Hospital In Northern Nigeria Research Articles

An assessment of stillbirths in a tertiary hospital in northern Nigeria

Objective: This study was undertaken to determine the stillbirth rate and causes in Birnin Kudu, North-west, Nigeria.Method: This was a retrospective study. It involved 705 women who presented for delivery in Federal Medical Centre, Birnin Kudu and had stillbirths. The hospital maternity and theatre registers were used to identify the women who had stillbirth during the study period from 1 January 2008 to 31 December 2012. The data obtained were analyzed using SPSS version 16.0 statistical software. Significant association between socio-demographic/obstetrics factors and stillbirth were tested using the chi-square test and p < 0.05 was considered significant.Result: The stillbirth rate was 170 per 1000 births. Most of the women who had stillbirths (29.1%) were aged 20–24 years, followed by those aged ≥35 years (27.1%). The uneducated women were more than those who had only primary education and this was statistically significant (p = 0.001). The mean parity of the women was 5 ± 3. Obstructed labour was the common cause of stillbirth followed by placental abruption (17.73%) and pre-eclampsia/eclampsia (13.33%).Conclusion: The stillbirth rate reported in this study was higher than those reported from other regions of Nigeria and obstructed labour was the common cause.

Pattern and outcome of gross congenital malformations at birth amongst newborns admitted to a tertiary hospital in northern Nigeria

Background: Congenital malformation(s) do occur in newborns and are thought to be often responsible for a significant proportion of perinatal morbidity and mortality worldwide.Objective: This prospective study was designed to determine the pattern and outcome of congenital malformation(s) among newborn deliveries admitted to the special care baby unit (SCBU) of the Usmanu Danfodiyo University Teaching Hospital, Sokoto.Methods: All newborns with any form of congenital malformation (s) admitted to the SCBU were recruited for the study for a 2-year period from January, 2011 to December, 2012. For ease of identification and classification, organ systems were used to classify malformations while, the recognized syndromes were classified under others.Results: The total deliveries for the study period were 6,578 while, admission to the SCBU was1165. Twenty four (2.1%, prevalence) of the neonates admitted to SCBU had congenital malformation(s); males were 15(62.5%) and females were 9(37.5%) with male to female ratio of 1.7:1. 6(25%) of the babies were delivered outside while, 18(75%) were delivered in our facility labour room. Most of the observed malformations wereseen in the central nervous system and the gastro intestinal tract.Conclusion: There is the need for early diagnosis and treatment toimprove the chance of survival for malformed babies. The prevalenceof 2.1% in our study is comparable to some previous studies however, a community based/multi-centre studies may illuminate a true prevalence.Key words: congenital malformations, newborns

Are there gender differences in longitudinal patterns of functioning in Nigerian stroke survivors during the first year after stroke?

Several studies have examined gender differences in various stroke outcomes. There is however little information on the influence of gender on post-stroke functioning in the context of the International Classification of Functioning, Disability and Health (ICF). Gender differences in selected components of functioning, namely motor performance (body function), activity and participation, were examined in a sample of Nigerian stroke survivors. This longitudinal study involved consenting first-incidence stroke survivors who were consecutively recruited from in-patient wards of a University teaching hospital in northern Nigeria. Demographic and clinical data were obtained at recruitment while motor performance, activity and participation were assessed at the 1st, 3rd, 6th, 9th and 12th months using the Simplified Fugl Meyer scale, the Functional Independence Measure Motor Sub-scale and the London Handicap Scale respectively. Participants were thirty-three male (60%) and 22 female (40%) stroke survivors who did not significantly differ in age, stroke sub-type, laterality and initial severity (P > 0.05). There were also no significant differences in motor performance, activity and participation between the male and female stroke survivors across the time points. Gender differences were not observed in the components of functioning over the first 12 months post-stroke.

Missed Opportunities for Breast Awareness Information Among Women Attending the Maternal and Child Health Services of an Urban Tertiary Hospital in Northern Nigeria

Background: Breast cancer is the most common cancer that affects women worldwide. Many women, however, are not exposed to information that will promote awareness and early detection of this disease. We undertook this study to determine the missed opportunities to breast awareness information at the maternal and child health (MCH) services of our hospital. Materials and Methods: Between July and September 2011, we conducted a cross-sectional survey of women attending the postnatal and immunization clinics (ICs) of our hospital. Data were collected using a structured interviewer-administered questionnaire. A total of 492 respondents were randomly selected. Data were analyzed using SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: The mean age of the respondents was 27.67 years (standard deviation 5.92 years). Only 56.1% (276/492) had a postsecondary education, and 58.7% (289/492) were multiparous. Among the respondents, 81.7% had been exposed to breast awareness information at the antenatal clinic, 6.55% at the postnatal clinic, and 5.24% at the IC. There was a statistically significant association (P Conclusion: Most of the opportunities to educate women on breast awareness were missed at the postnatal and ICs of our hospital. Integrating breast health education into MCH care programs in developing countries will assist in the early detection of breast pathologies.

Availability, And Awareness of Non-Pneumatic Antishock Garment in Tertiary Hospitals of Northern Nigeria

Background: The (NASG) was introduced as a gadget that can be used for first aid treatment of women in postpartum shock prior to proper investigation and appropriate management of the patient. Purpose of the study: aims at assessing the availability, awareness and utilization of non-pneumatic Antishock garment in tertiary hospitals of Northern Nigeria. That is the North West, North East and North central. Materials and methods: A descriptive design was used .Isaac & Michael, (1981); Smith, (1983) sample size chart revealed that for a given population of 100,000 and above the sample size for such population should be 398. A four point level likert scale questionnaire was structured. The data collected was analysed using one way analysis of variance (ANOVA) and with a 0.05 level of confidence to answer the hypotheses. A constant mean of 2.5 was used to ascertain the agreement of the respondents on the questionnaire items. Results of the study, revealed that, NASG is available in the selected hospitals but strictly within the control of the hospitals’ management in Northern Nigeria with an aggregate mean score of 2.32 .Nurses and doctors in tertiary hospitals in Northern Nigeria are aware of the NASG for postpartum haemorrhage with an aggregate mean score of3.18. There is significant difference in the availability and awareness of the NASG for postpartum haemorrahage among nurses and doctors of the selected tertiary hospitals in Northern Nigeria. Conclusion: the NASG is available strictly in tertiary hospitals in Northern Nigeria and doctors and nurses are

Primary pulmonary fibrosarcoma: A case report from a Teaching Hospital in Northern Nigeria

Primary pulmonary fibrosarcomas are rare malignant tumors of mesenchymal origin. We report a case of primary pulmonary fibrosarcoma in a 35-year-old man who presented with chronic cough and progressive breathlessness. Further clinical evaluation revealed a right lung mass extending from the base of the lung to the mid zone. Histology of biopsied sections of the mass confirmed a lung fibrosarcoma thought to be primary in view of the absence of any other source. Outcome was however unfavorable due to death of the patient. Late presentation and the extensive nature of the disease were identified as the cause of mortality. This case is reported because of its rarity.

Surgical procedures in obstetrics and gynecology department of a teaching hospital in northern Nigeria: A 5 year review

Background: Surgical procedures in obstetrics and gynecology have witnessed significant improvements in terms of morbidity and mortality. This is not unrelated to advancement in asepsis and anesthesia over the years. This study aimed at describing the pattern of surgical procedures in obstetrics and gynecology at a tertiary health center in Northern Nigeria. Patients and Methods: This is a retrospective study of patients who had surgical procedures in Obstetrics and Gynecology at Aminu Kano Teaching Hospital, Nigeria from 1 st January, 2005 to 31 st December 2009. The data retrieved from their case notes were analyzed using Mini Tab Electronic Statistical Software. Information extracted were age, type of surgery and anesthesia used. The data analyzed were presented using simple tables. X 2 and P value were used to test for significant statistical associations where appropriate. Results: A total of 2741 operations were done within the period under review. The mean age of the patients was 29.95 ± 8.26 years. Emergency surgeries were performed in1643 (59.9%) patients while the remaining 1098 (40.1%) were elective. General anesthesia was used for the majority 2093 (76.4%) of the cases. Cesarean section accounted for the majority (62.6%) of the procedures performed. Other surgeries include myomectomy (4.2%), total abdominal hysterectomy (4.7%), and andlaparotomy (9.3%) among others. Obstetric cases accounted for 1510 (55.1%) of the surgeries conducted while 1231 (44.9%) were gynecological cases. Conclusion: Most of the procedures were emergency obstetric surgeries performed under general anesthetic. Caesarean section rate was highest among all surgical procedures. There was statistically significant association between the type of surgery and the administered form of anesthesia.

Impact of poststroke fatigue on health-related quality of life of nigerian stroke survivors.

Background and PurposeA stroke event is often characterized by a number of debilitating consequences that may impact negatively on the health-related quality of life (HRQL) of survivors. This study examined the impact of poststroke fatigue (PSF), a persistent and prevalent stroke consequence, on HRQL of Nigerian stroke survivors.MethodsOne hundred stroke survivors were recruited from the physiotherapy outpatient departments of two tertiary hospitals in Northern Nigeria. The Fatigue Severity Scale and Health-Related Quality of Life in Stroke Patients-26 were respectively used to assess PSF and HRQL. The independent impact of PSF on overall and domain-specific HRQL was examined using hierarchical regression analyses.ResultsMean age of the stroke survivors was 55.32 years (SD 13.9 years). The majority were males (66%), had suffered ischemic stroke (70%) and presented with moderately severe disability (42%). After controlling for demographic and stroke-related variables, PSF was found to be significantly and independently associated with all the domains of HRQL albeit at varying degrees. While the influence of PSF on the emotional domain was the most pronounced and uniquely contributed to 15% of the variance in the domain, its influence on the cognitive domain was the least prominent. PSF also solely accounted for 9% of the variation in overall HRQL with higher levels of PSF related with lower HRQL.ConclusionsBeing a potentially treatable condition, PSF's significant impact on HRQL has implications for successful stroke care and rehabilitation. For instance, addressing PSF through appropriate interventions may assist in enhancing HRQL of stroke survivors.

Out-patient percutaneous renal biopsy among children in Northern Nigeria: a single center experience.

The safety of percutaneous renal biopsy (PRB) has been debated. The primary aim of this study was to review the procedure and secondary aim is to evaluate the safety of PRB in children in a developing nephrology unit in Northern Nigeria. Renal biopsies carried out in the renal unit of a teaching hospital in northern Nigeria between November 2011 and April 2013 were retrospectively reviewed. All biopsies were carried out electively and under real-time ultrasound guidance using an automatic spring-loaded biopsy gun. Risk factors for complications were analyzed using logistic regression. A total of 24 biopsies were carried out in 20 children with nephrotic syndrome during the period under review. Mean age was 8.3 ΁ 3.0 years. Steroid resistant nephrotic syndrome was the most common indication for biopsy in 11 (55%) cases. Adequate tissue was obtained in 91.7%. Complications occurred in 2 (8.3%) cases. One required hospitalization with blood transfusion. Pre-biopsy hemoglobin concentration of <10 g/dL was found to be a significant predictor for the development of complications (P < 0.05). There was no significant difference in the rate of complications between the in-patient biopsies and day case biopsies. PRB can be safely carried out as an out-patient procedure in children. Low hemologlobin concentration was the major risk factor for complication.

Pattern of adipose tissue tumors in Ahmadu Bello Universty Teaching Hospital, Zaria, Nigeria

Background: Adipose tumors are the most common soft tissue tumors in humans. The reported incidence of lipoma is probably less than the actual incidence because of its insidious growth pattern and minimal associated symptoms. Objective: The objective of this study is to document the pattern of these tumors in a tertiary hospital in Northern Nigeria. Materials and Method: This is a retrospective study of all diagnosed adipose tissue tumor over a 10-year period (January 2002 to December 2011), in the Department of Pathology, Ahmadu Bello University Teaching Hospital. Tissue biopsies fixed in 10% formalin and stained routinely with hematoxylin and eosin were studied. Biodata and sites of involvement were retrieved from patients' requisition cards. Results: Four hundred and three adipose tissue tumors were diagnosed during this period. Three hundred and ninety-five (98.0%) of the tumors were benign, while 8 (2.0%) were malignant. The male to female distribution was 197 and 206, respectively. Patients ages ranged from 3 months to 75 years with a peak age distribution in the fifth decade (23.6%). The most common site of involvement was the trunk (38.0%), followed by the head and neck region (21.3%) and lower limbs (17.4%). Conventional lipoma was the most common benign tumor, accounting for 328 cases (81.4%), while myxoid liposarcoma was the most common malignant tumor with 4 cases (1.0%). Conclusion: Adipose tissue tumors are not uncommon in our setting and accounted for 6.0% of all tumors seen within the study period. There is a slight female preponderance and the trunk is the most common site of involvement. Benign tumors formed the bulk of lesions recorded.

Corneal ulcers in a tertiary hospital in Northern Nigeria

To highlight the pattern of corneal ulcers at the Guinness Ophthalmic Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria. A retrospective review of case notes of patients who presented with corneal ulcer at the Guinness Ophthalmic Unit, Ahmadu Bello University Teaching Hospital between January 1995 and December 2005. Information obtained include demographic data, presenting complaints, predisposing factors, microbiological diagnosis, use of orthodox or traditional medications before presentation, duration before presentation and, presenting and final visual acuity. A total of 228 cases presented within the 10 years study period. There were 129 (56.6%) males and 99 (43.4%) females. The age range was 15 months to 66 years. The commonest presenting complaints was poor vision 109 (47.8%) followed by lacrimation 97 (42.5%) and ocular pains 96 (42.1%). The common predisposing factors were trauma 117 (51.3%), use of traditional eye medications 39 (17.1%), self medication with topical steroids 13 (5.7%) and measles 9 (4.0%). The presenting visual acuity was <6/60 in 49.8% of the patients, <6/18-6/60 in 23.4%, and 6/6-6/18 in 25.5% of the patients. At discharge, 45.6% had a visual acuity of 6/6-6/18, 27.2% had borderline vision (<6/18-6/60), 18.0% had severe visual impairment (<6/60), while 6.6% had no light perception. The commonest organisms isolated were Staphylococcus aureus in 19.7%, fungal hyphae in 15.8% and Streptococcus pneumoniae in 4.8%. In this study most patients with corneal ulcer presented with poor vision and excessive lacrimation. Trauma was the commonest predisposing factor with bacterial organisms as the commonest isolate.

Morbidity and Mortality Patterns of Hospitalised Adult HIV/AIDS Patients in the Era of Highly Active Antiretroviral Therapy: A 4-year Retrospective Review from Zaria, Northern Nigeria

Background. This study, undertaken in major tertiary hospital in northern Nigeria, examined the morbidity and mortality patterns of hospitalised adult HIV/AIDS patients in the HAART era. Methods. Between January 2006 and December 2009, admission records and causes of deaths of hospitalised medical HIV-infected patients were retrieved and analysed according to antiretroviral (ART) status. Results. Of the 207 HIV/AIDS patients reviewed, majority were newly diagnosed (73.4%), and most were hospitalised and died from various AIDS-defining illnesses, mainly disseminated tuberculosis and sepsis. Immune-inflammatory-reconstitution-syndrome, ART-toxicity and ART-failure, contributed to morbidity and mortality in patients receiving ART. Sixty six (31.9%) patients died, with higher mortality in males and in those with lower CD4-cell count, lower PCV, and shorter hospital stay. However, hospital stay ≤3 days and severe anaemia (PCV < 24%) were independent predictors of mortality. Conclusion. In the current HAART era, late presentation and tuberculosis continue to fuel the HIV/AIDS pandemic in Africa, with emerging challenges due to ART-related complications.

Laparoscopic paediatric surgery: A potential for paradigm shift in developing countries

Until recently, surgical conditions in children requiring operation were managed by the traditional open method. The introduction of the laparoscopic surgical technique seems to be reversing this trend in many centres. We are pioneering some laparoscopic surgery procedures in our environment and the aim of this study was to document our experience with laparoscopic paediatric surgical procedures in a developing country. This was a prospective analysis of all consecutive children that had laparoscopic surgery at 5 hospitals in Northern Nigeria from June 2008 to February 2011. Twenty-one patients had laparoscopic surgeries during the study period with a mean age of 12.5 ± 2.6 years and age range of 10-16 years. There were 14 females and 7 males with a M:F ratio of 1:2. Seven patients (33.3%) had cholecystectomies and 13 (61.9%) had appendicectomies and the remaining one patient (4.8%) had adhesiolysis for partial adhesive intestinal obstruction following previous open appendicectomy. The mean operating time was 89 min with a range of 45-110 min for appendicectomies, 55-150 min for cholecystectomies and the adhesiolysis took 50 min. The mean hospital stay was 2 days except for the conversions that stayed up to 7 days. There were 2 (9.5%) conversions with no mortality. We solicit a paradigm shift in our approach to surgical management and implore other centres to embrace laparoscopic surgery in the management of surgical conditions in children since it confers obvious advantages over open surgery.

Socio-demographic and maternal factors in anaemia in pregnancy at booking in Kano, northern Nigeria.

Anaemia in pregnancy still causes significant maternal morbidity and mortality in the developing countries including Nigeria. The burden and underlying factors are varied even within countries. We studied the prevalence of anaemia at booking and underlying factors in a teaching hospital in northern Nigeria. Using the capillary technique and blood film, the packed cell volume (PCV) and red cell morphology of 300 pregnant women was determined. Additional information was obtained on sociodemographic characteristics, obstetric and past medical history using an interviewer administered questionnaire. Of the 300 pregnant women studied, 51 (17%) [95% Confidence Interval (CI)=12.9%-21.7%] were anaemic. Specifically, 12.7% and 4.3% of the women had mild and moderate anaemia respectively. Blood film of 74.5%, 15.7% and 11.8% anaemic women showed normochromic normocytic, haemolytic and microcytic hypochromic pictures respectively. Low educational attainment [Adjusted Odds Ratio (AOR)=2.13], being single or divorced [AOR=2.02], high parity [AOR=2.06], late booking [AOR=2.71] and short intervals between pregnancies [AOR=2.37] were significant predictors of anaemia in pregnancy. The high prevalence of anaemia in pregnancy related to low educational and economic status especially among women with background obstetric risk factors calls for vigilance, sustained health education and chemoprophylaxis for pregnant women.

Communication Skills among Surgical Trainees: Perceptions of Residents in a Teaching Hospital in Northern Nigeria

Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for training in communication skills as a basis for developing an effective education programme. Method A survey of patient care - related communication skills among surgery residents and assessment of competence, rating the importance and perceived need for training in communication skills. Results Most residents rated their skills as either fairly or extremely competent in all areas except in providing bereavement counseling. They found all skills important and indicated a need for training in them. Senior registrars rated their competence and the importance higher in skills relating to breaking bad news, educating and preparing patients and families for surgery and encouraging them to express their anxieties. (p 0.05). Conclusion Residents face difficult communication challenges with patients and their families. There is a dire need for improved education in communication skills. Understanding the surgical trainees perceptions of patient care related communication skills is the first step in designing an effective education programme. Key Words: Communication skills, surgical trainees, perception

Domestic violence among women living with HIV/AIDS in Kano, Northern Nigeria.

Despite the increased risk of domestic violence among women living with HIV/AIDS, its burden has not been adequately explored in many developing countries including Nigeria. Using interviewer administered questionnaires we assessed the prevalence and risk factors for domestic violence among 300 HIV seropositive women attending a teaching hospital in northern Nigeria. Participants have been diagnosed HIV positive for an average of 6.7 years; 66.3% were seroconcordant with their intimate partners while 16.3% were serodiscordant, the rest 17.4% did not know the partner's status; 67.1% had disclosed their status to their partners; and 64(22.1%) [95% CI (17.5% to 27.4%)] had experienced domestic violence following HIV diagnosis. Specifically, 30.0% (n = 19) experienced physical violence (slapping, kicking and punching), 59.3% (n = 38) reported verbal violence (insults, threats) and 10.7% (n = 7) endured emotional violence. None was sexually assaulted. Predictors of domestic violence were the woman's age, marital status, disclosure and partner's educational status. This calls for urgent steps and strategies for prevention, protection and post-test counseling on disclosure to avert this human right infringement.

Obstetric quality assurance to reduce maternal and fetal mortality in Kano and Kaduna State hospitals in Nigeria

Objective To achieve Millennium Development Goals 4 and 5 in Nigeria, a quality assurance project in obstetrics in 10 hospitals in northern Nigeria was established to improve maternal and fetal outcome. Methods The project commenced in January 2008 with assessment and improvement of the structure of the 10 hospitals. Continuous maternal and fetal data collection and analysis were conducted from 2008 to 2009 by means of a maternity record book and structured monthly summary form. The quality of hospital infrastructure and equipment was also assessed. Results The mean maternal mortality ratio (MMR) was reduced from 1790 per 100 000 births in the first half of 2008 to 940 per 100 000 births in the second half of 2009. The average fetal mortality ratio (FMR) decreased slightly from 84.9 to 83.5 per 1000 births. There was an inversely proportional relationship between the total number of deliveries in a hospital and MMR and FMR. There was a close correlation between the MMR and the equipment status and hygiene conditions of the hospitals. Conclusion Continuous monitoring of quality assurance in maternity units raised the awareness of the quality of obstetric performance and improved the quality of care provided, thereby improving MMR.

Ovarian cyst at general hospital Aliero, Nigeria: A one-year review

Background: The ovary is a frequent site for the occurrence of neoplastic tumours that could be either benign or malignant.Method: A prospective study of ovarian cyst at a General Hospital in northern Nigeria from October 2005 to November 2006. Clinical case notes ofpatients diagnosed of ovarian cyst were kept and analyzed.Result: 15 patients where diagnosed with ovarian cyst during the period of study. They all presented with abdominal swelling. Surgery was done andpatients recovered post operatively.Conclusion: Early diagnosis and treatment of ovarian cyst is necessary for prevention of complications of ovarian cyst. Definitive diagnosis is madeafter histopathology

The Pattern of Chest Radiographs findings in Metastatic Cancer Patients seen in a Tertiary Hospital in Northern Nigeria

To evaluate the pattern of chest radiographs findings in metastatic cancer patients at first presentation in a tertiary hospital in northern Nigeria with a view to contributing to existing literature and making recommendation for optimal patients care in Nigerian hospitals. From January 2002 to December 2007, 712 new patients were seen and 688 patients' chest radiographs excluding children (below 16 yr) were reviewed of which 118 were considered abnormal due to pathology arising from primary cancer. Those Chest radiographs showing pathology not related to cancer were excluded. Results were analysed using EPI-Info, version 3.4.1. 2007. 118 (17%) patients' chest radiographs (CXR) were having evidence of metastases from primary cancer. The sex ratio is M: F = 1: 1.7 with a mean age of 48.1 years (Range 16 - 82 yrs). Breast cancer was the commonest cause of metastatic spread to the lungs seen in 44 (37.3%) patients followed by colorectal 10 (8.5%), soft tissue sarcoma 9 (7.6%), and bone sarcoma 8 (6.8%). Cervical cancer which was the commonest type of malignancies seen at presentation accounted only for 8 (6.7%) cases. Both lungs were involved in 62 (52.5%) patients, followed by right lung alone in 42 (35.6%) cases and left lung alone in 14 (11.9%) cases. The mid zone was the commonest site of lung metastases 102 (86.4%) followed by lower zone 42 (35.6%). Pleural effusion seen in 26 (22%) patients affected both lungs equally. Multiple lung metastases were the predominant pattern of metastases seen in 94 (80%) cases. Majority 82 (69.5%) of lungs metastases were of sizes less than 2cm. Multiple lung metastases were the commonest pattern of lung metastases. Both lungs and mid zone were mainly affected. Lung metastases were very common from breast, colorectal, bone sarcoma, prostate cancers but relatively rare from cervical, head and Neck cancers and lymphomas. Chest radiographs should be part of initial evaluation of all cancer patients.

Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria

Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria