Distribution of the McKenzie Syndromes and pelvic girdle pain in pregnancy-related back pain

This study investigated the distribution of the three McKenzie syndromes and pelvic girdle pain (PGP) among participants with pregnancy-related back pain (BP) attending some selected medical facilities. The aim was to determine if pregnancy-related BP can be classified into the three McKenzie syndromes and also to find out the distribution pattern of PGP among the participants.Participants were recruited into the study consecutively and were assessed using the McKenzie assessment protocol and pelvic girdle pain provocative tests. Participants with low back pain (LBP) or high back pain (HBP) were classified into the three McKenzie syndromes and those with PGP were classified according to their pain site. Data were analysed using descriptive and inferential statistics. Alpha level was set at 0.05.The participants with HBP had the lowest mean age (26.2 ±5.6 years). There was a significant difference in the mean age of the participants across the three BP groups (F = 3.9525; p = 0.0199). Among the participants with LBP, derangement syndrome constituted 95.7% and postural syndrome 4.3%. All the participants with HBP had derangement syndrome. Bilateral pain was present in 62% of the participants with PGP.Derangement syndrome was predominant among participants with LBP and HBP while bilateral pain presentation is prevalent among the participants with PGP.It is recommended that the McKenzie approach should be promoted and used in the physical assessment of women with pregnancy-related back pain.Keywords: McKenzie syndromes, pelvic girdle pain, pregnancy-related back pai

Profile of children with cerebral palsy attending outpatient physiotherapy clinics in southwest Nigeria

Cerebral palsy (CP) is a major cause of childhood disability. The objective of this study was to investigate the causes, types, severity, history of pregnancy, delivery, maternal care, demographic and clinical characteristics of children with CP and their parents as seen in outpatient physiotherapy clinics of the selected hospitals in Southwest Nigeria.A cross-sectional survey of children with CP and their parents was conducted in twelve hospitals in Southwest Nigeria. Information about the participants was obtained from hospital case records, physical examination and interviews. Data were summarized using descriptive and Chi-square tests with Alpha level put at 0. 05.Two hundred and thirteen children with CP were seen, aged 18 months to 12 years, and most of them were male (59.2%). The majority (41.0%) of the mothers were in the age range of 28 to 33 years. Jaundice (39.9%), asphyxia (26.8%) and infection (17.4%) were the leading causes of CP and spastic CP was the most common type (81.7%). Quadriplegic CP presentation was predominant (67.1%), and leading co-morbidities were mental retardation (31%) and speech impairment (26.3%). About 50% of the children severely affected by CP fell within Levels 4 and 5 of the Gross Motor Function Classification System (GMFCS) of CP severity.It was concluded that cerebral palsy in Southwest Nigeria is mainly associated with jaundice, asphyxia and infections. Spastic cerebral palsy was most common and quadriplegic affectation was predominant. It is recommended that factors promoting perinatal problems should be curtailed.Keywords: cerebral palsy, jaundice, asphyxia, infections, childhood disabilitie

Prevalence and pattern of musculoskeletal pain among undergraduates from a Nigerian University

Musculoskeletal pain (MSP) is a common cause of severe long-term pain and physical disability affecting millions of people around the world. This study investigated the prevalence and pattern of MSP among Nigerian undergraduates.A cross-sectional survey of undergraduates from three purposively selected halls of residence of the University of Ibadan, Nigeria was conducted over a period of 10 weeks using a standardized Nordic questionnaire and a pre-tested questionnaire. Data obtained were analysed using descriptive and inferential statistics.Of the 600 questionnaires administered 532 (88.67%) were fully completed and found admissible for analysis. The mean age of the respondents was 23.4±2.34 years (range 17-34)]. Lifetime and point prevalence of MSP was 54.5% and 51.7% respectively. Lifetime occurrence of MSP was highest in the low back (55.1%) followed by the neck (53.8%). Duration of pain resulting from MSP was 1-7 days and it prevented normal daily activities in 20.7% of respondents. There was a significant association between lifetime prevalence of MSP and each of age group (p = 0.001), sex (p = 0.046), lecture duration (0.001), and extracurricular activity (p = 0.001). Self-medication (55.6%) was the most common health practice for MSP.Musculoskeletal pain is a common disorder among Nigerian undergraduates. The low back and the neck were the most affected. MSP was perceived to be caused by prolonged poor postures assumed during lectures, and it predisposes to limitation of daily activities. Preventive strategies to reduce MSP among Nigerian undergraduates are necessary.Keywords: Musculoskeletal pain, university undergraduates, prevalence, pattern, Nigeri

High performance liquid chromatographic determination of proguanil after derivatisation with sodium benzoxazole-2-sulphonate

A simple, fast and reproducible method for the determination of proguanil using high performance liquid chromatographic with UV/Fluorescence detection is described. Proguanil was derivatised to its corresponding derivative [(N1-(4-chlorophenyl)-N5-(1 -methyl ethyl) imidocarbonimideamide-Nbenzoxazole]. The derivatisation reaction was conducted in methanol at 60°C using sodium benzoxazole-2-sulphonate under alkaline conditions. The resulting derivative was extracted with chloroform after which the extract was observed under UV lamp at 254 nm before TLC and HPLC analysis. Similarly, the derivatisation process was adapted for derivatisation of proguanil in urine sample. The reaction proceeded smoothly and rapidly. The extraction process was not cumbersome and eliminated the need for costly extraction and evaporation equipments. The resulting derivative fluorensced intensely under UV lamp. Direct HPLC analysis of the reaction mixture was found possible without interferences from excess reagent and endogeneous compounds like ammonium salts. The derivative eluted in less than seven minutes thus making the method suitable for routine use. The calibration plot was linear over the concentration range. A correlation regression of the order of 0.94 was obtained from the calibration curve which indicated a strong relationship between the instrument response and the concentration of proguanil. The discussion also summarizes the derivatisation chemistry that have not being fully explored to date but may find utility in future development of highly sensitive analytical methods for biquanide drugs

Physiotherapy Management of Faecal Impaction: A case report*

This case report describes how a physiotherapy modality was used to resolve faecal impaction. A 38-year old man developed faecal impaction after 8 weeks of intensive medical care. A physiotherapist was invited to apply a suitable modality that could bring relief to the patient. The pre-treatment measurement of the distended abdomen was 102 cm. Modified passive mobilization of the lower limbs towards the abdominal surface was carried out. After 6 sessions, the faecal impaction was resolved. The post-treatment measurement of the abdomen was 86.5 cm. This case demonstrates the important role of a physiotherapy modality in the management of faecal impaction. It is hoped that this study will stimulate the interest of physiotherapists in the management of this condition. KEY WORDS: faecal impaction, megacolon, modified passive mobilization, abdominal distention *This case report was presented at the 46th Annual Scientific Conference of the Nigeria Society of Physiotherapy, November 2006

Suitability of the leaf extract of Jatropha gossypifolia as an anticoagulant for biochemical and haematological analyses

The extract of Jatropha gossypifolia leaf was obtained by crushing the leaf in a mortal and the fluid expressed out. The suitability of the leaf extract as an anticoagulant for biochemical and haematological analyses was determined. The anticoagulant effect of the extract was found to be highest at a concentration of 0.1 ml per ml of blood. Blood tubes with dried leaf extract at the stated concentration were used for obtaining plasma. Mean plasma glucose values obtained from fluoride oxalate plasma were compared with values obtained from dried leaf extract plasma. The values obtained for biochemical parameters with the exception of bicarbonate from the leaf extract plasma samples were significantly higher (

A 37-year-old woman presenting with impaired visual function during antituberculosis drug therapy: a case report

Abstract Introduction Combination antituberculosis drug therapy remains the mainstay of treating tuberculosis. Unfortunately, antituberculosis drugs produce side effects including (toxic) impaired visual function, which may be irreversible. We report a case of antituberculosis-drug-induced impaired visual function that was reversed following early detection and attention. Case presentation A 37-year-old Yoruba woman, weighing 48 kg, presented to our facility with impaired visual functions and mild sensory polyneuropathy in about the fourth month of antituberculosis treatment. Her therapy comprised ethambutol 825 mg, isoniazid 225 mg, rifampicin 450 mg, and pyrazinamide 1200 mg. Her visual acuity was 6/60 in her right eye and 1/60 in her left eye. She had sluggish pupils, red-green dyschromatopsia, hyperemic optic discs and central visual field defects. Her intraocular pressure was 14 mmHg. Her liver and kidney functions were essentially normal. Screening for human immunodeficiency virus was not reactive. Her impaired visual function improved following prompt diagnosis and attention, including the discontinuation of medication. Conclusions The ethambutol and isoniazid in antituberculosis medication are notorious for causing impaired visual function. The diagnosis of ocular toxicity from antituberculosis drugs should never be delayed, and should be possible with the patient's history and simple but basic eye examinations and tests. Tight weight-based antituberculosis therapy, routine peri-therapy visual function monitoring towards early detection of impaired function, and prompt attention will reduce avoidable ocular morbidity.</p

Health status and blood parameters of weaner rabbits fed diets containing varying dietary fibre and digestible energy levels

The maintenance of a good health status in rabbits is hinged upon appropriate balance between dietary fibre and energy level. A 70-day feeding trial was conducted to study the health status and blood parameters of weaner rabbits fed diets containing varying fibre and digestible energy (DE) using a total of ninety 4-weeks-old rabbits. There were 9 dietary treatments laid out in a 3 × 3 factorial arrangement of 3 levels of dietary fibre [low (249-258 g/kg NDF and 149-157 g/kg ADF), optimum (349-381 g/kg NDF and 188-193 g/kg ADF) and high (430-456 g/kg NDF and 249-253 g/kg)] and digestible energy levels [low (8-8.5 MJ/kg), optimum (10.5-11 MJ/kg) and high (12-12.30 MJ/kg)]. Each of the diet was fed to 10 rabbits individually caged in a completely randomized design. Polynomial contrasts were done for linear and quadratic effects. Results indicated that rabbits fed low fibre diets showed high incidence of transitory diarrhoea, total morbidity and symptoms of other sickness. Interaction effect (fibre × digestible energy) indicated that irrespective of the digestible energy level of the diet, mortality, tendency to go off feed and incidence of transitory diarrhoea increased as dietary fibre level increased. Rabbits fed low fibre diets had the least packed cell volume (36.00%) and highest serum uric acid concentration (51.22 mg/dl). Rabbits fed diet containing high fibre + optimum DE recorded the highest packed cell volume (44.00%) and serum glutamate oxaloacetate transaminase (29.00 IU/L). Highest haemoglobin (16.00 g/dl), total serum protein (66.00 g/L) and serum cholesterol concentration (165.00 mg/dl) were recorded with rabbits fed diet containing optimum fibre + optimum DE. It was concluded that feeding low fibre diets increased the susceptibility of rabbits to transitory diarrhoea, morbidity and tendency to go off feed. High fibre diets in rabbit nutrition thus favoured improved health status.   Keywords: Health status, Blood parameters, Weaner rabbits, Dietary fibre, Digestible energ

Comparative Efficacy of Clinic-Based and Telerehabilitation Application of McKenzie Therapy in Chronic Low-Back Pain

Studies on validation of telerehabilitation as an effective platform to help manage as well as reduce burden of care for Low-Back Pain (LBP) are sparse. This study compared the effects of Telerehabilitation-Based McKenzie Therapy (TBMT) and Clinic-Based McKenzie Therapy (CBMT) among patients with LBP. Forty-seven consenting patients with chronic LBP who demonstrated ‘directional preference’ for McKenzie Extension Protocol (MEP) completed this quasi experimental study. The participants were assigned into either the CBMT or TBMT group using block permuted randomization. Participants in the CBMT and TBMT groups received MEP involving a specific sequence of lumbosacral repeated movements in extension aimed to centralize, decrease, or abolish symptoms, thrice weekly for eight weeks. TBMT is a comparable version of CBMT performed in the home with the assistance of a mobile phone app. Outcomes were assessed at the 4th and 8th weeks of the study in terms of Pain Intensity (PI), Back Extensors Muscles’ Endurance (BEME), Activity Limitation (AL), Participation Restriction (PR), and General Health Status (GHS). Data were analyzed using descriptive and inferential statistics. Alpha level was set at p&lt; 0.05.Within-group comparison across baseline, 4th and 8th weeks indicate that both CBMT and TBMT had significant effects on PI (p=0.001), BEME (p=0.001), AL (p=0.001), PR (p=0.001) and GHS (p=0.001) respectively. However, there were no significant differences (p&gt;0.05) in the treatment effects between TBMT and CBMT, except for ‘vitality’ (p=0.011) scale in the GHS where TBMT led to significantly higher mean score. Mobile-app platform of the McKenzie extension protocol has comparable clinical outcomes with the traditional clinic-based McKenzie Therapy, and thus is an effective supplementary platform for care of patients with low-back pain

Medical ethics in sub-Sahara Africa: closing the gaps

Background: Health care providers are expected to have the skills and knowledge relevant to their field and should also be familiar with the ethical and legal expectations that arise out of the standard practices. Objectives: To elucidate the practice of the health care providers in relation to healthcare ethics in Nigeria. Methods: A self-administered structured questionnaire was devised and distributed to staff of two tertiary health care facilities in Northern Nigeria. The questionnaire comprised of detailed questions regarding day-to-day aspects of Medical ethical issues. Results: A total of 307(76.2% ) out of 403 health care providers responded to the questionnaire. The median age of the respondents was 34 years. More than half 168(54.7%) of the respondents disagreed as to whether \u201cEthical conduct is important only to avoid legal action. Many respondents 135 (44.0%) agreed to adhering to \u201cpatient\u2019s wishes\u201d, on the other hand over two-third of the respondents 211 (68.7%) agreed that \u201cdoctor should do what is best\u201d irrespective of the patient\u2019s opinion. There were significant differences (p&lt;0.05) between the perception of physicians and non-physicians on many ethical issues. Conclusion: This study has shown gap in knowledge and practice of healthcare ethics among health care providers. There is a need for periodic education on clinical ethics in our hospitals