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  Citation statistics : Table of Contents
   2014| January-June  | Volume 17 | Issue 1  
    Online since April 7, 2014

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Assessment of the food hygiene practices of food handlers in the Federal Capital Territory of Nigeria
Chigozie O Ifeadike, Okechukwu C Ironkwe, Prosper O. U. Adogu, Chinomnso C Nnebue
January-June 2014, 17(1):10-15
Background: The principle of food hygiene implies that there should be minimal handling of food items. Food handlers are thus expected to observe proper hygiene and sanitation methods as the chances of food contamination largely depend on their health status and hygiene practices. Objective: This study assessed the food hygiene practices of food handlers and made recommendations for improved food safety measures within food establishments in the Federal Capital Territory. Materials and Methods: The study design was cross-sectional descriptive. A multistage sampling technique was employed to select 168 food handlers of various types. Data was collected using a mix of quantitative methods (structured interviewer-administered questionnaires and observation checklist). Data were analyzed using the statistical package for social sciences version 14. Results: Four categories of food handlers were identified in 45 food establishments. Seventy-one (42.3%) of the subjects are males, whereas 97 (57.7%) are females. Most of them, 122 (72.7%), had secondary education and above, whereas 46 (27.3%) had primary education and below. One hundred and fifty (89.3%) of them wash their hands after the use of toilets, whereas only 44 (26.7%) change their hand gloves at work. One hundred and twenty (71.4%) of them undergo regular medical checkup, whereas 53 (31.5%) are isolated from workplace when ill. A few of them, 51 (30.4%) use sanitizers/disinfectants at workplace, whereas 38 (22.6%) check food temperature with thermometer. Also, 103 (61.3%) use ideal waste disposal methods at workplace (P < 0.01). Conclusion: Establishments should train staff regularly on basic personal hygienic techniques, self care and good house-keeping practices.
  2 30,507 2,082
An ulcerated mass in the cervix: Carcinoma or tuberculosis
Deepa Kapoor, Prerna Kapoor, Niraj Kumari, Narendra Krishnani, Pallavi Aga
January-June 2014, 17(1):48-50
Tubercular involvement of the cervix is rare and the clinical presentation often simulates that of cervical carcinoma leading to misdiagnosis. We report here the case of a 31-year-old female who presented with secondary amenorrhea, post-coital vaginal bleeding, lower abdominal pain, and mild low-grade fever. Cervical examination revealed an unhealthy cervix, with an irregular, ulcerated mass that bled on touch, raising the suspicion of a cervical malignancy. Histopathology of the cervical biopsy revealed typical necrotizing granulomas and also confirmed the presence of acid fast bacilli in the specimen. Antitubercular therapy was started and the patient responded, with rapid amelioration of symptoms and regression of the cervical mass. Tuberculosis of the cervix is an uncommonly encountered entity and presentation may closely resemble that of cervical carcinoma. Tuberculosis should be considered an important differential diagnosis of a malignant-appearing lesion of the cervix, especially in areas where it is endemic.
  1 3,047 186
A review of traumatic spinal cord injuries at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
Chima C Ihegihu, Anthony I Ugezu, Chibuzo U Ndukwu, Ngozi C Chukwuka, Robinson O Ofiaeli, Ebere Y Ihegihu
January-June 2014, 17(1):31-36
Objective: To determine the pattern of traumatic spinal cord injuries in our center. Materials and Methods: A retrospective review of 46 case files of patients with traumatic spinal cord injuries, treated by the Orthopedic and Physiotherapy Units at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria from January 1 2001 to December 31 2005 (a five-year period). Results: A total of 46 patients were treated within this period. Thirty-four case files with complete data were reviewed. Thirty of the patients (88.2%) were males, while four (11.8%) were females. The male: female ratio was 7.5 to 1. The age range was from 15 years to 72 years. The mean age was 42 years and the median was 40 years. Most of the injuries, 64.7%, were as a result of a fall from a height. The most common level of injury was of the thoracic spine, 17 patients (50%); followed by the lumbar spine, 11 patients (32.4%); and cervical spine, six (17.6%) patients. Conclusion: Most of the injuries in this study were a result of a fall from a height, hence, could have been prevented. Use of better climbing tools and precautionary measures taken to ensure that scaffolds were built with good quality wood or steel, making them well secured, may have led to a reduction in the incidence of fall from a height.
  1 2,331 187
Open pathological dislocation of the hip secondary to trochanteric decubitus ulcer
Chima C Ihegihu, Ebere Y Ihegihu
January-June 2014, 17(1):42-44
This is a case report of a 30-year-old male hand digging manual borehole driller who became quadriplegic as a result of a complete cervical cord injury at the level of C5. He subsequently developed a trochanteric decubitus ulcer through which the head of the femur dislocated; a rare and unusual complication which has not been previously described in adult quadriplegics.
  - 2,934 146
Three different opportunistic infections in the same renal allograft recipient at the same time: Unusual case report
Rohit Rungta, Deepak Shankar Ray, Pratik Das, Soumava Gupta
January-June 2014, 17(1):45-47
Infection affects all kidney transplant recipients in one form or another. Over 50% of the transplant patients have at least one infection in the first year following transplantation; and for those individuals lucky enough to make it through the first year without an infectious complication, they will be indirectly affected too, as they must take prophylactic medications. With high rates of mortality and graft loss owing to infections, it is imperative to render early diagnosis and treatment to immunosuppressed patients. We present here an unusual case, one year post transplant, who had three different opportunistic infections, all at the same time, and who finally succumbed to them.
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Tropical diseases and climate change
Harshal T Pandve
January-June 2014, 17(1):51-51
  - 1,272 155
Filariasis in breast masquerading malignancy
Anju Bansal, Chintamani Chintamani, Sunita Saxena
January-June 2014, 17(1):52-53
  - 1,598 165
Evaluation of heart rate variability among caregivers of geriatric patients undergoing surgery
Amrith Pakkala, Chitradurga Palaiah Ganashree, Thippeswamy Raghavendra
January-June 2014, 17(1):7-9
Background: Caregivers of geriatric patients undergoing surgery are likely to suffer from mental and physical exhaustion leading to stress. This is important in view of the prevailing socioeconomic and the healthcare system available in a developing country like India. Therefore, the present study is designed to measure heart rate variability (HRV) among this special group of population who give care to geriatric patients undergoing surgery. Materials and Methods: In all, 15 female subjects were enrolled from among attendants of patients admitted with an immediate indication of surgery, who required constant care. They were free from any type of physical and mental health issues, nonsmokers and nonaddicts. Each caregiver was subjected to HRV analysis on three occasions: The first record was performed on the first day of their arrival in the hospital as caregivers. The second observation was recorded after 3 days of caregiving. The final HRV analysis was done after 1 month of caregiving. Two types of parameters were analyzed: Time domain and frequency domain. Statistical analysis was done using paired t-test. Results: Both the HRV parameters, time and frequency domain, showed decreased values during the third day and 1 month recording as compared with the first day recording. The decrease is much more during the 1 month recording as compared with the third day recording. Statistically significant decrease is observed in mean RR interval, heart rate, very low frequency (VLF), and low frequency (LF) only when the first day recording is compared with the third day recording, but when the first day recording was compared with the 1 month recording, significant decrease was found in mean RR interval and heart rate. Conclusion: Subjects involved in taking care of geriatric patients are likely to undergo a lot of physical and mental stress, thus affecting their autonomic status. HRV analysis using short term electrocardiography (ECG) recording was used to detect changes consequent to this stress. It was found that almost all HRV parameters measuring heart rate complexity were decreased in the period of caregiving.
  - 2,150 161
Challenges of data collection and disease notification in Anambra State, Nigeria
Chinomnso C Nnebue, Chika N Onwasigwe, Prosper O. U. Adogu, Echendu D Adinma
January-June 2014, 17(1):1-6
Background/Objective: Disease surveillance and notification (DSN) in Nigeria have been characterized by weaknesses such as insufficiencies in health infrastructure, scientific methods, and concepts of operation; essential human, technical, and financial resources; and international or local policies as well as lack of intra- and intersectoral collaboration. These weaknesses in DSN system thus compromise efficiency and quality of data. This study examined the challenges of data collection and disease notification in Anambra state, Nigeria. Materials and Methods: This was a cross-sectional descriptive study of 270 healthcare workers selected by multistage sampling technique. Data collection was done using a mix method comprising interviewer administered questionnaires, health facility observational checklist, key informant interviews (KIIs), and desk review. Results: Commonest problems associated with DSN system as mentioned by the health workers were as follows: Most facility workers were not trained on DSN system (23.7%), lacked transportation (15.8%), poorly motivated/poor staff attitude (15.4%), inadequate supply of forms (11.8%), and poor funding (11.4%). An observational checklist on preparedness for DSN showed that 100% of primary and tertiary health facilities had facility records, while 81% at the secondary level had records. Only 51.9% facilities had community health officers (CHOs), while junior community health extension workers (JCHEWs) were more in primary health facilities compared to other levels of care (χ2 = 4.25, P = 0.040). Conclusion: Regular training program on DSN should be encouraged, while regular monthly supervision and quarterly meetings of health facilities should be organized for health facility workers. Regular and adequate information feedback should be emphasized.
  - 6,283 357
Assessment of relationship between measures of obesity and arterial stiffness in young healthy adults
Suganthi Vajiravelu, Anu Sengottaiyan, Sivagami Gurusamy, Shankar Radhakrishnan
January-June 2014, 17(1):37-41
Background: Obesity increases the risk of cardiovascular diseases. Overweight and obese individuals have significantly stiffer arteries than normal weight individuals, which might lead on to various cardiovascular complications. Aim: This study was undertaken to assess the effect of body fat on arterial stiffness in young adults. Arterial stiffness was analyzed by stiffness index (SI) and reflection index (RI) derived from digital volume pulse (DVP) waveform. Settings and Design: A cross-sectional study was conducted among healthy adults in the age group of 17-25 years from private medical, nursing, and dental colleges in Tamil Nadu. Materials and Methods: Ninety-seven young healthy adults of both sexes in the age group of 17-25 years were included in the study. Anthropometric measures like height, total body weight, body mass index (BMI), and waist circumference (WC) were measured. SI and RI derived from the finger photoplethysmographic DVP waveform. Statistical Analysis: Associations between SI and RI, and BMI and WC were assessed with Pearson correlation coefficient. Results: There was a strong correlation between SI/RI and BMI and WC in males and females (r > 0.9). Conclusion: Obesity is associated with arterial stiffness in the young Indian population the association between SI/RI and BMI, the age at which it appears, and the prevalence of obesity among the young adults warn us about the increase in incidence of cardiovascular diseases.
  - 2,417 169
Histopathological patterns of prostate cancer in an African population: A private practice experience
Gerald Dafe Forae, Jonathan Umezulike Aligbe
January-June 2014, 17(1):16-19
Background: Prostatic cancer is the most common urological tumor seen in middle-aged and elderly men. It constitutes a source of morbidity and mortality in the adult male population. Aim: Highlight the frequency and histological types of prostatic cancer in a private practice in Benin-City, Southern Nigeria. Materials and Methods: Hematoxylin- and eosin-stained-slides of prostatic biopsies diagnosed at the Ashamas foundation clinic, Benin-City for 10 years were archived and studied. Request forms were scrutinized for clinical bio-data, diagnosis, and histological sections and slides were analyzed. Results: During this 10-year study, a total of 908 prostatic tumors and 226 urological malignancies were diagnosed. Among this, 214 were prostatic cancer. Prostatic cancer, therefore, constitutes 23.6% and 94.7% of all prostatic tumor and urological tumor, respectively. The peak age range was 70-79 years constituting 83 cases (38.8%) of all age group. The mean age for prostate cancer was 68 years ± 4.6 S.D. Prostatic adenocarcinoma accounted for 201 cases constituting 93.9% of prostatic cancer. A total of 53 cases (30.4%) had Gleason's score 2-4, 104 cases (59.8%) had Gleason's score 5-7, and 17 cases (9.8%) had Gleason's score 8-10. Conclusion: Prostate cancer is the most common tumor of the uro-genital system in males with majority as moderately differentiated prostatic adenocarcinoma having Gleason's score of 5-7.
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A study of the short-term cardiopulmonary effect of mawa chewing in rural India
Amrith Pakkala, Chitradurga Palaiah Ganashree, Thippeswamy Raghavendra
January-June 2014, 17(1):20-24
Background: Tobacco is consumed in smoking and smokeless forms all over the world. Smokeless tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risk and needs to be discouraged. Previous reports have described long-term harmful effects of nicotine on various body parameters, little is known about the acute effect of smokeless tobacco, such as mawa, consumed very rampantly in rural India, on cardiopulmonary parameters. Use of smokeless tobacco indeed represents a health concern of growing magnitude among these groups. As a consequence of its addictive qualities, the consumption of smokeless tobacco often becomes a lifelong habit with cumulative and deleterious effects on health. Very few studies have been undertaken on the acute effect of use of mawa, a common form of tobacco used in India, on cardiopulmonary parameters of youngsters. Materials and Methods: Treadmill Exercise Testing and Pulmonary Function Tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups, namely, healthy sedentary controls and healthy mawa chewers. Results: On studying the differences in cardiopulmonary efficiency in the two groups, the resting heart rate was found to be statistically significantly higher in the study group and the delta heart rate was found to be statistically significantly lower among mawa chewers. There was no significant difference seen in parameters such as VO 2max , maximum oxygen pulse, MVV, VE max as an acute effect of mawa. Conclusion: In this study, it appears that mawa chewers are physically fit similar to the controls, but immediately after smoking a lesser delta HR suggests a higher risk for cardiovascular mortality. Stopping mawa at this juncture can be helpful in reverting back the risk, and parameters such as resting HR, recovery HR, and delta HR can be used as prognostic assessment tools for any intervention therapy to stop mawa chewing in asymptomatic individuals.
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Prevalence of symptomatic cervical spondylosis in a Nigerian tertiary health institution
Ngozi Iheukwumere, Emmanuel c Okoye
January-June 2014, 17(1):25-27
Background: Cervical spondylosis (CS) is the most common disorder of the cervical spine with its associated neck pain reported as a very common problem in clinical practice. There seemed to be a dearth of research on the prevalence of symptomatic CS in a physiotherapy clinic in Nigeria. Objective: To determine a 5-year prevalence of CS in a tertiary physiotherapy outpatient clinic in southeastern Nigeria. Materials and Methods: This was a 5-year retrospective survey, from 1 st January 2006 to 31 st December 2010. Information was got from the participants' case notes, and only those who were diagnosed as having symptomatic CS without any associated disorders were recruited for the study. Data was analyzed using descriptive statistics of frequency counts, percentages, and range. Result: Fifty (5.4%) participants presented to the clinic with symptomatic CS during the 5-year period. Their age ranged from 30 to 70 years. Twenty-seven (54%) of the participants were males; 30 (60%) were urban dwellers as well as civil servants; 20 (40%) were rural dwellers; 11 (22%) of the rural dwellers were farmers; whereas, the rest (9 (18%)) were traders. Conclusion: The prevalence of CS in the physiotherapy outpatient clinic was fairly low. Civil servants had 100% affectation. There was relatively poor turnout of the rural dwellers to the hospital. Thus, there seems to be a need to educate civil servants on ergonomically good working techniques. There may also be a need to enlighten the entire population (especially the rural dwellers) on health matters in order to help them make preinformed decision on health issues.
  - 2,381 228
Response of the respiratory system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal obese homemakers
Amrith Pakkala, Chitradurga Palaiah Ganashree, Thippeswamy Raghavendra
January-June 2014, 17(1):28-30
Background: The role of hormones on lung function tests were well known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle-stimulating hormone and luteinizing hormone was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the respiratory system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal obese homemakers. Materials and Methods: Healthy young adult females between 42 and 45 years who regularly undergo training and participate in competitive middle distance running events for at least previous 3 years were considered in the control, whereas the study group did not have any such regular exercise program were obese homemakers. The two groups were in perimenopausal age group. They were made to undergo computerized spirometry after undergoing maximal exercise testing on a motorized treadmill. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters Maximum Mid Expiratory Flow rate (MMEF), peak expiratory flow rate, mid-expiratory flow 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.
  - 1,725 155