Anatomical distribution and biochemical composition of urolithiasis in Kano, northern Nigeria

Urinary lithiasis disorder is one of the oldest disorders known to man yet the anatomic locations of urolithiasis and the chemical compositions vary from one geographic location to another. This study therefore analyzed the anatomic location of urolithiasis and their chemical composition in a sudano-sahelian tropical region. All Urolithiasis extracted from or passed by patients attending Murtala Mohammed Specialist Hospital, Abubakar Imam Urology centre and Aminu Kano Teaching Hospital within the period of four years (2000-2003) were collected, their anatomic locations documented, and analyzed for chemical composition by chemical method. Urolithiasis occur in males six fold more than in females. On the whole the lower urinary stones consisted of 55.7%, while the upper urinary stone was 44.3% of the total urolithiasis extracted (p>0.05). The most frequent anatomic site for all urolithiasis is the urinary bladder (38.6%) followed by ureteric lithiasis (21.4%). Renal stone is more frequent than stones excreted in the urine, 17.1% and 16% respectively. Both urethral and gall gladder lithiasis presented with equal frequency of 8%. Calcium was present in 86.2% of the stones analyzed. Urate and magnesium were not components of all the urethral lithiasis analyzed. Urolithiasis was rare over the age of 65years. Frequency of composite analytes in the stones is presented. The lower urinary calculi were commonest in this centre than the upper urinary calculi and the chemical composition of urological calculi is similar to those reported in other parts of Nigeria.Keywords: Urinary lithiasis, biochemical composition and distribution, calculi and stone formation

Role of a diagnostic laboratory in the management of diabetes mellitus

To elucidate the role of a modern diagnostic laboratory in the management of diabetesmellitus Available literature on local and international studies on the role of the laboratory in the management of diabetesmellitus Preclinical diagnosis of diabetes mellitus, good monitoring of short, medium and long-term glycaemic control necessary to avoid diabetic complications in poor resource settings are now possible with modern diagnostic laboratories. Creating the required awareness on the roles of a diagnostic laboratory in the management of diabetesmellitus is needed now more than ever before in resource poor nations otherwise the success achieved by the developed world where diabetic patients become insulin independent after islet cell transplant with glucocorticoid free immunosuppression cannot be attained in the near future. Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp.68-7

Bacterial pathogens associated with wound infections at the university of maiduguri teaching hospital, Maiduguri, Nigeria

Wound infection is a significant health problem in many parts of the world especially, Africa. It complicates the recovery of the patient, increases trauma care, prolongs hospital stay and has economic consequences on the patient. It also undermines the cost-effectiveness of wound management objectives in health settings. Objective: The study aims at investigating bacterial pathogens associated with wound infections at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methods: Each of the 165 various wound specimens included in the study were streaked on blood and MacConkey agar plates, incubated aerobically at 37oC for 24 hours and colonies were identified and characterized using conventional methods. Result: Out of the 165 wound samples cultured and examined bacteriologically, 98.8% were positive for bacterial growth. Pure culture was obtained in 139 (84.2%), mixed growth of two organisms in 24 (14.5%) and 2 (1.2%) were negative for isolate. The most prevalent (57%) of gram positive organisms was Staphylococcus aureus and of the gram negative organisms, Proteus spp (16.4%). Twenty (83.3%) out of 24 polymicrobial infections were between Staphylococcus aureus and other organisms and 4(16.7%) were among gram negative organisms.Conclusion: It is hoped that reports of this type will create greater awareness in the selection of prophylactics and suitable antibiotic therapy for prompt healing of wounds and reduction of emergence of resistant strains

Outcome of surgery for toxic goitres in maiduguri: A single teaching hospital’s perspective

Background: Thyrotoxicosis a common endocrine disorder of the thyroid gland in Nigeria is commonly treated surgically. The outcome of thyroidectomy for toxic goiters in Maiduguri Nigeria is evaluated.Materials and Methods: Over the last 5 years (Jan 2005-July 2010), in a prospective review, the demographic, and clinical data of patients operated for toxic goiters in our department was entered, into a predesigned proforma and analyzed. The objective of the study is to review our experience with subtotal and near-total thyroidectomy as treatment for benign toxic goiters.Results: Seventy-eight patients, 11 males (14.1%) and 67 females (85.9%), with male: female ratio of 1:6.1 and the mean age of 30 ± 10.9 (range, 17-65 years), underwent thyroidectomy for toxic goiters. The mean duration of symptoms was 41.9 (range 3-126 months). There were 53 patients with toxic diffuse goiters (Grave’s disease) with their mean age of 27.6 ± 6.93 (range 17-38 years), 23 with toxic multinodular goiters, the mean age of 43.7 ± 15.68 (range 17-65 years) and two with toxic nodule. There was no case of permanent recurrent laryngeal nerve palsy or permanent hypocalcemia. Transient hypocalcemia occurred in 9 (11.5%) patients and hemorrhage with hematoma, requiring exploration in 4 (5.1%). There were two cases of wound infection and no postoperative mortality. The mean hospital stay was 7.6 ± 2.34 (range 5-15 days). There was no disease recurrence over a mean follow-up of 20.7 (range 2-48) months.Conclusion: Subtotal thyroidectomy is an effective procedure for the treatment of thyrotoxicosis with few postoperative complications and majority of patients being euthyroid after long follow-up

Seroprevalence of HIV and other sexually transmitted infections (STI 's) among commercial sex workers using lime/lemon juice for vaginal douching.

Aim: The objective is to establish the relationship between STD'S/ HIV infection and vaginal douching with lime/lemon juice among commercial sex workers.Method: 194 CSW's consented for this population base study in-depth interviews were conducted Pelvic examination was carried OUI, vaginal swabs were taken and samples of venous blood were collected for HIV serology test The data obtained from this study was analyse using simple percentage and chi square.Result : Vaginal douching wilh lime juice was practiced by 61.9% of the CSWs. The Sero-prevalence of HIV was higher among lime users 58(48.3%) than non users 29(39.2%). About half of those who were HIV positive usc a higher concentration of lime juice. Significant numbers of users are harbouring Trichomonas vaginalis 65%( P0.004) and Bacterial Vaginosis 58.3%(P0.0000) than non usersConclusion: Vaginal douching with lime/lemon juice is practiced by CSWs. but associated with higher prevalence of HIV/STls. To minimised the risks of HIV infection its used should be modified.Keyword : HIV, vaginal douching lime/lemonjuice commercial sex worker

Determination of the antimicrobial susceptibility pattern of extended spectrum beta lactamase (esbl) producing and the non-esbl producing strains of Escherichia coli

Background: The extended spectrum beta lactamases producing bacteria are bacteria of great concern among Gram negative bacilli. Escherichia coli stand out as major carrier of this enzyme. The appropriate control of this resistance pattern depends on using the antimicrobial regimen of best choice. Therefore the value of the susceptibility profile of organism harboring this enzyme cannot be overemphasized.Objectives: To determine the antimicrobial susceptibility of extended spectrum beta lactamases (ESBL) producing and the non-ESBL producing strains of Escherichia coli from clinical isolates of Escherichia coli in University of Maiduguri Teaching Hospital.Methodology: Confirmed variants of Escherichia coli were screened and confirmed for ESBL possession. Subsequently, modified Kirby Bauer method was utilized to test for antibiotic susceptibility using the commercially available Oxoid single disc for some major antibiotics.Results: A total of 172 strains of Escherichia coli were identified during the study period. Out of this number; 131 were identified as ESBL positive while a total of 41 were ESBL negative. The highest sensitivity for both the ESBL positive and ESBL negative strains of Escherichia coli was observed with Imipenem followed closely by Gentamicin.Conclusion: The study reveals narrow choice of antibiotics for the ESBL positive isolates of Escherichia coli although Imipenem antibiotic still retains its sensitivity.Keywords: Cephalosporins, Resistance, Maiduguri, Nigeri

Stratification enhances sensitivity of reference values for serum urea

To determining the influence of age and gender on reference values for serum urea and electrolytes in north central Nigeria, 480 consented healthy adults (reference individuals) were selected using standard inclusion and exclusion criteria from the locality the Hospital serves. Subjects were stratified by age and sex. Serum urea was determined by Fearon's Method and serum electrolytes determined by flame emission spectrophotometer. Ratio of subgroup standard deviation exceeding 1.5, known physiological difference between subgroups and difference of subgroups' mean values of statistical difference at 0.05 probability were used to categorize health associated reference values for serum urea and electrolytes. Results indicated that reference values for serum urea in North Central Nigeria require stratification by age. However, the sex difference observed for serum urea was not significant enough to justify separate reference values. All the age and sex groups studied had similar reference values for the electrolytes studied. We therefore concluded that enhancing the sensitivity of health associated reference values for serum urea in north central Nigeria would require stratification by age. Keywords: adult reference values, stratification, urea and electrolytes The Tropical Journal of Health Sciences Vol. 13(2) 2006: 24-2

Correlation of oxidative stress and inflammatory markers with the severity of sickle cell nephropathy

Background: Reactive oxygen species have been shown to mediate inflammatory process and may be involved in lipid peroxidation.Methods: This study evaluates superoxide dismutase, glutathione peroxidase, catalase, malondialdehyde, C- reactive protein and fibrinogen in the serum of patients with sickle cell disease and their correlation with renal insufficiency. Superoxide dismutase, glutathione peroxides and C - reactive protein were assayed using sandwich ELISA technique while malondialdehyde and fibrinogen were determined using thiobarbituric reactive substance and turbidometric technique, respectively.Results: The study group consisted of 40 patients with sickle cell disease along with macroalbuminuria, 16 with chronic kidney disease and 144 sickle cell disease controls. Superoxide dismutase, glutathione peroxidase andcatalase were decreased while malondialdehyde, C-reactive protein and fibrinogen were increased in patients with sickle cell disease along with renal insufficiency. These parameters correlated with the severity of renal disease.Conclusion: Oxidative stress and inflammatory parameters correlate with sickle cell disease nephropathy

Oral Glucose Tolerance Test Revisted

Objective: The present review was undertaken to create the required utilization of oral glucose tolerance test in a developing country with a high prevalence of diabetes mellitus and its complications. Sources of data: This review is primarily based on available literature on local and international studies on oral glucose tolerance test Result: Pregnant and non- pregnant preparation; indications, contra indications and the diagnostic criteria for diabetes mellitus using oral glucose tolerance test was elucidated. Determinant for the usefulness or otherwise of oral glucose tolerance test for diagnosis of diabetes mellitus was also discussed Conclusion: Proper understanding of oral glucose tolerance test and teamwork of pathologist, physician, obstetrician, surgeon and pediatrician to face the challenges of diabetes mellitus and its unwanted complications is recommended Nigerian Journal of Clinical Practice Vol.6(1) 2003: 34-3

Serum total antioxidant correlates with hyperglycemia and dyslipidermia in diabetes mellitus

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