Usmanu Danfodiyo University Teaching Hospital Research Articles

Patients and Patients’ Relatives Perception of Cleanliness in Radiology Department of a Nigerian Teaching Hospital

Background: Cleanliness and dirt are a dichotomy to categorize a particular environment especially hospital settings in which cleanliness pave a great linkage to patient satisfaction on quality of care and reduction of infection. Dirt creates negative thought on the quality of services being rendered to patients in the hospital environment. Objectives: To assess the perception of patients and their relatives on the level of cleanliness in radiology department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto and to determine which amongst the diagnostic rooms is the cleanest (Computed Tomography (CT) room, Routine X-rays room or contrast exams room (fluoroscopy)). Materials and Method: A descriptive cross-sectional study was conducted, 100 questionnaires were distributed to the respondents of which 66 in Routine xray room, 23 in CT suit and 11 in contrast examination room. Out of the 100 questionnaires nine were not returned and the remaining 91 were analysed. The questionnaire contains fifteen statements in total apart from the socio-demographic component. The count of responses was considered and for each type of response (SA, A, N, D, and SD) the percentage were calculated using statistical package for social sciences (SPSS) version 23.0. Results: Sixty percent of the respondents were patients while 40% were relatives of patients that were critically ill. The modal age range of the respondents was 25-34years, 58% were married, while 48.4% were civil servants. The result of our study shows that the respondents have adequate knowledge on cleanliness with a mean score of 4.3, they perceived radiology department as a clean environment for diagnosis and visitation but need further improvement. According to the findings, CT room was the cleanest (87.0%) followed by contrast examination room 64.0% and routine X-rays room was the least 47.0%. It also revealed that lack of manpower is the cause of inadequate sanitation. Conclusion: Radiology Department in Usmanu Danfodiyo University Teaching Hospital is clean and the CT suit is the cleanest.

Epistaxis among children in Usmanu Danfodiyo University Teaching Hospital Sokoto Nigeria

Background: Epistaxis is a life-threatening otorhinolaryngological emergency and presents as a symptom of varied clinical conditions. The study was designed to determine the frequency and forms of epistaxis among children in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Materials and Methods: It was a prospective study of children ≤12 years with epistaxis presenting to UDUTH, Sokoto from January to December 2017. Information on age, gender, causes, nature, and laterality of epistaxis was collected and analyzed. Results: Of 1078 children who presented with otorhinolaryngological complaints during the study period, 39 (3.6 %) had epistaxis, with majority 14 (35.9 %) of children aged 7 – 8 years. Epistaxis was more prevalent in males than females in the ratio 1.6:1. Epistaxis digitorum was the most common cause 19 (48.7 %) of epistaxis in children in the study area. First episode epistaxis was more common 35 (89.7 %) than recurrent epistaxis 4 (10.3 %), while bilateral epistaxis was more 26 (66.7 %) than unilateral epistaxis 13 (33.3 %). There were more children with left unilateral epistaxis 10 (25.6%) than right epistaxis 3 (7.7 %).

Epistaxis among children in Usmanu Danfodiyo University Teaching Hospital Sokoto Nigeria

Background: Epistaxis is a life-threatening otorhinolaryngological emergency and presents as a symptom of varied clinical conditions. The study was designed to determine the frequency and forms of epistaxis among children in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Materials and Methods: It was a prospective study of children ≤12 years with epistaxis presenting to UDUTH, Sokoto from January to December 2017. Information on age, gender, causes, nature, and laterality of epistaxis was collected and analyzed. Results: Of 1078 children who presented with otorhinolaryngological complaints during the study period, 39 (3.6 %) had epistaxis, with majority 14

Surgical Anatomy of Variations in Sphenoid Sinus Pneumatisation using Computerized Tomograph

Background: The cavity of the sphenoid sinus is a natural surgical route for accessing the middle cranial fossa. The extent of pneumatisation of the sphenoid is key to the preoperative evaluation of transsphenoidal, surgical procedures. Aim: To determine the prevalence and variations in the extent of pneumatisation of the body of the sphenoid bone using computerised tomography (CT). Methodology: Head CT scans of 323 patients were studied at the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, after ethical approval was granted. The CT scans were taken with a GE Bright Speed Multidetector Helical CT Scanner, and viewed with the Digital Imaging and Communication in Medicine (DICOM) viewer, powered by RadiAnt Version 4.2 software. Sphenoid sinus pneumatisation was defined by the anteroposterior extent of the sinus cavity of the sphenoid bone on sagittal images. The extent of pneumatisation was classified into four; conchal, presellar, sellar and postsellar, based on the position of the posterior wall of the cavity in relation to the anterior and posterior walls of the sellar turcica. Results: The predominant type of pneumatisation was the postsellar. The prevalence of the different types of pneumatisation were: postsellar, 50.2%, sellar, 32.0%, presellar, 14.7%, and conchal, 3.1%. There was no statistically significant relationship between pneumati- sation and sex (X2 = 0.585), or age (X2 = 0.076). Conclusion: With the prevalence of the different types of pneumatisation, a pre-operative CT assessment of the sphenoid sinus anatomy is essential, whenever the options for a transsphenoidal access to the sellar is being contemplated.

Nutritional Status of Young Children newly diagnosed with HIV-Infection at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria

Nutritional Status of Young Children newly diagnosed with HIV-Infection at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria

Assessment of breast cancer immunohistochemistry and tumor characteristics in Nigeria.

BACKGROUNDFemale breast cancer is the leading type of cancer worldwide with an incidence of approximately 2.1 million in 2018. Hormone receptor status plays a vital role in its management.AIMTo determine the molecular expression pattern of biomarkers in breast cancer and their correlation with tumor variables.METHODSThis prospective study was designed to analyze expression patterns of estrogen receptor(ER), progesterone receptor (PR) and human epidermal growth factor receptor(HER2/neu) in breast cancer patients. The dataset has been taken from the Department of Radiotherapy and Oncology of Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria from 1 January 2015 to 2 December 2019. The dataset had 259 records and 7 attributes. SPSS version 23.0 for statistical analysis was used. The data analyzed demographic and other clinicopathological characteristics as categorical variables. The mean and standard deviation were determined for the quantitative variable.RESULTSA total of 259 breast cancer cases were included in the study. The mean age was 48.3 ± 11.0, with an age range of 26-80 years and a median age of 46 years. The morphological categories were invasive ductal carcinoma 258 (99.6%) and invasive lobular carcinoma 1 (0.4%). ER, positivity increased in 73 patients (50%) under the age of 50 years, as well as PR positivity increased in 34 patients (23.6%) under the age of 50 years. HER/2neupositivity decreased in 8 patients (5.6%) under the age of 50 years. Hormonal receptors were statistically significant with clinicopathological characteristics (P < 0.05).CONCLUSIONOur study showed that ER, PR and HER2/neuexpression had a strong correlation with age, tumor grade, tumor size and lymph node status. Hence, hormone receptor assessment is highly recommended because of its significance in clinical management and prognostication.

Health care providers counselling of caregivers on their children’s condition at Usmanu Danfodiyo university teaching hospital, Sokoto, North-Western Nigeria

Introduction: Counselling of caregivers about common childhood diseases is an importantcomponent of health care services. Objective: To assess the quality of counselling offered tocaregivers on their children’s condition by health care providers at Usmanu Danfodiyo UniversityTeaching Hospital (UDUTH), Sokoto. Methods: A prospective cross-sectional study carried out from1st August 2015 to 30th April 2016. Caregivers with children less than 15 years of age seen in theunits of Paediatric Department of UDUTH, Sokoto, were consecutively interviewed. Thecorresponding case notes of their children were reviewed to obtain data on the child’s diagnosis andto check whether the attending physicians have documented the content of the counselling offeredto caregivers. Results: A total of 420 caregivers were interviewed. Their mean age was 28.9±8.6years (range of 15-64 years). Only 218 (51.9%) caregivers were counselled, but there was nodocumentation of the content of counselling in the case notes of their children. 81 (37.2%) of thediagnosis mentioned by caregivers did not tally with the one documented in the case notes of theirchildren (p=0.0001). Conclusion: This study revealed inadequate counselling of caregivers on theirchildren condition and poor counselling practices among healthcare providers in UDUTH, Sokoto.Hence, there is the need for training and retraining of healthcare providers on counselling ofcaregivers on their children condition in the hospital.

Can reading too much make me run mad? Exploring students’ assumptions and academic performance

Objectives To determine the prevalence of the assumption that ‘reading too much’ could cause madness (i.e., severe mental illness) among medical, nursing, and community health students, and also explore the relationship between these students’ status on this assumption and their academic performance. Methods This study was a cross-sectional study conducted among a convenient sample of medical, nursing, and community health students (n = 122) studying within the Usmanu Danfodiyo University Teaching Hospital campus, Sokoto, Nigeria. Study tool was a paper questionnaire, which obtained information on the demographic profile, awareness of ‘madness’, assumption that ‘reading too much’ is a cause of madness, and self-rating of the participants’ academic performance in their current course of study. Data collected was analysed using the SPSS version 20 software. Test of associations between variables were done using Chi square test. Results The mean age of the 122 respondents was 27.3 years, majority (61.5%) of them were males, and 53.3% were medical students. More than half of the surveyed nursing students (54.2%) and community health students (55.6%), unlike the surveyed medical students (24.6%), had the assumption that reading too much could make them run mad. There was no statistically significant relationship between the assumption that ‘reading too much’ is a cause of mental illness and academic performance of the respondents. Conclusion Assumption that reading too much could cause madness is a fairly common phenomenon among the surveyed tertiary school students, irrespective of their level of academic performance. There exists the need to disabuse the minds of tertiary school students from the assumption that reading too much could make one run mad.

Paediatric Tuberculosis at the Directly Observed Treatment Short-Course Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Introduction: Tuberculosis (TB) is the leading infectious disease killer worldwide, despite significant progress against the disease in recent years. Most cases of TB in children occur in the TB endemic countries but the actual burden of paediatric TB is unknown. With early diagnosis and treatment using the first-line anti-tuberculous drugs, most people who develop the disease can be cured and onward transmission of infection curtailed.&#x0D; Objective: To determine the pattern and outcome of paediatric tuberculosis managed at a tertiary facility in Sokoto, Nigeria.&#x0D; Materials and Methods: Records of children managed for TB at the Directly observed treatment short-course (DOTS) clinic over a three-and-a-half-year period were reviewed retrospectively. All children (≤ 15 years) treated for TB over the study period was included. Relevant information was retrieved from the register and analysed accordingly.&#x0D; Results: 74 children were treated with 33(44.6%) being males, giving a M: F ratio of 1:1.2. Mean (±SD) age was 85.78 (±55.40) months and 34 (45.9%) belonged to the 0.0-5.0-year age group. Seventy-one (95.9%) were new cases and three (4.1%) were relapse. Pulmonary TB (PTB) was seen in 50 (67.6%), more females had PTB than males, which was not significant (χ2=0.4, p=0.52).&#x0D; Acid fast bacilli (AFB) were positive in only 8 (10.8%) while GeneXpert MTB/RIF sensitivity was detected in 7 (9.2%). Majority 36 (48.6%) were lost to follow up, 30 (40.5%) completed treatment, only 4(5.4%) were cured with no recorded mortality. Successful treatment outcome was low (45.9%).&#x0D; Conclusion: Treatment outcome using DOTS strategy was poor, far below the WHO benchmark. There is need to improve adherence to DOTs therapy to prevent development of multi drug resistant TB.

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines.

BackgroundAdequate management of childhood acute asthma exacerbation requires optimal non-pharmacotherapy and pharmacotherapy. Global asthma guidelines provide critical information and serves as a quick reference decision-support material for clinicians.ObjectivesWe aimed at evaluating hospital management of childhood acute asthma exacerbation to ascertain its conformity to the global treatment guidelines, and to identify factors that predict short or prolonged observation in the hospital.MethodThis was a retrospective audit of the management of acute asthma exacerbation in children seen between 01 January 2017 and 31 December 2018 at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Relevant data on demography, asthma triggers and severity, functional and clinical diagnoses, types of controller medications used before and after presentation, non-pharmacotherapy and pharmacotherapy instituted during presentation, duration of observation in the hospital, and treatment outcomes were extracted from the case file of each eligible patient.ResultsA total of 119 children presented with features of suspected acute asthma exacerbations during the study period but only 63 (52.9%) that met the inclusion criteria for the study were included for analysis. The 63 children that were evaluated had mild (47; 74.6%) and moderate (16; 25.4%) acute asthma exacerbations. Their median (interquartile range) age was 8 (5–15) years. More males (36; 57.1%) than females (27; 42.9%) presented with features of the condition. Majority (50; 79.8%) of the patients had at least one trigger factor and of the 73 trigger factors reported, cold weather (19; 26.0%) was the commonest. Nebulized salbutamol (48; 76.5%), in addition to intravenous (23; 57.9%) and oral (17; 42.5%) corticosteroids, was used during hospital treatment. Patients were discharged mostly on short course of oral corticosteroid only (37; 58.8%). Of the 17 major recommendations in the Global Initiative for Asthma (GINA) guidelines, good (5; 29.4%), moderate (7; 41.2%), and poor (5; 29.4%) levels of adherence were observed. Specifically, moderate and poor levels of adherence were observed in the management of 61(96.8%) and 2(3.2%) patients, respectively. The odds of admission for ≤12 h were higher for female children and patients with mild cases.ConclusionGood and moderate adherence levels to 12 of the 17 GINA recommendations were observed in our center. Nonetheless, reinforcement of institutional guidelines for acute asthma management is suggested to further improve the quality of care of childhood acute asthma exacerbations.

Histopathological Pattern of Fungal Infections Seen in Usmanu Danfodiyo University Teaching Hospital Sokoto from 2014 To 2018

Introduction: Fungal infection is a common manifestation in this part of the country and worldwide. It is essential to define the epidemiology of fungal infection in a particular environment.&#x0D; Aim: This study aims to analyze the diagnosis of fungal infection carried out in patients attending the histopathology department (UDUTH) Sokoto from 2014 to 2018.&#x0D; Method: This study is a retrospective study of all fungal infection biopsies carried out from 2014 – 2019 in Usmanu Danfodiyo University Teaching Hospital, Sokoto, northwestern Nigeria, a referral centre for the neighbouring northern states Kebbi and Zamfara. Ethical clearance was obtained from the ethical committee of UDUTH, data was collected from histological report cards and analyze manually. Some tissue blocks of the case were retrieved to confirm the diagnosis. A total of 66 requests for fungal diagnosis were received from January 2014 to December 2018, which represent about 0.7% of the total biopsies received over the study period.&#x0D; Result: Out of the 66 of request for fungal diagnosis 32(48.5%) were fungal positive. Subcutaneous mycosis was the most frequent fungal infection with a frequency of 18(56.25%). Males were more frequently affected than females with the frequencies of 18(56.25%) and 14 (43.75%) respectively.

Congenital Melanocytic Hairy Nevi in a Child from North-Western Nigeria

Aim: To present the first report of a large congenital melanocytic nevus with satellite nevi in an apparently healthy child from Sokoto, North-Western Nigeria.&#x0D; Presentation of Case: A three year old girl was brought to the paediatric out-patient clinic of Paediatrics department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto with complaints of darkened skin colour on the left side of the face and scalp, the left arm, lower back, buttocks, and thighs, and excessive hair growth over the same side of the face since birth. There were no neurological symptoms Physical examination findings revealed a well-nourished, not ill looking child. She had a hyper pigmented patch on the left side of the face extending from the lower jaw to the scalp, measuring 21 cm in its longest length, with hypertrichosis on the same site, and two distinct, firm, painless nodular lesions on the left temporal region measuring 3 mm and 4mm respectively. On the lower one-third of the left arm was a hairy, velvety area of hyperpigmentation measuring 2X3 cm in diameter. Other affected sites were the lower back, the gluteal region and the thighs. Her neurologic and other systemic examinations were normal. A diagnosis of large congenital facial melanocytic hairy nevus with multiple satellite nevi was made.&#x0D; Discussion: Congenital melanocytic nevi are benign proliferations of melanocytic cells said to be present at birth or in the first two years of life. Large lesions are rare, they measure 20 cm or more and are said to occur more commonly on the trunk and thighs. The exact pathogenesis of congenital melanocytic nevi is yet, unknown. It is thought to occur as a result of a morphological error in the neuroectoderm during embryogenesis. Treatment of patients with large congenital melanocytic nevus may include surgical or non-surgical procedures as well as psychological interventions. Large lesions, multiple satellite lesions or paravertebral and axial locations are sometimes associated with the risk of neurological complications and malignant transformation.&#x0D; Conclusion: Large congenital melanocytic nevi are uncommon skin lesions that can occur in apparently healthy children. Individualization of the patients with regards to treatment options and long term monitoring are imperative.

Prevalence and Predictors of Elevated Pulmonary Artery Pressure in Nigerian Children with Sickle Cell Anaemia

Background: Sickle Cell Anaemia (SCA) is the most common inherited disorder in Nigeria. Pulmonary Hypertension (PH) is a known complication of SCA that commences from childhood and progresses as they grow older.&#x0D; Aim: To determine the prevalence and predictors of elevated pulmonary artery pressure (PAP) in children with SCA.&#x0D; Study Design: This is an analytical cross-sectional study.&#x0D; Methods: Three hundred subjects with SCA in steady state and 300 HbAA controls, aged 6 months – 15 years, were enrolled into the study. Children with SCA were recruited by simple random sampling, from the Paediatric Sickle Cell Clinic, Usmanu Danfodiyo University Teaching Hospital, Sokoto. All the children had clinical evaluation, echocardiography, full blood count and reticulocyte count. Pulmonary artery systolic pressure (PASP) and mean pulmonary artery pressure (MPAP) were determined by measurement of tricuspid regurgitant velocity (TRV) and mean gradient (MG) respectively. &#x0D; Results: Seventy-two children with SCA (24.0%) had elevated PAP (defined as TRV ≥ 2.5 m /s) while only 9 (3.0%) had pulmonary hypertension (defined as MPAP ≥ 25 mmHg). Older age (O.R = 1.03, p &lt; 0.001), high systolic blood pressure (O.R = 1.2, p = 0.01), and high reticulocyte count (O.R = 1.33, p = 0.04) were weakly associated with increased likelihood of elevated PAP. Normal pulse oxygen saturation (SPO2 ≥ 95%, O.R = 0.4, p = 0.002) and normal heart sounds on auscultation (O.R = 0.2, p = 0.04) were associated with a reduced likelihood of elevated PAP. Presence of left parasternal heave (O.R = 8.4, p = 0.001) significantly predicted elevated PAP in children with SCA.&#x0D; Conclusion: PH occurs as a complication in children with SCA and certain clinical and laboratory parameters do predict this complication in children.

Prevalence of Carbapenem-Resistance among Enterobacteriaceae Isolated from Patients Attending Uduth Sokoto, North West Nigeria

The major problem threatening the continued success of antimicrobial drugs is the development of resistant organisms. This study was designed to determine the occurrence and prevalence of carbapenem resistance among enterobacteriaceae isolated from in-patients attending Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, and also to determine the antimicrobial susceptibility patterns of the organisms isolated. The Methodology involves the use of trypticase soy broth containing 10 μg of carbapenem (imipenem) for primary isolation. The secondary isolation involves the use of MacConkey agar and biochemical (Simmon citrate Agar) for identification, and then antimicrobial susceptibility testing by the disk diffusion method. A total of 191 stool samples from male and female in-patients within the range of 2-60 years were screened for the gastrointestinal colonization of Carbapenem Resistance Enterobacteriacea (CRE). Data were analysed using Statistical Package for Social Sciences (SPSS) windows version 21. The overall prevalence was 15.7% The prevalence rate was found exclusively in males. The highest prevalence was found within the age group of 30-40 years. Escherichia coli, Klebsiella species, Pseudomonas species and salmonella species were the bacteria isolated. The most predominant bacteria isolated were Escherichia coli, accounting for 85 (9.4%) resistant strains, Klebsiella species accounting for 50 (8%) resistant strain, Pseudomonas aeruginosa 21% and Salmonella species accounting for 42 (0%) no resistant strain isolated. The misuse of antibiotics is a major factor responsible for the high rate of bacterial resistance. Improvement on the management and personal hygiene, as well as the appropriate use of antibiotics would reduce the prevalence of Nosocomial Carbapenem Resistance (NCR) especially among prolonged hospitalized patients.

Antimicrobial resistant and virulence genes profiles of some Gram-negative bacteria from clinical isolates at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

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Pattern and Outcome of Cardiac Interventions Performed within and Outside Nigeria for Children with Structural Heart Diseases in Sokoto, North-western Nigeria

Background: Management of structural heart diseases is quite challenging in Nigeria, due to limited availability and access to cardiac care services. There is paucity of data on the pattern and outcome of cardiac interventions in children from the study area. &#x0D; Aims: To determine the pattern of cardiac interventions and the early outcome (within six-months) of such interventions in children with structural heart diseases (SHD) seen in our hospital.&#x0D; Study Design: Descriptive cross-sectional study.&#x0D; Place and Duration of Study: Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, between August 2012 to September 2019.&#x0D; Methodology: All children with SHDs seen at our hospital, but had Cardiac surgery or interventional cardiac procedures within and outside Nigeria were recruited. Relevant information including type of lesion, procedure performed and the outcome within the first six months and length of hospital stay was analyzed.&#x0D; Results: Only 63 out of 780 (8.1%) children with structural heart diseases, aged 6 months-15 years (Mean age 6.5± 5.0 years, M: F = 1.3:1), had cardiac interventions. The interventions were surgical in 61 ((96.8%) and catheter-based in 2 (3.2%) patients; with 49 (77.8%) of these performed abroad. Patent Ductus arteriosus 14 (22.2%), Tetralogy of Fallot 14 (22.2%), ventricular septal defect 13 (20.6%) and atrial septal defect 6 (9.5%) were the commonest lesions for which interventions were undertaken. Early post-operative complications included pulmonary hypertensive crises, pericardial and pleural effusion, complete heart block and left branch pulmonary artery stenosis warranting re-intervention. During the first six months after the interventions, three (4.8%) patients died while 60 (95.2%) survivors were followed up. However, 25 (39.7%) of them were thereafter lost to follow.&#x0D; Conclusion: Majority of the cardiac interventions were surgical, performed predominantly in older children with CHDs; and associated with good outcome. However, most of them were undertaken outside the country, highlighting the need to ensure these services are available and accessible locally.

Pattern of Blood Specimen Rejection at a Nigerian Public Clinical Laboratory

Obtaining appropriate blood specimen is central towards provision of reliable results in a clinical laboratory. To ensure that blood specimen collected for analysis reflect the physiologic or pathologic processes they represent, potential sources of pre-analytic errors should be identified and avoided. Our study aimed at determining the pattern of blood specimen rejection in a public clinical laboratory with a view of identifying inadequacies that should be improved upon. The sample rejection register at the Haematology laboratory of Usmanu Danfodiyo University Teaching Hospital Sokoto, Northwest Nigeria was accessed for a two-year period data on number of specimens rejected, reasons for rejection, types of tests for which rejections were made and affected clinical units; and the retrieved data were analysed using Microsoft Excel 2010. Of the 53,955 specimens received during the study period, 122 were rejected giving an overall specimen rejection rate of 0.23%. Incomplete specimen labelling and clotted specimens were the commonest reasons for specimen rejection having accounted for 59.8% (73) and 30.3% (37) of the rejections respectively. Coagulation Screening Tests and Packed Cell Volume had the highest rejection rates of 52.5% (64) and 18.0% (22) respectively. The Accident and Emergency (A&amp;E) and Emergency Paediatric Unit (EPU) recorded the highest rates of sample rejection with 31.1% (37) and 11.8% (14) rejection rates respectively. We concluded that the reasons for blood specimen rejection in our public clinical laboratory could be avoided via the use of appropriate and properly labelled specimen containers and avoidance of faults in specimen collection, storage and transportation to the laboratory.

Oxidative Stress and Antioxidant Vitamins Status of Diabetic Subjects Supplemented with Antioxidant Rich Supplement (Alphabetic) Attending Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion / insulin action or both which could leads to increase level of oxidative stress and decrease in antioxidant defense system and may play role in the development of diabetic complications. The present study examines the effects of antioxidant rich supplements (Alphabetic) on antioxidant status of one hundred (100) diabetic subjects attending Usmanu Danfodiyo University Teaching Hospital (UDUTH) for at least one year and the results were compared with those of fifty (50) diabetes mellitus non-supplemented and fifty (50) apparently healthy non-diabetic subjects. Standard analytical procedures were used for all the parameters measured including the effects of supplementation on Fasting Blood Glucose, oxidative stress marker (MDA), Reduced gluthathione and antioxidant vitamins (C, E and β-carotene) parameters were evaluated. The results revealed that the supplementation significantly (P˂0.05) reduce Serum glucose and Malondialdehyde and also significantly (P˂0.05) increases Vitamin C, Vitamin E and Reduced glutathione compared with the non-supplement group. The findings suggests that supplementation with Alphabetic might reduce the risk of oxidative stress associated with diabetes mellitus leading to diabetic complications and might be beneficial in the routine treatment of diabetes mellitus.

Giant Encephalocele in Sokoto, Nigeria: A 5-Year Review of Operated Cases

Encephalocele is a common congenital malformation of the central nervous system; however, giant encephaloceles are rare. The use of folic acid supplementation and termination of pregnancies, which are prenatally diagnosed with encephaloceles and other congenital malformation of the central nervous system, has significantly reduced the occurrence of this type of congenital malformation, especially in developed countries. This was a retrospective review over a 5-year period from January 2006 to December 2010 at the Department of Neurosurgery, Regional Centre for Neurosurgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. The records of patients with giant encephalocele were retrieved from the case notes of patients who had excision and repair for encephalocele. Seventy-three patients had excision and repair of encephalocele over the study period. However, the records of only 50 patients were retrieved. Fourteen (28%) of the 50 whose records were retrieved had giant encephalocele. There were 4 male and 10 female patients (1:2.5). Thirteen (92.9%) had the lesion located in the occipital region, whereas in 1 patient (7.1%) the lesion was at the vertex. Three (21%) of the cases had microcephaly, 1 (7.1%) had macrocephaly, and 1 (7.1%) developed postoperative hydrocephalus. The average size of defect was 2.43 cm, and the size of the lesion ranged from 12× 6 cm to 40× 50 cm. The average maternal age was 20.3 years (n= 6), and the paternal age was 29 years (n= 4). Four out of 7 (57%) mothers had febrile illness in early pregnancy. Seven out of 10 patients (70%) did not have antenatal care. This condition is more common in children conceived during the period when farm products are yet to be harvested, and whose mothers did not attend antenatal care visits. It is recommended that mothers should be educated on the necessity of preconception folic acid. Implementation of a national strategy on food fortification is also advised. We recommend surgery after the first month of life to reduce poor early postoperative outcomes. In developing countries and centers with suboptimal pediatric intensive care units, surgical intervention is preferred after the first month of life with good temperature control, adequate fluid replacement following rupture of the sac, blood transfusion availability, and, only if necessary, complex cranial reconstruction.

Application of Machine Learning Techniques in Predicting of Breast Cancer Metastases Using Decision Tree Algorithm, in Sokoto Northwestern Nigeria

According to international agency for research on cancer, female breast cancer was the leading type of cancer worldwide in terms of the number of new cases (approximately 2.1 million) diagnosed in 2018. Predicting outcome of a disease is a challenging task. Data mining techniques tends to simplify the prediction segment. Automated tools have made it possible to collect large volumes of medical data, which are made available to the medical research groups. This study aimed to apply machine learning algorithms using decision three classifier and descriptive statistics to evaluate the performance of the model in predicting the probability of cancer metastasis in patients that present late. Materials and method: The breast cancer disease dataset has been taken from the department of Radiotherapy and Oncology of Usmanu Danfodiyo University Teaching Hospital, Sokoto state, Nigerian. Dataset has 259 instances and 10 attributes. The experimental results of this study used, decision three classifier in IMB SPSS (version 23) software environment. In the experiment, two classes were used and therefore a 2 × 2 confusion matrix was applied. Class 0=Not Metastasized, Class 1=Metastasized. We applied supervised machine learning approach in which dataset were divided into two classes that is training and testing using 10 fold cross validation. Results: Shows that 259 instance of breast cancer, 218(84.2%) cases were not metastasized while 41(15.8%) cases were metastasized to the other region of the body. The overall accuracy of the model was found to be 87%, with the sensitivity of 88%, specificity 75% and the precision of 98% Conclusion: Based on these findings, the machine learning algorism using decision three classifiers predicted that 87% of the tumor presented at stage IV, indicating that the tumour can spread to the other region of the body.