Hospital In North-West Nigeria Research Articles

Assessment of depressive symptoms among post stroke patients attending a Nigerian tertiary hospital

Background: Post Stroke Depression (PSD) occurs in a significant number of patients and constitutes an important complication of stroke, leading to greater disability as well as increased mortality. This study examined depressive symptoms among post stroke patients attending neurology clinic in a tertiary hospital in Northwest Nigeria. Methods: This cross-sectional study was carried out among 83 stroke survivors. Participants were administered socio-demographic, clinical characteristics pro-forma questionnaire and depression subscale of the Hospital and Anxiety Depressive Scale (HADS). Results: The 83 participants recruited for study had a mean age of 56.8 years (s.d. = 10.2) and 62.7 % were female. Majority (60.2%) had formal education, 83.1% were employed, and 73.5% were married. Overall, the prevalence of depressive symptoms was 34.9% while 2.4% were rated as having severe depressive symptoms. Unemployment, having disabilities and post stroke complications were significantly associated with depressive symptoms. Conclusion: The presence of depressive symptoms among stroke patients supports the need to consider routine screen for psychiatry morbidity among patients with medical condition that causes disabilities. Disability has been identified as the main predictor of depressive symptoms. In view of this, psychosocial evaluation and intervention should be integrated into clinical care of stroke patients for early detection of depressive symptoms.

Histopathological patterns of endometrial carcinoma in a tertiary hospital in North-West Nigeria.

There are relatively few studies in Nigeria, and indeed, sub-Saharan Africa that have documented the relative frequencies and histomorphological patterns of endometrial carcinoma. This study aimed to determine the relative frequencies and clinic-epidemiological characteristics of endometrial carcinoma and its histological variants in Kano, North-Western, Nigeria. A 10-year retrospective study of all endometrial carcinoma cases in the Department of Pathology, Aminu Kano Teaching Hospital, Kano. All relevant information was retrieved and data was analysed using Statistical Package for Social Sciences version 22. Endometrial carcinoma showed an increment in prevalence from 0.5% of all gynaecologic admission in 2008 to 1.0% in 2017. Type I endometrial carcinoma, specifically endometrioid adenocarcinoma accounted for 80% of cases, while endometrial serous carcinoma was the most common type II endometrial carcinoma representing 20% of cases. Over 75% of endometrial carcinomas occurred in postmenopausal women with a mean age of 59 years. There is a rise in the prevalence of endometrial carcinoma and endometrioid adenocarcinoma is the most common histologic type.

Chronic osteomyelitis of the jaws: A 7-year retrospective clinico-surgical evaluation in a tertiary hospital in Northwest Nigeria

Chronic osteomyelitis of the jaws: A 7-year retrospective clinico-surgical evaluation in a tertiary hospital in Northwest Nigeria

Concurrent incidence of noma and necrotizing fasciitis in a male child: A rare clinical case report from a referral hospital in Northwest Nigeria

Concurrent incidence of noma and necrotizing fasciitis in a male child: A rare clinical case report from a referral hospital in Northwest Nigeria

Awareness and Acceptance of Cervical Cancer Screening in Pregnancy among Antenatal Clinic Attendees in a Tertiary Hospital in Northwest Nigeria

Awareness and Acceptance of Cervical Cancer Screening in Pregnancy among Antenatal Clinic Attendees in a Tertiary Hospital in Northwest Nigeria

LEVELS AND ASSOCIATED FACTORS OF DEPRESSION AMONG VESICOVAGINAL FISTULA PATIENTS IN A STATE HOSPITAL, NORTHWEST NIGERIA

Vesico-vaginal stula (VVF) is the commonest urogenital stula in Sub-Saharan Africa. The psychological consequences of the condition though neglected may be more devastating than the physical injuries. The study aims to assess the levels and associated factors of depression among VVF patients in State Hospital in Northwest Nigeria. Adescriptive survey research design was utilized and data was collected among sixty women (60) with vesico-vaginal stula selected using purposive sampling technique using an interviewer administered questionnaire. The data was analyzed using SPSS Version 23.0 and ndings were presented in frequency distribution tables. Findings from the study shows that more than half (60%) of the respondents were between 15-24years old, four-fth (80%) of the respondents had no formal (Quranic) education and Three-fourth (71.7%) of the respondents were married. Majority of the respondents (61.7%) had moderate depression and the main factors associated with depression were lack of employment (96%), nancial problems (95%), lack of family support (95%), and stigma from the society (91.7%). Their main coping strategies adopted were prayers and emotional support. The study concluded that majority of women with VVF are faced with moderate depression and these are linked to the factors associated with depression. The nurses, family, hospital management and the government should assist in providing psychological support through various services to enhance and also improve mental health and quality of life of women suffering from Vesico-Vaginal Fistula.

Informed Consent: The Surgical Patient's Experience in a Tertiary Hospital in Northwest Nigeria

Background: Obtaining informed consent (IC) before a surgical procedure is the cornerstone of medical practice. The practice of IC continues to evolve as litigations increase. Most studies on patients' perspectives of IC are either old or were done in southern Nigeria. This study assessed the surgical patients' IC experience in a tertiary hospital in northwest Nigeria.
 Methods: This cross-sectional study assessed 244 consecutive patients who had elective surgeries in surgical departments of a tertiary hospital. Pretested questionnaires were used to collect data regarding their perception of the meaning of IC, the process of obtaining it, satisfaction with how it was obtained, and factors associated with satisfaction on how consent was obtained.
 Results: Most were females (61.9%); their mean age was 34.8±14.3 years; 52.9% and 61.9% of respondents did not believe that IC enables patient-clinician shared decision-making or patient's self-decision making, respectively. Most were allowed to ask questions (83.2%), received information on the surgical procedure (91.4%), diagnosis (97.9%); however, 38.5% and 48.8% did not receive information about surgical procedures' immediate and long-term complications, respectively. Surgical procedure explanation was mostly provided by Resident Doctors (53.7%). Most (88.9%) were satisfied with how IC was obtained; satisfaction was associated with being allowed to ask questions, receiving explanations on diagnosis, surgical-procedure, complications of surgery, available alternative treatments, and when the resident/ consultants gave the explanation (all P<0.05).
 Conclusion: Deficiencies exist in the process of getting IC. Satisfaction with this process was high though associated with following the recommended strategies. Improving the IC process will require appropriate interventions in this and similar settings.
 Author
 B A Grema 1, S T Tanimu 1, G C Michael 1, I Aliyu 2, S A Aji 3, I U Takai 4, A I Sulaiman 4

Audit of Radiology Request Cards in a Tertiary Hospital in NorthWest Nigeria


 
 
 
 
 Background: Radiology request cards are essential communication tools between physicians and radiation personnel. Clinical audit is part of quality assurance that guarantees patient care.
 Objective: To assess the adequacy of patient data and clinical information filled in request cards sent to Radiology Department of our facility by referring clinicians.
 Material and methods: Four hundred (400) radiology request cards were randomly selected from the records of the department and scrutinized for bio-data/clinical information.
 Result: Completely filled request cards were 2/267 (ultrasound), 1/40 (computed tomography) and 2/93 (conventional x-ray). 
 Conclusion: Consistency in complete filliing of radiology request cards in our facility was lacking. The audit revealed actual practice, and the need for improvement.
 
 
 
 
 

Audit of Radiology Request Cards in a Tertiary Hospital in NorthWest Nigeria


 
 
 
 
 Background: Radiology request cards are essential communication tools between physicians and radiation personnel. Clinical audit is part of quality assurance that guarantees patient care.
 Objective: To assess the adequacy of patient data and clinical information filled in request cards sent to Radiology Department of our facility by referring clinicians.
 Material and methods: Four hundred (400) radiology request cards were randomly selected from the records of the department and scrutinized for bio-data/clinical information.
 Result: Completely filled request cards were 2/267 (ultrasound), 1/40 (computed tomography) and 2/93 (conventional x-ray). 
 Conclusion: Consistency in complete filliing of radiology request cards in our facility was lacking. The audit revealed actual practice, and the need for improvement.
 
 
 
 
 

Extensively Drug Resistant Acinetobacter Species From Burns Sepsis At A Tertiary Hospital In Northwest Nigeria: Case Series

Background: Acinetobacter species are organisms with low virulence; however, they cause infections in immunocompromised patients. Studies of extensively drug resistant (XDR) Acinetobacter are rare in Nigeria. This organism poses a significant threat and challenge in the management of burns patients particularly as the pipeline for newer antimicrobials is drying up. Most available recommended antimicrobials are toxic, expensive and not readily available especially in low income countries. Case series: Case 1: A 25 year old nursing mother who presented with inhalational and 19.5% flame burns involving the head, neck, trunk, and both upper/lower limbs. She developed sepsis after eight days while on admission. Specimens (sputum, blood, tissue biopsy) all yielded Acinetobacter baumannii. Case 2: Is a 29 year old lady who had road traffic accident and was admitted with 38% flame burn injury involving both lower limbs, part of the upper limbs, buttocks, abdomen and the back. She developed sepsis ten days while on admission. Blood and tissue biopsy specimens yielded Acinetobacter baumannii. Case 3: A 29 year old male gas plant worker presented with inhalational and 63% flame burn injury involving both upper and lower limbs, trunk, neck, buttocks, back, and abdomen. He developed sepsis two weeks later while on admission. Blood and tissue biopsy specimens yielded Acinetobacter iwoffii. Specimens from all three (3) cases were processed using conventional biochemical and Microbact 24E identification system. Antimicrobial susceptibility testing was done using modified Kirby-Bauer single disc diffusion method, and results interpreted according to Clinical and Laboratory Standard Institute (CLSI) 2021 guidelines. Cases 1 and 3 were treated with combination antibiotherapy while case 2 had monotherapy. Conclusion: We present case series of three patients with difficult to manage burns sepsis caused by XDR Acinetobacter species. Combination antibiotherapy was effective. We recommend active surveillance of burns patients in all hospital as well as strengthening infection prevention and control practices

Disclosure of human immune deficiency virus status to infected children at a tertiary hospital in North-western Nigeria

Background: With the advent of highly active anti-retroviral therapy, human immunodeficiency virus (HIV)-infected children are surviving into adolescence and adulthood. Disclosure of HIV-positive status is important for the life-long management of HIV. However, disclosing HIV-positive status is a challenging task due to the associated blame, shame, and potential stigma. Aim: The aim of this study is to assess the prevalence of disclosure to HIV-infected children and associated factors in a tertiary hospital in North-west Nigeria. Materials and Methods: A descriptive, cross-sectional study was carried out. Fifty-two parents/caregivers were interviewed using a pretested interviewer-administered questionnaire. The questionnaire had three sections: sociodemographic characteristics of caregivers, child's profile, and determinants of disclosure of HIV status. Data were collected and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21, and results were presented using the tables. The Chi-square test was used to test for the association. Fisher's exact test was used where conditions for the Chi-square test were not met. P < 0.05 was statistically significant. Results: The prevalence of disclosure of HIV-positive status to HIV-infected children was 32.7%. Children's age (P = 0.003) and their level of education (P = <0.001) had significant associations with the disclosure. The most common (9, 52.9%) reason given for disclosure was persistent questioning of caregivers about reasons for taking medication despite not being ill. Conclusion: The prevalence of HIV status disclosure to HIV-positive children was low in this study. Health-care workers can provide support to encourage and better prepare parents/caregivers for the process of disclosure.

Profile of People with Epilepsy seen at a Tertiary Hospital in North-West Nigeria

Epilepsy is one of the most prevalent chronic non-communicable neurological disorder. Persons with epilepsy (PWE) have unique characteristics that have social impacts on the affected individuals and their family. This study sought to describe the profile of patients with epilepsy attending the out-patient neurology clinic in a tertiary health care centre in North West Nigeria. The study was carried out at Neurology clinic of Ahmadu Bello University Teaching Hospital Kaduna State, Nigeria from August 2013 to October 2014. Consecutively presenting PWE on follow-up were recruited after obtaining ethical approval and informed consent. Those recruited were at least 18 years and have been on routine follow-up for at least 1 year. Patients with clinical and electroencephalography (EEG) features suggestive of non-epileptic seizures, acute metabolic or febrile illness precipitating seizures were excluded. A structured questionnaire was used to obtain all relevant information. The data was analyzed using SPSS version 17 with p-value set at less than 0.05. A total of 103 PWE were recruited with median age of 29 years. More than 50% were in the 21-30 years age group. About 55.3% were single (never married), 58.2% were unemployed and earned &lt; ₦50,000.00 monthly income. The median age of onset of epilepsy was 20 years, while median duration of illness was 7 years. About 50.5% were focal seizures, with traumatic head injury (14.6%) and febrile convulsion (12.6%) as aetiological factors, while 52.5% of them had no identifiable aetiological factor. About 96% were on antiepileptic drug monotherapy, 82% of them on carbamazepine only for a median duration of 7.5 years. Our study shows that epilepsy is predominant among the young population, who are mostly single (never married), unemployed, with poor monthly income occurring more as focal seizure type, with majority of them on carbamazepine monotherapy. There is the need for public enlightenment campaign and effort targeted at mitigating the prevalence of the disease among the young and productive population.

Clinical and Microbiologic Profile of Patients With Staphylococcus aureus Infection

Background Invasive Staphylococcus aureus infection (ISA) is increasingly being recognized as an important cause of morbidity and mortality in developing countries. This problem is confounded by the increasing prevalence of antibiotic-resistant S. aureus. The aim of the study was to describe the clinical presentation and antibiotic susceptibility profile of ISA infection in a tertiary hospital in North West Nigeria. Materials and Methods This study was a prospective cohort study carried out on patients with ISA infection who were seen at a regional referral tertiary hospital in North West Nigeria. One hundred forty patients with ISA infection were studied. Clinical evaluation and relevant laboratory investigations were conducted. Antibiotic susceptibility tests were carried out by disk diffusion method according to Clinical and Laboratory Standard Institute guidelines. Results The mean age of the patients was 40.7 ± 15.6 years, with male-to-female ratio of 1.4:1. Skin and soft tissue infections (108 [77.1%]) and primary bacteremia (17 [12.1%]) were the most common diagnoses. Most infections were community-acquired infections (94 [67.1%]). Risk factors were identified in 112 (80%), of which diabetes mellitus (40 [35.7%]) and chronic kidney diseases (33 [29.5%]) predominate. Eighty-two (52.2%) of the isolates were methicillin-sensitive S. aureus, and 75 (47.8%) were methicillin-resistant S. aureus (MRSA). More cases of MRSA compared with methicillin-sensitive S. aureus were seen among patients with pneumonia and primary bacteremia. The overall mortality was 25 (19.7%) at 1-month follow-up. On multiple logistic regression analysis, the only factors predictive of mortality were sepsis (odds ratio, 6.723; 95% confidence interval, 1.431–31.585) and infection with MRSA (odds ratio, 5.523; 95% confidence interval, 1.506–20.250). Conclusions This study shows high burden of ISA with high prevalence of MRSA. This underscores the need for antimicrobial stewardship program and strengthening of infection control practices in our hospital.

Management of benign bone tumors in a tertiary hospital in North West Nigeria

Background: Tumors originating from bone and cartilage are mostly benign with distinct feature of non-metastasis. Such tumors may occur in any bone of the skeleton, and are more frequent in the younger age group. Complete excision and curettage as the main modality of treatment is in most of the cases adequate with satisfactory outcomes. This study reviewed the histological types of primary benign bone tumors and results of various surgical options of treatment offered. Patients and Methods: Thirty-nine patients with histologically confirmed benign bone tumors arising from upper and lower limbs were retrospectively selected over 13-year period from August 2007 to August 2020 and analyzed. Results: Twenty-two patients were males while 17 were females. Age range is between 3 and 53 years, mean of 24.8 years with highest frequency in the third decade. Histological types were 18 giant cell tumors, 14 osteochondromas, 3 Ecchondromas, 2 Enchondromas and 2 Ossifying fibromas. Twenty five patients had excisional biopsy alone, 6 had excisional biopsy and bone grafting, 3 had limb amputation/dis articulation, 2 had excision with limb reconstruction using dynamic external devices, a patient underwent excision with bone cementing, one had excision and joint replacement (hip hemiarthroplasty), and another one had excision and joint arthrodesis. Conclusion: Benign bone tumors remain largely asymptomatic accounting for the late presentation. Excisional biopsy alone remains the commonest modality of treatment with good result. Giant cell tumor remained the commonest benign tumor in our center. Population based study is needed to assess its true epidemiology.

A comparative assessment of health-related quality of life in people with epilepsy and healthy controls in a tertiary hospital in Northwest Nigeria

Introduction: Epilepsy impacts negatively on the health-related quality of life (HRQoL) of affected individuals. Aim: This study compared the HRQoL of patients with epilepsy with age- and-sex matched healthy controls. Materials and Methods: A comparative cross-sectional case–control study was carried out on 206 participants who were ≥18 years. The World Health Organization Quality Of Life instrument was interviewer administered to all the participants. Statistical significance was set at P

Sexual activities of pregnant women attending antenatal clinic of a tertiary hospital in North-West Nigeria.

Introductionmyths about sex during pregnancy harming fetus and leading to preterm labor or miscarriage are very strong factors releasing fear and leading to avoidance of sexual contact during gestation. We therefore evaluated the attitude, sexual experiences and changes in sexual function during pregnancy.Methodsa cross-sectional study was conducted among 170 pregnant women who were selected using systematic sampling. Data were collected using an interviewer-administered questionnaire. Data was analysed using IBM SPSS® version 22.0. Descriptive statistics, Chi-square test and Cochran´s Q-test were estimated.Resultsthe mean age of respondents was 27.2 ± 6.2 years. Most of the respondents, 107 (62.7%) had formal education. One-fifth of the respondents, 34 (20.2%) have been married for over 10 years. More than half of them were multiparous, 112 (68.3%) and in the third trimester of pregnancy, 99 (59.6%). Majority of the respondents, 153 (87.9%) thought coitus was safe in pregnancy. More than half 89 (58.2%) had coitus at least thrice a week before pregnancy and 98.8% have engaged in sexual activities during pregnancy. Most of the respondents, 105 (61.1%) enjoyed coitus during pregnancy. The desire for coitus significantly reduced in the third trimester, p=0.001.Conclusionsexual intercourse during pregnancy was universal and respondents engaged in sexual activities during different stages of pregnancy. Although sexual frequency declined in pregnancy compared to pre-pregnancy period, most of the respondents desired and enjoyed it. We recommend that couples are well educated to understand the normal fluctuations in sexual interest and practices during pregnancy.

Neck trauma: a profile of experience from otorhinolaryngology unit of a referral hospital in North West Nigeria

Background: Neck trauma is a potentially life threatening clinical condition often presenting as a challenging surgical emergency to otolaryngologist due to high concentration of vital structures in the neck that are at risk. We aimed to study the clinical profile and management challenges of neck trauma in our environment.Methods: This is a retrospective study in which case records of patients diagnosed with neck trauma over 6 years (January 2013 to December 2018) were reviewed. Data extracted included the demography, etiology, presenting symptoms, nature of trauma, surgical intervention and their complications.Results: A total of 28 cases of neck trauma 15 (53.6%) males and 13 (46.4%) females with an M: F ratio of 1.2:1 was analyzed. Age range 8 years to 60 years with a mean age of 30.2 years. The highest incidence was 39.3% in patients within the age group 21-30years. Hoarseness and difficulty in breathing were the commonest presenting symptoms. The commonest etiology of neck trauma in this study is accidental 17 (60.7%) followed by homicidal 6 (21.4%) with zone II site of the neck being the commonest site of injury. Most cases presented to the hospital 2-8 hours of trauma except 5 patients that took more than 24 hours. Nineteen of the patient had emergency tracheostomy and Neck exploration. Most common complication was supraglottic stenosis 12 (42.8%). No mortality recorded in this study.Conclusions: Neck trauma is a potentially life threatening surgical emergency requiring timely multi-disciplinary management thereby reducing complications and postoperative morbidity.

Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

Purpose of the Study: Quinsy also known as Peritonsillar abscess (PTA) is a life threatened complication of acute exudative tonsillitis requiring immediate surgical intervention. We profile the clinical presentation and highlight challenges in management.&#x0D; Materials and Methods: A retrospective analysis of all patients diagnosed with Quinsy at the departments of otorhinolaryngology of two-government referral hospital in northwest Nigeria from May 2014 to April 2017. These patients’ clinical records were retrieved from the health record department and data extracted were analyzed using Microsoft excel program.&#x0D; Results: A total of 147 adult patients had tonsillitis within the study period. Only eighteen patients with quinsy 13(72.2%) females and 5(27.8%) males with an M: F=1:2.6 were analyzed. Age range is between 18 years – 58 years with a mean age of 35.4 years. The highest incidence was 66.7% in patients within the age group 21-40 years. Odynophagia and trismus were the commonest presenting features in all the patients. Side of Quinsy involvement was on the left tonsils 12(66.7%). There was spontaneous rupture in 5(27.8%) while 13(72.2%) of patients had incision and drainage. All patients had broad-spectrum antibiotics. Interval tonsillectomy was carried out on 12(66.7%) of patients while 6(33.3%) of patients did not consent for tonsillectomy and were subsequently lost to follow up. No recurrence of symptoms or mortality recorded.&#x0D; Conclusion: Quinsy is a life threatening otorhinolaryngological emergency common amongst young female adults. Optimal management is still antibiotics therapy and drainage of abscess in our center.

Appropriateness of postoperative analgesic doses among pediatric surgical patients in a teaching hospital in Northwest Nigeria

The inappropriate and suboptimal use of analgesic drugs is a global problem, and is an area of concern with regard to the management of postoperative pain, particularly in children. Information relating to the management of postoperative pain in children is generally limited, particularly in low- and middle-income countries, and is unavailable in Northwest Nigeria. The aim of this study was to describe the types of analgesics used postoperatively in children, evaluate the appropriateness of their doses compared with best practice, and determine risk factors for underdosing of analgesics. We performed a retrospective chart review of patients administered analgesics after surgery between 1 January 2015 and 31 December 2017. The appropriateness of the analgesic doses was categorized as underdose, normal dose, or overdose. Simple descriptive and comparative statistical analyses were performed. Logistic regression was used to build an analgesic underdose risk-prediction model. Overall, 194 patients received a total of 281 prescriptions for seven different analgesics, with 112 (57.7%), 77 (39.7%), and 5 (2.6%) patients receiving one, two, and three analgesics, respectively. Of the 281 analgesic prescriptions, paracetamol accounted for 148 (52.7%) and pentazocine accounted for 77 (27.4%), and there were 64 cases of overdosing (22.8%) and 89 of underdosing (31.7%). There was a statistically significant association between analgesic type and category of dose appropriateness (p < 0.001). The risk of underdosing was not predicted by any of the patient demographic characteristics or by the number of analgesics used. Inappropriate use of analgesics (overdosing or underdosing) is common and is found across all analgesic types and all age groups. A substantial number of children were underdosed, suggesting undertreatment of pain.

Childhood diabetes mellitus in a rural tertiary hospital in North-West Nigeria

Childhood diabetes mellitus in a rural tertiary hospital in North-West Nigeria