Adenoma malignum of the cervix is a rare variant of Adenocarcinoma of the uterine cervix. Its overall incidence rate is low. We report a case of a 51-year-old married multipara who presented with a 4-year history of recurrent, heavy, prolonged menstrual flow, postcoital bleeding, and passage of mucoid vaginal discharge. Pelvic examination revealed a bulky, firm, endophytic cervical mass with ulcerative areas. Ultrasonography showed features of multiple uterine fibroids. Cervical smear cytology and histology of cervical punch biopsy did not show evidence of malignancy. The patient subsequently had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a purportedly benign pathology of the cervix. Diagnosis of cervical adenoma malignum was made from the surgical specimen postoperatively.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Gravitational pull and subtle uterine contractions on huge polypoidal submucous uterine fibroid may dilate the cervix and prolapse into the vagina. Such prolapsed fibroid can either be removed through the vaginal route if it is connected with a long stalk or through an abdominal route if it has a broad base or if it is coexisting with multiple uterine fibroids. We present two cases of grand multiparous women with huge prolapsed submucous fibroids where neglect led to presentation with life-threatening infection and bleeding.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Context: The birth of a baby is a major reason for celebration worldwide. Yet, in most countries of the world, pregnancy and childbirth is a perilous journey. In Kaduna State, Northwestern Nigeria, the estimated maternal mortality ratio figure is 1025/100,000 live births. Despite the higher rates of maternal deaths, there is no empirical evidence on women's knowledge, perception, and attitudes toward pregnancy danger signs in Kaduna State. Aims: To determine the knowledge, attitude, and perception of pregnancy danger signs among women of childbearing age (15–49 years) in Samaru community Sabon-Gari Local Government Area in Kaduna State. Settings and Design: A community-based descriptive, cross-sectional study was conducted among 185 women of reproductive age group. Subjects and Methods: Participants were randomly selected using a multistage sampling technique. Pretested structured interviewer administered questionnaire was used for data collection. The completed questionnaires were cleaned, coded, the data entered into a computer and SPSS version 20.0 was used for analysis. Statistical Analysis Used: Frequency, percentage, and descriptive summaries were used to describe the study variable using univariate analysis, while bivariate analysis was carried out to test for a relationship between categorical variables. Results: Only 4.9% of the respondents had good knowledge about danger signs in pregnancy while 3.8% of them have good attitude and one in ten respondents only (10.3%) has good perception of pregnancy danger signs. Conclusions: Our findings show that majority of women in childbearing age have poor knowledge, attitude, and perception on danger signs of pregnancy. Hence, the need to train and involve them on pregnancy dangers signs to curb the unnecessary deaths occurring during such period.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Water is one of the basic needs for survival, and potable water is essential for good health. Contaminated drinking water is a major health hazard in developing countries, and water-related diseases are a significant contributor to the global burden of illness. Thus, for populations without reliable access to safe drinking water, household water treatment provides a means of improving water quality and preventing disease. This study aimed to assess the knowledge, attitudes, and practices of household water purification among caregivers of under-five children in Biye community. Methodology: This was a descriptive cross-sectional study. A multi-stage sampling technique was used to recruit 142 caregivers of under-five children who were randomly selected. Data were collected using a semi-structured questionnaire and analyzed using IBM SPSS. Chi-square was used to test associations. The level of significance was set at <0.05. Results: Majority (63.4%) of respondents used unprotected well, and only 26.1% used protected well as a source of water. Only 12% of respondents had good knowledge. However, the majority of respondents (63.4%) had a positive attitude toward household water purification. Boiling was the most common (79.6%) method of water purification respondents are aware of and only about a third (32.4%) currently practiced household water purification. Conclusion: Majority of the respondents had poor knowledge and practice of household water purification. However, significant proportion of the respondents had a positive attitude toward household water purification. The local government authority should embark on the mass campaign on the importance and methods of household water purification in rural communities.

[ABSTRACT]  [FULL TEXT]  [PDF]

Background: Nigeria like the rest of the world is exposed to a wide range of natural and human-induced disasters such as flood, plane crash, communal clashes, and postelection violence and recently, insurgency from Boko Haram. Most of these disasters have led to population displacement and its consequences. This study assessed the social characteristics and risk factors for diseases among the internally displaced persons (IDPs) at Stefano's foundation camp in Jos, Nigeria. Methodology: The study was a cross-sectional descriptive in nature carried out on March 1–30, 2015. The data were collected using 312 interviewer-administered questionnaire, key informant interview, and participant's observation and analysis was performed using SPSS version 20.0. Results: Majority (85%) of the respondents were within the age bracket of 18–49 years, 61% of females, 39% had no formal education, 53% of farmers by profession among others, 96% and 4% of them were displaced as a result of the insurgency in Borno and Adamawa States, respectively and had stayed in the camp for 3 months (43.8%). There was report of several morbidities and one case of mortality from malaria, diarrhea, and cholera due to inadequate water supply, poor refuse, and fecal disposal and the presence of disease vectors in the camp and a case of death of a 6-year-old child from malaria. Majority (83%) of the IDPs obtained medical treatment at the ill-equipped camp clinic. Conclusion: This study showed that the IDPs were faced with so many challenges and the nongovernmental organization has been rendering assistance. There is a need for all relevant stakeholders to key in to make life meaningful to this vulnerable group.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Nigeria has high maternal mortality ratios, and women of high parity are at higher risk of obstetric complications. Understanding barriers to the uptake of contraception is thus important. Methodology: A cross-sectional quantitative survey was done at the antenatal and postnatal clinics of Barau Dikko Teaching Hospital between September and December 2015. Questionnaires were administered to 400 married consenting women of high parity (five or more deliveries). The questionnaire extracted general and demographic information, history of contraception, and possible barriers to contraceptive uptake. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 22. Descriptive analysis was done using frequencies, percentages, and cross-tabulation. Chi-square test was used as a test of association where relevant, and P< 0.05 was considered statistically significant. Results: About 353 questionnaires were retrieved; respondents were mainly aged between 30 and 39 years, educated up to secondary level, Hausa and Muslims, and homemakers or traders. Women had a mean parity of 7 deliveries and highest, 15. There was high level of awareness of contraception, adequate spousal communication, and approval but a perception of high risk and side effects with contraceptive use. Conclusion: Fear of side effects was a major barrier to contraceptive use. However, a window of opportunity exists because they would be willing to use contraception in future. Hence, specific and individualized contraceptive counseling and patient selection is needed, as well as further education of women.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Pathologic conditions of the falciform ligament of the liver are rare. Only a few cases have been reported. We are reporting a case of chronic epigastric pain due to lipoma of the falciform ligament. Case report and discussion of the relevant literature is presented. A 38-year-old woman presented to the emergency room with a 5-day history of an exacerbated epigastric pain which has been on and off for 3 years. She was wrongly diagnosed to have peptic ulcer disease and has been on anti-ulcer regime for close to 6 months without improvement of symptoms. On physical examination, she was in painful distress, though generally preserved the tenderness in the epigastrium was accompanied by mild local rebound tenderness. Hence, it was difficult to properly delineate the abdominal mass in the epigastrium. Laboratory data done at this occasion and in the past were normal. Plain abdominal X-ray, contrast studies, and esophagogastroduodenoscopy findings were essentially normal. Only abdominal ultrasound revealed a suspected well-defined hypodense area located dorsally to the rectus muscles. Although the computed tomography and magnetic resonance imaging were not done due to logistics and financial constrain the patient presented with haven moved from one clinic to another receiving anti-ulcer regimen. A diagnosis of intra-abdominal mass was made, and the patient subsequently had an exploratory laparotomy. The findings at open operation through an upper midline abdominal incision were a moderate size lipoma of the ligament of the liver which was removed. Postoperative period and recovery was uneventful. Histology revealed well-differentiated adipocytes arranged in the nest with essentially benign features. The patient was discharged home and has remained hailed and hearty for 6 months of surgery. Tension due to lipoma of the falciform ligament of the liver is a rare cause of intractable epigastric pain associated with a diagnostic dilemma.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: The aim of the study is to determine the pattern, frequency, and types of anterior segment disorders in diabetic patients attending the outpatient specialist Diabetes Clinic of Aminu Kano Teaching Hospital (AKTH), Kano. Patients and Methods: This was a descriptive cross-sectional study of diabetic patients in AKTH over a 1-year period. Sample size was estimated using Fisher's formula, and systematic sampling was done to ensure proper randomization of patients that fulfilled the study criteria. Information obtained included patients' bio-data, height, weight, fasting blood sugar (FBS), type and duration of diabetes, associated comorbidities; visual acuity and anterior segment were examined using slit lamp biomicroscopy. Results: A total of 390 patients were examined during the study. There were 166 (42.6%) males and 224 (57.4%) females (M:F ratio = 1:1.35). Mean age was 54.81 ± 12.21 years. Seventy-four (18.97%) patients had type I disease, while 316 (81.03%) patients had type II disease. The mean presenting FBS was 9.52 mmol/L ± standard deviation 4.22, with a wide range of 3.4–24.8 mmol/L. Four patients were bilaterally blind, while ten were unilaterally blind from cataract and glaucoma. Myopia and myopic astigmatism were the most observed refractive errors though not statistically associated with high FBS (ײ = 1.00 P = 0.3165). Chronic blepharitis was the main lid finding and found to be related to high FBS (ײ = 38.68 P< 0.000001). Ocular surface findings included pterygia (3.85%), pinguecula (2.56%), dry eyes (2.31%), and combination of these. Bilateral rubeosis iridis and iris atrophy were found in 8 (2.1%) and 6 (1.5%) patients, respectively. Lens opacities varied in location and visual significance. Nuclear sclerosis was the most common lens disorder while posterior subcapsular cataract was the second predominant type observed and was associated with disease duration >10 years (ײ = 11.48, P = 0.0007039). Conclusion: Anterior segment eye disorders in diabetic patients could be clinically significant and yet unreported by the patient. These may cause low vision and blindness similar to nondiabetic population. The screening protocol in the study location should include routine eye examination.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]