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  Citation statistics : Table of Contents
   2016| Sep-Dec  | Volume 3 | Issue 3  
    Online since November 2, 2016

 
 
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ORIGINAL ARTICLES
Renal cysts: Sonographic evaluation and classification in Sudanese adults
Moawia Bushra Gameraddin, Mahmoud S Babiker
Sep-Dec 2016, 3(3):111-115
DOI:10.4103/2394-2010.193181  
Background: Renal cysts were common findings in the kidneys encountered in daily routine ultrasound examination. The majority is benign, but they can become complicated in the case of infection, hemorrhage, and ischemia. Sonographic evaluation plays a great role in classification and characterization of these lesions. Objective: The aim was to classify the renal cysts using ultrasound, to analyze the frequency of symptoms and signs, and to identify the significant factors. Materials and Methods: This is a cross-sectional prospective study conducted from September 2014 to December 2015. A total of 105 patients (78 males and 27 females) have been examined with ultrasound and confirm diagnosed with renal cysts. The sonographic criteria used for assessing renal cysts were wall-definition, thickness of septa, acoustic enhancement, shape and numbers of cysts, in addition to the genetic history of the family. Results: The incidence of renal cysts is significantly higher in male than female (74% vs. 26%, P= 0.01). Renal cysts were common in patients above 50 years old (80%). Aging was a significant factor of the renal cyst (P = 0.03) and size of the cysts was not significantly associated with age (P = 0.261). The majority of cysts was solitary (66%), unilateral (86%), and located in the right kidney (49%). The incidence of cortical simple renal was 73%, para-pelvic simple cysts was 17%, autosomal-dominant polycystic kidney disease (ADPKD) was 4.76%, and acquired cystic kidney disease (ACKD) was 4.76%. The majority of simple renal cysts were asymptomatic (75%). Hypertension and flank pain were the common symptoms of ADPKD and ACKD. Conclusion: Age and gender were significant risk factors of renal cysts. ADPKD and ACKD were less frequent among Sudanese adults. Hypertension and flank pain were the most common symptoms and signs of ADPKD and ACKD. Ultrasound plays an effective role to classify and assess renal cysts that help in management and follow-up.
  2 3,434 180
Incidence of neonatal tetanus in a Nigerian State Hospital, Benin, Nigeria
Florence O Adeyemo, Tijani A Abioye, Amiegheme Ehobhayi Felicia, Agbontaen Usunobun
Sep-Dec 2016, 3(3):102-106
DOI:10.4103/2394-2010.193187  
Aim: The study was aimed at determining the incidence of neonatal tetanus (NT) in Stella Obasanjo State Hospital, Benin City over a period of 5 years. Settings and Design: Retrospective design was used where past records were reviewed from January 2008 to June 2013 and analyzed. Materials and Methods: An observational checklist was developed for manual collection of secondary data from the case notes and the neonatal ward register (the admission and discharge records of patients). The checklist includes information on the following; age at birth, age at discharge, duration of hospitalization, date of manifestation of the disease, entry point of the disease, mother's immunization, place of birth, treatment modality, and outcome of treatment. Statistical Analysis: Descriptive statistics was used which involves the use of simple percentage and bar chart to analyze the data. Results and Conclusions: The result of findings shows that 5 cases were admitted in 2008 and 2010 and the age at manifestation of disease range from 3 to 15 days old while age at admission ranges from 5 to 17 days old. The highest number of days infants stayed in the hospital is 44 days while the least was 2 days whereas the age at discharge ranges between 7 and 52 days. The result further revealed that 60% of the cases were born in the hospital, 26.6% were born out of the hospital while 13.3% gave were born in traditional birth attendant quarters. Finally, this study showed that the percentage of unimmunized mothers outweighs that of immunized mothers. NT is a key cause of neonatal mortality even though it is preventable and it was recommended that all babies born on the floor, roadside, or in a motor vehicle due to precipitated labor should be given injection ATS 4 units/kg before the disease appears.
  1 7,012 314
CASE REPORTS
Ambiguous external genitalia in a Nigerian neonate seen at a private health facility in South Eastern Nigeria
KI Achigbu, KK Odinaka, EO Achigbu
Sep-Dec 2016, 3(3):116-118
DOI:10.4103/2394-2010.193182  
The birth of a child with ambiguous genitalia poses a huge emotional burden to the parents and erodes the joyful experience of childbirth. Ambiguous genitalia is a disorder of sex development that affects 1 in 4500 live births. The diagnosis of ambiguous genitalia in a newborn infant is a social emergency because of the need to assign gender of rearing to the child early in life. We report a case of ambiguous genitalia in Nigerian neonate seen at a private health facility in Nigeria as well as highlight challenges in the management.
  - 2,502 147
Acquired tracheo-esophageal fistula from disc battery in a child: A case report and review of literature
Umar Abubakar, Salisu Ismail, Solomon I Ukwuani
Sep-Dec 2016, 3(3):119-122
DOI:10.4103/2394-2010.193183  
Disc battery ingestion has increased drastically due to the fact that most household devices use these batteries. Children have access to these devices either as their toys which they play with or as devices that are used on daily basis such as remote control and watches. Children place things in their mouth, using it as a means of exploring their environment. It is common for these batteries to get impacted in the esophagus and if not removed immediately will cause liquifactive necrosis leading to perforation into the trachea which is closely related to the esophagus. We report a case of disc battery ingestion that presented to us with a tracheo-esophageal fistula. We also reviewed literature related to this pathology.
  - 2,963 185
ORIGINAL ARTICLES
Nasal injuries: The place of foreign bodies
Jones Ndubuisi Nwosu
Sep-Dec 2016, 3(3):107-110
DOI:10.4103/2394-2010.193185  
Objectives: The study was aimed to access foreign body (FB) injuries of the nose, the variety, age group affected, management, and complications as seen in our center. Materials and Methods: It was a retrospective study of 27 consecutive patients with suspected FB in the nasal cavity, seen and managed in the Otolaryngology (ENT) Department of a tertiary health facility in a suburban town, Southeast Nigeria over 18 months. The case notes of the patients in the emergency department, ENT clinic, and ward were consulted for the relevant data that were analyzed and presented in descriptive and tabular forms. Results: Male cases were less than females in the ratio of 1:1.7. All the patients involved were 5 years old and less with an average age of 2.54 years (standard deviation: 0.99). Beads 8 (29.6%) was the most popular FB retrieved. All the FBs were removed in the ENT department without general anesthesia, and no complication was recorded. Conclusions: FBs in the nose were more commonly seen in children. The types of FBs varied along the common objects, the children come in contact with. Seamless removal can be achieved with the right personnel operating in a conducive environment.
  - 2,726 190
Quantifying the arthritis pyramid for Ontario by using comprehensive community health data
Tanveer Towheed, Shikha Gupta, Shari Glustein, Vic Sahai
Sep-Dec 2016, 3(3):86-91
DOI:10.4103/2394-2010.193188  
Introduction: Arthritis is a leading cause of functional impairment and health care utilization in Canada and in the Western world. The aim of this investigation is to quantify the frequency, severity, and magnitude of arthritis in Ontario, Canada, using recognized databases supplemented with comprehensive, population-based survey data to facilitate informed, evidence-based planning. Materials and Methods: Data from Vital Statistics (2011, mortality), Canadian Institute for Health Information (2013, Discharge Abstract Database), Census (2011, demographic information), National Ambulatory Care Reporting System (2013, emergency department visits), and the Canadian Community Health Survey (2011/12) were used to construct an arthritis pyramid for residents of Ontario aged 15 years and older. Results and Discussion: Although arthritis is not a common cause of death, it is an important reason for hospitalizations and emergency room visits. Its greatest impact lies in the prevalence of individuals who are affected; approximately 1.8 million individuals in Ontario, and the resulting negative impact on functional ability, health care utilization, and health-care costs. The impact on society is immense and is expected to worsen as the population ages. Conclusion: A nationwide health care strategy to prevent and manage all forms of arthritis is crucial. In order to do this, we must first understand its prevalence and impact on society. This study provides a detailed information on the iceberg effect for arthritis and offers valid information for regional planning, provincial comparisons and an illustration for similar analyses nationally and internationally.
  - 3,433 1,608
Effect of lysine supplementation on cardiovascular response to stressors of households in two peri-urban communities in Ghana
Frederick Vuvor, Thomas Ndanu
Sep-Dec 2016, 3(3):92-97
DOI:10.4103/2394-2010.193184  
Introduction: Lysine affects the level of stress/anxiety, increases resistance to diseases, and prevents protein deficiency disorders. It is the most limiting amino acid that affects protein quality. The main aim was to study the effect of lysine supplementation on stressor of adults in two peri-urban communities in Ghana. Materials and Methods: It was a double-blind, randomized, placebo-controlled trial involving 90 men and 90 women. At the baseline and after intervention, the subjects' blood pressures (BPs) were measured before and after subjecting them to stressor in the form of blood draw. Halves of the men and women were assigned to lysine and the other assigned to placebo as a control. After taken the initial measurements 1,000 g lysine tablets were daily given to the subjects for 112 days to supplement their dietary lysine intake. Results: No significant variation was observed among the subjects at baseline. However, after the supplementation, there were significant drops in the delta of systolic BP by the margin of 7.26 ± 11.64 mmHg in men and 8.50 ± 14.96 mmHg in women. The mean arterial blood pressure also dropped by 1.09 ± 8.22 mmHg in men; but not in women while the delta in the control remains fairly unchanged in both men and women in the control groups. Conclusion: There were positive effects of lysine supplementation on the outcomes of cardiovascular response to stressors by normalizing and reducing the stress of subjects.
  - 9,252 278
The priority of using hypertonic saline over ventolin in the treatment of bronchiolitis
Kamali Aghdam Mojtaba, Asadi Fardin, Kazemi Seyed Ali Naghi, Kamali Koorosh, Emami Elham
Sep-Dec 2016, 3(3):98-101
DOI:10.4103/2394-2010.193180  
Introduction: Bronchiolitis is one of the important causes of hospitalizing infants in the hospital. Nebulized saline and/or ventolin are usually used in the treatment of this disease. This study aims to compare the effects of these two methods on the treatment of this disease. Materials and Methods: This cohort study was conducted on 67 hospitalized children ranging in age from 2 to 7 months with the diagnosis of bronchiolitis in Ayatollah Mousavi hospital in Zanjan City, from 2013 to 2014. In Group A; 33 patients received nebulized ventolin, and in Group B; 34 patients received nebulized 5% hypertonic saline. The two groups were compared in terms of the length of hospitalization and respiratory status, in the 3rd day of hospitalization. The data were described using SPSS software, according to the independent t-test. Results: In this study, the length of hospitalization was 4.2 days, on average, in the patients treated with ventolin, and 3.8 days in the patients treated with hypertonic saline. The patients treated with hypertonic saline had a lower respiratory rate and retraction, on the 3rd day, than the patients treated with ventolin. These differences are not statistically significant either. Conclusion: In this study, the patients in the hypertonic saline group have benefited a little more, in terms of the improvement of clinical symptoms and reduction in the length of hospitalization. Although these differences are not statistically significant, but considering the fact that hypertonic saline is cheaper and more accessible than ventolin, and unlike ventolin, the remaining of the hypertonic saline vial can be re-used, thus the use of hypertonic saline has priority over ventolin.
  - 3,370 209
REVIEW ARTICLE
Measuring severity of acne vulgaris and impairment in quality of life of its patients and aiming for their concomitant reduction facilitates comprehensive management
Yugal Kishor Sharma, Aayush Gupta
Sep-Dec 2016, 3(3):81-85
DOI:10.4103/2394-2010.193186  
Some of the adolescent patients of chronic acne, some women aged 25–40 years, and particularly, patients with psychiatric diseases (primary or secondary to acne) have disproportionately severe acne and its attendant psychosocial distress. Although no consensual clinical gold standard regarding the severity of acne exists despite abundance of scales developed over six decades, global acne grading system is used most commonly. The “subjective” psychosocial consequences of acne can be better evaluated by self-assessed health-related quality of life (QoL) tools than the traditional clinical assessment by the physician. The correct interpretation of these tools such as health status surveys (generic and specific) and preference-based measures, requires adherence to the rules regarding reliability, validity, sensitivity, and complete transcultural adaptation. The Cardiff Acne Disability Index is the most commonly employed specific health state survey for acne. Comprehensive therapy addressing the severity of acne as well as the resultant impaired QoL concomitantly can, fortunately, mitigate negative mental symptoms; this mitigation may even be proportional to the clinical remission. In addition, the routinely integrated practice of these twin measures may also speed up patient encounters by inculcating perspicacity in the treating physician.
  - 4,110 3,532