Gallbladder stone as a possible cause of acute and recurrent abdominal pain in Nigerian adolescent sicklers: A report of two cases

Nigeria has the highest population of people with sickle cell disease globally. As these patients live longer chronic complications are bound to be encountered more frequently. This case report presents two adolescents with gallbladder stones, to highlight the increasing importance of the condition as a cause of acute and recurrent abdominal pain in Nigerian sicklers. First patient is a 14-year-old male sickler with recurrent abdominal pain, and typical changes in the stool, over a period of six months. Abdominal ultrasonography revealed gallbladder stones as the most likely cause of the pain. The second patient is a 17-year-old male who presented with a day history of abdominal pain. Ultrasonography also revealed gallbladder stone as the most likely cause of the pain. It is concluded that gallbladder stone is becoming an increasing important cause of abdominal pain in Nigerian sicklers. Abdominal ultrasonography with a deliberate search for gallbladder stones should be routine in sicklers presenting with abdominal pain

Ulcerative colitis in a Nigerian child: case report

Ulcerative colitis (UC) is a chronic re-occuring inflammatory disease affecting mainly the colon. It is more prevalent in the United Kingdom, North America Scandinavia and less common in southern Europe, Asia and Africa. Commonly, UC is suspected in patients presenting with bloody diarrhoea, tenesmus, abdominal pain, and, when severe, weight loss, fatigue, and vomiting. Perhaps one child so far with UC has been reported southwest geo-political zone of Nigeria. We here report the first case of ulcerative colitis in a child in south-south Nigeria.The objective of this report was to highlight the occurence of ulcerative colitis in a Nigerian child in the setting of poor sociopsychological/economic background coupled with difficulty in investigating patient to arrive at a diagnosis. An 11 year old Nigerian male child who was referred to the University of Calabar Teaching Hospital with bleeding per rectum, abdominal pain and swelling, bilateral leg swelling and weight loss for seven months prior to presentation. Examination and investigations done including colonoscopy, histology of biopsy, faecal calprotectin and pANCA confirmed ulcerative colitis. Ulcerative colitis though rare in Africa may have been missed in some children due to mis-conception and lack of diagnostic facilities/expertise. We may begin to see more of this with increasing interest in the subspecialty of paediatric gastroenterology and presence of diagnostic facilities.Keyword: Ulcerative Colitis, Diagnostic difficulties, Nigerian chil

Pre-presentation management, metabolic state and outcome of children admitted for diarrhoea disease in Calabar, Nigeria

Background: Much of the activities for the prevention and management of diarrhoea should occur or be initiated at home. In addition, management is guided by clinical and metabolic state. This work was designed to examine some prehospital management practices and the metabolic state of children with diarrhoea in Calabar, Nigeria.Methodology: Prospective study of the pre-presentation management, clinical and metabolic states of children with diarrhoea presenting at University of Calabar Teaching Hospital, Calabar from April to November 2016. History was used to determine prepresentation management while blood glucose and electrolytes were determined before initiation of treatment.Results: Forty-four children aged 4 – 13years, mean 18.65 ± 17.37months were recruited into the study. Forty (90.91%) had acute watery diarrhoea and 4 (9.09%) had dysentery. Of these, 72.27%had oral electrolyte solutions at home and nine (20.45%) zinc. Twelve (27.27%) had mild, 26 (45.4%) moderate and 3(6.82%) severe dehydration.Twenty (63.64%) had metabolic acidosis, 18(40.91%) hyponatraemia and 18(40.9%) azotaemia suggesting Acute Kidney Injury. Two (4.50%) had hypoglycaemia while 16(36.30%) had hypozincaemia.Conclusion: A majority of children with diarrhoea have oral electrolytes solution before presentation in the hospital and all had continued feeding. There is a high proportion with hyponatremia and more than a third hadazotaemia. Modality of treatment at home did not seem to affect these parameters, perhaps because all subjects had continued feeding. Further studies on the appropriateness of low osmolarity ORS in this environment and renal function of children with diarrhoeaare recommended.Keywords: Diarrhoea, Prehospital Management, electrolytes derangemen

KNOWLEDGE AND PRACTICE OF EMERGENCY CONTRACEPTION AMONG FEMALE UNDERGRADUATES IN THE UNIVERSITY OF LAGOS, NIGERIA

Objectives: To assess the level of knowledge and practice of emergency contraception among female undergraduates in University of Lagos and to determine the factors that influence knowledge and practice of emergency contraception among female undergraduates.Design: Cross-sectional descriptive study.Setting: The University of Lagos, Lagos, South-West, Nigeria between August 2003 and March 2004.Subjects: Four hundred and eighty randomly selected female undergraduate students.Results: The findings revealed that 67.8% of the respondents reported knowing about emergency contraception. More than half (56.1%) were sexually active and of this group, 96.8% had ever practiced contraception with only 33.9% having ever practiced emergency contraception. However, only 37.8% and 36.3% of respondents who had reported knowing about emergency contraception knew the correct time frame for effective use, and correctly identified emergency contraceptives respectively. Among those who were aware of, and had used emergency contraception, 34.1% obtained their information from health care providers, while the larger majority obtained from friends. Knowledge and practice of emergency contraception was found to be directly related to age, level of study, medical education, marital status, sexual activity, previous history of use of contraceptives and previous history of induced abortion.Conclusion: Education efforts that focus on the training of health care providers and young adults on emergency contraception with regards to available methods and correct timing of use would greatly improve women’s access to and effective use of this method in Nigeria

Clinical significance of oestrogen and progesterone receptors in the growth and symptomatology of uterine fibroids

Background: Uterine fibroids are responsible for significant morbidity in a large proportion of the female population of the reproductive age worldwide. Hence, there is a need to determine the levels of oestrogen and progesterone receptors in relation to the growth and symptomatology in a purely African population noted for high  incidence of uterine fibroids.Objectives: To determine the levels of oestrogen and progesterone receptors in normal myometrium and uterine fibroids and ascertain whether there are any significant clinical associations.Materials and Methods: This was a prospective study conducted at the Obstetrics and Gynaecology Department in collaboration with the Morbid Anatomy Department, both at the University of Benin Teaching Hospital (UBTH). Tissue specimens obtained from uterine fibroids and normal myometrium during surgeries performed on patients with a pre‑operative diagnosis of uterine fibroids were histologically  examined. The concentrations of oestrogen and progesterone receptors were  histochemically determined for the selective tissue slides. The results and the  socio‑demographic characteristics of the patients were used to generate a database for analysis.Results: A total of 262 cases of uterine fibroids were analysed. Those presenting with lower abdominal mass had more oestrogen receptors in uterine fibroids (57.0%, P = 0.014), whereas more progesterone receptors were found in those presenting with menorrhagia (P = 0.001). A comparison of oestrogen and progesterone receptors in uterine fibroids and normal myometrium showed significantly higher levels of oestrogen and progesterone receptors in fibroids than in normal  myometrium (P = 0.000).Conclusion: The concentrations of oestrogen and progesterone receptors in uterine fibroids were significantly higher than those in normal myometrium. The steroid dependence of the growth and symptomatology of uterine fibroids may be related to the steroid receptor level. Identification and quantification of the concentrations of oestrogen and progesterone receptors will be useful in the prognostication and the development of newer treatment modalities for uterine fibroids. Further research in this area is clearly warranted.Key words: Myometrial tissues; oestrogen receptors; progesterone receptors;  uterine fibroids; University of Benin Teaching Hospital

Sexual behaviour, HIV-related knowledge and condom use by intra-city commercial bus drivers and motor park attendants in Lagos, Nigeria

A study was undertaken among 395 intra-city commercial bus drivers, conductors and motor park attendants in a sub-urban community in Lagos, Nigeria. It was aimed at ascertaining the level of knowledge of the participants on sexually transmitted diseases including AIDS, their sexual practices and perceived vulnerability to these diseases and, in particular, their attitude to and use of condoms. A semi-structured interview schedule was used for data collection. The men were found to have a strongly woven network of sexual relationships. Their sexual network included, apart from their wives and regular partners, commercial sex workers, young female hawkers, schoolgirls, and market women within and outside the motor parks. More than two thirds (74.3%) of the men had multiple sex partners and many of them had had sexually transmitted diseases at one time or another. Condom ever-use rate was 65.6% but consistent and regular use rate with casual partners was 11.6%. Almost all the respondents (96.4%) knew themselves to be at high risk of contracting STDs, while 87.6% felt that it was impossible for them to "catch" AIDS. Poor knowledge of risk factors for STDs was exhibited, as many of them attributed their previous STDs to excessive exposure to the sun, having sex in the sun, and their partners remaining in the bath for too long. Intra-city commercial bus operators and men at motor parks are a high risk group for acquiring HIV infection. Their sexual networking with a variety of women within and outside the parks also seems to suggest that they play a major role in transmitting HIV infection in urban communities in Nigeria. There is a need for intervention programmes with a focus on men at motor parks and similar high risk groups. (Afr J Reprod Health 2005; 9[1]: 78-87

Lipid profile of apparently healthy adolescents in Calabar, Nigeria.

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Ureteric injuries complicating obstetric and gynecologic operations in the University of Calabar Teaching Hospital.

A retrospective study to determine the rate and pattern of ureteric injuries complicating gynecologic and obstetric operations in the University of Calabar Teaching Hospital (UCTH) during a ten-year period (1990 –1999) was undertaken. The number of major operations carried out during the period was 9350. Of these, 8670 (92.7%) were gynecologic procedures and 680 (7.3%) obstetric. Eight cases of ureteric injuries were recorded during the period under study. Three of these occurred with obstetric operation giving an injury rate of 0.4% (3 of 680), while the rate for gynecologic operations was 0.06% (5 of 8670). The overall injury rate was 0.09 % (8 of 9350). We conclude that ureteric injuries complicating obstetric and gynecologic in this centre are very rare. Such injuries are more frequent with obstetric compared to gynecologic operations. Prognosis is good when these injuries are recognized early and given appropriate treatment. (Global Journal of Medical Science, 2004, 3 (1&2): 1-3

The influence of sociodemographic factors, knowledge and attitude on the practice of blood donation

Background: Maintaining a constant supply of blood in the blood bank is essential to the practice of medicine today. Safe supplies can only be achieved by continual recruitment and retention of voluntary blood donors which is based on effective and efficient education/intervention.Aim: The study was aimed at assessing the knowledge, attitude and practice of blood donation amongst adults in Mushin local government of Lagos and determining the factors which affect the practice of blood donation.Study Design: This was a cross-sectional study involving 360 adults recruited using a multistage sampling technique. A structured pre-tested questionnaire was used to collected data on knowledge, attitude and practice. Data analysed using SPSS version 21. Frequency and percentages were calculated for categorical data and mean was determined for continuous data. Association was determined by unconditional logistic regression. Statistical significance was considered at P=0.05.Results: The mean age of respondents was 35.08± 11.6years and males accounted for 54.89% (194) of study population. Two hundred and forty three (67.5%) had adequate knowledge of blood donation while 315(87.5%) had a favourable attitude. Only 63(17.5%) had ever donated blood before. Males, who had adequate knowledge (AOR=7.128, CI=2.55-19.91), tertiary education (AOR=6.433, CI=2.084-19.85) and between the ages of 41-50years (AOR=6.027, CI=2.655-13.680) had greater odds of donating blood. Fear was the major deterrent to donation blood.Conclusion: The practice of blood donation was low. Key determinants for the practice of blood donation were male sex, adequacy of knowledge, tertiary education and age between 41 and 50years.Keywords: Voluntary non remunerated donors, knowledge, attitude, practice, blood donatio