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Record No. 13526 Record ID 013526 Publication type Journal Article Title Incidence of Dog Bite Injuries and Clinical Rabies in a Tertiary Health Care Institution: A 10-Year Retrospective Study Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Abubakar, S. A.; Bakari, A. G. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 109-111, tab. Language English Descriptor Dogs; Bites and Stings; Urban Population Abstract Background: It is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre. Materials and Methods: Case records of patients managed at the accident and emergency unit of Ahmadu Bello University Teaching Hospital, Zaria, between June 2000 and May 2010 with diagnosis of dog bite and rabies were retrieved. Relevant clinical data were extracted using a structured questionnaire designed for the study. Results: Eighty-one persons out of 24,683 consultations in the accident and emergency unit presented with dog bite injuries with two clinical cases of human rabies. Mean age of victims of dog bite injuries was 21.1 ± 14.3 years and the majority (55.6) were children. Males were more affected than females with a male:female ratio of 4.8:1, lower limb/buttock injuries were significantly higher in children than adults, but the adults sustained significantly more severe (type III) injury. The majority of dog bite injuries were washed with soap and irrigated with water or saline and 87.7of the victim of dog bite received postexposure anti-rabies vaccine. Conclusion: Hospital incidence of dog bite injuries was low, but the use of postexposure prophylaxis was high.

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Record No. 13525 Record ID 013525 Publication type Journal Article Title Age at Menarche among School Girls in Sokoto, Northern Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Tunau, K. A.; Adamu, A. N.; Hassan, M. A.; Ahmed, Y.; Ekele, B. A. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 96-102 Language English Descriptor Menarche; Rural Population; Anthropometry; Urban Population; Rural Population Descriptor-Geographic Nigeria-Sokoto; Abstract Background/Objectives: Menarche, the first menstrual period, is influenced by many factors including socio-economic status and rural or urban dwelling. The aims of the study were to compare the age at menarche between rural and urban girls and evaluate the anthropometric indices at menarche. Materials and Methods: A cross-sectional study of rural secondary school girls and urban school girls. A structured questionnaire was used to obtain information on their age at menarche and other relevant data. Their weights and heights were measured using computerized scales and calibrated walls. Results: Two hundred and twenty eight (228) rural girls and four hundred and eighty (480) urban girls that had attained menarche within a year were studied. Mean age at menarche for all the girls was 15.26 years. Mean menarcheal age for the rural and urban girls were 15.32 years and 15.20 years, respectively. Mean weight and height were 47.6 kg and 156.76 cm, respectively for the rural girls and 48.12 kg and 156.8 cm, respectively for the urban girls. There was no significance difference in age of menarche among the groups (P 0.05). Conclusion: The mean age at menarche for the school girls is 15.26 years. There was no difference in menarcheal age between the rural and urban school girls. Further longitudinal studies to compare rural school girls and urban school girls in private schools are required

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Record No. 13524 Record ID 013524 Publication type Journal Article Title Gender Differences in the Variables of Exercise Treadmill Test in Type 2 Diabetes Mellitus Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Adekunle, Ajayi E.; Akintomide, Anthony O. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 91-95, tab. Language English Descriptor Breast Neoplasms; Diabetes Mellitus, Type 2; Exercise Test Descriptor-Geographic Nigeria Abstract Background: Exercise capacity, like some other variables of exercise stress test, is a strong predictor of cardiovascular and overall mortality. Many confounding factors, including gender, have been found to affect exercise capacity. This study evaluated whether exercise capacity differs in age-matched type 2 diabetic Nigerian men and their women counterparts and the hemodynamic variables of exercise treadmill test that correlate with exercise capacity in them. Materials and Methods: A total of 61 type 2 diabetics (male = 34; female = 27) aged 30 to 60 years who were recruited through the Medical Out-patient Department of OAUTHC, Ile Ife, Nigeria, underwent symptom-limited maximal treadmill exercise using Bruce protocol. Result: Patients had comparable clinical and demographic patterns. There was no gender difference in the chronotropic response to exercise. Males had faster heart rate recovery (HRR) than females. Though both sexes had similar resting systolic blood pressure (SBP), males had significantly higher peak SBP than females (216.2 ± 23.7 mmHg vs 203.3 ± 21.7 mmHg; P = 0.03). Exercise capacity was significantly higher in males (7.5 ± 2.0 METs) than females (6.4 ± 1.5 METs); P = 0.01. Significant correlates of exercise capacity in both sexes were fasting plasma glucose, resting diastolic blood pressure, Duke Treadmill Score, and HRR. Majority of the patients were in moderate DUKE risk subgroup and there was no statistically significant difference between males and females in this regard. Conclusion: Gender difference occurs in the exercise capacity of diabetic patients and the factors associated with this disparity may be related to gender differences in resting heart rate and HRR, both reflecting a withdrawal of vagal tone.

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Record No. 13523 Record ID 013523 Publication type Journal Article Title Left Ventricular Structure and Function in Black Normotensive Type 2 Diabetes Mellitus Patients Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Aigbe, Igben F.; Kolo, Philip M.; Omotoso, Ayodele B. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 84-90 Language English Descriptor Cardiovascular Diseases; Ventricular Function, Left; Diabetes Mellitus, Type 2 Descriptor-Geographic Nigeria Abstract Background: Relationship between type 2 DM and cardiovascular disease (CVD) is well known, with CVD being the most common cause of mortality in diabetics. Significant myocardial injury before overt CVD in DM can be identified early using echocardiography. This study therefore aimed at evaluating left ventricular structure and function of patients with type 2 DM. Materials and Methods: One hundred and fifty adult type 2 DM patients were recruited with 150 age- and sex-matched controls. Patients and subjects with systemic hypertension, pregnancy, sickle cell disease and structural heart disease were excluded from the study. Participants were evaluated clinically; had anthropometric parameters and electrocardiogram taken. Echocardiograms were obtained according to the American Society of Echocardiography (ASE) recommendations. Results: Mean age of the patients (55.4±11.6 years) was similar to that of the control (54.2±9.6 years) (P=0.348) and the duration of DM was 4.53 years. Left ventricular (LV) systolic function was normal in both groups but was higher in patients than controls (ejection fraction=70.3±10.7and 64.4 ± 9.4, P =0.001 respectively). The prevalence of LV diastolic dysfunction (LVDD) was 72in the patients compared with 6in controls (P=0.001). Patients' age, body weight, duration of DM, LV mass index and left atrial dimension were positive correlates of LVDD while patients' age, weight and left atrial dimension were independent predictors of LVDD. Conclusion: There is high prevalence of alterations in LV structure and function in normotensive type 2 DM; and there is a need for early intervention to prevent overt LV dysfunction.

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Record No. 13522 Record ID 013522 Publication type Journal Article Title Trichiasis Surgical Coverage in Three Local Government Areas of Sokoto state, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Nasiru Muhammad Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 81-83, tab. Language English Descriptor Trichiasis-surgery; Delivery of Health Care National Health Programs Descriptor-Geographic Nigeria-Sokoto; Abstract Background: Community-based lid surgery for trachomatous trichiasis (TT) is provided in 8 local government areas (LGAs) of Sokoto state since 2003 as part of a trachoma control programme. This study aims to assess the impact of community-based lid surgery on the magnitude of TT in 3 LGAs of Sokoto state. Materials and Methods: A population-based survey was conducted in persons aged 15 years and above. A stratified multistage cluster sampling with probability proportional to size was used. Trachoma was assessed using the WHO simplified grading system. Results: Despite high (13) refusals, 72of the minimum sample size was examined. The prevalence of blindness ranged from 1.3to 2.5in the LGAs while the prevalence of TT in persons aged 15 years and above was 2in the Silame, 2.7in the Wamakko and 5.6in the Kware LGAs, respectively. The prevalence of TT in females 15 years and above was 1.1in the Silame, 4in the Wamakko and 6.3in the Kware LGAs, respectively. The trichiasis surgical coverage is 9.5in the Kware and 12.5in the other LGAs respectively. The minimum number of TT lid surgery required to achieve the elimination level is 873 in the Silame LGA, 2611 in the Wamakko LGA and 4672 in the Kware LGA. Conclusion: The burden of TT is high in the study communities while the trichiasis surgical coverage is low. There is a need to strengthen the control programme to meet up with existing need.

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Record No. 13521 Record ID 013521 Publication type Journal Article Title Pattern of Diabetic Retinopathy in Kano, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Abdu Lawan,; Tijjani Bashir Mohammed Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 75-79, fig., tab. Language English Descriptor Diabetic Retinopathy; Diabetes Mellitus, Type 1; Eye Manifestations; Hospitals, Teaching Descriptor-Geographic Nigeria-Kano; Abstract Background: The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: Consecutive patients who were attending the diabetic clinic and who consented were examined over a three-month period. Information obtained includes patient's bio data, type and duration of disease, and findings on eye examination. The fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS). Results: A total of 214 patients were examined during the study period. There were 88 males and 126 females (M: F = 1: 1.43). The mean age of the study population was 52.14 ± 13.23 years. The mean age of patients without diabetic retinopathy (DR) was 49.14 ± 13.17 years and the mean age of patients with DR was 58.51 ± 10.94 years. Forty nine patients (23) had insulin-dependent diabetes mellitus (IDDM) while 165 patients (77) had non insulin dependent diabetes mellitus (NIDDM). There was statistically significant difference in presence of retinopathy in patients with IDDM compared to those with NIDDM [X2 =29.77 \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\{95CI\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\}, P=0.000]. DR was significantly more common in patients with disease duration of 15 years or more compared with those with disease duration of 14 years or less [X2 = 65.85, \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\{95CI\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\} P= 0.000]. Based on ICDRDSS scale, 136 patients (64) had no retinopathy and 78 patients (36) had retinopathy. Some patients were visually impaired and the cause of blindness was DR in 6 patients (2.8). Cataract and glaucoma were the cause in 6 patients (2.8). Conclusion: Diabetic retinopathy is common in our environment and is more frequent in IDDM and those with long disease duration. DR is a cause of visual disability although diabetic patients are not exempted from blindness from other eye diseases such as cataract and glaucoma. A screening program needs to be developed to facilitate early detection and prompt treatment.

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Record No. 13520 Record ID 013520 Publication type Journal Article Title Review of Intrauterine Adhesiolysis at the Aminu Kano Teaching Hospital, Kano, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Gaya, Sule A.; Adamu, Ibrahim S.; Yakasai, Ibrahim A.; Abubakar, Sanusi Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(2) Pages 65-69 Language English Descriptor Hysteroscopy; Tissue Adhesions; Review; Hospitals, Teaching; Review Descriptor-Geographic Nigeria-Kano; Abstract Background: Hysteroscopic adhesiolysis is shown to significantly improve the outcome of intrauterine adhesions (IUA). The Minimally Invasive Surgical Unit (MISU) of our Department recently acquired a hysteroscope which is being used for hysteroscopic adhesiolysis among others. Materials and Methods: There were 57 patients diagnosed to have IUA of which 54 case notes were available for analysis, giving a retrieval rate of 95. The information extracted includes age, parity, and menstrual pattern, predisposing factors, treatment option, outcome, complications and the year of the procedure. The data extracted were analyzed using Epi info Version 3.4.1. Chi squared test (Fisher's exact test) was used to test for statistical difference in the outcome of the modalities of treatment. P value of less than 0.05 was considered significant. Results: There were 57 cases of IUA out of 4160 gynecological patients seen, giving a prevalence of 14/1000. The mean age was 28.9 years (SD 4.5) and mean parity was 1.4 (SD 1.4). Etiologic factors include Dilatation and curettage (D and C) (33.3), Caesarean section (C/S) (31.5), manual removal of placenta and Pelvic Inflammatory Disease (PID) (7.4each), and unexplained (3.7). Mode of presentation was secondary amenorrhoea (50), oligomenorrhoea (22.2), and hypomenorrhoea (10). As for the management, 68had blind procedure while 25.9had hysteroscopic procedure. Lippes loop was used in all except three patients who had pediatric Foleys catheter instead. Upon follow-up 59.3resumed normal menses, 11.1had oligomenorrhoea, hypomenorrhoea 13and amenorrhoea 5.6. There was no statistical difference in the outcome of treatment between hysteroscopic adhesiolysis and the blind procedure when return to normal menses is considered as the end point, OR=2.27, CI 0.45-12.65, Fisher exact test (one-tailed) P=0.2184818. Conclusion: There was no significant difference between the blind and hysteroscopic procedures. Dilatation and curettage was found to be the commonest cause of IUA.

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Record No. 13436 Record ID 013436 Publication type Journal Article Title An Audit of Basic Practical Skills Acquisition of Final Year Medical Students in a Nigerian Medical School Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Jebbin, N. J.; Adotey, J. M. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(1) Pages 42-45 Language English Descriptor Clinical Competence; Professional Competence; Students, Medical; Schools, Medical Descriptor-Geographic Nigeria Abstract Background/Objective: Young medical graduates undertaking their housemanship are naturally expected to demonstrate reasonable competence in basic practical skills. Failure to do this may not only be a source of anxiety to the doctor but also potentially dangerous to the patient. The objective was to assess the level of exposure of final year medical students of a Nigerian medical school to basic practical skills. Materials and Methods: This is a descriptive cross-sectional study. Structured questionnaires were distributed to a set (all) of 86 final year medical students of the University of Port Harcourt immediately after their last lecture in their final posting in medicine and surgery. The questionnaires listed some selected basic practical skills (e.g. phlebotomy, male urethral catheter insertion, etc.) that house officers are expected to be competent in. The students were asked to anonymously fill them and return same before leaving the lecture hall. Results: Of the 86 students, 84 completed and returned the questionnaires, giving a 97.7response rate. No student had performed an arterial puncture for an arterial blood sample. Seventy-six students (90.5) had not inserted a naso-gastric tube. Only 14 (16.7) students had successfully inserted more than 10 intravenous canulae. A significant number, 38 (45.2), had never inserted a urinary catheter (for male patients) nor had any experience with bag/mask skills. Majority, 59 (70.2) had had some experience with intravenous antibiotics administration. Forty-one (48.7) students had had 6 or more successful attempts at venous blood sampling. Conclusion: The exposure level of final year medical students to basic practical skills was low.

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Record No. 13435 Record ID 013435 Publication type Journal Article Title An Observational Study of Road Safety around Selected Primary Schools in Ibadan Municipality, Oyo State, Southwestern Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Sangowawa, Adesola O.; Adebiyi, Akindele O.; Faseru, Babalola; Popoola, Olusola J. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(1) Pages 32-35 Language English Descriptor Accidents, Traffic-prevention & control; Safety Child Schools Descriptor-Geographic Nigeria-Ibadan; Abstract Background/ Objective: Child pedestrians have been identified as vulnerable road users. Although walking as a means of transport has health and other benefits, it exposes children to the risk of road traffic injuries. This study was conducted to assess the availability of road safety features around government-owned primary schools in Ibadan municipality. Materials and Methods: A multistage sampling technique was used to select 46 of the 74 schools in the study area. Some (11) of the selected schools were sited within the same premises and shared a common entrance; thus a total of 35 school premises were eventually observed. Trained research assistants observed the school environment around the selected schools for road safety features such as location of schools, presence of "school", "child crossing" and "speed limit" road signs, and presence of traffic calming devices (road bumps or zebra crossing). Results: Five (14) of the schools were located on major roads and eight (23) had road signs indicating that a school was nearby. Seven (20) had road bumps close to the school, 15 (43) had a warden who assisted children to cross, and none had a zebra crossing. Five (14) schools had pedestrian sidewalks. Conclusions: The study revealed that the environment around a number of the observed schools in the municipality compromised the pupils' road safety. The local government, school authorities, parents, and road safety professionals need to institute definite measures to enhance the road safety environment around schools in the municipality.

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Record No. 13434 Record ID 013434 Publication type Journal Article Title On the Safety of Diagnostic Ultrasound in Pregnancy: Have we Handled the Available Data Correctly? Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bello, Shaibu O.; Ekele, Bissallah A. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(1) Pages 1-4 Language English Descriptor Ultrasonography; Diagnostic Imaging; Women Pregnancy Descriptor-Geographic Nigeria Abstract Robust evidence of the bioeffects of ultrasound is available from animal studies but human studies are less convincing. Nevertheless, it is disturbing that the only response to safety issues is a twenty-year old principle known as ALARA (As Low As Reasonably Applicable). Using experience from obstetrics and toxicology, and drawing information mainly from two recent systematic reviews and meta-analysis that extensively covered the subject of ultrasound safety, this review captures the current knowledge of ultrasound bioeffects and suggests that it may be time for an international, multidisciplinary meeting on ultrasound safety to decide how to provide the evidence (available data) to patients and sonographers in a succinct manner.

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Record No. 13433 Record ID 013433 Publication type Journal Article Title Progestogen-only Injectable Contraceptive: Experience of Women in Osogbo, Southwestern Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Adeyemi, A. S.; Adekanle, D. A. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(1) Pages 27-31 Language English Descriptor Contraceptive Agents; Progestins; Injections; Women Descriptor-Geographic Nigeria Abstract Background: Progestogen-only injectable contraceptive is a long-acting contraceptive given intramuscularly to give protection against unwanted pregnancy for a period of 2 or 3 months, depending on the type. Alterations in menstrual pattern are a well known side effect of this effective contraceptive method. Objectives: To determine the characteristics of women accepting the method, complications and indications for discontinuation. Materials and Methods: This was a retrospective review of clients using progestogen-only injectable contraceptive between 1 st January, 2001 and 31 st December, 2009. Relevant information extracted from the case notes was analyzed. Survival analysis was carried out using Log-Rank Chi-square test to measure association over 12-month period of usage. Level of significance was set at P value less than 0.05.Results: A total of 1,967 women used contraception during the study period and 433 (22.1) made progestogen-only injectable their method of choice. 199(45.96) used NET-EN, while DMPA was used by234 (54.04) women. Many of the women (197, 45.5) used the method for terminal fertility control. Menstrual abnormality was the commonest (264, 71.4) complaint about progestogen-only injectable contraceptive, of which amenorrhea was experienced by constituted 176(66.7). Eighty-three (22.4) women had discontinued the contraceptive, and menstrual abnormality was the commonest reason for the discontinuation (68, 81.9). No pregnancy was reported among the women that came for follow up while on the method. Conclusion: Short duration of POIC use that is within 12 months is still high. However the main reason for discontinuation was found to be due to menstrual irregularities, hence the need for effective education of the women about this side effect, thus increasing the acceptance and continuation rate of the contraceptive method.

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Record No. 13432 Record ID 013432 Publication type Journal Article Title Electrocardiographic Abnormalities among Dialysis Naïve Chronic Kidney Disease Patients in Ilorin Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) hijioke, A.; Makusidi, A. M.; Kolo, P. M. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(1) Pages 21-26, fig. Language English Descriptor Kidney Failure, Chronic; Electrocardiography; Dialysis Descriptor-Geographic Nigeria-Ilorin; Abstract Background: Chronic kidney disease (CKD) has an increased risk of not only end-stage renal disease (ESRD), but majority of moderate CKD patients do die from cardiovascular disease (CVD) before reaching ESRD. The prognosis of these patients is very poor in most developing countries because of late presentation, inadequate diagnostic facilities, and inability to pay for treatment. Knowledge about CVD in CKD is crucial because of unpredictable progressive nature of the disease and increased risk of premature death from cardiovascular events. We sought to determine prevalence and pattern of electrocardiographic abnormalities in dialysis naïve CKD patients. Materials and Methods: This is a 10-year prospective cross-sectional study carried out at the University of Ilorin Teaching Hospital, Ilorin. Patients were recruited from the nephrology clinic and renal wards and all who met diagnostic criteria for stages 4 and 5 CKD were included. All had their standard 12-lead electrocardiogram (ECG) recorded and various findings were critically studied and interpreted independently by two consultant physician including a cardiologist. Data analysis was done using SPSS version 16. Results: Overall, 86of the patients had at least one form of ECG abnormality, with hypertension (HTN) and anemia being the main contributory factors. These include left ventricular hypertrophy (LVH) (27.6), left atrial enlargement (LAE) (21.6), combination of LVH and LAE (17.2), and ventricular premature contractions (6). Etiology of CKD appears to have influence on ECG changes as prevalence of LVH and LAE were high among hypertensive renal disease, chronic glomerulonephritis (CGN), and diabetic nephropathy patients. Conclusion: LVH and LAE were very common ECG abnormalities in our dialysis naïve CKD patients. HTN, CGN, anemia, late presentation, and male gender appear to be the main risk factors for the ECG abnormalities. There is need for gender-specific intervention strategies directed at early detection and treatment of HTN, anemia, and underlying kidney disease, especially in resource poor nations where the burden of CKD is assuming epidemic proportion.

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Record No. 13431 Record ID 013431 Publication type Journal Article Title Social Network as a Determinant of Pathway to Mental Health Service Utilization among Psychotic Patients in a Nigerian Hospital Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Lasebikan, Victor O.; Owoaje, Eme T.; Asuzu, Michael C. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2012 Volume and n° 11(1) Pages 12-20 Language English Descriptor Psychotic Disorders; Mental Health Services; Social Support Descriptor-Geographic Nigeria Abstract Objective: The main objectives of the study were to determine the relationship between social network and pathway to service utilization among psychotic patients. Materials and Methods: This descriptive study was carried out in a psychiatric unit in a general hospital in South West Nigeria. Using structured questionnaires, primary data were collected from 652 psychotic patients on their social network, health behaviors and pathway to current service use. Logistic regression analysis was used to assess the effect of social network on patients' use of services, controlling for sociodemographics, health and functional status. Results: Mean age of the respondents was 29.0 ± 7.5 years, range 14-58 years, males constituted 52.6. Regarding pathway to services, alternative sources of care such as priests, spiritualists, natural therapists, herbalists, was the first port of call for 78.9of respondents. Family dominated the social network in 51.1of patients. The presence of some social network and social support structures were significantly associated with the use of general medical and specialty psychiatric services for patients with schizophrenia (P = 0.03), schizoaffective disorder (P = 0.02), bipolar I disorder (P = 0.01), but not with major depression and symptoms of psychological distress. Conclusions: Findings indicate that social support and social network enhanced utilization of mental health services for psychiatric patients except for those with psychotic depression or those with symptoms of psychological distress. In addition, alternative sources of care are still relevant in mental health service delivery in South West Nigeria.

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Record No. 11606 Record ID 011606 Publication type Journal Article Title Proximate Predictors of early Antenatal Registration among Nigerian Pregnant Women Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Oladokun, Adesina; Oladokun, Regina E.; Morhason-Bello, Imran; Bello, Adenike F.; Adedokun, Babatunde Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(4) Pages 222-225 Language English Descriptor Prenatal Diagnosis; Pregnant Women; Gestational Age Descriptor-Geographic Nigeria Abstract Background : Provision of antenatal care (ANC) is included in the pillars of maternal health care promoted as effective answers to maternal mortality. Early antenatal registration has been linked with optimal utilization and appreciable reduction of perinatal morbidity and mortality. This study aimed to determine the profile and possible predictors of pregnant women who presented early for antenatal registration. Methods : A cross-sectional study was conducted among 796 women presented for antenatal registration at a tertiary hospital. Information was obtained by a self-administered open- and closed-ended questionnaire and analyzed with Statistical Package of Social Science (SPSS) 12.0 software. Results : The mean gestational age at booking was 20 weeks. Univariate analysis showed that first trimester booking was significantly with more educated women, professionals, women of lower parity and those who have had previous stillbirths (P 0.05). Low parity (OR 1.76, 95CI 2.79-1.11) and previous stillbirth (OR 2.97, 95CI 1.61-5.51) were significant predictors of early booking on multivariate analysis. Conclusion : Long-term advocacy and investment in female education will contribute significantly to primary prevention of late or non-attendance of ANC. Pre-conception clinics and community awareness campaigns would be necessary tools to reach these women and encourage them to register early when pregnant.

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Record No. 11605 Record ID 011605 Publication type Journal Article Title Experience with the Use of Community Health Extension Workers in Primary Care, in a Private Rural Health Care Institution in South-South Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ordinioha, Best; Onyenaporo, Chinyere Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(4) Pages 240-245 Language English Descriptor Health Personnel Community Health Aides-utilization; Primary Health Care Descriptor-Geographic Rural Health Abstract Background : The difficulty in recruiting and retaining doctors in rural areas has encouraged the use of substitute health workers in the provision of primary care for undiagnosed patients with undifferentiated health problems. This study was performed to report the experience of the use of Community Health Extension Workers (CHEWs) in the provision of primary care in a private rural health care facility in a community in Nigeria. Methods : The study was carried out over a 6-month period in a private health facility in a semiurban community. The CHEWs were recruited through the recommendation of their schools and were retrained and deployed incognito, but with a clear job description. Their performances were monitored using the level of patient satisfaction, the type of cases seen, the number of telephone consultations made with the doctors of the NGO, the length of prescriptions and the number of adverse events that followed the consultations. Results : A total of 1,028 patients were seen in the health facility during the 6-month study period, of which 294 (28.6) telephone consultations were made with the doctors of the NGO, 215 (20.9) of the patients were admitted in the hospital, while 81 (7.9) were referred to other health facilities. Most of the cases were malaria (54.2), typhoid (6.9) and minor injuries (12). The average length of the prescriptions given to the patients per encounter was 6.3, and most of the patients (86.5) were satisfied with the quality of care provided by the CHEW. A total of 7.6of the patients seen by the CHEWs were readmitted as emergencies, mainly with severe anemia (47.4) and the deterioration of previously treated ailment (24.4). Conclusions : CHEWs, working under the direct supervision of doctors can provide safe and good quality care, to the satisfaction of most of their patients, when required to provide primary care. It cannot however be assumed that similar results would be obtained if the health workers are used in different settings or with more complicated patients.

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Record No. 11604 Record ID 011604 Publication type Journal Article Title Serum Levels of Antioxidant Vitamins and Mineral Elements of Human Immunodeficiency Virus Positive Subjects in Sokoto, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bilbis, Lawal S.; Idowu, Dorcas B.; Saidu, Yusuf; Lawal, Mansur; Njoku, Chibueze H. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(4) Pages 235-239 Language English Descriptor Antioxidants; Minerals; Serum; HIV Descriptor-Geographic Nigeria-Sokoto; Abstract Background : Undernourishment and micronutrient deficiencies exacerbate immunosuppression, oxidative stress, acceleration of human immunodeficiency virus (HIV) replication and CD4 T-cell depletion in HIV-infected individuals. Materials and Methods : The current work reports the serum levels of antioxidant vitamins (vitamins A, C and E) and minerals (Zn, Fe, Cu) in 90 HIV positive subjects attending the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. The serum levels of the micronutrients were correlated with the CD4 count of the subjects. Results : The results showed that the HIV positive subjects have significantly lower (P 0.05) levels of vitamins A, C and E. Also, serum Zn, Fe, Cu and CD4 count were also significantly (P 0.05) lower compared with the HIV negative subjects. Micronutrient deficiencies were more pronounced in HIV positive subjects with CD4 counts less than 200 cell/µl. The results based on age and sex showed no significant (P 0.05) difference. Vitamins A, E and C and Zn and Fe showed positive correlation with CD4 count of the HIV positive subjects. Conclusion : The results suggest that the HIV subjects in the study area have lowered serum levels of antioxidant micronutrients and that the levels decrease with increase in the severity of the infection. These may increase the chances of the symptomatic and asymptomatic subjects progressing into full-blown Acquired Immunodeficiency Syndrome.

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Record No. 11603 Record ID 011603 Publication type Journal Article Title Otology Practice in a Nigerian Tertiary Health Institution: A 10-Year Review Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Salisu, A. D. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(4) Pages 218-221 Language English Descriptor Otolaryngology; Institutional Practice; Review Descriptor-Geographic Nigeria Abstract Background : The practice of otology in developing countries has remained unsatisfactory. The aim of this study is to describe the practice in a tertiary health institution with a view to articulate strategies for improvement. Materials and Method : This a retrospective study of patients with otology problems, who attended Ear, Nose and Throat clinic of Aminu Kano Teaching Hospital, Kano, over a 10-year period (1997-2007). Case notes were retrieved and studied. Results : Otologic conditions accounted for 56.3of the 8070 clinic visits. The most frequent condition seen was chronic otitis media (25.4). Sensorineural hearing loss (mostly preventable) accounted for 16. Other cases included wax impaction (7.5) and foreign body in ear (7.3). Modern diagnostic and operative equipment were lacking. Operative surgery was offered to 4of cases of chronic suppurative otitis media and 72of patients needing hearing aid could not afford one. There was no middle ear reconstructive or inner ear operation in the 10-year period. Conclusion : A significant number of patients are in need of otology services. These services are inadequate presently. Concerted effort should be geared toward strengthening preventive ear health, training and re-training, procurement of relevant diagnostic and operative equipment

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Record No. 11602 Record ID 011602 Publication type Journal Article Title Appendicitis: Trends in Incidence, Age, Sex, and Seasonal Variations in South-Western Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Oguntola, A. S.; Adeoti, M. L.; Oyemolade, T. A. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(4) Pages 213-217 Language English Descriptor Appendicitis; Incidence; Age Groups; Seasons Descriptor-Geographic Nigeria Abstract Background : Appendicitis is a common clinical condition worldwide. Differences in incidences, sex, age, and seasonal variations have been reported widely, with paucity of information from Nigeria. Aim : To assess the trends in incidence and pattern of variation with age, sex, and seasons of the year. Materials and Methods : A review of the records of all patients with confirmed appendicitis treated in both the LAUTECH Teaching Hospital (LTH) and the Abake Medical Center (AMC), both situated in Osogbo, Nigeria, between January 2003 and December 2008, was done. LTH was a 320-bed University Hospital (with 100 surgical beds), while AMC was a 20-bed surgical center. The age, sex, and month of admission of all the histologically proven cases of appendicitis were retrieved and treated. Analysis was done using simple percentages, Student t or Chi-square tests, where applicable. Results : A total of 299 out of 321 cases of appendicitis recorded during the observed period were confirmed histologically from both hospitals (69.56from LTH). Fifty-two percent were males. It made up 0.94, 1.43, and 1.86of the total hospital admissions in 2004, 2006, and 2008, respectively. There has been an increasing incidence in both sexes almost in a similar pattern. The overall mean age was 25.79 years (M 25.94 and F 25.43 years) with 6below the age of ten and 1.3above 60 years. The highest incidence in males and females occurred in the second and third decades, respectively. Incidences were higher during the rainy season (April to September) 68, P 0.05), with peaks from June to August, when 39.5of all cases presented. Conclusion : The increasing incidence of appendicitis in both sexes in this region may be due to the change to a Western lifestyle. The age distribution has a similar pattern in both sexes and 87are 40 years or less, although the incidence is marginally higher in males. Higher prevalence of infections and allergens from pollens in the rainy season could contribute to a higher incidence of appendicitis.

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Record No. 11201 Record ID 011201 Publication type Journal Article Title Routine Surgical Intervention for Childhood Intussusception in a Developing Country Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ekenze, S. O.; Mgbor, S. O.; Okwesili, O. R. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(1) Pages 27-30 Language English Descriptor Intussusception; Surgical Procedures, Operative; Child Descriptor-Geographic Nigeria Abstract Objective/Purpose: We aim to determine the basis for the routine surgical treatment of intussusception in southeast Nigeria. Methods: We analyzed 71 children operated for intussusception between June 1998 and May 2006 at the University of Nigeria Teaching Hospital Enugu, southeastern Nigeria. Results: The median age at presentation was 6 months (range 3 months to 7 years), and the average duration from onset to presentation 3.2 days (range 4 hours to 7 days). Forty-six (64.8) had ileocolic intussusception, 7 (9.9) colocolic, and 5 (7.0) ileoileal. In 31 (43.7), there was no identifiable cause, while mesenteric lymphadenopathy and inflamed Peyer's patches were noted in 37 (52.1), and polyp in 3 (4.2). Manual reduction was successful in 39 (55), while 32 (45) required bowel resection for gangrene, or irreducibility. After average follow up of 9.7 months (range 4-22 months) there was no recurrence, but overall mortality was 6 (8.5) from septicemia. Late presentation, dearth of facilities and trained manpower, and lack of multidisciplinary collaboration may contribute to the regular surgical treatment. Conclusion: Intussusception in our setting is characterized by late presentation, high rate of bowel resection, and high mortality. Surgery may remain our main stay of treatment until deficiencies in time to diagnosis, specialized facilities, and personnel improvement Electronic Access :  Full Text-1

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Record No. 11200 Record ID 011200 Publication type Journal Article Title Rhinosinusitis: A Retrospective Analysis of Clinical Pattern and Outcome in North Western Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Iseh, K. R.; Makusidi, M. Journal Title Annals of African Medicine ISSN 1596-3519 Place of Publication Sokoto Publisher Usmanu Danfodiyo University Teaching Hospital, Annals of African Medicine Society Date of publication 2010 Volume and n° 9(1) Pages 20-26, fig., tab. Language English Descriptor Sinusitis-diagnosis; Physician's Practice Patterns Retrospective Studies Descriptor-Geographic Nigeria Abstract Background/Objectives: Rhinosinusitis is the commonest viral infection in man and the commonest inflammatory disorder encountered by general practitioners, chest physicians, and otorhinolaryngologists all over the world. The clinical pattern and outcome of conventional management measures were assessed. Method: All new patients with the diagnosis of rhinosinusitis over a 2-year period from July 1999 to July 2001 were analyzed for clinical features, conventional radiological findings, and treatment modalities over a period of 3 years follow up. Results: There were 195 (11.7) new cases of rhinosinusitis out of a total number of 1661 patients seen over the period under review. Only 146 case notes were accessible for the study. Eighty-four (57.5) were males and 62 (42.5) were females. Their ages ranged from 7 months to 70 years. The main clinical symptoms and signs were nasal discharge or rhinorrhea (84.9), nasal obstruction (24.7), epistaxis (22.0), and sneezing (20.6). The duration of symptoms ranged from few days to about 10 years with 24 (16.4) being acute cases while 122 (83.6) were chronic cases giving a prevalence of 1.4and 7.3, respectively. Maxillary sinus (58.9) was the commonest sinus involved. More than one sinus involvement accounted for 37.7of the cases. Infective causes accounted for 67.1of cases followed by allergy (28.8). There were complications in 21 (14.4) cases with orbital involvement (33.3) being the commonest complication. Mode of treatment were medical (86.3), and conventional surgery was carried out in 13.7of the cases for either failed medical treatment or associated complications. Facial paraesthesia along the sites of surgery was the commonest complications, otherwise the outcome of treatment was excellent. Conclusion: Rhinosinusitis in this region was more of chronic (83.6) variety than acute (16.4) variety. Infective causes (67.1) and allergy (28.8) were the commonest etiological factors. About (86.3) were amendable to medical treatment while surgical treatment was carried out in 13.7of the cases. Rhinosinusitis should be managed medically first before recourse to surgical measures in carefully selected cases. Endoscopic sinonasal surgery is most desirable in keeping with current global trends of treatment of rhinosinusitis but where facilities do not exist, conventional surgical measures may be used. Electronic Access :  Full Text-1

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