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Record No. 12510 Record ID 012510 Publication type Journal Article Title Multiple Sclerosis in a Nigerian Alcoholic Male: A Case Report from Enugu, South East Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Onwuekwe, I. O.; Ekenze, O. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 107-114, fig. Language English Descriptor Multiple Sclerosis-diagnosis; Magnetic Resonance Imaging Alcohol Drinking Case Reports Abstract Background: Multiple sclerosis is a rare neurological disorder in black Africans. In Nigeria it had been difficult to confirm suspected cases due to the paucity of diagnostic facilities. The availability of magnetic resonance imaging has enabled an increased confidence in making the diagnosis. Method: This is a case report of a 40- year old Nigerian farmer of the Igbo ethnic group living in a rural community in Enugu who presented with clinical features suggestive of multiple sclerosis. Though the patient had a significant history of alcohol consumption, he had clinical and magnetic resonance imaging features diagnostic of multiple sclerosis. Results: A 40-year old male farmer presented to the Neurology Clinic of the University of Nigeria Teaching Hospital Enugu in January 2010 with a 10-year history of recurrent episodes of weakness of the legs. Each episode was sudden, affected either limb alternately, was associated with paraesthesiae and would resolve spontaneously after a few days or weeks without any intervention. Over the years he became unable to walk. The sphincters and vision were unaffected. A week prior to presentation he developed tremors of the hands with disorientation. The patient exhibited confabulation and had flaccid quadriparesis with glove and stocking sensory loss. Spinal fluid protein was raised and there were classic periventricular and intracerebral white matter hyper-intensities on magnetic resonance imaging. Conclusion: This report of a case of multiple sclerosis suggests a need for clinicians in Africa to increase their index of suspicion in probable clinical scenario especially where magnetic resonance imaging exists. Electronic Access :  Full Text-1

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Record No. 12509 Record ID 012509 Publication type Journal Article Title Knowledge and Perception of Menopause and Climacteric Symptoms among a Population of Women in Enugu, South East, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ikeme, A. C. C.; Okeke, T.C.; Akogu, S. P. O.; Chinwuba, N. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 31-36, tab. Language English Descriptor Menopause; Climacteric; Knowledge; Perception; Women Descriptor-Geographic Nigeria-Enugu; Abstract Background: Menopause alters the physiological, biochemical and psychological environment of a woman. Thus the knowledge and perception of its symptomatology is invaluable to enable appropriate adjustment to this natural phenomenon. Objective: The objective of this study was to determine the knowledge and perception of menopause and climacteric symptoms among a sample of women in Enugu, South East Nigeria. Methods: This was a cross sectional survey of 432 women aged 45-60 and above drawn from the general population of Enugu metropolis of Nigeria. These women were randomly selected from the gynaecology clinic attendees in a tertiary health care facility in Enugu. A self administered structured pre-tested questionnaire was designed. The data were analysed using SPSS software. The primary methods used were cross tabulation (with X2 or Mantel Haenszel trend tests as appropriate) and one way analysis of variance. Results: Majority of women in the population studied experienced climacteric symptoms but relatively few regarded these symptoms as a problem. For example hot flushes and night sweats were experienced by 70.0but defined as a problem by only 30.0. Out of 432 women studied, only 33.3sought medical attention in hospital for their symptoms. 58.3of the women did not regard them as a medical problem and took them as part of aging process. Conclusion: Physicians should be aware of climacteric symptoms among women in the population so as to offer appropriate counselling and support without undue recourse to wasteful clinical assessment and investigations. Public enlightenment would also help to improve awareness of the menopause and its symptoms that may often lead to misdiagnosis in gynaecological clinics Electronic Access :  Full Text-1

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Record No. 12508 Record ID 012508 Publication type Journal Article Title Prevalence and Analysis of Factors Related to Occurrence of Pulp Stone in Adult Restorative Patients Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Udoye, C. I.; Sede, M. A. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 9-14 Language English Descriptor Dental Pulp Calcification; Chronic Periodontitis; Tooth Abrasion Descriptor-Geographic Adult; Nigeria Abstract Background: Pulp stone, though of an unclear aetiology, is clinically common. It potentially poses procedural difficulty to the endodontist and may also be a marker of an underlying systemic condition. Objectives: The study investigated pulp stone occurrence in adult restorative patients. It also highlighted the relationship between pulp stone and pristine posterior teeth, chronic periodontitis and posterior teeth with abrasion, as well as the effect of age and gender on pulp stone occurrence. Method: Three hundred subjects, aged 18-60 years participated in the cross sectional study. Pristine teeth, teeth with chronic periodontitis and those with abrasion were recruited. Result: Pulp stone was seen more often in the 41-50 years age band, in molars and in teeth with chronic periodontitis but less often in teeth with abrasion. In addition, coronal and free form of pulp stone were more popular. Conclusion: It is recommended that researchers should pay special care in case selections, and during biomechanical coronal instrumentation Electronic Access :  Full Text-1

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Record No. 12507 Record ID 012507 Publication type Journal Article Title Certain Red Blood Cell Indices of Maternal and Umbilical Cord Blood in Owerri, Nigeria: A Preliminary Report Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Nneli, R. O.; Amadi, S. C. A.; Nwafia, W. C. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Language English Descriptor Umbilical Cord; Fetal Blood; Blood Cells; Erythrocyte Indices; Hematocrit Descriptor-Geographic Nigeria Abstract Background: Umbilical cord blood analysis may give a clue to the state of health of both pregnant mothers and their neonates. However, there is paucity of literature on some of these indices from our area. Objectives: This present study determined the red blood indices of maternal and umbilical cord blood in Owerri, Nigeria. Methods: Pregnant mothers aged 18 - 42 years who booked and received antenatal care until vaginal delivery at the antenatal clinics of two tertiary health care centres in Owerri, Nigeria were divided into five age groups I - V. Maternal blood samples were obtained immediately after delivery of the baby. The umbilical blood samples were collected from the umbilical cord of the baby at the end of the second stage of labour. The haemoglobin (Hb) concentration and packed cell volume (PCV) were determined using standard procedures. The mean corpuscular haemoglobin concentration (MCHC) was calculated mathematically. Results: The result of the cord blood haemoglobin concentration and packed cell volume were significantly higher than the maternal values (14.22 ± 1.25 g/dl versus 11.20 ± 0.92g/d and 42.6 9± 3.80versus 33.67 ± 2.71respectively; ( P 0.0001).However, there was no significant differences between cord blood and maternal mean corpuscular haemoglobin concentration (33.24 ±0.23versus 33.29 ± 0.45;P = 0.310). Furthermore, a positive linear Pearson's correlation was observed between the mean Hb and PCV of cord blood and maternal blood (r=1.11 and r=1.15 respectively 0.0001). Conclusion: This result provides a baseline data for further studies on establishing a reference value for maternal and umbilical cord packed cell volume and haemoglobin concentration in our locality. Electronic Access :  Full Text-1

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Record No. 12506 Record ID 012506 Publication type Journal Article Title Survey of Women's Opinions on Female Genital Mutilation (FGM) in Southeast Nigeria: Study of Patients Attending Antenatal Clinic Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ezenyeaku, C. C.; Okeke, T. C.; Chigbu, C. O.; Ikeako, L. C. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 15-20 Language English Descriptor Circumcision, Female-legislation & jurisprudence; Public Opinion Women Data Collection Descriptor-Geographic Nigeria Abstract Background: Female genital mutilation is known to exist especially in many third world countries including Nigeria with many women being victims of this harmful practice and its complications. The practice is rife in Southeast Nigeria and efforts have been made to discourage it. Objective: To determine women's views on aspects of female genital mutilation and the prevalence among the study population. Method: Women attending the antenatal clinics of two university teaching hospitals in Southeast Nigeria were interviewed by means of structured pre-tested interviewer- administered questionnaires. The data obtained were analysed using SPSS version 10.0 and the results expressed in descriptive statistics as percentages. Results: The prevalence of FGM was 42.1. However, only 14.3of the respondents circumcised their own daughters or showed willingness to circumcise their daughters indicating considerable reduction in uptake of the practice. A larger proportion (63.7) would support legislation against FGM. Conclusion: There is a high opinion against the practice of FGM in Southeast Nigeria, with the majority of the women showing support for legislation Electronic Access :  Full Text-1

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Record No. 12505 Record ID 012505 Publication type Journal Article Title Pre-operative Anaesthesia visit: Problems and Prospects in a University Teaching Hospital in Enugu, South East Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ezike, H. A.; Amucheazi, A. O.; Ajuzieoegu, V. O. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 97-102 Language English Descriptor Preoperative Care; Anesthesia; Hospitals, Teaching Descriptor-Geographic Nigeria-Enugu; Abstract Background: Pre-anaesthetic evaluation is a basic component of safe anaesthetic practice and ends with the establishment of an anaesthetic plan of action for individual patients. Objectives: The aim of the present study was to assess the difficulties encountered by the anaesthetist during such visits and suggest ways they can be overcome Subjects and Methods: The `activity book' of anaesthetic resident doctors in the hospital was reviewed retrospectively for documented problems they encountered during the pre-operative visit. The problems listed were then subjected to analysis using the SPSS 17. Result: The commonest problem was the unavailability of the patient for review 73.1followed by very busy schedule (7.4) and unfit patients (6.9) Conclusion: Anaesthetists still do encounter problems during the pre-operative visit. Exposing such problems creates the necessary awareness for improvement of patient care Electronic Access :  Full Text-1

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Record No. 12504 Record ID 012504 Publication type Journal Article Title Oxidative Stress and Glycaemic Control in Type 2 Diabetic Patients in Enugu, South-East Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ikekpeazu, E. J.; Neboh, E. E.; Ejezie, F. E.; Ibegbu, M. D.; Ike, I. E. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 123-128 Language English Descriptor Oxidative Stress Glycemic Index Diabetes Mellitus, Type 2-complications; Descriptor-Geographic Nigeria-Enugu; Abstract Background: There is growing evidence that excess generation of highly reactive free radicals, largely due to hyperglycaemia causes oxidative stress, which further exacerbates the development and progression of type 2 diabetes and its complications. Objectives: In this study, the level of oxidative stress was compared with glycaemic control in type 2 diabetic patients. Method: Fifty confirmed type 2 diabetic patients, aged between 25 and 70 years were used for the study. 20 patients with good glycaemic control served as positive control while 20 apparently healthy non-diabetic age-matched individuals served as negative control. The FBS, MDA and HbA1c were determined in fasting blood samples using standard methods. Results: Patients with poor glycaemic control had significantly raised MDA and HbA1c (P =0.0001) when compared with non diabetics However, those with good glycaemic control only had a significant increase in the MDA when compared to non diabetic. (P =0.0001).).The MDA level when compared to fasting blood sugar (FBS) and glycated haemoglobin (HbA1c) showed a positive correlation.( r= 0.77; P = 0.0001 and r=0.69; P = 0.0001 respectively) Conclusion: This study showed that both glycaemic control and lipid peroxidation are factors to be monitored or evaluated in the management of type2 diabetics to avoid the development of diabetic complications

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Record No. 12503 Record ID 012503 Publication type Journal Article Title Assessment of Iron Content of Breast Milk in Preterm and Term Mothers in Enugu Urban Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ejezie, F. E.; Nwagha, U. I.; Ikekpeazu, E. J.; Ozoemena, O. F. N.; Onwusi, E. A. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 85-90 Language English Descriptor Iron; Milk, Human; Premature Birth; Infant Descriptor-Geographic Nigeria-Enugu; Abstract Background: It is commonly assumed that preterm babies are malnourished and this has led to all forms of micronutrient supplementation including iron. Objective: The aim of the study is to compare the iron content in breast milk of mothers who had preterm and term babies. Methods: Ninety six (96) lactating mothers who delivered their babies at term and 68 lactating mothers who had preterm deliveries were recruited for the study. The mothers were attending the postnatal clinic of one secondary and two tertiary healthcare facilities in Enugu. Breast milk iron concentration was determined by Atomic Absorption Spectrophotometer. Results: The differences in the mean values for the iron concentrations in preterm and term breast milk were statistically significant (39.06±10.78 versus 32.79±14.17 µmol/L, P =0.02). In both groups, the breast milk iron concentration gradually decreased as lactation progressed. (P 0.0001). Conclusion: The iron content of breast milk from mothers who had preterm babies is higher when compared to mothers who had term babies. It may thus be needless to introduce exogenous iron during lactation Electronic Access :  Full Text-1

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Record No. 12502 Record ID 012502 Publication type Journal Article Title Zinc Concentration during Pregnancy and Lactation in Enugu, South-East Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ejezie, F. E.; Nwagha, U. I. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 69-76 Language English Descriptor Zinc; Pregnancy; Pregnant Women; Lactation Descriptor-Geographic Nigeria-Enugu; Abstract Background: There is no doubt that micronutrient deficiency is common in our environment. Replacements have thus been instituted without adequate information on specific and peculiar micronutrient needs of our people. Zinc is an essential micronutrient which is prone to maternal depletion during pregnancy and lactation. Unfortunately, studies in that regard in Nigeria has received diminutive interest. Objectives: To determine zinc concentration during pregnancy and lactation. Methods: This is a cohort study involving one hundred and twenty (120) pregnant women attending the antenatal clinic of one tertiary and two secondary health care institutions in Enugu. Thirty-five (35) apparently healthy, non pregnant women were used as control subjects. Atomic Absorption Spectrophotometer (AAS) was used to determine the zinc levels in the serum of the mothers during pregnancy, postpartum and in the breast milk. Results: Results showed that mean serum zinc levels were significantly decreased (P 0.0001) in pregnancy when compared with non-pregnant control subjects. The levels decreased as gestation progressed, with the lowest concentration of serum zinc obtained during the third trimester. It was also observed that serum zinc levels which decreased in pregnancy, increased non- significantly (P Electronic Access :  Full Text-1

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Record No. 12501 Record ID 012501 Publication type Journal Article Title A Five-year Survey of Caesarean Delivery at a Nigerian Tertiary Hospital Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ugwu, E. O. V.; Obioha, K. C. E.; Okezie, O. A.; Ugwu, A. O. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 77-84, tab. Language English Descriptor Cesarean Section; Obstetric Surgical Procedures; Health Surveys Descriptor-Geographic Nigeria-Enugu; Abstract Background: The rising global rate in caesarean delivery has been a source of concern to obstetricians worldwide. In spite of remarkable improvement in the safety of anaesthesia and surgical techniques, caesarean section has higher risks of maternal death when compared with normal vaginal delivery. Thus, the current emphasis is to limit the rising rate of caesarean section to as much as possible. Objective: To determine the rate of caesarean section, pregnancy out-come, major indications and complications of caesarean section. Methods: A five year (January 1st 2005 to December 31st 2009) retrospective analysis of clinical data from the ward admissions and discharge books, patients' folders and the operating theatre record books at the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu. Results: Out of the 3,554 deliveries during the study period, 980 cases were by caesarean section, giving a rate of 27.6. Most cases 918 (93.7) were by emergency caesarean sections, with elective procedure accounting only for 6.3of the cases. The age range of the women was between 16-48yrs. Four hundred and seven (41.5) were primigravidae, 503(51.4) were between para one and para four, while 70 (7.1) were grand-multipara. The rate of caesarean section was higher amongst the booked patients, 563 (57.5) than the unbooked patients 355 (36.2). Two previous caesarean section was the commonest indication for caesarean section 211(21.5), followed by cephalopelvic disproportion 198 (20.2), and foetal distress188 (19.2). A total of 1009 babies were delivered through caesarean section by the 980 women; 955 cases of singleton gestations and 25 cases of multiple gestations (21 twins and 4 triplets). Majority of the babies 918 (91) were delivered by emergency procedure. More than half of the babies 582(57.7) had birth asphyxia and there were 39 (3.9) perinatal deaths. All the cases of perinatal deaths and 549 (94.3) of birth asphyxia were following emergency procedure. Anaemia was the commonest postpartum morbidity and the maternal case fatality rate was 0.7. Conclusion: There is now a further rise in rate of caesarean section after a slight drop that followed the initial high 1.5fold rise from previous studies. The perinatal outcome is poor especially following emergency caesarean section. Reducing primary caesarean section rate and more encouragement of vaginal delivery after one previous caesarean section may reduce the prevalence of two previous caesarean sections which is the leading indication for caesarean section in the hospital.

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Record No. 12500 Record ID 012500 Publication type Journal Article Title Evaluation of the Analgesic Activity of the Methanolic Stem Bark Extract of Dialium Guineense (Wild) Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ezeja, M. I.; Omeh, Y. S.; Ezeigbo,; Ekechukwu, A. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 55-62 Language English Descriptor Fever-therapy; Headache-therapy; Analgesics Plant Extracts Aspirin Reaction Time Descriptor-Local Dialium Guineense Descriptor-Geographic Nigeria Abstract Background: Dialium guineense is a medicinal plant used by some communities of Enugu-Ezike in Enugu State, Nigeria for treatment of fever, headache and other diverse ailments. Objectives: The present study evaluated the analgesic activity of the methanolic stem bark extract of the plant. Method: Acetic acid-induced abdominal constriction or writhing, tail immersion and hot plate analgesic models in albino Wistar mice were used for the study. Three test doses (250, 500, 1000 mg/kg body weight) of the extract were administered orally by gastric gavage. The activity was compared with a standard reference drug, acetylsalicylic acid (aspirin) (400 mg/kg) and negative control. The results were analysed by SPSS version 17 using ANOVA and Post Hoc Duncan. Result: In the acetic acid-induced writhing reflex model, D. guineense extract and the reference drug significantly (P =0.014 - 0.002) decreased the mean total number of abdominal constriction in the mice in a dose dependent fashion. The percentage inhibition of the abdominal constriction reflex was increased dose dependently from 0in the negative control group to 71at the highest dose of the extract (1000mg/kg). In the tail immersion model the extract at the dose of 1000 mg/kg significantly (P = 0. 048) increased the pain reaction time (PRT) while in hot plate model the extract and drug also significantly (P = 0.048 - 0.05) increased the mean PRT at the doses of 500 and 1000 mg/kg. The dose of 250 mg/kg showed no analgesic activity in tail immersion and hot plate models. Conclusion: Dialium guineense demonstrated significant analgesic activity that may be mediated through peripheral pain mechanism. Electronic Access :  Full Text-1

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Record No. 12499 Record ID 012499 Publication type Journal Article Title Neonatal Malaria in the Gambia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Obu, H. A.; Ibe, B. C. Journal Title Annals of Medical and Health Sciences Research ISSN 2141-9248 Place of Publication Enugu Publisher Department of Physiology, Obstetrics and Gynecology University of Nigeria Date of publication 2011 Volume and n° 1(1) Pages 45-54 Language English Descriptor Malaria-prevention & control; Infant, Newborn Sepsis Descriptor-Geographic Gambia Abstract Background: Neonatal malaria was thought to be uncommon, even in malaria endemic areas. Neonates with febrile illness and / or related symptoms are often presumed to have neonatal septicaemia and examination of blood films for malaria parasites is rarely included in the initial work-up of these babies. Objective: To determine the existence, or otherwise, and the clinical features of malaria in neonates with clinical features suggestive of septicaemia. Patients and Methods: In a prospective study, all consecutive babies admitted in the neonatal unit of the Royal Victoria Hospital over an eighth month period with an initial diagnosis of neonatal septicaemia were screened for malaria in addition to an extensive sepsis work-up. Malaria parasitaemia was diagnosed on Giemsa stained blood smears. Results: One hundred and five babies admitted in the neonatal unit of the Royal Victoria Hospital, The Gambia with an initial diagnosis of neonatal septicaemia were studied. Fourteen (13.3) of these babies had positive blood smears for malaria parasites and bacterial cultures of their blood, cerebrospinal fluid and urine yielded no pathogen. Plasmodium falciparum was the only species identified in all the babies. A male preponderance was obtained with a male: female ratio of 2.5:1. Malaria occurred more commonly in babies aged more than one week, thus suggesting that acquired rather than congenital malaria was the more common form of neonatal malaria in the area. All the babies with malaria were admitted within the rainy season period. The principal clinical features observed in these babies were fever, refusal to feed, maternal fever in the last trimester, excessive crying, difficulty in breathing, vomiting, hepatomegaly, abdominal distension and irritability. A similar picture was observed among babies with proven neonatal septicaemia. In addition, depressed primitive reflexes was found to be more common in babies with septicaemia (p=0.01). Conclusions: These data show that neonatal malaria is not uncommon in The Gambia and that the clinical features are akin to those of neonatal septicaemia.

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