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   Table of Contents - Current issue
April-June 2023
Volume 28 | Issue 2
Page Nos. 81-195

Online since Tuesday, March 21, 2023

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Cannabis as medicine: The pros and cons p. 81
Michael T Okafor, Uzoamaka A Okoli, Uwamleeka Opoke, Germaine A Okafor, Elvis N Shu, Chikere A Anusiem
The use of cannabis for medical purposes has been a subject for discussion for so many years. Cannabis as a source of medical treatment first came to light in the 19th century. However, origins of cultivation of marijuana as a medical plant can be traced back to thousands of years. Attempts to completely legalize the use of cannabis for medical purposes are strongly contested in many places due to some of its negative effects on users physically, psychologically, and socially. This review is aimed to discuss the mechanism of action and pharmacogenetics of cannabinoids to elucidate its uses as medicine as well as negative effects. Online searches on the following database: Google Scholar, PubMed, Biomed Central, and SciELO were done. An attempt was made to review articles with keywords such as cannabis, cannabinoid receptors, genes, and medical marijuana. This review has highlighted with evidence the importance of genomic profiling to prevent side effects associated with predisposing genes for the benefit of patients who are medical candidates for medicinal cannabis use. Medical profiling via cannabinoid gene expression studies of patients who are medical candidates of cannabis could prevent the negative effects associated with its use.
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Clinical utility of peak flow meter in asthma diagnosis and monitoring in low- and middle-income countries: A narrative review p. 87
Oluwafemi T Ojo, Adeola O Ajibare, Ayoola Odeyemi, Temitope Fapohunda, Olufunke O Adeyeye
Low- and middle-income countries (LMICs) suffer a disproportionate burden of asthma-related deaths. This may be attributed to the underdiagnosis and undertreatment. It remains unclear the extent to which the access to utility of peak flow meters (PFMs) affect the mortality rates recorded across LMICs. The purpose of this narrative review was to offer a comprehensive overview of PFMs’ clinical value for diagnosing and monitoring asthma in low- and middle-income nations. Using the standards for conducting a narrative review, this paper carried out a literature search on three major databases: Google Scholar, ResearchGate, and PubMed. Search terms were created from the variables present in the topic and strung together to find relevant literature. Exclusion criteria were used to ensure that the chosen articles were relevant after a trickle of articles was collected from various databases on the internet. There is limited knowledge about the clinical utility of PFM in LMICs despite the evidence that it can be used to demonstrate large airway obstruction. There is also limited access to the device in most health facilities and patients for self-monitoring. There is a need for more awareness on the usefulness of peak flow among doctors on the utility of the device for asthma diagnosis and monitoring. There is also a need for more research to assess the impact of the poor use of the device on asthma diagnosis, management, and overall outcome.
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Impact of coronavirus disease (COVID-19) on reproductive health p. 93
Benedict A Falana, Olawale O Obembe, Opeyemi S Adeleke, Gbenga A Adefolaju, Olorunfemi S Tokunbo
The coronavirus disease (COVID-19) is a communicable respiratory disease caused by a new strain of coronavirus that causes illness in humans. The disease is caused by a pathogen called Severe Acute Respiratory Syndrome Coronavirus-2 and can be transmitted from person to person through infected air droplets that are projected during sneezing or coughing. The coronavirus disease has generally affected all sectors of the society, including the health sector and reproductive health in particular. Reproductive health contributes greatly to physical and psychosocial comfort and closeness between individuals. Adequate and balanced reproductive health can be impaired and deprived by diseases, abuse, exploitation, unwanted pregnancy, and death. This review paper looked into possible effects of COVID-19 pandemic on reproductive health. Human and nonhuman primate literatures were examined to extract empirical data detailing the impact of COVID-19 on reproductive health. Literatures were sourced from Ovid MEDLINE, SCOPUS, the Cochrane Library, Ovid EMBASE, CINAHL Plus, PROQUEST, PUBMED, and Web of Science. Experimental and clinical evidence were used to examine whether COVID-19 adversely impacted on the reproductive health of infected and non-infected population. The global outbreak of COVID-19 has led to measures driven by the pandemic, to prevent further spread and effectual treatment of those affected. This has literally caused decrease in sexual and reproductive health care services due to global lockdowns and closures of health sectors deemed to be non-essential in combating the disease.
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Awareness and knowledge of HIV/AIDS among senior secondary school students in Zaria, Nigeria p. 99
Abdulhakeem A Olorukooba, Fahad A Saulawa, Babandi S Zaharaddeen, Ismail A Raji, Halima O Olorukooba, Salamatu Belgore
Background: Nigeria has one of the largest human immunodeficiency virus (HIV) epidemics in the world and one of the highest rates of new infections in Sub-Saharan Africa. The younger age group has been identified as bearing half of the burden of HIV worldwide. This includes secondary-school children. Objectives: The aim of this study was to determine the awareness and Knowledge of senior secondary-school (SSS) students concerning HIV/AIDS. Materials and Methods: A cross-sectional, descriptive study was conducted among SSS students in Zaria, Kaduna state, Nigeria. Respondents were selected using a multistage sampling technique. Data were collected using a pretested, semi-structured, self-administered questionnaire. Descriptive statistics were used to represent univariate level data, whereas chi-square and Fisher’s exact test where applicable were used to identify the relationship between knowledge of HIV and other categorical variables with a level of significance of P < .05. Results: The mean age (± SD) of respondents was 16.1 ± 1.1 years. All (100%) of the respondents were aware of HIV/AIDS. The majority of the respondents knew HIV/AIDS was caused by a virus (89%). Almost a quarter of the respondents (22.1%) believed that antibiotics can prevent HIV. The mean (±SD) knowledge score was 80.5 (± 15.8) out of a total of 100%. Overall, 62 (84.9%) of the respondents had good knowledge of HIV/AIDS. There was a statistically significant relationship between knowledge and tribe as well as the religion of the respondents (P = 0.008 and P = .016, respectively). No statistically significant relationship was found between knowledge and other sociodemographic factors (P > .05). Conclusion: HIV/AIDS awareness and knowledge were good among respondents though some misconceptions still existed. Respondent’s tribe was significantly associated with the level of knowledge of HIV/AIDS. The school authorities and all other concerned agencies should design campaigns targeted at correcting specific misconceptions and gaps in knowledge for the benefit of the students in the study area and the country at large.
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The occupational prestige of the physiotherapy profession: Perception of physiotherapy students p. 107
Chigozie I Uchenwoke, Oliver C Mba, Ijeoma B Anieto, Stephen S Ede, Antoninus O Ezeukwu, Chisom F Okoh
Background: Occupational prestige defines the social standing of a profession. It is a useful indicator of the profession’s marketability and desirability. Objectives: This study aimed at determining the perception of Nigerian students on the prestige of the physiotherapy profession relative to some other selected occupations, and how their perception was influenced by some selected sociodemographics. Materials and Methods: Four hundred and twenty-two copies of a self-administered questionnaire were distributed, completed, and returned from students on the two campuses in Southeastern Nigeria. Data were analyzed using descriptive statistics, Kendall’s W, and chi-square analysis. Results: Respondents included 212 males (50.2%) and 210 females (49.8%). Most of them were between the ages of 20 and 30 years (88.6%). The result of the study showed that Physiotherapy was ranked second on the levels of education, social standing, and responsibility; and third on the levels of income and usefulness to society. The only sociodemographics that influenced the overall perceived occupational prestige of the Physiotherapy profession significantly were age and gender (P < 0.05). Conclusion: There is a need to further improve and maintain the social standing of the physiotherapy profession, to bring about a more improved perception of their profession by the students and the public.
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Sex hormones, antioxidants and lipid profile of aqueous Cucumis sativus L. (cucumber) treated male rats p. 114
Olawale O Obembe, Taiwo A Abayomi, Olorunfemi S Tokunbo, Joseph B Dare, Taofeek O Usman
Background: Cucumis sativus (cucumber) is regarded as a healthy fruit because of the beneficial effects of its phytochemical constituents. However, there is a deficit of information about its effect on male reproductive physiology. Objective: This study was conducted to investigate the effect of aqueous extract of C. sativus (AECS) on male reproductive hormones, oxidative stress biomarkers, and lipid profile. Materials and Methods: Ten male rats were randomly assigned into two (control and treated) groups (n = 5). In the treated group, a single dose of AECS (500 mg/kg) was administered daily for 6 weeks and thereafter sacrificed under sodium pentobarbital anesthesia. Blood was collected and analyzed for sex hormones, antioxidants, and lipid profile markers. The testicular homogenate was also analyzed for antioxidants. Results: The AECS increased (P < 0.05) serum testosterone and luteinizing hormone levels (4.43 ± 0.34 and 7.50 ± 1.31, respectively) when compared with the control. Also, testicular catalase and serum level of high-density lipoprotein were increased (27.45 ± 0.19 and 30.08 ± 5.22, respectively) (P < 0.05), whereas serum low-density lipoprotein decreased (72.79 ± 9.56) (P < 0.05) in the extract treated rats. However, serum antioxidant levels were not affected. Conclusions: AECS is beneficial to male reproductive physiology evidenced by improved lipid profile and hormonal indices. Also, the integrity of the testicular redox profile was well maintained.
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Microalbuminuria among HIV-infected patients from a tertiary health facility in northwest Nigeria p. 119
Bawa I Abubakar, Kabiru Abdulsalam, Sanni Musa, Isah A Yahaya, Sani Adamu, Daniel O Aina
Background: Microalbuminuria and gradual reduction of glomerular filtration rate (GFR) are some of the early manifestations of renal involvement in HIV/AIDS. Therefore, early detection of microalbuminuria provides an opportunity to identify individuals at risk of developing chronic kidney disease, creating a platform for the institution of preventive measures and optimization of comorbid conditions. Objective: The main objective of this study was to determine the prevalence of microalbuminuria in HIV/AIDS-infected adults in a tertiary heath institution in Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out among 750 participants including 250 highly active antiretroviral therapy (HAART)-treated and 250 HAART-naive HIV/AIDS participants and 250 age-matched controls. An interviewer-administered structured questionnaire was used to collect relevant demographic and clinical information. Blood and urine samples were collected for serum creatinine and urinary albumin and creatinine measurements, respectively, and the results were collated and analyzed. Data were analyzed with SPSS version 20.0 with level of significance set at P < 0.05. Results: The prevalence of microalbuminuria among HIV/AIDS-infected participants was 20.6% when compared with 4.0% for the control group with statistically significant difference (P = 0.001). HAART-treated and HAART-naive groups have prevalence of 18.4% and 22.8%, respectively, with no statistically significant difference (P = 0.22). Low CD4 count and estimated GFR <90/mL/min/1.73 m2 were associated with the development of microalbuminuria. Conclusion: This study has shown that microalbuminuria is common among both HAART-treated and HAART-naive HIV/AIDS patients. Screening for microalbuminuria is recommended in all HIV/AIDS patients to allow for early detection of renal damage.
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Knowledge of hand hygiene and use of alcohol-based hand rub among interns in a Nigerian Tertiary Health Facility p. 127
Ifeoma J Ogugua, Kingsley I Achigbu, Denning M Chukwumam, Chioma A Ejim, Eunice O Enabulele, Chioma F Friday-Edeh, Hope O Nwoga, Ernest O Nwazor, Johnson S Mafuka, Somtochukwu R Akunne
Background: Healthcare-associated infections and antimicrobial resistance are both largely prevented through hand hygiene. There are still gaps in hand hygiene knowledge and routine use of alcohol-based hand rub among healthcare workers. Objectives: This study assessed the knowledge of hand hygiene and the use of alcohol-based hand rub among interns at the University of Nigeria Teaching Hospital, Enugu State, Nigeria. Materials and Methods: A cross-sectional study was conducted among 230 interns using a structured WHO hand hygiene knowledge questionnaire. A two-stage sampling technique was employed. Descriptive and inferential statistics were carried out and p-value was set at ≤ 0.05. Results: Two respondents (0.9%) had good knowledge of hand hygiene while slightly more than half (117/230, 50.9%) had moderate knowledge. Also 50.9% (n = 117) used alcohol-based hand rub. Majority of the respondents, 140 (60.9%) had attended training in hand hygiene. Sex was significantly associated with the knowledge of hand hygiene (p=0.03) as male respondents had a higher proportion of good knowledge while having received training on hand hygiene was significantly associated with routine use of hand hygiene (p=0.004). Conclusions: Since only very few of the interns had overall good knowledge of hand hygiene, targeted structured training on hand hygiene and infection prevention and control practices to improve the knowledge of such healthcare workers is highly recommended.
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Assessing current and preferred sources of information on adolescents’ sexual and reproductive health in Southeast Nigeria: A mixed-methods study p. 134
Chibuike I Agu, Chinyere O Mbachu, Ifunanya C Agu, Chinyere Okeke, Mildred N Ndubuisi, Nkoli Ezumah, Obinna E Onwujekwe
Background: Although there are numerous information on sexual and reproductive health (SRH), these vary in content and quality. Objectives: This study examined the sources of SRH information, its value, and their significance for adolescent health programming. Materials and Methods: This was a mixed methods, community-based study conducted in six local government areas. Quantitative data were collected from 1057 unmarried adolescents aged 13–18 years. The qualitative data were collected through in-depth interviews (IDIs), and focus group discussions (FGDs). Descriptive and inferential analyses were performed for quantitative data using Stata software, while thematic framework approach was used to analyze qualitative data. Results: Adolescents reported school teachers (60.5%) and mothers (39.8%) as their major sources of information on signs of puberty. While, teachers (36.3%) and friends/peers (29.8%) were reported as their major source of information on relationship with opposite sex. Bivariate analysis shows that gender had statistically significant associations with parents/guardians (P < 0.001), other family members (P < 0.001), and friends (P = 0.01) as adolescents’ sources of information about relationship with opposite sex. Age category was found to be statistically significant associated with other family members (P < 0.001), teachers (P < 0.01), and friends (P < 0.001) as adolescents’ sources of information about puberty. Other common sources of SRH information elicited through adolescents’ interviews were internet, social media and mass media. Most adolescents valued information from teachers and parents, but preferred receiving SRH information from their friends/peers, social media and mass media because these sources are easy to access with a guarantee of some level of confidentiality. In the opinion of parents and other stakeholders, sources of appropriate SRH information for adolescents were health workers, teachers, parents and adult family members; whereas peers/friends and social media were considered as inappropriate sources of SRH information for adolescents. Conclusion: Efforts at addressing adolescents’ needs for SRH information should be targeted at their valued and preferred sources, whilst maintaining a delicate balance with the expectations of parents and other adults.
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Demand for plastic surgery services via inpatient referrals in a Nigerian Teaching Hospital p. 145
Uchechukwu J Achebe, Obinna R Okwesili, Okechukwu O Onumaegbu
Background: Plastic surgery is one of the most collaborative surgical specialties and is also considered the most consulted service in a hospital. Plastic surgeons respond to many medical consults or inpatient referrals, and the comprehensive impact of these services, when they are nonoperative, often goes unnoticed. Objectives: The objectives of the study were to assess the nature of demands of plastic surgery services for admitted patients in a teaching hospital and the specialties and types of patients that benefit from them. Materials and Methods: Clinical records of inpatients evaluated by plastic surgeons were retrieved using a compendium of consults received from other specialties within the hospital over a period of 1 year period. Results: The plastic surgeons received a total of 151 hand-written consults from surgeons, physicians, gynecologists, and pediatricians. The vast majority came from physicians (45.7%) and surgeons (40.4%). Among the physicians, endocrinologists sent the highest number of consults (42.5%). Ulcers constituted the commonest reason for inpatient referrals (66.2%). Over 29% of consults were for patients with primary diagnosis of diabetes mellitus, whereas 13.9% were for head injuries. Conclusions: The demands for the services of plastic surgeons come from virtually all the clinical specialties in a tertiary hospital. The commonest reason for such referral is for their review and management of ulcers. There is a need to utilize telemedicine in reducing the burden of reviewing these patients, especially in large tertiary hospitals.
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Blood transfusion reactions and institutional hemovigilance protocols: A 2-year retrospective single center audit p. 150
John C Aneke, Chisom G Chigbo, Perpetua O Emeh, Francis Ifediata, Chilota C Efobi, Ugochinyere J Chilaka, Nkechinyere T Ibekwe, Theodora U Ezeh, Chiamaka B Aneke
Background: Blood transfusion reactions contribute significantly to the morbidity and mortality of both in- and outpatients in hospitals globally. Developing adequate protocols for detecting and reporting this complication is key to attaining global blood transfusion safety. Objective: The objective of the study was to review the frequency of blood transfusion reactions and the adequacy of institutional hemovigilance efforts in a Nigerian hospital. Materials and Methods: Records of patients that had blood transfusion reactions (cases) and those that did not (controls) were analyzed over a 2-year period. Sociodemographic information, transfusion and admission histories, primary diagnoses, as well as transfusion reaction details (where applicable) were recorded. Data were analyzed using STATA 16.1 (StataCorp. 2019, Stata Statistical Software: Release 16, College Station, TX: StataCorp LLC). Sociodemographic characteristics were presented in frequency tables and charts, whereas relationships between study variables were compared using the Chi-square and the Person Correlation. P value less than 0.05 was considered to be statistically significant (confidence level = 95%). Results: One death was recorded among the cases during the study, whereas febrile nonhemolytic reactions constituted the most type of reaction (41.5%). Only 37.5% of reactions were investigated, and none was reported to the hospital blood transfusion/hemovigilance committee. There was no significant association between the study-related variables and the type of reaction or the likelihood of experiencing a new reaction with subsequent transfusions (P values all > 0.05). Conclusion: Febrile reactions are the commonest complication of blood transfusion in our data set; institutional hemovigilance efforts remain suboptimal and should be further strengthened.
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Substance abuse among medical students of a Nigerian University: Prevalence, factors influencing use, and effects on academic performance p. 156
Chinedu A Idoko, Ikechukwu C Chidolue, Chinelo I Idoko, Chibueze K Eze, Emmanuel Ucheya
Background: Substance abuse is simply the use of illegal drugs, prescription/over-the-counter drugs as well as alcohol for purposes other than they are designated for, or in excessive amounts. Indulgence in these is high among students, with attendant negative consequences. Objectives: The objectives of this study were to determine the prevalence of substance use among the students, factors influencing use and the effect on academic performance. Materials and Methods: It was a cross-sectional descriptive study with respondents selected by simple random sampling. Structured questionnaires were self-administered and data analyzed using Statistical Package for Social Sciences (SPSS). Results: Caffeine (170/300, 56.7%) happened to be the substance mostly abused and cannabis least abused (6/300, 2%). The major reason for the excessive usage of caffeine was for alertness (215/300, 71.7%) during exams period. There was no significant association between drug use prevalence and improvement in respondents reading pattern/ability to effectively concentrate at lectures. However, there existed a significant association between respondents’ sociodemographics (age, sex) and prevalence of substance use (p < 0.05). Conclusions: Substance abuse is common among medical students and it is influenced by some sociodemographic factors. Substance use had no significant effect on the academics of the study participants. Stress management strategies/courses should be included in the medical education curriculum.
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COVID-19 vaccine uptake among clinical medical students in Enugu, Nigeria p. 161
Chinedu A Idoko, Ikechukwu C Chidolue, Ntat C Ibiok, Kingsley Eze
Background: The COVID-19 pandemic shook the world, claimed a lot of lives, incapacitated many, and forced majority of the world into a lockdown. Vaccination is the key strategy to tackling the virus. Objectives: To ascertain the level of vaccination and the difficulties associated with vaccination, among clinical medical students in Enugu, South-East Nigeria. Materials and Methods: A multistage sampling was used to select 160 respondents while questionnaires (hard and soft copy) were administered to the participants. The IBM Statistical Package for the Social Sciences was used for data entry and data analysis. Results: There was a poor (16.3%) knowledge, negative perception (66.3%), and poor uptake of the COVID-19 vaccine (20.6%). There were statistically significant relationships between vaccination status, knowledge of vaccine, age, and perception of the vaccine (P = 0.000) as well as between level of training and vaccine perception (P = 0.03). Conclusion: There was very low level of COVID-19 vaccination in the study population that may be attributable to the low knowledge of the vaccine and the high negative perception. The rush to development of the vaccine, possible side effects, and possible long-term complications may be contributory to the poor uptake of the COVID-19 vaccine among the study respondents.
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Analysis of burden and outcomes of anticoagulant induced adverse drug effects at a tertiary care centre p. 167
Arnav H Tongaonkar, Kavita S Joshi, Alhad A Mulkalwar, Shweta D Gajare
Background: Anticoagulants are among the most commonly used drugs in hospitalized patients known to cause adverse drug reactions (ADRs). They have commonly been used as standard therapy in venous thromboembolism, stroke prevention, etc. Objectives: The authors aimed to assess the incidence of ADRs, clinical profile, severity and causality among the admitted patients taking anticoagulants in a tertiary care hospital. Materials and Methods: This was a hospital-based, prospective, observational, non-interventional cohort study undertaken in the General Medicine Wards of King Edward Memorial Hospital, Mumbai from June 2017 to December 2018. Every patient’s data was recorded using a structured ADR reporting form. The baseline parameters, medical history and underlying diseases, clinical data, characteristics of ADRs, and details of medication responsible for ADRs, as well as details of the drugs used for treatment of ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences (SPSS) version 26.0 software. Results: Out of the 164 patients admitted due to ADRs within the study period, 32 (19.5%) had developed ADRs due to anticoagulant treatment. Most anticoagulant-related ADRs involved the vascular system (n = 32). The severity of ADR was found to be mild in one patient (3.1%), moderate in 22 patients (68.8%), and severe in nine patients (28.1%). Twenty (62.5%) patients completely recovered, nine (28.1%) patients were still recovering (at the time of the analysis of the data), and three (9.4%) patients had a fatal outcome. Presence of systemic comorbidities and polypharmacy were found to be significant risk factors associated with anticoagulant-associated ADRs. Conclusion: Anticoagulants commonly cause ADRs in the study population. Patient education at the time of prescription can prevent many ADRs due to medication error or poor compliance. In addition, installing a better surveillance system in hospitals could alleviate the prevalence of ADRs.
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Clinical profile and short-term outcomes of patients admitted with acute pulmonary embolism in a tertiary care centre p. 173
Vinayak Pai, Suyash Ambekar, Milind Nadkar, Alhad Mulkalwar, Priyadarshi Prajjwal
Background: Venous thromboembolism is a major contributor to the global disease burden, with an incidence of around 10 million cases per year and substantially associated morbidity and mortality. Objectives: The study aimed to assess the clinical, laboratory, and radiological profile along with electrocardiogram and echocardiogram changes and the treatment and outcomes in patients admitted with acute pulmonary embolism (PE) in a tertiary care centre. The etiologies and risk factors of the same were also evaluated. Materials and Methods: This was a hospital-based prospective observational study conducted among 31 patients over a period of 18 months. The study was conducted at a tertiary care centre in the Department of General Medicine. Patients of age more than 12 years, admitted with a confirmed diagnosis of acute PE based on computed tomography pulmonary angiography (CTPA), were included in the study. Results: Thrombolysis was done in 12.9% cases, while anticoagulants were given in 87.1% cases. Oxygen therapy was required in 74.2% cases on day 1 while in 9.7% on day 30. Secondary pulmonary hypertension was the commonest complication observed in the study, in 54.8% cases. Severe hypoxia was seen in 35.4% cases. No complications were seen in 6.4% cases. Mortality was recorded in 9.6% of the cases. Conclusion: Since PE is among the leading causes of death and disability, there should be a high degree of suspicion in all clinical settings. And since prolonged immobilisation is a strong risk factor for PE patients at risk, they should be offered prophylactic anticoagulation.
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Can Gartner’s duct cyst trigger marital disharmony? A case report p. 182
Olanrewaju S Jimoh, Rofiat T Lemboye-Bello, Olawale O Ogunjinrin, Adewale M Alayo
Gartner’s duct cyst (GDC) is a remnant of the mesonephric (Wolffian) duct in females. The GDC is formed from the persistence of some portions of the mesonephric duct in adult females resulting in small-sized cysts usually in the anterolateral vaginal wall but could be found elsewhere along the tract of the duct. The case of a 33-year-old para 5+1 (three alive) woman who had GDC is reported. The patient presented with incidental findings of a vaginal mass during gynecological evaluation and subsequently had dyspareunia. A provisional diagnosis of GDC was made and this was confirmed by transvaginal ultrasound. The patient had transvaginal excision of the cyst and histological confirmation of a benign cystic lesion with the diagnosis of GDC. GDC is a rare entity and clinical examination revealing a cystic vaginal wall mass with or without symptoms should raise a high suspicion of this condition.
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Unruptured sinus of valsalva aneurysm coexisting with ventricular septal defect p. 188
Nneka C Udora, Amamihechineke G Ojiakor, Nelson I Oguanobi, Raphael C Anakwue
Unruptured sinus of valsalva aneursym is an incidental, relatively rare finding on cardiac imaging and is often found in association with other cardiac defects with ventricular septal defect as the commonest. It presents a diagnostic challenge on transthoracic echocardiography in coexistence with ventricular septal defect in adulthood, mimicking other cardiac defects. Unruptured sinus of valsalva aneurysm coexisting with ventricular septal defect usually presents with symptoms of rupture—a surgical emergency in the third and fourth decade of life. We report a case of a 24-year-old single mother referred to the Cardiology Clinic of the University of Nigeria Teaching Hospital with 5 months symptoms of heart failure. Investigations showed cardiomegaly, prominent pulmonary conus, and upper lobe vessel diversion on chest x-ray. There were bigeminal premature ventricular contractions, left atrial abnormality, biventricular hypertrophy with a right strain on electrocardiogram, and bidirectional membranous ventricular septal defect with right sinus of valsalva aneurysm on transthoracic echocardiography.
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A case report of intracholecystic papillary neoplasm presenting as gallbladder polyp p. 193
James Thiek, Lachit Kalita, Kiran Kamalasanan
Intracholecystic papillary neoplasm was a newly proposed term in the 2019 World Health Organization classification of tumors of the digestive system, as a preinvasive neoplasm of the gallbladder. We report a case of intra-cholecystic papillary neoplasm, biliary type with high-grade dysplasia presenting as a polypoidal mass in the fundus of the gallbladder, in a 47-year-old man with a history of periodic abdominal pain and dyspepsia of 6-month duration. As the term for the pathological classification in itself is new, we wish to report this case for record storing purposes that may be imperative if any further study on the said topic is planned in the future.
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