Nigerian Medical Journal

The role of preoperative evaluations in otorhinolayngological procedures Waheed Atilade Adegbiji, Gabriel Toye Olajide, Fatai Olatoke, Olubunmi Kolawole Ogundipe, Sulyman Biodun Alabi Nigerian Medical Journal 2018 59(6):59-63 Background: Routine laboratory investigations are important in preoperative preparation of otorhinolaryngological, head and neck patients to assess and to prevent operative risks. This study aimed at determining the American Society of Anesthesiologist (ASA) classification of the preoperative patients, causes of delayed surgery, associated comorbidity and abnormal laboratory investigation results in ear, nose, and throat surgical practice in a low-resource setting. Materials and Methods: This is a prospective hospital-based study of patients being worked up for elective surgical procedures in Ekiti State University Teaching Hospital, Nigeria, from January 2014 to December 2016. Patients that gave consent were enrolled into the study. Interviewer-assisted questionnaires were used to obtained data from the patients. Data obtained were collated and statistically analyzed by using SPSS version 16. Results: A total of 424 patients were enrolled into the study. Males constituted 61.8% and male to female ratio was 2:1. Majority, i.e. 69.8% of the patients belonged to the ASA Grade I. Preoperative findings leading to delayed surgery occurred in 17.9% of the patients. They were due to 2.4% arterial hypertension and 6.4% delayed routine laboratory investigations results. The overall comorbid illness was 21.2%. Major comorbid illnesses were 2.4% arterial hypertension and 6.8% diabetes mellitus. The types of surgery in the patients were 14.6% ear surgery, 12.3% nasal surgery, and 59.2% throat surgery. Delayed surgery occurred in 25.5% of the patients. The most common findings were 6.8% anemia, 6.3% abnormal prothrombin/international normalized ratio, and 5.7% blood electrolyte and urea. Conclusion: All surgical conditions are peculiar with different comorbid illnesses which can lead to untoward outcome. Adequate preoperative evaluation and preoperative laboratory investigation of ear, nose, and throat conditions are mandatory to detect subclinical illnesses in poor-resource setting.

Evaluation of diagnostic accuracy of rapid diagnostic test for malaria diagnosis among febrile children in Calabar, Nigeria Anthony Achizie Iwuafor, Okokon Ita Ita, Godwin Ibitham Ogban, Ubong A Udoh, Chimereze Anthony Amajor Nigerian Medical Journal 2018 59(6):64-69 Background: The WHO recommends that all cases of suspected malaria should undergo parasitological test. Currently, the parasitological test comprises the rapid diagnostic test (RDT) or the microscopy. The performance of RDT in relation to microscopy is yet to be fully comprehended. Objectives: This study evaluated the diagnostic accuracy of RDT as against the diagnosis provided by microscopy in detecting malaria parasites among febrile under-5 children. Design: The study was a cross-sectional hospital-based design. Materials and Methods: Capillary blood samples were collected from 167 children who came to the hospital with a history of fever over a period of 6 months. The Paracheck-Pf RDT kit was used and its performance was compared with the gold standard, microscopy using thick film. Results: The prevalence of malaria infection was 41.9%. On comparing RDT with microscopy (microscopy assumed to be 100% sensitive and specific), RDT had a sensitivity of 51.4% and a specificity of 73.2%. The false-positive rate was 26.8% whereas the false-negative rate was 48.6%. The positive predictive value was 58.1% whereas the negative predictive value (NPV) was 67.6%. The RDT also had a positive likelihood ratio (LR) of 1.92 and a negative LR of 0.67. The RDT test accuracy was 64.1%. Conclusion: Malaria prevalence among febrile children was found to be high. The findings also suggest that inconsistencies in the performance of RDT kits may arise from many extraneous factors, and as such, they should not be used as a stand-alone test kit except a prior batch/lot validation test was carried on them.

Awareness, attitude and knowledge regarding oral health among pregnant women: A comparative study Gautami S Penmetsa, K Meghana, P Bhavana, M Venkatalakshmi, Vivek Bypalli, B Lakshmi Nigerian Medical Journal 2018 59(6):70-73 Background: Pregnancy in a woman's life is associated with many physiological changes in the body due to alterations in the hormone levels. These altered hormonal levels are associated with many systemic diseases. The incidence of oral diseases in general and periodontal diseases in particular are higher in pregnant women, with gingivitis and periodontitis being the most common. Furthermore, it has been evidenced in literature that periodontal diseases are associated with adverse pregnancy outcomes such as preterm low birth weight and preeclampsia. Aims and Objectives: The aim of this study was to evaluate the oral health knowledge among pregnant women visiting and not visiting a dental professional. Materials and Methods: The study was a survey-based one with a sample size of 260. The study population was divided into two groups based on their visits to a dentist. A questionnaire comprising 20 questions has been used to assess their awareness and attitude towards oral health. Results: The awareness regarding oral health and association with adverse pregnancy outcomes among the study population was very low, irrespective of their dental visit. Furthermore, majority of the study population in neither of the groups were aware that dental treatment was safe during pregnancy. Conclusion: The results of the study clearly reflected that the awareness levels among the pregnant women regarding this association were low. Hence, more collective efforts are required from dental and medical professionals to improve the oral and periodontal health outcomes during pregnancy.

Prevalence and pattern of late-stage presentation in women with breast and cervical cancers in Lagos University Teaching Hospital, Nigeria Opeyemi Awofeso, Alero Ann Roberts, Omolola Salako, Lanre Balogun, Paul Okediji Nigerian Medical Journal 2018 59(6):74-79 Background: Cervical and breast cancers are the most common cancers among women in developing countries contributing to high morbidity and mortality. Even though both these cancers have a better prognosis if caught early; however, studies conducted in Nigeria still show a large incidence of late tumor stage presentation. Objectives: This study aimed at identifying the patient and disease characteristics of women with breast and cervical cancers presenting at a tertiary medical facility in Nigeria, with emphasis on the prevalence of late-stage presentation and reasons for late-stage presentation. Patients and Methods: This cross-sectional study recruited women at Lagos University Teaching Hospital (LUTH) with breast and cervical cancers from April to June 2016; an interviewer-based questionnaire was administered to 105 patients who seen to elicit information needed to achieve the set objectives. Results: The mean age of patients was 51.09 (±11.70) years; majority had no known family history and no health insurance. Most cervical cancer patients were unaware of their human papillomavirus status. About 72.81% of all patients presented late, surprisingly 87.6% of patients presented in an appropriate health-care facility as place of the first contact, but still presented in LUTH at late stages of their disease mostly due to misdiagnosis. Reasons for late presentation included fear, misconceptions, misdiagnosis, ignorance, and prolonged investigation time. Conclusion: As late-stage presentation was associated with both poor health-seeking behavior and health system delays; interventions should not only include increased awareness for the early detection and diagnosis but also measures to ensure improvements in health service delivery to ensure timely diagnosis and the management of breast and cervical cancers.