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Table of Contents
April-June 2016
Volume 13 | Issue 2
Page Nos. 45-94
Online since Monday, April 4, 2016
Accessed 59,651 times.
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EDITORIAL
Discrepancies in interlaboratory plasma bicarbonate measurement
p. 45
Elaine Chinyelu Azinge
DOI
:10.4103/2408-7408.179647
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ORIGINAL RESEARCH REPORTS
Frequency of neuropathic pain in type 2 diabetes mellitus at the Lagos University Teaching Hospital: A questionnaire-based outpatient survey
p. 46
Oluwadamilola O Ojo, Ifedayo A Odeniyi, Sandra O Iwuala, Olajumoke O Oshinaike, Njideka U Okubadejo, Olufemi A Fasanmade
DOI
:10.4103/2408-7408.179648
Background:
Neuropathic pain (NP) is one of the most common complications of type 2 diabetes mellitus (DM). The frequency of NP in population living with type 2 DM is unclear.
Objective:
To determine the frequency of NP symptoms in patients with type 2 DM.
Materials and Methods:
This cross-sectional study recruited 250 type 2 DM patients attending the outpatient diabetes clinic of the Lagos University Teaching Hospital (LUTH) over a period of 4 weeks. Demographic data and data regarding current DM treatment, prior diagnosis of NP, and current treatment of NP were obtained using a structured questionnaire. Glycaemic status of the patients was assessed measuring fasting blood glucose and glycosylated hemoglobin level. Presence of NP was documented using the painDETECT questionnaire (PDQ).
Results:
NP was present in 54 out of the 250 type 2 DM patients studied giving a frequency of 21.6%. Out of 54 patients 36 (66.7%) were females and 18 (33.3%) were males giving a male: female ratio of 1:2 (
P
< 0.05). The mean age of type 2 DM patients with NP was significantly higher than the mean age of type 2 DM patients without NP (62.4 ± 10.9 years vs 58.9 ± 11.7 years;
P
= 0.05). Glycaemic status and disease duration did not differ among DM patients with or without NP. Only 10 out of 54 (18.5%) patients were treatment naοve at the time of study; however, out of the 44 patients receiving treatment only 9 (20.5%) were on appropriate treatment compared to international guidelines on treatment of diabetic NP.
Conclusion:
NP was present in 21.6% of type 2 DM patients attending the LUTH.
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Self-reported adherence rates in glaucoma patients in Southwest Nigeria
p. 51
Adeola Olukorede Onakoya, Chigozie Anuli Mbadugha
DOI
:10.4103/2408-7408.179649
Context:
Nigerian glaucoma patients have an aversion to surgery and often rely on medical therapy to prevent disease progression. For medical therapy to be effective, the drugs have to be used as prescribed. Compliance has been reported to be low in the previous Nigerian studies.
Aims:
To evaluate the adherence rates of primary open angle glaucoma (POAG) patients on medical therapy using patient self-report.
Settings and Design:
A hospital-based cross-sectional design was used to assess consecutive POAG patients attending a glaucoma clinic in a Tertiary Hospital in Lagos, Nigeria. Subjects and Methods: Self-reported adherence was evaluated by trained interviewers. Comprehensive clinical assessment including intraocular pressure, gonioscopy, visual field assessment, and dilated binocular funduscopy using the slit lamp and + 78D fundus lens was done.
Statistical Analysis Used:
Data analysis was done using MedCalc Statistical Software.
Results:
One hundred and fourteen patients reported adherence rates ranging from 10% to 100% with a mean adherence rate of 82.33% ± 19.25%. Only 31 respondents (27.2%) reported 100% adherence. Duration of the disease was the only significant factor on multiple regression analysis.
Conclusions:
The development of strategies to improve compliance and persistence in glaucoma patients is crucial for the reduction of disease progression and blindness.
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The challenges of lymphoma diagnosis in a Tertiary Hospital in Lagos, Nigeria
p. 58
Olakanmi Ralph Akinde, Charles Chidozie Anunobi, Oluseye Vincent Osunkalu, Adekoyejo Abiodun Phillips, Olatunji Micheal Afolayan
DOI
:10.4103/2408-7408.179679
Background:
In most tertiary centers across sub-Saharan countries, hematoxylin and eosin (H and E) stained slide is the main method of diagnosing lymphomas, and this has been found to be inadequate in diagnostic hematological malignancies.
Aim and Objectives:
To review the diagnostic utility and limitations of H and E, tissue diagnostic modality of solid hematolymphoid malignancies.
Materials and Methods:
The diagnosis based on both morphology and immunohistochemistry (IHC) assessments were compared with those based solely on morphology.
Results:
Of all, the 116 cases of lymphomas, only 32 (27.6%) were correctly diagnosed and subtyped by morphology while 53 (46%) cases were diagnosed to be lymphomas but could not be subtyped by morphology. Nineteen (16.4%) cases were wrongly subtyped. Five cases of reactive lesions were wrongly diagnosed as malignant lymphoma.
Conclusion:
This study makes a case for the mandatory use of IHC in the diagnosis of suspected cases of lymphomas.
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Circulating levels of plasma lipids and cardiovascular risk in Nigerian women with severe preeclampsia
p. 72
Ifeoma C Udenze, Babasola O Okusanya, Oyetunji O Soriyan, Iwuchukwu O Ajie, Ephraim U Egbuagha
DOI
:10.4103/2408-7408.179680
Background and Objectives:
Preeclampsia has been associated with disorders of lipid metabolism. In the general population, dyslipidemia has been identified as a cause of endothelial damage and cardiovascular disease. Few studies have evaluated these relationships in Nigerian women with preeclampsia. This study aims to determine the level of plasma lipids in severe preeclampsia and assess the relationship between dyslipidemia, organ damage, and C-reactive protein (CRP) in Nigerian women with severe preeclampsia.
Materials and Methods:
This was a case-control study conducted on 50 women with severe preeclampsia and 50 with normal pregnancy matched for gestational age. The women were included from the antenatal clinic of the Lagos University Teaching Hospital, Lagos, Lagos State, Nigeria. Informed consent was obtained and sociodemographic and clinical data were obtained using a questionnaire. Blood was collected from the women after an overnight (10-12 h) fast for biochemical analysis. Employing the IBM SPSS statistical software, comparisons of the continuous variables and categorical variables were done using the Student's
t-
test and Chi-square test, respectively. Correlation analysis was used to determine the associations between the variables. Statistical significance was set at
P
< 0.05.
Results:
The levels of high-density lipoprotein (HDL) cholesterol were significantly lower (
P
< 0.0003) and the levels of triglyceride (TG), low-density lipoprotein (LDL) cholesterol, and total cholesterol (TC) were significantly higher in women with severe preeclampsia compared to the controls (
P
< 0.0005,
P
< 0.007,
P
< 0.009, respectively). The HDL/LDL ratio was significantly lower and CRP was significantly higher in severe preeclampsia (
P
< 0.0001 and
P
˂ 0.0002, respectively). The lipid profile parameters showed a significant association with the markers of organ dysfunction. TG showed a statistically significant correlation with uric acid, creatinine, alkaline phosphatase (ALP), systolic blood pressure (SBP), and diastolic blood pressure (DBP). HDL showed a statistically significant correlation with uric acid, ALP, aspartate aminotransferase (AST), SBP, and DBP. While TC showed a statistically significant correlation with SBP and DBP, TG, in addition, had a statistically significant correlation with CRP in women with severe preeclampsia.
Conclusion:
Severe preeclampsia is associated with dyslipidemia, which has been linked to organ damage and an increased cardiovascular risk in Nigerian women. Although dyslipidemia resolves with each pregnancy, risk of cardiovascular disease in the future remains. Thus, continuous monitoring of Nigerian women with a history of severe preeclampsia is suggested.
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A comparative study of the effects of infrared radiation and warm-up exercises in the management of DOMS
p. 77
Ayoola I Aiyegbusi, Adebimpe J Aturu, Adegoke M Akinfeleye
DOI
:10.4103/2408-7408.179681
Introduction:
Delayed onset muscle soreness (DOMS) is associated with temporary morbidity as a result of pain, soreness, and reduced muscular performance that affects the overall performance of the individual. Several interventional modalities have been studied without a conclusive evidence of efficacy.
Objective:
This study was carried out as part of a continuous attempt to find an effective and quick relief for DOMS. The study investigated the comparative effects of warm-up exercises and infrared radiation in ameliorating the symptoms associated with DOMS.
Materials and Methods:
Sixty volunteer subjects between the age of 16 years and 35 years had DOMS induced in the left biceps brachii muscle. They were randomized into three groups with 20 subjects in each group. The groups were allocated as follows: Group A as control that received no treatment, Group B had a bout of warm-up exercises consisting of 10 sets of maximal elbow flexion and extension after which DOMS was experimentally induced, and Group C had infrared radiation for 20 min after which DOMS was experimentally induced. Assessment for muscle soreness, pain, and joint range of motion (ROM) was carried out immediately after inducing DOMS and it was repeated 24 h and 48 h later using the Numerical Pain Rating Scale (NPRS), deep palpation (DP), and goniometry, respectively.
Results:
The infrared group (Group C) had significantly lower scores on NPRS and DP throughout the 3 days compared with the control while the significant effects of warm-up exercises were seen from day 2. There was, however, no significant difference (
P
> 0.05) in the range of movement (ROM) scores. Compared with warm-up exercises (Group B), infrared resulted in significantly lower NPRS and DP scores and greater ROM only on day 1.
Conclusion:
Infrared radiation (IRR) is effective in ameliorating the symptoms of DOMS immediately after treatment on day 1 while the effect of warm-up exercises is seen 24 h later. IRR, thus, has a better effect than warm-up exercises in ameliorating the symptoms associated with DOMS.
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Knowledge, attitude, and practice of abortion among female students of two public senior secondary schools in Lagos Mainland Local Government Area, Lagos State
p. 82
Abdul-Hakeem O Abiola, Oluwabunmi A Oke, Mobolanle R Balogun, Foluke A Olatona, Maymunah A Adegbesan-Omilabu
DOI
:10.4103/2408-7408.179682
Background:
Unsafe abortion is a public health concern because of its dire reproductive health consequences and impact on maternal morbidity and mortality. Tackling this problem will go a long way toward achieving one of the Millennium Developmental Goals, which aim to reduce overall maternal mortality by two-thirds by the year 2015. The aim of this study was to determine the knowledge, attitude, and practice of abortion and the factors associated with it among female students of two public senior secondary schools in Mainland Local Government Area, Lagos state.
Materials and Methods:
This was designed as a cross-sectional, descriptive study. The multistage sampling method was used to select 210 respondents. Data were collected with self-administered questionnaires and analyzed using the EPI Info software. The questionnaire was divided into four sections: the sociodemographic characteristics of the respondents, knowledge about abortion, attitudes toward abortion, and the practice of abortion. The responses to the knowledge and attitude questions were scored and graded as good (≥50%) and poor (<50%).
Results:
The response rate was 98%. The mean age of the respondents was 15.6 1.3 years. The majority (83.3%) of the respondents had good knowledge of abortion; almost all (99.2%) demonstrated poor attitude toward abortion; and only a few (2%) had ever had an abortion. There was a statistically significant association between the ages of the respondents and their knowledge of abortion (
P
= 0.004) as well as their attitude toward abortion (
P
= 0.03).
Conclusion:
The respondents showed good knowledge of abortion, poor attitude toward abortion, and a low of practice of abortion. There is, therefore, a need to improve and sustain the existing knowledge and attitudes toward abortion so as to reduce the practice of abortion among students of the two schools.
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Bone suturing as a new way for splinting of single standing molar tooth after intentional replantation: A technical note
p. 88
Amin Rahpeyma, Saeedeh Khajehahmadi
DOI
:10.4103/2408-7408.179683
Introduction:
Single standing mandibular and maxillary teeth are difficult situations for splinting. Convectional splinting techniques that use wire only techniques or wire composite are not usable in this case.
Method:
Bone suture technique in a mandibular molar, directly through the socket and in the maxillary single standing molar through adjacent edentulous space was done for splinting after intentional replantation.
Results:
This method was effective in tooth splinting.
Conclusion:
Bone suture technique is valuable method for splinting after intentional replantation in the case of lone standing molar.
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CASE REPORT
Unusual occurrence of primary malignant melanoma of the nasal cavity
p. 90
Madhu Kumar, Veerendra Verma, Monika Singh
DOI
:10.4103/2408-7408.179684
Malignant melanoma of nasal cavity is an extremely rare tumor with an incidence rate of 0.67% among all malignant melanomas. Melanomas are tumors arising from melanocytes that are neuroectodermal cells located in the basal layers of skin, skin adnexa, uveal tract, and occasionally in mucosal membranes. We report a case of malignant melanoma of nasal cavity in a 60-year-old female for its rare occurrence. These tumors have poor prognosis owing to high rates of locoregional recurrence and distant metastasis. We report this case without the symptom of epistaxis because of its rarity.
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LETTER TO EDITOR
Adenocarcinoma of the lung presenting as a solitary pulmonary nodule
p. 93
Vipul Malpani, Sourya Acharya, Satish Narayan Mahajan, Arvind Bhake
DOI
:10.4103/2408-7408.179685
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