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  Citation statistics : Table of Contents
   2015| July-December  | Volume 15 | Issue 2  
    Online since May 12, 2016

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Challenges of body mass index classification: New criteria for young adult Nigerians
O Ogunlade, OA Adalumo, MA Asafa
July-December 2015, 15(2):71-74
Background: There are evidences to suggest that the World Health Organization (WHO) general cutoff points for body mass index (BMI) may not be the most appropriate for young adults globally irrespective of racial and ethnic considerations. Objective: This study assessed body anthropometric parameters in healthy population of young adult Nigerians with a view to determining race and gender-specific criteria (Ife criteria) for BMI classification. Methods: Four hundred and eighty-four (242 males and 242 females) healthy subjects aged between 18 and 41 years (inclusive) were recruited for the study. The participants were age- and sex-matched (mean age: 22.81 ± 3.83 years). The weight and height of the subjects were obtained using standard techniques while BMI was calculated as derivatives of height and weight. The BMI was classified using 5 th , 85 th , and 95 th percentiles and delineated into underweight (<5 th percentile), normal (5-85 th percentile), overweight (85-95 th percentile), and obese (>95 th percentile). Results: The result showed that the general BMI cutoff values for underweight, normal, overweight, and obesity were <17.8, 17.8-24.7, 24.8-27.8, and ≥27.9, respectively. The sex-specific BMI cutoff values for underweight, normal, overweight, and obesity in males and females were < 17.8 and < 17.8; 17.8-23.6 and 17.8-25.6; 23.7-26.8 and 25.7-28.7; and ≥26.9 and ≥28.8, respectively. Conclusions: The cutoff values for the new criteria for BMI classification were lower than the WHO defined values and sex differences were demonstrated in BMI. Therefore, WHO criteria may not be universally applicable.
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Experiences of sexual abuse by adolescent girls in Ife/Ijesa zone, Nigeria
AA Ogunfowokan, BR Fajemilehin
July-December 2015, 15(2):89-97
Background: Sexual abuse of adolescent girls is a menace that has been reported globally, and it is increasing at an alarming rate. Objectives: The study assessed experiences of sexual harassment (SH), sexual exploitation (SE), and rape among school adolescent girls in Ife/Ijesa Zone of Osun State, Nigeria. It also assessed the perpetrators, settings of the abuse, and reactions of survivors to sexual abuse. Latent variables underlying revictimization during adolescent years were also explored. Methods: Cross sectional design was employed with qualitative and quantitative components. Two hundred twenty four adolescent girls from two public high schools were selected using cluster sampling technique. Quantitative data were collected using a semi structure questionnaire while qualitative data were collected using Focus Group Discussion Guide (FGDG). Institutional Review Board approval was received for the study. Results: Quantitative findings showed that 55.5% experienced SH and 23.7% experienced SE while 20.8% experienced rape. Three factors that were extracted using factor analysis were labeled as "forceful sexual interaction," "romance," and "actual sexual intercourse." Perpetrators of rape and SH were mostly male friends (69% and 50% respectively) while perpetrators of SE were mostly sexual partners (91%) which some of girls referred to as "aristos" in FGD. The mostly reported setting for various acts of sexual abuse was the perpetrators' house (rape 3%; SH 7%; SE 6%) and many of the survivors reported they did nothing about the abuse (rape 1%; SH 1%; SE 1%). However, all those who were sexually abused as children experienced high level of sexual abuse in adolescent stage. The FGD revealed that perpetrators of sexual abuse were mostly teachers, sexual partners, and peers while the bush path was mentioned as setting for rape contrary to data from the questionnaire. Conclusion: Sexual abuse educational intervention should focus more on male friends and sexual partners as perpetrators; the perpetrator's house as the settings for abuse; the necessity to report; and romance and force as elements of sexual abuse.
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Childhood community-acquired pneumonia at the wesley guild hospital, Ilesa: Prevalence, pattern, and outcome determinants
BP Kuti, AO Oyelami
July-December 2015, 15(2):98-104
Background: Pneumonia remains a leading cause of childhood morbidity and mortality despite the presence of effective preventive and curative management. The factors at presentation that determine prognosis particularly mortality among children with pneumonia have not been fully characterised in resource-poor centres. Objectives: This study set out to determine the hospital prevalence, pattern of presentation, associated risk factors, and determinants of deaths among children admitted with community-acquired pneumonia in Ilesa. Methods: We carried out a retrospective review of 352 children managed for pneumonia at the Wesley Guild Hospital, Ilesa, Nigeria over a three year period (2011 to 2013) by analysing hospital records. History, clinical features and laboratory findings at presentation were compared in children who survived and those who died. Binary logistic regression analysis was used to determine the independent predictors of mortality. Results: Pneumonia accounted for 23.5% of the 1470 total admission among children one month - 15 years during the period with a male preponderance of 1.4:1 and 84.9% of the children being less than two years. Sixty (17.0%) of the children were undernourished with 12 (3.4%) being severely wasted. Radiological pneumonia was observed in 44.0% of the children, 116 (33.3%) presented with heart failure while 18 (5.1%) had underlying cardiac lesions. Thirty-five (9.9%) of the children died. Children with pneumonia who in addition had concurrent measles infection, heart failure, cyanosis, head nodding and severe undernutrition were at increased risk of death. (p < 0.05) Severe wasting independently predicts mortality among the children. (RR = 5.86; 95% CI = 1.34 - 12.11; p = 0.01). Conclusion: Children with pneumonia who in addition had measles, heart failure, cyanosis and severe protein energy malnutrition should be aggressively managed because they are at increased of dying
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Restrictive feeding and airway obstruction from sub-glossopalatal synechiae with cleft palate: An african case report and review of literature
LO Abdur-Rahman, AA Nasir, MF Adeyemi
July-December 2015, 15(2):116-118
Glossopalatal and congenital alveolar synechiae are rare and often occur in association with orofacial anomalies. The occurrence of sub-glossopalatal membrane causing restrictive mouth opening associated with complete cleft of hard palate has not been reported from Africa. A report of a case of the subglossopalaal membrane and its management in a term male child delivered per vaginum by a 24-year-old primiparous woman in a rural setting in Nigeria. All available English literature was search using Medline, PubMed, and Google scholar. A 3-day-old boy was presented because of a restrictive mouth opening due to sub-glossopalatal membrane associated with a palatal cleft that made him to choke when feeding and snores all the time. He was admitted and nursed prone to allow the tongue to fall forward and prevent airway obstruction. He was also fed through nasogastric tube. He had a successful excision of membrane under local anesthesia on the 10 th day of life. He did well postexcision and was placed on cup and spoon feeding while awaiting a palatal cleft repair. He had an uneventful cleft palate repair at 10 months of age. This is the first African report of sub-glossopalatal membrane associated with a cleft palate. A careful management brings good outcome.
  - 3,348 115
From the Editor-in-chief table
JA Owa
July-December 2015, 15(2):69-70
  - 3,212 116
Giant tumor calculus
T Pereira, S Shetty, M Chande, P Kamath
July-December 2015, 15(2):119-120
  - 3,006 106
Healing of postsurgical wound in the maxillofacial region: The role of exposure time
A Nwashindi, BD Saheeb
July-December 2015, 15(2):105-108
Background: Although the maxillofacial region is very rich in blood supply, surgical wounds in this region are also prone to infection, if good aseptic techniques are not strictly followed. There is a need to evaluate healing of surgical wound following the removal of wound dressing at different days postoperative in the maxillofacial region. This paper describes and compares healing in terms day of exposing a clean surgical wound. Objective: To evaluate healing of surgical wound following the removal of wound dressing at different days postoperative in the maxillofacial region. Materials and Methods: One hundred and fifteen patients who met inclusion criteria, admitted for surgeries in maxillofacial regions were randomly grouped into one of the five surgical dressing options. ASEPSIS wound scoring system was used for the study. All patients were monitored for a period of 7 days when wound healing and suture removal is expected to take place uneventfully. Chi-square, Fisher's exact, and nonparametric Kruskal-Wallis tests as appropriate. Statistical significance was set at P < 0.05. Results: There was no difference in healing between males and females (χ[2] = 2.832, df = 4, P = 0.586). There was no significant difference in healing within the different days of exposure of the wound (χ[2] = 8.479, df = 4, P = 0.076). Conclusion: Early exposure of surgically clean wounds does not impair healing.
  - 4,544 123
Plasma lactate dehydrogenase level as indicator of severe Homozygous sickle cell disease
O Adefehinti, OO Adeodu, EM Obuotor
July-December 2015, 15(2):75-79
Background: Homozygous sickle cell disease (SCD) (SS), also called sickle cell anemia (SCA) is the most common SCD in Nigeria. Studies done in the developed world showed that serum lactate dehydrogenase (LDH) levels correlated positively and significantly with clinical severity of the disease. This study attempts to provide information on the relationship between the plasma LDH level and the clinical severity of SCA in Nigerian children. Objective: The objective of this work was to assess plasma LDH level in Nigerian SCA children, aged 5-15 years, as a clinical indicator of disease severity. Methods: Plasma LDH level was measured quantitatively using Randox LDH reagent kit. A semi-quantitative assessment of clinical severity of SCA was carried out on all the SCA subjects using the Bienzle et al. assessment profile modified for this study. Subjects were classified as having mild, moderate, or severe disease based on their clinical severity score. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21 software. Results: Eighty SCA children, 40 in steady state and 40 in hemolytic (with or without vaso-occlusive) crises were studied. Mean plasma LDH level was significantly higher in SCA subjects in crises than for those in steady state (P = 0.0284). Only steady state plasma LDH level correlated positively and significantly with clinical severity score (P = 0.0151). Conclusion: Plasma LDH appears to be a reliable indicator of SCA disease severity in the steady state in Nigerian children.
  - 5,106 149
Knowledge, attitude, and practice of voluntary blood donation among residents in a rural local government area in Lagos state: A mixed methods survey
ALN Udegbe, OO Odukoya, BE Ogunnowo
July-December 2015, 15(2):80-88
Background: The safest blood is obtained from voluntary, non-remuneration blood donors. Objectives: This study was carried out to assess the knowledge, attitude, and practice of voluntary blood donation, and to determine the factors associated with willingness to donate blood among residents of Badagry, Lagos State, Nigeria. Methods: This descriptive cross-sectional study used quantitative and qualitative techniques. Multistage sampling method was used to select 439 respondents and pretested, interviewer-administered questionnaires were used to collect the quantitative data. Qualitative data were collected through two focus group discussions (FGDs) with male and female adult residents. Ethical approval was obtained from the Human Research and Ethics Committee of the University of Lagos, Lagos, Nigeria. Results: Most of the respondents were male (55.1%), married (60.6%), of Yoruba ethnicity (71.4%), and had, at least, a secondary education (81.0%). The mean age was 36.7 ± 11.1 years. All the respondents had heard of blood donation primarily from health workers (46.7%). Only 35.5% had ever donated blood, and this was primarily for a relative or friend (72.8%). Only 2.3% of previous donations were for an unknown person. Males were more likely to have donated blood (P < 0.001) and more willing to donate blood voluntarily (P = 0.015) compared to females. The FGDs showed that voluntary blood donation practice within the community was poor. Conclusion: The respondents are knowledgeable about blood donation and expressed positive attitude. However, this has not been translated into practice. Health authorities should collaborate with rural communities to organize blood donation campaigns to provide opportunities for altruistic blood donation.
  - 6,978 176
Deep brain stimulation in Parkinson's disease
H Kaptan, H Ekmekci, M Ayaz
July-December 2015, 15(2):109-115
Before the era of L-Dopa, surgical ventures (pallidotomy and thalamotomy) were applied in the treatment of Parkinson's disease (PD). The first experience of deep brain stimulation (DBS) was carried out by Heath and Pool for chronic pain in mid-1950s. From those times, DBS is placed a legitimate position in PD treatment whereas that it is in principle "reversible lesion" - in the state of previous ones where the condition was "irreversible lesion" - in the target nuclei. The latter are globus pallidus inserta or subthalamic nucleus and DBS does not interfere with the use of other future therapies. The touchstone for DBS surgery is "the right patient" by "the experienced team" at "the right time" so that the last three can provide magnificent benefits. Indeed both acute and the long-term results ends up with a dramatic and stable improvement of a patient's having DBS. The outlet of this article is to build an awareness of the roles of DBS in PD with clinical evaluation, electrophysiological bases, importance of surgical techniques with unilateral - bilateral approaches, postoperative follow-up early, and late acquirement of DBS and the gainings of the interdisciplinary - team approach.
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