ward of a state university teaching hospital was done. Results One hundred and nine (76.2%) of patients were young adults in the 20-44 years age group. Forty-six (32.2%) of them presented within the first week of onset of the illness and only 84(58.7%) of them did not have a comorbid medical condition at the time of presentation. Prayer house operators were widely consulted before presentation in the hospital. Schizophrenia and related disorders were the commonest and has equal gender distribution. Depression and organic mental disorders were more common among the females while there is no significant difference in the age group distribution of the diagnosis. Conclusion There is need to study the gender issues influencing development of mental disorders in the developing countries. Key Words: Socio-demographic, clinical profile, psychiatry, admission
Context: As the glaring inequity in maternal death ratios becomes more apparent between countries in the Northern and Southern Hemispheres, health experts try to achieve a reduction in their own nations' pregnancy-related deaths. Perhaps no research holds as much potential to make a difference in the developing world as research conducted on the gynaecological indications of misoprostol. The media tend to portray that misoprostol is widely available among private sector pharmaceutical distributors in Nigeria, yet evidence is lacking to that effect. Objective: To examine the availability of misoprostol in two major Nigerian cities, in order to explore the supply side of misoprostol six months after the drug's registration for management of postpartum hemorrhage in Nigeria. Methods: This was a cross sectional descriptive study involving proprietors, pharmacists or vendors of pharmaceutical and patent medicine outlets in two Nigerian cosmopolitan cities, Lagos and Abuja. They were interviewed using a semi-structured questionnaire in May and June 2006 in Abuja and Lagos respectively. Result: Misoprostol was not well-known or widely available in either city. Out of nearly six hundred shops surveyed, only 18 (4%) reported misoprostol cost information, indicating they had stocked the drug in the past, and only 15 of these (3%) currently had misoprostol on their shelves. When pharmacists and drug sellers who stocked misoprostol were asked what it was recommended for, treatment or prevention of postpartum hemorrhage was not mentioned. Conclusion: Concerted efforts to disseminate scientific information and educate all levels of health care providers should accompany new policy and protocol changes to achieve maximum national impact. Key words: Availability, pharmacists, postpartum haemorrhage, misoprostol, Nigeria.
Background The changes in lipid profile have long been associated with cancer because lipids play key role in maintenance of cell integrity. Aims . The study evaluated alterations in plasma lipid profile in patients with advanced squamous cervical cancer. Materials And Method This hospital-based study included 30 cervical cancer patients, with 30 controls. Plasma lipids including: Total cholesterol (TC), Low Density Lipoprotein cholesterol (LDL ), High Density Lipoprotein cholesterol C (HDL ) and triglycerides (TAG) were analyzed by spectrophotometric kits. C Student's t-test was performed to compare mean values of the parameters. Results A significant decrease in plasma total cholesterol, HDLC and triglycerides was observed in cervical cancer patients as compared to the controls. The LDL lipid fraction was however higher in the cases than in the C controls. Also there was direct relationship between reduced lipid levels and cervical cancer progression, this was statistically significant. Conclusion The lower levels of plasma cholesterol and other lipid constituents in patients might be due to low levels of antioxidants which is a common finding among cancer patients, however this would have to be confirmed by evaluating the anti-oxidant levels of these patients. There is also the need to conduct a study with a much larger sample size. The findings strongly warrant an in-depth study of alterations in plasma lipid profile in cervical cancer patients as a means of monitoring and evaluating such patients. Key Words: Lipid profile, cancer, cervix, spectophotometry, Benin City.
Context Biopsies provide histological diagnosis and as such may guide subsequent management of breast lumps. Regular audit of such biopsies are necessary to document epidemiological pattern of the histological diagnosis within a population. Objective To review the histological diagnoses of breast biopsies in two referral centres in the Niger Delta region of Nigeria. Methodology This is a descriptive analysis of retrospective data obtained from the Central Hospital Warri and the University of Benin Teaching Hospital, Benin City, all in the Niger-Delta region of Nigeria between 2005 and 2010. Results Data on 367 biopsies were analysed. Patients with benign diagnoses aged in range between 14 and 48 years and those with malignant conditions between 20 and 85 years. Fibroadenoma was the commonest histological diagnosis (36.0%) with a mean age at diagnosis of 22.9 5.5 years. Just one case of fibroadenoma was recorded beyond 36 years. years. Malignancies were seen in 29.4% of biopsies with Invasive ductal carcinoma being the dominant histological type, 89.8%. The mean age at diagnosis of breast cancer was 46.0 12.1 years. Incidence of malignant findings ranged from less than 1 in 10 biopsies below 30 years, 1 in 2 biopsies at the 31-35 years age range to nearly unit in those 56 years and above. Conclusion Fibroadenoma is the commonest breast biopsy finding in the referral centres in the Niger Delta. Breast cancer occurs commonly among premenopausal women.Key words: Breast, Biopsy, Fibroadenoma, Invasive ductal carcinoma.
Context: Fluid collection in the pleural space following pleural and pulmonary disease and trauma remain a major problem in developing countries. The judicious use of antibiotics and tube thoracostomy remains a management modality. Objective: To determine the pattern, indications and complications associated with tube thoracostomy in a tertiary health centre. Methods: Descriptive analysis of retrospective data on all patients who underwent tube thoracostomy at the Ebonyi State University Teaching Hospital, Abakaliki betweem 2000 and 2005. Results: There was a total of eigty five cases during the study period with a male to female ratio of 2:1. Twenty patients (23.5%) were below 10 years of age. Infective cases accounted for 52 (61.2%) of the cases that had thoracostomy. Fifty-two patients had tube drainage for twelve days or less. Complications were recorded in 22 (25.9%) patients, and dislodgement of the tube accounted for about half of the cases. There were eight failures (9.4%) and four deaths (4.7%). However, no death was related to the procedure. Conclusion: Closed tube thoracostomy is a simple and efficacious procedure for the treatment of pleural space collections such as empyema. The safety of the procedure can be improved upon by adequate training of residents in the insertion procedure, while proper selection of cases will reduce failure rate and unnecessary morbidity. Early resort to thoracoscopic op open surgery when closed tube thoracostomy has failed will improve the success rate in the overall management of pleural fluid collections.Key words: Tube thoracostomy, indications, outcome and complications.
Background: Vaginal discharge is a major complaint among women attending gynaecological clinics. While some seek treatment services for the symptom, others just tolerate it despite the associated long term disabilities. Aims and Objective: This study assessed the perception of vaginal discharge and care seeking behavior among women in Ebonyi State. Materials and Methods: Yhis is a descriptive cross sectional study of women visiting obstetric and gynaecological clinic of Ebonyi State University Teaching Hospital, Abakaliki, between 1st April and 31st August 2010.The data was analyzed using EPI-info 3.3.2 and results presented in tabular forms as frequencies and percentages. Result: The age of the 163 participants ranged between 18 and 52 years with a mean of 29.6 + 6.8 years. Majority of participants 68(41.7%) had tertiary education while eight (4.9%) had no formal education. Seventy nine (48.5%) had experienced abnormal vaginal discharge. Over 64% of them attributed vaginal discharge to dirty toilet seats and 13 (16.5 %) to sexual intercourse. Associated symptom in most cases was vulval itching (74.7%) while coital bleeding was the least (3.8%). Majority felt sad 35(44.3%) about having the symptom, eight (10.1%) thought it normal. Only Fifty- four (68.4%) of the participants who experienced vaginal discharge consulted a doctor, Six (7.6%) ignored the symptoms. Most of the patients, 36 (45. 6%), believed infertility is a possible consequence. EMJ 2010; 9(2): 101-105 Conclusion: The relative high educational attainment of the participants and their paradoxical poor knowledge about the causes of vaginal discharge underscore the need to incorporate reproductive health education into secondary schools curriculum in Nigeria. Keywords: Vaginal discharge, antenatal, perception, health
Context Several oral diseases and conditions are associated with tooth loss. Objective: The aim of this study was to determine the prevalence of oral health problems seen at the University of Nigeria Teaching Hospital (UNTH) in one year with the view to highlighting causes of tooth loss in this environment. Methods This study utilised data from the Record book of the Oral Diagnosis unit of the Dental clinic in UNTH, Enugu. Records of patients seen from January to December 2008 with complete information were included in the study. Data obtained were patient's age, gender, provisional diagnosis, teeth lost and reasons for the loss. The data were computer- analysed; Chi square statistics was used to test for association and differences. Values were considered significant when p-value was equal to or less than 0.05. Results A total of 1663 entries were made; 686 (41.3%) were males and 977 (58.7%) females. On the whole, 110 (6.6%) had traumatic injuries, 70 (4.2%) had malocclusion while 583 (35.1%) had periodontal disease. Periodontal disease, pulpitis and dental caries were not only the most common oral health problems encountered but also the major causes of tooth loss. Conclusion The major causes of tooth loss in our study were periodontal disease and dental caries and its sequelae. Since these two diseases are preventable, existing measures to check them should be more aggressively pursued. Also, recruitment of manpower to manage the different conditions would be very timely for greater retention of teeth despite an aging society.Key words: Oral health; Tooth loss; UNTH; Enugu
Context Cervical cancer despite being largely preventable, is still the leading cause of gynaecological cancer related death among females in developing countries. Identification of risk factors will help to reduce the morbidity and mortality associated with cervical cancer. Methodology This was a prospective study involving four hundred and eighty five women consecutively selected among the women attending gynaecological clinic at the University of Benin Teaching Hospital, Benin- City. Results The prevalence of cervical intraepithelial lesion in this study was 20.6%. A total of 216 (44.9%) of the women were aware of cervical cancer and only 32.4% were aware of cervical cancer screening while only 13.5% ever had at least a Pap smear testing. Premalignant cervical lesion was significantly higher among women 30 years and older and lower socioeconomic class with a significant linear trend in each of these groups. High parity especially vaginal delivery, cigarette smoking and having had a previous Pap testing were each associated with increased risk of abnormal Pap smear. First marriage before 20 years of age and lifetime partners in excess of four were associated with increased risk of abnormal Pap smear. Conclusion the study demonstrated that high parity and women over 30 years of age (especially those who married earlier than 20 years of age) had a higher yield of cervical premalignant lesions.Key Words: Risk Factors, Cervical intraepithelial lesions.
Context Exposure of the dentine of a tooth ultimately leads to its hypersensitivity which often presents as a painful response to applied stimulus. It is a common complaint among patients and is associated with multiple etiologic factors. To date, the prevalence of this condition and the response by patients to different non – surgical modalities of treatment in the study area have not been exhaustively investigated. Objective This study aims to determine the prevalence of tooth hypersensitivity and its response to non-surgical treatment modalities at the Periodontics Clinic of the University of Benin Teaching Hospital (UBTH), Benin City. Method This was a prospective study of males and females aged 16 to 75 years who were attending the University of Benin Teaching Hospital Periodontics clinic at the time of this study ( 2003 to 2004 ). Tooth hypersensitivity was recorded as present or absent based on patients' complaints, information from the questionnaire administered and corroborated by clinical findings. All clinical oral examinations were carried out at the Periodontics clinic. Result Of the 330 patients seen, 70 (21.2%) had tooth hypersensitivity. Females and patients aged 46-55 years were most affected while upper left molars were mainly implicated. Many of the patients investigated responded to oral hygiene instructions and dentine desensitisation. Conclusion Tooth hypersensitivity which results from exposed dentine affected a reasonable percentage of the population and caused discomfort, pain and sometimes tooth loss. Many of such cases (41.5%) responded to non-surgical treatment.Keywords: Tooth, Dentine, Hypersensitivity, Non-surgical.
Context: Extremes of umbilical cords have been associated with antepartum and intrapartum complications. Few studies which have investigated both risk factors and outcomes associated with these conditions contain conflicting reports. Aims and Objectives: This study aims at documenting the length of the umbilical cord in babies born in Ebonyi State University Teaching Hospital (EBSUTH), as well as any association between umbilical cord length and fetal sex, number of fetuses, presenting part, cord accidents and certain intrapartum complications. Methodology: Prospective study of umbilical cords length of deliveries conducted in the department of Obstetrics and Gynaecology of EBSUTH, Abakaliki, from 1st October, 2008 over a six months period was done. Analyses were done using EPI info. Results: A total of 588 consecutive deliveries met the inclusion criteria. The mean cord length was 57.87 +12.6 cm and ranged between 22cm and 124cm.The mean cord length for male babies were significantly more than the females (58.16cm vs 57.59 cm). Significant difference also existed in cord lengths for multiple deliveries and singletons. The mean umbilical cord length associated with loops was significantly higher than that of the study population 63.58cm vs 57.28cm. Shoulder dystocia, hand prolapse in a transverse lying fetus, abruptio placentae and prolonged second stage of labour had shorter cords while fetal distress, cord prolapse and mecunium stained liquor had longer cords when compared with the mean umbilical cord length of the study population. Conclusion: Umbilical cord length was positively associated with number of fetuses and sex of the babies, but not with FETAL presentations. Extremes of cord length could predispose to certain intrapartum complications.Keywords: Umbilical cord, Length, intrapartum complications
Context: The complications associated with the removal of impacted third molars should not be underestimated. The surgery entails incision, stripping of periosteum, bone and tooth removal, and suturing. Swelling is almost universal after this procedure which, affect patients daily life activities. Objectives: To assess the use of tape measuring technique in the clinical evaluation of facial swelling following lower third molar surgery. Patients and Methods: Clinical evaluation of facial swelling after the surgical removal of impacted mandibular third molars using a tape measuring technique was carried out among 50 patients of both genders at the oral and maxillofacial surgery clinic of the University of Nigeria Teaching Hospital and Ntasiobi Specialist Hospital both in Enugu. Postoperative facial swelling was evaluated at 24 hours, 72 hours and five days. The measurements obtained were recorded and converted to relative values, which provided numerical data for comparative analysis Results: The result of our study shows that swelling usually reaches its maximum within 48 – 72 hours after surgery and begins to subside from the day after. We equally observed that there was an increase in the duration of surgical procedure in different molar positions with corresponding increase in amount of facial swelling. Conclusion: Patients are hampered by the level of physical discomfort within 2 – 3 days after surgery, which include perception of their appearance and oral function. Treatment for minimizing this postoperative sequalae should commence immediately after surgery to achieve desired and maximum effect. The tape measuring method is simple, non-invasive, cost effective and time-saving method, which provides numerical data for determination of facial contour changes. Keywords: Third molar surgery, Swelling, Clinical evaluation, Tape measuring Technique
Aim: One of the commonest alternatives to Pap's smear is direct visualization of the cervix using Acetic acid. The investigators set out to evaluate cervical cancer screening using Visual inspection with Acetic acid in a Faith based organizational setting. Methods: The study was carried out at the premises of the headquarters of the Redeemed Christian Church of God, Edo Province 1. Women were mobilized and had the VIA test in the church vestry done by trained nurses. The subjects with positive VIA results were referred to the University of Benin Teaching Hospital for further assessment, that is, Pap's smear and Colposcopy as indicated. Results: A total of 367 women had the VIA test of which 31 were positive, a detection rate of 8.4%. Seventeen (17) women came for further evaluation. Of the 17 patients that had Pap's smear 3patients had low grade squamous intra-epithelial lesions, this was confirmed at Colposcopy. The positive predictive value of VIA was 25%. However 14 women refused follow up making the non compliance rate 45% a Conclusion: This study has shown the indispensible role of the faith based organizations in screening programmes and the need for them to be incorporated into such programmes, particularly in areas where there is no structured screening programme. It also highlighted issues such as ignorance as evident by a non compliance rate of 45% and low level of man-power.Key Words: Faith based setting, Cervical screening, VIA.
Context The incidence of breast cancer in Nigerian women has been rising since the mid 1970s and it is now the commonest malignancy in Nigerian females. The need for diagnostic approaches that take into cognisance the demographic and socio-economic uniqueness that fuels the high prevalence of this disease in our environment cannot be overemphasised. Objective This is a prospective study to determine the cost effectiveness of the introduction of Fine Needle Aspiration Cytology (FNAC) on the cost of care of women with palpable breast masses in the University of Benin Teaching Hospital (UBTH). Method One hundred and three (103) consecutive FNAC of palpable breast masses were performed on 98 patients referred from the surgical outpatient clinic between January 2005 and March 2006. Comparison was made with subsequent histological diagnoses in order to ascertain the diagnostic accuracy of the procedure and later, determine savings made by the introduction of the procedure compared to hitherto only available option of open surgical biopsy. Results The impact of the introduction of FNAC on the cost of care of patients with breast lumps was assessed and it is established that a reduction of between N7,000 and N15,000 in expenses incurred by these patients was achieved and also a direct impact on patient compliance and reduction in number of surgical cases was noted. Conclussion The introduction of FNAC was found to be useful in the reduction of cost of management of all categories of patients with breast lumps.Key words: Fine needle, breast cancer, cytology, cost.
Context Health care institutions are service-oriented establishments that provide observational, diagnostic, research, therapeutic and rehabilitative services. These facilities are involved in the generation of large amount of solid wastes on a per capita basis. Accidental and hospital acquired infections may be consequent upon ignorance, and careless handling of medical wastes. Objective This research work was conducted to determine the awareness and practices associated with the handling of medical wastes at a University Teaching Hospital. Method This descriptive cross sectional study was conducted at Ebonyi State University Teaching Hospital among health workers, multistage sampling technique and the data were collected with structured, self-administered questionnaires. The quantitative Data obtained from the study was collated and analysed using Statistical Package for Social Sciences (SPSS) version 10 software. Results Four hundred and eighty six (486) health workers were recruited into the study, out of whom 36% were females and 62.3% of the participants were married. Polythene bags (39.9%) were the commonest means of collecting hospital wastes. Waste segregation is not practiced at all in the hospital. Refuse truck (71.8%) was the most frequent means of transporting hospital waste while open van was the least used (28.2%). Conclusion Standard practices in handling medical wastes were not adhered to, hence health education towards safe practices is recommended.Keywords: Awareness, Practices, Medical Wastes, Teaching Hospital, Nigeria.
Context. HIV positive individuals continue to engage in sexual activities, especially during the early asymptomatic phase or when stabilised with anti-retroviral therapy. The potential risks associated with disclosure may lead them not to disclose status to 'significant others', especially sexual partners. Objective To assess the level of sexual activity, and the pattern and outcome of HIV positive status disclosure to a 'significant other'. Methodology This is a cross sectional descriptive study of all the patients seen from October 2008 to January 2010 in two HIV clinics in Abakaliki Nigeria. Result There were 63.3% sexually active people among the cohort. Of this, 37.4% had engaged in a recent sex act; 81.3% used condom during their last sex act; 94.6% disclosed their status to a 'significant other'; 20.5% suffered one form of discrimination or stigmatization following disclosure. Conclusion There is a high level of sexual activity with a corresponding high level of HIV status disclosure to a 'significant other' amongst this group. However, a significant proportion (20.5%) still suffered discrimination/ stigmatization following disclosure.Key Words: Persons Living With HIV/AIDS; Sexual activity; Sero-status disclosure; Significant Other; Abakaliki Southeast Nigeria.
