Iman Journal, published by the Islamic Medical Association of Nigeria, is an international peer-reviewed platform committed to advancing the field of medicine. We offer a unique space where health professionals can share their research and insights, thus contributing significantly to the collective knowledge across various medical disciplines. As a bridge between clinical practice and scientific exploration, IMAN Medical Journal (IMJ) facilitates the dissemination of findings and fosters engaging discussions among peers. Our journal welcomes a diverse array of submissions, including original articles, case reports, review articles, book reviews, historical/faith-based perspectives, editorials, and letters to the editor, covering all aspects of medical, health, ethical, and related research.
Role of immunisation in preventing tetanus - A case report of tetanus in a 19 year old boy
Introduction: The aim of this report is to highlight the importance of immunisation in the prevention of tetanus. Tetanus is an acute neurologic disease caused by Clostridium tetani, leading to release of neurotoxin – Tetanospasmin, which causes muscle spasm. It is a major cause of morbidity and mortality in Nigeria. The high prevalence of tetanus in Nigeria is due to poor access and poor utilisation of routine immunisations as tetanus is a vaccine preventable disease with low morbidity and mortality in developed countries where routine immunisations are taken religiously. Methodology The case presented highlights the management of tetanus in a nineteen year old boy at the Irrua Specialist Teaching Hospital, Irrua, with a ten day history of dirty wound secondary to road traffic accident who presented with trismus and generalized spasms of three and two days duration respectively. He was from a poor socio-economic background and has not received immunisation for tetanus in the past fifteen years and could not ascertain if he was given routine childhood immunisation. Results: He was hospitalised for a month and discharged without sequelae. Immunisation is vital in the prevention of tetanus and it saves a lot of time, money and resources spent in combating tetanus when it arises and should therefore be embraced by all. Conclusion: This case brings to fore the disease burden of tetanus and the need for routine and booster immunisations to prevent tetanus.
Tetanus, trismus, spasm, neurotoxin, 19 year-old
Imperforate hymen with cryptomenorrhae in a 14 year old girl: a case report
Introduction: Imperforate hymen is a rare congenital obstruction of the vagina that is associated with accumulation of uterovaginal secretions often producing hydrometrocolpos. Methodology/Results (Case report): This is a report of miss A. B., a 14 year old premenarchial secondary school student who presented to our unit in July 2010 with three months history of progressive abdominal swelling and six months history of cyclical lower abdominal pain. There was no history of bleeding per vaginum. On examination her general condition was satisfactory and her vital signs were stable. Abdominal examination revealed a 30 weeks size pelvic mass which was tense and non tender. Vaginal examination showed normal external genitalia with a tense, bulging imperforate hymen. After investigations a diagnosis of imperforate hymen with cryptomenorrhea was made. The patient had cruciate incision of the hymen done with gentle evacuation of about 2 litres of altered blood. She had a good post operative recovery and was discharged home five days later. She had regular normal follow up visits. Conclusion: Imperforate hymen with Cryptomenorrhea is a rare surgically correctable condition which in severe untreated forms may lead to infertility and urinary retention.
Imperforate hymen, Crptomenorrhea, Nigerian, Secondary school student
Umar-Sulayman H., Sule I. B., Barde A.S.
A case report of pelvic infection as a major risk factor for ectopic gestation
Introduction: Nigeria has one of the highest maternal mortality rates in the world and ruptured ectopic is a significant cause of morbidity and mortality in pregnant women in their first trimester in Nigeria. This case report is to bring to the fore the importance of pelvic infection as a major cause of ectopic gestation in our environment as well as review other risk factors to help our women recognise and avoid them as well as the dangerous sequelae. Methodology/ Result (Case report): This is a report of a 35 year old nullipara with 2 previous terminations of pregnancy via dilatation and curettage and previous history of pelvic inflammatory disease who presented with 8 weeks history of amenorrhoea and 5 days history of abdominal pain. She was diagnosed with right tubal gestation at 8 weeks for which she had right salpingectomy without sequelae. The loss of a fallopian tube reduced her chances of subsequently becoming pregnant and carrying the pregnancy to term. Conclusion: The case highlights the importance of preventing and avoiding possible causes of pelvic infection including induced abortion to minimise the incidence of ruptured ectopic thus reducing maternal morbidity and mortality and infertility both of which remain high in our society.
Ectopic gestation, Rupture ectopic pregnancy, Pelvic infection, Nigerian nullipara
Awareness of causes of road traffic accident and safety measures among drivers in Sokoto, North Western Nigeria
Introduction: Significant numbers of people are dying and several are being injured on a daily basis as a result of road traffic accident. This is seen more in low socioeconomic communities and should be regarded as public health problem. This study aimed to determine the awareness of causes of road traffic accidents as well as safety measures among drivers in Sokoto State. Methodology: This is a cross-sectional descriptive study; conducted in June 2010 in Sokoto metropolis. Self-administered semistructured questionnaire was used to interview the commercial, public and private drivers to determine their knowledge on the causes and preventive measures of road traffic accident. Results A total of 123 drivers were interviewed, 83(67.5%) of whom were public/private and 40(32.5%) commercial drivers. The gender distribution depicts 102(82.9%) male participants giving a male to female ratio of 4.9:1. There was no commercial female driver in this study. Fourteen (11.4%) of these drivers started driving below the age of 18years. The majority 75 (61.0%) of participants possess tertiary education while 30 (24.4%) had no formal education. Ninety nine (80.5%) drivers have driving license, among whom 66 (66.7%) were reported to have been tested before issuance of the license. Regarding the location of driving, 44(35.8%) drive locally, 20(16.3%) mostly on highway and the remaining 59 (48.0%) are both local and highway drivers. Only 31(25.2%) of the drivers interviewed were aware that there is a sign on the road that indicate prohibition of overtaking. About the use of seat belt, 40(43%) of Private/public drivers and 7(23%) of commercial drivers use seat belt always, while 21 (23%) and 3 (11%) respectively use seat belt only some times. Significant number of the drivers 90 (73.17%) interviewed believed that high rate of vehicular accidents are seen on bad roads, others said it is more frequent on good roads. Nevertheless, 18 (14.6%) of all the drivers interviewed knew that vehicle tyre has an estimated life span or expiry date. Conclusion: Knowledge of road signs and road traffic rules and guidelines among the drivers interviewed is inadequate. These drivers knowledge of causes of road traffic accident and means of prevention is fair. We recommend continuous awareness campaigns and enforcement of road traffic regulations in order to minimize the burden of road traffic crashes
road traffic accident, awareness, safety measures, drivers
Roles of Islamic Medical Organizations in modeling Mini-Med Schools: A periodic analysis of public lectures of the Aminu Kano Teaching Hospital Chapter of the Islamic Medical Association of Nigeria
Introduction: Mini-Med Schools serve as an outreach medical education program of some American medical colleges and universities to their host community. The schools provide medical lectures to willing members of the community in simple, everyday language over a course of few days or weeks. This idea of Mini—Med schools is rare here in Nigeria, as neither the conventional medical schools nor related professional bodies have any such programs. This study thematically analyzes the periodic public lectures of a chapter of a faith-based professional body in modeling and providing Mini-Med school programs to its host community. Methodology: Public lectures organized by the Aminu Kano Teaching Hospital Chapter of the Islamic Medical Association of Nigeria were qualitatively analyzed over a 5-year period (2008-2012). Non- medical lectures too were included and analyzed. Results Half of all the 18 public lectures organized over the period under review followed Mini-Med school syllabus and it was relevant to the host community. Thematic issues identified were: doctor-patient relationship (M1); teamwork and development (M2); health workers investment (M3); death and dying (M4); and community health education (M5). All were provided to address the ‘faith-based’ question regarding health in the community. Conclusion: The need for this and other faith-based organizations to use their public lectures to help the host community understand these identified thematic issues and other related healthcare community programs were identified.
Mini-Med schools, Roles of Islamic Organizations, Outreach medical education, Public lectures, IMAN
Abiola T., Habib ZG., Musa HM., Usman HS., Umar A., Anas I.
The significance of the involvement of all levels of care towards achieving effective healthcare services in Nigeria – experience from students’ vacation course
Introduction: Generally, healthcare services are grouped into three levels: the primary, secondary and tertiary; for convenience and effectiveness. In Nigeria, these tiers of care are coordinated at various levels of government services. Effective healthcare service is achievable if respective governments own up to their responsibilities to make these services functional. This will in turn reduce the burden on tertiary health institutions and thus, allow them function effective as training and research centres in addition to rendering care services. This study reports experiences of healthcare services provided at various levels of care as conducted during students’ vacation course organized by the Muslim Students’ Society of Nigeria held in December 2009 in Sokoto. Methodology: Eight thousand people attended the vacation course; five clinics were established to provide primary care at the various camps during the period of the course. Basic equipment needed for patient consultation and examination were provided for each clinic. The clinics operated 24 hours. One medical doctor, two nurses and a pharmacy technician were available at every shift in each of the clinics. Two general hospitals served as secondary referral centres and one teaching hospital as tertiary referral centre. Results: Total numbers of participants were eight thousand (8,000); 1,976 (24.7%) patients presented with various ailments and were all attended to and treated accordingly. Out of this number, only 36 (1.8%) patients were referred to secondary centres and 4(0.2%) were further referred to tertiary centre for further management. Conclusion: This study showed that effective healthcare services with a proper referral system could be achieved if all levels of healthcare delivery work optimally. Government and policy makers should pay special attention to this in order to reduce morbidity and mortality due to unwholesome or partial care.
Healthcare, Tiers of government, Referrals
Freedom of information act and concerns over medical confidentiality among healthcare providers in Nigeria
Background: Freedom of Information Act tends to be misused especially in healthcare settings if limits are not well understood. It has long been established that patients have lost control over how their health information is obtained and used, and that responsibility for medical confidentiality is not clearly understood by healthcare providers. Therefore, assurances about medical confidentiality are essential to the efficient provision of safe, effective and quality healthcare to patients and the public especially, with the passage of the Freedom of Information (FOI) Act in May, 2011. Hence, this cross-sectional study was carried out to determine possible concerns over medical confidentially in the era of FOI among healthcare providers in two public tertiary hospitals in Nigeria. Methodology: A 23-item questionnaire was designed for data collection. The study deployed stratified random sampling method in the recruitment of participants. Results: Nearly three-quarter (223, 74.3%) of the participants were females in a sample with a Mean age of 40±9 years. Most (228, 76.8%) participants indicated that they know the reasons for keeping the patients’ health records which include, education (66, 22.0%), continuity of patients’ care (51, 17.0%) and research purposes (50, 16.7%). The vast majority of participants (275, 92.3%) have heard about medical confidentiality, mostly (196, 65.3%) from the hospitals, and nearly two-third (191, 64.3%) of them have not heard about Freedom of Information Act. A few (11, 3.7%) knew it was the responsibility of all health workers to maintain medical confidentiality in any hospital setting. Notable factors that influenced the perceptions of participants on medical confidentiality in the era of FOI include profession, age, sex and years of experience. About two-third (184, 62.0%) of participants shared concerns that healthcare consumers may lose trust in the healthcare providers; more than half (155, 52.2%) were concerned that patients may not want to reveal sensitive information for the fear of the unknown, and nearly a half of the participants (142, 47.8%) were apprehensive that FOI Act will constitute threats to medical confidentiality. Conclusion: Most healthcare professionals as well as other health workers in Nigeria hold much concern about the emerging FOI Act which is largely misconstrued as having the potentials to pose threats to medical confidentiality. Their concerns were largely due to inadequate information about FOI Act and poor understanding of the tenets of medical confidentiality. This trend has the tendency to pose threats to the management of health information especially when the society may likely assume that FOI Act means free world and free speech in the public. These identified challenges require training and retraining on the need and obligations to protect medical confidentiality especially, in this era of FOI.
Freedom of information, Health information management, Healthcare services in Nigeria, Medical confidentiality, Patients’ health records
Adeleke IT., Ezike SO., Ogundele OA., Ibraheem SO.
Head and neck paragangliomas: Update on laryngeal paraganglioma
Introduction Head and Neck paragangliomas are mostly benign, slow growing tumours originating from sympathetic and parasympathetic ganglia, most frequently from carotid bodies, jugular, tympanic, vagal paraganglia and rarely from the larynx. This aimed to highlight the peculiarities of Laryngeal paragangliomas as per presentation, diagnosis and treatment. Method Review of literature and published peer reviewed works in Medline and HINARI databases for articles in English language from 1970 to 2015 was done. Results The diagnosis is primarily made on light microscopy and sometimes special staining might be required. It should be confirmed by immunohistochemical studies. The main stay of treatment is surgery. Primary radion theraphy with adjuvant chemotheraphy has been reported with variable success in other head and neck paragangliomas but has not been reported on the laryngeal paragangliomas with success. Conclusion While surgery is still the goal standard in treating head and neck paragangliomas with very limited data on the role of radiotherapy. It is pertinent to consider the role and future of radiotherapy in the treatment of paraganglioma of the larynx.
Paraganglioma, Larynx, Management, Surgery; Radiotherapy
Muhammad SI., Odutoye TA., Salisu AD., Nwaorgu OGB
The impact of pharmacovigilance on the Nigerian healthcare system
Introduction: Pharmacovigilance (PV) is the science and activities relating to the detection, assessment, understanding and prevention of adverse drug reaction or any other drug- related problems such as drug abuse and misuse, medication errors, lack of efficacy and counterfeit or substandard medicines. PV also encompasses surveillance of side effects after short-term and long-term use of medicines. The experiences from the thalidomide tragedy which occurred from 1956 to 1962 resulting in the births of about 10,000 severely malformed infants , have influenced the World Health Organization (WHO) to initiate an international programme called pharmacovigilance in the year 1968 for the sole purpose of monitoring the safety of medicines use by the general population. Since year 2004, several African countries have been actively involved in PV including Nigeria, Ghana, South Africa, Kenya, Morrocco, Botswana, Cameroon, Mozambique, Sierra Leone,Tanzania, Togo, Uganda, Zambia and Zimbabwe. Methodology/Results: This paper highlights the pharmacovigilance activities in Nigeria The activities include training and capacity building for healthcare providers, cohort event monitoring study, incorporating PV in public health programmes, public enlightenment, assessment of the National pharmacovigilance system, development of data tools for capturing of Adverse Events Following Immunizations (AEFIs), quality assurance through PV, research, safety of herbal medicines and the recent launch of the National PV policy Conclusion: These activities have no doubt contributed to safety awareness and generated evidence-based safety data for the benefit of the health systems. Consequently, the risks that are associated with the use of medicines are significantly reduced.
Pharmacovigilance, adverse drug reactions, Nigerian PV policy
Ibrahim Oreagba, Kazeem Oshikoya, Olayinka Ogunleye
Psychotrauma often come in the context of catastrophic disasters like war, terrorism and natural tragedy. Hence, psychotrauma is a mind wound that affect the overall wellbeing of individual or significant others in such individual’s life. Nigeria, like other parts of the world continues to have an increase in occurrence of catastrophes and subsequently, psychotraumas. Psychotraumas of recent occurrence in Nigeria are the militancy, kidnapping and Ebola outbreak in the south, and insurgency and terrorism in the north. Nigerian Studies on psychotraumas identified high prevalence of post traumatic stress disorder (41-42%)3,6 compared to the almost non-existence of PTSD in the non-exposed Nigerians. The prevalence in exposed Nigerians is higher than in those exposed outside Africa (1-36%).4,8 These are pointers to the huge burden of the psychological distresses experienced by exposed Nigerians. This burden is not likely to decrease soon because mental health professionals are not only in short supply, but there is also no psychotrauma center/agency to take up this challenge. The IMAN Medical Journal has a few suggestions on the way forward that might address these.
Benign histocytosis: case report and challenges with its management in a Nigerian Tertiary Hospital
Background: Sinus histocytosis is a rare benign histocytic proliferative disorder affecting several body tissues. Managing histocytosis is associated with a lot of challenges that could result in a delay in initiating therapy. This contributes to poor outcome taking into cognizance the usual problem of late presentation in developing countries. Methods: We report a case of a 10 year old female child with Sinus histocytosis and outlined the challenges in her management and concomitant intervention we offered. Results: Findings revealed that there were limitations faced with diagnosing and managing sinus histocytosis. This is a common finding with rare conditions especially in low resource countries. Conclusion: To improve the quality of care for this group of patients, a multidisciplinary approach to its management is recommended in low resource countries.
Sinus histocytosis, lymphadenopathy. Rare, Biopsy
Bello OA., Oladele DP., Mohammed SS., Ibrahim RM., Adeyemi MF., Adedoyin OT.
Introduction: We present the second reported case of a paraganglioma of the larynx treated with radiotherapy. Methodology: We present two cases and a literature review of paraganglioma of the larynx. Case number one: A 68-year-old woman, with hoarseness,
Introduction: We present the second reported case of a paraganglioma of the larynx treated with radiotherapy. Methodology: We present two cases and a literature review of paraganglioma of the larynx. Case number one: A 68-year-old woman, with hoarseness, dyspnoea and supraglottic mass. Biopsy showed laryngeal paraganglioma, excised by transhyoid approach with laryngofissure. Histopathology confirmed tumour completely excised with close margins (less than 5mm). 45 Gy of adjuvant radiotherapy was added. She is doing well on ninth year clinic follow up. Cases number two: A 77-year-old woman with change in voice, progressive dyspnoea and supraglottic mass. Biopsy revealed a Laryngeal Paraganglioma. CT scan and carotid angiogram are in keeping with the histological diagnosis. She was offered primary radiotherapy giving her age and additional co-morbidities. Now on her seventh year clinic follow up. Larynx stable and no concerns clinically. Conclusion: There is very limited data on the role of radiotherapy. This is the second reported case of primary radiotherapy in the English literature. It is pertinent to appreciate the role and future of radiotherapy in the treatment of paraganglioma of the larynx.
Free Medical Services as a means of improving Health care delivery: The role of a Charity Organization
Introduction: Health is a dire need of any community and its absence will lead to the decline in the community’s productivity. Many people cannot afford to pay for the cost of Health care services in developing countries. Due to such constrains, charity organizations complement government efforts by providing free health services in such communities. Islamic Medical Association of Nigeria (IMAN) is one of such organizations. Methodology: This is a report of the experience of an IMAN Chapter in providing free medical services to a community in Sokoto-State over a period of 41/2 years (December 2010 to May 2015). It also provides analysis of the role of IMAN Sokoto-State Chapter in improving Health care delivery. Results: Nine thousand five hundred and thirty (9530) people benefitted from the free medical services provided by IMAN Sokoto-State. Age ranges of beneficiaries are from 1month to 70years, with mean age group of 15-59years. Female constituted 72.3% and male 27.7%. Malaria was found to be the most prevalent disease followed by upper respiratory tract infections. Other common diseases treated include systemic hypertension, skin rashes, diarrheal diseases and measles. In addition, women with normal pregnancy were also monitored. Conclusion: It was therefore concluded that charity organizations can play important roles in improving health care delivery through provision of free medical services especially in low-income communities. We recommend that health care workers, government and individuals should embrace the spirit of free Medical services and partner with charity organizations in order to meet the challenges of health care delivery in the 21st century.
Free Medical Services, Healthcare delivery, Charity organization
Ismail S., Tahir Y., Ahmad MH., 4angaza AM.
Substance use disorder and crime among prison population in north-central Nigeria
Background: The association between substance use and criminality can be discerned through the acknowledgement of the increase of what are commonly called drug defined offences. These include those having to do with violation of drug laws and the illicit nature of drug industry, or drug related offences, and those offences committed while under the influence of drug and/or alcohol. Aim: To determine the prevalence of substance use disorder and assess the relationship between offence committed and presence of substance use disorder among awaiting trial inmates. Methodology: A cross-sectional descriptive study was carried out among 366 male inmates awaiting trial in Jos maximum security prison, Plateau state. They were screened with self-administered General Health Questionnaire item 28 (GHQ-28) and interviewed with the Composite International Diagnostic Interview (CIDI). Result: Prevalence of substance use disorder was 32.8% (120) among subjects. Statistical significant association was found between type of offence committed and the use of substance (P <0.01). Conclusion: Substance use disorder was statistically associated with the type of offence committed, with the crime of murder more related to substance use disorder than the other offences.
Substance use disorder, Crime, Prison, Awaiting trial, Prevalence
Sexual intercourse during menstruation and the risk of Sexually Transmitted Infections
Introduction: Allah, exalted in might commands Muslims to abstain from sexual intercourse during menstruation describing it as filth. In spite of this divine command, people still engage in sex during menstruation while some even encourage it. The study aims at determining if there is an association between sexually transmitted infections and sexual intercourse during menstruation as well as use of condom by those who practice it. Methodology: A total of 330 female undergraduates from Auchi polytechnic were selected using systematic random sampling and recruited for the study. Pre-tested questionnaires were administered to the students and the results were entered into epi-info statistical software and analysed. Results: Of the 330 respondents, 243 (73.6%) were sexually active while the remaining 87 (26.4%) were virgins. The Muslim respondents were 60 (18.2%). Thirty six (10.9%) of the respondents were married and 180 (54.5%) respondents have been treated for sexually transmitted infection in the past. Of the 243 respondents that were sexually active, 66 (27.2%) respondents have had sex during their menses out of which 60 (90.9%) had sexually transmitted infection which was significant (P < 0.001). Most of them were married (P < 0.001). Though more than half (63.6%) of those who had sex during menstruation used barrier contraceptive, the difference was not significant (p > 0.1). Conclusion: There was an association between having sex during menstruation and occurrence of sexually transmitted infection (p < 0.001) and the difference between those who used barrier contraceptives and those who did not was not significant (p > 0.1).
Characteristics of Patients with Obstetric Fistula in a Fistula Centre, Zamfara State, Northern Nigeria
Introduction: Obstetric fistula is a highly stigmatized medico-social problem affecting mainly women of reproductive age group. It is commonly due to prolonged obstructed labour leading to necrosis of the urinary bladder and/ or rectum and subsequently to uncontrolled leakage of urine and or/ stool, disability and occasionally death . About two million women live with obstetrics fistula worldwide with 400,000 to 800,000 in Nigeria. We conducted this study to describe the socio-demographic characteristics of patients with obstetric fistula, and determine the causes and types of obstetric fistula seen in Zamfara State, northern Nigeria Methodology: This was a cross-sectional study. A total of 210 cases were enrolled and administered semistructured questionnaire to obtained data on socio-demographic characteristics and obstetric history. We performed speculum examination screening procedure to ascertain the type of fistula. We analyzed data using SPSS software and Microsoft office Excel 2007. Results: The median age at marriage and occurrence of fistula were 14years and 17years (IQR; 15.5-20.3) respectively. Of 210 cases, 18 (8.6%) had at least primary education and 178 (84.8%) were rural dwellers. Only 8 (3.8%) had antenatal care services (ANC), 144 (68.6%) laboured for more than 24hours and 145 (69.1%) delivered at home. The main reasons for home delivery were husband/family did not allow hospital delivery (44.8%), not customary (22.7%), no transport (21.4%) and care expensive (7.6%). 96 cases (66.2%) were assisted by Traditional birth attendants, 36 (24.8%) by health workers at home and 13 (9%) by relatives. Vesico-vaginal fistula cases were 203 (96.6%), recto-vaginal fistula 2 (1%) and combination of both fistulae 5 (2.4%). Conclusion: Obstetric fistula is common among teenage women with poor educational status and barrier to health services. Zamfara state government should support girl child education and ensure access to quality health services. Behavioural change/modification and increase awareness of people on the dangers of obstetric fistula are essential.
Obstetric fistula, home delivery, prolonged labour, Zamfara state, Nigeria
Abdullahi MB., Nguku P., Idris SH., Idris S., Isah A., Sabitu K.
The efficacy of sulphadoxine-pyrimethamine in the prevention of peripheral malarial parasitaemia among antenatal attendees at the Ahmadu Bello University Teaching Hospital, Shika-Zaria
Objective: To determine the efficacy of Sulphadoxine-Pyrimethamine (IPT) in the prevention of peripheral malarial parasitaemia among antenatal attendees at the Ahmadu Bello University Teaching Hospital, Shika-Zaria. Methodology: It was a Cohort study in which women in their index pregnancy, not more than Para 2 between 16 and 24 weeks of pregnancy were recruited. A total of one hundred and eleven participants who fulfilled the inclusion criteria were followed up till 36 weeks of gestation. All participants took Sulphadoxine Pyrimethamine (3 tablets) at booking after assessment and they all had the second dose after four to six weeks. Results: At booking 16 (14.4%) of the participants had Malaria Parasites; this figure reduced significantly to 1 (3.6%) at 36 weeks. There was also marked improvement in the packed cell volume. Conclusion: This study has shown that the use of two treatment doses of Sulphadoxine-Pyrimethamine for the prevention of malaria is associated with a significantly lower prevalence of peripheral malarial parasitaemia, clinical malaria in pregnancy, maternal anaemia, and a high mean packed cell volume.
Malaria in antenatal attendees, Prevention, Sulphadoxine-pyrimethamine, ABUTH
Umar Sulayman H., Shittu SO., Sadauki HM.
Impact of age and gender on the CD4+ t-lymphocyte count among apparently healthy under-5 children as seen in Sokoto, Nigeria
Background: CD4+ T-lymphocyte is a subset of T-lymphocyte that plays a pivotal role in immune response. It is a major target of viruses like HIV. As a result, its monitoring forms an important part of the management of HIV infected patients. Objectives: To determine the effect(s) of the age and gender on the CD4+ T-lymphocyte count and percentage among apparently healthy under-5 Nigerian children. Methodology: It was a prospective cross-sectional study conducted among apparently healthy well-nourished HIVnegative under-5 children aged 6 months to 59 months from January 1st to June 30th 2011. The age, gender and weight of these children were documented. The CD4+ T-lymphocyte counts and percentages were determined using Partec cytoflow machine. Data was analyzed using SPSS statistical package version 20.0. A p-value ≤ 0.05 was regarded as statistically significant. Results: One-hundred children were studied over the period. The mean age (±SD) was 19.1+9.7 months. There were 63 males and 37 females. The mean CD4+ T-lymphocyte count was highest among those aged 6.0 – 11.9 months (2675.7±464.5cells/μL) and lowest among 48 –59.9months of age (1770.0±70.7cells/μL) showing a negative correlation (r= - 0.52, p=0.0001). There was no statistically significant difference in the mean CD4+ T-lymphocyte count of the females (2144±553cells/μL) and the males (2120±483cells/μL) (t= 0.22, p= 0.83). There were no significant differences in the mean CD4+ T-cell percent across the age group (F=0.28,p=0.89) and between the gender (t=0.03,p=0.98). Conclusion: The age has depletive effect on the CD4+ T-lymphocyte count; however, gender seems to have no significant effect on the CD4+ T-lymphocyte count among under-5 children.
Impact, Age, Gender, Under-5, CD4+ T-Lymphocyte
Yusuf T., Jiya NM., Ahmed H., Baba J., Raji H.
Contemporary management of epistaxis: a useful guide for primary care physicians
Introduction: Epistaxis (nasal bleeding) is a common condition. It may be very severe and life-threatening but in most cases is trivial and easily controlled by first aid management, and in severe cases, primary care physicians are consulted before seeing a specialist (Otorhinolaryngologist). The initial management instituted determines the overall outcome. This aims to review the literature and current knowledge for evidences supporting up to date management of epistaxis at primary level of care. Methodology: Review of current literature and published peer reviewed works in Medline, PubMed, Embase, and Cochrane Database of systematic reviews for articles in English language. Results: It was found that tremendous advancement have been recorded in the care of patients presenting with Epistaxis. While little has changed in the first aid measures with more patient-friendly conservative measures, advanced technology in imaging and optics have rendered endoscopic treatment safer, cost effective and almost routine over the traditional open approaches. Conclusion: Recent advances in the management of epistaxis have made it possible to restore normalcy from various degrees of epistaxis.
Epistaxis; Nosebleed; primary care, Management
Counterfeit and fake medicines and their threat to delivery of quality health care to our society: a way forward
Background: Counterfeit and fake drugs serve as a mean of generating illegal money to the culprits at the expense of the patient, health care providers and the entire healthcare system. The lucrative nature of this dirty business poses danger of the malicious so-called drugs being in the circulation, which consequently hamper the delivery of quality health care services to the populace. However, governments at various levels should not accede to the menace of counterfeit drugs by putting many strategies in place in order to subdue their hazardous impact on the community. This article aimed to review the prevalence of counterfeit and fake medicines in Nigeria, as well as various methods employed by the perpetrators in counterfeiting and faking medicines. It also highlights strategies to be adapted by the relevant government agencies in order to bring the peril to its minimum bearable level. Methodology: An intensive study of the literatures and oral interviews on counterfeit and fake medicines in Nigeria was done. This was achieved through accessing public libraries and data from the internet. Additionally, reports from Zamfara State task force on counterfeit and unwholesome products was studied and reflected in this article. Results: The threats depicted by continuing existence of counterfeit and fake medicines are real. The consequence include: Morbidity and mortality as a result of treatment failure, decreases confidence on healthcare providers, among other shortcomings. Nonetheless, the task forces counter faking efforts brought down the circulation of counterfeit and fake medicines to a lower level in recent time, although more could be done in order to curtail the menace. Conclusion: Although governments are making a lot of efforts to limit the spread of counterfeit and fake medicines in the country, the change of tactics by the perpetrators among other factors, make the efforts insufficient for curtailing the menace, hence more need to be done.
Counterfeit and fake drugs, Quality healthcare delivery, Healthcare system, Nigeria
Psychotrauma and literacy of the adolescent internally displaced people (IDPS) in Nigeria: implications for redefining content area literacy
Introduction/Methodology: By its very nature, illiteracy could lead to insecurity that could be further worsened by psychotrauma anywhere in the world.. Family, social, economic, political and other aspects of human security will tend to remain at stake in Nigeria if literacy is not adequately enhanced among adolescents in Nigeria, most especially among the Internally Displaced People (IDPs). Results: The review first identified adolescent IDPs literacy major needs as inability to attend school and have access to educational materials and scholarship. It also discussed how the literacy needs could be acquired, enhanced and utilized as an instrument to overcome the mind wounds which affect their overall wellbeing. This entailed literacy processes that motivate and engage the adolescent IDPs, including strategic teaching and learning in terms of focused reading and writing structured to inculcate leadership qualities. Conclusion: It was concluded that the framework that guided the study be employed in overcoming the three major literacy problems (educational, emotional, and health-related) that IDPs face at their respective camps. It was however recommended that content area teachers must have an extensive knowledge base and develop strategies to facilitate the reintegration of the adolescent IDPs back into their community for personal growth and national development.
Literacy needs, Adolescent literacy, Content area literacy, Adolescent IDPs, Psychotrauma
Sexuality is defined as one’s sexual orientation, sexual activity and capacity for sexual feeling. Homosexuality and heterosexuality are examples of sexuality. Sexual right is a controversial term that has become pervasive in the 21st century description of human sexuality. In the light of such pervasiveness, minorities sexual discussions predominates. Sexual minorities are people whose sexual desires or identities challenge the normative heterosexual structures of society. They include Lesbians, Gay men, Bisexual people, Transgender people and transvestites (LGBT), as well as sex workers. This calls for the need to recognise the intersection of ethnicity, gender, age and culture in influencing the fluidity of sexual identities.
Teamwork in Islam: A model for the Health Professions
The first Muslim team on earth is that of Adam and Hauwau (Eve). Such team populated the earth giving rise to several communities and teams. Examples of historical teams noted in the glorious Quran were that of Moses and Aaron, the story of Dhul Qarnayn, the father-son relationship of Ibrahim and Ismail which ended up building the Ka`bah. The achievements of these historical teams emphasized the uniqueness of all believers to honor and fulfill the duty of ‘holding on to the rope of Allah together.
Poor teamwork, recurrent strikes and the need for volunteer work by health workers in Nigeria
Public hospitals are equipped and health workers are employed to serve patients. Without patients, there will be no need for hospitals and health workers. Recent events in Nigeria however have made the patient to receive less than optimal services from public hospitals and health workers. Team work in public hospitals is currently at an all time low. The health workers are embroiled in a supremacy battle with each other. All the professional groups pledge their allegiance to their various unions which are projecting the image of being superior or at par with each other. This also affects service. Ward rounds are no longer what they used to be as they are conducted by separate professional groups at different times. The laboratories are locked down by infighting among the various health workers. The list goes on. As there is no unity of purpose, the quality of health care has dramatically fallen.
Students’ perceptions of the causes and influence of drug abuse on their learning behaviour in public secondary schools, North-Centre Nigeria
Background: Drug abuse among youths in Nigeria has become a national concern because it has serious impacts on their academic performances and future leadership potentials. Most of the studies in Nigeria youths related to drugs of abuse were among undergraduates and rarely in secondary schools. The study contributed to fill this gap by assessing students’ perception of the causes and influence of drug abuse on their learning behaviour. Methodology: The study adopted a cross-sectional survey design to collect information from 6 public secondary schools in Bida, Niger-State, Nigeria. Data were collected through respondents filling the researchers self-developed questionnaire entitled “Students’ Perceived Causes and Influence of Substance Abuse” (SPCISA). Results: This study found that majority of the respondents defined drug abuse as the use of drugs without prescription (87.6%) and/or the unusual use of prescribed medications (59.9%). Some of them identified perceived causes of using drug abuse to include poor parental influence (25.1%), peer pressure (25.1%) and the ready availability of drugs of abuse (32.7%). They also note some of the consequences as reducing their understanding of class lessons (69.9%), disobeying schools’ rules and regulations (25.1%), missing classes frequently (14.9%) and behaving irrationally (32.5%). Conclusion: This study concluded that respondents had better understanding of what drug abuse is, some understanding of the perceived causes and subsequent consequences. It was suggested that there is need for more addiction prevention education in addition to policy makers taking appropriate measure to reduce availability of drugs of abuse.
Drug abuse; Students’ perception of causes; Public secondary school; Bida.
Screen prevalence of drugs of abuse in patients’ urine – a retrospective study
Background: Screening for drugs of abuse in the urine of patients presenting for drug related clinical problems has become a necessity in hospital management programs. Such ability to carry out a simple rapid test with good reliability and of low financial implication has made the request for this procedure routine. The purpose of the present study was to present the screen prevalence of drug of abuse in urine of patients seeking treatment at a tertiary mono-specialist hospital in north-west Nigeria. Methodology: A retrospective analysis of results of drug urine testing for the years 2012 to 2015 were carried out based on the laboratory register of Federal Neuropsychiatric Hospital, Barnawa- Kaduna. The drugs screened for were benzodiazepine, tetrahydrocannabinoid (i.e. THC – the cannabis substrate), opiate, cocaine, ketamine, barbiturate, ecstasy and phencyclidine. Results: The mean age of the 574 patients’ results obtained was 28.51 (SD=10.30) years, majority were males (92.7%) and close to half were Muslims. Overall screen prevalence was 57.3% with majority (38.0%) screening positive for one drug of abuse. The screen prevalence of individual drug of abuse found in descending order was: benzodiazepines (36.4%), THC (27.4%), opiate (10.6%), ketamine (2.1%), cocaine (1.6%), barbiturate (1.6%) and phencyclidine (1.2%). Patients’ specific parameters with more positive results were being less than 30years in age and belonging to the male gender. Conclusion: The present study showed that the drug urine positive test screen prevalence was high with majority of those affected being less than 30 years of age and belonging to the male gender. This calls for further study to show the relevance of routine drug urine testing based on the type of treatment being sought.
Substance use; Psychiatric Hospital; Urine tests
Musa MA., Abiola T., Sheikh TL., Ebiti WN.
Development of a rapid LATE-PCR-based dipstick for the detection of Schistosomiasis haematobium in human urine samples
Background: Schistosomiasis caused by Schistosoma haematobium has become a serious public health problem in tropical and subtropical countries. It is associated with considerable morbidity and mortality in developing and underdeveloped countries. Diagnosis of Schistosoma haematobium infection in both adult and children patients is a clinically important challenge. In the work presented here, we report on an alternative diagnostic method based on presence of the S. haematobium -specific Dra 1, 121 bp repeat fragment in human urine. This study aims to develop Linear-After-The-Exponential- Polymerase Chain Reaction (LATE-PCR) dipstick for the detection of Schistosoma haematobium in urine samples. Methodology: In an effort to developed or improved the current PCR techniques LATE-PCR Lateral flow was developed, in order to allow specie-specific amplification of Schistosoma haematobium in urine samples. Results: Evaluation study on 50 urine samples showed 100% sensitivity and specificity suggesting the primers and designed probe is specific. Sensitivity of LATE-PCR currently was said to be higher when compared to parasitological methods (Microscopy). LATE-PCR dipstick is highly sensitive since 30 positive urine samples with very low eggs burden were also seen to be positive by the test. The analytical sensitivity was performed and detection limit determine for Schistosoma haematobium. The detection limit of the PCR reaction on Schistosoma haematobium was found to be 1fg/ μl using 10 fold serial dilution. Conclusion: LATE-PCR dipstick developed in this study provides a valuable alternative for the detection of Schistosoma haematobium infection in the study area to speed up diagnosis in addition to the conventional method currently used.
Polymerase chain reaction, Lateral flow assay, Schistosoma haematobium, Urine samples
Mohammed K., Ikeh EI., Omar J., Ismail S., Ismail A., Abdullah MR.
A three-year review of reproductive hormonal profiles of infertile women attending gynaecological clinics at UITH, Ilorin
Background: Reproductive hormonal profile is an invaluable tool in evaluation of infertile women. It aids the diagnosis of biochemical causes of infertility and monitoring of patients on treatment for infertility of various causes. This study highlights the various patterns of hormonal profile results obtained from female patients being evaluated for infertility and seeks correlations between these patterns, age at presentation and anovulation. Methodology: This was a retrospective cross-sectional study of 555 women who carried out hormonal profile as part of their evaluations for infertility, over a 3-year period between 1st of January 2013 and 31st of December 2015. Results: Of the 555 women whose results were reviewed, 188 (33.9%) had primary infertility and 367 (66.1%) had secondary infertility. The mean age of the participants was 33.7±5.3 years. Two hundred and twenty one (38.1%) were anovulatory, 229 (41.3%) had adequate ovulatory cycles and 105 (18.9%) had ovulatory cycles with luteal phase insufficiency. The pattern of hormonal abnormalities included 15 (2.7%) with hypogonadotrophic hypogonadism, 29 (5.2%) with normogonadotrophic normogonadism, 57 (10.3%) with hypergonadotrophic hypogonadism, 78 (14.1%) with hypergonadotrophic normogonadism. Three hundred and seventy six (67.7%) had normogonadotrophic normogonadism with 80 (14.4%) being hyperprolactinemic and 16 (2.9%) had hyperandrogenism. Conclusion: Secondary infertility, hypergonadotrophism, anovulation and hyperprolactinemia are relatively common findings among our patients.
Reproductive, Hormonal patterns, Infertile, Women
Oladosu WO., Adelekan A., Yusuff JO., Aliyu GG., Abdulazeez IM., Biliaminu SA., Akande AA., Okesina AB.
The challenges of the internally displaced persons in the face of disasters: the role of the health care workers
Introduction/Methodology: disasters unleash untold hardships to people and these bring untold challenges to victims often internally or externally displaced. The purpose of this paper is to briefly review literature on the challenges of the IDPs vulnerable groups in the face of disasters and the role of health care workers in disaster was highlighted. Results: Several empirical studies described some of these challenges which include: injuries, mal nutrition, exacerbation of communicable disease and chronic illness, and predisposition to mental disorder, injuries loss of lives and property. Conclusion: It was concluded that health care workers should render the necessary care, support and education to the IDPs before, during and in the aftermath of disasters through education on tolerance, peaceful resolution of conflict and misunderstanding leading to displacement.
internally displaced person, disasters, health care workers, conflict resolution, injuries
Dahiru A., Suleiman MA., Ogwu TN., Dashe V., Ubangari AA.
Substance abuse prevention: role of the pharmacists
Background/Methodology: Substance abuse is a major societal problem requiring urgent attention by the government and healthcare providers. The objective of this paper was to prepare and provide resources to pharmacists and other healthcare professionals, enabling them to carry out a critical analysis on drug abuse prevention, acquiring knowledge in several areas that effectively contribute to their personal development in this professional field. Results: Pharmacists play a crucial role in the reduction and prevention of substance abuse, since they are able to advise patient about illicit drugs, psychotropic medicines and alcohol abuse. Conclusion: There is an urgent need to encourage pharmacists and other healthcare providers to specialise in this discipline and join the campaign towards reducing the prevalence of the drug addiction scourge in the country.
Substance abuse; drug abuse prevention; pharmacists’ role