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   2015| June  | Volume 6 | Issue 1  
    Online since December 19, 2017

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Plasmid-mediated multiple antibiotic resistance among Klebsiella pneumoniae and Escherichia coli in a tertiary hospital in Nigeria
O Iyoha, MY Tula
June 2015, 6(1):23-32
Introduction: About 34 and 31% respectively of Klebsiella pneumoniae and Escherichia coli from clinical samples were isolated and identified on the basis of morphology, growth and biochemical characteristics. Urinary samples had the highest occurrence of K. pneumoniae and E. coli with 50 and 64.2% incidence rate respectively. Results: Although there was no significant difference in their susceptibility to all the antibiotics (p>0.05), the results of their susceptibility profile showed that K. pneumoniae was more susceptible to augmentin (73.5%), followed by ofloxacin (64.7%) and Cefixime (61.8%). Moreover, E. coli showed highest susceptibility to nitrofuratoin (75%), followed by Cefixime (74.2%) and ceftriaxone (71). The results of their antibiotic resistance pattern revealed that both K. pneumoniae and E. coli showed multi-drug resistant (MDR) phenotype against the tested antibiotics. Both K. pneumoniae and E. coli showed highest resistance against cefuroxime (76.5 and 83.9% respectively) followed by gentamycin (67.7 and 77.4% respectively). However, both K. pneumoniae and E. coli exhibit similar resistant pattern to all the class of antibiotics under investigation (p>0.05). The MAR indexes for the antibiotics used against both K. pneumoniae and E. coli showed that nitrofurantoin has the lowest MAR index (0.018), while the highest was found for cefuroxime (0.08). Curing of resistant markers in K. pneumoniae was variable; but the highest resistant marker cured was that of cefuroxime (76.9%). In E. coli, cloxacillin resistant markers were not cured, but resistant markers to other antibiotics were cured variably. The result further revealed that the frequency of resistant markers cured in K. pneumoniae and E. coli were not significantly different (p>0.05). A total of 18 plasmids with molecular weight ranging from 0.56 to >23.13kbp were observed in the selected multi-drug resistant (MDR) isolates of K. pneumoniae and E. coli. Conclusion: Four different plasmid profile groups were detected for selected MDR isolates of K. pneumoniae with 23.13kbp as the most abundant plasmid. Only one (1) plasmid profile group for MDR E. coli was detected.
[ABSTRACT]   Full text not available  [PDF]
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Relationship between lipid profile and severity of chronic kidney disease among patients attending the Nephrology Clinic of University of Ilorin Teaching Hospital, Ilorin
IM AbdulAzeez, SA Biliaminu, MB AbdulRahaman, A Chijioke, MS Sanni, AO Shittu, AM Makusidi
June 2015, 6(1):15-22
Back ground: Chronic kidney disease (CKD) is a major public health problem worldwide with increasing incidence and prevalence with antecedent high medical cost and poor outcome. The increasing risk of cardiovascular disease (CVD) and the high prevalence of dyslipidaemia in patients with CKD coupled with paucity of data correlating lipid profile with stages of CKD necessitate this study. Methodology: One hundred and twenty CKD patients were consecutively selected from among the predialysis CKD patients attending the nephrology unit of the University of Ilorin Teaching Hospital (U.I.T.H) Ilorin, Nigeria. Sixty (60) age and sex matched controls were also selected from among the staff and medical students. Creatinine, urea and lipid profile [total cholesterol (T-c), triglyceride (TG) high density lipoprotein (HDL-c) and low density lipoprotein (LDL-c)] were estimated in the serum of both patients and controls. Student t-test was used to compare means of results where appropriate. Pearson correlation formula was used to examine relationship between variables. Results: There were statistically significant differences when the mean lipid profiles of the CKD patients were compared with that of the controls (p<0.05). Significant elevations were observed in the values of LDL-c, TG and T-c in CKD patients when compared with controls, while significant decrease was observed in the case of HDLc. Significant negative correlations were observed when both HDL-c and coronary heart disease risk ratio were compared with stages of CKD (r= 0.565 and 0.542 respectively and p-value<0.05 for both). There was a significant positive correlation between serum triglycerides level and stages of CKD (r = 0.601 and p<0.05). Correlation indices between BMI, T-c, LDL-c and stage of CKD were weakly positive with r values of 0.032, 0.032, 0.051 and 0.213 respectively with p-value>0.05 in all Conclusion: We concluded that dyslipidaemia is common in chronic kidney disease and worsened with the severity of CKD. Therefore early lipid profile is advised in CKD patients as well as holistic interpretation of lipid profile as prompt treatment may prevent cardiovascular events and retard the progression of kidney disease.
[ABSTRACT]   Full text not available  [PDF]
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Profile of cervical cytology screening in a tertiary hospital in Nigeria: A ten year review
SM Amin, JS Abubakar, IM Liman
June 2015, 6(1):39-45
Introduction: It is estimated that worldwide cervical cancer accounts for death of 231,000 women annually and over 80% of these are said to be in the developing countries.1 This sordid fact is observed in spite of the globally acknowledged effectiveness of cervical cancer screening methods in detecting and indeed eradicating the disease. Setting: National Hospital Abuja is a tertiary hospital located in the cosmopolitan city of Abuja, capital of Nigeria. It offers regular cervical conventional cytology screening services to Abuja metropolis and surrounding environment. Material and Method: A retrospective review of all cervical cytology samples received in the department of Histopathology of the NHA from 1st January 2004 to 31st December 2013. Slides were reviewed and diagnosis made according to the Bethesda 2001 classification of cervical cytology. Results are analyzed using simple Microsoft Excel 2011 statistical methods. Result: Of 5667 samples reviewed 14.8% (n=816) showed abnormal cellular changes. Approximately 49.4%, 24.4%, 20.7% and 5% of the abnormal smears constituted the LSIL, HSIL, ASCUS and invasive categories respectively. Majority of the women (72%) and most of the abnormal smears belong to the age group 30 to 49 years. Conclusion: Abnormal cervical smears are considerably high and age group 30 to 49 years are at increased risk. Intense and sustained cervical cancer screening programme needs to be embarked upon in Nigeria.
[ABSTRACT]   Full text not available  [PDF]
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Seroprevalence of HIV-1, Hepatitis B and C viruses in sickle cell disease patients in Zaria, Nigeria
Aliyu A Babadoko, Aisha I Mamman, Zakari Y Aliyu, Suleiman A Maude, Victor Gordeuk, Vandana Sachdev, Peter Akpanpe, Ester Attah, Yusuf Suleiman, Nurudeen Aliyu, Jamilu Yusuf, Laurel Mendelsohn, Gregory J Kato, Mark T Gladwin
June 2015, 6(1):33-37
Introduction: Transfusion of blood is an important and a frequent modality of treatment for either vaso-occlussive or haemolytic crisis in patients with sickle cell disease (SCD). Sickle cell disease patients are therefore at risk of transfusion transmissible infection, blood transfusion been a recognized route of transmission of HIV, Hepatitis B and C virus particularly in resource constraint settings lacking antigen detection techniques as well as an organized and effective blood transfusion services. Aim: To determine the prevalence of HIV-1, Hepatitis B and C viral antibodies in patients with sickle cell disease. Patients and Method: A cross sectional study of 208 consecutive SCD patients at steady state and 94 healthy non-matched controls were screened for HIV-1antibodies (parallel ELIZA Determine and Uni-Gold), Hepatitis B surface antigen (NOVA) and anti-HCV (NOVA) in 2006. Results: Of the total number of 204 SCD patients screened, 102 (49%) were males and 106 (51%) were females .The mean age of the subjects was 22 ± 8 years. One hundred and nine patients (95.2%) were haemoglobin S homozygote's and 10 (4.8%) were compound heterozygote's for haemoglobin S and C. Ninety percent of the subjects reported less than 5 units of whole blood transfusion during their lifetime. Prevalence of HIV, Hepatitis B and C was 3.9%, 2.0% and 4.4% respectively. Conclusion: Prevalence of HIV, Hepatitis B and C is low in our setting and this may not be unconnected with routine screening of prospective donors. However increased public awareness, health education programs and better screening techniques will further reduce the spread of these viruses, as other routes of transmission may also play a role.
[ABSTRACT]   Full text not available  [PDF]
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Sebaceous carcinoma - An overlooked tumour in Black Africans
Modupeola O Samaila, Tahir T Mohammed, Sunday A Adewuyi, Garba D Waziri, Usman Bello
June 2015, 6(1):7-14
Background: Sebaceous carcinoma is an uncommon malignant adnexal tumour with female preponderance and peak age presentation in the seventh decade of life. It is overlooked in the plethora of cutaneous tumours in general because of its rarity and diagnosis is often missed or delayed, thus increasing disease morbidity. Materials and Method: Formalin fixed, paraffin processed tissue biopsies stained with haematoxylin & eosin, oil red O and immunohistochemical antibodies for EMA, S100, CD15 and Ki67 were studied over a 14year period in a Pathology laboratory. Results: Six males and one female were diagnosed during the period. They had mean age of 44.7years and a range of 25years to 65years. Patients' symptoms included orbital mass and ulceration, conjunctiva mass, visual loss, ulcerated axillary mass and contact bleeding. Two patients gave history of recurrent conjunctiva growths. Clinical diagnoses included melanoma, lymphoma, basal and squamous cell carcinomas. Histology sections from all seven patients showed varying sized irregular lobular formations of undifferentiated and distinct sebaceous cells exhibiting considerable nuclear and nucleolar pleomorphism with pagetoid spread of malignant cells in the eyelid and conjunctiva epithelium. Immunoreactivity for Epithelial membrane antigen (EMA) was demonstrated in all the cases. Conclusion: Middle aged males were predominantly affected. The extraocular type involved the axilla mainly as fungating masses and over seventy percent of the cases were ocular with associated extensive destruction of ocular structures and visual loss. None of the clinical diagnosis considered sebaceous carcinoma.
[ABSTRACT]   Full text not available  [PDF]
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Audit of histopathology reports for melanoma: A case for adopting synoptic reports
AT Atanda, I Yusuf, MI Imam, A Salihu
June 2015, 6(1):47-51
Background: The aim of this study is to audit degree of completeness of textual histopathology reports generated for melanoma. This is to exemplify the need for adoption of synoptic report format for reporting cancer cases in Nigeria. Materials and Method: Completeness of histopathology reports for all cases of melanoma diagnosed in the histopathology department of a teaching hospital in northwestern Nigeria were audited from 2006 to 2010; followed by departmental presentation on deficient areas and then re-audited from 2011 to 2014. The results were then compared with results of City hospital, Birmingham, United Kingdom, before and after adoption of synoptic report format in that hospital. Results: In the 9 years audited 139 cases of melanoma were diagnosed. In the first 5 years audited overall completeness of issued reports was 36%. This marginally improved to 44% in the following 4 years audited. However, there was no statistically significant improvement in performance (p = 0.1). Conclusion: Adoption of a standardized synoptic report format for histopathological reporting of cancers will improve the quality of reports issued to clinicians.
[ABSTRACT]   Full text not available  [PDF]
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Audit in histopathology; Matters arising
Modupeola Samaila, Olusegun Ojo
June 2015, 6(1):41-41
Full text not available  [PDF]
  294 59 -
Ethical and human rights issues of HIV screening
EE Igbigbi
June 2015, 6(1):53-54
Full text not available  [PDF]
  286 60 -