Annals of African Medicine

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ISSN / EISSN : 0975-5764 / 0975-5764
Current Publisher: Medknow (10.4103)
Total articles ≅ 634
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Muhammad Zaria Ibrahim, Joseph Bako Igashi, Suleiman Lawal, Bello Usman, Abdullahi Zubair Mubarak, Hafsatu Maiwada Suleiman
Published: 13 March 2020
Annals of African Medicine, Volume 19, pp 8-14; doi:10.4103/aam.aam_62_18

Abstract:
Deep-venous thrombosis (DVT) of lower limbs is one of the most common causes of death caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. B-mode and color Doppler imaging are needed for the early diagnosis of DVT to prevent complications and sequalae of DVT. The objectives of this study are to evaluate the role of Doppler ultrasound in diagnosing DVT of lower limbs and to study the spectrum of findings in patients with DVT in Zaria. A retrospective study was carried out on patients who had Venous Doppler Scan in the Department of Radiology ABUTH, Zaria, Nigeria, for suspected DVT over a period of 4 years from February 2014 to January 2018. Scans were done using DC-3 and DC-6 Mindray Ultrasound machines (2009 and 2013 Models, respectively, Shantou, China) coupled with high-frequency (7.5–12 MHz) linear and low-frequency curvilinear (2–5 MHz) transducers. Analysis of cases of DVT was performed in terms of age, sex, clinical features, predisposing conditions, anatomic distribution, stage, and pattern of thrombus involvement in the veins. Data were analyzed using the SPSS version 20.0 and value of P < 0.005 was considered as statistically significant. A total of 252 patients’ results were reviewed which consisted of 122 males (48.4%) and 130 females (51.6%). The patients’ ages ranged from 11 to 80 years, averaging 45.5 ± 9.56 years. The most common indication for Doppler request was leg swellings. The most common risk factor for DVT was malignancy (36%), cardiac disorders (18%), and traumas (14%). Sixty-six (61%) cases showed left-sided and 26 (24%) right-sided, whereas 16 (15%) cases showed bilateral lower limb involvement. Predominant thrombus was above-knee region with 54% in the superficial femoral vein. Chronic stage was seen in 46 (42%) cases, subacute in 44 (41%) cases, and acute in 18 (17%) cases. Middle–aged females, left-sided leg, and above-knee segment were predominantly affected with DVT; hence, this buttresses the need for Doppler ultrasound in the diagnosis of DVT in all patients.
Paa-Kwesi Blankson , Francis Kwamin, Aaron B. Osei Asibey
Published: 13 March 2020
Annals of African Medicine, Volume 19, pp 40-46; doi:10.4103/aam.aam_22_19

Abstract:
The prevalence of hypertension and diabetes is increasing in Ghana and sub-Saharan Africa. Screening is a useful tool in improving the early detection of both diseases to reduce the mortality and morbidity associated with the conditions. This study set out to determine the prevalence of patients with hypertension and hyperglycemia attending a dental clinic in Accra. A cross-sectional study, modeling a screening exercise, was conducted in a major dental clinic in Accra. Hypertension and diabetes were screened for with serial blood pressure checks at rest and random blood glucose measurements, respectively. Other variables were the pulse rate, the respiratory rate, and the background characteristics of respondents. Data were analyzed with Stata Version 14, and descriptive statistics were generated and reported. There were a total of 175 participants in the study, comprising 76 males (43.4%) and 99 females (56.6%). This represented a male-to-female ratio of 0.8:1. The ages ranged from 18 to 86 years, with the median and mean ages of 40 years and 43.1 years (±16.9), respectively. This study found the prevalence of hypertension and hyperglycemia in the dental clinic to be 31.4% and 24.6%, respectively. The results of this study demonstrate the importance of the dental clinic in detecting both undiagnosed hypertension and diabetes, as well as those who have previously been diagnosed, but do not have their blood pressure and blood sugar under adequate control. With efficient referrals and follow-up systems in place at dental offices, they could be harnessed as a fertile place for hypertension and diabetes screening.
Athanasia K. Papazafiropoulou, Konstantina Anagnostopoulou, Konstantina Petropoulou, Andreas Melidonis
Published: 13 March 2020
Annals of African Medicine, Volume 19, pp 73-74; doi:10.4103/aam.aam_32_19

V. S Meghana, Sunil Baikadi Vasudevarao, Shaila S. Kamath
Published: 1 January 2020
Annals of African Medicine, Volume 19; doi:10.4103/aam.aam_58_19

Abstract:
Objective: Administration of warm intravenous (IV) fluid infusion and use of forced air warmers is the most easy and physiologically viable method for maintaining normothermia during surgery and postsurgical periods This study was conducted to assess the effect of combination of active warming (AW) methods namely warm IV fluid infusion and forced air warming versus forced air warming only (WA) on maternal temperature during elective C-delivery under spinal anesthesia. Materials and Methods: A total of 100 patients scheduled for elective c-section were grouped into those who received both warmed IV fluid infusion and forced air warmer (Combination of active warming WI= 50) and those who received only forced air warmer (WA = 50). Core body temperature and shivering incidence were recorded using a tympanic thermometer from prespinal till the end of surgery every 10 min and in postanesthesia care unit (PACU) at 0, 15, and 30 min. Results: Core temperature showed statistically significant difference in 15, 35, 45, and 55 min between air warmer and warm infusion groups and in PACU at 0, 15, and 30 min, it was statistically significant (P = 0.000) among WI group (mean temperature = 36.79°C) when compared to WA group (mean temperature = 35.96°C). There was a lower incidence of shivering in WI compared to WA group, which is statistically significant. Conclusion: Combination of warm Intravenous fluid infusion and Forced air warming is better than forced air warming alone. In maintaining near normal maternal core body temperature during elective cesarean section following spinal anesthesia. Combined warming method also reduces shivering incidence. RésuméObjectif: L'administration d'une perfusion de liquide intraveineux chaud (IV) et l'utilisation de réchauffeurs à air forcé sont les plus faciles et les plus viables sur le plan physiologique méthode pour maintenir la normothermie pendant la chirurgie et les périodes post-chirurgicales Cette étude a été menée pour évaluer l'effet de la combinaison des méthodes de réchauffement actif (AW), à savoir la perfusion de liquide IV chaud et le réchauffement à air forcé par rapport au réchauffement à air forcé uniquement (WA) sur la mère la température pendant la livraison élective de C sous anesthésie rachidienne. Matériel et méthodes: Un total de 100 patients programmés pour un stage électif les césariennes ont été regroupées dans celles qui ont reçu à la fois une perfusion de liquide IV chauffée et un réchauffeur à air forcé (combinaison de réchauffement actif WI = 50) et ceux qui n'ont reçu qu'un réchauffeur d'air forcé (WA = 50). La température corporelle centrale et l'incidence des frissons ont été enregistrées en utilisant un thermomètre tympanique du préspinal jusqu'à la fin de la chirurgie toutes les 10 min et dans l'unité de soins postanesthésiques (PACU) à 0, 15 et 30 min. Résultats: La température centrale a montré une différence statistiquement significative en 15, 35, 45 et 55 min entre les groupes de réchauffement de l'air et de perfusion chaude et dans le PACU à 0, 15 et 30 min, il était statistiquement significatif (P = 0,000) dans le groupe WI (température moyenne = 36,79 ° C) en comparaison au groupe WA (température moyenne = 35,96 ° C). Il y avait une incidence plus faible de frissons dans WI par rapport au groupe WA, qui est statistiquement important. Conclusion: La combinaison de la perfusion de liquide intraveineux chaud et du réchauffement forcé de l'air est meilleure que le réchauffement forcé de l'air seul. Dans maintien d'une température corporelle maternelle près de la normale pendant la césarienne élective après anesthésie rachidienne. Réchauffement combiné La méthode réduit également l'incidence des frissons.
Durga Shankar Meena, Deepak Kumar, Gopal Krishana Bohra, Sunil Kumar Bhambu
Published: 1 January 2020
Annals of African Medicine, Volume 19; doi:10.4103/aam.aam_34_19

Abstract:
Sjogren syndrome (SS) is a systemic autoimmune disorder with predominant exocrine gland involvement leading to sicca symptoms. Among extraglandular manifestations, renal disease is the most common. Tubular interstitial nephritis and renal tubular acidosis (RTA) are the common presentations. Mild hypokalemia associated with distal RTA is common in SS, however, severe hypokalemia causing paralysis is unusual. We report the case of a 26-year-old female who presented with hypokalemic paralysis. On evaluation, distal RTA was diagnosed. Further evaluation showed positive SS-a/SS-b antibodies in high titer, which confirms the diagnosis of primary SS. Our report illustrates that SS is a rare but important cause of hypokalemic paralysis. Résumésyndrome de Sjogren (SS) est une maladie auto-immune systémique avec une atteinte prédominante des glandes exocrines entraînant des symptômes de sicca. Parmi manifestations extraglandulaires, la maladie rénale est la plus courante. La néphrite interstitielle tubulaire et l'acidose tubulaire rénale (RTA) sont les présentations. Une hypokaliémie légère associée à un RTA distal est courante dans les SS, cependant, une hypokaliémie sévère provoquant une paralysie est inhabituelle. Nous rapportons le cas d'une femme de 26 ans qui présentait une paralysie hypokaliémique. À l'évaluation, un RTA distal a été diagnostiqué. Plus loin l'évaluation a montré des anticorps SS-a / SS-b positifs à titre élevé, ce qui confirme le diagnostic de SS primaire. Notre rapport montre que SS est un cause rare mais importante de paralysie hypokaliémique.
Chidinma Magnus Nwogu, Kehinde Sharafadeen Okunade, Muisi A. Adenekan, Adebayo Isaiah Sekumade, Sarah John-Olabode, Ayodeji Ayotunde Oluwole
Published: 1 January 2020
Annals of African Medicine, Volume 19; doi:10.4103/aam.aam_41_19

Abstract:
Background: There is still conflicting evidence on the extent to which maternal hyperhomocysteinemia is a risk factor for pregnancy complications. Aims: The study aimed to investigate the impact of elevated maternal homocysteine concentrations on adverse pregnancy outcomes among Nigerian women in Lagos. Materials and Methods: This was a prospective cohort study conducted at the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. Participants were enrolled during the first trimester of pregnancy following which relevant data were obtained by the interview. Fasting blood samples were collected for the measurement of maternal homocysteine concentration using the enzyme-linked immunosorbent assay method. Pregnancy outcomes and complications were obtained by abstracting the antenatal, delivery, and newborn medical records. Preterm births, low-birth weight (LBW), and antepartum fetal death were used as confirmatory outcome variables in the final analysis. Descriptive statistics for all data were computed using SPSS version 22.0. The associations between the variables were tested and multivariate analyses were used to study the effects of the major baseline characteristics on the pregnancy outcome. P < 0.05 was considered statistically significant. Results: Hyperhomocysteinemia was recorded in 41 (24.6%) patients. Women with a high homocysteine concentration and those with a normal homocysteine level did not differ significantly in terms of age (P = 0.684), level of education (P = 0.866), and parity (P = 0.647). Women with hyperhomocysteinemia had an approximately twelve-fold higher risk of preterm birth (P = 0.001) and a ten-fold higher risk of delivering a term neonate with LBW (P = 0.004), but had no risk of antepartum fetal death (P = 0.118) compared to women with a normal homocysteine concentration. Conclusions: The prevalence of hyperhomocysteinemia among mothers in Lagos was relatively low. The associations between hyperhomocysteinemia and adverse pregnancy outcomes could have implications in future for the prevention of these adverse outcomes. RésuméHistorique: Il existe encore des preuves contradictoires sur la mesure dans laquelle l'hyperhomocysteinemia maternel est un facteur de risque de complications de grossesse. Objectifs: L'étude visait à étudier l'impact des concentrations élevées d'homocystéine maternelle sur les résultats défavorables de la grossesse chez les Femmes nigérianes à Lagos. Matériel et Méthodes: Il s'agissait d'une étude de cohorte prospective menée à l'Hôpital universitaire d'enseignement de Lagos, Idi-Araba, Lagos, Nigeria. Les participants ont été inscrits au cours du premier trimestre de la grossesse, après quoi les données pertinentes ont été obtenues par l'entrevue. Des échantillons de sang à jeun ont été prélevés pour la mesure de la concentration maternelle d'homocystéine utilisant le méthode d'essais immunosorbent. Les résultats et les complications de grossesse ont été obtenus en reprochant le prénatal, l'accouchement, et le médical nouveau-né medical Dossiers. Les naissances prématurées, le faible poids à la naissance (LBW) et la mort fœtale antepartum ont été utilisés comme variables de résultats confirmatoires dans l'analyse finale. Les statistiques descriptives pour toutes les données ont été calculées à l'aide de la version 22.0 du SPSS. Les associations entre les variables ont été testées et multivariées ont été utilisées pour étudier les effets des principales caractéristiques de base sur les résultats de la grossesse. P 0,05 a été considéré statistiquement Important. Résultats: Hyperhomocysteinemia a été enregistré dans 41 (24,6%) Patients. Les femmes à forte concentration d'homocystéine et celles qui un niveau normal d'homocystéine n'a pas différé significativement en termes d'âge (P - 0.684), niveau d'éducation (P - 0.866), et parité (P - 0.647). Femmes l'hyperhomocysteinemia présentait un risque environ douze fois plus élevé de naissance prématurée (P - 0,001) et un risque dix fois plus élevé d'accouchement un terme nouveau-né avec LBW (P - 0,004), mais n'avait aucun risque de mort fœtale antepartum (P - 0,118) par rapport aux femmes ayant une homocystéine normale Concentration. Conclusions: La prévalence de l'hyperhomocysteinemia chez les mères à Lagos était relativement faible. Les associations entre L'hyperhomocysteinemia et les résultats défavorables de grossesse pourraient avoir des implications à l'avenir pour la prévention de ces résultats défavorables.
Oche Mansur Oche, Okafoagu Christina Nneka, Oladigbolu Remi Abiola, Ismail Raji, Ango Timane Jessica, Hashimu Abdulmumini Bala, Ijapa Adamu
Published: 1 January 2020
Annals of African Medicine, Volume 19; doi:10.4103/aam.aam_50_18

Abstract:
Background: Roadside automobile mechanics are in the course of their work exposed to several hazards that put them at risk of severe debilitating health challenges. This group of workers, however, is reported not to know much about such hazards and to have little or no training on workplace safety. Aim: The study aimed to identify the determinants of occupational health hazards among roadside automobile mechanics in Sokoto Metropolis. Methodology: This was a descriptive, cross-sectional study, and using a two-stage sampling technique, a total of 205 roadside mechanics were recruited for the study. A semi-structured interviewer-administered questionnaire was used, and the data were imputed into and analyzed using IBM SPSS. Results: The mean age of the respondents was 31.10 ± 10.19 years, and over one-third of them (38.1%) were general vehicle repairers. Majority of the respondents had good knowledge of and attitude toward workplace hazards. However, a good proportion (91.0%) of the mechanics felt that their occupation was a risky one and 80.1% ate and 86.1% drank while working. Type of training and job description were the predictors of knowledge of workplace hazards. Job description was the only predictor of attitude. Burns, bruises, headache/dizziness, and cuts were the most reported work-related illnesses and injuries. Conclusion: Although most of the auto-mechanics were aware and had good knowledge of workplace hazards, they did not adhere to safety practices in the workplace, mostly due to nonavailability of protective apparels. There is, therefore, need for continuous health education under the platform of the auto-mechanics association so that they can voluntarily adopt safety practices in their workplace. RésuméContexte: Au cours de leur travail, les mécaniciens d'automobiles au bord de la route sont exposés à plusieurs risques qui les exposent à de graves problèmes de santé débilitants. Cependant, ce groupe de travailleurs ne connaît pas grand-chose à ces dangers et n'a pas ou peu de formation sur la sécurité au travail. Objectif: L'étude visait à identifier les déterminants des risques professionnels en matière de santé chez les mécaniciens automobiles de Sokoto Metropolis. Matériel et Méthodes: Il s'agissait d'une étude transversale descriptive et, en utilisant une technique d'échantillonnage en deux étapes, un total de 205 mécaniciens de bord de route ont été recrutés pour l'étude. Un questionnaire administré par un intervieweur semi-structuré a été utilisé et les données ont été imputées et analysées à l'aide d'IBM SPSS. Résultats: L 'âge moyen des répondants était de 31.10 ± 10.19 et plus d' un tiers d 'entre eux (38.1%) étaient des réparateurs de véhicules généraux. La majorité des répondants avaient de bonnes connaissances et une bonne attitude à l'égard des dangers au travail. Cependant, une bonne partie des mécaniciens estimaient que leur profession était risquée 183 (91,0%) et majoritaire, en mangeait 161 (80,1%) et en buvait 173 (86,1%) pendant qu'ils travaillaient. Le type de formation et la description de poste étaient des prédicteurs de la connaissance des dangers au travail. La description de travail était le seul prédicteur de l'attitude. Les brûlures, les ecchymoses, les maux de tête/vertiges et les coupures étaient les maladies et les blessures liées au travail les plus souvent rapportées. Conclusion: Bien que la plupart des mécaniciens et des mécaniciennes d'automobiles aient été au courant et aient une bonne connaissance des risques au travail, ils n'ont pas respecté les pratiques de sécurité sur le lieu de travail. Il existe donc un besoin d'éducation continue en matière de santé dans le cadre de la plate-forme de l'association de mécanique automobile afin qu'ils puissent adopter volontairement des pratiques de sécurité sur leur lieu de travail.
Husain Yahya , Hadiza Sani
Published: 1 January 2020
Annals of African Medicine, Volume 19; doi:10.4103/aam.aam_37_19

Abstract:
Neurofibromatosis type 1 is the most common inherited nervous system disorder affecting 1 in 3500 live births. Cutaneous neurofibromas, the most characteristic feature of the disease, begin to appear in adolescence and continue throughout adulthood. Although neurofibromas have been noted to increase in size or number during pregnancy, there have been very few reports of eruption of a large number of lesions during this period. We report a case of a 24-year-old Nigerian woman of 32-week gestation who presented with a history of sudden eruption of neurofibromas during the current pregnancy and the previous one 3 years earlier. We discuss how hormones and growth factors contribute to the increase in numbers of neurofibromas during pregnancy, which is occasionally severe, as in our case, and the complications which may arise in the mother and fetus. RésuméLa neurofibromatose de type 1 est le trouble du système nerveux héréditaire le plus répandu, touchant 1 naissance sur 3 500 naissances vivantes. Les neurofibromes cutanés, la caractéristique la plus caractéristique de la maladie, commencent à apparaître à l'adolescence et se poursuivent à l'âge adulte. Bien que l'on ait noté une augmentation de la taille ou du nombre des neurofibromes au cours de la grossesse, très peu de cas d'éruption d'un grand nombre de lésions ont été rapportés au cours de cette période. Nous rapportons le cas d'une femme nigérienne de 24 semaines de gestation nigérienne présentant des antécédents d'éruption soudaine de neurofibromes au cours de la grossesse en cours et la précédente trois ans plus tôt. Nous discutons de la manière dont les hormones et les facteurs de croissance contribuent à l'augmentation du nombre de neurofibromes pendant la grossesse, parfois sévère, comme dans notre cas, ainsi que des complications pouvant survenir chez la mère et le fœtus.
Fatimah I. Tsiga-Ahmed , Abdulazeez Ahmed
Published: 1 January 2020
Annals of African Medicine, Volume 19, pp 20-25; doi:10.4103/aam.aam_9_19

Abstract:
Delegating ear and hearing care (EHC) tasks to frontline health workers may help to improve muchneeded access to this specialized care. Primary healthcare workers (PHCWs) need to acquire relevant knowledge and skill to recognize, refer, and/or treat simple ear problems. This study aims to evaluate the effectiveness of an EHC training program for PHCWs. The training intervention was a 2day course based on an adapted WHO training resource in EHC for frontline workers. A pre and posttest study design was undertaken with the assessment of EHC at two time points using the same questionnaire at baseline and at completion of the training. One hundred and ninety PHCWs were recruited for the study. Overall, there was a statistically significant improvement from baseline to course completion. However, participants' scores in the domain of knowledge for risk factors were slightly low compared to other domains (54.3%, 95% confidence interval [CI]: 52.0%-56.6%), and this improved significantly following the training (72.7%, 95% CI: 71.0%-74.0%). A potential confounder in this evaluation may be that of the scores recorded at pretest, which may change in the posttest due to regression to the mean phenomenon. The findings from this study indicate that the training program demonstrated the potential to be an effective way to improve knowledge of EHC, and we suggest the inclusion of "primary ear care" as a component of primary health care.
Abdulmoein Eid Al-Agha , Yusra Mohammed Mabkhoot, Ashjan Salem Bahwirith, Arwa Nabil Mohammed, Rahaf Ragbi, Elham Allhabi, Bashaer Khalid Dumyati, Asmaa Milyani
Published: 1 January 2020
Annals of African Medicine, Volume 19, pp 15-19; doi:10.4103/aam.aam_8_19

Abstract:
The objective of the study was to investigate the causative factors and complications attributable to obesity in children living in Jeddah, Saudi Arabia. This is a retrospective study encompassing a sample size of 151 children and adolescents between the ages of 4 and 20 years. Data were collected through reviewing medical records, medical files on the hospital electronic system, and clinical interviews conducted with legal guardians. The date of the study was from January to June 2018, and the study was carried out in Jeddah, Western Region, Saudi Arabia. Data were entered, coded, cleaned, and analyzed using the Statistical Package for the Social Sciences (IBM SPSS), version 22. The analysis was done by assessing the significance of various risk factors and sequelae in their contribution to pediatric obesity by one-way ANOVA for nominal variables of more than two categories and independent-samples t-test for the nominal variables with two categories. The sample was 47% of the male gender, whereas females made for the remaining 53%. The causation of obesity was distributed among the following factors: an unhealthy diet, a sedentary lifestyle, medications such as glucocorticoids, and complications attributed to obesity including gastroesophageal reflux, hypertension, precocious puberty, sleep apnea, psychological disturbances, and fatty liver diseases. Environmental factors were found to be the most predominant cause, where the majority of children were found to be leading a sedentary lifestyle, following an unhealthy diet, and skipping meals. The most recurring complications involved psychosocial and behavioral abnormalities, and among the medical consequences, gastroesophageal reflux and obstructive sleep apnea were the most prevalent.
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