Obafemi Awolowo University Teaching Hospitals Research Articles

Pediatric Neuropathology in Africa: Local Experience in Nigeria and Challenges and Prospects for the Continent.

The present state of pediatric neuropathology practice is in rudimentary developmental stages in most parts of sub-Saharan Africa. We sought to determine the pattern of neurosurgical lesions in children diagnosed in southwestern Nigeria and briefly address issues surrounding the practice of this aspect of pathology in Africa. We performed a retrospective review of histopathologic results of biopsies obtained from pediatric patients with neurosurgical lesions at the Department of Pathology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, between January 2001 and December 2011. Demographic and clinical data were extracted from the Ife-Ijesha cancer registry and histopathological diagnoses were confirmed. A total of 111 biopsies were reviewed with a maximum of 17 in 2001 and minimum of 3 in 2005. Patient ages ranged between 1 day and 16 years with a male:female ratio of 1.02:1. There were 53 spinal lesions, 15 intracranial lesions, 36 scalp masses, 6 skull lesions and 1 muscle biopsy. Most of the specimens were from myelomeningoceles. This documentation of the major types of pediatric neurological conditions encountered in clinical practice in this relatively resource-limited setting indicate the need for collaboration with better developed centers to improve training in neurosurgery and neuropathology to enhance the quality of clinical care for young patients in Africa.

Prevalence of Antenatal Chlamydia trachomatis Infection in Ile-Ife, Nigeria

Background: Chlamydia infection is the most common sexually transmitted infection worldwide with a high prevalence in developing countries. Chlamydia infection in pregnancy is associated with increased perinatal and neonatal complications such as prelabour rupture of membranes, preterm birth, low birth weight, neonatal inclusion conjunctivitis and neonatal pneumonia. Objectives: The aim of this study was to determine the prevalence and risk factors of antenatal Chlamydia trachomatis infection in Ile Ife. Methods: One thousand, six hundred and eighty-two pregnant women were screened for antenatalChlamydia trachomatis infection at the Obafemi Awolowo university teaching hospitals complex, Ile Ife, Nigeria. After obtaining informed consent, endocervical swabs were processed with the one step Chlamydia rapid test kit manufactured by Span Biotech limited, Hong Kong. Data were analyzed using the SPSS software version 20. A P value < 0.05 was taken as statistically significant. Results: The prevalence was 13.2% and the highest prevalence was found among pregnant women aged less than 20 years (21.1%). There was a statistically significant relationship between antenatalChlamydia trachomatis infection and yellowish vaginal discharge (χ = 5.48, df = 1, P = 0.03), new sexual partner in the preceding 3 months (χ = 9.91, df = 1, P = 0.01) and previous sexually transmitted infection. (χ = 5.66, df = 1, P = 0.02). The determinants on multivariate analysis were yellowish vaginal discharge (AOR1.51, 95%CI 1.22 3.63, P = 0.005), age group (AOR 0.90, 95%CI 0.84 0.97, P = 0.001) and previous treatment for sexually transmitted infection (AOR 1.97, 95%CI 1.26-2.90, P = 0.005). Conclusions: Pregnant women within the younger age group and those with previous history of sexually transmitted infections are at increased risk of antenatal Chlamydia trachomatis infection and therefore may be screened to prevent the adverse perinatal outcomes. Further studies are however necessary to evaluate the cost-effectiveness of screening programs.

Clinical presentation and visual status of retinitis pigmentosa patients: a multicenter study in southwestern Nigeria.

BackgroundTo review the visual status and clinical presentation of patients with retinitis pigmentosa (RP).MethodologyMulticenter, retrospective, and analytical review was conducted of the visual status and clinical characteristics of patients with RP at first presentation from January 2007 to December 2011. Main outcome measure was the World Health Organization’s visual status classification in relation to sex and age at presentation. Data analysis by SPSS (version 15) and statistical significance was assumed at P<0.05.ResultsOne hundred and ninety-two eyes of 96 patients with mean age of 39.08±18.5 years and mode of 25 years constituted the study population; 55 (57.3%) were males and 41 (42.7%) females. Loss of vision 67 (69.8%) and night blindness 56 (58.3%) were the leading symptoms. Twenty-one (21.9%) patients had a positive family history, with RP present in their siblings 15 (71.4%), grandparents 11 (52.3%), and parents 4 (19.4%). Forty (41.7%) were blind at presentation and 23 (24%) were visually impaired. Blindness in six (15%) patients was secondary to glaucoma. Retinal vascular narrowing and retinal pigmentary changes of varying severity were present in all patients. Thirty-five (36.5%) had maculopathy, 36 (37.5%) refractive error, 19 (20%) lenticular opacities, and eleven (11.5%) had glaucoma. RP was typical in 85 patients (88.5%). Older patients had higher rates of blindness at presentation (P=0.005); blindness and visual impairment rate at presentation were higher in males than females (P=0.029).ConclusionClinical presentation with advanced diseases, higher blindness rate in older patients, sex-related difference in blindness/visual impairment rates, as well as high glaucoma blindness in RP patients requires urgent attention in southwestern Nigeria.

Application of quantitative techniques in decision making by healthcare managers and administrators in Nigerian public tertiary health institutions

Introduction The study was aimed at comparing the applicability of quantitative techniques and its relevance in decision making by clinical and non-clinical healthcare managers and administrators. Methods A comparative cross-sectional study in design conducted at the Obafemi Awolowo University Teaching Hospital, Ile-Ife amongst 52 clinical and 50 non-clinically related healthcare managers and administrators. Data collection tool was a semi-structured self-administered questionnaire. Data were analysed using descriptive and inferential statistics of SPSS version 20 with statistical significance determined at p &lt; 0.05. Results A higher proportion of the non-clinical healthcare managers and administrators were familiar and had used more quantitative techniques than their clinical counterparts. Experience ranked highest as the current method employed by both groups for most decision needing scenarios presented. There was no statistically significant difference in their perceived effectiveness of the current methods guiding decision making. However, a statistically significant difference was found in the methods preferred by both study population only for ‘reducing waiting lines, p = 0.015’ and in ‘maximising the use of human resources, p = 0.017’. Conclusions Approach to decision making in the Nigerian health sector is still largely experiential and more of a personalised bargaining process. Acknowledgement of the relevance of quantitative techniques by clinical and non-clinically related health managers and administrators as found in this study is hoped to accelerate the adoption of these techniques. It is believed that its application will lead to improved health service delivery and health outcomes.

Prevalence and Pattern of Birth Brachial Plexus Injuries Seen in Nigeria

Birth brachial plexus injury (BBPI) is still one of the major causes of birth injury in Nigeria despite improved medical care. Physiotherapy, one of the main conservative managements, has some controversy. This study, therefore, assessed the prevalence and pattern of children with BBPI attending physiotherapy. A 10-year (January 2005–December 2014) retrospective analysis of children with BBPI was performed at the Department of Physiotherapy, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Data about patients' demographic and clinical variables were collected and analyzed using Statistical Program for Social Sciences for Windows version 22 (SPSS Inc., Chicago, Illinois, United States). BBPI constitutes 8.8% of all cases reviewed with a male-to-female ratio of 1.6:1. Their mean birth weight was 3.80 ± 0.66 kg, with an average incidence rate of 4.1 per 1,000 live births. Vaginal delivery (74.6%) was the most common mode of delivery, and shoulder dystocia of 35.2% was the most implicated etiology of the condition. Most BBPI children were born in private hospitals (66.2%) with the first and fourth parity showing the highest cases (28.2% each). The middle class parents (47.9%) had the highest prevalence of children with BBPI and only 19.7% had a formal discharge. BBPI in Nigeria still has a high prevalence despite improved medical care. There should be an established continual interdisciplinary working relationship and standardized protocols or guidelines for the management of children with BBPI.

Do diabetes-specialty clinics differ in management approach and outcome? A cross-sectional assessment of ambulatory type 2 diabetes patients in two teaching hospitals in Nigeria.

To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes-specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about diabetes were also explored. A cross-sectional prospective study using semi-structured interview among consented patients for eightweek, and a review of participants' case notes at 3-month post-interactive contact for details of diabetes-specific parameters and antidiabetes medications. The University College Hospital (UCH) and Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in southwestern Nigeria. Adult patients with type 2 diabetes, on therapies for >3-month and who had average fasting blood glucose (FBG)>6.0mmol/L were enrolled. All patients with type 1 diabetes, and type 2 diabetes who decline participation were excluded. Out of 185 participants who were approached, 176(95.1%) consented and completed the study including 113(64.2%) from UCH and 63(35.8%) in OAUTHC. Mean FBG for patients were 9.6mmol/L in UCH and 11.0mmol/L in OAUTHC (p=0.03). Medication adherence among patients was 47(46.5%) in UCH and 31(52.5%) in OAUTHC (p=0.46). Prescribed antidiabetes medications between the clinics significantly differ. Practice of self-monitoring of blood glucose among participants was 26(23.0%) in UCH and 13(20.6%) in OAUTHC (p=0.72). Thirty-two participants (29.4%) in UCH and 33(43.4%) from OAUTHC (p=0.02) mentioned complications as perceived fear about type 2 diabetes. There are differences and similarities between the diabetes-specialty clinics with respect to diabetes management and outcome. This underscores the necessity for a protocol-driven treatment approach in ensuring improved diabetes care and outcome. None declared.

Source apportionment analyses for fine (PM2.5) and coarse (PM2.5–10) mode particulate matter (PM) measured in an urban area in southwestern Nigeria

To determine the influence of regional and local sources of the fine and coarse fractions of airborne particulate matter (PM), samples were collected in 2006, 2007, 2010, and 2013 covering the 2 major seasons (wet and dry) at multiple locations in Ile-Ife, Nigeria. A total of 216 samples for each of the PM2.5 and PM2.5–10 were collected on polycarbonate filters using low volume Gent samplers. Elements and black carbon was measured using x-ray fluorescence (XRF) spectrometry and optical transmissometry, respectively. The average mass concentration for the PM2.5 and PM2.5–10 at Obafemi Awolowo University (OAU) in 2006, 2007, and 2010 exceeded the annual National Ambient Air Quality Standards (NAAQS) of 15 and 60 μg/m3 for PM2.5 and PM2.5–10, respectively. At the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) sites, the PM2.5 and PM2.5–10 mass fractions also exceeded the NAAQS standards except at the urban background site. Positive matrix factorization (PMF) was used to identify and apportion the PM sources for the combined data from these sampling sites. Four sources each were identified for both PM2.5 and PM2.5–10. The sources are soil (44%), savannah burning (26%), scrap processing (18%) and vehicular emissions (12%) for PM2.5 and soil plus biomass burning (71%), sea salt (22%), scrap processing (5%) and vehicle emissions (tire wear) (2%) for PM2.5–10. Most of the PM mass originated from anthropogenic contributions. The highest contributions were associated with northwesterly wind from the urbanized areas of Ile-Ife.

Preparing Mammograms for Classification Task: Processing and Analysis of Mammograms

Breast cancer is the most common cancer found in women in the world. Mammography has become indispensable for early detection of breast cancer. Radiologists interpret patients’ mammograms by looking for some significant visual features for decision making. These features could have different interpretations based on expert’s opinion and experience. Therefore, to solve the problem of different interpretations among experts, the use of computer in facilitating the processing and analysis of mammograms has become necessary. This study enhanced and segmented suspicious areas on mammograms obtained from Radiology Department, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Also, Features were extracted from the segmented region of interests in order to prepare them for classification task. The result of implementation of enhancement algorithm used on mammograms shows all the subtle and obscure regions thereby making suspicious regions well visible which in turn helps in isolating the regions for extraction of textural features from them. Also, the result of the feature extraction shows pattern that will enable a classifier to classify these mammograms to one of normal, benign and malignant classes.

Pattern of paediatric dermatoses at dermatology clinics in Ile-Ife and Ilesha, Nigeria

Background: In developing countries, skin diseases are one of the most common causes of morbidity. Aim: A prospective descriptive study was conducted to determine the pattern of skin diseases in childhood and adolescents presenting to the outpatient dermatology clinics of Obafemi Awolowo University Teaching Hospitals Complex at Ile-Ife and Ilesha, Osun State. Methods: Patients aged 2 weeks to 19 years attending the clinics between October 2009 and September 2012 were included. Results: A total of 491 dermatoses were recorded in 441 patients. There were 244 (49.6%) males. Dermatophyte infections (17.1%), papular urticaria (6.7%), atopic dermatitis (6.3%), vitiligo (5.3%), acne (4.7%) and viral warts (3.7%) were the most frequent dermatoses. Skin infections and infestations, mostly dermatophyte infections and viral warts, accounted for 57.6% of the skin conditions. Of the non-infectious diseases, papular urticaria and atopic dermatitis were the most common. Dermatophyte infections were the most prevalent in children (25.8%), and acne vulgaris in adolescents (11.8%). Conclusion: Skin infections and infestations, mostly dermatophyte infections, were the most prevalent in children, and acne vulgaris in adolescents.

Assessment of Nutritional Knowledge of HIV Positive Adult Patients of Obafemi Awolowo University Teaching Hospitals Complex Ile - Ife, Nigeria

Citation: Fadeiye EO, Adegbenro CA, Olumakaiye MF (2016) Assessment of Nutritional Knowledge of HIV Positive Adult Patients of Obafemi Awolowo University Teaching Hospitals Complex Ile Ife, Nigeria. J Nutr Health Sci 3(1): 102. doi: 10.15744/2393-9060.3.102 Volume 3 | Issue 1 Journal of Nutrition and Health Sciences

Advanced Abdominal Pregnancy As a Cause of Symptomatic Hemoperitoneum

Background: Abdominal pregnancy is an ectopic pregnancy in which a fetus develops in the peritoneal cavity. Rates of maternal mortality and morbidity are high and are largely the result of hemorrhage because of separation of the placenta. Abdominal pregnancies are rare and are often misdiagnosed. Case: A 31-year-old multipara with an abdominal pregnancy that was initially misdiagnosed as a missed abortion was referred to the Obafemi Awolowo University Teaching Hospitals Complex, in Ile Ife, Osun State, Nigeria, from a peripheral hospital because of failed attempts at medical evacuation of uterine contents at the peripheral hospital. This patient later had an emergency exploratory laparotomy and evacuation of the products of conception from the peritoneal cavity at a gestational age of 24 weeks. Hemostatic stitches were applied to the sites of placental attachment on the anterior abdominal wall, sigmoid colon, and small bowel. The patient was discharged from the hospital on the 14th postoperative day in stable condition. Results: The patient had a remarkable improvement on follow-up. She expressed her desire for contraception and later opted for hormonal implant (Implanon). Conclusions: Diagnosis of abdominal pregnancy continues to be a challenge, resulting in delays in diagnosis and decision making. A high index of suspicion is needed with an appropriate management approach to limit morbidity and prevent mortality. (J GYNECOL SURG 32:59)

Anti-oxidative and Hepato-protective Effects of Pseudocedrela kotschyi against Paracetamol Induced Liver Damage: A Biochemical and Histological Evaluation in Rats

Department of Chemical Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria. Department of Histopathology, Faculty of Medical Laboratory Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria. School of Medical Laboratory Science, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Department of Pathology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria. Department of Anatomy, University of Ilorin, Ilorin, Nigeria.

Gender Differences in Dermatoses at Obafemi Awolowo University Teaching Hospitals’ Complex, Ile-Ife

Gender Differences in Dermatoses at Obafemi Awolowo University Teaching Hospitals’ Complex, Ile-Ife

Prevalent risk factors for nonsyndromic cleft lip and palate in a South-Western Nigerian population

Objective: Various risk factors (RFs) have been associated with cleft lip and/or cleft palate (CL/P) in many populations, but none has been identified in a South-Western Nigerian population. We sought to identify the prevailing RFs for nonsyndromic CL/P in the South-Western Nigerian population. Study Design: We conducted a case-control study at Obafemi Awolowo University Teaching Hospital (OAUTH) Ile-Ife. Patients with nonsyndromic CL/P presenting at the OAUTH and randomly selected infants conceived and delivered in the same zone as the patients were studied. We elicited information on RFs for CL/P around subjects' conceptions. Results: 157 patients aged 1 day to 4 months and 157 controls were reviewed. A female preponderance was observed (F:M= 1.24:1). Chi-square tests reveal that mother's age, gravidity at the birth of index child, pregnancy illnesses, child's birth rank, maternal medication use in the first trimester (FT), the absence of antenatal care (ANC), positive family history; and parent's occupational exposure differed significantly between these groups. A logistic regression revealed increased odds of having a child with CL/P with paternal age ≥40 years, maternal age ≤20 years, pregnancy illness, febrile illness in FT, attempted abortion, and birth rank ≥4 th . Furthermore, primigravid status at birth of index child, the absence of ANC, history of neonatal death, medication use in the FT, as well as parent's occupation demonstrated varying increased odds that attained statistical significance. Conclusion: Multiple interrelated factors may be implicated in the etiology of CL/P in the studied population. We advocate prompt health education and public enlightenment directed at addressing and eliminating these RFs.

Surgical eye removal in Ile-Ife, Nigeria

Objective: To determine the indications and pattern of surgical removal of the eyeball at a Tertiary Hospital in South Western Nigeria. Materials and Methods: Retrospective review of case files and theatre records of all patients who had evisceration, enucleation, or exenteration at the ophthalmic theatres of Obafemi Awolowo University Teaching Hospital, Ile-Ife between July 2005 and June 2013 was done. Information on age, sex, indication for surgery, and the type of surgery was analyzed using SPSS 16 software. Results: Eighty eyes of 79 patients, age, ranged from 3 months to 88 years with a male: female ratio of 3.4:1 were surgically removed. The major indications for surgery were ocular trauma (43.8%), orbito-ocular neoplasm (22.5%), fulminant ocular infection (15%), and staphyloma (12.5%). Children accounted for 33.8% of all cases reviewed. Conclusion: Indications for eye removal in our geographical area of practice are largely preventable and similar to those reported in major Nigerian cities and other developing countries, but dissimilar to what obtains in many developed countries.

Association of fasting blood glucose and glycated haemoglobin with some markers of oxidative stress in Ile-Ife, Nigeria

Background: Increased oxidative stress is a widely accepted contributor to the development and progression of diabetes mellitus (DM). A lot of work is being done to unravel the mechanisms linking oxidative stress with diabetes and its complications. Objective: The objective was to investigate the relationship between blood glucose levels, glycated haemoglobin and three markers of oxidative stress in DM: catalase (CAT), superoxide dismutase (SOD) and glutathione transferase (GST). Methods: Subjects were consecutive patients with Type 2 DM receiving treatment and apparently healthy controls. Fasting blood glucose, HbA1c, CAT, SOD and GST were assayed in the diabetic subjects and controls using standard procedures. Information on the presence of neuropathy and nephropathy was obtained from case notes, whereas screening for retinopathy was carried out at the Ophthalmology Unit of Obafemi Awolowo University Teaching Hospitals Complex. Data were analysed using Statistical Package for the Social Sciences for Windows, version 17. Results: A total of 115 subjects comprising 65 diabetics and 50 controls were studied. Mean fasting blood glucose, CAT, SOD and GST activities in test and control subjects were 9.12 (0.48) and 4.78 (0.63) mmol/L, 48.20 (2.69) and 63.22 (1.83) units/mg, 53.22 (2.44) and 62.55 (2.68) units/mg and 1.35 (0.09) and 3.47 (0.11) units/mg, respectively. Statistically significant differences were observed when levels of fasting blood sugar, CAT, SOD and GST were compared between diabetic and non-diabetic subjects. Diabetic subjects with one or more microvascular complications were found with significantly higher HbA1c levels than those without apparent complication. There was significant negative correlation between fasting blood glucose and all three antioxidant enzymes. Conclusion: The results of the present study suggested that fasting blood sugar modulated levels of antioxidant enzymes while protein glycation plays a role in the development of microvascular complications.

Determinants of re-operation following tibia intramedullary nailing at a tertiary hospital in south-west Nigeria.

Introductionintramedullary nailing is a method of choice in the management of long bone diaphyseal fractures. However, complications necessitating re-operation may arise. This study was aimed at determining the rate and indications for re-operation following intramedullary nailing of tibia shaft fractures.Methodsit was a cross-sectional study done at Orthopaedic Department of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife in Southwest Nigeria. Records of patients who had interlocking nailing for tibia shaft fracture between 2005 and March 2013 were retrieved. Variables of interest extracted included aetiology of fracture, type of fracture, cadre of surgeon and indication for re-operation. Frequency distribution and chi-square analysis were done using SPSS version 22. Level of statistical significance was determined at p-value <0.05ResultsOne hundred and forty-six patients had tibia nailing done during the study period. Eighty-six patients met the study criteria with male to female ratio of 2.6:1. There were 51 (59.3%) with open fractures and 35 (40.7%) with closed fractures. Ten patients had re-operation giving a re-operation rate of 11.6 %. Two most common indications for re-operation included loose screw 3 (25%) and surgical site infection (SSI) 3 (25%). There was no statistically significant association between rate of re-operation and the cadre of surgeon (p=0.741) and type of fracture whether closed or open (p=0.190).ConclusionRe-operation following tibia intramedullary nailing is an ever present risk. Precautions should be taken to prevent the common indications such as loose screw and surgical site infections.

Pattern of presentation and outcome of routine dental interventions in patients with halitosis.

The aims of this study were to describe the pattern of presentation of halitosis and to evaluate the success rate following routine dental intervention irrespective of the type of halitosis. This cross-sectional study was conducted among sixty consecutive patients who presented in our Oral Diagnosis and Oral Medicine Clinic, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, on account of halitosis from May 2015 to April 2016. Diagnosis of halitosis was made using the organoleptic method from a whole mouth breath test as described by Miyazaki et al., 1999. Halitosis was assessed before treatment, 2 and 6 weeks after treatment. The results were analysed with STATA statistical software version 11. Sixty out of 305 patients seen in the clinics during the study period had halitosis, with a prevalence of 19.5%. Fourteen (23%) patients had pseudohalitosis while 46 (77%) had genuine halitosis; no case of halitophobia was seen. Majority (71.6%) brush their teeth once daily. The predominant extra-oral etiologic factors were respiratory 2 (3.3%) and ear, nose and throat disorders 1 (1.6%). Twenty-nine (63%) patients with genuine halitosis who had organoleptic scores of ≥4 had no perceivable odour, following routine dental interventions (P < 0.001); the remaining 17 (37%) patients only had slight malodour. Similarly, all the 14 (100%) patients with pseudohalitosis had complete remission after the treatment. The prevalence of halitosis was 19.5%, with male predilection. Routine dental interventions achieved >90% success rate. Preventive oral care is recommended for all halitosis patients.

A review of the clinicopathologic characteristics of intestinal metaplasia in gastric mucosal biopsies.

IntroductionAlthough it is a well recognized premalignant lesion of the stomach, there is a dearth of information on the clinicopathologic features of gastric intestinal metaplasia in Nigerians. It is, therefore, necessary to study these features and their possible contribution to the development of gastric carcinoma in Nigerians.MethodsAll gastric biopsies with the histo-morphologic features of intestinal metaplasia diagnosed at the department of morbid anatomy and forensic medicine, Obafemi Awolowo university teaching hospitals complex, Ile-Ife, Nigeria between January 2006 and December 2010 were used for the study.ResultsA total of 165 biopsies (21.3% of all gastric biopsies within the study period) with background chronic gastritis and intestinal metaplasia were reviewed. The mean age of patients with intestinal metaplasia was 50.3 years ± 17 standard deviation (SD) while the ages of the patients ranged from 10-100 years. There were 83 males (50.3%) with a mean age of 48.1 ± 18.2 SD years and 95% confidence interval (CI) of 44.1-52.1 years. There were, however, 82 females (49.6%) with a mean age of 52.5 (± 15.8 SD) years and a 95% CI of 49.0-56.0 years. There was no significant association between the histologic type of intestinal metaplasia and the patients’ sex, age groups, severity of chronic gastritis, disease activity or degree of gastric glandular atrophy.ConclusionThere are no statistically significant differences in the clinicopathologic characteristics of the subtypes of intestinal metaplasia. In majority of patients, progression from intestinal metaplasia to gastric adenocarcinoma probably takes an average of about 7 years.

Upright or dorsal? childbirth positions among antenatal clinic attendees in Southwestern Nigeria

Background: Upright childbirth positions are associated with better delivery outcomes. These positions such as kneeling and squatting were the norm for childbirth in indigenous Nigerian custom. However, westernization has largely replaced them with supine positions. Objective: This study was conducted to compare the knowledge, attitude and experience regarding childbirth positions between antenatal clinic attendees in southwest and northwest Nigeria. Materials and Methods: A mixed methods design was employed. Quantitative data were obtained using a structured questionnaire in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife (n = 201) and Federal Medical Centre, Katsina (n = 104). Knowledge was graded as poor, fair or good whereas attitude toward each position was graded as favoured, indifferent or against. The resulting proportions were compared using Chi-square. Qualitative data were obtained through key-informant interviews. Results: Knowledge of childbirth positions was generally poor. Overall, only to women (0.6%) had good knowledge, whereas 60 (19.7%) had fair knowledge and the rest (79.7%) had poor knowledge. More women in Katsina than Ile-Ife knew the squatting position (32.7% vs. 16.4%; P Conclusion: Knowledge about childbirth positions was very poor. Women in northwestern Nigeria were more aware and favorably disposed to childbirth in their customary squatting position. Training of Nigerian midwives on upright childbirth positions is recommended.